Publications by category
Journal articles
Ball S, McAndrew A, Aylward A, Cockcroft E, Gordon E, Kerridge A, Morgan-Trimmer S, Powell R, Price A, Rhodes S, et al (In Press). Detailed statistical analysis plan for a randomised controlled trial of the effects of a modified muscle sparing posterior technique (SPAIRE) in hip hemiarthroplasty for displaced intracapsular fractures on post-operative function compared to a standard. lateral approach: HemiSPAIRE.
TrialsAbstract:
Detailed statistical analysis plan for a randomised controlled trial of the effects of a modified muscle sparing posterior technique (SPAIRE) in hip hemiarthroplasty for displaced intracapsular fractures on post-operative function compared to a standard. lateral approach: HemiSPAIRE
Background: the HemiSPAIRE trial is being conducted to determine whether a modified
muscle sparing technique (SPAIRE - “Save Piriformis and Internus, Repairing Externus”) in
hip hemiarthroplasty brings clinical benefits compared to the standard lateral technique in
adults aged 60 years or older, with a displaced intracapsular hip fracture. This article describes
the detailed statistical analysis plan for the trial.
Methods and design: HemiSPAIRE is a definitive, pragmatic, superiority, multicentre,
randomised controlled trial (with internal pilot) with two parallel groups. Participants, ward
staff and all research staff involved in post-operative assessments are blinded to allocation.
This article describes in detail (1) the primary and secondary outcomes, (2) the statistical
analysis principles, including: a survivor average causal effect (SACE) method chosen
specifically to address the issue of potential bias from differential survival between trial arms,
which was seen from data review by the Trial Steering Committee; the participants that will be
included in each analysis; the covariates that will be included in each analysis, and how the
results will be presented, (3) planned main analysis of the primary outcome; (4) planned
analyses of the secondary outcomes, (5) planned additional analyses of the primary and
secondary outcomes.
Abstract.
Price A, Mitchell S, Janssens A, Eke H, Ford T, Newlove-Delgado T (In Press). In transition with attention deficit hyperactivity disorder (ADHD): children’s services clinicians’ perspectives on the role of information in healthcare transitions for young people with ADHD.
BMC PsychiatryAbstract:
In transition with attention deficit hyperactivity disorder (ADHD): children’s services clinicians’ perspectives on the role of information in healthcare transitions for young people with ADHD
Abstract
Background
National clinical guidelines emphasise the need for good communication of information by clinicians to young people and their parent/carers about what to expect during transition into adult services. Recent research indicates that of young people in need of transition for attention deficit hyperactivity disorder (ADHD), only a minority experience continuity of care into adulthood, with additional concerns about quality of transition. This qualitative analysis explored the role that information plays in the transition from child to adult mental health services for young people with ADHD, from the perspectives of clinicians working in children’s services.
Methods
Participants were recruited from National Health Service (NHS) Trusts located across the United Kingdom (UK), with varying service configurations. Twenty-two qualitative interviews were conducted with fifteen paediatricians and seven psychiatrists working in child services and supporting young people with ADHD. The Framework Method was used to complete a thematic analysis of data related to the role of information in transitional care.
Results
Two themes were identified in relation to the role of information in supporting transition and promoting continuity of care. Information for clinicians; about adult mental health services, the young person and their ADHD, and exchanged between services. Sharing information with young people; about transition processes, self-management, to support service engagement, and tailored to be accessible to young people with ADHD. Clinicians in children’s services reported variable access to information. Clear protocols and being able to communicate about ADHD as a long-term condition, were described as having a positive impact on the transition process.
Conclusions
These findings illustrate that clear information on the transition process, and communication of evidence based and up-to-date information on ADHD as a long-term condition are essential components for clinicians supporting transition into adult services. Information exchange can be supported through transition discussions with young people, and joint meetings between services Discussions should be accompanied by accessible resources for young people and parents/carers such as leaflets and websites. Further efforts should be focussed on enabling clinicians to provide timely and appropriate information to young people with ADHD to support transition.
Abstract.
Benham-Clarke S, Ford T, Mitchell S, Price A, Newlove-Delgado T, Blake S, Eke H, Moore D, Russell A, Janssens A, et al (In Press). Role of Education Settings in Transition from Child to Adult Health Services for Young People with ADHD. Journal of Emotional and Behavioural Difficulties
Allen K, Hansford L, Hayes R, Longdon B, Price A, Byford S, Norwich B, Ford T (In Press). Teachers’ views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial.
British Journal of Educational PsychologyAbstract:
Teachers’ views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial
Background
The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may reduce disruptive behaviour in the classroom and improve child and teacher mental health, however few studies have considered how acceptable TCM is to teachers or what facilitators and barriers there are to its implementation.
Aims
In this paper we examine the acceptability of the full six-day TCM programme and teachers’ perceived barriers and facilitators to implementation in the English (UK) primary school context.
Sample
Forty-four English (UK) primary school teachers who attended the TCM programme as part of the STARS trial.
Methods
We completed focus groups and telephone interviews with participating teachers two months after they completed the TCM programme. Thematic analysis was used to examine the data, and a framework approach was applied to organise and summarise themes.
Results
Teachers liked the structure of the course, the peer group learning environment, delivery methods, and the opportunity to reflect outside the classroom on their practice. They reported that the video clips used lacked cultural relevance and highlighted the importance of group leadership style. Perceived facilitators to implementation included an understanding of the theory underpinning TCM and adaptability of the TCM strategies. Barriers included perceived gaps in the course content in relation to challenging behaviour, applying strategies with older children and the school context within which teachers were working.
Conclusion
Our findings suggest high levels of acceptability to TCM overall, but also highlight the need for a whole school approach to combat potential barriers to implementation.
Abstract.
Coelho H, Price A, Kiff F, Trigg L, Robinson S, Thompson Coon J, Anderson R (In Press). The experiences of children and young people from ethnic minorities in accessing mental health care: rapid scoping review of qualitative evidence.
Health and Social Care Delivery ResearchAbstract:
The experiences of children and young people from ethnic minorities in accessing mental health care: rapid scoping review of qualitative evidence
Background
Mental health problems are common among children and young people in the UK. They are experienced in different ways for some young people from ethnic minority backgrounds. Furthermore, those from ethnic minority backgrounds often have greater difficulties accessing mental health support, variable levels of engagement with services, and may prefer different support to their White British peers.
Objective
To describe the nature and scope of qualitative research about the experiences of children and young people from ethnic minority backgrounds in seeking or obtaining care or support for mental health problems.
Data sources
We searched seven bibliographic databases (ASSIA, CINAHL, MEDLINE, PsycInfo, HMIC, Social Policy and Practice, and Web of Science) using relevant terms [23 June 2021].
Methods
The scoping review included qualitative research about young people’s experiences of seeking or engaging with services or support for mental health problems. Included studies were: published from 2012 onwards, from the UK, were about those aged 10 to 24 years and were from ethnic minority backgrounds (i.e. not White British). Study selection, data extraction and quality assessment (with ‘Wallace’ criteria) were conducted by two reviewers. We provide a descriptive summary of the aims, scope, sample, methods and quality of the included studies, and selected presentation of authors’ findings (i.e. no formal synthesis).
Findings
From 5335 unique search records, we included 26 papers or reports describing 22 diverse qualitative studies. Most of the studies were well conducted and clearly described.
There were studies of refugees/asylum seekers (5 studies), university students (4), and studies among young people experiencing particular mental health problems (14; some studies appear in multiple categories): schizophrenia or psychosis (3), eating disorders (3), post-traumatic stress disorder (3; in asylum seekers), substance misuse (2) self-harm (2), and obsessive compulsive disorder (1). There were also three studies in ethnic minority young people who were receiving particular treatments (CBT, multi-systemic therapy for families, and a culturally adapted family-based talking therapy).
Most studies had been conducted with young people or their parents from a range of different ethnic backgrounds. However, nine studies were conducted in particular ethnic groups: asylum-seekers from Afghanistan (2), Black and South Asian (2), Black African and Black-Caribbean (2), South Asian (1), Pakistani or Bangladeshi (1), and Orthodox Jewish (1).
The studies suggested a range of factors that influence care-seeking and access to mental health care, in terms of the beliefs and knowledge of young people and their parents, the design and promotion of services, and the characteristics of care professionals. Poor access was attributed to a lack of understanding of mental health problems, lack of information about services, lack of trust in care professionals, social stigma, and cultural expectations about mental resilience.
Limitations
As a rapid scoping review there was only basic synthesis of the research findings.
Future work
Future research about young people from ethnic minorities could cover a wider range of ethnic minorities, sample and analyse separately experiences from particular ethnic minorities, cover those accessing different services for different needs, and adopt multiple perspectives (e.g. service user, carer, clinician, service management).
Review protocol was pre-registered with Open Science Framework at: https://osf.io/wa7bf/
Abstract.
Ahuja L, Price A, Bramwell C, Briscoe S, Shaw L, Nunns M, O'Rourke G, Baron S, Anderson R (2022). Implementation of the Making Safeguarding Personal Approach to Strengths-based Adult Social Care: Systematic Review of Qualitative Research Evidence.
BRITISH JOURNAL OF SOCIAL WORK,
52(8), 4640-4663.
Author URL.
Janssens A, Blake S, Eke H, Price A, Ford T (2022). Parenting roles for young people with attention‐deficit/hyperactivity disorder transitioning to adult services. Developmental Medicine & Child Neurology, 65(1), 136-144.
Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT (2022). What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? an evidence and gap map. Campbell Systematic Reviews, 18(3).
Titheradge D, Godfrey J, Eke H, Price A, Ford T, Janssens A (2022). Why young people stop taking their attention deficit hyperactivity disorder medication: a thematic analysis of interviews with young people. Child: Care, Health and Development, 48(5), 724-735.
