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Despite the public health implications of language difficulties associated with social disadvantage, there is a dearth of effectiveness studies investigating the effects of targeted speech and language programmes in this area.To determine the effects of a targeted selective community-based child language intervention programme (Happy Talk), which simultaneously engaged with parents and early childhood educators, in the Republic of Ireland.A mixed methods methodology was applied with quantitative outcome and qualitative process data collected. Effectiveness was examined using a quasi-experimental single blind study design comparing Happy Talk with 'usual care' across four preschools. Qualitative process data were also gathered to examine the acceptability and feasibility of the Happy Talk approach in practice, and to identify factors to improve the probability of successful wider implementation. Child language (PLS-5) and quality-of-life measures were administered pre- and immediately post- the 11-week intervention. Responsiveness was assessed as the parental outcome, and the oral language environment of preschools was measured using the Communication Supporting Classroom Observation Tool (CSCOT). Retrospective acceptability was analysed with reference to the theoretical framework of acceptability (v 2).Pre-/post-expressive and composite language scores were collected for 58 children, and receptive scores for 54 children. Multiple linear regression revealed significant intervention effects for comprehension and total language with large and moderate effect sizes, respectively (0.60 and 0.46 SD). No significant effect was shown for parental responsiveness. No effects were found for the preschool environment or children's quality of life. Preschool staff deemed the programme to be an acceptable method of enhancing children's speech and language skills and rated the intervention positively.The Happy Talk pilot effectiveness trial shows that comprehension can be improved (with a large effect) in preschool children from areas of social disadvantage, following an 11-week intervention, in which parents and preschool staff are simultaneously engaged. The ecological validity of the programme, as well as feasibility and acceptability to staff, make it a suitable programme to be delivered at scale.What is already known on the subject Up to 50% of children from socially disadvantaged areas enter preschool with speech and language difficulties. The majority of intervention studies are (1) researcher led; (2) efficacy trials carried out in ideal conditions; and (3) focus on working with parents or early childhood educators rather than engaging with both groups simultaneously. Many studies omit child language outcomes, and those that include them tend to show relatively modest effects for expressive language and negligible effects for receptive language. What this paper adds to existing knowledge This pilot study shows that the Happy Talk programme, which is embedded in the community and which simultaneously engages with parents and early childhood educators, is highly effective in improving children's receptive language skills. These findings are particularly important in the context of (1) the study taking place in real world conditions; and (2) the programme being designed and refined by speech and language therapy services, rather than one which is researcher led. What are the potential or actual clinical implications of this work? Implementing an 11-week targeted selective community-based language intervention can result in a large positive effect on receptive language for children from areas of social disadvantage. The study findings highlight the importance of embedding intervention programmes in the community and of simultaneously engaging with parents and preschool staff.

Social factors have been linked to disease severity and mortality in COVID-19. These social factors are ethnicity, social disadvantage, age, gender and occupation. Pre-existing medical conditions have also been identified as an increasing risk. This paper explores the relationship between these social and biological factors using a syndemic frame of reference. The paper argues that although the associations have been very well documented, the mechanisms linking the social factors and disease outcomes are not well understood. An approach that seeks to find commensurability between the social and the biological, is suggested.

There is known to be considerable overlap among the victims and perpetrators of crime. However, the extent of this overlap early in life among children and young adolescents is not clear. We examined the sociodemographic profiles of young people who had early contact with police regarding a criminal incident as a person of interest, victim and/or witness, as well as the patterns of multiple police contact types from birth to 13 years of age. Data were drawn from a longitudinal, population-based sample of 91,631 young people from New South Wales, Australia. Among the 10.6% (n = 9677) of young people who had contact with police, 14.4% (n = 1393) had contact as a person of interest and as a victim and/or witness on two or more separate occasions. The most common first contact type was as a victim/witness, but those children with a first contact as a person of interest were most likely to have at least one further contact. Young people with both types of police contact were younger at first police contact, were more likely to reside in a socioeconomically disadvantaged area, and to be recorded as having an Aboriginal and/or Torres Strait Islander background. Our findings demonstrate that, by 13 years of age, 1 in 10 young people had been in early contact with police and that a minority have contact with the police as both a person of interest and a victim/witness. These young people may represent a particularly disadvantaged group in the community who are likely to be at risk of future adversity, including repeated contact with the criminal justice system.

This study addresses criminal convictions, social disadvantage and problem gambling as an interwoven set of problems. It makes use of data from a population-based gambling survey (n = 7,186) conducted in three Finnish regions. The survey data are combined with national registers to examine associations between sociodemographic factors and gambling severity, comparing persons with and without a criminal record. Gambling behavior included past-year (2016) gambling severity and perceived life-time problem gambling. Social disadvantage was assessed using sociodemographic factors such as education, employment status, level of income and receipt of basic social assistance. Logistic regression analysis showed that both past-year problem or pathological gambling (OR: 2.725) and perceived life-time gambling problems (OR: 2.363) were associated with having a conviction, compared to recreational gambling. Low education, unemployment, low income and receipt of basic social assistance were associated with receiving a conviction. When gender, age and sociodemographic factors were controlled for, odds ratios for both past-year gambling problems (OR: 1.223) and perceived life-time gambling problems (OR: 1.586) did not remain statistically significant. The current study suggests that preventive efforts against problem gambling and interventions in criminal justice systems should be expanded to incorporate the aim of reducing social disadvantage.

