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Background: Those supporting children and young people who use augmentative and alternative communication (AAC) contribute to ongoing complex decision‐making about communication aid selection and support. Little is known about how these decisions are made in practice and how attributes of the communication aid are described or considered. Aims: To understand how communication aid attributes were described by those involved in AAC recommendations and support for children and young people, and how these attributes were described as impacting on AAC use. Methods & Procedures: A secondary qualitative analysis was completed of interview and focus group data from 91 participants involved in the support of 22 children and young people. Attributes of communication aids described by participants were extracted as themes and this paper reports a descriptive summary of the identified software (non‐hardware) attributes. Main Contribution: Decisions were described in terms of comparisons between commercially available pre‐existing vocabulary packages. Attributes related to vocabulary, graphic representation, consistency and intuitiveness of design, and ease of editing were identified. Developmental staging of vocabularies, core and fringe vocabulary, and vocabulary personalization were attributes that were described as being explicitly considered in decisions. The potential impact of graphic symbol choice did not seem to be considered strongly. The physical and social environment was described as the predominant factor driving the choice of a number of attributes. Conclusions & Implications: Specific attributes that appear to be established in decision‐making in these data have limited empirical research literature. Terms used in the literature to describe communication aid attributes were not observed in these data. Practice‐based evidence does not appear to be supported by the available research literature and these findings highlight several areas where empirical research is needed in order to provide a robust basis for practice. What This Paper Adds: What is already known on the subject: Communication aid attributes are viewed as a key consideration by practitioners and family members in AAC decision‐making; however, there are few empirical studies investigating language and communication attributes of communication aids. It is important to understand how those involved in AAC recommendations and support view communication aid attributes and the impact different attributes have. What this paper adds to existing knowledge: This study provides a picture of how communication aids are described by practitioners and family members involved in AAC support of children and young people. A range of attributes is identified from the analysis of these qualitative data as well as information about how participants perceive these attributes as informing decisions. What are the potential or actual clinical implications of this work?: This study provides a basis on which practitioners and others involved in AAC support for children and young people can review and reflect on their own practice and so improve the outcomes of AAC decisions. The study provides a list of attributes that appear to be considered in practice and so also provides a resource for researchers looking to ensure there is a strong empirical basis for AAC decisions. [ABSTRACT FROM AUTHOR]

Qualitative research has long critiqued a simplistic association between youth parenting and poor outcomes. Despite this, the UK youth parenting policy continues to view young parents through a narrow deficit lens, focused on assumed risk rather than structural inequalities. The paper brings together the direct accounts of young parents' experiences, with ethnographic observation of practice, to argue that discrimination is the critical issue associated with being a young parent. This is then set within a wider critique of the policy framework which, it is argued, perpetuates and normalises negative ideas about young parents prevalent in political, societal and cultural processes. An integrative theoretical approach is used to highlight how a deficit lens at a policy level upholds, rather than undermines, young parents' intersectional experiences of discrimination and has ethical implications for practitioners working with them. The paper calls for a reorientation of policy which addresses and disrupts discrimination. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic and subsequent measures to reduce transmission risk has led to unprecedented digital transformation across health, education and social care services. This includes UK paediatric speech and language therapy (SLT), which sits at the crossroads of these services. Given the rapid onset of this pandemic‐induced digital transition, there is now a need to capture, reflect and learn from the SLT profession so that benefits can be sustained, and barriers addressed. Aims: To survey the impact of COVID‐19 remote working on UK paediatric SLTs' digital views and experiences using the Capability, Opportunity, Motivation and Behaviour (COM‐B) model. Methods & Procedures: An online survey was conducted from May to October 2020. Respondents were asked to rate their use of technology in service delivery before and during the pandemic, to select factors facilitating digital practice, and to provide open‐response aspirations for the future role of technology in paediatric SLT which were analysed thematically using the COM‐B behaviour change model. Outcomes & Results: A total of 424 UK paediatric SLTs responded to the survey. Findings indicate a marked increase in clinicians' perception of their frequency, convenience and confidence with digital practice during COVID‐19 compared with before the pandemic. Respondents identified that specialist training (27%), funding for workplace devices (22%) and supportive leadership (19%) were most likely to facilitate sustained digital practice. Clinicians hoped for a blended approach going forward with technology enhancing existing best practice. Further prominent themes included digital accessibility for all and maintaining the increased opportunity for multidisciplinary working that videoconferencing has afforded. More service‐specific aspirations were bespoke technological solutions as well as parents/carers being able to engage remotely with school‐based provisions. Conclusions & Implications: During COVID‐19, paediatric SLTs' recognition and acceptance of how technology can augment practice has accelerated, with particular value being placed on inclusivity, choice, training, resources, leadership and indication of effectiveness. These are important considerations to help guide the profession towards the long‐term digital enhancement of SLT services. WHAT THIS PAPER ADDS: What is already known on the subject: The COVID‐19 pandemic led to an unprecedented interest in the use of technology across SLT practice. Studies are emerging nationally and internationally to identify the digital priorities of the SLT workforce, the areas of digital SLT provision that are thriving or lacking, and the evidence to guide clinical practice and service development. What this study adds to existing knowledge: This is the first UK‐wide COVID‐19 survey solely focusing on the digital practice of paediatric SLTs. The findings provide critical insights into SLT perception of how practice has been impacted in the early stages of the COVID‐19 pandemic, including digital trends that are service, condition and demographic specific. Tools and channels required to support sustained beneficial change are also discussed. What are the potential or actual clinical implications of this work?: This paper demonstrates the potential for digital solutions to enhance SLT practice, as long as implementation is guided by clinicians' experiences and perspectives. The findings lay groundwork for service development work, such as the creation of training packages, updating of clinical guidelines and care pathways, and development of processes to ensure equitable allocation of evidence‐based resources. [ABSTRACT FROM AUTHOR]

Background: Degree apprenticeships (DA) help employees gain new knowledge and skills by allowing them to study towards a university degree while working full time. For these programmes to be effective, the learning design should be adapted to the needs of these students, who are goal oriented (i.e. they want to gain only knowledge that can be applied within their workplace), have limited time for studying, and usually have not attended formal education for some time. As these programmes are relatively new, there is limited research on how these students can be supported to achieve the programmes' learning goals by using information and communication technologies. Objectives: This paper aims to understand whether a learning design that combines game‐based learning with online flipped classrooms can engage DA students in their learning and help them develop their reflective skills. Methods: Two focus groups were conducted with DA students that study at a UK Business School towards gaining the Chartered Manager status. The focus groups recordings have been analysed using reflexive thematic analysis. Results and Conclusions: The three main themes, "change can be helpful and challenging at the same time", "the ideal game", and "the effect of others", show that DA students find game‐based learning and online flipped classrooms useful, with the right support. Simulation games can be more fulfilling to DA students than quiz games, even if they take more of their out‐of‐class time. In addition, instructors are advised to work more closely with diverse teams to enable students share their work experiences and learn from each other. Lay Description: What is already known about this topic?: Online flipped classrooms offer flexibility in learning, but instructors need to find solutions to challenges, like students' limited e‐learning readiness and lack of motivation.Game‐based learning has been found to facilitate learning in general, but there is a need to identify the specific circumstances (i.e. settings, gaming elements) under which it is effective.Degree apprenticeship students need more support with their learning compared to traditional university students, as they face additional challenges in terms of family life‐work balance and connecting their learning to their working experience. What this paper adds?: Game‐based learning can be useful to degree apprenticeship students providing that focuses on the application of knowledge and provides feedback.Despite facing challenges related to maintaining work‐study‐life balance, degree apprenticeship students are willing to complete the flipped classroom's out‐of‐class activities, if they see a clear benefit from doing so.Online group activities can be challenging for degree apprenticeship students, if they are not able to form teams with other learners that work for the same organisation. The implications of study findings for practitioners: Avoid quiz‐like games and select the ones that use real‐life scenarios for degree apprenticeship students to help them link their learning to their practice.Formative feedback should be provided by both the instructor and the game to motivate degree apprenticeship students to spend the additional time to complete the out‐of‐class activities.Students should be reminded frequently of the purpose of any new learning elements (e.g. learning analytics) as they may not have the time to explore them on their own.When forming student teams based on students' workplace is not possible, spend more time in each breakout room to facilitate the online group discussion and help students bring their different working experiences together. [ABSTRACT FROM AUTHOR]

