Welcome to the 21st edition of our A Better Start Southend Research Bulletin, bringing you the latest on ‘what works’ in early years’ around our outcomes: Social and Emotional Development, Diet and Nutrition, Communications and Language, Community Resilience and Systems Change.

Your regular update, edited by Rachel Wood, also shows how we are using these findings to influence our work in Southend. In addition, we invite you to help shape our ‘test and learn’ projects and innovations in prevention and early intervention.

If you would like to contribute an article, want to sign up to receive these updates, or have a question, please e-mail: abssresearch@pre-school.org.uk

Public Health, the Social Sciences and Health Inequalities (Systems Change)
Systems Thinking and Ethics (Systems Change)
Adverse Life Experience and Pregnancy (Social and Emotional)

Public Health, the Social Sciences and Health Inequalities (Systems Change)

Title: Public Health England (2018), Improving people’s health: Applying behavioural and social sciences to improve population health and wellbeing in England

Research source: https://www.gov.uk/government/publications/improving-peoples-health-applying-behavioural-and-social-sciences

Publication date: September 2018

Our Summary: This collaborative strategy has been put together to enable the public health system (health improvement, protection and health care) to use behavioural and social sciences (e.g. psychology, behavioural economics, sociology and anthropology) to reduce health inequalities.

It recognises that there is a need to use these approaches in order to understand complex systems in order to support deliver effective and efficient change.

The eight priority themes within the strategy are as follows:

  • Evidence and theory;
  • Leadership of our organisations;
  • Wider system leadership;
  • Access to expertise;
  • Tools and resources;
  • Capacity building;
  • Research and translation; and
  • Communities of Practice.

The five key principles for good practice as agreed to be:

  • We should all use inclusive language that does not alienate;
  • We should all think outside of our disciplinary boundaries and cooperate across disciplines in order to ensure a multi-disciplinary approach;
  • We should promote our common focus on improving public health and reducing health inequalities;
  • We should involve end users in the development and implementation of behavioural and social sciences to benefit the public health;
  • Our approach should be reflective and critical, informed by evidence, and involve the highest possible standard of evaluation.

How we’re applying this in Southend

  • A Better Start Southend is a partnership of people who care about Southend’s children;
  • We are committed to co-production in the design and delivery of our projects and services;
  • Our evaluation framework process is supported by evidence that involves reflective and critical thinking;

Help us help Southend

  • In what ways do you think that we can further develop this kind of approach to improving our families and children’s health?

Let us know what you think by e-mailing abssresearch@pre-school.org.uk

Systems Thinking and Ethics (Systems Change)

Title: Silva, DS. Norman, C. and Smith, MJ. (2018), Systems Thinking and ethics in public health: a necessary and beneficial partnership, Monash Bioethics Review, https://doi.org/10.1007/s40592-018-0082-1

Research source: https://europepmc.org/abstract/med/29948960

Publication date: June 2018

Our Summary: The article recognises that there has in the past been little engagement between systems scientists and those working in ethics and in public health.

It acknowledges that systems thinking in terms of public health can be broadly categorised into:

  • Simple problems – where ‘best practice’ can be applied and there is a known pathway and guidance can be provided based on evidence;
  • Complicated problems – where a cause is difficult to predict and parts of the system need expertise, time and ‘good practice’;
  • Complex problems – where solving the problem can only be done by all functions and roles that interact by working together. It also needs to be acknowledged that the system is dynamic and may even be non-linear and that there will be a need for feedback loops. It is also noted that solutions may be counter-intuitive and an understanding of how value systems have been shaped.

It is these problems, which systems thinking seeks to solve.

The article highlights that systems thinking is a new interdisciplinary perspective. However, that its development will bring a new model for understanding how we might solve complex health issues, as well as understand the values and ethics that might support this.

Editor’s note Systems thinking is challenging to define. It is broadly about having an awareness of structures, and is often used as a diagnostic tool. It has been recognised that it is crucial when an issue is considered to be chronic, it is known and familiar, and no solution as yet has been found. It is helpful in moving from observation of events to be able to identify patterns of behaviour. It is recognised as needing curiosity, compassion and courage.

How we’re applying this in Southend

  • As part of our service design process we map the system and pathway within which the service or pathway will work.

Help us help Southend

  • How do you feel that we can learn from our pathway mapping?
  • Are there other ways that our pathway mapping, or that systems thinking could support our projects and services?

Let us know what you think by e-mailing abssresearch@pre-school.org.uk

Adverse Life Experience and Pregnancy (Social and Emotional)

Title: Lydsdottir, LB. Howard, LM. Olafsdottir, H. Einarsson, H. Steingrimsdottir, T. Sigurdsson, JF. (2018), Adverse life experiences and common mental health problems in pregnancy: a causal pathway analysis, Archives of Women’s Mental Health, https://doi.org/10.1007/s00737-018-0881-7

Research source: https://www.ncbi.nlm.nih.gov/pubmed/30056536

Publication date: July 2018

Our Summary: The authors argue that it is unclear from evidence as to whether pregnancy is a time of susceptibility to mental health problems. The paper aims to investigate which adverse experiences in adulthood and early childhood could affect common mental disorders in mothers. A second aim included an analysis of potential mediating influences strength.

The study interviewed and undertook psychological questionnaires with 521 women attending prenatal care.

It is argued, that a history of depression, adverse experiences mediated the relationship with adverse childhood events and symptoms associated with common mental health disorders. From this, it appeared that adverse childhood events were found to have an association, but not as closely as other factors.

On this basis, the authors concluded that mental health problems in the antenatal period were more at risk when there was a history of depression, domestic violence, financial difficulties, spousal substance abuse and lack of support.

How we’re applying this in Southend

  • We ensure that all our services and projects have the latest evidence embedded into our design process;

Help us help Southend

  • What sort of services and projects do you think that Southend could be doing to further develop pathways of support in this way?

Let us know what you think by e-mailing abssresearch@pre-school.org.uk

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