Background:\ud Children from Black and South Asian ethnic groups are at risk for childhood obesity in the UK. To inform local action for childhood obesity prevention, it is crucial to explore the basis of ethnic disparities and consider the perspectives of children. This study aimed to understand cultural and contextual factors influencing childhood obesity in an ethnically diverse population using child‐centred methodology.\ud \ud Methods:\ud ‘Draw, write and tell’ interviews were held with children aged 9‐10 years in Coventry, an urban, multi‐ethnic city in the UK. Data were analysed thematically using framework analysis.\ud \ud Results:\ud Twenty‐six children participated (85% from Black or Minority Ethnic Groups). Children’s perspectives revealed universal themes around health, diet, physical activity and weight and highlighted issues specific to ethnic groups and those living in deprived areas. An underlying feature was weight‐based stigmatisation and group stereotyping, and an emphasis on internal factors as the cause of obesity. Children described some experiences of social disadvantage, but did not regard these as a barrier to being physically active. Children identified cultural or religious practices or experiences of migration that influenced diet and physical activity.\ud \ud Conclusions:\ud These findings allow a broad range of children’s perspectives to inform future intervention design. In addition, the study was able to identify the many similarities and small amount of diversity in children’s perspectives across ethnic groups.

Oral language skills underpin children’s educational success and enhance positive life outcomes. Yet, significant numbers of children struggle to develop competence in speaking and listening, especially those from areas of high economic deprivation. A tiered intervention model, graduating the level of provision in line with levels of need, has been posited as most appropriate for supporting children’s language development. The first tier, or universal provision, is characterised by high-quality, evidence-informed language teaching for all. To date, our understanding of effective universal language delivery remains limited, particularly in the primary-school age range. This systematic review addresses this gap by identifying and evaluating existing evidence with the aim of informing practice and future research. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic search protocol was used to identify experimental and quasi-experimental studies evaluating universal approaches designed to support children’s oracy skills. Thirty-one studies were identified for inclusion and their characteristics and findings are reported and their reliability evaluated. Studies provide indicative evidence for the effectiveness of interactive book reading, structured vocabulary programmes, manualised curricula and approaches involving speech and language therapists. The strengths and weaknesses of our current knowledge are outlined and implications for practice and research are discussed.

Las desigualdades en salud comúnmente son evaluadas en una sola dimensión de análisis y poco se conoce sobre el efecto sumativo o multiplicativo cuando se combinan 2 o más dimensiones sociales; representando un desafío para la prevención y control de la Presión Arterial Elevada (PAE). Objetivo: analizar los factores involucrados en las desigualdades poblacionales de la prevalencia de PAE en el espacio inter seccional de los procesos de ventaja y desventaja social por referencia étnica y de género. Métodos: estudio observacional, de corte transversal con enfoque interseccional. Participaron sujetos mayores de 18 años con residencia permanente en Cochabamba (n=10595), seleccionados mediante muestreo aleatorio trietápico. Se utilizó la encuesta WHO-STEPS para recopilar información sobre PAE y factores de riesgo asociados. Se construyeron cuatro posiciones interseccionales por la combinación de género y etnicidad. La descomposición de Oaxaca-Blinder se aplicó para estimar las contribuciones de los factores explicativos de las desigualdades. Resultados: la prevalencia de PAE fue mayor en los hombres-mestizos (10,76%); la disparidad por referencia de género fue más importante entre mestizos (3,74%) e indígenas (3,11%); la disparidad interseccional entre grupos extremos (3,53%) fue mayor a la disparidad entre grupos medios (3,32%). La edad, el tipo de trabajo y estilos de vida, contribuyeron más para explicar estas diferencias. Conclusiones: la PAE no se distribuye según los patrones esperados de desventaja social en el espacio interseccional de etnicidad y género. Una alta ventaja social se relacionó con prevalencias más altas de PAE, así como los factores de riesgo de comportamiento asociados.

Fear of crime among older people has been a frequent topic in ageing research, criminology and urban studies. The ‘environmental docility hypothesis’ assumes that older people are more vulnerable to adverse neighbourhood conditions than younger age groups. Yet, few studies have tested this influential hypothesis using samples of respondents covering the complete adult lifespan. Looking at fear of crime, we investigated the person–environment interaction of age and neighbourhood disadvantage, using two independent surveys comprising 12,620 respondents aged 25–90 years residing in 435 neighbourhoods in four cities in Germany and Australia. We used multi-level analysis and cross-level interactions to model age-differential effects of neighbourhood disadvantage on fear. Contrary to the hypothesis, we found a weakening of neighbourhood effects on fear with age. The strong effect of neighbourhood disadvantage on fear of crime dropped by around half from the youngest (25 years) to the oldest age (90 years) in both countries. Younger people were almost as fearful as older people in the most disadvantaged neighbourhoods, but older people were considerably more fearful than younger ages in better-off neighbourhoods. We found limited empirical support for the assumption that this diminished association between neighbourhood disadvantage and fear can be explained by the stronger neighbourhood attachment of older people. The limitations of the analysis and potential future directions of research are discussed.

Purpose This study analyzes the pathways leading to violent offending. We examine whether the lethality of a violent crime could be predicted based on individuals' prior history of violent crime and income, and whether the trajectories of lethal offenders are distinguishable from the pathways of non-lethal offenders. Methods We use a sample of police-reported violent crimes committed in Finland in 2010–2011 (N = 26,303) and contrast the pathways to homicide with the trajectories leading to petty assault, assault, aggravated assault, and attempted homicide. Group-based trajectory modeling is applied for identifying individuals with similar trajectories, and multilevel modeling is used for estimating the mean trajectories for offenders of differing severity. Results Results indicate that homicide offenders display a clear escalation in the frequency of violent offending and a slight decrease in income prior to the offense, but the pathways to homicide largely resemble the pathways to aggravated assault and attempted homicide. Conclusions The lethality of violent offending cannot be predicted from the offender's crime and income. The greatest divide in the violence severity continuum is between offenders of assaults and offenders of aggravated assaults, with the latter group largely resembling offenders of completed and attempted homicides.