Young people are more likely to seek help about abusive relationships from friends, rather than adults or professionals, irrespective of gender, age or ethnic group. However, friends may be unequipped to deal with relationship problems and unable to provide adequate emotional or practical support. The aim of this paper is to explore how young people would support friends if they were seeking help or shared experiences of abuse. Qualitative findings drawn from a larger UK mixed‐methods study are used to explicate this. Data was gathered using 16 focus groups and one interview with girls, young women and non‐binary young people aged 13 to 24 years. Thematic analysis provided six themes pertaining to supporting friends and help‐seeking around relationship abuse. Findings showed young people recommended supporting friends in a non‐judgemental way to keep conversations open and help them recognise unhealthy behaviours. However, young people confirmed this is a difficult topic and many would feel fearful, helpless and under pressure. Conversations illustrated the need for more awareness of non‐physical abuse and resources specifically aimed at young people to enable them to help friends and know where and when to seek professional support. [ABSTRACT FROM AUTHOR]

Introduction: Co‐production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co‐production and how to operationalize it. The current paper describes the development of a co‐production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK. Methods: The strategy used Appreciative Inquiry (AI), an approach following a five‐step iterative process: to define (Step 1) scope and guide progress; to discover (Step 2) key issues through seven focus groups (N = 36) and eight in‐depth interviews with key stakeholders representing community groups, and the voluntary and statutory sectors; to dream (Step 3) best practice through two workshops with AI participants to review findings; to design (Step 4) a co‐production strategy building on AI findings and to deliver (Step 5) the practical guidance in the strategy. Results: Nine principles for how to do co‐production well were identified: power should be shared; embrace a wide range of perspectives and skills; respect and value the lived experience; benefits should be for all involved parties; go to communities and do not expect them to come to you; work flexibly; avoid jargon and ensure availability of the right information; relationships should be built for the long‐term; co‐production activities should be adequately resourced. These principles were based on three underlying values of equality, reciprocity and agency. Conclusion: The empirical insights of the paper highlight the crucial importance of adequate resources and infrastructure to deliver effective co‐production. This documentation of one approach to operationalizing co‐production serves to avert any misappropriations of the term 'co‐production' by listening to service users, stakeholders and other relevant groups, to develop trust and long‐term relationships, and build on the learning that already exists amongst such groups. Patient or Public Contribution: The work was overseen by a steering group (N = 17) of individuals, both professional and members of the public with experience in undertaking co‐production, and/or with some knowledge of the context of the two ActEarly field sites, who provided regular oversight and feedback on the AI process. [ABSTRACT FROM AUTHOR]

Background: Phonetic transcription is recognized in regulatory standards as an essential skill for Speech and Language Therapists (SLTs) in the assessment, diagnosis and management of clients with speech difficulties. Previous research has identified that approaches to phonetic transcription vary, and that SLTs often lack confidence in transcribing. However, SLTs' views and working practices have not been investigated in detail, particularly in terms of whole service approaches and following the recent increase in telehealth. Aims: To investigate SLTs' views about phonetic transcription, their working practices at both individual and service levels, and the factors that influence these. Methods & Procedures: A total of 19 SLTs from the UK were recruited to online focus groups via social media and local networks. Participants discussed their views of, and practices in, phonetic transcription. Themes were identified using reflexive thematic analysis. Outcomes & Results: Three broad themes were generated division and unity; one small part of a big job; and fit for purpose. SLTs were uniformly proud of their ability to phonetically transcribe and viewed this as a unique skill, but clear differences existed between different groups of SLTs in their views and practices. Investing in phonetic transcription was not always a priority for SLTs or services, and although many felt under‐confident in their skills they considered these to be adequate for the populations they usually encounter. SLTs make an early judgement about possible therapy targets, which influences the level of detail used in their phonetic transcription. Practical barriers are often not addressed at service level, and assessment via telehealth poses some specific challenges. Conclusions & Implications: SLTs and services would benefit from increased investment in phonetic transcription in terms of time, opportunities for continuing professional development (CPD) and initiatives such as electronic patient records (EPRs) which support the use of phonetic symbols. Identifying target sounds at an early stage raises questions about the implications of disregarding other features of speech, and the selection of appropriate intervention approaches. Further research is needed to analyse actual rather than reported practices, and to consider the relationship between phonetic transcription and intervention approaches. Future studies could also identify precise CPD requirements and evaluate the effectiveness of CPD. What this paper adds: What is already known on the subject: Previous research has demonstrated that SLTs often lack confidence in phonetic transcription and that practices are varied, with relatively little use of narrow transcription. SLTs are interested in opportunities to maintain and develop transcription skills but do not often undertake CPD for transcription. What this paper adds to existing knowledge: By using focus groups as a forum for discussions, this study provides a rich and detailed insight into SLTs' views about clinical transcription and their working practices, with previously unreported details about the reasons for these practices in a clinical context and at a service‐wide level. What are the potential or actual clinical implications of this work?: Transcription is often de‐prioritized in non‐specialist contexts, with practical barriers and a lack of clear and consistent protocols at a whole‐service level. There is an opportunity for service managers to address the systemic difficulties in using transcription effectively by raising the profile and value of transcription amongst clinicians, and promoting CPD opportunities, using the findings of this study as a rationale for funding this. Together, these recommendations have the potential to improve client outcomes through more accurate assessment and diagnosis, and hence more appropriate intervention. [ABSTRACT FROM AUTHOR]

Objective: The DAISIES trial, comparing inpatient and stepped‐care day patient treatment for adults with severe anorexia nervosa was prematurely terminated in March 2022 due to poor recruitment. This qualitative study seeks to understand the difficulties faced during the trial by investigating stakeholders' views on and experiences of its implementation. Method: Semi‐structured interview and focus group transcripts, and trial management and oversight group meeting minutes from May 2020‐June 2022 were analysed using thematic analysis. Participants were 47 clinicians and co‐investigators involved with the DAISIES trial. The Non‐Adoption, Abandonment, Scale‐up, Spread, and Sustainability (NASSS) framework was applied to the interpretive themes to classify barriers and facilitators to implementation. Results: Five themes were identified: incompatible participation interests; changing standard practice; concerns around clinical management; systemic capacity and capability issues; and Covid‐19 disrupting implementation. Applying the NASSS framework indicated the greatest implementation challenges to arise with the adopters (e.g. patients, clinicians), the organisational systems (e.g. service capacity), and the wider socio‐political context (e.g. Covid‐19 closing services). Conclusions: Our findings emphasise the top‐down impact of systemic‐level research implementation challenges. The impact of the Covid‐19 pandemic accentuated pre‐existing organisational barriers to trial implementation within intensive eating disorder services, further limiting the capacity for research. Highlights: The paper highlights the particular challenges to research implementation that arise within an NHS intensive service context.Applying an implementation science framework to the interpretive themes indicated that challenges to implementation spanned the individual to the systemic level, with the latter posing greater barriers and impacting implementation success in other areas.The results suggest that future research into intensive treatment needs to better accommodate patient preferences and emphasise clinician‐researcher relationships and the alignment of clinical and research teams. [ABSTRACT FROM AUTHOR]

