Establishing Research Priorities for Children Living With Chronic Health Conditions: A Value-Weighting Study by Australian Caregivers.

Aim: Improving the wellbeing of children with chronic health conditions and their caregivers can be maximised through research that addresses the priorities of this population. This study aimed to investigate the research topics and areas of care deemed most important to caregivers of children living with chronic health conditions in Australia.

Methods: A list of 25 research topics were presented in two rounds of a classic Delphi consensus survey to caregivers of children with chronic health conditions.

Feasibility, acceptability and outcomes of a health education intervention for children with emotional and behaviour difficulties: a pilot cluster randomised trial.

Objective: To assess the acceptability, feasibility and outcomes of a codesigned health education model aiming to improve outcomes for children with emotional and behavioural difficulties (EBD).

Methods: 12 Australian primary schools from metropolitan and rural settings participated. Half of the schools from each setting were randomised to the intervention and half to the control group.

Intervention overuse in paediatric care in Australian metropolitan general practice.

Background And Objectives: General practitioner (GP)-provided low-value paediatric primary care (LVC)/intervention overuse is not routinely evaluated. The aim of this paper is to evaluate prevalence, associated GP characteristics and cost of GP-provided LVC for five common paediatric conditions.

Method: Patient-level data were extracted from 22 practices in Sydney and Melbourne.

Paediatric care in general practice: Case mix, referral patterns and healthcare costs.

Background And Objectives: There are no contemporary data to describe which paediatric conditions general practitioners (GPs) see, which conditions they refer, and where and whether referrals differ by general practice, patient or GP factors. A better understanding of the this could inform GP training needs and workforce planning. The aim of this study was to address knowledge gaps around the case mix of general practice paediatric consultations, as well as GP referral patterns, associated factors and costs.

"If we ask, we must act": co-designing the implementation of the EQ-5D-Y-5L as a Paediatric Patient Reported Outcome Measure in Routine hospital Outpatient Care for Kids to meaningfully impact clinical visits (P-PROM ROCK Phase 2).

Purpose: To co-design use of the EQ-5D-Y-5L, a generic Paediatric Patient Reported Outcome Measure (P-PROM), in Routine Outpatient Care for Kids (ROCK), maximising its impact on patient-clinician visits.

Methods: This Phase 2 co-design study was guided by the co-design framework for public service design and Double Diamond model. Data collection involved facilitated workshops (building on Phase 1), followed by feedback and optimisation sessions.

Use of a generic Paediatric Patient Reported Outcome Measure (P-PROM) in Routine hospital Outpatient Care for Kids (ROCK): A qualitative exploration of adolescent, caregiver and service provider perspectives (P-PROM ROCK Phase 1).

Purpose: To explore patient, caregiver, and service provider perspectives on the implementation of a generic Paediatric Patient Reported Outcome Measure (P-PROM), their perspectives on the EQ-5D-Y-5L, and to consider how these insights can be used to co-design routine use of EQ-5D-Y-5L in paediatric outpatient care.

Methods: Individual semi-structured interviews were conducted with adolescent patients, caregivers, and providers (allied health, nurses, doctors) who had provided or received outpatient care at The Royal Children's Hospital, Australia. Interview transcripts were analysed using framework analysis and subsequent themes were mapped to an acceptability framework.

Paediatric Emergency Department Mental Health and Behavioural Presentations in Australia Before and After the Onset of the COVID-19 Pandemic: Retrospective Observational Study.

Objectives: Although child and adolescent mental health and behavioural presentations to hospital emergency departments (EDs) increased during the first 2 years of the COVID-19 pandemic (2020 and 2021), little is known about the characteristics of these presentations. We aimed to compare demographic, clinical and psychosocial profiles of paediatric presentations to Australian EDs before and after the onset of the pandemic.

Methods: We conducted a retrospective observational study of 100 randomly sampled presentations by children (6-11-year-olds) and adolescents (12-17-year-olds) to 10 Australian EDs between 1 January and 31 December 2019 (pre-COVID-19) and 1 January and 31 December 2021 (COVID-19).

Health Justice Partnership: An Opportunity to Respond to Childhood Adversity.

Background: Health justice partnerships (HJP) embed legal support into health care teams to address patient unmet legal needs. Families experiencing adversity are likely to have multiple legal needs yet are unlikely to seek legal assistance. Implementing a HJP within an integrated health and social care hub may improve outcomes for families by addressing adversity related to unmet legal need.

Acceptability, Feasibility, and Preliminary Effectiveness of a Wellbeing Coordination Program in an Integrated Health and Social Care Hub: A Mixed Methods Study.

Introduction: Families experiencing adversity often have complex needs and face barriers to accessing health and social care. This study evaluated the acceptability, feasibility and preliminary effectiveness of a Wellbeing Coordination (WBC) program to improve access to services. The program combined care navigation and social prescribing within an integrated health and social care Child and Family Hub.

Screening parents of children with a chronic condition for mental health problems: a systematic review.

Objective: Parents of children with a chronic condition (CC) have a high prevalence of mental health (MH) difficulties. It is not known whether establishing screening programmes in paediatric clinics to identify parental MH difficulties increases detection or referrals to support services. We aimed to identify approaches to routine screening programmes for parents of children with a CC attending hospital outpatient clinics (aim 1); associated prevalence of MH symptoms (aim 2); and whether screening impacted referrals to, and uptake of, MH services (aim 3).