Intimate partner violence (IPV) is a pervasive public health problem. Within the U.S., urban emergency department (ED) patients have elevated prevalence of IPV, substance use, and other social problems compared to those in the general household population. Using a social-ecological framework, this cross-sectional study analyzes the extent to which individual, household, and neighborhood factors are associated with the frequency of IPV among a socially disadvantaged sample of urban ED patients. Confidential survey interviews were conducted with 1037 married/partnered study participants (46% male, 50% Hispanic, 29% African American) at a public safety-net hospital. Gender-stratified multilevel Tobit regression models were estimated for frequency of past-year physical IPV (perpetration and victimization) and frequency of severe IPV. Approximately 23% of participants reported IPV. Among men and women, impulsivity, adverse childhood experiences, substance use, and their spouse/partner&rsquo, s hazardous drinking were associated with IPV frequency. Additionally, household food insufficiency, being fired or laid off from their job, perceived neighborhood disorder, and neighborhood demographic characteristics were associated with IPV frequency among women. Similar patterns were observed in models of severe IPV frequency. IPV prevention strategies implemented in urban ED settings should address the individual, household, and neighborhood risk factors that are linked with partner aggression among socially disadvantaged couples.

Working memory is the ability to keep information in one's mind and mentally manipulate it. Decrements in working memory play a key role in many behavioral and psychiatric disorders, therefore identifying modifiable environmental risk factors for such decrements is important for mitigating these disorders. There is some evidence that prenatal exposure to individual chemicals may adversely impact working memory among children, but few studies have explored the association of co-exposure to multiple chemicals with this outcome in adolescence, a time when working memory skills undergo substantial development. We investigated the association of organochlorines (DDE, HCB, PCBs) and metals (lead, manganese) measured in cord serum and cord blood, respectively, with working memory measured with the Wide Range Assessment of Memory and Learning, 2nd Edition among 373 adolescents living near a Superfund site in New Bedford, Massachusetts. We used Bayesian Kernel Machine Regression (BKMR) and linear regression analyses and assessed effect modification by sex and prenatal social disadvantage. In BKMR models, we observed an adverse joint association of the chemical mixture with Verbal, but not Symbolic, Working Memory. In co-exposure and covariate-adjusted linear regression models, a twofold increase in cord blood manganese was associated with lower working memory scaled scores, with a stronger association with Verbal Working Memory (difference = −0.75; 95% CI: −1.29, −0.20 points) compared to Symbolic Working Memory (difference = −0.44; 95% CI: −1.00, 0.12 points). There was little evidence of effect modification by sex and some evidence associating organochlorine pesticides with poorer working memory scores among those with greater prenatal social disadvantage. This study provided evidence of an adverse joint association of a chemical mixture with a verbal working memory task among adolescents, as well as an adverse association of prenatal manganese exposure with working memory.

Bolstering low-income students’ postsecondary participation is important to remediate these students’ disadvantages and to improve society’s overall level of education. Recent research has demonstrated that secondary schools vary considerably in their tendencies to send students to postsecondary education, but existing research has not systematically identified the school characteristics that explain this variation. Identifying these characteristics can help improve low-income students’ postsecondary outcomes. We identify relevant characteristics using population-level data from Wisconsin, a mid-size state in the United States. We first show that Wisconsin’s income-based disparities in postsecondary participation are wide, even net of academic achievement. Next, we show that several geographic characteristics of schools help explain between-secondary school variation in low-income students’ postsecondary outcomes. Finally, we test whether a dense set of school organisational features explain any remaining variation. We find that these features explain virtually no variation in secondary schools’ tendencies to send low-income students to postsecondary education.

Describing young people who offend or who are more likely to offend as vulnerable or having vulnerability seems commonplace in the literature as of late. Although the use of vulnerability in the research literature on youth crime appears widespread, its meaning, nonetheless, is unclear: if not assumed or implicit, it fluctuates across studies. Because of this ambiguity, we systematically review the empirical literature on youth crime between 1990 and 2020 to gauge how vulnerability is understood now and over time. A total of 19 studies out of 631 original records met the inclusion criteria. The included studies neatly fit into pre-existing classifications of vulnerability from the research literature. The vast majority of the included studies appeared in the decade 2010 to 2019, and meanings of vulnerability as social disadvantage and risk first appeared during this time. Overall and underlying meanings of vulnerability as well as their research and real-world implications are discussed.

Young people with a migrant background are often overrepresented in crime statistics. This study used data from the third International Self-Report Delinquency (ISRD3) study to examine to what extent cultural alignment—cultural resemblance between host and heritage country—and structural influences—socioeconomic starting position and related disadvantage—mediated differences in offending between native students and students of four different migrant backgrounds—Western, Post-Communist, Asian, Middle Eastern—in five Western European countries. This study showed that all migrant groups, except for the Asian group, had significantly higher lifetime serious offending rates than native students. Opposed to the expectations, however, the Western group with the highest levels of cultural alignment—suggesting easier adaptation to the host country—also had the highest offending rates. In the mediation analysis, cultural alignment and structural disadvantage did not satisfactorily explain the relatively large differences in offending between Western and native students and further research would be needed to better understand these differences. In contrast, for the Middle Eastern group, structural disadvantage fully explained differences in offending with native students, also when accounting for cultural alignment; in other words, mechanisms related to structural disadvantage—for example, exposure to risks of delinquent development—for this group appeared to be more determining in explaining differences in offending with natives than their level of cultural alignment or background. For Asian and Post-Communist students, structural disadvantage mediated the largest part of the difference in offending with natives, but cultural alignment for these groups also explained part of this difference. This finding suggests that for these two groups mechanisms related to both cultural alignment—for example, acculturation processes, higher probability of parent–child conflict, and so on—and structural disadvantage are needed to understand differences in offending with native students.

