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Child poverty is associated with poorer physical and mental health, negative educational outcomes and adverse long-term social and psychological consequences, all of which impact on service demand and expenditure. Until now, however, prevention and early intervention practice has tended to focus on enhancing inter-parental relationships and parenting skills (e.g., via relationship skills education, home visiting, parenting programs, family therapy) or child language, social-emotional and life skills (e.g., early childhood education, school-based programs, youth mentoring). Programs often target low-income neighborhoods or families but rarely address poverty directly. While there is substantial evidence for the effectiveness of such interventions in improving child outcomes, null results are not uncommon and even positive effects are often small, short-term, and difficult to replicate. One avenue to enhance intervention effectiveness is to improve families’ economic circumstances. There are several arguments for this refocusing. It is arguably unethical to focus on individual risk without acknowledging or seeking to address (where relevant) families’ social and economic contexts, while the stigma and material constraints associated with poverty can make it harder for families to engage with psychosocial support. There is also evidence that increasing household income improves child outcomes. Although national policies to alleviate poverty are important, it is increasingly recognized that practice-based initiatives have a role to play (e.g., income maximization, devolved budgets, money management support). However, knowledge about their implementation and effectiveness is relatively thin. For instance, there is some evidence that co-located welfare rights advice in healthcare settings can improve recipients’ financial circumstances and health, but it is mixed and of limited quality. Moreover, there is little rigorous research on whether and how such services affect mediators (parent-child interactions, parenting capacity) and/or child physical and psychosocial outcomes directly. We call for prevention and early intervention programs to attend more to families’ economic circumstances, and for experimental studies to test their implementation, reach and effectiveness.

UK general practitioner (GP) trainees are taught a consultation model which elicits the patients' main reason for consulting 'today'. This approach will often miss important issues for the increasing number of patients with multimorbidity. We developed the SHERPA model as a person-centred biopsychosocial framework for consulting patients with multimorbidity to address this. We aimed to examine GPs trainees' responses to SHERPA when integrated into their vocational training. The research design was qualitative and participants were GPs trainees in vocational training from one UK training location. GP trainees were introduced to the SHERPA model through interactive workshops. Qualitative data were collected from 16 participants, through four hours of teaching observation, 24 feedback templates, six practical applications of SHERPA and eight one-to-one interviews. Data were transcribed, and, using the Framework approach, systematically analysed, focussing on trainees' learning and application of the model. The results demonstrated that all participants engaged well with the teaching sessions, brought observations from their own experience, and reflected on particularly complex consultations. Half of the participants applied SHERPA successfully with their patients, particularly repeat attenders. Barriers to this approach were: selecting appropriate patients; perceived time pressure; lack of familiarity using the model; viewing SHERPA as 'additional', rather than integral, to shared decision-making in complex situations. The SHERPA model was viewed as helpful by these GP trainees for patients with whom they had established a relationship. Earlier introduction and regular support from trainers, where trainees reflect on experience of SHERPA, could increase confidence in using this method.

Background Primary care trainees are traditionally taught to use a consultation model which focuses on eliciting the patients’ main reason for consulting “today”. As the number of patients with multi-morbidity increases, this approach is often inappropriate or unhelpful. Patients can be left without an understanding of their interacting health issues. The SHERPA model provides a biopsychosocial framework for consulting patients with multi-morbidity. We aimed to examine the responses to this model when integrated into a training programme for newly registered GPs. Methods Sixteen participants provide qualitative data on their experience and follow-up use of SHERPA. Four hours of teaching were observed. Twenty-four feedback templates on training (n = 18) and SHERPA application (n = 6) were collected. Individual semi-structured one-to-one interviews were conducted with trainees (n = 5) and trainers (n = 3). Data were transcribed and, using the Framework approach, systematically analysed focussing on the trainees’ reaction to the teaching sessions and their ability to use the SHERPA consultation model. Results Participants engaged well with the teaching sessions, enjoying the scenarios and bringing observations from their own experience. Five participants went on to apply SHERPA successfully with their patients. Barriers to using this approach were: not seeing appropriate patients with multi-morbidities (due to current placement or patient type); time; lack of confidence and familiarity; concern about missing important immediate clinical issues; and viewing the approach as “in addition” rather than key to shared decision-making. Conclusion The SHERPA model was viewed as a helpful addition by trainee GPs, although practical issues, fears and not seeing it as their priority for their case-mix, limited their application of it. Regular support from trainers, where trainees reflect on their experience of using SHERPA, could increase their confidence and familiarity with this method. These findings suggest that SHERPA may be relevant to other specialities such as geriatric medicine, where multi-morbidity is common.

