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Introduction Children who are next-of-kin, for a parent who experience illness or disability, need support. In Norway, guidelines, routines and structured approaches in the community health services are lacking regarding involving children in the care of a parent and for services when supporting children as next-of-kin. Additionally, no existing international review has focused on support from community health and social services for children who are next-of-kin to a parent regardless of the specific illness or disability. Aims This scoping review examined the current knowledge regarding the types of community health and social services support to children 0 to 17 years old living with a parent experiencing illness or disability. The review also identified children’s support preferences and needs. Methods The scoping review involved five stages; identifying research question; identifying relevant articles; selecting articles; charting the data and finally, collating, summarizing and reporting the results. Results Articles which included community health and social services interventions and children’s preferences or needs for support were included. The foci of interventions included preventive education, peer support, psychosocial support, and interventions focusing on family communication and recovery planning. Articles focusing on children’s preferences or need for support described their wish to be recognized as a next-of-kin, having someone to talk to and professional and peer support. Conclusion The review highlighted the importance of children receiving support according to their preferences. It is important to elicit children’s voices, to ensure community health and social services are developed for and tailored to this population.

ObjectivesIn the first wave of the COVID-19 pandemic, social isolation, school/child care closures and employment instability have created unprecedented conditions for families raising children at home. This study describes the mental health impacts of the COVID-19 pandemic on families with children in Canada.Design, setting and participantsThis descriptive study used a nationally representative, cross-sectional survey of adults living in Canada (n=3000) to examine the mental health impacts of the COVID-19 pandemic. Outcomes among parents with children <18 years old living at home (n=618) were compared with the rest of the sample. Data were collected via an online survey between 14 May to 29 May 2020.Outcome measuresParticipants reported on changes to their mental health since the onset of the pandemic and sources of stress, emotional responses, substance use patterns and suicidality/self-harm. Additionally, parents identified changes in their interactions with their children, impacts on their children’s mental health and sources of support accessed.Results44.3% of parents with children <18 years living at home reported worse mental health as a result of the COVID-19 pandemic compared with 35.6% of respondents without children <18 living at home, χ2 (1, n=3000)=16.2, p<0.001. More parents compared with the rest of the sample reported increased alcohol consumption (27.7% vs 16.1%, χ2 (1, n=3000)=43.8, p<0.001), suicidal thoughts/feelings (8.3% vs 5.2%, χ2 (1, n=3000)=8.0, p=0.005) and stress about being safe from physical/emotional domestic violence (11.5% vs 7.9%, χ2 (1, n=3000)=8.1, p=0.005). 24.8% (95% CI 21.4 to 28.4) of parents reported their children’s mental health had worsened since the pandemic. Parents also reported more frequent negative as well as positive interactions with their children due to the pandemic (eg, more conflicts, 22.2% (95% CI 19.0 to 25.7); increased feelings of closeness, 49.7% (95% CI 45.7 to 53.7)).ConclusionsThis study identifies that families with children <18 at home have experienced deteriorated mental health due to the pandemic. Population-level responses are required to adequately respond to families’ diverse needs and mitigate the potential for widening health and social inequities for parents and children.

ObjectivesChildren exposed to social adversity—hardship as a result of social circumstances such as poverty or intergenerational trauma—are at increased risk of poor outcomes across the life course. Understanding what promotes resilient outcomes is essential for the development of evidence informed intervention strategies. We conducted a systematic review to identify how child resilience is measured and what factors are associated with resilient outcomes.DesignSystematic search conducted in CINAHL, MEDLINE and PsychInfo from January 2004 to October 2018 using the keywords ‘resilien* and child* in the title or abstract. Eligible studies: (1) described children aged 5–12 years; (2) identified exposure to social adversity; (3) identified resilience; and (4) investigated factors associated with resilience.Outcome measures(1) approaches to identifying resilience and (2) factors associated with resilient outcomes.ResultsFrom 1979 studies retrieved, 30 studies met the inclusion criteria. Most studies were moderate to high quality, with low cultural competency. Social adversity exposures included poverty, parent loss, maltreatment and war. Only two studies used a measure of child resilience; neither was psychometrically validated. Remaining studies classified children as resilient if they showed positive outcomes (eg, mental health or academic achievement) despite adversity. A range of child, family, school and community factors were associated with resilient outcomes, with individual factors most commonly investigated. The best available evidence was for cognitive skills, emotion regulation, relationships with caregivers and academic engagement.ConclusionsWhile there is huge variation in the type and severity of adversity that children experience, there is some evidence that specific individual, relational and school factors are associated with resilient outcomes across a range of contexts. Such factors provide an important starting point for effective public health interventions to promote resilience and to prevent or ameliorate the immediate and long-term impacts of social adversity on children.

