Publications
238 results found
Lorenc A, Ilan-Clarke Y, Robinson N, et al., 2009, How parents choose to use CAM: a systematic review of theoretical models., BMC complementary and alternative medicine, Vol: 9, Pages: 9-9, ISSN: 1472-6882
BACKGROUND: Complementary and Alternative Medicine (CAM) is widely used throughout the UK and the Western world. CAM is commonly used for children and the decision-making process to use CAM is affected by numerous factors. Most research on CAM use lacks a theoretical framework and is largely based on bivariate statistics. The aim of this review was to identify a conceptual model which could be used to explain the decision-making process in parental choice of CAM. METHODS: A systematic search of the literature was carried out. A two-stage selection process with predetermined inclusion/exclusion criteria identified studies using a theoretical framework depicting the interaction of psychological factors involved in the CAM decision process. Papers were critically appraised and findings summarised. RESULTS: Twenty two studies using a theoretical model to predict CAM use were included in the final review; only one examined child use. Seven different models were identified. The most commonly used and successful model was Andersen’s Sociobehavioural Model (SBM). Two papers proposed modifications to the SBM for CAM use. Six qualitative studies developed their own model. CONCLUSION: The SBM modified for CAM use, which incorporates both psychological and pragmatic determinants, was identified as the best conceptual model of CAM use. This model provides a valuable framework for future research, and could be used to explain child CAM use. An understanding of the decision making process is crucial in promoting shared decision making between healthcare practitioners and parents and could inform service delivery, guidance and policy.
Blair M, Koury S, De Witt T, et al., 2009, Teaching and training in community child health: learning from global experience., Archives of disease in childhood. Education and practice edition, Vol: 94, Pages: 123-128, ISSN: 1743-0593
Rudolf MCJ, Hunt C, George J, et al., 2009, Development and Pilot of HENRY: A National Health Promotion Programme to Reduce Obesity Risk in Babies and Preschool Children, Obesity, Vol: 17, ISSN: 1930-7381
Robinson N, Lorenc A, Blair M, 2009, Developing a decision-making model on traditional and complementary medicine use for children, European Journal of Integrative Medicine, Vol: 1, Pages: 48-56, ISSN: 1876-3820
Aim: To explore why parents choose traditional and complementary approaches to health for their children, particularly the influence of cultural beliefs and norms, and develop a conceptual model based on Andersen’s sociobehavioural model. Materials and methods: Focus groups with 92 parents from at least 20 different countries living in London, UK, explored the influence of predisposing, enabling, need factors and healthcare experience on traditional and complementary healthcare use for children. Themes were identified using Framework Analysis. Results: Traditional home remedies including herbs, spices, foods, prayer and rituals were used by most parents, often as a first choice of treatment. Parents were categorised into one of seven typologies depending on how these approaches were used: informed, routine, committed, pragmatic, open, last resort and nonbeliever. All three components of the sociobehavioural model (predisposing, enabling, need) were involved in parents’ decision-making when using traditional and complementary healthcare for children. Conclusions: The sociobehavioural model can be used to conceptualise parental decision-making process for child use of traditional and complementary healthcare. This process is crucial in promoting shared decision-making between primary care practitioners and parents and could inform service provision, delivery and policy. ?? 2009 Elsevier GmbH. All rights reserved.
Blair M, 2009, Healthy Child Programme- The Two Year Review, London, Publisher: Department of Health England
Blair M, Gore J, Isaza F, et al., 2008, Multi-method evaluation of a paediatric ambulatory care unit (PACU): impact on families and staff., Archives of disease in childhood, Vol: 93, Pages: 681-685, ISSN: 0003-9888
AIM: To assess the impact of a purpose-built, short stay paediatric ambulatory care unit (PACU) on the patient journey and perceptions of parents, staff and referrers. METHODS: Multi-method evaluation, including a parent survey (n = 104), patient journey mapping (n = 10), staff interviews (n = 10), a referrer survey (n = 16), routine activity analysis, and a comparison with the A&E service (A&E parent survey: n = 41). RESULTS: Almost all parents attending PACU (94%) were satisfied with the service and significantly more likely to feel "very" satisfied than parents attending A&E (PACU: 51%, A&E: 31%; p = 0.03). Further, over three quarters (77%) of PACU parents preferred the new model to traditional A&E services. They reported receiving sufficient information (93%), reduced anxiety (55% anxious before service, 13% anxious after; p<0.001), "quick" waiting times (median: 35 min), and enhanced confidence (87%) and understanding (89%) in dealing with their ill child. The number of stages in the patient journey was reduced from six ("traditional" A&E pathway) to four (PACU pathway). Staff and referrers reported this was a "superior" model to A&E, but that improvements were required around appropriate referrals and the need for more multi-disciplinary protocols and liaison. CONCLUSION: Our study suggests that the PACU model is perceived to be an effective alternative to standard A&E services for the assessment and early management of acutely ill children and their families attending a hospital. It is highly valued by users, staff and referrers and enhances the patient journey. Lessons learnt include the need to enhance multi-disciplinary processes and clarify the role of this form of acute care provision in the wider healthcare system.
