Children and Childhood Network Projects

Environment

(Re)Connect the Nexus: Young Brazilian's Experiences of and Learning about food-water-energy

Principle Investigator: Professor Peter Kraftl
Co-Investigators: Dr Sophie Hadfield-Hill (University of Birmingham); Dr John Horton (University of Northampton); Dr Ben Coles (University of Leicester); and Professor Jose Antonion Perrella Balastieri (UNESP, Brazil)
Funding: ESRC and FAPESP: £399,000
Dates: January 2015-September 2018

Summary: Recent research about the food-water-energy nexus has tended to focus on flows (e.g. between producers and consumers) and ways of governing the nexus. However, there is a real need to examine how people (especially young people) understand, learn about and participate in the nexus, in their everyday lives. Only by doing so can we address crucial concerns - such as persistently high levels of poverty amongst Brazil's children, their unequal access to nexus resources, their resilience to nexus threats, and the role of education in addressing those threats in the future. In Brazil, as in similar countries, young people are a hugely important group, demographically and socially. In Brazil, young people (aged 0-24) make up 42% of the population. Moreover, we already know that in diverse global contexts, young people are instrumental in terms of securing access to resources (including nexus resources), economic productivity, societal resilience, and community life. In addition, young people are often the main recipients of education programmes - especially Education for Sustainability (EfS) - that attempt to address nexus threats and sustainable development goals. However, there is scant research - either in Brazil or globally - that focuses on young people and their interactions with the nexus. This unique, collaborative research will address these important gaps.

This project's main aim is to examine young people's (aged 10-24) understandings, experiences and participation in the nexus in Brazil. It focuses on this age group as older children/young adults are a key target group for EfS, and research shows that they are likely to have greater capacities for reflection on the nexus than younger children. In achieving this aim, the project will address three core research questions.

1: What are young people's (aged 10-24) understandings, experiences and participation in the nexus in Brazil? 

2: What is the role of '(re)connection' in young people's engagements with the nexus? 

3: How does EfS in Brazil address the nexus? 

The research questions were addressed through a survey of over 3,700 young people and detailed, multi-method, qualitative research with 50 young people. It also involved research with 64 key professionals and a global video competition

Further Information: http://www.foodwaterenergynexus.com/ 

 

Plastic Childhoods

Principle Investigator: Professor Peter Kraftl
Funding: The Leverhulme Trust (Leverhulme Research Fellowship): £51,000
Dates: September 2018-March 2020

Summary: The main aim of this fellowship is to develop a critical, interdisciplinary, empirically-informed study that critically addresses multiple contemporary concerns with plastics. The study will ask whether entanglements of plastics with/in children’s lives may be risk-laden or affirmative, malignant or benign.  It will identify and evaluate children’s (aged 11-17) everyday encounters with, and attitudes to, plastics: both in light of contemporary fears about the widespread, insidious presence of plastics in global ecological and hydrological systems (e.g. in oceanic trash ‘vortices’ and terrestrial watercourses); and, conversely, in light of everyday plastics that might support or enliven their lives, wellbeing and learning – toys, digital technologies, clothing, cleaning products, prostheses and more besides. Working with colleagues in the School, including Iseult Lynch and Sophie Hadfield-Hill, it will examine, for the first time, the literal presence and circulation of micro- and nano-plastics in children’s bodies and their environs, given concerns about the appearance of plastics in human food systems and the increasing use of micro- and nano-plastics in a range of children’s products. It will critically analyse the online-offline circulation of plastic objects that are characteristic of modern childhoods, via a novel suite of social media methods. And finally, it will critically reflect on, and intervene into, key popular/policy debates about the artificial, ‘toxic’ or (pejoratively) ‘plastic’ state of Western childhoods. The main outcome from the fellowship will be a major research monograph, to be published by Routledge, called 'After Childhood'.