There can be a tendency for investigators to disregard or explain away null or negative results in prevention science trials. Examples include not publicizing findings, conducting spurious subgroup analyses, or attributing the outcome post hoc to real or perceived weaknesses in trial design or intervention implementation. This is unhelpful for several reasons, not least that it skews the evidence base, contributes to research “waste”, undermines respect for science, and stifles creativity in intervention development. In this paper, we identify possible policy and practice responses when interventions have null (ineffective) or negative (harmful) results, and argue that these are influenced by: theinterventionitself (e.g., stage of gestation, perceived importance);trial design,conduct,and results(e.g., pattern of null/negative effects, internal and external validity);context(e.g., wider evidence base, state of policy); andindividual perspectives and interests(e.g., stake in the intervention). We advance several strategies to promote more informative null or negative effect trials and enable learning from such results, focusing on changes to culture, process, intervention design, trial design, and environment.

The study evaluated the implementation fidelity and effectiveness of KiVa, an evidence-based program that aims to prevent and address bullying in schools, with a particular emphasis on changing the role of bystanders. The study was a two-arm waitlist control cluster randomized controlled trial in which 22 primary schools (clusters) (N = 3214 students aged 7–11) were allocated using a 1:1 ratio to intervention (KiVa; 11 clusters, n = 1588 students) and a waitlist control (usual school provision; 11 clusters, n = 1892 children)). The trial statistician (but not schools or researchers) remained blind to allocation status. The outcomes were as follows: student-reported victimization (primary outcome) and bullying perpetration; teacher-reported child behavior and emotional well-being; and school absenteeism (administrative records). Implementation fidelity was measured using teacher-completed online records (for class lessons) and independent researcher observations (for school-wide elements). Outcome analyses involved 11 intervention schools (n = 1578 children) and 10 control schools (n = 1636 children). There was no statistically significant effect on the primary outcome of child-reported victimization (adjusted intervention/control OR 0.76; 95% CI 0.55 to 1.06; p = 0.11) or on the secondary outcomes. The impact on victimization was not moderated by child gender, age, or victimization status at baseline. Lesson adherence was good but exposure (lesson length) was lower than the recommended amount, and there was considerable variability in the implementation of whole school elements. The trial found insufficient evidence to conclude that KiVa had an effect on the primary outcome. A larger trial of KiVa in the UK is warranted, however, with attention to issues regarding implementation fidelity. Trial registration: Current Controlled Trials ISRCTN23999021 Date 10-6-13