This study investigates the impact of accessible and inaccessible role models on early adolescents’ conceptions of their identities. Accessible role models have regular direct interactions with adolescents, while inaccessible role models like celebrities do not. This investigation was based within the context of a broader educational intervention targeting educational resilience of school students by prompting them to interact with material drawn from outstanding Irish career role models. Data were collected by interviewing 15 students and analyzing the transcripts thematically. Results revealed that adolescents mostly selected role models perceived as emotionally available, relatable, and successful, within proximal contexts. These accessible role models gave adolescents behavioral cues on overcoming difficulties and attaining success. Adolescents selected inaccessible role models to scaffold future selves, based on how the role models’ life stories connected personally to their lives. This signals how adolescents select and use different types of role models in their identity formation. Irish Research Council

Group-based physical activity (PA) in community-based settings represents a promising avenue for promoting healthy ageing, however, lower levels of adherence have been found to be associated with aspects of social disadvantage. Providers are in a key position to provide important insights about strategies to improve adherence, however, few studies have examined their perspectives. In this study, 30 community service providers were interviewed, and 42 older people participated in focus groups to identify actions perceived as effective for promoting adherence to organised PA, with a focus on factors relevant to older people experiencing socio-economic disadvantage, social isolation, living with a disability or from culturally and linguistically diverse backgrounds. Data were analysed thematically. Adherence barriers included deteriorating health, lack of belonging and loss of motivation. Helpful strategies for addressing deteriorating health included maintaining programme flexibility, facilitating access to health and other services, and supporting participants to adapt to acquired limitations. Belonging can be fostered by creating positive and inclusive experiences, ensuring safe and stigma-free environments, providing opportunities to forge personal connections and demonstrating care. Motivation may be enhanced by ensuring activities are of interest and functional benefit, programme settings are suitable and appealing, and enjoyment is prioritised. In conclusion, a range of strategies is likely to be necessary to mitigate risks to adherence and support continued participation in organised PA among socially disadvantaged older people.

The study presented here focuses on northeastern Brazil and aims to analyse the relationship among children's situation of social disadvantage -as reported by children-, subjective well-being and coping. The sample analysed comprises 864 pre-adolescents in the final year of primary and first year of secondary education (age range 10–15) attending 27 randomly-selected state-run and private schools in the province of Ceara. The administered questionnaire contains: (a) items related to situations of multidimensional social disadvantage combined within an index, (b) three psychometric scales of subjective well-being, and (c) a measure of coping strategies and styles (cognitive-behavioural distraction, acting out and active strategies). Results indicate that the social disadvantage index predicts subjective well-being as measured by any of the three indicators used here; however, the perception of social disadvantage reported by children using different indicators seems to increase with age. Children reporting situations of greater social disadvantage according to this index exhibit significantly lower subjective well-being scores; children using the distraction coping strategy tend to display higher scores and children using the acting out coping strategy tend to display lower scores on the subjective well-being indicators. Surprisingly, girls in this sample report using acting out coping estrategies more frequently than boys.

The focus of this study concerns the intergenerational consequences of the era of mass incarceration and its role in promoting an educational demobilization of primarily marginalized groups. Using the Howard B. Kaplan Multigenerational and Longitudinal data set, this article links incarceration in the first generation to educational experiences of the second generation at two stages in the life course: adolescence (N = 1303) and emerging adulthood (N = 1621). Intergenerational theories of strain and stigma are argued to be mechanisms in the transmission of reduced educational success and attainment among the second generation. The findings reveal that children of once incarcerated parents are significantly more likely to report that they are experiencing unhappiness in school and have significantly lower levels of educational success than their counterparts not experiencing parental incarceration. Due to these outcomes, I argue that the reproduction of disadvantage produced by the intergenerational effects of parental incarceration will linger in society even with a reduction of incarcerated populations. The need for understanding the intergenerational implications of mass incarceration among disadvantaged populations is discussed.

There is increasing emphasis in research and at the level of international human rights bodies such as the United Nations on the gendered contours of age-based disadvantage and discrimination, and the cumulative effects of gender inequalities over the life-course on outcomes in later life. However, to date, the role of mental health in shaping the age/gender nexus in the realization of human rights has received little attention. In response, this paper aims to 1) elucidate the economic, social and cultural disadvantages and discrimination faced by older women living with mental health conditions; and 2) identify opportunities to protect their human rights. It concludes that older women face inequalities and disadvantages at the intersections of age, gender, and mental health and wellbeing that compromise their capacity to age well, illuminating the urgent need for a UN Convention on the Human Rights of Older Persons that considers the role of mental health in shaping the realization of human rights among older people. (Am J Geriatr Psychiatry 2021; 29:1009-1014)

