Improving well-being and outcomes for looked after children in Wales: a context sensitive review of interventions

Improving outcomes for looked after children and young people has been a longstanding concern in Wales. This article reports the findings of a scoping study which sought to identify interventions aimed at improving outcomes for looked after children that are effective or promising. The study was commissioned by an independent funding body to inform a £5 million investment programme for Wales. It comprised a rapid review of literature, informed through consultation with an expert advisory panel and groups of young people who had been in care. The article outlines the rapid review method, provides details of shortlisted interventions and describes the interventions subsequently approved for investment. It concludes that although there are many promising interventions which address the factors associated with poor outcomes for looked after children, the evidence base is weak. It is argued that decision-making on interventions should be informed by appraisal of the empirical evidence available, but should also be guided by professional judgement that considers the needs, priorities and preferences of service users, carers, practitioners and policy-makers

Implementation and the Governance Problem: A Pressure Participant Perspective

This article has two aims: to qualify the UK government's ‘problem' of governance in a comparison with Scotland and Wales, and to use implementation studies (the ancestors of the new governance literature) to explore policy developments since devolution in Britain. It presents a puzzling finding from extensive interview research: that while we may expect UK government policy to suffer a bigger ‘implementation gap' based on distinctive governance problems (such as greater service delivery fragmentation and the unintended consequences of top-down policy styles), pressure participants in Scotland and Wales are more likely to report implementation failures. Using a ‘top-down' framework, it explores three main explanations for this finding: that the size of the implementation gap in England is exaggerated by a focus on particular governance problems; that pressure participant dissatisfaction follows unrealistic expectations in the devolved territories; and that the UK government undermines devolved policy implementation, by retaining control of key policy instruments and setting the agenda on measures of implementation success

A survey of local health promotion initiatives for older people in Wales

<p>Abstract</p> <p>Background</p> <p>As the demographic profile of the UK changes, policy makers and practitioners have to respond to health challenges presented by a progressively ageing population. The health promotion plan for older people, aged over 50 years, in Wales included eight key areas: physical activity, healthy eating, home safety and warmth, emotional health, health protection, smoking, alcohol and sexual health. The aim of this study was to describe the extent, content and regional variation of existing health promotion initiatives for older people in Wales, provided by statutory, voluntary and private sector agencies.</p> <p>Method</p> <p>A questionnaire was sent to senior health promotion specialists employed in the 22 local authority areas in Wales to ascertain details of all projects promoting health and wellbeing in the eight key areas where the priority population was aged over 50, or the majority of users were older people. Additional information was sought from project leads and websites.</p> <p>Results</p> <p>Eighteen questionnaires were returned; not all were fully completed. Four areas did not return a questionnaire. Additional information was obtained from internet searches but this mainly concerned national initiatives rather than local projects. In all, 120 projects were included, 11 were throughout Wales. Best provision was for physical activity, with 3 national and 42 local initiatives, but local provision was patchy. Healthy eating, and home safety and warmth had far fewer initiatives, as did health protection, which comprised two national immunisation campaigns. Smoking and alcohol misuse were poorly provided for, and there was no provision for older people's sexual health. Evaluation arrangements were poorly described. Half of those who responded identified unmet training needs.</p> <p>Conclusion</p> <p>The reasons for patchy provision of services were not clear. Increased efforts to improve the coverage of interventions known to be effective should be made. Rigorous evaluation of projects is needed to ascertain the most effective and appropriate interventions, especially for alcohol misuse and sexual health. These conclusions are relevant to the other countries of the United Kingdom (UK), and more widely across Europe.</p

Acceptability, reliability, referential distributions and sensitivity to change in the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE) outcome measure: Replication and refinement

