Recent seminars hosted by CHSPR:
Wednesday 1st December 2021
Thinking beyond effectiveness – evaluating the reach and equity of The Daily Mile in England using routine data
Tishya Venkatraman, University College London
Recording link (Passcode: i8!%9rk%)
Abstract: Children in England are insufficiently active, which is a major public health concern. Simple, effective interventions are required to tackle shortfalls in children’s physical activity. The Daily Mile (TDM) is a school-based active mile intervention that has been widely adopted to address this shortfall. This study aimed to assess the reach and equity of TDM by: 1) examining primary school and local authority characteristics associated with registration for TDM; and 2) identifying local authorities in England with the greatest need to increase children’s physical activity and assess whether TDM reaches school populations in areas with the highest need.
Multilevel models were used to determine the association between school and local authority characteristics associated with TDM registration and to assess variation at school and local authority levels. A hierarchical cluster analysis was conducted to group local authorities by ‘need’ and a Poisson regression was used to estimate the association between ‘need’ and registration to TDM.
TDM is a wide-reaching intervention with one in five state-funded primary schools in England having registered for TDM since 2012. Determinants of children’s physical activity cluster geographically across local authorities in England. TDM appears to be a potentially equitable intervention reaching populations that could benefit from it the most. Health policy should account for clustering of health determinants to match interventions with populations most in need and TDM’s implementation and sustainability must be monitored before recommending wider uptake.
Read more about Tishya’s doctoral work here - https://sphr.nihr.ac.uk/trainee/tishya-venkatraman/
Wednesday 3rd November 2021
We are the future: involving young people in defining what it means to ‘Make the world a better place’
Dr Hannah Cowen, King’s College London
Recording link (Passcode: @8O%f.gv)
Abstract: Universities have long held authority over what the future should look like and indeed King’s College London (KCL) as an institution is very conscious of its power to change and even “serve” the world, with its mission statement, “to make the world a better place”. Our work has been focused on asking: what is this better place? A better place for whom?
Inspired by young climate activists’ claims that they “are” the future, we have been working with young people on KCL’s doorstep to compare their hopes and fears for the future with the ‘better worlds’ being made by health researchers at KCL. Rather than think about how researchers can serve to improve the world for young people, we want to hear from young people themselves, who have been making it clear from their marches that we need to start listening to them. We therefore decided to use arts-based methods to engage often underprivileged young people in London to extend the conversation beyond climate change, and create their own utopias and dystopias at the intersection of health, technology, and society. Simultaneously, we have been hearing about their experiences and reflections on how the pandemic has affected their mental wellbeing.
In this presentation we describe some of our key findings so far: 1) look to how stark social inequalities are affecting young people’s health and wellbeing, leaving many young people feeling like they have no future at all; 2) reveal the ways in which young people’s hopes and fears for the future misalign with the world some researchers are trying to create; and 3) force us to re-examine who should have authority over the production of medical knowledge. In this last section we draw on feminist literature to understand why young people have long not been given a voice because of their association with women and the home, and how we need to draw on feminist arguments to challenge ideas about who has agency to shape emerging worlds. Further information here: www.utopianow.co.uk
Wednesday 6th October 2021
Parenting ideologies, media influence, and maternal wellbeing
Hilllary Collins, University of Glasgow
Abstract: This presentation reports on a project which aimed to better understand how ‘parental determinism’ is perceived by mothers, the role of the media in shaping these perceptions, and the impact of these perceptions on their wellbeing. ‘Parental determinism’, a term coined by Frank Furedi, is at its core about associating the everyday actions (or inactions) of parents with harming their children, and thus society. As well as parental determinism, this project was grounded in Clive Seale’s argument that people use cultural scripts presented in the media to construct the self.
The project used a multimethod approach of initial and follow up interviews with mothers and analysis of an online parenting forum and BBC News items. It explored mothers’ understanding and endorsement of parental determinism; sources of influence to their parenting beliefs and practices (focusing on the media); and impacts to their wellbeing related to parenting and perceptions of media representations. The results indicated a tendency of higher endorsement of parental determinism to come from mothers who had experienced poor parenting, and for some feelings of worry and guilt to come from reflection of their own parenting practices which could be linked to ideas of parental determinism and the related concept of 'intensive motherhood'. The media played a complex role in mothers' social lives, as representation and infrastructure, and had positive and negative impacts on their wellbeing.