Introduction: An admission to a mental health ward is an uncertain and unexpected part of a person's journey with dementia and consequently, families require information about what to expect and how to prepare. This study aimed to establish the information needs of people with dementia and their families at the point of admission to a mental health ward and to collate existing ward information leaflets to explore if they meet these information needs. Methods: This research was conducted in two parts: (1) a qualitative study using focus groups, one with people with dementia and family carers with lived experience of such an admission (n = 6), and another with Admiral Nurses (n = 6) to explore information needs at the point of admission. (2) Each National Health Service (NHS) mental health trust (n = 67) was asked to provide a copy of their ward information shared at admission. A total of 30 leaflets were received from 15 NHS trusts; after removing duplicates, 22 were included. A content analysis was conducted to evaluate to what extent leaflets met the information needs identified by focus groups. Results: Two main categories 'honest, accurate and up‐to‐date information' and 'who is the information for' and four subcategories were derived from focus group data. Participants felt that people with dementia and their families were likely to have different information needs. Material for people with dementia needed to be in an accessible format. Information should cover the aim of the admission, a timeline of what to expect and details about how families will be involved in care. Practical information about what to pack and ward facilities was valued. Participants spoke about the need to consider the tone of the information, given that people are likely to be distressed. The information leaflets reviewed did not meet the information needs identified by focus group participants. Conclusions: People with dementia and family carers have different information needs at the point of admission to a mental health ward. Information provided to people with dementia needs to be in an accessible format with content relevant to these needs. Wards should aim to co‐create information to ensure that they meet people's information needs. Patient or Public Contribution: This research was supported by a patient and public involvement (PPI) group of people with dementia and carers who have experience in mental health wards. The idea for the study came from the group and was motivated by their experiences. The PPI group helped with the design of the study and took part in the focus groups. The information generated has been written up in this paper, and the knowledge generated has also been used to co‐create a guide for wards on writing their information leaflets and to support the co‐creation of a public information leaflet by Dementia UK about mental health admissions for people with dementia. [ABSTRACT FROM AUTHOR]

The gathering of 'wishes and feelings' in UK child protection proceedings (s.53 Children Act 2004) should highlight the child's opinion of social work intervention and services provided. However, with no statutory social work guidance on participation currently in place, children frequently miss opportunities to be involved in their own child protection planning. This paper is drawn from a 3‐year study into participation in child protection social work. It includes findings from qualitative interviews, and one focus group, with social workers, parents, children and participation workers, from three local authorities in the United Kingdom. The findings revealed some examples of significant gaps in service provision, particularly from the perspective and understanding of the child. The skewed translation of wishes and feelings legislation, along with its subsequent (and often inadequate) application to practice, prevents children from understanding and responding to social work intervention and can lead to idiosyncratic practice. This paper provides recommendations for a practical response to practitioner dilemmas regarding wishes and feelings and bridges the gap between research and practice. [ABSTRACT FROM AUTHOR]

Introduction: British South Asians have a higher prevalence of overweight and obesity than the wider population. Bradford (UK), with its high Pakistani presence and levels of economic deprivation, has exceptionally high instances, especially in deprived areas where many Pakistanis reside. British Pakistani women in Bradford are more likely to be overweight and obese. There is uncertainty on how these women can be aided to manage their weight. Therefore, the objective of this study was to explore the obesity concerns of Pakistani women living in deprived inner‐city areas of Bradford. Methods: Three focus groups interviews were carried out with 23 Pakistani women living in deprived areas of Bradford. Data were analysed thematically. Results: This exploratory study identified a wide range of concerns that women had around managing their weight. Participants disclosed distrust in information given around medication, conflicting dietary information and reported low levels of trust in women‐only organized physical activities. Cultural barriers were identified, which included the gender role of the woman, the lack of culturally appropriate dietary advice, cultural misunderstandings of what constitutes a healthy diet and healthy weight, the lack of culturally suitable exercise facilities and conforming to family and community expectations. Other concerns were language barriers around a lack of understanding, the inability to read Urdu and reliance on others to translate information. Conclusion: These findings have implications for researchers, local authorities, policy makers and others with an interest in reducing the rates of obesity in this population. Recommendations include training health practitioners to be culturally aware of the diet and eating practices of this community, exploring different ways to support socially isolated women to be more physically active at home, addressing physical activity and diet misconceptions and designing obesity management information materials appropriate for a range of literacy levels. Patient or Public Contribution: Public contributors were involved in the development of the interview guide and design of the research. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Interview transcripts were member checked by participants, and participants assisted with data analysis. [ABSTRACT FROM AUTHOR]

This paper reports on a feasibility study for an evaluation of a UK primary school‐based prevention programme that addresses multiple forms of abuse and neglect, identifying research design and ethical issues and exploring research practice. For this feasibility study, 194 children aged 6–11 years completed a baseline survey and 113 did so following the intervention. Eight focus groups were undertaken with 52 children and nine interviews with school staff. We highlight key considerations for conducting large‐scale mixed‐method research on sensitive topics with younger children, a focus that is largely absent from the extant research methods literature. The feasibility study showed that younger children can contribute their views on sensitive topics in ways that are measurable, replicable and reliable, contesting ideas that certain topics are too sensitive to explore with younger children. [ABSTRACT FROM AUTHOR]

Background: Very young children from lower socioeconomic status (SES) backgrounds often show poorer language development. Whilst there have been attempts to provide early intervention programmes, these sometimes miss the most disadvantaged groups. Aims: This report presents preliminary feasibility and effectiveness data for a novel language intervention designed for parents of toddlers in the United Kingdom. Methods and Procedures: In total, 43 UK families of 2–4‐year‐olds were recruited to the study, half of whom completed an 8‐week course (Tots Talking) focussed on parent interaction, and half of whom acted as wait‐list controls. Results and Outcomes: Results suggest that such programmes are feasible for families with 86% staying in the intervention. In addition, greater changes in underlying communication skills such as joint attention and gesture were evident compared to wait‐list controls. Conclusions and Implications: We conclude that pre‐verbal skills may be more important to measure as initial outcomes than language or vocabulary change in this population. What This Paper Adds: What is already known on the subject: Children from lower socioeconomic status (SES) backgrounds are at higher risk of communication difficulties and there is a need for community intervention programmes for very young children. What this study adds: This study suggests that such programmes can be feasible and effective, but that very early/basic communicative skills (such as joint attention) may be boosted first rather than language or vocabulary. What are the clinical implications of this work?: Children's centres and other community services could feasibly run short parent facing courses emphasising contingent communication in low SES families and other diverse groups. These may be more successful run with younger preschoolers. Joint attention may be a better focus of intervention before expecting vocabulary or language change. Community health professionals may find this information useful in referring and supporting families in need. [ABSTRACT FROM AUTHOR]

This paper examines the provision of primary care for young people with an eating disorder within the UK from the perspectives of three key stakeholder groups: young people with an eating disorder, carers of young people with an eating disorder and General Practitioners (GPs). Twenty‐two young people with an eating disorder (aged 16–25) and 10 carers completed qualitative questionnaires or participated in interviews about their experiences of seeking primary care from GPs. Forty‐one GPs participated in either focus groups or interviews about delivering care to young people with eating disorders. Interviews and focus groups were audio‐recorded and transcribed verbatim. All data were then analysed qualitatively using thematic analysis. Our analysis indicates that GPs often felt they lacked the necessary knowledge and/or resources to provide adequate support to young people with an eating disorder who they also often viewed as a "difficult" patient group. Young people and carers expressed mixed but predominantly negative experiences; reporting that GPs often lacked adequate understanding of eating disorder, failed to take participants' concerns seriously, and delayed referring patients to specialist services. Our findings indicate a need for interventions that will improve primary care provision and access to appropriate support for young people with an eating disorder. [ABSTRACT FROM AUTHOR]