Community

CONSORT-SPI: A CONSORT extension for social and psychological interventions

Principle Investigator: Professor Paul Montgomery
Co-Investigators: Dr Evan Mayo-Wilson (Assistant Scientist, Johns Hopkins University Bloomberg School of Public Health); Dr Sean Grant (Associate Behavioural & Social Scientist, RAND Corporation); Dr Sally Hopewell (Senior Research Fellow, Centre for Statistics in Medicine, University of Oxford); Professor Geraldine Macdonald  (Professor of Social Work, Institute of Child Care Research, Queen’s University Belfast); Professor Susan Michie (Professor of Health Psychology and Deputy Director of the Centre for Outcomes Research and Effectiveness University College London); Prof David Moher (Research Chair in Systematic Reviews, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Centre for Practice-Changing Research (CPCR), The Ottawa Hospital - General Campus). 
Funding: ESRC funded Development of an extension of the CONSORT guidelines for psychological, social and environmental interventions: £396,551
Dates: April 2013- December 2015

Summary: Social and psychological interventions are often complex. Understanding randomised controlled trials (RCTs) of these complex interventions requires a detailed description of the interventions tested and the methods used to evaluate them. However, RCT reports in child studies of criminology, education, psychology, public health, social work, and related disciplines often omit, or inadequately report, this information. The magnitude of these deficiencies is particularly striking when comparing RCT reporting quality in social and behavioural science journals to health care and medical journals. Incomplete and inaccurate reporting hinders the optimal use of research, wastes resources, and fails to meet ethical obligations to research participants and consumers.

The CONSORT Statement is a guideline widely used in medicine to help authors report RCTs. The original statement and later extensions have improved the quality of medical trial reporting, but there has been limited uptake in social and behavioural sciences, as the greater complexity of interventions in these disciplines gives rise to new issues that are not adequately addressed in existing guidelines.  

Scientists working in the field of child mental health who develop and evaluate social and psychological interventions need a reporting guideline that is appropriate for the trials that they conduct. To address this need, we developed a CONSORT extension for social and psychological interventions: CONSORT-SPI

Further Information: 

1) Montgomery, P., Grant, S., Hopewell, S., Macdonald, G., Moher, D., Michie, S., & Mayo-Wilson, E. (2013). Protocol for CONSORT-SPI: An Extension for Social and Psychological InterventionsImplementation Science, 8, 99. doi:10.1186/1748- 5908-8-99 

2) Grant, S., Mayo-Wilson, E., Melendez-Torres, G.J., & Montgomery, P. (2013). The reporting quality of social and psychological intervention trials: a systematic review of reporting guidelines and trial publicationsPLoS One8(5), e65442. doi:10.1371/journal.pone.0065442

3) Mayo-Wilson, E., Grant, S. Hopewell, S., Macdonald, G., Moher, D., & Montgomery, P., (2013). Developing a reporting guideline for social and psychological intervention trials. Versions available in:

4) Grant, S., Montgomery, P., Hopewell, S., Macdonald, G., Moher, D, & Mayo-Wilson, E. (2013). Letter to the Editor: New guidelines are needed to improve the reporting of trials in addiction sciencesAddiction, 108, 1687-1688.

5) Gardner, F., Mayo-Wilson, E., Montgomery, P., Hopewell, S., Macdonald, G., Moher, D, & Grant, S. (2013). Editorial Perspective: New guidelines are needed to improve the reporting of trials in child and adolescent mental healthJournal of Child Psychology and Psychiatry54(7), 810-812.

6) Grant, S., Montgomery, P., & Mayo-Wilson, E. (2012). Development of a CONSORT extension for interventions in public health and related disciplinesThe Lancet380(Supp. 3). S14.

