Immunisation status of children receiving care and support in Wales: a national data linkage study.

Background: In the UK, a robust childhood immunisation programme ensures children are offered protection against serious infections; identifying inequalities in vaccination coverage is essential. This is one of the first data linkage studies to examine coverage of primary, as well as pre-school booster and second dose of MMR vaccines, in children receiving support from social care services across Wales. Methods: By accessing records held within the Secure Anonymised Information Linkage (SAIL) Databank, vaccination status of children receiving social care and support between April 2016 and March 2021 (n = 24,540) was ascertained. This was achieved through linkage of the Children Receiving Care and Support (CRCS) Census and National Community Child Health Database which holds vaccination records for all children in Wales registered for NHS care. This sample was split into three groups - those children who had never been recorded on the Child Protection Register (CPR) or as 'Looked After' but in CRCS (n = 12,480), children ever on the CPR (n = 6,225) and those ever recorded as 'Looked After' but who were never on the CPR (n = 5,840). The comparison group of children and young people (CYP) never receiving welfare support consisted of 624,905 children. Results: Children receiving care or support were more likely to be up-to-date with all six vaccines (no recorded vaccines: 0.6-6.3%) compared to children in the comparison group (no recorded vaccines: 3-10.3%). However, of those who were vaccinated, they were less likely to be vaccinated in a timely manner; both early (5.2% vs. 22.2%; margin of error [ME] = 0.52, 95% CI [confidence interval] = -0.18 - -0.17, p < 0.001) and delayed vaccinations were more common (62.7% vs. 71.3%; ME = 0.58, 95% CI = 0.08-0.09, p < 0.001). Validation of the CRCS immunisation flag showed moderate levels of accuracy. Around 70% of immunisation flags were correct across all three groups. Discussion: Findings suggest a positive association between receiving services under a care and support plan and being up-to-date with immunisations; children receiving support under a care and support plan were more likely to have experienced early or late vaccinations, demonstrating that there is still more inter-disciplinary co-ordination and planning needed to improve these outcomes. Thus, identifying inequalities in vaccination coverage is essential to target interventions and to prioritise geographic areas for catch-up.

Understanding neighbourhoods, communities and environments: new approaches for social work research.

This article discusses some new ways in which social work research can explore the interaction between neighbourhoods and child and adult wellbeing. The authors note that social work practices are often criticised for taking an individualistic approach and paying too little attention to the service user's environment. The article uses examples of research projects from Chile, the United States of America and Wales, to discuss the use of spatially oriented research methods for understanding neighbourhood factors. Quantitative, qualitative and mixed methods approaches that are particularly appropriate for investigating social work relevant topics are discussed in turn, including quantitative and qualitative uses for geographical information systems (GIS), hierarchical linear modelling (HLM) for analysing spatially clustered data and qualitative mobile interviews. The article continues with a discussion of the strengths and limitations of using spatially orientated research designs in social work research settings and concludes optimistically with suggestions for future directions in this area.

The significance of place in middle childhood: qualitative research from Wales.

The paper presents some key findings of qualitative research with older primary school children in Wales on their attachments to places and cultures. There is discussion of children's perspectives on the global, national and local arenas. We argue both that there are continuities with adult perspectives and that the children's views on place and identity need to be understood in the context of the social location of middle childhood. The study shows children making relatively little use of culturally-filled categories of local, national and global place-identifications. The differences they articulate are largely framed in terms of divisions between groups of people rather than in the characteristics of place, and generally related back to the self.