Accessible summary: A supported internship is a work placement for people with disabilities that includes spending some time at work and some time at school or college. It usually lasts for a year and people get extra support in the work placement.We wanted to find out how supported internships for people with learning disabilities helped them to feel like they belong in workplaces and society.We found that the supported internships we studied did help people with learning disabilities to feel like they belong. The interns developed self‐confidence, they were able to talk to people more easily, and they learned that they were good at things. This was because the people they worked with saw them as individuals who were able to do helpful things. It was also because of the feedback they got at work and how they worked in different departments.We think there should be more supported internships because they help people with learning disabilities to take the next step in life more confidently. Researchers need to find out more about how supported internships can help people to be socially included. Background: Obtaining employment for young people with learning disabilities remains challenging, and people may not be able to experience work that offers them the opportunity for broader and deeper social inclusion. Supported internships (SIs) offer a possible solution to this problem, providing a bespoke, structured study programme designed for students with disabilities. Methods: This paper explores, through an ecological systems approach, the experiences of three graduates, six interns, two job coaches and three colleagues, from a long running SI in a large private‐sector organisation that delivers utilities in the midlands in the UK. The organisation has many different departments and interns work in several of these, including the mailroom, reprographics, catering, health and safety, reception, and customer services. The researchers conducted small focus groups and interviews with the participants described above. Findings: Thematic analysis identified three core phenomena of relevance to understanding the relationship between the SI programme and interns' experience of deepened and broadened social inclusion. The first theme illustrated positive changes to interns' and graduates' self‐concept (e.g. self‐determination) and participation, the second captured accounts of reciprocity in relationships, and the third contained insights into the SI practices that were relevant to improved social inclusion. Conclusions: The SI did lead to the broadening and deepening of social inclusion for interns and graduates. The person‐centred ethos of the SI, personalised approaches to workplace adaption and feedback policies were practices that began to emerge as implicated in this impact. Positive developments to self‐concept emerged as important in building interns' and graduates' capacities for participation. The study also demonstrated that an ecological systems approach is useful as a basis for conceptualising and investigating changes to the amount and quality of social inclusion, as experienced by people with learning disabilities. [ABSTRACT FROM AUTHOR]

Poor education and employment outcomes have long been associated with care experienced young people transitioning into independence, even after adjusting for prior disadvantage. In the United Kingdom, such young people are generally referred to as care leavers. Policies that aim to reduce the gap between care leavers and noncare experienced young people's success transitioning to employment and independence have had limited success. This paper draws on a qualitative methodology that utilized theories of resilience, to glean a range of perspectives from both care leavers and their employers. All the participants were engaged in a U.K. local authority's initiative to support care leavers into employment. Drawing on resilience theory, resilience was found to be located in a complex interaction between a resilience enabling environment and, crucially, emotionally supportive networks. Uniquely, we argue that emotional support, drawn from such networks, is the key factor that facilitates young people navigating towards such resources, leading to successful outcomes. Previous studies have underplayed this aspect in favour of more tangible resources. Attention to strengthening emotional support networks is thus identified as a significant factor that supports transition to employment and successful independence for care leavers. [ABSTRACT FROM AUTHOR]

Abstract: Since 2014, it has been a legal requirement in England and Wales for child care proceedings to be concluded, apart from “exceptional cases,” within 26 weeks. When this was first proposed, there were concerns that it might lead to poorer decision‐making or to delay being squeezed to either side of the court proceedings, before or afterwards. This paper reports on the messages from a pilot programme to hit the 26‐week target that took place in London in 2012–2013. The study compared the progress of the cases from the pilot year with those the year before, 180 cases in total, involving 256 children. The local authorities involved were able to achieve considerable improvements in timeliness, not just in the proceedings, but for the pre‐ and post‐court processes too; and the quality and fairness of decisions did not seem to be impaired, in terms of the plans for the children and subsequent outcomes over a period of 2 years. “Targets” do not generally find a warm welcome in the social work literature, but this paper shows that when collaboratively implemented, with a measure of flexibility and adequate resources, they can be an effective way of helping to achieve positive change. [ABSTRACT FROM AUTHOR]

Complementary feeding practices and adherence to health recommendations are influenced by a range of different and often interrelating factors such as socio‐economic and cultural factors. However, the factors underlying these associations are often complex with less awareness of how complementary feeding approaches vary across the UK's diverse population. This paper describes a qualitative investigation undertaken in a deprived and culturally diverse community in the UK which aimed to explore parents' knowledge, beliefs and practices of complementary feeding. One hundred and ten mothers and fathers, self‐identified as being White British, Pakistani, Bangladeshi, Black African/Caribbean or Polish took part in twenty‐four focus group discussions, organised by age group, sex and ethnicity. The findings revealed that most parents initiated complementary feeding before the World Health Organisation (WHO) recommendation of 6 months. Early initiation was strongly influenced by breast feeding practices alongside the extent to which parents believed that their usual milk; that is, breastmilk or formula was fulfilling their infants' nutritional needs. The composition of diet and parents' approach to complementary feeding was closely aligned to traditional cultural practices; however, some contradictions were noted. The findings also acknowledge the pertinent role of the father in influencing the dietary practices of the wider household. Learning about both the common and unique cultural feeding attitudes and practices held by parents may help us to tailor healthy complementary feeding advice in the context of increasing diversity in the United Kingdom. [ABSTRACT FROM AUTHOR]

Background: During the 2020 COVID‐19 pandemic, one of the key components of many countries' strategies to reduce the spread of the virus is contact tracing. Objective: To explore public attitudes to a COVID‐19 contact tracing app in the United Kingdom. Setting: Online video‐conferencing. Participants: 27 participants, UK residents aged 18 years and older. Methods: Qualitative study consisting of six focus groups carried out between 1st‐12th May, 2020 (39‐50 days into the UK 'lockdown'). Results: Participants were divided as to whether or not they felt they would use the app. Analysis revealed five themes: (1) lack of information and misconceptions surrounding COVID‐19 contact tracing apps; (2) concerns over privacy; (3) concerns over stigma; (4)concerns over uptake; and (5) contact tracing as the 'greater good'. Concerns over privacy, uptake and stigma were particularly significant amongst those stated they will not be using the app, and the view that the app is for the 'greater good' was particularly significant amongst those who stated they will be using the app. One of the most common misconceptions about the app was that it could allow users to specifically identify and map COVID‐19 cases amongst their contacts and in their vicinity. Conclusions: Our participants were torn over whether digital contact tracing is a good idea or not, and views were heavily influenced by moral reasoning. Patient or Public Contribution: No patients were involved in this study. The public were not involved in the development of the research questions, research design or outcome measures. A pilot focus group with participants not included in the present paper was used to help test and refine the focus group questions. Summary results were disseminated via email to participants prior to publication for feedback and comment. [ABSTRACT FROM AUTHOR]

This paper draws on a British Academy (BA) funded study exploring social workers' conceptions of family using a vignette and focus groups. The policy context is discussed and the data from the BA study are then compared and contrasted with families' accounts of their own situations using the data from a separate qualitative study about child protection social work. The paper discusses the themes emerging and argues for a renewed focus on theorizing family in children's social work and the implications for practice. [ABSTRACT FROM AUTHOR]

In healthcare settings, there is an emotional cost to caring which can result in compassion fatigue, burnout, secondary trauma, and compromised patient care. Innovative workplace interventions such as the Schwartz Rounds offer a group reflective practice forum for clinical and non‐clinical professionals to reflect on the emotional aspects of working in health care. Whilst the Rounds are established in medical health practice, this study presents an evaluation of the Rounds offered to mental health services. The Rounds were piloted amongst 150 mental health professionals for 6 months and evaluated using a mixed‐methods approach with standardized evaluation forms completed after each Round and a focus group (n = 9) at one‐month follow‐up. This paper also offers a unique six‐year follow‐up of the evaluation of the Rounds. Rounds were rated as helpful, insightful, and relevant, and at six years follow‐up, Rounds were still rated as valuable and viewed as embedded. Focus groups indicated that Rounds were valued because of the opportunity to express emotions (in particular negative emotions towards patients that conflict with the professional care‐role), share experiences, and feel validated and supported by colleagues. The findings indicate that Schwartz Rounds offer a positive application in mental healthcare settings. The study supports the use of interventions which provide an ongoing forum in which to discuss emotions, develop emotional literacy, provide peer support and set an intention for becoming a more compassionate organization in which to work. [ABSTRACT FROM AUTHOR]