Improving child and adolescent mental health requires the careful development and rigorous testing of interventions and delivery methods. This includes universal school-based mindfulness training, evaluated in the My Resilience in Adolescence (MYRIAD) trial reported in this special edition. While discovering effective interventions through randomised controlled trials is our ultimate aim, null or negative results can and should play an important role in progressing our understanding of what works. Unfortunately, alongside publication bias there can be a tendency to ignore, spin or unfairly undermine disappointing findings. This creates research waste that can increase risk and reduce benefits for future service users. We advocate several practices to help optimise learning from all trials, whatever the results: stronger intervention design reduces the likelihood of foreseeable null or negative results; an evidence-informed conceptual map of the subject area assists with understanding how results contribute to the knowledge base; mixed methods trial designs aid explanation of outcome results; various open science practices support the dispassionate analysis of data and transparent reporting of trial findings; and preparation for null or negative results helps to temper stakeholder expectations and increase understanding of why we conduct trials in the first place. To embed these practices, research funders must be willing to pay for pilot studies and ‘thicker’ trials, and publishers should judge trials according to their conduct and not their outcome. MYRIAD is an exemplar of how to design, conduct and report a trial to optimise learning, with important implications for practice.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. There is a social gradient to the determinants of health; low socioeconomic status (SES) has been linked to reduced educational attainment and employment prospects, which in turn afect physical and mental wellbeing. One goal of preventive interventions, such as parenting programs, is to reduce these health inequalities by supporting families with difculties that are often patterned by SES. Despite these intentions, a recent individual participant data (IPD) meta-analysis of the Incredible Years (IY) parenting program found no evidence for diferential beneft by socioeconomic disadvantage (Gardner et al. in Public Health Resesearch 5, 1–144, 2017). However, it did not examine whether this was infuenced by engagement in the intervention. Using intervention arm data from this pooled dataset (13 trials; N=1078), we examined whether there was an SES gradient to intervention attendance (an indicator of engagement). We ran mixed-efects Poisson regression models to estimate incidence rate ratios (IRRs) for program attendance for each of fve (binary) markers of SES: low income; unemployment; low education status; teen parent; and lone parent status. The multilevel structure of the data allowed for comparison of within-trial and between-trial efects, including tests for contextual efects. We found evidence that low SES was associated with reduced attendance at parenting programs—an 8–19% reduction depending on the SES marker. However, there was no evidence that this association is impacted by diferences in SES composition between trials or by the attendance levels of higher-SES families. The fndings underscore the importance of developing and prioritizing strategies that enable engagement in parenting interventions and encourage program attendance by low-SES families.

Aim: The present study aimed to investigate barriers to healthcare and their relationships to social and emotional well-being and intersectional inequalities for autistic adults during COVID-19 restrictions in the UK. Background: Autistic adults experience severe health inequalities and report more barriers to accessing health services compared to other both disabled and non-disabled populations. The COVID-19 pandemic has impacted many areas of society that may have increased vulnerability of autistic people to social and health inequalities, including delivery of healthcare from in-person to remote methods. Method: One hundred twenty-eight autistic adults who lived in the UK took part in an online survey. Measures included the Barriers to Healthcare Checklist (Short Form) and PROMIS outcome measure bank to assess emotional well-being and social support. Participants rated their agreement with items, retrospectively considering three different points of the trajectory of COVID-19 restrictions: before COVID-19, during the first lockdown in spring 2020, and in the month prior to taking the survey during autumn 2020. They completed a follow-up survey six months later to continue to assess change as restrictions in the UK were eased. Findings: The average number of barriers to healthcare showed no significant change between all four time points. However, the nature of barriers to healthcare changed at the point of lockdown and persisted beyond the easing of COVID-19 restrictions. Barriers to healthcare were associated with some social and emotional well-being variables and demographic groups including gender, education and presence of additional disabilities. The findings may help to identify areas to target to improve access to both remote and in-person health systems for autistic people as modes of delivery continue to change over time.

Adults on the autism spectrum are affected by health disparities which significantly reduce life expectancy and experience barriers to accessing healthcare. Social prescribing is a holistic approach that diverts patients from primary care to health-enhancing activities in communities. However, there has been a lack of research attention to how autistic people navigate the social prescribing pathway and the ability of these approaches to address existing disparities. This mapping review aimed to synthesise features of non-medical, community-based interventions for autistic adults to assess their suitability for a social prescribing approach. A systematic search and screening process was used to identify literature reviews from medical databases (Embase, Medline, PsycINFO, CINAHL and Cochrane reviews) and grey literature. We extracted data from 24 reviews and 19 studies including types of services, participants, outcomes, settings and procedures. A narrative and visual synthesis is used to map the variety of services and interventions identified, the outcome measures used, and the barriers and facilitators to progression through services in relation to a realist social prescribing framework. The review found that there has been minimal evaluation of holistic, low intensity services for autistic adults, such as those offered in social prescribing approaches. Outcome measures remain focused on features of autism and reveal less about the effects of interventions on health and wellbeing. Aspects of the social prescribing model were identified in the features of service pathways, but findings also suggested how social prescribing could be adapted to improve accessibility for autistic people.

