Why don't children and young people engage with diabetes services?

The studySharpe D, Rajabi M, Harden A, et al. Supporting disengaged children and young people living with diabetes to self-care: a qualitative study in a socially disadvantaged and ethnically diverse urban area. BMJ Open 2021;11:e046989.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/why-dont-young-people-engage-with-diabetes-services/.

Collaborative research methods and best practice with children and young people: protocol for a mixed-method review of the health and social sciences literature.

INTRODUCTION: Children and young people have the right to participate in research on matters that affect them, and their contribution improves research quality and insights from findings. Discrete participatory approaches are used across different disciplines. This review will provide a synthesis of existing literature from different disciplines by working with young people and adults experienced in participatory research to develop a broad definition of child and youth led research and to identify best practice. METHODS AND ANALYSIS: Comprehensive searches will be conducted in eight electronic databases (PsycINFO, Medline, CINAHL, Embase, SocINDEX, ASSIA: Applied Social Sciences Index and Abstracts (Proquest), Social Care Online and SCOPUS). Grey literature reports will also be sourced using Google searching. Eligible studies will be English-language primary studies and reviews on collaborative research with children and young people (aged 5-25 years) published from 2000 onwards. Qualitative and quantitative data will be integrated in a single qualitative synthesis following the JBI convergent integrated approach. Study quality will be assessed by developed checklists based on existing participation tools cocreated with the project steering group and co-creation activities with young people. ETHICS AND DISSEMINATION: Ethical approval is not required as no primary data will be collected. The review will develop guidance on best practice for collaborative research with children and young people, synthesising learnings from a wide variety of disciplines. Dissemination will be via peer-reviewed publications, presentations at academic conferences and lay summaries for various stakeholders. Opportunities for cocreation of outputs will be sought with the young researchers and the project steering committee. PROSPERO REGISTRATION NUMBER: CRD42021246378.

Supporting disengaged children and young people living with diabetes to self-care: a qualitative study in a socially disadvantaged and ethnically diverse urban area.

OBJECTIVE: To explore how to enhance services to support the self-care of children and young people (CYP) clinically considered 'disengaged' by diabetes services. DESIGN: Qualitative study. SETTING: Two diabetes clinics in an ethnically diverse and socially disadvantaged urban area in the UK. Eligible participants were CYP living with type 1 or type 2 diabetes aged between 10 and 25 years who did not attend their last annual hospital appointment. PARTICIPANTS: 22 CYP (14 female and 8 male) aged between 10 and 19 years old took part. The sample was diverse in terms of ethnicity, age at diagnosis, family composition and presence of diabetes among other family members. DATA COLLECTION: Semistructured interviews. DATA ANALYSIS: Data were analysed thematically. RESULTS: Analysis of participant accounts confirmed the crucial importance of non-medicalised care in CYP diabetes care. A life plan was considered as important to participants as a health plan. Participants valued the holistic support provided by friends, family members and school teachers. However, they found structural barriers in their health and educational pathways as well as disparities in the quality of support at critical moments along the life course. They actively tried to maximise their well-being by balancing life priorities against diabetes priorities. Combined, these features could undermine participants engagement with health services where personal strategies were often held back or edited out of clinical appointments in fear of condemnation. CONCLUSION: We demonstrate why diabetes health teams need to appreciate the conflicting pressures experienced by CYP and to coproduce more nuanced health plans for addressing their concerns regarding identity and risk taking behaviours in the context of their life-worlds. Exploring these issues and identifying ways to better support CYP to address them more proactively should reduce disengagement and set realistic health outcomes that make best use of medical resources.

Mental health and wellbeing implications of the COVID-19 quarantine for disabled and disadvantaged children and young people: evidence from a cross-cultural study in Zambia and Sierra Leone.

BACKGROUND: The mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone. METHOD: A total of 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and educational challenges during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the planning tool. RESULTS: The data showed that participants in the global south have increasing anxieties and fears centred on accessing offline educational resources and income loss in the family effecting food security and their ability to return to education. Mean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental well-being scores were lower in females, children aged 12-14 and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating. CONCLUSION: The study shows that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.

A professional development programme for care home nurses in east London.

There is a need for professional development opportunities for registered nurses undertaking leadership roles in care homes. This article examines the learning outcomes from a pilot career development programme for care home nurses, which was designed and delivered as part of a Florence Nightingale Foundation leadership scholarship. The six-month programme, consisting of one-day workshops, focused on four key competencies, one of which was to identify and consider potential pathways for career development in the sector. Fifteen nurses took part in the development programme. They contributed to the session discussions and activities by drawing on their professional experience. On completion, the nurses reported that they believed attending the programme would improve their practice and contribute towards any future career development. The findings indicate an increased confidence among some of the nurses who attended. The programme also had a positive effect on their professional self-image, with some reporting that it made them feel more like 'real nurses', who are proud to care for a vulnerable group in society.