Pivot to Telehealth: Narrative Reflections on Circle of Security Parenting Groups during COVID-19.

In response to COVID-19 hygiene and physical distancing restrictions, our service rapidly shifted to delivering Circle of Security-Parenting™ (COS-P) groups via telehealth. In this article we report the perspectives and experiences of the group facilitator and the parents who received the intervention during the COVID-19 pandemic. We use semi-structured, qualitative interviews to explore the advantages, challenges, and positive impacts of the online parenting group from the perspectives of the group leader and the five group participants. Participants' narrative reflections show that they were satisfied with the convenient and engaging online delivery of the program and would recommend it to other parents. Parents reported significant improvements in their parenting and greater awareness of their strengths and struggles. The online delivery of COS-P resulted in more efficient service delivery, greater attendance rates, and adherence to the model. The stressors on the experienced facilitator, due to the abrupt transition and multiple technical and communication challenges, may have been mitigated by supervisor and collegial support, as well as careful preparation for herself and the participants. Future research should investigate the effectiveness of online versus face-to-face delivery of the intervention, including what works for whom.

Asking the difficult questions: Building the capacity of community paediatricians to routinely enquire and respond to family violence.

AIM: To enhance the confidence and capacity of community paediatricians and paediatric trainees to identify and respond to family violence, through a series of education sessions and evidence-based recommendations. METHODS: The action research methodology included a literature search to review the data on family violence education programmes and evidence-based family violence screening tools. Six education sessions were then developed and held for physicians at the Community Paediatric and Child Health Service (CPCHS). An audit was performed on the charts of all new referrals to the CPCHS for a period of 18 months prior to the education sessions and 5 months following the education sessions. A questionnaire was distributed at the first and final education sessions to gauge physician comfort with enquiry into family violence. RESULTS: The documented rate of enquiry into family violence at CPCHS was 24% in the retrospective chart audit. Following the series of education sessions, the documented rate of enquiry increased to 60% (P < 0.05, odds ratio 4.7, confidence interval 2.7-8.4). The documented rate of disclosure of family violence also increased from 13% of all new patients in the retrospective chart audit to 24% in the prospective arm of the study (P < 0.05, odds ratio 2.1, confidence interval 1.0-4.0). Following the education sessions, all participants agreed that they routinely enquired about family violence and were comfortable enquiring about family violence. CONCLUSION: This study demonstrates that clinician education about family violence supports routine enquiry about family violence in community paediatric consultations.