Objective: The aim of the study was to evaluate the implementation and effectiveness of a therapeutic parenting program that targets parents of children aged 6 to 11 years identified as having behavioral and emotional difficulties. The intervention comprises two parts, delivered sequentially: a 10–12-week group-based program for all parents, and one-to-one sessions for up to 12 weeks with selected parents from the group-based element. Methods/Design: In a randomized controlled trial, 264 participants were allocated to the Inspiring Futures program (intervention) or services as usual (control) arms with follow-up assessments at 16 (post-group program) and 32 (post-one-to-one sessions) weeks. The primary outcome was the parent-rated Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score at 32 weeks. Secondary outcomes included parent-rated SDQ subscales, parent coping strategies, empathy in parenting and parenting skills. Results: All 264 participants were included in outcome analyses. There was no statistically significant effect on SDQ Total Difficulties (standardized mean difference: −0.07; 95% CI: −0.30 to 0.16; p = 0.54). There were no sub-group effects. Only 1 of 40 comparisons between the trial arms for secondary outcomes across both follow-ups was statistically significant at the 5% level. The mean number of group sessions attended by intervention arm participants was 6.1 (out of 10 to 12) and only 1 in 20 intervention arm participants received one-to-one support. Independent observation indicated scope to improve fidelity in terms of adherence, quality and participant responsiveness. Conclusions: The intervention is not more effective than services as usual at improving targeted outcomes. This may be related, in part, to implementation issues but arguably more to the inability of a non-behavioral intervention to improve caregiving adequately, particularly when it is not targeted at new parents who have experienced trauma or deprivation early in life or subsequently.

Across Europe many states are experiencing severe pressures on public services, both from escalating need and from diminishing budgets. As a result, there is increasing interest in understanding how much is spent on services for children and to what effect. All government departments and selected voluntary organisations in Northern Ireland were asked to share financial information about expenditure on services for children and families in the financial year 2012–2013. Respondents were also asked to list evidence-based programmes (EBPs) being implemented and the annual cost in 2012/13.In 2012/13, £2.28 billion was invested in services for children, young people and their families (on average £5,175 per child). This was spread across 10 departments, with the majority spent by the Department of Education (£1.64 billion, 72%). The split across levels of intervention was 57% prevention (mostly education), 13% early intervention and 19% treatment and maintenance (mostly social care). Unit costs ranged, ...

Vashti Berry's time is supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula.

The study, a two-arm, randomized controlled, parallel group, superiority trial, aimed to evaluate the implementation and effectiveness of a 12-month one-to-one volunteer mentoring program designed to improve behavioral and emotional outcomes in children aged 5 to 11 years who have teacher- and parent/carer-reported behavioral difficulties. Participants were 246 children (123 intervention, 123 control; mean age 8.4 years; 87% boys) in five sites in London, UK, scoring in the “abnormal” range on the teacher-rated Strengths and Difficulties Questionnaire (SDQ) Total Difficulties measure and in the “borderline” or abnormal range on the parent-rated SDQ Total Difficulties measure. Randomization on a 1:1 ratio took place using a computer-generated sequence and stratifying by site. Data collectors and statisticians were blind to participant allocation status. Outcome measures focused on parent- and teacher-rated child behavior and emotions, and child-rated self-perception and hope. Intention-to-treat analysis on all 246 randomized participants (using imputed data where necessary) showed that at post-intervention (16 months after randomization), there were no statistically significant effects on the primary outcome—parent-rated SDQ Total Difficulties (adjusted standardized mean difference = − 0.12; 95% CI: −0.38 to 0.13; p = 0.33)—or any secondary outcomes. Results from complier average causal effect (CACE) analysis using the primary outcome indicated the intervention was not effective for children who received the recommended duration of mentoring. Exploratory analyses found no sub-group effects on the primary outcome. The article concludes that the mentoring program had no effect on children’s behavior or emotional well-being, and that program content needs revising to satisfactorily address key risk and protective factors. Electronic supplementary material The online version of this article (10.1007/s11121-020-01132-4) contains supplementary material, which is available to authorized users.

