This protocol summarises the plans for a feasibility study to assess the acceptability and usefulness of a co-produced health assessment measure aimed at young people in care and their caregivers. The study will also look at how best to measure the impact of the health assessment measure on outcomes for children in care.
Background and problem statement
Children and young people in care are more likely to have significant physical and emotional health needs in comparison to their non-care-experienced peers. The negative impact of adverse childhood experiences such as poverty, abuse, neglect, and domestic abuse on health outcomes is well documented, and subjective wellbeing is generally lower for children in care compared to the general population.
The identification of health needs, and access to the right health services, plays a crucial role in promoting the health of young people in care. Local authorities carry out annual health assessments of children in care which aims to address their health needs. Despite this, children in care are more likely to have changes in general practitioners, incomplete immunisations, and limited health education when compared with their peers. Further, as young people grow older, they tend to disengage from these assessments because they do not want to stand out from their peers. The information gathered during these assessments is also not consistently collected to enable local authorities and clinical commissioning groups to understand the health requirements of young people in care and ensure appropriate services are commissioned to meet those needs.
Aims and objectives
This research project aims to develop a supplementary health assessment measure tailored to young people in care and evaluate its acceptability and usefulness. It also seeks to determine whether the questionnaire should differ for young people in residential care versus foster care. The contents of the questionnaire will be co-produced with three advisory groups, aiming to empower young people and their caregivers to better understand and take control of their own health. This additional information may support local authorities and Clinical Commissioning Groups (CCGs) to better consider the health needs of the looked-after population. The research aims to answer the following questions:
- Does a questionnaire to identify the health status of young people in care and their access to health services need to include different content for young people in residential versus foster care?
- What are the views of young people, caregivers and health professional on the questionnaire’s acceptability and usefulness?
- What are the most appropriate and acceptable measures of the outcomes identified in the theory of change?
- What methods would be appropriate for a larger efficacy trial?
Methods
The methodology involves collaborating with advisory groups to co-develop the questionnaire. It will be piloted with participants from different care settings, and perspectives of young people, caregivers, and health professionals will be gathered through interviews to assess the questionnaire’s acceptability and usefulness. Theory of Change workshops and interviews with health and social care professionals will explore appropriate outcome measures and suitable methods for a larger efficacy trial.