AimsThe theory of ‘what matters most’ (WMM) has been developed to understand differences in mental illness stigma between cultures, postulating that stigma becomes most pervasive in situations that matter most in a specific cultural context. The rise of populism in Western societies demonstrates that also within one cultural context, different values ‘matter most’ to different groups. We expand the WMM framework to explore the spectrum of stigma manifestations within Western societies, relating it to both conservative/authoritarian and liberal/modern values. From our findings, we will develop hypotheses on how further research into value orientations and stigma might address potential blind spots in stigma research.MethodsBased on a narrative review of the literature on mental illness stigma and value orientations, we apply the WMM framework to cultural mechanisms of stigma within modern Western societies.ResultsThere are several studies showing an association between traditional, authoritarian, conservative values with stronger mental illness stigma, while studies examining the stigma within liberal, modern value orientations are scarce. We hypothesise on situations where encountering a person with mental illness could threaten liberal values and thus might provoke stigma among persons with such value orientations. For example, living with a person with mental illness could be seen as consuming energy and time, thereby jeopardising ‘self-actualisation’, the modern value of realising one's own full potential. As a result, a person highly valuing self-actualisation might try to avoid contact with persons with mental illness. Instances of potential ‘liberal stigma’ also include structural stigma or self-stigma, when, e.g. changing assumptions of what is considered ‘normal’ increase perceptions of being fundamentally different when experiencing mental illness.Conclusions‘WMM’ appears to be a useful framework to direct research to potential blind spots within the field of stigma research. Looking at instances where liberal values conflict with dealing with a person with mental illness could provide a more comprehensive understanding of stigma experiences among persons with mental illness. However, for measuring stigma, tapping into liberal variations of mental illness stigma is methodologically challenging. Qualitative work could be the first step to elicit potential stigma experiences based on conflicts with liberal values.

Research has shown that childhood physical activity participation has a positive relationship with markers of wellbeing, such as self-esteem and quality of life, and physical activity participation may serve as protective mechanism against some mental illnesses including depression. The aim of the current study was to examine the relationship between gender, physical activity, screen time, body mass index and wellbeing in Irish school children (N = 705; mean age: 8.74 ± 0.52 years) from social disadvantage. In Northern Ireland, schools included in the 2010 Multiple Deprivation Measure (NIMDM) were invited to participate. Schools included for participation in the Republic of Ireland were from the Delivering Equality of Opportunity in Schools (DEIS) index. Data gathered included accelerometry (physical activity), self-report (screen time and wellbeing), and anthropometric measurements. Physical activity was objectively measured during eight consecutive days using Actigraph GT1M and GT3X devices, using stringent accelerometer protocol. Screen time activities were derived using questions adapted from the Health Promotion Agencies National Children’s Survey in Northern Ireland. The KIDSCREEN-27 is a health-related quality of life measurement, and this tool was used by participants to self-report their health and wellbeing. Results suggest that boys accumulated more minutes of daily screen time than girls, however, boys were more physically active when compared to girls. Wellbeing scores for gender showed inverse associations with daily screen time. Standard multiple regression revealed that gender, physical activity, screen time and body mass index (combined) explained little variance in the prediction of wellbeing. Results indicate the importance of gender-based considerations for physical activity and screen time with children from social disadvantage. The inverse relationship found between overall screen time and wellbeing will help guide future healthy lifestyle interventions for Irish children of low-income communities.

Purpose The transition to parenthood can pose challenges for women and men, and these are heightened in the context of social disadvantage (e.g. poverty, deprivation, social exclusion, housing instability and disabilities). There is mounting evidence that video-feedback approaches can provide a valuable buffer against such adverse outcomes. This study aims to evaluate the acceptability and preliminary clinical impact of video interaction guidance (VIG), delivered by health visitors and community support workers in a socially disadvantaged London borough, selected due to its multiple indices of deprivation predicting child and maternal adversity. Design/methodology/approach The study followed a non-randomised, before-and-after evaluation design. Health visitors and community support workers were trained in VIG delivery following the VIG Association-UK protocol. Families with infants under 12 months were conveniently recruited and received six weekly home-based sessions of VIG. The primary outcome was the acceptability of the intervention, assessing parents’ experiences using semi-structured interviews post-intervention. Clinical outcome measures were recorded pre-and post-intervention to yield preliminary evidence on intervention effectiveness. Findings In total, 23 families partook in the study, of which 19 completed the pre- and post-VIG quantitative analysis and 6 also completed the post-VIG qualitative interviews. Qualitative analyses documented high rates of acceptability and perceived improvement in family well-being. Preliminary outcome data indicated that completing the VIG intervention was associated with decreased parental anxiety and depression and increased parental confidence, parent-infant relationship quality, as well as an improvement in infant social and emotional development. However, the selective nature of convenience sampling limits the generalisability of the findings. The non-randomised design of the evaluation implies that findings can only be interpreted as preliminary evidence of intervention effectiveness. These considerations are addressed in the discussion. Originality/value The results of this study provide preliminary evidence of the acceptability and effectiveness of VIG delivery by health visitors and community support workers to new parents in socially disadvantaged urban communities. However, this study must be pursued further to be evaluated with larger, randomised samples to further explore the generalisability of VIG effectiveness in such settings.