ObjectiveTo determine whether there were inequalities in the sustained rise in infant mortality in England in recent years and the contribution of rising child poverty to these trends.DesignThis is an analysis of trends in infant mortality in local authorities grouped into five categories (quintiles) based on their level of income deprivation. Fixed-effects regression models were used to quantify the association between regional changes in child poverty and regional changes in infant mortality.Setting324 English local authorities in 9 English government office regions.ParticipantsLive-born children under 1 year of age.Main outcome measureInfant mortality rate, defined as the number of deaths in children under 1 year of age per 100 000 live births in the same year.ResultsThe sustained and unprecedented rise in infant mortality in England from 2014 to 2017 was not experienced evenly across the population. In the most deprived local authorities, the previously declining trend in infant mortality reversed and mortality rose, leading to an additional 24 infant deaths per 100 000 live births per year (95% CI 6 to 42), relative to the previous trend. There was no significant change from the pre-existing trend in the most affluent local authorities. As a result, inequalities in infant mortality increased, with the gap between the most and the least deprived local authority areas widening by 52 deaths per 100 000 births (95% CI 36 to 68). Overall from 2014 to 2017, there were a total of 572 excess infant deaths (95% CI 200 to 944) compared with what would have been expected based on historical trends. We estimated that each 1% increase in child poverty was significantly associated with an extra 5.8 infant deaths per 100 000 live births (95% CI 2.4 to 9.2). The findings suggest that about a third of the increases in infant mortality between 2014 and 2017 can be attributed to rising child poverty (172 deaths, 95% CI 74 to 266).ConclusionThis study provides evidence that the unprecedented rise in infant mortality disproportionately affected the poorest areas of the country, leaving the more affluent areas unaffected. Our analysis also linked the recent increase in infant mortality in England with rising child poverty, suggesting that about a third of the increase in infant mortality from 2014 to 2017 may be attributed to rising child poverty.

IntroductionChild maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence) is widely understood to be associated with multiple mental health disorders, physical health problems and health risk behaviours throughout life. However, Australia lacks fundamental evidence about the prevalence and characteristics of child maltreatment, its associations with mental disorders and physical health, and the associated burden of disease. These evidence gaps impede the development of public health strategies to better prevent and respond to child maltreatment. The aims of this research are to generate the first comprehensive population-based national data on the prevalence of child maltreatment in Australia, identify associations with mental disorders and physical health conditions and other adverse consequences, estimate attributable burden of disease and indicate targeted areas for future optimal public health prevention strategies.Methods and analysisThe Australian Child Maltreatment Study (ACMS) is a nationwide, cross-sectional study of Australia’s population aged 16 years and over. A survey of approximately 10 000 Australians will capture retrospective self-reported data on the experience in childhood of all five types of maltreatment (physical abuse, sexual abuse, emotional abuse, neglect and exposure to domestic violence). A customised, multimodule survey instrument has been designed to obtain information including: the prevalence and characteristics of these experiences; diagnostic screening of common mental health disorders; physical health; health risk behaviours and health service utilisation. The survey will be administered in March–November 2021 to a random sample of the nationwide population, recruited through mobile phone numbers. Participants will be surveyed using computer-assisted telephone interviews, conducted by trained interviewers from the Social Research Centre, an agency with extensive experience in studies of health and adversity. Rigorous protocols protect the safety of both participants and interviewers, and comply with all ethical and legal requirements. Analysis will include descriptive statistics reporting the prevalence of individual and multitype child maltreatment, multiple logistic and linear regression analyses to determine associations with mental disorders and physical health problems. We will calculate the population attributable fractions of these putative outcomes to enable an estimation of the disease burden attributable to child maltreatment.Ethics and disseminationThe study has been approved by the Queensland University of Technology Human Research Ethics Committee (#1900000477, 16 August 2019). Results will be published to the scientific community in peer-reviewed journals, scientific meetings and through targeted networks. Findings and recommendations will be shared with government policymakers and community and organisational stakeholders through diverse engagement activities, a dedicated Advisory Board and a systematic knowledge translation strategy. Results will be communicated to the public through an organised media strategy and the ACMS website.