7) Spreckelsen, T., Grant, S. P., & Montgomery, P. (2012). Letters: Additional requirements for complex interventions. BMJ, 345, e8003

 

Austerity and its impact on Early Years Informal and Family Learning in Disadvantaged Urban Communities

Principle Investigator: Professor Christine Pascal and Professor Tony Bertram, Centre for Research in Early Childhood
Project Team Members: Professor Chris Pascal – Project Director & Principal Investigator; Professor Tony Bertram – Family Case Studies Lead, Community Interviews – England; Professor Andy Cramp – Cultural Mapping Lead – England; Professor João Formosinho - Cultural Mapping Lead – Portugal; and Professor Júlia Formosinho - Family Case Studies Lead, Community Interviews – Portugal 
Funding: British Academy: £46,200.00
Dates: February 2017- February 2018

Summary: This investigative project focuses on informal family learning in urban disadvantaged communities experiencing austerity in England and Portugal. 

Poor families with young children are harder hit than any other group by austerity policies. Informal family learning in community spaces contributes to development of young citizens, for character building, positive learning dispositions and executive learning functions, influencing successful school outcomes. This connection between school outcomes and informal learning in urban environments is vital, under-researched and relevant to many urban communities experiencing austerity.

This project will map the impact of austerity in English and Portuguese disadvantaged urban communities, documenting changing levels of availability/access to what were, historically, public, free, cultural/leisure services on which poor families depend for stimulation and extension of family learning, including libraries, parks, playgrounds, youth clubs and museums.

The project aims to enhance family and informal learning for disadvantaged children before entry to school, generating learning with international relevance. The research will begin by mapping the cultural and community changes experienced by two inner-city Birmingham wards in the decade between 2007 and 2018.

This will include documenting changing levels of availability/access to what were, historically, public, free, cultural/leisure services on which poor families depend for stimulation and extension of family learning, including libraries, parks, playgrounds, youth clubs and museums.

The project aims to enhance family and informal learning for disadvantaged children before entry to school, generating learning with international relevance. A number of family and neighbourhood case studies will then be produced to learn more about how changes identified have impacted on what has existed, what exists now and what the consequences of changes might be for their family learning experiences and consequently children’s futures. Within this phase we will also work with existing community workers and cultural/arts-based services in each ward to explore and document, through focused interviews, their experiences of austerity on their services highlighting, in particular, examples of positive, enriching and creative responses to the impact of austerity on publicly funded community learning spaces and other environmentally based opportunities linked to informal family learning. We will interpret the data by looking for key themes and ideas of both loss and hope for the future in urban contexts 

Further Information: www.earlylearningausterityproject.org

Health

Communicating information from MRI: Patient and parent views

Principal Investigator: Prof. Andrew Peet
Local investigatorNatalie Tyldesley-Marshall
Funding: National Institute of Health Research: £130,000
Dates: Started October 2016 Finished March 2018

Summary: This project aimed to explore what young patients with brain tumours (and their parents) felt when first seeing, value and understand from viewing, the images from their Magnetic Resonance Imaging scans (called ‘MRIs’).  Semi-structured interviews were undertaken with young patients (8-15 years old) (with a parent present, also interviewed) using an MRI from a patient not present. 

This research found that emotional responses to seeing MRIS varied enormously.  Although not all parents viewed the MRIs, those that did, found benefits in seeing them.  These included reassurance, hope, improved understanding, and enhanced feeling of control over the condition.  Time between scanning and receiving the result was stressful causing ‘scanxiety’, but most prioritised accuracy over speed of receiving results.

These findings suggested that

  • clinical teams should always explain MRIs after first ‘framing’ the information e.g. ‘Good news’.  This should minimise participant confusion around meaning, periodically evident after many years; and
  • patient and parent preferences for being shown MRIs vary, and often change over time, therefore clinicians should identify, record and update these preferences.