Wednesday 1st September 2021
Projective Storytelling and Phased Dialogues for Collaboratively Analysing Young Tanzanians’ Sexual Health Knowledge
Dr Clare Coultas, King’s College London
Abstract: The evidence base for youth sexual behaviour change in low-income settings remains weak. This is often interpreted as a problem of interventions not being implemented ‘with fidelity to design’, or is identified as an issue of evaluation methods lacking rigour. Drawing on research undertaken in Tanzania over the last decade, this talk will outline a methodological approach that was used to question these interpretations. The projective storytelling method developed by Kitzinger and Powell (1995) was adapted to explore the arc of a fictional intimate relationship, ending with the protagonist attending a youth sexual behaviour change intervention. Discussions around these stories were phased, with each building on the former, enabling collaborative analyses. They highlighted an overarching resistance to intervention knowledge, with the young Tanzanians viewing it as ‘not for us’, instead identifying it as for privileged global ‘others’. A current impact project will also be discussed which brings together young people in Tanzania and London, UK to co-design a comic that will address feelings of exclusion from intervention knowledge that is meant to inspire.
This presentation was based on two of Dr Coultas' recent papers:
- Comprehensive sexuality education is ‘not for us’: Rethinking ‘cultural relevance’ through Young Tanzanians' identifications with/against intervention knowledge
- Accounting for colonial complicities through Refusals in researching agency across borders
Wednesday 7th July, 2021
Cigarette taxation and neonatal and infant mortality: a longitudinal analysis of 159 countries
Dr Anthony Laverty, Imperial College London
Abstract: Tobacco control has a significant but underutilised role in achieving Sustainable Development Goal 3, including improved child survival. The World Health Organization (WHO) states raising taxes is the most effective strategy to reduce tobacco use and recommends a level of 75% of retail price. Evidence has identified child survival benefits from raised tobacco taxes, but studies were based in high-income countries and did not examine the relative benefits of different taxation levels and structures. We evaluated longitudinal associations of cigarette taxes with neonatal and infant mortality globally. Analysing data from 159 countries, we found that a 10 percentage-point increase in total cigarette tax was associated with a –2.6% (95% Confidence Interval [CI]: –3.2% to –1.9%) decrease in neonatal mortality and a –1.9% (95% CI: –2.6% to –1.3%) decrease in infant mortality.
Wednesday 2nd June, 2021
Understanding the variability of the availability and use of rapid diagnostic tests for the management of acute childhood infections in Europe
Dr Manuel Dewez, London School of Hygiene and Tropical Medicine
Abstract: Fever is a common cause of consultation in children. The majority of febrile children have self-limiting infections which can be safely managed at home. However, a few will have potentially severe infections; identifying these children from the others can be difficult, as clinical symptoms and signs are often non-specific in this age group. This diagnostic uncertainty and avoidance of risk contributes to the over-prescription of antibiotics. Rapid point-of-care diagnostic tests (POCTs) are widely advocated to improve antibiotic use. However, the availability and use of POCTs for the management of febrile children seems to vary across Europe. This presentation will focus on an ongoing comparative health systems analysis aiming to understand factors that may explain this variation. At the macro and meso levels, a multilevel regression modelling was used to assess the contribution of workplace and country of work to the availability and use of POCTs, based on survey of paediatricians from across Europe. This was complemented by a mixed-methods case study comparing the implementation of a POCT (C-reactive protein) in the Netherlands and England to identify country-specific determinants, based on the non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) framework developed by Greenhalgh and colleagues. Finally, at the micro level, in-depth qualitative interviews of paediatricians and general practitioners from these two countries will provide insights about the use of POCTs in their current management of febrile children.
Wednesday 7th April, 2021
Parenting practices across generations – a mixed methods study of ‘vulnerable’ mothers
Dr Simon Barrett, University of Newcastle
Abstract: discussing the findings from Dr Barrett’s PhD study of how parenting practices are transmitted across generations, among women identified as having additional health and social care needs. It presents qualitative findings looking at how they feel their backgrounds, adverse events, and how they were raised, all impact upon the parenting practices they adopt with their own children. It also presents quantitative evidence of the factors associated with parental self-efficacy. Dr Barrett also discusses some of the issues raised when working with ‘vulnerable’ populations such as this.