ObjectivesWith rising poverty and widening health inequity among children in the UK, the objective of this study is to evaluate the impact of the Sure Start programme on child health outcomes in disadvantaged children.DesignSystematic review.Data sourcesWe conducted a comprehensive search of three databases: Embase, Medline and Social Policy and Practice, with grey literature searched using Open Grey, Social Care Online and Google Scholar. The search was conducted in January 2024.Eligibility criteria for selecting studiesAll primary studies investigating health outcomes in children as a result of Sure Start intervention were eligible for inclusion, without limitations on study design.Data extraction and synthesisFull-text articles in English were independently screened according to the eligibility criteria by two researchers. Results were synthesised and presented in both a quantitative and narrative format. We assessed the risk of bias in each included study.ResultsOur initial search identified 585 records, of which 9 met our inclusion criteria with a further 3 grey literature reports included. Three themes were identified: physical health, social functioning and neurodevelopmental disorders. In terms of physical health, our findings indicate significant reductions in hospitalisations in older children, accidental injury and obesity prevalence. Furthermore, Sure Start increased the prevalence of breastfeeding and improved dental hygiene in children. In the social functioning domain, the Sure Start programme produced mixed findings: with children from certain backgrounds observing adverse effects as a result of the intervention. Yet, Sure Start demonstrated significant improvement in education attainment, with a maximal improvement of grade improvement in children from low socio-economic and ethnic minority backgrounds. For neurodevelopmental disorders, Sure Start was able to significantly improve conduct disorder and attention-deficit hyperactivity disorder symptomatology with long-term clinical stabilisation, as well as improving screening rates for developmental disorders.ConclusionThis study examines the evidence of the Sure Start programme, as an example of an early-years community-based intervention, to mitigate health inequity among disadvantaged children. The findings suggest the Sure Start programme to be effective in health generation across the domains of physical health and neurodevelopmental disorders for disadvantaged children, but with mixed findings for social development that can only partially be explained by methodological flaws.Trial registration numberPROSPERO CRD42024503234.

ObjectivesTo determine any change in referral patterns and outcomes in children (0–18) referred for child protection medical examination (CPME) during the COVID-19 pandemic compared with previous years.DesignRetrospective observational study, analysing routinely collected clinical data from CPME reports in a rapid response to the pandemic lockdown.SettingBirmingham Community Healthcare NHS Trust, which provides all routine CPME for Birmingham, England, population 1.1 million including 288 000 children.ParticipantsChildren aged under 18 years attending CPME during an 18-week period from late February to late June during the years 2018–2020.Main outcome measuresNumbers of referrals, source of disclosure and outcomes from CPME.ResultsThere were 78 CPME referrals in 2018, 75 in 2019 and 47 in 2020, this was a 39.7% (95% CI 12.4% to 59.0%) reduction in referrals from 2018 to 2020, and a 37.3% (95% CI 8.6% to 57.4%) reduction from 2019 to 2020. There were fewer CPME referrals initiated by school staff in 2020, 12 (26%) compared with 36 (47%) and 38 (52%) in 2018 and 2019, respectively. In all years 75.9% of children were known to social care prior to CPME, and 94% of CPME concluded that there were significant safeguarding concerns.ConclusionsSchool closure due to COVID-19 may have harmed children as child abuse has remained hidden. There needs to be either mandatory attendance at schools in future or viable alternatives found. There may be a significant increase in safeguarding referrals when schools fully reopen as children disclose the abuse they have experienced at home.

ObjectivesTo provide an overview of the impact on children in the UK and globally while emphasizing the specific challenges faced by children from low-income families, children with mental health issues, and children with chronic conditions.MethodsThis review examines the literature, reports, and surveys pertaining to the cost-of-living crisis and its impact on children. It incorporates diverse sources such as academic research, governmental reports, and charity organizations to offer a comprehensive understanding of the issue.ResultsThe cost-of-living crisis has led to a range of adverse outcomes for children, including food and housing insecurity, poor physical and mental health, educational difficulties, and social disadvantages. Vulnerable children, such as those from low-income families, experience higher rates of infant mortality, lower birth weights, and increased risks of chronic diseases and mental health problems.ConclusionThe cost-of-living crisis has placed vulnerable children at a higher risk of physical, mental, educational, behavioural, and social difficulties. Addressing this issue requires a multi-faceted approach involving family support, community organizations, and the active involvement of healthcare practitioners, especially paediatricians. By providing support, raising awareness, and implementing effective interventions, it is possible to mitigate the detrimental effects of the cost-of-living crisis on vulnerable children and improve their overall well-being.ReferencesAyyash HF, Ogundele MO, Lynn RM, Schumm T-S, Ani C. Involvement of community paediatricians in the care of children and young people with mental health difficulties in the UK: implications for case ascertainment by child and adolescent psychiatric, and paediatric surveillance systems. BMJ Paediatrics Open, 2021;5(1):e000713. https://doi.org/10.1136/bmjpo-2020-000713.Bloch D, Chahroudi A. Poverty and chronic illness: why safety net programs matter. Pediatric Research, 2019;85(6):743–744. https://doi.org/10.1038/s41390-019-0363-2.Iacobucci G. Cost of living is directly harming child health, paediatricians warn. BMJ, 2022;o2286. https://doi.org/10.1136/bmj.o2286.Kingdon C. Paediatricians work to shift the dial of systemic child poverty and health inequalities. BMJ, 2022;o2416. https://doi.org/10.1136/bmj.o2416.