Background: Many outcome measures for young people exist, but the choices for services are limited when seeking measures that (a) are free to use in both paper and electronic format, and (b) have evidence of good psychometric properties. Method: Data on the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE), completed by young people aged 11-16, are reported for a clinical sample (N = 1269) drawn from seven services and a nonclinical sample (N = 380). Analyses report item omission, reliability, referential distributions and sensitivity to change. Results: The YP-CORE had a very low rate of missing items, with 95.6% of forms at preintervention fully completed. The overall alpha was .80, with the values for all four subsamples (11-13 and 14-16 by gender) exceeding .70. There were significant differences in mean YP-CORE scores by gender and age band, as well as distinct reliable change indices and clinically significant change cut-off points. Conclusions: These findings suggest that the YP-CORE satisfies standard psychometric requirements for use as a routine outcome measure for young people. Its status as a free to use measure and the availability of an increasing number of translations makes the YP-CORE a candidate outcome measure to be considered for routine services

Housing policy in the UK: the importance of spatial nuance

The UK has been engaged in an ongoing process of constitutional reform since the late 1990s, when devolved administrations were established in Northern Ireland, Scotland and Wales. As devolution has evolved there has been a greater trend towards divergence in housing policy, which calls into question any notion of a ‘UK experience’. Whilst the 2014 Scottish independence referendum again returned constitutional reform high onto the political agenda, there still remain tensions between devolved governments and the UK Government in Westminster, with England increasingly becoming the outlier in policy terms. Informed by ideas of social constructionism, which emphasises the politics of housing, this paper draws on an analysis of policy narratives to highlight the need for greater geographical sensitivity. This requires not only more spatial nuance, but also a recognition that these differences are underpinned by divergent political narratives in different parts of the UK. This emphasis on the politics underpinning policy has relevance internationally in other geographical contexts

The impact of local authorities’ interventions on household waste collection: a case study approach using time series modelling

At a local Government level there have been many interventions and changes made to household waste collection services to meet new regulatory requirements. These changes include separate collection of recyclable and organic materials. This paper has used a time series model to quantify the success of interventions introduced by a LA. The case study was a medium sized UK LA, Charnwood Borough Council (CBC), the research analyses monthly data of quantities of recyclates, garden waste for composting and residual waste for landfill disposal. The time series model was validated with a five year data set and used to measure the impacts of the various changes to identify which intervention was the most successful, while controlling for season and number of working days. The results show the interventions analysed both had abrupt and permanent positive impacts on the yield of recyclable materials, and a corresponding negative impact on the residual waste. The model could be added to the National data base to help LAs to compare interventions and to understand which schemes encourage householder participation and improve recycling performance

Love, rights and solidarity: studying children's participation using Honneth's theory of recognition

Recent attempts to theorize children’s participation have drawn on a wide range of ideas, concepts and models from political and social theory. The aim of this article is to explore the specific usefulness of Honneth’s theory of a ‘struggle for recognition’ in thinking about this area of practice. The article identifies what is distinctive about Honneth’s theory of recognition, and how it differs from other theories of recognition. It then considers the relevance of Honneth’s conceptual framework to the social position of children, including those who may be involved in a variety of ‘participatory’ activities. It looks at how useful Honneth’s ideas are in direct engagement with young people’s praxis, drawing on ethnographic research with members of a children and young people’s forum. The article concludes by reflecting on the implications of this theoretical approach and the further questions which it opens up for theories of participation and of adult–child relations more generally

Walking, sustainability and health: findings from a study of a Walking for Health group.

Not only is it tacitly understood that walking is good for health and wellbeing, there is now robust evidence to support this link. There is also growing evidence that regular short walks can be a protective factor for a range of long-term health conditions. Walking in the countryside can bring additional benefits, but access to the countryside brings complexities, especially for people with poorer material resources and from different ethnic communities. Reasons for people taking up walking as a physical activity are reasonably well understood, but factors linked to sustained walking, and therefore sustained benefit, are not. Based on an ethnographic study of a Walking for Health group in Lincolnshire, UK, this paper considers the motivations and rewards of group walks for older people. Nineteen members of the walking group, almost all with long-term conditions, took part in tape-recorded interviews about the personal benefits of walking. The paper provides insights into the links between walking as a sustainable activity and health, and why a combination of personal adaptive capacities, design elements of the walks and relational achievements of the walking group are important to this understanding. The paper concludes with some observations about the need to reframe conventional thinking about adherence to physical activity programmes