Williams N, Mughal S, Blair M, 2008, ’Is my child developing normally?’: A critical review of web-based resources for parents, Developmental Medicine and Child Neurology, Vol: 50, Pages: 893-897, ISSN: 0012-1622
Early detection of developmental problems improves outcomes for parents and children. Parents want to be involved in assessment and need high-quality, accurate, and reliable data on child development to help monitor progress and inform decisions on referral. The aim of this paper is to review which websites are readily accessible to parents on child development and to assess their quality. An internet search (on Google and Yahoo) was conducted using the search terms ’child development’, ’parenting’, and ’developmental milestones’. Criteria were agreed for evaluating web-based resources, adapted from and based on previously reported methods. Data were collected on site content, diagrams and layout, readability (Flesch Reading Ease Scale), design, navigability, overall design, and interactive features. Forty-four relevant websites were identified for further analysis: six government, three university, 15 health-care professional, four American Academy of Pediatrics, 10 by journalists, and six undisclosed. The best websites are presented, with justification for their choice. Overall, information available for parents about child development is accurate but much of it is incomplete, unclear, or difficult to access. There is a need to develop an easily accessible, clear, and authoritative resource for parents with illustrations. Focus groups are being held to inform this research further.
Robinson N, Blair M, Lorenc A, et al., 2008, Complementary medicine use in multi-ethnic paediatric outpatients, Complementary Therapies in Clinical Practice, Vol: 14, Pages: 17-24, ISSN: 1744-3881
Objective: To determine the prevalence and determinants of complementary medicine (CM) use in a multi-ethnic paediatric outpatient population. Methodology: A parent-completed questionnaire survey of paediatric outpatients attending general and sub-specialist outpatient clinics at a North West London hospital during September to December 2005. Results: Parents’ use of CM for their children in this multi-ethnic population was higher than expected at 37%. Use was correlated with parental CM use and education but independent of ethnic group. Parental CM use and child’s health status were significant predictors of child CM use. The main reason for using CM was word of mouth (45%) and the main source of information was friends and family (51%). The most popular treatments used for children were homeopathy and herbal medicine (used by 30% and 28% of CM users, respectively). 88% of CM was bought over the counter and 53% of CM use was not reported to their doctor. Parents also used traditional complementary remedies for their children. Conclusions: These results suggest that CM use in children is higher than previously estimated in the UK. This indicates the need for greater professional awareness of CM as part of clinical care. There is a need to acknowledge the beliefs that inform parents’ decision-making process. ?? 2007 Elsevier Ltd. All rights reserved.
Low-Beer N, Lupton M, Warner J, et al., 2008, Adapting and implementing PACES as a tool for undergraduate assessment, Clinical Teacher, Vol: 5, Pages: 239-244, ISSN: 1743-4971
Blair M, 2008, Book Review: Public Health Practice & the School-Age Population, Public Health, Vol: 122, Pages: 974-975, ISSN: 0033-3506
Jamrozik K, Samarasundera E, Miracle R, et al., 2008, Attendance for injury at accident and emergency departments in London: a cross-sectional study, Public Health, Vol: 122, Pages: 838-844, ISSN: 0033-3506
Objective: In order to set the foundation for the possible development of injury surveillance initiatives in north-west London, data on all presentations during 2002 at the nine accident and emergency departments (AEDs) in the relevant strategic health authority were examined. Study design: Descriptive, cross-sectional study. Methods: A search algorithm was devised to extract records pertaining to injury presentations. The results were validated against a manually checked sample. Descriptive, quantitative analyses were performed. Results: Only four of the nine hospitals in the study area routinely recorded data in a form useful for research on injury. In these four hospitals, presentations with injury accounted for 29.7% of total attendances at the AED, which is markedly lower than the national average. Conclusions: Certain characteristics of London regarding provision of primary care may explain why attendances for injury are proportionately low. However, the unusual pattern also underlines the importance of improving the quality of AED data in order to support adequate local surveillance of injury as the basis of efforts to prevent such incidents and to plan services to deal with injuries. © 2007 The Royal Institute of Public Health.