The effect of the environment on a child’s development starts in the womb. Many studies have shown that if the mother is stressed, anxious, or depressed during pregnancy, this increases the risk of a range of physical and neurodevelopmental problems for the child, even after allowing for relevant confounders. There is also strong evidence concerning the impact of both maternal and paternal anxiety and depression on parent–infant interaction in the postnatal period. Although there is good evidence for interventions that reduce depression and anxiety during the perinatal period for women, less is currently known about effective interventions for men or effective methods of prevention more generally. Overall, the evidence points to the importance of starting interventions in pregnancy.

This chapter summarizes evidence on (i) the prevalence and effects on the unborn and newborn infant of exposure to teratogenic substances such as tobacco, alcohol, or substances during pregnancy, and (ii) what works during the perinatal period in terms of universal and targeted interventions for smoking cessation, and preventing and treating alcohol and drug misuse. It concludes with recommendations for practice, drawing on the evidence presented and best practice guidance, and focusing on strategies for identification and intervention.

This chapter outlines the prevalence of intimate partner violence (IPV) in the UK, describes adverse effects for adult and child survivor-victims, and synthesizes evidence on the effectiveness of interventions to (i) prevent IPV, (ii) identify IPV, (iii) support adults and children affected by IPV, and (iv) treat perpetrators. Prevention covers school- and community-based dating violence prevention as well as media/educational campaigns and home visiting. Identification covers activity in hvealthcare and other services. Interventions for victim-survivors include advocacy, skill-building, counselling, therapy, and groups, and cover both adults and children. Treatments for perpetrators include group and individual and therapeutic and non-therapeutic approaches. The chapter closes with recommendations for practice.

The prognosis for children with early-onset conduct disorder is poor. Conduct disorder also has a social cost for families and communities, and an economic cost for society through the increased use of health, education, social, legal and detention services. In this study, the Incredible Years (IY) BASIC programme was delivered to parents of pre-school children at risk of developing a conduct disorder and evaluated by pragmatic randomised controlled trial. Participants were parents of 161 children (110 intervention, 51 control) aged between 36 and 59 months (mean age 44 months, 63% boys) and scoring over the clinical cut-off on the Strengths and Difficulties Questionnaire (SDQ). At follow-up (six months post-baseline), the intent-to-treat analysis showed a mean between group difference in favour of IY on the SDQ total difficulties score of 2.23 (p

Background Secure attachment is associated with optimal outcomes across all domains in childhood, and both insecure and disorganised attachment are associated with a range of later psychopathologies. Insecure and disorganised attachment are common, particularly in disadvantaged populations, pointing to the need to identify effective methods of addressing such problems. Aims This paper presents the findings of a review of secondary and primary studies evaluating the effectiveness of interventions aimed at improving attachment and attachment-related outcomes on a universal, targeted or indicated basis, which was undertaken as part of an update of the evidence base for a UK-based national programme targeting children aged 0–5 years (Healthy Child Programme). Method A systematic search of key electronic databases was undertaken to identify secondary and primary sources of data that addressed the research question and that had been published between 2008 and 2014; search sources included Cochrane Collaboration, NICE, EPPI Centre, Campbell Collaboration and PubMed, PsychInfo, CINAHL databases. Findings Six systematic reviews and 11 randomised controlled trials were identified that had evaluated the effectiveness of universal, selective or indicated interventions aimed at improving attachment and attachment-related outcomes in children aged 0–5 years. Potentially effective methods of improving infant attachment include parent–infant psychotherapy, video feedback and mentalisation-based programmes. Methods that appear to be effective in improving attachment-related outcomes include home visiting and parenting programmes. Conclusions A number of methods of working to promote attachment and attachment-related outcomes in preschool children are now being recommended as part of the Healthy Child Programme. The implications in terms of the role and contribution of practitioners working in child and adolescent mental health service are discussed.