Adverse childhood experiences (ACEs) have been associated with negative mental and physical health consequences. Neighbourhood police officers (NPOs) are thought to be well placed to identify and support children experiencing ACEs. Within this paper, we describe a qualitative exploration of an initiative deployed by a large UK police force which aimed to aid early identification of young people with ACEs using police data and provide subsequent support given by NPOs. A thematic analysis was conducted using transcripts from three focus groups of NPOs, supplemented by questionnaires. Key themes identified in both sets of data offer reflections for policing and other public service provision seeking to target on the basis of ACEs, including: limitations in the usefulness of police data to identify childhood adversity; challenges using the ACEs framework as a means to target such 'early intervention'; and debates regarding the appropriate role of the police in supporting young people in adversity. Prior to replication of this intervention elsewhere, there are several points to consider: whether police data alone are sufficient in identifying ACEs; ensuring clarity regarding the role of the public sector agencies in such intervention; and determining an apt measure of success for the scheme. Key practitioner messages: Modelling using only police data can provide insight into the population of children who may have suffered from ACEs but may not provide significant opportunities for early interventionThere is a clear need for defining the role of UK police forces in the delivery of early interventionIt is evident that multi‐agency working/data sharing is crucial to preventing the duplication of referrals and interventions conducted with young people who have experienced ACEs 'There is a clear need for defining the role of UK police forces in the delivery of early intervention' [ABSTRACT FROM AUTHOR]

Over 20 years of research has enhanced our understanding about the methodological and ethical benefits and challenges of involving children and young people in research. Concurrently, the increasing bureaucratisation of research ethics governance within UK universities has reified expectations about the methods used to gain informed consent for research participation. This paper explores how social researchers in the UK are navigating this tension and whether there is any scope for innovation through the use of technologies in how children and young people provide informed consent to take part in research. We conclude there is a need for the co‐creation of research information with children and young people and greater transparency by sharing creative solutions. [ABSTRACT FROM AUTHOR]

This article uses a socio‐material approach, social practice theory, to provide new insights into the self‐management of chronic illness. It demonstrates how this theory can bridge arguments about the respective roles of social and individual influences, and how it can foreground an oft‐overlooked aspect of the issue – the demands of self‐care technologies and consequences for participation in social life. Drawing on interviews and focus groups with 25 young type‐1 diabetes outpatients in London, UK, the study points to the conflicts that occur when disease management technologies compete for time and space with the social practices of everyday life, and when self‐care tasks threaten to interrupt the flow of social life and make people feel 'left behind'. The paper concludes that young people are disabled by the contingent position of self‐care activities in daily life, which oblige them to compromise either their physical health or their immersion in the social world. This disabling effect would be mitigated if social practices were reorganised to make them more amenable to the time‐space requirements of disease management. A social practice theory lens can help throw light onto this issue and make a valuable contribution to the study of the self‐management of chronic illness. [ABSTRACT FROM AUTHOR]

Although research on the experiences of unaccompanied asylum‐seeking young people in the UK has grown steadily in recent years, their experience of fostering and of the role played by foster carers in helping their adjustment have been neglected. This paper reports findings from the first UK study into these experiences, describing issues arising from initial assessment and preparation for fostering and the ways in which young people and foster carers adjusted to their lives together. It assesses the progress made by young people during placement, the strategies that appeared helpful to relationship building, and the extent to which young people had become integrated within the wider network of family relationships. Given that most young people first arrive as teenagers, it also considers the ways in which foster carers and social workers helped young people prepare for adult life in the context of uncertainties arising from the asylum process. [ABSTRACT FROM AUTHOR]

Rationale aims and objectives Problems exist with Do Not Attempt Cardiopulmonary Resuscitation ( DNACPR) orders: they are often misinterpreted by clinicians to mean that other treatments should be withheld; resuscitation decision discussions are difficult; patients remain inappropriately for resuscitation. We developed an alternative approach. Methods An adapted Delphi method was used. Senior clinicians were interviewed about the strengths and weakness of current practice. Teams who had initiated alternative approaches internationally were contacted. Focus groups were conducted with doctors, nurses and patients to further understand problems with DNACPR orders and establish essential aspects of a new approach. A behavioral economist and management consultant contributed advice. The resulting form was recirculated and further refined. It was: snowballed out to others with specialist expertise (palliative care physicians, intensivists, etc) for further feedback; assessed in simulated clinical encounters before being piloted; further adjusted once in clinical practice. In parallel, a patient information leaflet was developed along with education materials. Results Consensus was achieved that the new approach should: be universal; have discussions and clinical conditions documented first; clarify goals of overall treatment (active treatment or optimal supportive care); contextualize the resuscitation decision among other treatment decisions; have a free text box for 'opting out' of invasive treatments, rather than tick boxes; be green; be limited to one page. Conclusions The Universal Form of Treatment Options was developed iteratively with patients, doctors and nurses as an alternative approach to resuscitation decisions. This paper illustrates a cross-disciplinary approach to developing practical alternatives in health care. [ABSTRACT FROM AUTHOR]

Assent guidelines currently fail to include an assessment of a child's decision‐making ability, experience and interest. This paper summarises a two‐stage study, conducted in the United Kingdom, exploring perspectives on children's decision‐making power and ability within their family, as an indicator for overall decision‐making readiness. Children desired to make some decisions but knew their parents held ultimate authority. Parents believed their children could make some decisions and actively trained them through involvement in daily decisions. Researchers should strive to include children in enrolment decisions to some degree, based on a consideration of their expectations for involvement informed by their daily family context. [ABSTRACT FROM AUTHOR]

Accessible summary:: “Learning disability” replaced the outdated term, “mentally handicapped” in the UK over 20 years ago. Recently, some services and professionals have been using the term “intellectual disability” instead. In America, “intellectual disability” has been chosen to replace the old term, “mental retardation.” There has been lots of explanation why this has happened. In the UK, there has not been much explanation. It is important to know what terms mean and why they are being used because their use affects the lives of people with learning disabilities. This article looks at what different people in the UK think about term “intellectual disability.” Abstract: Background: The term “intellectual disability” is increasingly used to refer to people with learning disabilities in British learning disability policy, practice and research. This change is undoubtedly a reflection of the changing international context. The inclusion of the term “intellectual disability” has been particularly pronounced in countries such as the USA. By contrast, this change has been relatively silent in England. Methods: In light of this, the paper explores the discussions of 12 focus groups conducted with professional and lay groups working in or influencing learning disability research and practice in England. Each focus group was asked the following two questions: Have you heard of the term “intellectual disability” and how do you feel about the term “intellectual disability?.” Discussion and Conclusion: Thematic analysis of the discussions identified four dominant themes: dislike and disbelief; ambiguity; tautology; and fear. It is concluded that more explanation is required in order for researchers and practitioners in England to understand this semantic change. [ABSTRACT FROM AUTHOR]