Wise PH, Blair ME, 2007, The UNICEF Report on Child Well-Being, Ambulatory Pediatrics, Vol: 7, Pages: 265-266, ISSN: 1530-1567
Blair ME, 2007, An audit of the mental health problems of the parents of children on the Coventry Child Protection Register - Author's response, Archives of Disease in Childhood, Vol: 92, ISSN: 0003-9888
Blair M, 2007, How has research in the past 5 years changed my practice?, Archives of disease in childhood, Vol: 92, Pages: 246-250, ISSN: 0003-9888
Blair M, 2006, Training and Education as a Means of Increasing Equity in Child Health Teaching of Undergraduates, Pediatrics, Vol: 112, Pages: 747-748
Blair M, Hall D, 2006, From health surveillance to health promotion: the changing focus in preventive children’s services, Archives of disease in childhood, Vol: 91, Pages: 730-735, ISSN: 0003-9888
The shift from surveillance to promotion requires paediatricians to play several roles in a larger multidisciplinary and multi‐agency team
Basu A, 2005, Child Public Health * Mitch Blair, Sarah Stewart-Brown, Tony Waterston, and Rachel Crowther * 1st Edition, 2003 * ISBN 0192631934 * Oxford University Press (Oxford) * Price 29.50 (paperback), Journal of Tropical Pediatrics, Vol: 52, Pages: 152-152, ISSN: 0142-6338
Blair M, 2005, Review: Commonly recommended well-child care interventions are not supported by evidence: Commentary, Evidence-Based Medicine, Vol: 10, ISSN: 1356-5524
Law C, 2005, Child public health., JOURNAL OF PUBLIC HEALTH, Vol: 27, Pages: 233-233, ISSN: 1741-3842
Dale J, Jenkins HR, 2005, The paediatric research society Scientific abstracts, Current Paediatrics, Vol: 15, Pages: 183-194, ISSN: 0957-5839
Edmunds S, Haines L, Blair M, 2005, Development of a questionnaire to collect public health data for school entrants in London: Child Health Assessment at School Entry (CHASE) project., Child: care, health and development, Vol: 31, Pages: 89-97, ISSN: 0305-1862
BACKGROUND: To develop a multiprofessional consensus about the relative contributions of the components of children’s health and well-being and to develop a questionnaire that can be used to assess these in London’s children. METHODS: Semi-structured interviews with health, education and social services professionals were used to identify areas to include in the questionnaire. These ideas were used as the basis for a wider Delphi consultation, with 79 experts in the area of child health. Round 1 of the Delphi asked panelists to rate 54 items as to whether they should be included in the questionnaire or not. Responses were divided into four categories: item to be included measurement method agreed, item to be included measurement method not agreed, no consensus, or excluded. In round 2, consensus was sought for the categories where there was none following round 1. RESULTS: Themes identified by the interviews were: economic factors, ethnicity, environment, nutrition, hygiene and physical activity, growth, suffers from chronic/serious illness, development, disability and learning, accidents and hospital attendances, self-regulation, psychological well-being, significant life events. After Delphi round 1, items included, where quality measurement method was agreed, were: deprivation index (from postcode), child’s ethnicity, temporary accommodation, care status, registered with general practitioner, dental visits, height, weight, special educational needs status, baseline educational assessment result, immunization status, visual and hearing function. Following round 2, items relating to chronic illness, mental health, physical functioning, general health, self-esteem, family cohesion and accident status were agreed for inclusion with a measurement method also agreed. The questionnaire was acceptable to parents. CONCLUSION: The validity, reliability and feasibility of this questionnaire must now be examined. This data set, if collected across London, w
Edmunds S, Garratt A, Haines L, et al., 2005, Child Health Assessment at School Entry (CHASE) project: Evaluation in 10 London primary schools, Child: Care, Health and Development, Vol: 31, Pages: 143-154, ISSN: 0305-1862
AIMS: To assess the feasibility of implementing the Child Health Assessment at School Entry (CHASE) questionnaire, developed to capture the multiple dimensions of the health of children in their first year at school, and to evaluate data quality, reliability and validity. METHODS: Parents of 278 year-1 children, from 10 primary schools in two London boroughs, received a parent questionnaire and school nurses completed a separate questionnaire from health and education records for children whose parents consented. Additional data on free school meal eligibility and ethnicity were obtained from the two Local Education Authorities. The parent questionnaire included the Strengths and Difficulties Questionnaire (SDQ) and four dimensions of the Child Health Questionnaire Parent Form-28 (CHQ-PF28). RESULTS: Response rate was 61%. The association between school free school meals eligibility and response rate in each school approached significance (r = -0.62, P = 0.05). Data completeness of the parent questionnaire was high (mean 98%). Data completeness of the school nurse questionnaire was more variable (mean 82%). Cronbach’s Alpha was greater than 0.6 for four of the five SDQ scales and greater than 0.7 for the two CHQ-PF28 multi-item scales. Relative to parents with qualifications, parents with no qualifications rated their children as having significantly more conduct problems, peer problems, and overall mental health problems (P < 0.01) as assessed by the SDQ, and significantly lower global health (P < 0.01) as assessed by the CHQ-PF28. Children with special educational needs and children with long-standing illness or disability were rated as having significantly lower global health (P < 0.05) than children without these. Sample tables of inter-school and inter-borough comparison of key findings demonstrate considerable differences in physical and mental health status. DISCUSSION: The questionnaire was acceptable to parents and school nurses, and feasible