There are a growing number of school-based interventions designed to promote children’s social and emotional learning. One such intervention, PATHS (Promoting Alternative Thinking Strategies), was evaluated in a randomised controlled trial involving 5074 pupils aged 4–6 years at baseline in 56 primary schools across a large city in the UK. The programme was implemented for two academic years. The primary outcome measure was the teacher-rated Strengths and Difficulties Questionnaire (SDQ). A secondary measure was the PATHS Teacher Rating Scale (PTRS). Observations of child and teacher behaviours were undertaken in a third of intervention and control schools using the Teacher–Pupil Observation Tool (T-POT). Regarding fidelity, dose and adherence were measured via weekly logs completed by teachers, and a semi-structured questionnaire completed by PATHS coaches was used as a global measure of fidelity (capturing adherence, dose and quality). A cost-consequence analysis examined programme costs from a multi-agency public sector perspective. At 1 year post-baseline, there were no statistically significant differences between the programme and control groups on the SDQ subscales or the SDQ total difficulties and impact scores. There were statistically significant differences favouring the programme group for six out of 11 subscales on the secondary outcome measure (PTRS). At 2 years post-baseline, there were no statistically significant differences between the groups on either measure. Fidelity, according to the global measure, was relatively strong, and there was no relationship between fidelity and treatment effects. The average cost of PATHS was £12,666 per school or £139 per child. The study, which was fully powered and independent of the programme developer, shows no statistically significant effect of the programme on child behaviour or emotional well-being.

Contents: Introduction Part I The Theory of Need: Welfare and the value of liberty, Raymond Plant The priority of needs, Robert E. Goodin A theory of human need, Len Doyal and Ian Gough A theory of human need, Kate Soper Need the idea won't do - but we still need it, A.J. Culyer A taxonomy of social need, Jonathan Bradshaw. Part II The Needs of Children: A theory of human motivation, A.H. Maslow What do children need from parents?, Dora Black Pathways from childhood to adult life, Michael Rutter An ecological approach to social work with children and families, Gordon Jack. Part III Assessing the Needs of Individual Children: The strengths and difficulties questionnaire: a research note, Robert Goodman Classification of child and adolescent psychopathology, Dennis P. Cantwell Reflections on the assessment of outcomes in child care, Roy Parker Single case evaluation methods: review and prospects, Brian Sheldon. Part IV Measuring the Needs of Child Populations: Why do levels of human welfare vary across nations?, Ian Gough and Theo Thomas Auditing social needs, Janie Percy-Smith Mapping the needs of children in need, Michael Preston-Shoot and Veronica Wigley The background of children who enter local authority care, Andrew Bebbington and John Miles Child poverty and needs based budget allocation, D. Gordon and F. Loughran Mapping the data needed to plan integrated services: a case study of children's' services in one locality, Nick Axford, Jill Madge, Louise Morpeth and Jo Pring. Part V Towards Meeting Children's Needs: Needs, numbers, resources: informed planning for looked after children, Karin Janzon and Ruth Sinclair A developmental and clinical model for the prevention of conduct orders: the FAST Track Program, Conduct Problems Prevention Research Group Prevention and early intervention with children in need: definitions, principles and examples of good practice, Michael Little Measuring outcomes in the 'new' children's services, Nick Axford