This chapter provides some findings from the Blurred Lives Project, funded under the Erasmus+ scheme within the EU. This project aimed to investigate cyberbullying in schools among young people (age range 14–16 years old) in Northern Ireland, England, Germany, Italy, and the Netherlands. The young people came from lower socioeconomic backgrounds. In the first phase a survey was given to a minimum of 400 participants from schools in each country. The second phase aimed to provide accessible, up-to-date resources for teachers, pupils, and parent/carers, and make important recommendations to social networking providers. In each country, two classes were selected out of the schools that participated in the survey. Two procedures were then used to enable pupil voice: sequential focus groups (SFGs) and quality circles (QCs). The SFG sessions were carried out at three separate points; (1) before QCs, reflecting on the survey findings, and (2) and (3) after the QCs, reflecting on what the latter had produced. The QC sessions involved two classes from each country meeting for at least seven sessions. The task for the QCs was to design resources for pupils, what would be helpful for parents to know, how teachers could better equip pupils for using the internet, and recommendations for social network providers. In this chapter we will discuss the experience of carrying out SFGs and QCs with pupils from socioeconomically disadvantaged backgrounds, the challenges and difficulties faced, and recommendations for similar work in the future. We will also discuss the feedback from the young people themselves about the process of being involved in this way. The resources produced will be going on the Project website. We will evaluate the extent to which giving pupils power to design the resources themselves was appreciated by them, and the extent to which this led to new ideas and insights. The strengths and limitations to this kind of approach will be discussed.

Aims Persistent inequalities exist in how individuals from minority ethnic groups access mental health care. A failure to investigate how these inequalities are experienced and what they mean to people with psychosis has privileged professional narratives and hindered our understanding of how they are sustained and what could be done to reduce them. The aim of this study was to investigate the long-term experience of living with psychosis and navigating mental health services within different ethnic groups. Method Our approach was informed by work on narrative analysis and prioritised the meaning that mental health services held for participants. In-depth interviews with 17 black Caribbean, 15 white British and 3 non-British white people with psychosis as part of AESOP-10, a 10-year follow-up of an ethnically diverse cohort of individuals with first-episode psychosis in the UK. Thematic narrative analysis was used to examine experiences at the personal level within and then across the individual accounts. Results Service users shared many defining experiences and narratives frequently returned to individuals' first contact with mental health services, first hospital admission, the experience of impatient wards, and the meaning of medication and diagnosis in their lives. We found that experiences of powerlessness punctuated the journey through mental health services and this appeared to dominate the accounts of black Caribbean, and to a lesser extent, white British participants. The findings reveal how negative expectations and experiences of mental health services are compounded over time, creating a vicious cycle of disempowerment and mistrust that manifests for many in resistance to – or at the best passive acceptance of – intervention by mental health services. High levels of need, coupled with alienation from services, contributed to negative patterns of service use among black Caribbean participants. White participants recounted substantial, though fewer, experiences of disempowerment and more instances of shared decision making that for some helped protect positive aspects of their lives. Conclusions Against a background of entrenched social and economic disempowerment, services were experienced as disempowering by many black Caribbean people, compounding and perpetuating a sense of alienation. Concerted efforts by services to more systematically target social needs and to share power through partnership working may reduce the mistrust that many with psychosis feel when entering services and in turn reduce persistent inequalities across ethnic groups.

Socioculturalmente, la maternidad está vinculada como una característica de las mujeres y se ha identificado como una meta de vida y de desarrollo. Sin embargo, esta construcción se ha transformado a través del tiempo por factores sociales como son los programas sociales en los que se promueve el empoderamiento de la mujer y su participación en otros ámbitos sociales. Por lo tanto, el objetivo de este estudio consistió en evaluar si existe un efecto del empoderamiento y autoconcepto en las creencias sobre la maternidad como deber social y sentido de vida. Los resultados muestran que efectivamente existe este efecto y en particular, se observaron diferencias de estas en mujeres quienes desean la maternidad. Estos hallazgos permiten cuestionar el efecto de la formación cultural en la construcción individual de autoconcepto y la reinterpretación personal al ser madres., Do ponto de vista sociocultural, a maternidade é considerada uma característica natural da mulher e foi identificada como um objetivo de vida e realização. No entanto, essa construção social foi transformada ao longo do tempo por fatores sociais e políticos que são possíveis de identificar em programas sociais que promovem o empoderamento das mulheres e sua participação em outros campos sociais, a fim de melhorar sua desvantagem social. Portanto, o objetivo deste estudo foi avaliar se existe um efeito de empoderamento e autoconceito nas crenças sobre a maternidade como um dever social e senso de vida. Os resultados confirmam que há realmente um efeito e, mesmo foi possível identificar diferenças em mulheres que desejam maternidade. Esses achados permitem questionar o efeito da socialização cultural como enculturação na construção de um autoconceito pessoal e na reinterpretação pessoal como mãe., Motherhood is considered as a natural feature of women and has been identified as a goal of life and developmental achievement. However, this social construction has been transformed over time by social and political factors that are possible to identify in social programs that promote empowerment of women and their participation in other social fields in order to improve their social disadvantage. Therefore, the purpose of this study was to assess whether there is an effect of empowerment and self-concept on beliefs about motherhood as a social duty and a sense of life. The results confirm that there is indeed an effect and, even it was possible to identify differences in women who want motherhood. These findings allow us to question the effect of cultural socialization as enculturation on a personal self-concept construction and personal reinterpretation as mothers., Facultad de Psicología

