Child health – reducing the risk factors and promoting the protective factors  Linda de Caestecker Director of Public Heal...
Infant Mortality Rates Scotland, 1974-2006 Rate per 1,000 Live Births   (Source: GROS )
Number of Deaths in Children under 1 Year by  Scottish Index of Multiple Deprivation  Scotland, 2006 (Source: GROS & ISD S...
 
Reducing Risks and Enhancing Protection <ul><li>Critical periods for child health – pregnancy,  pre-school (0-3) </li></ul...
Smoking  <ul><li>Smoking in pregnancy – variations in recording and sensitive enquiry.  Routine CO monitoring being implem...
 
Family risk factors <ul><li>Poor parenting,  </li></ul><ul><li>family conflict,  </li></ul><ul><li>lack of a warm positive...
Lead to risk of…… <ul><li>Major behavioural and emotional problems </li></ul><ul><li>Substance misuse </li></ul><ul><li>An...
In contrast … <ul><li>Supportive family relationships… </li></ul><ul><li>Predict positive adjustment and </li></ul><ul><li...
The need for parent education <ul><li>Parenting interventions are amongst the most powerful and cost-effective tools avail...
Triple P,  positive parenting programme <ul><li>Multi-level, prevention orientated parenting and family support strategy <...
A population based approach to  large-scale implementation of positive parenting programme   <ul><li>Establish base rates ...
Population based approach <ul><li>An Effective Engagement strategy </li></ul><ul><li>Informed by a theory of inequality  <...
Universal interventions for under-3s <ul><li>Public awareness campaigns using the media more effectively </li></ul><ul><li...
Interventions <ul><li>The Solihull approach  </li></ul><ul><li>Use of evidence based parenting programmes - Triple P, Mell...
Take home messages <ul><li>Addressing the risk and protective factors for good health must be a multi-agency response </li...
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Improving Child Health: Discussion of evidence on promoting protective factors and reducing modifiable risk factors - Linda de Caestecker

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Professor Linda de Caestecker, Director of Public Health, NHS Greater Glasgow and Clyde, http://www.nhsggc.org.uk.

Session 2 - Building Better Childhoods, Understanding Contemporary Childhood.

Getting It Right for Every Child: Childhood, Citizenship and Children's Services, Glasgow, 24-26 September 2008.

http://www.iriss.org.uk/conference/girfec

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  • child health is one of the most important things we should be focusing on today great health info!! http://www.fithuman.net/
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  • great presentation. We at Sure start are trying to improve newborn health and maternal care in various parts of India.

    Our Twitter Profile: http://twitter.com/pathsurestart

    Facebook: http://www.facebook.com/pages/Sure-Start-Project-by-Path/178629192101
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  • Improving Child Health: Discussion of evidence on promoting protective factors and reducing modifiable risk factors - Linda de Caestecker

    1. 1. Child health – reducing the risk factors and promoting the protective factors Linda de Caestecker Director of Public Health NHS Greater Glasgow and Clyde
    2. 2. Infant Mortality Rates Scotland, 1974-2006 Rate per 1,000 Live Births (Source: GROS )
    3. 3. Number of Deaths in Children under 1 Year by Scottish Index of Multiple Deprivation Scotland, 2006 (Source: GROS & ISD Scotland)
    4. 5. Reducing Risks and Enhancing Protection <ul><li>Critical periods for child health – pregnancy, pre-school (0-3) </li></ul><ul><li>Modifiable risk factors </li></ul><ul><ul><li>Smoking in pregnancy, nutrition, obesity </li></ul></ul><ul><ul><li>Postnatal depression </li></ul></ul><ul><ul><li>Substance misuse </li></ul></ul><ul><li>Modifiable protective factors </li></ul><ul><ul><li>Parenting skills, parental self-efficacy </li></ul></ul><ul><ul><li>Stimulation – emotional, cognitive, language </li></ul></ul><ul><ul><li>Health related e.g. nutrition, immunisation </li></ul></ul>
    5. 6. Smoking <ul><li>Smoking in pregnancy – variations in recording and sensitive enquiry. Routine CO monitoring being implemented. </li></ul><ul><li>Protecting children from second-hand smoke </li></ul><ul><ul><ul><li>Legislation has not led to more smoking at home </li></ul></ul></ul><ul><ul><ul><li>Smokefree homes initiative </li></ul></ul></ul><ul><ul><ul><li>Training of professionals </li></ul></ul></ul>
    6. 8. Family risk factors <ul><li>Poor parenting, </li></ul><ul><li>family conflict, </li></ul><ul><li>lack of a warm positive relationship with parents, </li></ul><ul><li>insecure attachments, </li></ul><ul><li>harsh inflexible rigid or inconsistent discipline practices, </li></ul><ul><li>inadequate supervision or involvement with children </li></ul>
    7. 9. Lead to risk of…… <ul><li>Major behavioural and emotional problems </li></ul><ul><li>Substance misuse </li></ul><ul><li>Antisocial behaviour </li></ul><ul><li>Juvenile crime </li></ul>
    8. 10. In contrast … <ul><li>Supportive family relationships… </li></ul><ul><li>Predict positive adjustment and </li></ul><ul><li>Protect against conduct problems </li></ul>
    9. 11. The need for parent education <ul><li>Parenting interventions are amongst the most powerful and cost-effective tools available to prevent and treat serious behavioural and emotional problems in children. </li></ul><ul><li>The majority of parents do not participate in parent education. </li></ul><ul><li>Parenting Survey (2007) showed over 40% had not had any support with parenting and 77% would consider parenting support if available </li></ul>
    10. 12. Triple P, positive parenting programme <ul><li>Multi-level, prevention orientated parenting and family support strategy </li></ul><ul><li>Studies conducted on each intervention level and delivery format with consistent results </li></ul><ul><li>Effect sizes large for improved child behaviour </li></ul><ul><li>Independent replication trials in other countries </li></ul>
    11. 13. A population based approach to large-scale implementation of positive parenting programme <ul><li>Establish base rates for Child Problems and Modifiable Parental Risk and Protective Factors; </li></ul><ul><li>Interventions have evidence of effectiveness, are culturally appropriate and widely available; </li></ul><ul><li>Practitioner training and support; </li></ul><ul><li>A multi-disciplinary workforce </li></ul><ul><li>Consistent implementation and programme fidelity </li></ul>
    12. 14. Population based approach <ul><li>An Effective Engagement strategy </li></ul><ul><li>Informed by a theory of inequality </li></ul><ul><li>Enable parents to identify their own parenting objectives so that they are dynamic participants and go at their pace </li></ul><ul><li>Variants that are tailored to the requirements of high-need groups </li></ul><ul><li>Use Community Surveillance Monitoring to track Population-Level Outcomes </li></ul>
    13. 15. Universal interventions for under-3s <ul><li>Public awareness campaigns using the media more effectively </li></ul><ul><li>Web resources: </li></ul><ul><ul><li>Baby clubs </li></ul></ul><ul><ul><li>Netmums </li></ul></ul><ul><li>Bookstart </li></ul><ul><li>Open access large group classes </li></ul>
    14. 16. Interventions <ul><li>The Solihull approach </li></ul><ul><li>Use of evidence based parenting programmes - Triple P, Mellow Parenting </li></ul><ul><li>Coordination of parenting activity at CHP level </li></ul>
    15. 17. Take home messages <ul><li>Addressing the risk and protective factors for good health must be a multi-agency response </li></ul><ul><li>We need a population level approach to parenting support. </li></ul>

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