Overview
Study Processes
Figure 1 - Study Management Structure
Figure 2 - Coproduction Process
UKRI ESRC (UK Research and Innovation, Economic and Social Research Council) is the funder of the Partnership for Change Study. Building on our feasibility work (funded by What Works for Children's Social Care) we aim to reduce place-based inequalities by conducting an adaptive Randomised Controlled Trial (RCT) of Infant Parent Support (IPS), with embedded participatory systems mapping and processes evaluation in contrasting UK sites.
The Partnership for Change team includes researchers from the University of Glasgow, the University of Royal Holloway; and practitioners and development leads from the NSPCC.
Background
In 2019/20, UK referrals to child mental health services rose by 35%, yet access to treatment only rose by 4%. Children with psychiatric diagnoses incur more than four times in health and social care costs than their peers. If placed in care, these costs multiple. Providing support sooner is right for the child, family and society. Many children with a social worker and their parents, many of whom may have experienced challenges in their own childhoods or have neurodevelopmental conditions like ADHD or Autism. These families inevitably experience stress, often exacerbated by money or housing problems, and the stigma of living in poverty. This strains relationships and can lead to child maltreatment and children's mental health problems that, in turn, burden families, services and society. Our literature review found no trial evidence for programmes aiming to prevent child maltreatment. However, relationship-focused interventions show promise, especially if involving child protection services. Health and social care organisations, and governments, believe organisations should work together to support families before children are taken into care. A study of an intervention incorporating these elements is timely in this encouraging current policy landscape.
Vision and Approach
Through our parent-practitioner-community (PPC) partnership developed in the feasibility phase, we have coproduced Infant Parent Support teams (IPS), in Glasgow and London to offer mental health support to struggling families whose children are supported by social work services. In the definitive RCT we plan to further develop the place-sensitivity of IPS teams and test the clinical and cost-effectiveness of IPS in a definitive randomised controlled trial (RCT). The trial will aim to recruit families who have family support services, to explore an early intervention approach.
Placed-based inequalities in health begin early in childhood: young children experiencing poverty and/or racism are much more likely to develop physical and mental health problems earlier in the lifespan than their peers. Children in the most deprived 10% of small UK neighbourhoods are over 10 times more likely to be in care or on protection plans than children in the least deprived 10%. These social determinants of health and child welfare are "systemic, population-based, cyclical and intergenerational" resulting in certain geographical areas being plagued by overlapping physical and mental health problems and additions across generations. Infants and preschool children rely on parents and practitioners to become "candidates" for health and care services - a process vulnerable to structural inequalities. Our novel aim is to redress this.
IPS teams (NSPCC based) offer high quality relationship focused interventions to struggling families. Our coproduction has led to enhancements, including neurodevelopmental awareness, poverty awareness, and the employment of parents with children involved with social work as practitioners and managers in IPS. We have mapped the local contexts in which the IPS teams are embedded, created strong multi-agency partnerships, and involved key stakeholders in our PPC-partnership.
This study consists of four work packages (WPs). We aim to reduce place-based inequalities through: WP1, co-creating a new theory of change for IPS that takes the local context in which IPS tems are embedded into account; WP2,implementing findings from our f-RCT and WP1 to make IPS teams "place-sensitive", i.e., further embedding IPS tems within their local communities and enhancing each local community's ability to make best use of IPS; WP3, examining clinical and cost-effectiveness of IPS in reducing the risk of child maltreatment through a definitive RCT of IPS; and WP4, conducting a realist process evaluation examining what works best, for whom and in what context. RCT outcomes will also include child and parent mental health and community connectedness. At key adaptation points during the RCT, all four WPs will work with an expert scientific advisory group and the PPC-partnership to examine whether we are reaching our desired target population (including marginalised families) and, if not, to enhance our recruitment strategy to achieve equality of access to the study by employing recruiters who come from or have links with under-served populations, and/or targeting specific geographical areas through our extensive networks across Greater Glasgow and in ten diverse London Boroughs. Our success in reducing place-based inequalities will be measured by whether our RCT has recruited a trial population that demographically mirrors our target population. The techniques most successful in achieving this will inform recommendations for post-trial implementation of IPS to ensure the future IPS teams can reduce place-based inequalities by embedding optimally within their local community/service context, and targeting the families likely to most benefit.
Timelines
Dissemination
Supported by our PPI groups, our bespoke dissemination output creation and sharing will strengthen understanding and change practice, supporting implementation of early years mental health findings by practitioners, policy makers, academics, the public, participants and wider stakeholders. It will include peer reviewed publications and wider stakeholders. It will include peer reviewed publications, podcasts, case studies, articles and professional focused briefings.
Contact
School of Health and Wellbeing
Clarice Pears Building
90 Byres Road
Glasgow
G12 8TB
0141 330 8795
Meet the Team
Professor Helen Minnis, Child and Adolescent Psychiatry, University of Glasgow. Joint Principal Investigator and expert on trials of interventions to improve the mental health of chidlren and families involved in social care.
Helen has experience in epidemiology and trials. Helen has had a clinical research interest in the mental health problems of children in foster and adoptive placements for many years and, recently, her team has been focusing on testing the cost-effectiveness of therapeutic interventions for this group of children and their families. This includes an ongoing randomised controlled trial of an infant mental health service for abused and neglected chidlren (BeST?).
Matt Forde, Partnerships & Development Director, NSPCC, Joint Principal Investigator / Lead Applicant with expertise in developing and scaling up integrated health and social care models.