BACKGROUND: Studies have shown adverse effects of a disadvantaged childhood on adult health-promoting behaviors and related outcomes. Optimism and social support have been linked to greater likelihood of engaging in healthy behavior, but it is unclear whether these positive psychosocial factors may buffer harmful effects of early adversity. This study aims to determine if optimism and social support in adulthood can modify effects of childhood disadvantage on health behavior-related outcomes. METHODS: Longitudinal data were analyzed from a subset of participants in a US birth cohort established in 1959–1966 (ns of 681–840, per outcome). An index of childhood social disadvantage was derived from adverse socioeconomic and family stability factors reported by mothers at child’s birth and age 7 years. Health behavior-related outcomes were self-reported when participants were of mean age 47 years. Multivariable adjusted robust Poisson regressions were performed. RESULTS: Regardless of level of childhood social disadvantage, we found higher levels of optimism and social support were both associated with higher probabilities of being a non-smoker (relative risk [RR](optimism) = 1.17, 95% confidence interval [CI] = 1.09–1.26; RR(social support) = 1.24, 95%CI = 1.11–1.39), having a healthy diet (RR(optimism) = 1.25, 95%CI = 1.10–1.43; RR(social support) = 1.27, 95%CI = 1.04–1.56), and a healthy body mass index (RR(optimism) = 1.18, 95%CI = 1.00–1.40; RR(social support) = 1.29, 95%CI = 1.00–1.66). Interactions link higher optimism or social support with lower risk of smoking among those with moderate childhood disadvantage. CONCLUSIONS: Overall, these findings are consistent with the possibility that positive psychosocial resources contribute to maintaining a healthy lifestyle in mid-adulthood and may buffer effects of childhood social disadvantage.

In the present paper, we analyze the process of the transition to adulthood in contemporary Hungary. We identify typical pathways, describe them in terms of role transitions, as well as regarding their socio-economic and family background and various outcomes. In order to do so, we regard the transition to adulthood as a multi-dimensional and dynamic process. Using longitudinal data from four waves of the Hungarian Generations and Gender Survey (2001–2012), we apply the method of two-step latent class analysis to study the 1981–1983 birth cohort between ages 18–20 and 29–31. Our results indicate that the transitory period between adolescence and adulthood can be characterized by quite different role configurations. Four different pathways were identified. The most common one is characterized by prolonged education and delayed family formation (51%). Every fourth young person become employed early and form their own family late (24%), while 17% belongs to the early family formation group. Interestingly, the pathway that resembles a standard, linear model of transition to adulthood the most (rapid family formation after prolonged education) is the least frequent (9%). The four different pathways differ regarding their background and outcomes. Our results suggest that both becoming independent “too early” and “being stuck” in the postadolescent life phase may be associated with social disadvantage and they contribute to the transmission of social disadvantage across generations. Contrastingly, following the pathway of rapid family formation after prolonged education is a kind of “social privilege” and often leads to the most advantageous socio-economic status and wellbeing at around age 30.

The purpose of this interpretive phenomenological study was to describe intergenerational patterns in adverse childhood experiences (ACE) and protective childhood experiences among teen mothers, their parents and children, and to include social disadvantage as a source of ACE. At the seventh wave of a study that has followed teen mothers and families beginning in 1988 for 28 years, 42 family members were reinterviewed in 2016. Adult participants also completed two tools that identify ACE and childhood family strengths. After narrative data were coded inductively, Interpretive Family Profiles were created to facilitate case and cross-case analysis. Of the 9 participating teen mothers at Time 7, 4 reported few ACE and many family strengths; their parents and children reported similar scores. Of the 5 mothers reporting high ACE, children's scores improved with one exception. Findings suggest that mothers' aspirations to shield their children from trauma was a fragile endeavor for mothers who faced ongoing trauma and economic hardships. Clinicians may facilitate intergenerational repair by capitalizing on mothers' aspirations with trauma-informed care and referrals to community resources. Trauma assessment should also include poverty-related ACE and experiences related to stigma and discrimination.

Objective: This study investigated relative associations between physical activity and selected predisposing, reinforcing and enabling factors among 9- to 10-year-old children from socially disadvantaged communities and examined the extent to which these associations varied by sex. Design: Cross-sectional design. Setting: Ten public primary schools in Liverpool, England. Methods: A total of 194 children (107 girls) completed measures of stature, body mass, waist circumference and cardiorespiratory fitness. Physical activity, physical activity self-efficacy, perceived physical competence and parental physical activity support were self-reported. Sex-specific associations were examined by multiple linear regression and mediator analyses using bootstrapping method. Results: Boys’ physical activity was positively associated with parental physical activity support and perceived physical competence ( p Conclusion: As parents influence child physical activity directly and indirectly their involvement in future child physical activity intervention programmes is essential. Formative research with parents living in socially disadvantaged communities is warranted to explore the range and interaction of challenges they face to support different modes of physical activity participation for their children.

Shared social disadvantage relative to Whites is assumed to motivate inter-minority political behavior but we lack causal evidence. Using a survey experiment of 1,200 African Americans, we prompt respondents to consider group social position when evaluating political commonality with Latinos. The experiment describes racial disparities in a randomized domain (education or housing), varies the description of inequality (either Black versus White, Latino versus White, or Black and Latino versus White), and offers half of the respondents a political cue to test whether shared social disadvantage causes Blacks’ perceptions of political commonality with Latinos. We find little evidence of a causal relationship. We conclude that cross-racial minority political coalitions may be more difficult to activate than previously thought.

Speech, language and communication (SLC) skills are a critical factor in a child's development and in predicting children's wellbeing outcomes and later life chances. There are links between social disadvantage and SLC needs. This article provides an overview of SLC and describes the development of an online resource entitled Speech, language and communication: Giving children the best possible start in life. The tool aims to support health visitors and other early years workers to assess SLC development, and empower parents to facilitate it in their children.