Price A, Ball S, Rhodes S, Wickins R, Gordon E, Aylward A, Cockcroft E, Morgan-Trimmer S, Powell R, Timperley J, et al (2021). Effects of a modified muscle sparing posterior technique in hip hemiarthroplasty for displaced intracapsular fractures on postoperative function compared to a standard lateral approach (HemiSPAIRE): protocol for a randomised controlled trial.
BMJ Open,
11(6), e045652-e045652.
Abstract:
Effects of a modified muscle sparing posterior technique in hip hemiarthroplasty for displaced intracapsular fractures on postoperative function compared to a standard lateral approach (HemiSPAIRE): protocol for a randomised controlled trial
IntroductionCurrently National Institute for Health and Care Excellence clinical guidelines in the UK suggest that surgeons performing partial hip replacements (hemiarthroplasty) should consider using the lateral approach. Alternatively, a newer, modified posterior approach using a muscle sparing technique named ‘Save Piriformis and Internus, Repairing Externus’ (SPAIRE) can be used leaving the major muscles intact. This randomised controlled trial (RCT) aims to compare the SPAIRE approach to the standard lateral approach, to determine if it allows patients to mobilise better and experience improved function after surgery.Methods and analysisHemiSPAIRE is a two-arm, assessor-blinded, definitive pragmatic RCT with nested pilot and qualitative studies. Two hundred and twenty-eight participants with displaced intracapsular fractures requiring hip hemiarthroplasty will be individually randomised 1:1 to either the SPAIRE, or control (standard lateral approach) surgical procedure. Outcomes will be assessed at postoperative day 3 (POD3) and 120 (POD120). The primary outcome measure will be level of function and mobility using the Oxford Hip Score at POD120. Secondary outcomes include: De Morton Mobility Index (DEMMI), Cumulated Ambulatory Score and Numeric Pain Rating Scale (NPRS) at POD3; DEMMI, NPRS and EQ-5D-5L at POD120, complications, acute and total length of hospital stay, and mortality. Primary analysis will be on an intention-to-treat basis. Participant experiences of the impact of surgery and recovery period will be examined via up to 20 semi-structured telephone interviews.Ethics and disseminationThe protocol has been approved by Yorkshire and the Humber—Bradford Leeds Research Ethics Committee. Recruitment commenced in November 2019. Findings will be disseminated via research articles in peer-reviewed journals, presentations at conferences, public involvement events, patient groups and media releases. A summary of the trial findings will be shared with participants at the end of the study.Trial registration numberNCT04095611.
Abstract.
Eke H, Janssens A, Newlove-Delgado T, Paul M, Price A, Young S, Ford T (2020). Clinician perspectives on the use of National Institute for Health and Care Excellence guidelines for the process of transition in Attention Deficit Hyperactivity Disorder.
Child Care Health Dev,
46(1), 111-120.
Abstract:
Clinician perspectives on the use of National Institute for Health and Care Excellence guidelines for the process of transition in Attention Deficit Hyperactivity Disorder.
BACKGROUND: the UK National Institute for Health and Care Excellence (NICE) clinical guidelines recommends the following steps in the transition from child to adult services for young people with attention deficit hyperactivity disorder (ADHD): reassessment before and after transition, transition planning, formal meeting between services, and involvement from young person and carer, completed by age 18. METHODS: a UK surveillance study asked clinicians to report young people on their caseloads with ADHD in need of transition to adult services in 2016 to support their continued access to medication need. Clinicians reported young people as they aged to within 6 months of the transition boundary, a prospective questionnaire prior to transition asked about intended transition and the use of local transition protocols. A retrospective questionnaire sent 9 months later established which steps recommended by NICE were followed during transition. Clinicians (38) working in child or adult services were interviewed about their experiences of transition and the use of NICE guidelines during transition and were analysed using a framework approach. RESULTS: Information was shared between services in 85% of the 315 identified transition cases. A joint meeting was planned in 16% of cases; joint working before transfer occurred in 10% of cases. Clinicians were aware of NICE guidelines; they had mixed views on whether (local) guidelines or protocols were helpful. The main reason for not following guidelines was workload and resources: "NICE recommends stuff that is miles above what we will ever be able to provide". CONCLUSIONS: Clinicians involved in the transition process of young people with ADHD judged NICE guidelines to be unrealistic given the current limited resources and service organization. More open dialogue is needed for recommendations on service models to bridge the gap between guideline recommendations and what is viewed as feasible and how implementation of guidance is funded, monitored, and prioritized. This may lead to valuable changes in the consultation process, for example, consideration of a layered (gold, standard, and minimal) system for some NICE guidelines.
Abstract.
Author URL.
Price A, Janssens A, Newlove-Delgado T, Eke H, Paul M, Sayal K, Hollis C, Ani C, Young S, Dunn-Morua S, et al (2020). Mapping UK mental health services for adults with attention-deficit/hyperactivity disorder: national survey with comparison of reporting between three stakeholder groups.
BJPsych Open,
6(4).
Abstract:
Mapping UK mental health services for adults with attention-deficit/hyperactivity disorder: national survey with comparison of reporting between three stakeholder groups
. Background
. UK clinical guidelines recommend treatment of attention-deficit hyperactivity disorder (ADHD) in adults by suitably qualified clinical teams. However, young people with ADHD attempting the transition from children's to adults’ services experience considerable difficulties in accessing care.
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. Aims
. To map the mental health services in the UK for adults who have ADHD and compare the reports of key stakeholders (people with ADHD and their carers, health workers, service commissioners).
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. Method
. A survey about the existence and extent of service provision for adults with ADHD was distributed online and via national organisations (e.g. Royal College of Psychiatrists, the ADHD Foundation). Freedom of information requests were sent to commissioners. Descriptive analysis was used to compare reports from the different stakeholders.
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. Results
. A total of 294 unique services were identified by 2686 respondents. of these, 44 (15%) were dedicated adult ADHD services and 99 (34%) were generic adult mental health services. Only 12 dedicated services (27%) provided the full range of treatments recommended by the National Institute for Health and Care Excellence. Only half of the dedicated services (55%) and a minority of other services (7%) were reported by all stakeholder groups (P < 0.001, Fisher's exact test).
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. Conclusions
. There is geographical variation in the provision of NHS services for adults with ADHD across the UK, as well as limited availability of treatments in the available services. Differences between stakeholder reports raise questions about equitable access. With increasing numbers of young people with ADHD graduating from children's services, developing evidence-based accessible models of care for adults with ADHD remains an urgent policy and commissioning priority.
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Abstract.
Price A, Ford T, Janssens A, Williams AJ, Newlove-Delgado T (2020). Regional analysis of UK primary care prescribing and adult service referrals for young people with attention-deficit hyperactivity disorder.
BJPsych Open,
6(1).
Abstract:
Regional analysis of UK primary care prescribing and adult service referrals for young people with attention-deficit hyperactivity disorder
. Background
. Approximately 20% of children with attention-deficit hyperactivity disorder (ADHD) experience clinical levels of impairment into adulthood. In the UK, there is a sharp reduction in ADHD drug prescribing over the period of transition from child to adult services, which is higher than expected given estimates of ADHD persistence, and may be linked to difficulties in accessing adult services. Little is currently known about geographical variations in prescribing and how this may relate to service access.
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. Aims
. To analyse geographic variations in primary care prescribing of ADHD medications over the transition period (age 16–19 years) and adult mental health service (AMHS) referrals, and illustrate their relationship with UK adult ADHD service locations.
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. Method
. Using a Clinical Practice Research Datalink cohort of people with an ADHD diagnosis aged 10–20 in 2005 (study period 2005–2013; n = 9390, 99% diagnosed <18 years), regional data on ADHD prescribing over the transition period and AMHS referrals, were mapped against adult ADHD services identified in a linked mapping study.
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. Results
. Differences were found by region in the mean age at cessation of ADHD prescribing, range 15.8–17.4 years (P<0.001), as well as in referral rates to AMHSs, range 4–21% (P<0.001). There was no obvious relationship between service provision and prescribing variation.
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. Conclusions
. Clear regional differences were found in primary care prescribing over the transition period and in referrals to AMHSs. Taken together with service mapping, this suggests inequitable provision and is important information for those who commission and deliver services for adults with ADHD.
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Abstract.
Janssens A, Eke H, Price A, Blake S, Newlove-Delgado T, Logan S, Ford T (2020). Young people with Attention Deficit Hyperactivity Disorder (ADHD) in transition from children's services to adult services (CATCh-uS): a mixed methods national scoping study.
Health Services and Delivery Research, 1-184.
Abstract:
Young people with Attention Deficit Hyperactivity Disorder (ADHD) in transition from children's services to adult services (CATCh-uS): a mixed methods national scoping study
ADHD was previously seen as a childhood developmental disorder, so adult mental health services were not set up to support ADHD patients who become too old for child services. This is the first in-depth study of the transition of ADHD patients from child to adult health services in the UK. Our objectives were to explore:
o how many young people with ADHD are in need of services as an adult
o what adult ADHD services are available
o how ADHD stakeholders experience transition from child to adult services
Design
An interactive mixed method design was adopted with three study streams; (1) a twelve-month surveillance study with nine month follow-up to find out how many young people required ongoing medication when too old for child services (929 surveys completed by child clinicians); (2) a mapping study to identify and describe services for young adults with ADHD (2,686 respondents to online surveys for patients and health workers and Freedom of Information requests to service providers and commissioners); and (3) a qualitative study to explore key stakeholder experience of transition from child to adult services (144 interviews with 64 ADHD patients, 28 parents, 52 clinicians working in child or adult secondary health services and 14 general practitioners). Members of the public advised each stage of the study.