The influence of international governmental organisations (IGOs) on child welfare policy and practice in individual sovereign states is little explored. This article sets out the nature of these bodies’ main work with children. It then considers the mechanisms through which they seek to influence national child welfare policy and practice and the extent to which they can make nation states comply. ‘Soft’ mechanisms, such as awareness-raising, compiling statistical data and demonstration projects are contrasted with ‘hard’ mechanisms, such as making law and financial intervention. The article then reviews the effects of this activity and the factors explaining the varied pattern. It concludes that child welfare policy and practice are increasingly subject to supranational influence and that this has important implications for those seeking to influence this field.1

Evidence-based programs (EBPs) are increasingly being implemented in children's services agencies in developed countries. However, this trend is meeting resistance from some researchers, policy makers and practitioners. In this article we appraise the main critiques, focusing on scientific, ideological, cultural, organizational and professional arguments. We contend that some of the resistance stems from misconceptions or an oversimplification of issues, while others represent valid concerns that need to be addressed by proponents of EBPs. We set out implications for the development and evaluation of programs and how they are introduced into service systems, and conclude with broader recommendations for children's services.

When evidence-based parenting programs are implemented in real-world settings they often fail to produce the results shown in efficacy trials. One reason for this is difficulties in engaging parents. This paper identifies lessons from a review of literature on engaging parents in parenting programs and presents a case study of the implementation of the Incredible Years BASIC program in the context of a randomized controlled trial. It examines the challenges encountered and efforts to overcome them. Key recommendations include: a clear recruitment process; good communication and liaison with stakeholders; incentives for recruitment and retention; active and creative outreach work; investment in building relationships with parents; making programs easily accessible; and having realistic expectations.

Lots of child well-being data is collected but it is rarely exploited fully. In this article we set out the data that directors and service commissioners in children’s services need and methods to help them analyse it optimally. Using a case example we show how this will help with critical but complex tasks, such as choosing which outcomes to address, estimating realistic achievable change, designing services, and monitoring progress. We then discuss how to make the data work even harder, for example gathering well-being data on children in systems, improving the quality of service use information, and making data ‘live’ for practitioners via continuous feedback systems.

Axford N. Children and global social policy: exploring the impact of international governmental organisations International governmental organisations (IGOs) seek to influence child welfare policy and practice in individual sovereign states. But do they succeed and, if so, in what way? This article outlines the nature of selected IGOs' work, explores the nature of their impact and seeks to explain the pattern that emerges. It also notes areas for further research.

Interest in evidence-based programmes and the science underpinning them has mushroomed in the UK and Ireland in recent years as policy-makers and senior managers seek tried-and-tested methods of improving child well-being. This article examines whether study tours, a form of experiential learning, can help to promote evidence-based policy and practice in children's services. Participants on two study tours to the United States in 2005 to visit evidence-based programmes and their developers were interviewed by telephone 30–36 months later. Results are presented in terms of: (1) what participants felt they were exposed to on the study tours; (2) how the tours had changed their thinking; (3) what impact the tours had in terms of actions; (4) the factors that affected the impact of the study tours; and (5) the value added by the study tours over and above other means of learning about evidence and evidence-based services.

The measurement of ‘service’ in children's services is highly varied. We do not know in a meaningful sense what services children and families get. This paper sets out why it is important to measure services well. It outlines the dimensions of ‘service’, how they have been measured in research, policy and practice contexts, and the strengths and weaknesses of these approaches. It then explores implications for the field and identifies potential applications of a more nuanced and consistent approach to measuring services.

The measurement of child well-being in the UK for needs-led service planning and outcome assessment has tended to be poor. This article sets out the broad results from the application of a new methodology to assess the health and development of children aged 0–18 in a large local authority in England. It discusses briefly how these data helped inform strategy development and service design in the local authority and how the approach might be enhanced.