Background: Patient and public involvement and engagement (PPIE) have long been considered important to good research practice. There is growing, yet diverse, evidence in support of PPIE with children and young people (CYP). We must now understand the various approaches to involvement of CYP in research. Aims: This rapid umbrella review aimed to provide an overview of when, how and to what extent CYP are involved in the conduct of health research, as well as the reported benefits, challenges, and facilitators of involvement. Methods: We searched OVID Medline, Embase and PubMed. Published reviews were included if they reported meaningful involvement of CYP in the conduct of health research. Extracted data were synthesised using thematic analysis. Results: The 26 reviews included were predominately systematic and scoping reviews, published within the last decade, and originating from North America and the United Kingdom. CYPs were involved in all stages of research across the literature, most commonly during research design and data collection, and rarely during research funding or data sharing and access. Researchers mostly engaged CYP using focus groups, interviews, advisory panels, questionnaires, and to a lesser extent arts‐based approaches such as photovoice and drawing. Visual and active creative methods were more commonly used with children ≤12 years. The evidence showed a shared understanding of the benefits, challenges, and facilitators for involvement of CYP, such as time and resource commitment and building partnership. Conclusion: Overall, the review identified consistency in the range of methods and approaches used, and stages of research with which CYP are commonly involved. There is a need for more consistent reporting of PPIE in the literature, both in terminology and detail used. Furthermore, the impact of approaches to CYP involvement on research and community outcomes must be better evaluated. Patient/Public Contribution: This review forms part of broader research initiatives being led by the authors. Together, these projects aim to support embedding of child voices in research practice and to explore the desirability and suitability of Young Persons Advisory Groups within birth cohort studies. The findings from this review, alongside public and stakeholder consultation, will inform development of resources such as practice recommendations to guide future involvement of CYP in health research undertaken at the author's respective institutions. [ABSTRACT FROM AUTHOR]

Community involvement in archaeological digs aims to reconnect people with the history and heritage of where they live. This paper applies social psychological theories to understand how community archaeological projects create opportunities for place-based social identity and positive intergroup relations. Focus groups were conducted across five areas of Greater Manchester (UK) with 24 participants who volunteered for Dig Greater Manchester, a community archaeology initiative. The focus groups aimed to understand how experiences of participating in digs and exploring local heritage modified, strengthened or initiated identification with place and community, thus moving from individual levels to social levels of identity. The findings offer insight as to the ways in which people make sense of their own-and others'-place-based social identities as a result of participating in community archaeological digs . Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Care leavers constitute a small but important minority of social work students. Their dual role as previous ‘consumers’ of care and students is of inherent interest to both those involved in social work education and providers of social work services. This paper discusses a small research project that explored the experiences of such students through semi‐structured interviews. One theme that reoccurred in the analyses of the interview transcripts was how the students managed their identities, through the time that they were in care, in the period having left care and having been accepted on a social work course. What the interviewees had to say about their care and subsequent life experiences is worthy of consideration in terms of its implications for the delivery of social work education generally and how care leavers on social work courses should be treated by academics and on placement particularly. [ABSTRACT FROM AUTHOR]

Parental mental illness (PMI) can negatively affect the lives of all family members, and there is acknowledged need to work with family and social contexts to promote recovery. However, programmes undertaking such work remain rare and knowledge concerning mechanisms through which PMI impacts families and through which recovery might be achieved is underdeveloped. This paper outlines a new family intervention programme and presents evidence from focus groups with 16 professionals into their experiences of work with families with PMI. Evidence suggests that interactional effects of PMI, family communication and family relationships are key to understanding its impacts, but professionals are liable to struggle to engage with these due to concerns over stigma, lack of skills and low confidence. Positive impacts on practice were achieved through raising awareness of the whole‐family context in relation to PMI, building confidence to raise and engage with PMI and the provision of structured tools for use with families. Positive impacts on the lives of family members were then achieved by professionals in relation to symptoms for the ill parent, the burden on children and overall family well‐being, strongly mediated through improved family communication, understanding and relationships. Implications for policy and practice are considered. [ABSTRACT FROM AUTHOR]

Background and aims Regulation of electronic cigarettes has moved to the top of the addiction policy agenda, as demonstrated by the recent focus across the United Kingdom on introducing age-of-sale restrictions. However, the views of those affected by such regulation remain largely unexplored. This paper presents the first detailed qualitative exploration of adolescents' perceptions of existing, and opinions about potential e-cigarette regulation. Methods Sixteen focus groups, including a total of 83 teenagers between the ages of 14 and 17 years, were conducted in deprived, mixed and affluent urban areas in Scotland and England between November 2014 and February 2015. Transcripts were imported into Nivivo 10, coded thematically and analysed. Results Participants critically considered existing evidence and competing interests in regulatory debates and demonstrated sophisticated understanding of the advantages and disadvantages of regulation. They overwhelmingly supported strong e-cigarette regulation and endorsed restrictions on sales to minors, marketing and e-cigarette use in public places. Concern about potential health harms of e-cigarette use and marketing increasing the acceptability of vaping and smoking led these adolescents to support regulation. Conclusions In focus group discussions, a sample of UK adolescents exposed to particular communications about e-cigarettes supported strict regulation of e-cigarettes, including banning sales to minors and use in indoor public areas. [ABSTRACT FROM AUTHOR]

Leisure walking has known benefits to public health, from both physical and psychological viewpoints. Complementing traditional print information sources, dedicated online platforms and apps provide tools to search, discover, plan and share routes. While walking routes are highly heterogeneous in terms of their properties and geographical context, current platforms adopt simple representations of basic attributes. In this article, we report on a research project at the Ordnance Survey on the representation and recommendation of walking routes, which comprises the following contributions. Firstly, we outline a theoretical framework of leisure walking, intersecting its individual, social and environmental dimensions. Secondly, analysing about 4 million user‐generated walking routes produced in Great Britain, we characterise routes combining primary attributes and contextual information, including land cover and points of interest. Thirdly, by applying unsupervised learning to this data model, we produce the Walking Route Classification. This classification is methodologically similar to geo‐demographic classifications and identifies groups and supergroups of similar routes in a large multidimensional attribute space. This body of work is evaluated through a survey and a focus group with experts, showing encouraging results. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the parent‐proxy version of the pediatric Charcot Marie Tooth specific quality of life (pCMT‐QOL) outcome instrument for children aged 7 or younger with CMT. We have previously developed and validated the direct‐report pCMT‐QOL for children aged 8–18 years and a parent proxy version of the instrument for children 8–18 years old. There is currently no CMT‐QOL outcome measure for children aged 0–7 years old. Methods: Testing was conducted in parents or caregivers of children aged 0–7 years old with CMT evaluated at participating INC sites from the USA, United Kingdom, and Australia. The development of the instrument was iterative, involving identification of relevant domains, item pool generation, prospective pilot testing and clinical assessments, structured focus group interviews, and psychometric testing. The parent‐proxy instrument was validated rigorously by examining previously identified domains and undergoing psychometric tests for children aged 0–7. Results: The parent‐proxy pCMT‐QOL working versions were administered to 128 parents/caregivers of children aged 0–7 years old between 2010 and 2016. The resulting data underwent rigorous psychometric analysis, including factor analysis, internal consistency, and convergent validity, and longitudinal analysis to develop the final parent‐proxy version of the pCMT‐QOL outcome measure for children aged 0–7 years old. Conclusions: The parent‐proxy version of the pCMT‐QOL outcome measure, known as the pCMT‐QOL (0–7 years parent‐proxy) is a valid and sensitive proxy measure of health‐related QOL for children aged 0–7 years with CMT. [ABSTRACT FROM AUTHOR]

Charcot‐Marie‐Tooth disease (CMT) reduces health‐related quality of life (QOL) in children. We have previously developed and validated the English and Italian versions of the pediatric CMT‐specific QOL outcome measure (pCMT‐QOL) for children aged 8 to 18. There is currently no parent‐proxy CMT QOL outcome measure for use in clinical trials, which could provide complementary information in these children and adolescents. This study describes the validation studies conducted to develop the parent‐proxy version of the pCMT‐QOL outcome measure for children aged 8 to 18 years old. Development and validation of the parent‐proxy version of the pCMT‐QOL outcome measure for children aged 8 to 18 years old was iterative, involving identifying relevant domains, item pool generation, prospective pilot testing and clinical assessments, structured focus‐group interviews, and psychometric testing, conducted on parents of children with CMT seen at participating sites from the USA, United Kingdom, and Australia. We utilized previously described methods to develop a working parent‐proxy version of the pCMT‐QOL measure. From 2010 to 2016, the parent‐proxy pCMT‐QOL working version was administered to 358 parents of children with CMT aged 8 to 18, seen at the participating study sites of the Inherited Neuropathies Consortium. The resulting data underwent rigorous psychometric analysis, including factor analysis, test‐retest reliability, internal consistency, convergent validity, IRT analysis, and longitudinal analysis, to develop the final parent‐proxy version of the pCMT‐QOL outcome measure for children aged 8 to 18 years old. The parent‐proxy version of the pCMT‐QOL outcome measure is a reliable, valid, and sensitive proxy measure of health‐related QOL for children aged 8 to 18 with CMT. [ABSTRACT FROM AUTHOR]