Matt joined the NSPCC in 2010 as first National Head for Scotland. Previously, worked in statutory children's services, researching childhood experiences of offenders led him to develop evidence-based prevention services. Matt is a registered social worker who is active in policy, practice development, and research projects. In 2014, completed a Winston Churchill fellowship travelling in the USA and Europe to explore insights in preventing child abuse and upholding children's rights.
Kirsty Macleod, Project Manager (Glasgow), University of Glasgow
Kirsty is responsible for the coordination and management of the study across sites in Scotland and Englan. Kirsty's role includes ethical approvals, governance, reporting, budget management and partnership working with the referring sites and delivery partners (NSPCC). Before joining the team, Kirsty worked in the mental health sector, in education and community services in various roles, including strategical lead, team management and care-coordination.
Dr Abdullah Alvi, Trial Manager (Glasgow), University of Glasgow
Abdullah has specialise in complex, collaboration, multi-stakeholder healthcare delivery projects. He has extensive experience in clinical trial across England, Wales, Scotland and Northern Ireland. He is currently involved in developing branding and a comms strategy for Partnership for Change.
Anni Molloy, Trial Manager (London), University of Glasgow
Anni is a qualified social worker with over 10 years statutory experience in care proceeding, adoption, fostering, kinship, looked after children, child protection and child in need. She is an experienced trial recruitment manager and advises on participant recruitment and retention.
Anne Burns, Family Recruitment Manager, University of Glasgow
Anne worked in NHS children's services for over 40 years as a nurse, midwife, health visitor and had a lead role for maternal and child health improvement. The last 10 years she has been working in Family Nurse Partnership (FNP) as a Supervisor and then Lead Nurse/Service Manager. Anne has always been interested in maternal and child health, and this was the focus of her Masters research. She has a BSc in Health Studies, a Masters in Primary Care and a post-graduate diploma in Child Protection.
Noel Talbot, Family Recruitment Assistant, University of Glasgow
Noel has worked in addictions for over 20 years, primarily with Glasgow Drug Court, but also spent time in the community and voluntary sector. His first job in this area was a field worker on the Drug Outcomes Research in Scotland (DORIS) Study with University of Glasgow. Noel has a BA(Hons) in Sociology and Social Policy and postgraduate qualifications in Addictions and Counselling.
Hannah Paton, Family Recruitment Assistant, University of Glasgow
Hannah has a background in community education and grassroots food projects addressing poverty and supporting marginalised communities. Hannah has also worked with AMMA Birth Companions, support women through pregnancy and birth. She has a BA in Community Education.
Sharon Graham, Patient and Public Lead, University of Glasgow
Sharon has experience of the care system and professional experience of supporting parents and families who access social care. Sharon works in person centred and trauma informed way and will work in partnership with two groups of parent collaborators from Glasgow and Bromley to shape the development of the intervention and research.
Lindsay Dalgarno, Research Associate, University of Glasgow.
Lindsay is an experienced researcher on all aspects of social and health focused mixed methods studies and has particular expertise in qualitative research and analyses. Interests include societal impact on quality of life, health and wellbeing across a range of adult and child populations. Lindsay has worked on feasibility and pilot studies to multisite randomised controlled trials including formal process evaluations.
Dr Jaycee Pownall, Research Associate, University of Glasgow
Jaycee has 18 years' research/teaching experience. Jaycee has worked on a broad range of qualitative and quantitative projects, with particular focus on neurodiversity and health and well-being. Interests include exploring sex and relationship issues for young people with intellectual disabilities and their families and recently exploring alternative models of education for youths who experience school attendance difficulties. Jaycee is committed to working within a research framework of improving the health, well-being, and rights of vulnerable and socially excluded individuals.
Karen Bates, Specialist Partnership Assistant Director, NSPCC.
Karen has a wealth of experience in social work, direct work with children and families and significant management experience across a broad range of services. Karen has been involved in the development and delivery of different research projects, collaborating with academics and service leads to evaluate and scale up services. Karen has a BSc (Econ) in Psychology and Social Anthropology, a Dip SW and MA in Advanced SW.
Vicky Allen, Partnership Development Manager, NSPCC.
Vicky has a background in public sector Early Help and Preventive service development with a particular focus on Early Childhood. As well as leading services Vicky's career has included working as a practitioner with children, young people (0-19 years) and their families across a broad range of areas. Vicky works with NSPCC in Service Development and has a BSc in Child and Family Studies.
Emily Robson-Brown, Acting Development Manager, NSPCC.
Emily has a background in research evaluation, and worked with charities and local authorities in various areas with focus on social justice, specialises in Violence Against Women and Girls/domestic abuse and, Relationship and Sex Education (RSE). Emily works with NSPCC in Service Development, and has worked on projects in child brain development, prevention for child sexual abuse and families facing multiple adversity. Emily has a BSc in Psychology with Sociology, an MSc in Psychological Approaches to Health and a PhD with a focus on young people, gender, sexuality and domestic abuse. Emily is also an Education and Welling Specialist for Brook.
Ciara MacLaverty, Administrative Assistant, University of Glasgow
Ciara previously worked as a Survey Assistant at the University of Glasgow, collecting data in schools, prisons and marginalized communities. She enjoyed working on controlled trials aimed at improving health and wellbeing. Ciara understands the importance of research partnerships and the value of incorporating the lived experience of participants, and is keen to contribute her skills to help facilitate and advance the study.
Irene O'Neill, Senior Business Support Administrator, University of Glasgow / NHS GG&C
Irene has worked with the team for over 30 years and has built up a wealth of experience, and provides administrative support to various projects, for example budget-monitoring, site file maintenance, organising conferences, and website development/maintenance.