Results
Corrected for non-response and case ascertainment, the annual incidence of young people with an ongoing need for medication for ADHD lies between 270 and 599 per 100,000 people aged 17 – 19 years. of 315 eligible cases for transition, 64% of referrals were accepted but only 22% attended their first adult services appointment. Our interactive map describes 294 unique services for adults with ADHD across the UK; 44 were ‘dedicated’ ADHD services (defined chapter 4). Few services provide the full range of recommended provision, most focused on diagnosis and medication. They were unevenly distributed across the UK, with nearly all ‘dedicated’ services in England. Exploring stakeholders’ experiences revealed how invested they are in continuing ADHD treatment and the architecture of services impacted transition. An association between ADHD, education and continuance of medication into young adulthood, plus parent involvement and feeling prepared for transition and adult life with ADHD, influenced investment. However, even if invested; how accessible adult services were; how patient needs fitted with the remit of the adult service; and the level of patient information available impacted transition outcomes. The results also highlighted how GPs can end up as care-coordinator during transition by default.
Limitations
Transition estimates were based on those who want medication, so indicate a minimum level of need.
Conclusions
Few of those who need ongoing support for their ADHD successfully transfer to adult services, and a small proportion of those who transfer experience optimal transitional care. Adult ADHD service provision is patchy. Even among ‘dedicated’ services, few provide the whole range of NICE recommended treatments.
Future Work
We a need to evaluate various models of transitional care and adult ADHD provision, as well as develop and evaluate psycho-social interventions for young people and adults with ADHD.
Funding
The National Institute for Health Research - Health Services and Delivery Research Programme.
Abstract.
Price A, Newlove-Delgado T, Eke H, Paul M, Young S, Ford T, Janssens A (2019). In transition with ADHD: the role of information, in facilitating or impeding young people’s transition into adult services.
BMC Psychiatry,
19(1).
Abstract:
In transition with ADHD: the role of information, in facilitating or impeding young people’s transition into adult services
Abstract
. Background
. Many national and regional clinical guidelines emphasise the need for good communication of information to young people and their parent/carers about what to expect during transition into adult services. Recent research indicates only a minority of young people in need of transition for Attention Deficit Hyperactivity Disorder (ADHD) experience continuity of care into adulthood, with additional concerns about quality of transition. This qualitative study explored the role that information plays in experiences of transition from the perspectives of parent/carers and young people.
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. Methods
. Participants were recruited from 10 National Health Service Trusts, located across England, with varying service configurations. Ninety two qualitative interviews were conducted: 64 with young people with ADHD at different stages relative to transition, and 28 with parent/carers. Thematic analysis of data was completed using the Framework Method.
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. Results
. Interviewees reported a range of experiences; however reliance on parent/carers to gather and translate key information, and negative experiences associated with poor communication of information, were universal. Three themes emerged: Navigating information with help from parents; Information on ADHD into adulthood; Information about the transition process. The first revealed the essential role of parent in the translation and application of information, the other two explored distinct types of information necessary for a smooth transition. Interviewees made recommendations for clinical practice similar to UK (United Kingdom) National Institute for Health and Care Excellence (NICE) guidelines, with an additional emphasis on providing nuanced information on ADHD as a potentially long term condition. It was important to interviewees that General Practitioners had a basic understanding of adult ADHD and also had access to information about service provision.
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. Conclusions
. Our findings illustrate that the availability and communication of information to young people and their parent/carers is an essential component of the transition process between child and adult ADHD services. How and when it is provided may support or impede transition. This study constitutes a substantial contribution to the evidence base, drawing on interviews from a range of participants across England and from Trusts offering different types of services.
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Abstract.
Price A, Janssens A, Dunn-Morua S, Eke H, Asherson P, Lloyd T, Ford T (2019). Seven steps to mapping health service provision: lessons learned from mapping services for adults with Attention-Deficit/Hyperactivity Disorder (ADHD) in the UK.
BMC Health Serv Res,
19(1).
Abstract:
Seven steps to mapping health service provision: lessons learned from mapping services for adults with Attention-Deficit/Hyperactivity Disorder (ADHD) in the UK.
BACKGROUND: ADHD affects some individuals throughout their lifespan, yet service provision for adults in the United Kingdom (UK) is patchy. Current methods for mapping health service provision are resource intensive, do not map specialist ADHD teams separately from generic mental health services, and often fail to triangulate government data with accounts from service users and clinicians. Without a national audit that maps adult ADHD provision, it is difficult to quantify current gaps in provision and make the case for change. This paper describes the development of a seven step approach to map adult ADHD service provision in the UK. METHODS: a mapping method was piloted in 2016 and run definitively in 2018. A seven step method was developed: 1. Defining the target service 2. Identifying key informants 3. Designing the survey 4. Data collection 5. Data analysis 6. Communicating findings 7. Hosting/updating the service map. Patients and members of the public (including clinicians and commissioners) were involved with design, data collection and dissemination of findings. RESULTS: Using a broad definition of adult ADHD services resulted in an inclusive list of identified services, and allowed the definition to be narrowed to National Health Service (NHS) funded specialist ADHD services at data analysis, with confidence that few relevant services would be missed. Key informants included patients, carers, a range of health workers, and commissioners. A brief online survey, written using lay terms, appeared acceptable to informants. Emails sent using national organisations' mailing lists were the most effective way to access informants on a large scale. Adaptations to the methodology in 2018 were associated with 64% more responses (2371 vs 1446) collected in 83% less time (5 vs 30 weeks) than the pilot. The 2016 map of adult ADHD services was viewed 13,688 times in 17 weeks, indicating effective communication of findings. CONCLUSION: This seven step pragmatic method was effective for collating and communicating national service data about UK adult ADHD service provision. Patient and public involvement and engagement from partner organisations was crucial throughout. Lessons learned may be transferable to mapping service provision for other health conditions and in other locations.
Abstract.
Author URL.
Allen KL, Hansford L, Hayes R, Allwood M, Byford S, Longdon B, Price A, Ford T (2019). Teachers’ perceptions of the impact of the Incredible Years® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils.
British Journal of Educational PsychologyAbstract:
Teachers’ perceptions of the impact of the Incredible Years® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils
Background
The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may be an effective way to reduce teacher stress levels, improve child behaviour and promote positive socio-emotional development. However, few studies have considered what teachers think of the course and how it might work.
Aims
In this paper we examine teachers’ perceptions of the impact of the TCM programme and how it might work in the classroom.
Sample(s)
Fourty-four UK primary school teachers who attended the TCM programme as part of the STARS trial (Ford et al. 2018).
Methods
Focus groups and interviews were held with teachers two months after completing the TCM programme. Thematic analysis (Braun & Clarke, 2006) was employed to explore the subsequent data.
Results
Three main themes were identified: impact on the teacher; on children; and on parent-teacher relationships. Impact on the teacher included a positive change in their ethos. Teachers reported being more able to see things from the child’s perspective, placing a greater focus on building positive relationships, thinking before responding, feeling calmer, more confident and in control and employing strategies to create positive interactions with children. Teachers felt this had had a positive impact on their pupils’ development and relationships with parents. Feedback on whether or not TCM was effective in tackling particularly challenging behaviour was more mixed.
Conclusions
Our findings suggest that teachers experience the TCM programme as beneficial. This is discussed alongside other qualitative and quantitative studies in this field.
Abstract.
Hayes RA, Titheradge D, Allen K, Allwood M, Byford S, Edwards V, Hansford L, Longdon B, Norman S, Norwich B, et al (2019). The Incredible Years® Teacher Classroom Management programme and its impact on teachers’ professional self-efficacy, work related stress and general well-being: results from the STARS randomised controlled trial.
Journal of Educational PsychologyAbstract:
The Incredible Years® Teacher Classroom Management programme and its impact on teachers’ professional self-efficacy, work related stress and general well-being: results from the STARS randomised controlled trial
Background
Teaching is a stressful occupation with poor retention. The Incredible Years® Teacher Classroom Management (TCM) programme is a training program that past research has demonstrated may be an effective intervention for children’s mental health, but little research has explored any impacts there may be on the teachers’ own professional confidence and mental health.
Aims
In this paper we evaluate whether TCM may lead to changes in teachers’ wellbeing, namely a reduction in burnout and an improvement in self-efficacy and mental health.
Sample
Eighty schools across the South West of England were recruited between September 2012 and September 2014. Headteachers were asked to nominate one class teacher to take part.
Methods
Eighty teachers were randomised to either attend a TCM course (intervention) or not (control). TCM was delivered to groups of up to twelve teachers in six whole-day workshops that were evenly spread between October and April. At baseline and nine months follow-up we measured teachers’ mental health using the Everyday Feelings Questionnaire (EFQ), burnout using the Maslach Burnout Inventory-General Survey (MBI-GS) and self-efficacy using the Teachers’ Sense of Efficacy Scale-Short (TSES-Short).
Results
Using linear regression models there was little evidence of differences at follow-up between the intervention and control teachers on the outcomes (the smallest p-value was 0.09).
Conclusions
Our findings did not replicate previous research that TCM improved teachers’ sense of efficacy. However, there were limitations with this study including low sample size.
Abstract.
Ford T, Hayes RA, Edwards V, Logan GS, Norwich B, Allen KL, Hansford L, Longdon BM, Norman S, Price A, et al (2019). Training teachers in classroom management to improve mental health in primary school children: the STARS cluster RCT. Public Health Research, 7
Eke HE, Ford T, Newlove-Delgado T, Price A, Young S, Ani C, Sayal K, Paul M, Janssens A (2019). Transition between child and adult services for young people with ADHD:. findings from a British national surveillance study. British Journal of Psychiatry, 1-7.
Ayyash H, Ford T, Janssens A, Eke H, Price AM, Morton M, Lynn R (2018). G469 Impact of CAPSS and BPSU in identifying the imminent needs of ADHD patients in transition from children's to adult services across the United Kingdom. Archives of Disease in Childhood, 103, A191-A192.