Introduction: As children with long‐term conditions (LTCs) mature, they are usually expected to assume responsibility from their parents for self‐management of their condition. Little is known about what supports families with this handover of responsibility, including the role of healthcare professionals (HCPs). This study aimed to explore what supports young people with chronic kidney disease (CKD) to assume self‐management responsibility and parents to relinquish control. Methods: A qualitative study, using a grounded theory approach was conducted. Individual and dyadic interviews and focus groups were carried out with 16 young people aged 13–17 years old with CKD, 13 parents, and 20 HCPs. Participants were recruited from two UK children's renal units. Findings: Building and maintaining trust, fostering positivity, learning from mistakes, forming partnerships and individualized support, facilitated the transfer of self‐management responsibility. However, HCPs' focus on developing partnerships with young people meant some parents felt excluded, highlighting uncertainty around whether support should be child‐ or family‐centred. Although tailored support was identified as critical, aspects of local service provision appeared to impact on HCPs' capacity to implement individualized approaches. Conclusion: This study has identified what supports the handover of responsibility, and, importantly, HCPs' current, and potential role in helping young people to assume responsibility for managing their LTC. Further research is needed to explore how HCPs' involvement balances child‐ and family‐centred care, and how HCPs can adopt personalized, strengths‐based approaches to help ensure the support that families receive is tailored to their individual needs. Patient or Public Contribution: Patient and public involvement was integrated throughout the study, with young adults with CKD and parents who had a child with CKD actively involved in the study's design and delivery. [ABSTRACT FROM AUTHOR]

One way of tackling hazardous alcohol consumption is introducing warning labels on alcohol products. This research explores three under‐researched message content areas in relation to alcohol warning labels: negative/positive framing of the message; use of signal words and qualifiers and type of information used in the message (qualitative or quantitative), across message themes that depict social or health consequences. A qualitative and exploratory approach was undertaken using five focus groups of UK undergraduate students followed by 15 semi‐structured interviews with UK adults. Discussions centred around responses to the alcohol warning labels that varied in message content characteristics. The students also created their own warning label designs based on what they believed would be useful for encouraging students to keep to low‐risk drinking guidelines. Findings across both samples revealed a preference for negatively (loss) framed health messages that elicit fear and use evidence‐based reasoning and statistics. The avoidance of signal words (e.g. 'government warning') and qualifiers (e.g. may cause) would likely make the messages more persuasive. Our findings contribute to understanding the influence of message content on consumer responses to alcohol warning labels. However, such message content characteristics are inherent in the design of many product warnings and our findings may apply to other contexts. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disability often receive diagnoses which may complicate their clinical care. Among these, personality disorder diagnoses are still considered contentious. Little is also known on the perspectives of staff caring for people with intellectual disability who have received a personality disorder diagnosis. Methods: Three focus groups were carried out to explore 15 healthcare professionals' subjective experiences of working with people with intellectual disability who also have a recorded additional diagnosis of personality disorder. Data were analysed through thematic analysis. Findings: Four overarching themes were identified: (a) diagnostic issues and the need for person‐centred approaches; (b) challenges and adjustments to working with combined intellectual disability and PD diagnoses; (c) the importance of multidisciplinary team training, support, and cohesion; (d) provision issues and barriers to service access. Conclusions: The themes are outlined in depth and a number of implications for clinical management and service improvement are discussed. [ABSTRACT FROM AUTHOR]

There have been several arguments for the need to generate evidence‐based creative forms of psychological interventions in Improving Access to Psychological Services (IAPT), the main primary mental health provider in hospitals in England, UK. In this feasibility study, we sought to identify helpful and unhelpful factors of a new creative group psychotherapy, titled Arts for the Blues. We also wanted to find out whether the research tools used were acceptable and sensitive. We therefore engaged a group of seven patients attending an IAPT service in the North West of England, and a group of six staff working in the same service, to attend one creative workshop each, followed by a focus group. The two focus groups were transcribed and analysed using thematic analysis. We also collected pre‐ and post‐measures of depression (PHQ‐9) and anxiety (GAD‐7), measures commonly used in IAPT services, plus measures of well‐being (WHO‐5), the PANAS, and goal‐setting, which were considered for acceptability and sensitivity. We received largely positive responses from service users and staff in the use of creative methods in psychotherapy. Although the measures used had limitations due to the short duration of one‐off creative workshops, we found that they were sensitive enough, easy to complete and, thus, were acceptable. We concluded that Arts for the Blues is a promising intervention in IAPT, especially since it is shaped by service users and staff working in these services. Further work is needed to establish the effectiveness of this new intervention. [ABSTRACT FROM AUTHOR]

Introduction: There is limited research exploring how smoking cessation treatment should be implemented into lung cancer screening in the United Kingdom. This study aimed to understand attitudes and preferences regarding the integration of smoking cessation support within lung cancer screening from the perspective of those eligible. Methods: Thirty‐one lung cancer screening eligible individuals aged 55–80 years with current or former smoking histories were recruited using community outreach and social media. Two focus groups (three participants each) and 25 individual telephone interviews were conducted. Data were analysed using the framework approach to thematic analysis. Results: Three themes were generated: (1) bringing lung cancer closer to home, where screening was viewed as providing an opportunity to motivate smoking cessation, depending on perceived personal risk and screening result; (2) a sensitive approach to cessation with the uptake of cessation support considered to be largely dependent on screening practitioners' communication style and expectations of stigma and (3) creating an equitable service that focuses on ease of access as a key determinant of uptake, where integrating cessation within the screening appointment may sustain increased quit motivation and prevent loss to follow‐up. Conclusions: The integration of smoking cessation into lung cancer screening was viewed positively by those eligible to attend. Screening appointments providing personalized lung health information may increase cessation motivation. Services should proactively support participants with possible fatalistic views regarding risk and decreased cessation motivation upon receiving a good screening result. To increase engagement in cessation, services need to be person‐centred. Patient or Public Contribution: This study has included patient and public involvement throughout, including input regarding study design, research materials, recruitment strategies and research summaries. [ABSTRACT FROM AUTHOR]

Forced marriage is recognised as a form of child abuse in the UK. Despite evidence that this is a growing problem, there is little current research concerning the responses of child protection practitioners. This article is based on a study that explored the views and experiences of a range of practitioners who had been involved with safeguarding children with respect to forced marriage. Ten semi‐structured interviews were carried out, followed by two focus groups (n = 13); these explored the challenges and best practice related to working with children at risk of or in forced marriage situations. The findings highlighted the complex nature of the work and the particular vulnerability of children affected by forced marriage. The study found that practitioners struggled to respond effectively when guidance was unclear or when they had limited knowledge and experience of forced marriage. Effective practice was associated with a high standard of interagency work locally and with practitioners who had confidence and experience and were able to work proactively and assertively. Key Practitioner Messages: Effective practice responses to forced marriage require clearer national and local policy and guidance.Knowledgeable, confident and proactive staff enable good‐quality risk assessments and service responses.Practitioner training and development should include enhancing cultural competence and confidence when working with marginalised/BME families.Forced marriage is a nuanced, complex and diverse issue affected by high levels of vulnerability in children and young people. [ABSTRACT FROM AUTHOR]