More Information:

 

An evaluation of the implementation of national school food standards in secondary schools and their impact on the school food environmental and pupil intake of free sugars: a mixed methods study

Co-Principle Investigators: Dr Miranda Pallan and Professor Peymane Adab 
Project Investigators: Emma Lancashire; Alice Sitch; Emma Frew; Suzanne Bartington; Kiya Hurley; Jayne Parry; KK Cheng; and Vahid Ravaghi. External: Sandra Passmore; Scott Wheeldon; Tania Griffin; Ashley Adamson; and Emma Foster.
Funding: National Institute for Health Research Public Health Research Programme (17/92/39): £815,889
Dates: 1st March 2019; project ends: 31st May 2021

Summary: National School Food Standards are a legal requirement for the majority of state schools. In addition, the School Food Plan, a wider set of non-legislative recommendations for schools, has been introduced. There is little information on the impact of this national policy on school food provision and pupil food intake in secondary schools. Some secondary schools with academy status are exempt from the school food standards, therefore we aim to make comparisons between secondary school academies required to meet the standards and those who are not. We will compare 1) school food choices and sales, the school eating environment, and learning about food, 2) the influence of the School Food Plan recommendations, and 3) the consumption of sugar and other dietary elements, and dental health in pupils.

We will recruit 44 schools in the West Midlands to take part. To achieve our aims we will: examine a variety of school documents; observe the food on offer and the eating spaces in schools; ask key staff members, governors and parents to complete a questionnaire; compare food sales data; and assess nutritional intake and dental health in a sample of pupils in the participating schools. In a smaller sample of schools (4-6), we will conduct interviews with key staff members and discussion groups with pupils to gain more in-depth information.

 

A cluster randomised controlled trial evaluating the effectiveness and cost-effectiveness of the daily mile on childhood obesity and wellbeing: the Birmingham daily mile

Principle InvestigatorDr Emma Frew
Co-Investigators: Peymane Adab; James Martin; Emma Lancashire; and Karla Hemming.  External: Sandra Passmore and Katie Breheny
Funding: Birmingham City Council
Dates: January 2017-December 2018.

Summary: The Daily Mile is an initiative developed to improve children’s physical activity levels and is a simple, inclusive activity that involves children doing an extra 15-minutes of activity by running or walking around a track within the school grounds daily.  It has been suggested as an intervention to help reduce childhood obesity within the UK. The Birmingham Daily Mile study aims to conduct a robust evaluation of the effectiveness and cost-effectiveness of the Daily Mile (intervention) by comparing it to usual practice (control), with 20 primary schools randomised to each arm.  Information will be collected at 4 and 12 months following the initiation of the Daily Mile on the children's Body Mass Index (BMI), academic attainment, fitness, quality of life and wellbeing.  These outcomes will also be offset against the cost of the Daily Mile to form a comprehensive economic evaluation.

The Daily Mile is a simple and low-cost intervention which could provide a significant contribution to tackling childhood obesity. It therefore has great potential to impact health and education policy in the UK. 

 

Effectiveness and cost effectiveness of the CHIRPY DRAGON intervention in preventing obesity in Chinese primary-school aged children: a cluster randomised controlled trail

Investigators: Dr Bai Li; Peymane Adab; Miranda Pallan; Emma Frew; Karla Hemming; James Martin; Mandana Zanganeh; Kiya Hurley; and KK Cheng. External: Weijia Liu; Rong Lin; and Wei Liu
Funding: Philanthropic donation from Zhejiang Yong Ning Pharmaceutical Ltd Co.
Date: August 2015-March 2019.

Summary: Rates of increase in childhood obesity in China and many low-to-middle-income countries exceed that in the West, but effective preventive interventions are lacking. We used the UK Medical Research Council complex intervention framework to inform the development of the Chirpy Dragon intervention in primary schools in Guangzhou, China. Using a cluster randomised controlled trial, we recruited Year One children (six-to-seven years) from 40 state-funded primary schools to evaluate the intervention. Children underwent baseline assessment of their height, weight, diet, physical activity and other measures. Schools were then randomised to receive either the intervention or routine care. The 12-month intervention programme included four school and family-based components. We promoted physical activity and healthy eating behaviours through educational and practical workshops, family activities, and supporting the school to improve physical-activity and food provision. We have completed follow up measurements at the end of the intervention period and are evaluating the effects of the intervention on children’s weight status at 12 months, as well as the cost-effectiveness of the programme.