Titheradge D, Hayes R, Longdon B, Allen K, Price A, Hansford L, Nye E, Ukoumunne O, Byford S, Norwich B, et al (2018). Psychological distress amongst primary school teachers: a comparison with clinical and population samples. Public Health, 166, 53-56.
Price AM, Janssens A, Woodley AL, Allwood M, Ford T (2018). Review: Experiences of healthcare transitions for young people with attention deficit hyperactivity disorder: a systematic review of qualitative research. Child and Adolescent Mental Health, 12-12.
Ford T, Hayes RA, Byford S, Edwards V, Fletcher M, Logan G, Norwich B, Pritchard W, Allen K, Allwood M, et al (2018). The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial.
Psychological MedicineAbstract:
The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial
Abstract
Background. We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools’ important influence on child mental health.
Methods. A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers
in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the
outcomes. Trial registration: ISRCTN84130388.
Results. Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (S.D.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference
= −1.0; 95% CI−1.9 to −0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori
subgroup analyses suggested TCM is more effective for children with poor mental health.
Conclusions. TCM provided a small, short-term improvement to children’s mental health particularly for children who are already struggling.
Abstract.
Allwood M, Allen K, Price A, Hayes R, Edwards V, Ball S, Ukoumunne OC, Ford T (2018). The reliability and validity of the pupil behaviour questionnaire: a child classroom behaviour assessment tool.
Emotional and Behavioural Difficulties,
23(4), 361-371.
Abstract:
The reliability and validity of the pupil behaviour questionnaire: a child classroom behaviour assessment tool
This paper assesses the reliability and validity of the teacher-completed Pupil Behaviour Questionnaire (PBQ), by comparing it to the already extensively validated teacher-completed Strengths and Difficulties Questionnaire (SDQ). Participants included 2074 primary school children participating in a universal school-based trial and 41 vulnerable children who were taking part in a study exploring the impact of exclusion from school. Exploratory factor analysis results (first factor accounts for 80.8% of the variation in the items) and the high Cronbach’s alpha value of 0.85 indicate that the PBQ consists of one substantive factor/dimension. Strong correlations between the total PBQ score and the conduct sub-scale (Spearman’s correlation coefficient (rs) = 0.67) and total difficulties score (rs = 0.59) of the SDQ indicate convergent validity. This study suggests that the PBQ is a reliable measure, and provides some evidence of validity. Further work is needed to test the PBQ in an older, more diverse populations and to measure sensitivity to change.
Abstract.
Price A, Allen K, Ukoumunne OC, Hayes R, Ford T (2017). Examining the psychological and social impact of relative age in primary school children: a cross-sectional survey.
Child: Care, Health and Development,
43(6), 891-898.
Abstract:
Examining the psychological and social impact of relative age in primary school children: a cross-sectional survey
Background: a number of studies demonstrate that children who are younger within their school year have poorer academic attainment and are more likely to have special educational needs. Few, however, have considered the impact relative age may have on child mental health, behaviour and happiness in school. Methods: This paper utilized data from the Supporting Teachers and Children in Schools study (2075 pupils aged 5 to 9 years from 80 primary schools) to explore the relationship among relative age, behaviour and happiness in school. Behavioural and emotional development was assessed by using the teacher-reported and parent-reported Strengths and Difficulties Questionnaire and the Pupil Behaviour Questionnaire. Children's happiness within school was assessed by using the How I Feel About My School Questionnaire. Results: Relatively younger children had higher Total Difficulties scores on the Strengths and Difficulties Questionnaire than their peers. There was a mean increase per 30-day decrease in relative age of 0.09 (95% CI: 0.03 to 0.16; p = 0.007) in teacher-reported and 0.08 (0.001 to 0.16; p = 0.05) in parent-reported scores. There was little evidence of a relationship between relative age and children's behaviour and happiness in school. Conclusions: for children with complex difficulties, being relatively young for their school year may be an additional stressor that may undermine mental health.
Abstract.
Allen K, Marlow R, Edwards V, Parker C, Rodgers L, Ukoumunne O, Chan Seem E, Hayes R, Price A, Ford T, et al (2017). ‘How I feel About My School’: the construction and validation of a measure of wellbeing at school for primary school children. Clinical Child Psychology and Psychiatry, 55
Hurst A, Price A, Walesby R, Doolan M, Lanham W, Ford T (2014). Routine outcome monitoring of evidencebased parenting programmes: Indications of effectiveness in a community context.
Journal of Children's Services,
9(1), 58-74.
Abstract:
Routine outcome monitoring of evidencebased parenting programmes: Indications of effectiveness in a community context
Purpose: Despite an increasing policy focus, routine outcome monitoring (ROM) is not common practice in UK children's services. This paper aims to examine whether it is feasible and valid to use measures from ROM of evidence-based parenting programmes (EBPPs) to assess the impact of services and to drive service improvements through feedback mechanisms. Design/methodology/ approach: This is a secondary analysis of ROM measures collected from a London clinic offering EBPPs over five years. Demographic information from referrals was compared for attendees and non-attendees. Changes in parent reported child behaviour were measured using the Strengths and Difficulties Questionnaire (SDQ), and a Visual Analogue Scale (VAS). Findings: No significant differences were found in socio-demographic characteristics of attendees and non-attendees. Statistically significant differences were found between pre- and post-scores on parent reported SDQ scores and VAS concerns, as well as the SDQ Added Value Score. The data collected did not allow for investigation of a dose-response relationship between the level of attendance and any improvement made. Originality/value: This study illustrates that ROM can provide useful information about the impact of EBPPs in a particular clinical context. Demographic data could support service managers to evaluate reach and uptake while evidence of improvements can be communicated back to parents and support future funding bids. Incomplete data limited the inferences that could be drawn, and collaborations between research centres and clinics may be a way to optimise the use of ROM to drive service improvement and innovation. © Emerald Group Publishing Limited, ISSN 1746-6660.
Abstract.
Thompson H, Reville MC, Price A, Reynolds L, Rodgers LR, Ford T (2014). The Quality of Life scale for Children (QoL-C). Journal of Children's Services: research informing policy and practice, 9, 4-17.
Conferences
Price A, Ahuja L, Bramwell C, Briscoe S, Shaw L, Nunns M, O’Rouke G, Baron S, Anderson R (2021). P90 Implementation of strategies for fostering strengths-based adult social work in the UK: a systematic review of research evidence. SSM Annual Scientific Meeting.
Reports
Price A, Ahuja L, Bramwell C, Briscoe S, Shaw L, Nunns M, O'Rourke G, Baron S, Anderson R (2020). Research evidence on different strengths-based approaches within adult social work: a systematic review., NIHR.
Publications by year
In Press
Ball S, McAndrew A, Aylward A, Cockcroft E, Gordon E, Kerridge A, Morgan-Trimmer S, Powell R, Price A, Rhodes S, et al (In Press). Detailed statistical analysis plan for a randomised controlled trial of the effects of a modified muscle sparing posterior technique (SPAIRE) in hip hemiarthroplasty for displaced intracapsular fractures on post-operative function compared to a standard. lateral approach: HemiSPAIRE.
TrialsAbstract:
Detailed statistical analysis plan for a randomised controlled trial of the effects of a modified muscle sparing posterior technique (SPAIRE) in hip hemiarthroplasty for displaced intracapsular fractures on post-operative function compared to a standard. lateral approach: HemiSPAIRE
Background: the HemiSPAIRE trial is being conducted to determine whether a modified
muscle sparing technique (SPAIRE - “Save Piriformis and Internus, Repairing Externus”) in
hip hemiarthroplasty brings clinical benefits compared to the standard lateral technique in
adults aged 60 years or older, with a displaced intracapsular hip fracture. This article describes
the detailed statistical analysis plan for the trial.
Methods and design: HemiSPAIRE is a definitive, pragmatic, superiority, multicentre,
randomised controlled trial (with internal pilot) with two parallel groups. Participants, ward
staff and all research staff involved in post-operative assessments are blinded to allocation.
This article describes in detail (1) the primary and secondary outcomes, (2) the statistical
analysis principles, including: a survivor average causal effect (SACE) method chosen
specifically to address the issue of potential bias from differential survival between trial arms,
which was seen from data review by the Trial Steering Committee; the participants that will be
included in each analysis; the covariates that will be included in each analysis, and how the
results will be presented, (3) planned main analysis of the primary outcome; (4) planned
analyses of the secondary outcomes, (5) planned additional analyses of the primary and
secondary outcomes.
Abstract.
Price A, Mitchell S, Janssens A, Eke H, Ford T, Newlove-Delgado T (In Press). In transition with attention deficit hyperactivity disorder (ADHD): children’s services clinicians’ perspectives on the role of information in healthcare transitions for young people with ADHD.
BMC PsychiatryAbstract:
In transition with attention deficit hyperactivity disorder (ADHD): children’s services clinicians’ perspectives on the role of information in healthcare transitions for young people with ADHD
Abstract
Background
National clinical guidelines emphasise the need for good communication of information by clinicians to young people and their parent/carers about what to expect during transition into adult services. Recent research indicates that of young people in need of transition for attention deficit hyperactivity disorder (ADHD), only a minority experience continuity of care into adulthood, with additional concerns about quality of transition. This qualitative analysis explored the role that information plays in the transition from child to adult mental health services for young people with ADHD, from the perspectives of clinicians working in children’s services.
Methods
Participants were recruited from National Health Service (NHS) Trusts located across the United Kingdom (UK), with varying service configurations. Twenty-two qualitative interviews were conducted with fifteen paediatricians and seven psychiatrists working in child services and supporting young people with ADHD. The Framework Method was used to complete a thematic analysis of data related to the role of information in transitional care.
