Suchergebnisse

ObjectivesSocioeconomic disadvantage and poverty are considered important drivers of child maltreatment, particularly child neglect. We examine the prevalence, cumulative incidence, and notification rate of child protection (CP) contact among children who experienced intergenerational welfare contact (IWC) compared to families with other types of welfare contact (WC).
ApproachA whole-population linked administrative data study of children in South Australia born 1991-1995 (n=94,358), followed from birth up to age 20 years and their parent/s (n=143,814). The study used de-identified data from the Better Evidence Better Outcomes Linked Data (BEBOLD) platform including data from Australian Government Centrelink (welfare payments), birth registration, perinatal birth records, and child protection records. Children were classified as: No WC, parent only WC, child only WC, or IWC. Child protection contact prevalence, rates, and cumulative incidence were estimated by age, level of contact (reported notifications, screened-in reports, investigations, substantiations and out-of-home care), and WC group.
ResultsUsing Australian Government Centrelink data, WC was defined as parent/s receiving a means-tested welfare payment (low-income, unemployment, disability or caring) when children were aged 11-15, or children receiving payment at ages 16-20. IWC was WC occurring in both parent and child generations. Children who experienced IWC accounted for 84.7% of all CP notifications at ages 0-17 years and had the highest prevalence of CP contact (37.3%, n=12,286), compared to children experiencing parent only WC (16.1%), child only WC (11.6%), and no WC (4.7%). This trend was consistent across all levels of CP contact. Children who experienced IWC had higher notification rates at every age compared to all other WC types.
Conclusions and RelevanceChildren experiencing IWC represent a third of the population aged 11-20, yet account for 84.7% of all child protection notifications. Our study shows that children who experience IWC have higher personal (cumulative incidence and prevalence) and societal (notification rates) child protection costs than their counterfactual (parent only WC).

ObjectivesIntergenerational welfare contact (IWC) is a policy issue due to personal and social costs of 'entrenched disadvantage' across generations, yet few studies have quantified the burden of IWC on health. We examine the proportion of children who experienced IWC and other welfare contact (WC) types; and estimate cause-specific hospital burden.
ApproachA whole-of-population linked administrative data study of children in South Australia born 1991-1995 (n=94,358), followed from birth up to age 20 years and their parent/s (n=143,814). The study used de-identified data from the Better Evidence Better Outcomes Linked Data platform including data from Australian Government Centrelink (welfare payments), birth registration, perinatal birth records, and inpatient hospitalisations. Children were classified as: No WC, parent only WC, child only WC, or IWC. Cause-specific hospitalisation rates and cumulative incidence were estimated by age and WC group.
ResultsUsing Australian Government Centrelink data, WC was defined as parent/s receiving a means-tested welfare payment (low-income, unemployment, disability or caring) when children were aged 11-15, or children receiving payment at ages 16-20. IWC was WC occurring in both parent and child generations. IWC affected 34.9% of children, who had the highest hospitalisation rate (133.5 per 1,000 person-years) compared to no WC (46.1 per 1,000 person-years), parent WC (75.0 per 1,000 person-years), and child only WC (87.6 per 1,000 person-years). Of all IWC children, 43.0% experienced at least one hospitalisation between 11-20 years, frequently related to injury, mental health, and pregnancy.
Conclusions and RelevanceChildren experiencing IWC represent a third of the population aged 11-20. Compared to children with parent-only WC, IWC children had 78% higher hospitalisation rates from age 11 to 20, accounting for over half of all hospitalisations in this age group. Frequent IWC hospitalisation causes were injuries, mental health, and pregnancy.

Background Systematic reviews have highlighted that school-based diet and physical activity (PA) interventions have had limited effects. This study used qualitative methods to examine how the effectiveness of future primary (elementary) school diet and PA interventions could be improved. Methods Data are from the Active For Life Year 5 (AFLY5) study, which was a cluster randomised trial conducted in 60 UK primary schools. Year 5 (8–9 years of age) pupils in the 30 intervention schools received a 12-month intervention. At the end of the intervention period, interviews were conducted with: 28 Year 5 teachers (including 8 teachers from control schools); 10 Headteachers (6 control); 31 parents (15 control). Focus groups were conducted with 70 year 5 pupils (34 control). Topics included how the AFLY5 intervention could have been improved and how school-based diet and PA interventions should optimally be delivered. All interviews and focus groups were transcribed and thematically analysed across participant groups. Results Analysis yielded four themes. Child engagement: Data suggested that programme success is likely to be enhanced if children feel that they have a sense of autonomy over their own behaviour and if the activities are practical. School: Finding a project champion within the school would enhance intervention effectiveness. Embedding diet and physical activity content across the curriculum and encouraging teachers to role model good diet and physical activity behaviours were seen as important. Parents and community: Encouraging parents and community members into the school was deemed likely to enhance the connection between schools, families and communities, and "create a buzz" that was likely to enhance behaviour change. Government/Policy: Data suggested that there was a need to adequately resource health promotion activity in schools and to increase the infrastructure to facilitate diet and physical activity knowledge and practice. Discussion and Conclusions Future primary school diet and PA programmes should find ways to increase child engagement in the programme content, identify programme champions, encourage teachers to work as role models, engage parents and embed diet and PA behaviour change across the curriculum. However, this will require adequate funding and cost-effectiveness will need to be established.