Physical fitness seems to be related to academic performance, at least when taking the role of executive functioning into account. This assumption is highly relevant for the vulnerable population of low academic achievers because their academic performance might benefit from enhanced physical fitness. The current study examined whether physical fitness and executive functioning are independent predictors of low mathematics and spelling achievement or whether the relation between physical fitness and low achievement is mediated by specific executive functions. In total, 477 students from second- and third-grade classes of 12 primary schools were classified as either low or average-to-high achievers in mathematics and spelling based on their scores on standardized achievement tests. Multilevel structural equation models were built with direct paths between physical fitness and academic achievement and added indirect paths via components of executive functioning: inhibition, verbal working memory, visuospatial working memory, and shifting. Physical fitness was only indirectly related to low achievement via specific executive functions, depending on the academic domain involved. Verbal working memory was a mediator between physical fitness and low achievement in both domains, whereas visuospatial working memory had a mediating role only in mathematics. Physical fitness interventions aiming to improve low academic achievement, thus, could potentially be successful. The mediating effect of executive functioning suggests that these improvements in academic achievement will be preceded by enhanced executive functions, either verbal working memory (in spelling) or both verbal and visuospatial working memory (in mathematics).

Social determinants of health have long been recognised but their importance is often overlooked. Globally social determinants are responsible for most childhood illness and death. In the UK, conditions which constitute a large part of paediatric practice are socially patterned. Social determinants exert their influence on child health through a complex inter-relationship of more distal social factors such as income and education with more proximal factors such as health behaviours. The pathways by which the social determinants exert their influence operate over time and across generations. Socially related risk and protective factors cluster in different social groups and accumulate over time. Social determinants are profoundly influenced by social and political decisions which are beyond the control of parents and individual paediatricians. Societies can protect children against the adverse effects of social disadvantage. National paediatric societies have a key role in promoting policies which protect children. This brief review summarises the impact of social determinants on children's health in the UK and considers the role of paediatricians in reducing the health inequities generated by these determinants.

Background Physical activity (PA) has been shown to improve psychological wellbeing in adults, however less is known about this relationship in children. The aim of this study was to examine the relationship between PA and wellbeing in children for the first time across Ireland and to explore potential differences by gender, jurisdiction (Northern Ireland and the Republic of Ireland) and region of Ireland. Method A sample of 673 8–9 year olds attending school in socially disadvantaged areas took part. Participants completed a measure of PA and the KIDSCREEN-27 quality of life questionnaire. Results 18% of children accumulated the recommended 60 min of MVPA per day for health, with 18% of boys (n = 63) and 17% girls (n = 55) achieving this level. Children in Northern Ireland reported higher wellbeing scores than those in Republic of Ireland. Children achieving the recommended level of MVPA scored significantly higher on measures of wellbeing than less active children. Gender differences in wellbeing were found for perceived parental, social and school support with girls scoring higher than boys. Conclusions Children who meet the recommended MVPA guidelines and those who live in Northern Ireland report a higher level of wellbeing than their peers who live in the Republic of Ireland.

Since the early 70s, there has been recognition that there are specific differences in achievement based on variables, such as gender and socio-economic background, in terms of mathematics performance. However, these differences are not unilateral but rather quite specific and relate strongly to spatial reasoning. This early work has paved the way for thinking critically about who achieves in mathematics and why. This project innovatively combines the strengths of the two Chief Investigators—Lowrie’s work in spatial reasoning and Jorgensen’s work in equity. The assumptions, the approach and theoretical framing used in the study unite quite disparate areas of mathematics education into a cogent research program that seeks to challenge some of the long-held views in the field of mathematics education.

Background: uncertainty remains concerning how children’s reading and academic self-concept are related and how these are differentially affected by social disadvantage and home learning environments. Aims: to contrast the impacts of early socioeconomic risks and preschool home learning environments upon British children’s reading abilities and academic self-concept between 7-10 years.Sample: n=3,172 British children aged 3-10 years and their families.Methods: a secondary analysis of the nationally-representative UK EPPE database. Multilevel Structural Equation Modelling calculated the direct, indirect, and total impacts of early socioeconomic risks (0-3 years) and preschool home learning environments (3-5 years) upon children’s reading ability and academic self-concept between 7-10 years.Results: early socioeconomic risk had different effects upon children’s reading ability and academic self-concept. Early socioeconomic risks affected children’s reading at ages 7 and 10 both directly and indirectly via effects upon preschool home learning environments. By contrast, early socioeconomic risks had only indirect effects upon children’s academic self-concept via less stimulating home learning environments in the preschool period and by limiting reading abilities early on in primary school.Conclusions: although the impacts of early socioeconomic risks are larger and more easily observed upon reading than upon academic self-concept they can impact both by making it less likely that children will experience enriching home learning environments during the preschool period. This has implications for social policy makers, early educators, and interventionists. Intervening early and improving preschool home learning environments can do more than raise children’s reading abilities; secondary benefits may also be achievable upon children’s self-concept.

Social values and concepts have played a central role in the history of mental health care. They have driven major reforms and guided the development of various treatment models. Although social values and concepts have been important for mental health care in the past, this Personal View addresses what their role might be in the future. We (DG, PH, and SP) did a survey of professional stakeholders and then used a scenario planning technique in an international expert workshop to address this question. The workshop developed four distinct but not mutually exclusive scenarios in which the social aspect is central: mental health care will be patient controlled; it will target people's social context to improve their mental health; it will become virtual; and access to care will be regulated on the basis of social disadvantage. These scenarios are not intended as fixed depictions of what will happen. They could, however, be useful in guiding further debate, research, and innovation.