Results
Two themes were identified in relation to the role of information in supporting transition and promoting continuity of care. Information for clinicians; about adult mental health services, the young person and their ADHD, and exchanged between services. Sharing information with young people; about transition processes, self-management, to support service engagement, and tailored to be accessible to young people with ADHD. Clinicians in children’s services reported variable access to information. Clear protocols and being able to communicate about ADHD as a long-term condition, were described as having a positive impact on the transition process.
Conclusions
These findings illustrate that clear information on the transition process, and communication of evidence based and up-to-date information on ADHD as a long-term condition are essential components for clinicians supporting transition into adult services. Information exchange can be supported through transition discussions with young people, and joint meetings between services Discussions should be accompanied by accessible resources for young people and parents/carers such as leaflets and websites. Further efforts should be focussed on enabling clinicians to provide timely and appropriate information to young people with ADHD to support transition.
Abstract.
Benham-Clarke S, Ford T, Mitchell S, Price A, Newlove-Delgado T, Blake S, Eke H, Moore D, Russell A, Janssens A, et al (In Press). Role of Education Settings in Transition from Child to Adult Health Services for Young People with ADHD. Journal of Emotional and Behavioural Difficulties
Allen K, Hansford L, Hayes R, Longdon B, Price A, Byford S, Norwich B, Ford T (In Press). Teachers’ views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial.
British Journal of Educational PsychologyAbstract:
Teachers’ views on the acceptability and implementation of the Incredible Years ® Teacher Classroom Management programme in English (UK) primary schools from the STARS trial
Background
The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may reduce disruptive behaviour in the classroom and improve child and teacher mental health, however few studies have considered how acceptable TCM is to teachers or what facilitators and barriers there are to its implementation.
Aims
In this paper we examine the acceptability of the full six-day TCM programme and teachers’ perceived barriers and facilitators to implementation in the English (UK) primary school context.
Sample
Forty-four English (UK) primary school teachers who attended the TCM programme as part of the STARS trial.
Methods
We completed focus groups and telephone interviews with participating teachers two months after they completed the TCM programme. Thematic analysis was used to examine the data, and a framework approach was applied to organise and summarise themes.
Results
Teachers liked the structure of the course, the peer group learning environment, delivery methods, and the opportunity to reflect outside the classroom on their practice. They reported that the video clips used lacked cultural relevance and highlighted the importance of group leadership style. Perceived facilitators to implementation included an understanding of the theory underpinning TCM and adaptability of the TCM strategies. Barriers included perceived gaps in the course content in relation to challenging behaviour, applying strategies with older children and the school context within which teachers were working.
Conclusion
Our findings suggest high levels of acceptability to TCM overall, but also highlight the need for a whole school approach to combat potential barriers to implementation.
Abstract.
Coelho H, Price A, Kiff F, Trigg L, Robinson S, Thompson Coon J, Anderson R (In Press). The experiences of children and young people from ethnic minorities in accessing mental health care: rapid scoping review of qualitative evidence.
Health and Social Care Delivery ResearchAbstract:
The experiences of children and young people from ethnic minorities in accessing mental health care: rapid scoping review of qualitative evidence
Background
Mental health problems are common among children and young people in the UK. They are experienced in different ways for some young people from ethnic minority backgrounds. Furthermore, those from ethnic minority backgrounds often have greater difficulties accessing mental health support, variable levels of engagement with services, and may prefer different support to their White British peers.
Objective
To describe the nature and scope of qualitative research about the experiences of children and young people from ethnic minority backgrounds in seeking or obtaining care or support for mental health problems.
Data sources
We searched seven bibliographic databases (ASSIA, CINAHL, MEDLINE, PsycInfo, HMIC, Social Policy and Practice, and Web of Science) using relevant terms [23 June 2021].
Methods
The scoping review included qualitative research about young people’s experiences of seeking or engaging with services or support for mental health problems. Included studies were: published from 2012 onwards, from the UK, were about those aged 10 to 24 years and were from ethnic minority backgrounds (i.e. not White British). Study selection, data extraction and quality assessment (with ‘Wallace’ criteria) were conducted by two reviewers. We provide a descriptive summary of the aims, scope, sample, methods and quality of the included studies, and selected presentation of authors’ findings (i.e. no formal synthesis).
Findings
From 5335 unique search records, we included 26 papers or reports describing 22 diverse qualitative studies. Most of the studies were well conducted and clearly described.
There were studies of refugees/asylum seekers (5 studies), university students (4), and studies among young people experiencing particular mental health problems (14; some studies appear in multiple categories): schizophrenia or psychosis (3), eating disorders (3), post-traumatic stress disorder (3; in asylum seekers), substance misuse (2) self-harm (2), and obsessive compulsive disorder (1). There were also three studies in ethnic minority young people who were receiving particular treatments (CBT, multi-systemic therapy for families, and a culturally adapted family-based talking therapy).
Most studies had been conducted with young people or their parents from a range of different ethnic backgrounds. However, nine studies were conducted in particular ethnic groups: asylum-seekers from Afghanistan (2), Black and South Asian (2), Black African and Black-Caribbean (2), South Asian (1), Pakistani or Bangladeshi (1), and Orthodox Jewish (1).
The studies suggested a range of factors that influence care-seeking and access to mental health care, in terms of the beliefs and knowledge of young people and their parents, the design and promotion of services, and the characteristics of care professionals. Poor access was attributed to a lack of understanding of mental health problems, lack of information about services, lack of trust in care professionals, social stigma, and cultural expectations about mental resilience.
Limitations
As a rapid scoping review there was only basic synthesis of the research findings.
Future work
Future research about young people from ethnic minorities could cover a wider range of ethnic minorities, sample and analyse separately experiences from particular ethnic minorities, cover those accessing different services for different needs, and adopt multiple perspectives (e.g. service user, carer, clinician, service management).
Review protocol was pre-registered with Open Science Framework at: https://osf.io/wa7bf/
Abstract.
2022
Ahuja L, Price A, Bramwell C, Briscoe S, Shaw L, Nunns M, O'Rourke G, Baron S, Anderson R (2022). Implementation of the Making Safeguarding Personal Approach to Strengths-based Adult Social Care: Systematic Review of Qualitative Research Evidence.
BRITISH JOURNAL OF SOCIAL WORK,
52(8), 4640-4663.
Author URL.
Janssens A, Blake S, Eke H, Price A, Ford T (2022). Parenting roles for young people with attention‐deficit/hyperactivity disorder transitioning to adult services. Developmental Medicine & Child Neurology, 65(1), 136-144.
Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT (2022). What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? an evidence and gap map. Campbell Systematic Reviews, 18(3).
Titheradge D, Godfrey J, Eke H, Price A, Ford T, Janssens A (2022). Why young people stop taking their attention deficit hyperactivity disorder medication: a thematic analysis of interviews with young people. Child: Care, Health and Development, 48(5), 724-735.
2021
Price A, Ball S, Rhodes S, Wickins R, Gordon E, Aylward A, Cockcroft E, Morgan-Trimmer S, Powell R, Timperley J, et al (2021). Effects of a modified muscle sparing posterior technique in hip hemiarthroplasty for displaced intracapsular fractures on postoperative function compared to a standard lateral approach (HemiSPAIRE): protocol for a randomised controlled trial.
BMJ Open,
11(6), e045652-e045652.
Abstract:
Effects of a modified muscle sparing posterior technique in hip hemiarthroplasty for displaced intracapsular fractures on postoperative function compared to a standard lateral approach (HemiSPAIRE): protocol for a randomised controlled trial
IntroductionCurrently National Institute for Health and Care Excellence clinical guidelines in the UK suggest that surgeons performing partial hip replacements (hemiarthroplasty) should consider using the lateral approach. Alternatively, a newer, modified posterior approach using a muscle sparing technique named ‘Save Piriformis and Internus, Repairing Externus’ (SPAIRE) can be used leaving the major muscles intact. This randomised controlled trial (RCT) aims to compare the SPAIRE approach to the standard lateral approach, to determine if it allows patients to mobilise better and experience improved function after surgery.Methods and analysisHemiSPAIRE is a two-arm, assessor-blinded, definitive pragmatic RCT with nested pilot and qualitative studies. Two hundred and twenty-eight participants with displaced intracapsular fractures requiring hip hemiarthroplasty will be individually randomised 1:1 to either the SPAIRE, or control (standard lateral approach) surgical procedure. Outcomes will be assessed at postoperative day 3 (POD3) and 120 (POD120). The primary outcome measure will be level of function and mobility using the Oxford Hip Score at POD120. Secondary outcomes include: De Morton Mobility Index (DEMMI), Cumulated Ambulatory Score and Numeric Pain Rating Scale (NPRS) at POD3; DEMMI, NPRS and EQ-5D-5L at POD120, complications, acute and total length of hospital stay, and mortality. Primary analysis will be on an intention-to-treat basis. Participant experiences of the impact of surgery and recovery period will be examined via up to 20 semi-structured telephone interviews.Ethics and disseminationThe protocol has been approved by Yorkshire and the Humber—Bradford Leeds Research Ethics Committee. Recruitment commenced in November 2019. Findings will be disseminated via research articles in peer-reviewed journals, presentations at conferences, public involvement events, patient groups and media releases. A summary of the trial findings will be shared with participants at the end of the study.Trial registration numberNCT04095611.
Abstract.
Price A, Ahuja L, Bramwell C, Briscoe S, Shaw L, Nunns M, O’Rouke G, Baron S, Anderson R (2021). P90 Implementation of strategies for fostering strengths-based adult social work in the UK: a systematic review of research evidence. SSM Annual Scientific Meeting.
Shaw EH, Nunns M, Briscoe S, Ahuja L, Price A, Bethel A, Shaw N, Anderson R, Thompson Coon J (2021). What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? Protocol for a systematic evidence map Version 2: 24th May 2021.