Background: Postoperative complications contribute to unplanned hospital readmissions, reoperations, and increased mortality for surgical patients. Discharge education for general surgical patients is often inadequate, and challenged by organizational, clinician and patient factors. Purpose: This research describes the development of the web‐based discharge education intervention to improve patients' knowledge, skills, and confidence in self‐managing their recovery after general surgery. Methods: The intervention was informed by the UK Medical Research Council guidance for developing and evaluating complex interventions and Knowledge‐to‐Action framework, consisting of four iterative stages. Stakeholder engagement was undertaken throughout the development process and a logic model was utilized to map the working mechanism of the intervention. The concept of patient activation and Knowles adult learning theory underpinned the development process. Results: The literature review and stakeholders' engagement in qualitative interviews and a series of meetings resulted in a web‐based discharge education program with three different components: (1) post general surgery warning signs; (2) post general surgery everyday care instructions; and (3) animation video on wound potential wound complications. Conclusion: The web‐based discharge education was developed according to the needs and preferences of healthcare providers and general surgical patients. Despite the rigorous and systematic approach used to develop the intervention, its effectiveness requires testing. Clinical relevance: This comprehensive iterative approach serves as a guide for others planning web‐based interventions designed for surgical patients and the research approach used may inform those developing web‐based interventions for other patient groups. [ABSTRACT FROM AUTHOR]

Introduction: Advanced practice roles for allied health professionals continue to expand and provide key services within pathways of care for patients with musculoskeletal conditions. Despite the extensive utilisation of these roles and previously reported high patient satisfaction, little is understood about how these practitioners interact with their patients and the factors that influence decision‐making conversations. Study: A qualitative study utilised Interpretive Phenomenological Analysis (IPA) to explore the decision‐making process occurring between Advanced Practitioners (APs) and their patients in a musculoskeletal service. AP data were collected through focus groups and analysed using IPA methodology. Conclusions: Advanced practice decision‐making is a complex process and APs exhibit a range of styles, from paternalistic to shared decision‐making. APs may have a personal preference, but exhibit the ability to flex between styles in consultations. Multiple themes emerged from the data that influenced the decision‐making process, including AP staff understanding the importance of patient expectations and the complex factors that influence patient interactions. It is important that clinicians have an awareness of the multiple factors that contribute to the decision‐making process. [ABSTRACT FROM AUTHOR]

Aims: To develop a core outcome set for trials investigating interventions to prevent stillbirth. Materials & Methods: Outcomes identified from a systematic literature review and semi‐structured interviews with parents in Australia and the UK were entered into a two‐round online Delphi survey and focus group/consensus meetings. Results: A core outcome set containing 11 outcomes in two categories. Five outcomes were related to the mother; fetal loss, onset of and mode of delivery, maternal mortality or near miss, psychological and social impact on the women, women's knowledge. Six outcomes were related to the baby; timing of stillbirth, neonatal mortality, gestational age at delivery, birthweight, congenital anomaly, NICU/SCBU or other higher‐level neonatal care length of stay. Conclusions: Implementation and dissemination of this core outcome set in future trials will contribute towards coordinated outcome reporting and advancing usefulness of research to guide clinical practice. [ABSTRACT FROM AUTHOR]

Aim: The provision of information to patients is an important part of recovery after colorectal surgery. This study aimed to define patient information needs, barriers to effective understanding and insights into how information provision may be improved. Method: A patient focus group was convened. This comprised a broad, convenience sample of 11 participants from across the United Kingdom with experience of major colorectal surgery. A semistructured topic guide was used to facilitate discussion about previous experiences of information provision and how this may be improved. Data were analysed thematically and are presented as major themes. Results: Overall, participants felt that their information needs are poorly prioritized by healthcare professionals. Barriers to understanding and retaining information include highly emotional situations (such as receiving bad news) and inappropriate information design (such as the use of inaccessible language). Participants expressed how information resources should: (a) address patients' individual information needs; (b) empower patients to take an active role in their recovery; (c) support patients with meaningful education and sign‐posted resources; and (d) recognize patients' heightened need for information during recovery at home. Conclusion: This study provides key insights into the information needs of patients undergoing colorectal surgery. These should inform the development of future information resources, whose format, timing and design are currently supported by low‐quality evidence. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages: Closed, often tight‐knit army communities can potentially provide protective factors for children; however, this environment can make it difficult to seek help or to speak out when there are concerns about children's safety or wellbeing.The needs and experiences of non‐serving parents (often female partners) can be overlooked unless, or until, child protection concerns are serious.Army‐connected children benefit from accessing army and civilian health, education and welfare services; however, transitions and communication between these services need to be improved. [ABSTRACT FROM AUTHOR]

Some women with severe perinatal mental health difficulties in England are cared for by acute home treatment services, known as Crisis Resolution Teams (CRTs), which provide short‐term home‐based treatment for adults experiencing a mental health crisis. Intensive home treatment has been trialed in a number of countries, but it is not known how well suited it is to the needs of perinatal women. This qualitative study aimed to explore how women and practitioners experience the provision of intensive home treatment for perinatal mental health problems. Semi‐structured interviews were conducted with women who had received intensive home treatment in the perinatal period (n = 15), and focus groups were held with practitioners working in CRTs or in specialist perinatal mental health services (3 groups, n = 25). Data were analysed thematically. Women commonly found intensive home treatment problematic, experiencing it as intrusive and heavily risk‐focused, with poor staff continuity and little tailoring to the perinatal context. However, women valued emotional support when provided, particularly when it had a perinatal focus, sometimes based on practitioners sharing their own experiences. Some women also appreciated avoiding hospital admission, but choice was often limited. Practitioners reported a lack of perinatal training among CRT staff and described difficulties tailoring treatment to perinatal women's needs. Currently, intensive home treatment, as offered by CRTs, may not be well suited to women with perinatal mental health difficulties. Findings suggest a need to develop community crisis responses that are better tailored to the needs of this population. [ABSTRACT FROM AUTHOR]

Globally, the exodus of individuals who have been forced to flee their home and seek refuge in countries of safety has led to a refugee crisis. The United Kingdom (UK) has engaged with the United Nations High Commissioner for Refugees (UNHCR) in playing a significant role in the long‐term resettlement of refugees, half of whom are children and young people. One initiative of such humanitarian resettlement is the Gateway Protection Programme (GPP). To date, there is a dearth of studies investigating aspects of acculturation that affect the mental health of young refugees resettled under the UNHCR humanitarian programme. This study aimed to explore aspects of acculturation that could enhance the mental health of GPP young refugees several years after resettlement. Using narrative research, a purposive sample of 31 GPP young refugees, who had a minimum of three‐year stay in the UK, were recruited from local refugee community organizations. Data were collected through a multi‐method design combining focus group discussions (FGDs) with visual arts‐based narrative research (VABNR) and analysed thematically. Three overarching themes emerged: People and places; Its nearly all new to me; and Finding self. This study contributes important knowledge regarding the mental well‐being of young people who have engaged in a resettlement programme and offers valuable information for policymakers and mental health professionals working with GPP young refugees. [ABSTRACT FROM AUTHOR]

Background: People with intellectual disabilities are at increased risk of forced marriage compared to those without intellectual disabilities. In the UK, this risk is particularly, though not exclusively, associated with South Asian communities and is linked to the desire to secure long‐term care. Method: Focus groups and semi‐structured interviews were undertaken with South Asian parents and family carers (n = 22) of adults with intellectual disability and the resultant data thematically analysed. Results: Although securing care for their intellectually disabled relative was identified as a key motivator for forced marriage, other important themes also emerged. These included cultural and religious beliefs about disability and marriage, and limited understanding of relevant laws. Factors militating against forced marriage were also identified, including fears of abuse and neglect. Conclusions: Implications for the provision of services and the need for improved access to information on forced marriage of people with intellectual disabilities are highlighted. [ABSTRACT FROM AUTHOR]