Enablers and Barriers to Home Management for Children with Gastroenteritis: Systematic Review.

Objective: To identify enablers and barriers to home management for children with acute gastroenteritis perceived by health care professionals and caregivers.

Study Design: A systematic review was conducted using the following databases: PubMed, Embase, Web of Science, and Cumulative Index to Nursing & Allied Health. Studies from high-income countries published from 2003 to 2023 who included children with acute gastroenteritis younger than 6 years, treated via home management, and addressed enablers or barriers from the perspective of healthcare professionals or caregivers, were eligible for inclusion.

Caregivers' experiences of being asked about adverse childhood experiences and receiving support from an integrated health and social care hub: a qualitative study.

Objectives: Adverse childhood experiences (ACEs) are significant contributors to the burden of disease and remain a serious concern for the health and wellbeing of children in Australia. To address ACEs, we co-designed and implemented two integrated health and social care hubs (Child and Family Hubs [CFHs]). This study explores the experiences of caregivers who received care from the CFHs, including the way they were asked about ACEs and the services offered to address identified ACEs.

A co-designed health education model to improve outcomes for children with emotional and behavioural difficulties: a study of acceptability, feasibility and impacts.

Objective: To assess the acceptability and impacts of a co-designed health education model aiming to improve outcomes for children with emotional and behavioural difficulties.

Design: Qualitative focus group study.

Setting: Six primary schools from metropolitan and rural settings in the state of Victoria, Australia.

Lessons Learned From the Implementation of an Integrated Health and Social Care Child and Family Hub - a Case Study.

Introduction: Childhood adversity is associated with poor physical and mental health outcomes across the lifespan. Integration of health and social care may provide a solution to childhood adversity through practices of better detection and response. There is growing interest in the creation of child and family hubs that integrate health and social care but little literature that describes the development process.

What are the priorities of consumers and carers regarding measurement for evaluation in mental healthcare? Results from a Q-methodology study.

Background: The purpose of this study was to identify and describe common views of people with lived experience of mental health challenges - consumers and carers, families and supporters - of what they consider the most important measures to include in health economic evaluations which assess the incremental value of competing options in mental health care.

Methods: Participants (n = 111) were people living in the state of Victoria, Australia, who identified as consumers of mental healthcare (n = 38); carers, family members and/or supporters (n = 43); or both (n = 30). Factor analysis based on Q-Methodology was used to identify clusters of people who hold similar viewpoints.

How should we fund integrated primary care for children in Australia? A resource allocation study.

Objectives: Integrated primary care provides health and social care services to intervene early and support children and families. Funding of integrated care is a barrier to care provision, but evidence is limited for which funding models are most appropriate. Our study aimed to provide expert judgement on what funding model, or mix of models, are most likely effective for integrating primary care for families with children aged 0-12 years in Australia.

A pilot randomised controlled trial of a telehealth-delivered brief 'Sleeping Sound Autism' intervention for autistic children.

Background: Access to behavioural sleep intervention is beneficial for autistic children, yet many families face barriers to access associated with location and time. Preliminary evidence supports telehealth-delivered sleep intervention. However, no studies have evaluated brief telehealth sleep intervention.

Identifying Service, Research and Policy priorities for preventing the impacts of family adversity on children's mental health: An Australian national resource allocation study with professional and lived experience experts.

Objectives: The objective of this study was to develop Service, Research and Policy priorities to prevent the impact of family adversity on child mental health and determine comparative priorities of diverse stakeholders to those with lived experience of adversity.

Methods: Value-weighting approach conducted in a staged process: (i) professionals and experts with lived experience from health, education, justice and social care sectors attended a national symposium to identify priorities for family adversity and mental health and (ii) a subsequent resource allocation survey gathered views from participants and external experts on symposium priorities.

Results: Consensus was reached on priorities.

Mothers' experience seeking healthcare advice for their unsettled infants in Victoria, Australia.

Unsettled infant behaviours are highly prevalent in the postnatal period and constitute a significant proportion of visits to healthcare services. Unsettled infant behaviours can be highly distressing for parents and are identified as a significant risk factor for postnatal depression. Understanding parents' experiences is paramount to reducing the gap between consumer expectations and service delivery.

Caring for kids: Australian general practice registrar confidence in delivering paediatric primary care.

Background And Objectives: The burden of disease for Australian children from non-acute conditions is growing; however, little is known about how well prevocational training experiences prepare trainee doctors. This study examines the confidence of general practice registrars in managing paediatric consultations in primary care and whether confidence varies by prevocational training type.

Method: This was a cross-sectional national survey of Australian general practice registrars that measured confidence in managing paediatric primary care presentations.

Comparing healthcare systems between the Netherlands and Australia in management for children with acute gastroenteritis.

Background: Acute gastroenteritis is a highly contagious disease demanding effective public health and clinical care systems for prevention and early intervention to avoid outbreaks and symptom deterioration. The Netherlands and Australia are both top-performing, high-income countries where general practitioners (GPs) act as healthcare gatekeepers. However, there is a lower annual incidence and per-case costs for childhood gastroenteritis in Australia.