Abstract:
What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? Protocol for a systematic evidence map Version 2: 24th May 2021
Evaluating the potential of peer support is receiving abundant attention. This is in response to the increasing financial pressures on NHS, which has led health and social care sector to realise the importance of enabling patients and carers to support themselves more effectively. While there is strong evidence on effectiveness and cost-effectiveness of peer support intervention, it is currently not clear how future research could contribute in better understanding peer support interventions. Also, limited synthesised literature is available on which method of delivery of peer support may be the most effective in achieving positive patient outcomes and in terms of costs incurred. Thus, we aim to systematically map the volume, diversity and nature of recent, robust evidence for the use of peer support interventions in health and social care. We will conduct the systematic mapping in two stages: in stage 1 we will map systematic reviews of peer support, and in stage 2 we will map randomised controlled trials and health economic studies of peer support interventions that have not been included in recent systematic reviews. We will search several databases: MEDLINE, PsycINFO, Social Policy and Practice, HMIC, CINAHL, ASSIA and the Campbell Library. Supplementary web searches will be conducted. Results will be limited to English language studies conducted in high-income countries. Stage 1 search will be date limited from 2015 to-date. The date cut-off for the stage 2 searches will be determined following the completion of stage 1. Eligible studies will be those that involve users of adult services with a defined health and/or social care need accessing peer support delivered in any format (such as face-to-face, online, group, individual, mixed modes etc.), delivered by paid or unpaid peer supporters. Any comparator will be eligible for inclusion and all outcomes are of interest. In stage 1 of the review, high quality, recently published systematic reviews that include comparative studies (RCTs, non-randomised controlled trials, controlled and uncontrolled before-and-after trials and interrupted time series designs) evaluating the effectiveness and/or cost-effectiveness of peer support interventions will be included. The quality of all systematic reviews identified as eligible at stage 1 will be appraised using the AMSTAR2 quality appraisal tool. At stage 2. We will use the Cochrane Risk of Bias (ROB) tool and the CHEC list for assessing risk of bias of RCTs and the quality of economic evaluations, respectively. Following data extraction using EPPI Reviewer 4, studies will be entered into an interactive evidence map to visually represent the distribution of evidence across health and social care domains. The map will have multiple layers, such that studies can be identified by population group, type of peer support and outcome. We expect that by conducting this review, we will be able to direct users to existing evidence, funders to existing gaps, and reviewers to pockets of evidence that could be reviewed to help decision making. It may also be possible to use the map to identify research questions that cut across settings, populations and interventions that would help us to understand how to use peer support interventions most effectively.
Abstract.
2020
Eke H, Janssens A, Newlove-Delgado T, Paul M, Price A, Young S, Ford T (2020). Clinician perspectives on the use of National Institute for Health and Care Excellence guidelines for the process of transition in Attention Deficit Hyperactivity Disorder.
Child Care Health Dev,
46(1), 111-120.
Abstract:
Clinician perspectives on the use of National Institute for Health and Care Excellence guidelines for the process of transition in Attention Deficit Hyperactivity Disorder.
BACKGROUND: the UK National Institute for Health and Care Excellence (NICE) clinical guidelines recommends the following steps in the transition from child to adult services for young people with attention deficit hyperactivity disorder (ADHD): reassessment before and after transition, transition planning, formal meeting between services, and involvement from young person and carer, completed by age 18. METHODS: a UK surveillance study asked clinicians to report young people on their caseloads with ADHD in need of transition to adult services in 2016 to support their continued access to medication need. Clinicians reported young people as they aged to within 6 months of the transition boundary, a prospective questionnaire prior to transition asked about intended transition and the use of local transition protocols. A retrospective questionnaire sent 9 months later established which steps recommended by NICE were followed during transition. Clinicians (38) working in child or adult services were interviewed about their experiences of transition and the use of NICE guidelines during transition and were analysed using a framework approach. RESULTS: Information was shared between services in 85% of the 315 identified transition cases. A joint meeting was planned in 16% of cases; joint working before transfer occurred in 10% of cases. Clinicians were aware of NICE guidelines; they had mixed views on whether (local) guidelines or protocols were helpful. The main reason for not following guidelines was workload and resources: "NICE recommends stuff that is miles above what we will ever be able to provide". CONCLUSIONS: Clinicians involved in the transition process of young people with ADHD judged NICE guidelines to be unrealistic given the current limited resources and service organization. More open dialogue is needed for recommendations on service models to bridge the gap between guideline recommendations and what is viewed as feasible and how implementation of guidance is funded, monitored, and prioritized. This may lead to valuable changes in the consultation process, for example, consideration of a layered (gold, standard, and minimal) system for some NICE guidelines.
Abstract.
Author URL.
Price A, Janssens A, Newlove-Delgado T, Eke H, Paul M, Sayal K, Hollis C, Ani C, Young S, Dunn-Morua S, et al (2020). Mapping UK mental health services for adults with attention-deficit/hyperactivity disorder: national survey with comparison of reporting between three stakeholder groups.
BJPsych Open,
6(4).
Abstract:
Mapping UK mental health services for adults with attention-deficit/hyperactivity disorder: national survey with comparison of reporting between three stakeholder groups
. Background
. UK clinical guidelines recommend treatment of attention-deficit hyperactivity disorder (ADHD) in adults by suitably qualified clinical teams. However, young people with ADHD attempting the transition from children's to adults’ services experience considerable difficulties in accessing care.
.
.
. Aims
. To map the mental health services in the UK for adults who have ADHD and compare the reports of key stakeholders (people with ADHD and their carers, health workers, service commissioners).
.
.
. Method
. A survey about the existence and extent of service provision for adults with ADHD was distributed online and via national organisations (e.g. Royal College of Psychiatrists, the ADHD Foundation). Freedom of information requests were sent to commissioners. Descriptive analysis was used to compare reports from the different stakeholders.
.
.
. Results
. A total of 294 unique services were identified by 2686 respondents. of these, 44 (15%) were dedicated adult ADHD services and 99 (34%) were generic adult mental health services. Only 12 dedicated services (27%) provided the full range of treatments recommended by the National Institute for Health and Care Excellence. Only half of the dedicated services (55%) and a minority of other services (7%) were reported by all stakeholder groups (P < 0.001, Fisher's exact test).
.
.
. Conclusions
. There is geographical variation in the provision of NHS services for adults with ADHD across the UK, as well as limited availability of treatments in the available services. Differences between stakeholder reports raise questions about equitable access. With increasing numbers of young people with ADHD graduating from children's services, developing evidence-based accessible models of care for adults with ADHD remains an urgent policy and commissioning priority.
.
Abstract.
Price A, Ford T, Janssens A, Williams AJ, Newlove-Delgado T (2020). Regional analysis of UK primary care prescribing and adult service referrals for young people with attention-deficit hyperactivity disorder.
BJPsych Open,
6(1).
Abstract:
Regional analysis of UK primary care prescribing and adult service referrals for young people with attention-deficit hyperactivity disorder
. Background
. Approximately 20% of children with attention-deficit hyperactivity disorder (ADHD) experience clinical levels of impairment into adulthood. In the UK, there is a sharp reduction in ADHD drug prescribing over the period of transition from child to adult services, which is higher than expected given estimates of ADHD persistence, and may be linked to difficulties in accessing adult services. Little is currently known about geographical variations in prescribing and how this may relate to service access.
.
.
. Aims
. To analyse geographic variations in primary care prescribing of ADHD medications over the transition period (age 16–19 years) and adult mental health service (AMHS) referrals, and illustrate their relationship with UK adult ADHD service locations.
.
.
. Method
. Using a Clinical Practice Research Datalink cohort of people with an ADHD diagnosis aged 10–20 in 2005 (study period 2005–2013; n = 9390, 99% diagnosed <18 years), regional data on ADHD prescribing over the transition period and AMHS referrals, were mapped against adult ADHD services identified in a linked mapping study.
.
.
. Results
. Differences were found by region in the mean age at cessation of ADHD prescribing, range 15.8–17.4 years (P<0.001), as well as in referral rates to AMHSs, range 4–21% (P<0.001). There was no obvious relationship between service provision and prescribing variation.
.
.
. Conclusions
. Clear regional differences were found in primary care prescribing over the transition period and in referrals to AMHSs. Taken together with service mapping, this suggests inequitable provision and is important information for those who commission and deliver services for adults with ADHD.
.
Abstract.
Price A, Ahuja L, Bramwell C, Briscoe S, Shaw L, Nunns M, O'Rourke G, Baron S, Anderson R (2020). Research evidence on different strengths-based approaches within adult social work: a systematic review., NIHR.
Janssens A, Eke H, Price A, Blake S, Newlove-Delgado T, Logan S, Ford T (2020). Young people with Attention Deficit Hyperactivity Disorder (ADHD) in transition from children's services to adult services (CATCh-uS): a mixed methods national scoping study.
Health Services and Delivery Research, 1-184.
Abstract:
Young people with Attention Deficit Hyperactivity Disorder (ADHD) in transition from children's services to adult services (CATCh-uS): a mixed methods national scoping study
ADHD was previously seen as a childhood developmental disorder, so adult mental health services were not set up to support ADHD patients who become too old for child services. This is the first in-depth study of the transition of ADHD patients from child to adult health services in the UK. Our objectives were to explore:
o how many young people with ADHD are in need of services as an adult
o what adult ADHD services are available
o how ADHD stakeholders experience transition from child to adult services
Design
An interactive mixed method design was adopted with three study streams; (1) a twelve-month surveillance study with nine month follow-up to find out how many young people required ongoing medication when too old for child services (929 surveys completed by child clinicians); (2) a mapping study to identify and describe services for young adults with ADHD (2,686 respondents to online surveys for patients and health workers and Freedom of Information requests to service providers and commissioners); and (3) a qualitative study to explore key stakeholder experience of transition from child to adult services (144 interviews with 64 ADHD patients, 28 parents, 52 clinicians working in child or adult secondary health services and 14 general practitioners). Members of the public advised each stage of the study.