 

Long term impact of pre-incision antibiotics on babies born by caesarean section

Principle Investigator: Dr Dana Sumilo
Co-Investigators: Prof. Peter Brocklehurst; Prof. Jon Deeks; Dr. Krishnarajah Nirantharakumar; Dr Brian Willia; and Dr Nicola Adderley
Funding: NIHR HTA programme (16/150/01): £324,516
Dates: April 2018-April 2020

Summary: In the UK, about a quarter of women give birth by caesarean section. In 2011, there was a change in the NICE guideline on caesarean section (CG132) recommending switching from giving antibiotics after the umbilical cord is cut to giving antibiotics before the operation to further reduce the risk of infection, such as wound infection, in mothers. There are no known short-term harms to the baby or their mother having these antibiotics around the time of the birth.

We currently do not know, however, whether these antibiotics have any long term impact on children’s health. This research project is very timely as there is growing evidence of the role of the human microbiome (different microbes that live in and on our body) in health and disease. Antibiotics given around the time of birth alter the gut microbiome of babies, which may impact on the development of the child’s immune system and increase susceptibility to allergic and other diseases in later life.

This study will therefore look to see if there is any longer term impact of antibiotics given at the time of caesarean section on the health of children. The study findings will help women and their families to make informed decisions before caesarean section with regards to whether or not, and how, they wish to receive antibiotics before their baby is born. 

This project draws on the growing strengths fo the Institute of Applied Health Research in health informatics research (including policy evaluation using routine electronic healthcare data), biostatistics, and maternal and child health. This project will combine anonymised data from several sources, including two UK primary care databases and hospital episode statistics datacase for England. 

Further Information: https://www.birmingham.ac.uk/research/activity/applied-health/research/health-informatics/Long-term-impact-of-pre-incision-antibiotics-on-babies-born-by-caesarean-section.aspx

Technology

Social media and its impact on adolescent health and wellbeing: A scoping study of the new ethical challenges

Principle Investigator: Dr Victoria Goodyear
Co-Investigators: Prof. Kathleen Armour
Funding: Wellcome Trust: £60,141
Dates: September 2016-December 2017

Summary: This project provides new empirical evidence on the ways in which young people engage with health-related content on social media, and how this impact on their health-related understandings and behaviours. Focussing on the key content areas of physical activity, diet/nutrition and body image, researchers from the University of Birmingham worked with young people to better understand the issues from their perspectives. The data highlight positive impacts of social media use as well as the risks and potential harm to young people’s physical and mental health. The data have also informed the development of guidelines and actions to support parents, practitioners in education and health, policy-makers and  researchers.

Further Information: 

 

"There's an app for that!" An Exploratory Study into Digital Technologies and Health/Wellbeing Education in Schools

Principle Investigator: Dr Victoria Goodyear 
Co-Investigators: Prof. Kathleen Armour
Funding: Society for Educational Studies: £7,384
Dates: September 2016-December 2017

Summary: Young people’s engagement with digital health technologies is dominated by risk narratives. Yet, there are very limited understandings, from the perspectives of young people, about the health-related issues and opportunities generated by digital health technologies. This project presents new evidence on the types of health-related apps and devices young people find, select and use, and the reasons for their choices. Data were generated from a participatory mixed method design with 245 young people (age 13-18). The data were analysed using a content-led pedagogical framework. The data illustrate, vividly, young people’s agency in digital health contexts and the complexity and fluidity of young people’s decision-making.  Schools, PE lessons and sport, as well as family members and peers, were powerful influencers on young people’s digital health-related knowledge and behaviours. It is argued that better understanding young people’s agency in digital health contexts offers important insights into developing effective health-related pedagogies.