Blair M, Gore J, Malhotra A, et al., 2004, Keeping young children out of hospital: paediatric ambulatory care (short stay) units reduce the proportion of children under four being admitted, Archives of Disease in Childhood, Vol: 89, Pages: 23-25
Blair M, 2004, The challenge of quality assurance in preventive child health care in the 21st century - experiences from the UK, European Journal of Public Health, Vol: 14, Pages: 59-60, ISSN: 1101-1262
Hampshire AJ, Blair ME, Crown NS, et al., 2004, Variation in how mothers, health visitors and general practitioners use the personal child health record, Child: Care, Health and Development, Vol: 30, Pages: 307-316, ISSN: 0305-1862
BACKGROUND: In the UK, a national personal child health record (PCHR) with local adaptations is in widespread use. Previous studies report that parents find the PCHR useful and that health visitors use it more than other health professionals. This study was carried out in Nottingham, where the local PCHR is similar to the national PCHR. OBJECTIVES: To explore variation in use of the PCHR made by mothers with differing social characteristics, to compare heath visitors’ and general practitioners’ (GPs’) use of the PCHR, and to compare health visitors’ and GPs’ perceptions of the PCHR with those of mothers for whose children they provide care. METHODS: Questionnaires to 534 parents registered with 28 general practices and interviews with a health visitor and GP at each practice. A score per mother for perceived usefulness of the PCHR was developed from the questionnaire, and variation in the score was investigated by linear regression adjusted for clustering. RESULTS: Four hundred and one (75%) questionnaires were returned. Three hundred and twenty-five (82%) mothers thought the PCHR was very good or good. Higher scores for usage of the PCHR were significantly associated with teenage and first-time mothers, but no association was found with mother’s social class, education or being a single parent. There was no association between variation in the score and practice, health visitor or GP characteristics. Mothers, health visitors and GPs reported that mothers took the PCHR to baby clinic more frequently than when seeing their GP, and that health visitors wrote in the PCHR more frequently than GPs. Eighteen (67%) health visitors and 20 (71%) GPs said they had difficulty recording information in the PCHR. CONCLUSION: The PCHR is used by most mothers and is important for providing health promotion material to all families with young children. It may be particularly useful for first-time and teenage mothers.
Blair M, Waterston T, Stewart Brown S, et al., 2003, Child Public Health, Publisher: Oxford University Press, ISBN: 9780192631923
Blair M, 2003, Training and education as a means of increasing equity in child health teaching of undergraduates, Joint Meeting of the Royal-College-of-Paediatrics-and-Child-Health/American-Academy-of-Pediatrics, Publisher: AMER ACAD PEDIATRICS, Pages: 747-748, ISSN: 0031-4005
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Hughes S, Brent K, Kumar S, et al., 2003, Is procalcitonin a discriminant marker of invasive bacterial infection in children?, Annual Meeting of the Pediatric-Academic-Society, Publisher: INT PEDIATRIC RESEARCH FOUNDATION, INC, Pages: 20A-20A, ISSN: 0031-3998
Rigby MJ, Köhler LI, Blair ME, et al., 2003, Child Health Indicators for Europe: A priority for a caring society, European Journal of Public Health, Vol: 13, Pages: 38-46, ISSN: 1101-1262
Background: Measurement of children's health is important for two reasons: first, because young people are citizens in their own right, yet largely unable to act as self-advocates, particularly at the population level; and second, because their health determines the health of the future population. Indicators based on measurements of child health are important for identifying progress, problems and priorities, changes over time, and newly emergent issues. The European Community Health Monitoring Programme (HMP) is a comprehensive programme to develop and implement a set of national-level indicators. The Child Health Indicators of Life and Development (CHILD) project is the only population group-specific project, seeking to determine a holistic set of measures. Methods: The project endeavoured to address all aspects of child health and its determinants, balancing positive and negative aspects. It undertook a structured search of published evidence to seek to identify, and validate, indicators of health and illness, health determinants and challenges to health, quality of healthcare support and health-promoting national policies. A systematic approach was used in identifying valid indicators, and in assembling a balanced composite list. All ages from infancy to adolescence were covered. Results: The project's final report identifies 38 core desirable national indicators, citing purpose and evidence for each. Of equal importance, it also identifies 17 key child health topics on which further research work is needed in order to identify and validate indicators appropriate across different national settings.
Blair M, 2003, Principles and Purpose for Child Health Informatics, Vision and Value in Health Information, Editors: Rigby, Publisher: Radcliffe
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