Results
Corrected for non-response and case ascertainment, the annual incidence of young people with an ongoing need for medication for ADHD lies between 270 and 599 per 100,000 people aged 17 – 19 years. of 315 eligible cases for transition, 64% of referrals were accepted but only 22% attended their first adult services appointment. Our interactive map describes 294 unique services for adults with ADHD across the UK; 44 were ‘dedicated’ ADHD services (defined chapter 4). Few services provide the full range of recommended provision, most focused on diagnosis and medication. They were unevenly distributed across the UK, with nearly all ‘dedicated’ services in England. Exploring stakeholders’ experiences revealed how invested they are in continuing ADHD treatment and the architecture of services impacted transition. An association between ADHD, education and continuance of medication into young adulthood, plus parent involvement and feeling prepared for transition and adult life with ADHD, influenced investment. However, even if invested; how accessible adult services were; how patient needs fitted with the remit of the adult service; and the level of patient information available impacted transition outcomes. The results also highlighted how GPs can end up as care-coordinator during transition by default.
Limitations
Transition estimates were based on those who want medication, so indicate a minimum level of need.
Conclusions
Few of those who need ongoing support for their ADHD successfully transfer to adult services, and a small proportion of those who transfer experience optimal transitional care. Adult ADHD service provision is patchy. Even among ‘dedicated’ services, few provide the whole range of NICE recommended treatments.
Future Work
We a need to evaluate various models of transitional care and adult ADHD provision, as well as develop and evaluate psycho-social interventions for young people and adults with ADHD.
Funding
The National Institute for Health Research - Health Services and Delivery Research Programme.
Abstract.
2019
Price A (2019). Health service transitions for young people with attention deficit hyperactivity disorder (ADHD): investigating information provision and United Kingdom adult ADHD service availability.
Abstract:
Health service transitions for young people with attention deficit hyperactivity disorder (ADHD): investigating information provision and United Kingdom adult ADHD service availability
Within this thesis I explored transition between child and adult services for young people with attention deficit hyperactivity disorder (ADHD); focussing on the role of information provision, and mapping current availability of and geographic variations in United Kingdom (UK) services for adults with ADHD.
A systematic review of stakeholder transition experiences was conducted, providing an overview of current literature. Qualitative interviews were conducted with young people (n=64) and parents/carers (n=28), to explore the role of information through transition. A national survey was piloted and then run to map UK health services for adults with ADHD. Finally, an analysis of regional differences in prescribing of ADHD medication and referrals to adult mental health services (AMHS) was conducted, using primary care records from the Clinical Practice Research Datalink (CPRD) database.
The systematic review identified negative transition experiences related to limitations of adult mental health services, inadequate care, and a need for better information. Three themes emerged from the qualitative study: navigating information with help from parent/carer; information on ADHD into adulthood; and information about the transition process, providing insight into how communication may affect transition. The UK mapping study had 2686 responses from commissioners, health workers and service users and identified 294 National Health Service (NHS), voluntary and private services. of 44 dedicated NHS adult ADHD services, 27% provided all treatments recommended by National Institute for Health and Care Excellence. Analysis of CPRD data revealed significant regional differences in primary care prescribing of ADHD medication through the transition period as well as in referral rates to AMHS.
Findings highlight an urgent need to improve information provision and provide accessible adult ADHD services across the UK, to support transition for young people with ADHD and reduce health inequalities. Services need to recognise the crucial role of parents/carers as information navigators, and the importance of young people understanding about ADHD into adulthood and being informed about transition processes. Strategies are needed to reduce negative emotional experiences associated with this information vacuum. The limited number of dedicated NHS adult ADHD services appears to represent a significant barrier to transition, however clarity is needed on optimum service configurations and the role of primary care.
Abstract.
Price A, Newlove-Delgado T, Eke H, Paul M, Young S, Ford T, Janssens A (2019). In transition with ADHD: the role of information, in facilitating or impeding young people’s transition into adult services.
BMC Psychiatry,
19(1).
Abstract:
In transition with ADHD: the role of information, in facilitating or impeding young people’s transition into adult services
Abstract
. Background
. Many national and regional clinical guidelines emphasise the need for good communication of information to young people and their parent/carers about what to expect during transition into adult services. Recent research indicates only a minority of young people in need of transition for Attention Deficit Hyperactivity Disorder (ADHD) experience continuity of care into adulthood, with additional concerns about quality of transition. This qualitative study explored the role that information plays in experiences of transition from the perspectives of parent/carers and young people.
.
. Methods
. Participants were recruited from 10 National Health Service Trusts, located across England, with varying service configurations. Ninety two qualitative interviews were conducted: 64 with young people with ADHD at different stages relative to transition, and 28 with parent/carers. Thematic analysis of data was completed using the Framework Method.
.
. Results
. Interviewees reported a range of experiences; however reliance on parent/carers to gather and translate key information, and negative experiences associated with poor communication of information, were universal. Three themes emerged: Navigating information with help from parents; Information on ADHD into adulthood; Information about the transition process. The first revealed the essential role of parent in the translation and application of information, the other two explored distinct types of information necessary for a smooth transition. Interviewees made recommendations for clinical practice similar to UK (United Kingdom) National Institute for Health and Care Excellence (NICE) guidelines, with an additional emphasis on providing nuanced information on ADHD as a potentially long term condition. It was important to interviewees that General Practitioners had a basic understanding of adult ADHD and also had access to information about service provision.
.
. Conclusions
. Our findings illustrate that the availability and communication of information to young people and their parent/carers is an essential component of the transition process between child and adult ADHD services. How and when it is provided may support or impede transition. This study constitutes a substantial contribution to the evidence base, drawing on interviews from a range of participants across England and from Trusts offering different types of services.
.
Abstract.
Price A, Janssens A, Dunn-Morua S, Eke H, Asherson P, Lloyd T, Ford T (2019). Seven steps to mapping health service provision: lessons learned from mapping services for adults with Attention-Deficit/Hyperactivity Disorder (ADHD) in the UK.
BMC Health Serv Res,
19(1).
Abstract:
Seven steps to mapping health service provision: lessons learned from mapping services for adults with Attention-Deficit/Hyperactivity Disorder (ADHD) in the UK.
BACKGROUND: ADHD affects some individuals throughout their lifespan, yet service provision for adults in the United Kingdom (UK) is patchy. Current methods for mapping health service provision are resource intensive, do not map specialist ADHD teams separately from generic mental health services, and often fail to triangulate government data with accounts from service users and clinicians. Without a national audit that maps adult ADHD provision, it is difficult to quantify current gaps in provision and make the case for change. This paper describes the development of a seven step approach to map adult ADHD service provision in the UK. METHODS: a mapping method was piloted in 2016 and run definitively in 2018. A seven step method was developed: 1. Defining the target service 2. Identifying key informants 3. Designing the survey 4. Data collection 5. Data analysis 6. Communicating findings 7. Hosting/updating the service map. Patients and members of the public (including clinicians and commissioners) were involved with design, data collection and dissemination of findings. RESULTS: Using a broad definition of adult ADHD services resulted in an inclusive list of identified services, and allowed the definition to be narrowed to National Health Service (NHS) funded specialist ADHD services at data analysis, with confidence that few relevant services would be missed. Key informants included patients, carers, a range of health workers, and commissioners. A brief online survey, written using lay terms, appeared acceptable to informants. Emails sent using national organisations' mailing lists were the most effective way to access informants on a large scale. Adaptations to the methodology in 2018 were associated with 64% more responses (2371 vs 1446) collected in 83% less time (5 vs 30 weeks) than the pilot. The 2016 map of adult ADHD services was viewed 13,688 times in 17 weeks, indicating effective communication of findings. CONCLUSION: This seven step pragmatic method was effective for collating and communicating national service data about UK adult ADHD service provision. Patient and public involvement and engagement from partner organisations was crucial throughout. Lessons learned may be transferable to mapping service provision for other health conditions and in other locations.
Abstract.
Author URL.
Allen KL, Hansford L, Hayes R, Allwood M, Byford S, Longdon B, Price A, Ford T (2019). Teachers’ perceptions of the impact of the Incredible Years® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils.
British Journal of Educational PsychologyAbstract:
Teachers’ perceptions of the impact of the Incredible Years® Teacher Classroom Management programme on their practice and on the social and emotional development of their pupils
Background
The Incredible Years® (IY) Teacher Classroom Management (TCM) programme may be an effective way to reduce teacher stress levels, improve child behaviour and promote positive socio-emotional development. However, few studies have considered what teachers think of the course and how it might work.
Aims
In this paper we examine teachers’ perceptions of the impact of the TCM programme and how it might work in the classroom.
Sample(s)
Fourty-four UK primary school teachers who attended the TCM programme as part of the STARS trial (Ford et al. 2018).
Methods
Focus groups and interviews were held with teachers two months after completing the TCM programme. Thematic analysis (Braun & Clarke, 2006) was employed to explore the subsequent data.
Results
Three main themes were identified: impact on the teacher; on children; and on parent-teacher relationships. Impact on the teacher included a positive change in their ethos. Teachers reported being more able to see things from the child’s perspective, placing a greater focus on building positive relationships, thinking before responding, feeling calmer, more confident and in control and employing strategies to create positive interactions with children. Teachers felt this had had a positive impact on their pupils’ development and relationships with parents. Feedback on whether or not TCM was effective in tackling particularly challenging behaviour was more mixed.
Conclusions
Our findings suggest that teachers experience the TCM programme as beneficial. This is discussed alongside other qualitative and quantitative studies in this field.
Abstract.
Hayes RA, Titheradge D, Allen K, Allwood M, Byford S, Edwards V, Hansford L, Longdon B, Norman S, Norwich B, et al (2019). The Incredible Years® Teacher Classroom Management programme and its impact on teachers’ professional self-efficacy, work related stress and general well-being: results from the STARS randomised controlled trial.