Further Information: https://www.tandfonline.com/doi/abs/10.1080/17439884.2019.1539011 

Equality, Risk & Violence

Evaluation of Good Way programme for harmful sexual behaviour in young people with learning disabilities

Investigators: C. Bradbury-Jones; J. Taylor; P. Yates; and S. Allardyce
Funding: NSPCC: £20,000 and £12 million
Dates: 2019

Summary: This is a realist evaluation study that will analyse the effectiveness of the Good Way model for young people with mild to moderate learning disabilities who have engaged in harmful sexual behaviour (HSB). The Good Way model helps address the need to develop a common and coherent narrative so that clients and therapists can meaningfully discuss the client’s behaviour and experiences.  Originally developed in New Zealand, the NSPCC has adopted the approach and is currently delivering Good Way interventions in a number of locations in the UK. The aim of this study is to evaluate the effectiveness of the approach in this new context. Following analysis and synthesis of the data, findings will be developed in consultation with key stakeholders. The study’s empirical and theoretical findings will inform recommendations about how to build on the Good Way model’s existing strengths and will highlight areas of concern or future development. This will contribute to efforts to continually improve the effectiveness of the model and the quality and consistency of support it provides to young people and their families.

 

Improving outcomes for children and families affected by paternal substance use: a feasibility study of the Parents Under Pressure (PuP) programme with a focus on fathers

Investigators: A. Whittaker; L. Elliott; S. Dawe; P. Harnett; J. Taylor; C. Kirk; P. Littlewood; and A. Stoddart
Funding: NIHR: £350,000
Dates: 2016-2019

Summary: In the UK, an estimated 350,000 children are affected by parental drug misuse [4], with prevalence increasing. Parental drug misuse severely compromises the caregiving environment in which children grow up and is strongly associated with inequalities, the intergenerational transmission of harm and child protection involvement, with rates of parental substance misuse listed as key concerns in 30-70% of all child protection cases. Parents affected by drug misuse are a highly stigmatised and marginalised group of parents, who are often reluctant to engage with family support services and group-based parenting programmes.Thus a targeted approach to supporting these families, with effective programmes specifically designed for high-risk parents, is required. This study involves opioid-dependent fathers in aparenting intervention – the Parents under Pressure (PuP) programme – which is specifically designed for high-risk parents. It aims to improve family functioning by addressing affect regulation as a key driver of parenting and couple-related behaviours in men. This fits with the most recent research and clinical recommendations on father-inclusive parenting and co-parenting interventions. Importantly, this study focuses on vulnerable children (aged 0-8 years old) living with opioid-dependent fathers.

 

Behavioural Couples Therapy as an adjunct to opioid substitution therapy for drug dependent parents: A feasibility study. 

Investigators: A. Whittaker; L. Elliott; T. O'Farrell; J. Taylor; K. Klostermann; and A. Stoddart
Funding: Chief Scientist Office: £163,000
Dates: 2015-2018

Summary: This mixed-methods feasibility study aimed to assess whether Behavioural Couples Therapy (BCT), a US developed evidence-based psychosocial intervention for the treatment of addiction, can be successfully delivered within NHS drug treatment services with drug-dependent couples in opioid substitution therapy (OST) who have children living in the home, and whether it is possible to collect outcome data on participating families for a future trial.

Study recruitment, couple engagement in the intervention, follow-up of participants, and embedding the intervention in routine clinical practice was a lengthy and challenging process. All families reported complex needs related to multiple health and social problems. Multiple barriers to implementation were reported including patient, clinician, treatment, service/organisational, and structural-level obstacles to recruitment, engagement, retention, acceptability, suitability and delivery of BCT. Strategies which facilitated successful implementation were also identified as well as potential solutions to implementation issues.

Conclusions: Adoption of BCT within NHS addiction services as an adjunct to opioid substitution therapy for parents with children is extremely challenging for multiple, inter-related reasons. Findings suggest an ideological shift is required, towards a more integrated ‘whole family’ practice model approach. Structural changes in joint working between health/social care and child/adult services could enable joint care planning and better engagement in the intervention. A pilot RCT is not recommended at this time given the feasibility problems identified in this study.