Journal of Educational PsychologyAbstract:
The Incredible Years® Teacher Classroom Management programme and its impact on teachers’ professional self-efficacy, work related stress and general well-being: results from the STARS randomised controlled trial
Background
Teaching is a stressful occupation with poor retention. The Incredible Years® Teacher Classroom Management (TCM) programme is a training program that past research has demonstrated may be an effective intervention for children’s mental health, but little research has explored any impacts there may be on the teachers’ own professional confidence and mental health.
Aims
In this paper we evaluate whether TCM may lead to changes in teachers’ wellbeing, namely a reduction in burnout and an improvement in self-efficacy and mental health.
Sample
Eighty schools across the South West of England were recruited between September 2012 and September 2014. Headteachers were asked to nominate one class teacher to take part.
Methods
Eighty teachers were randomised to either attend a TCM course (intervention) or not (control). TCM was delivered to groups of up to twelve teachers in six whole-day workshops that were evenly spread between October and April. At baseline and nine months follow-up we measured teachers’ mental health using the Everyday Feelings Questionnaire (EFQ), burnout using the Maslach Burnout Inventory-General Survey (MBI-GS) and self-efficacy using the Teachers’ Sense of Efficacy Scale-Short (TSES-Short).
Results
Using linear regression models there was little evidence of differences at follow-up between the intervention and control teachers on the outcomes (the smallest p-value was 0.09).
Conclusions
Our findings did not replicate previous research that TCM improved teachers’ sense of efficacy. However, there were limitations with this study including low sample size.
Abstract.
Ford T, Hayes RA, Edwards V, Logan GS, Norwich B, Allen KL, Hansford L, Longdon BM, Norman S, Price A, et al (2019). Training teachers in classroom management to improve mental health in primary school children: the STARS cluster RCT. Public Health Research, 7
Eke HE, Ford T, Newlove-Delgado T, Price A, Young S, Ani C, Sayal K, Paul M, Janssens A (2019). Transition between child and adult services for young people with ADHD:. findings from a British national surveillance study. British Journal of Psychiatry, 1-7.
2018
Ayyash H, Ford T, Janssens A, Eke H, Price AM, Morton M, Lynn R (2018). G469 Impact of CAPSS and BPSU in identifying the imminent needs of ADHD patients in transition from children's to adult services across the United Kingdom. Archives of Disease in Childhood, 103, A191-A192.
Titheradge D, Hayes R, Longdon B, Allen K, Price A, Hansford L, Nye E, Ukoumunne O, Byford S, Norwich B, et al (2018). Psychological distress amongst primary school teachers: a comparison with clinical and population samples. Public Health, 166, 53-56.
Price AM, Janssens A, Woodley AL, Allwood M, Ford T (2018). Review: Experiences of healthcare transitions for young people with attention deficit hyperactivity disorder: a systematic review of qualitative research. Child and Adolescent Mental Health, 12-12.
Ford T, Hayes RA, Byford S, Edwards V, Fletcher M, Logan G, Norwich B, Pritchard W, Allen K, Allwood M, et al (2018). The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial.
Psychological MedicineAbstract:
The effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management programme in primary school children: results of the STARS cluster randomised controlled trial
Abstract
Background. We evaluated the effectiveness and cost-effectiveness of the Incredible Years® Teacher Classroom Management (TCM) programme as a universal intervention, given schools’ important influence on child mental health.
Methods. A two-arm, pragmatic, parallel group, superiority, cluster randomised controlled trial recruited three cohorts of schools (clusters) between 2012 and 2014, randomising them to TCM (intervention) or Teaching As Usual (TAU-control). TCM was delivered to teachers
in six whole-day sessions, spread over 6 months. Schools and teachers were not masked to allocation. The primary outcome was teacher-reported Strengths and Difficulties Questionnaire (SDQ) Total Difficulties score. Random effects linear regression and marginal logistic regression models using Generalised Estimating Equations were used to analyse the
outcomes. Trial registration: ISRCTN84130388.
Results. Eighty schools (2075 children) were enrolled; 40 (1037 children) to TCM and 40 (1038 children) to TAU. Outcome data were collected at 9, 18, and 30-months for 96, 89, and 85% of children, respectively. The intervention reduced the SDQ-Total Difficulties score at 9 months (mean (S.D.):5.5 (5.4) in TCM v. 6.2 (6.2) in TAU; adjusted mean difference
= −1.0; 95% CI−1.9 to −0.1; p = 0.03) but this did not persist at 18 or 30 months. Cost-effectiveness analysis suggested that TCM may be cost-effective compared with TAU at 30-months, but this result was associated with uncertainty so no firm conclusions can be drawn. A priori
subgroup analyses suggested TCM is more effective for children with poor mental health.
Conclusions. TCM provided a small, short-term improvement to children’s mental health particularly for children who are already struggling.
Abstract.
Allwood M, Allen K, Price A, Hayes R, Edwards V, Ball S, Ukoumunne OC, Ford T (2018). The reliability and validity of the pupil behaviour questionnaire: a child classroom behaviour assessment tool.
Emotional and Behavioural Difficulties,
23(4), 361-371.
Abstract:
The reliability and validity of the pupil behaviour questionnaire: a child classroom behaviour assessment tool
This paper assesses the reliability and validity of the teacher-completed Pupil Behaviour Questionnaire (PBQ), by comparing it to the already extensively validated teacher-completed Strengths and Difficulties Questionnaire (SDQ). Participants included 2074 primary school children participating in a universal school-based trial and 41 vulnerable children who were taking part in a study exploring the impact of exclusion from school. Exploratory factor analysis results (first factor accounts for 80.8% of the variation in the items) and the high Cronbach’s alpha value of 0.85 indicate that the PBQ consists of one substantive factor/dimension. Strong correlations between the total PBQ score and the conduct sub-scale (Spearman’s correlation coefficient (rs) = 0.67) and total difficulties score (rs = 0.59) of the SDQ indicate convergent validity. This study suggests that the PBQ is a reliable measure, and provides some evidence of validity. Further work is needed to test the PBQ in an older, more diverse populations and to measure sensitivity to change.
Abstract.
2017
Price A, Allen K, Ukoumunne OC, Hayes R, Ford T (2017). Examining the psychological and social impact of relative age in primary school children: a cross-sectional survey.
Child: Care, Health and Development,
43(6), 891-898.
Abstract:
Examining the psychological and social impact of relative age in primary school children: a cross-sectional survey
Background: a number of studies demonstrate that children who are younger within their school year have poorer academic attainment and are more likely to have special educational needs. Few, however, have considered the impact relative age may have on child mental health, behaviour and happiness in school. Methods: This paper utilized data from the Supporting Teachers and Children in Schools study (2075 pupils aged 5 to 9 years from 80 primary schools) to explore the relationship among relative age, behaviour and happiness in school. Behavioural and emotional development was assessed by using the teacher-reported and parent-reported Strengths and Difficulties Questionnaire and the Pupil Behaviour Questionnaire. Children's happiness within school was assessed by using the How I Feel About My School Questionnaire. Results: Relatively younger children had higher Total Difficulties scores on the Strengths and Difficulties Questionnaire than their peers. There was a mean increase per 30-day decrease in relative age of 0.09 (95% CI: 0.03 to 0.16; p = 0.007) in teacher-reported and 0.08 (0.001 to 0.16; p = 0.05) in parent-reported scores. There was little evidence of a relationship between relative age and children's behaviour and happiness in school. Conclusions: for children with complex difficulties, being relatively young for their school year may be an additional stressor that may undermine mental health.
Abstract.
Allen K, Marlow R, Edwards V, Parker C, Rodgers L, Ukoumunne O, Chan Seem E, Hayes R, Price A, Ford T, et al (2017). ‘How I feel About My School’: the construction and validation of a measure of wellbeing at school for primary school children. Clinical Child Psychology and Psychiatry, 55
2014
Hurst A, Price A, Walesby R, Doolan M, Lanham W, Ford T (2014). Routine outcome monitoring of evidencebased parenting programmes: Indications of effectiveness in a community context.
Journal of Children's Services,
9(1), 58-74.
Abstract:
Routine outcome monitoring of evidencebased parenting programmes: Indications of effectiveness in a community context
Purpose: Despite an increasing policy focus, routine outcome monitoring (ROM) is not common practice in UK children's services. This paper aims to examine whether it is feasible and valid to use measures from ROM of evidence-based parenting programmes (EBPPs) to assess the impact of services and to drive service improvements through feedback mechanisms. Design/methodology/ approach: This is a secondary analysis of ROM measures collected from a London clinic offering EBPPs over five years. Demographic information from referrals was compared for attendees and non-attendees. Changes in parent reported child behaviour were measured using the Strengths and Difficulties Questionnaire (SDQ), and a Visual Analogue Scale (VAS). Findings: No significant differences were found in socio-demographic characteristics of attendees and non-attendees. Statistically significant differences were found between pre- and post-scores on parent reported SDQ scores and VAS concerns, as well as the SDQ Added Value Score. The data collected did not allow for investigation of a dose-response relationship between the level of attendance and any improvement made. Originality/value: This study illustrates that ROM can provide useful information about the impact of EBPPs in a particular clinical context. Demographic data could support service managers to evaluate reach and uptake while evidence of improvements can be communicated back to parents and support future funding bids. Incomplete data limited the inferences that could be drawn, and collaborations between research centres and clinics may be a way to optimise the use of ROM to drive service improvement and innovation. © Emerald Group Publishing Limited, ISSN 1746-6660.
Abstract.
Thompson H, Reville MC, Price A, Reynolds L, Rodgers LR, Ford T (2014). The Quality of Life scale for Children (QoL-C). Journal of Children's Services: research informing policy and practice, 9, 4-17.
