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Cost-effectiveness and acceptability of interventions for children on the Edge of Care: a mixed methods study


Bristol Medical School

Applications accepted all year round Self-Funded PhD Students Only

About the Project

Background
Children’s Social Care Services in England are in crisis. Numbers of looked after children (LAC) are increasing as potential foster placements for these children are decreasing. Consequently, placement of LAC in expensive, non-family residential settings are also increasing. Health and social outcomes for all LAC continue to be extremely poor and Local Authority funding is extremely constrained. For all these reasons, Children’s Social Care Services are increasingly focusing on interventions for children at the “Edge of Care” (children from families where there is a strong possibility of a child or children becoming looked after) and their families aimed at preserving family unity and improving child outcomes cost effectively. There are a wide range of interventions being implemented by Children’s Social Care Services such as functional family therapy, signposting to key services and dedicated key work support. The evidence base for these interventions is limited which limits the scope for evidence-based policy in this crucial area.

The proposed research will investigate the acceptability and cost-effectiveness of such interventions to improve outcomes for looked after children and reduce the adverse health and social impact of adverse childhood experiences.

Aims
The aims of the research are (i) to identify the range of interventions for children on the Edge of Care or those in care aimed at either promoting or restoring family unity and improving child outcomes, (ii) investigate the cost-effectiveness of interventions implemented across the West of England and (iii) investigate the acceptability of such interventions by children and families, and other key stakeholders such as commissioners.

Plan of investigation
This project has three elements; (i) A systematic review with quantitative synthesis and cost-effectiveness analysis of evidence on the effectiveness of interventions for children on the Edge of Care or those in care aimed at either promoting or restoring family unity and improving child outcomes:

(ii) Analysis of routine data from health and care services in the West of England on the cost-effectiveness of these interventions
(iii) A qualitative interview study with key stakeholders (commissioners, practitioners and families) on the aims and acceptability of these interventions.

This research will contribute significantly to the currently limited evidence base on the feasibility, acceptability and effectiveness of interventions to improve outcomes for looked after children and reduce the adverse health and social impact of adverse childhood experiences.

We are looking to recruit an enthusiastic and talented PhD student to work with Professor John Macleod, Professor Geraldine Macdonald and Professor Julian Higgins at the University of Bristol. This 3-year studentship will provide training in both quantitative and qualitative methods. In exceptional circumstances, a candidate with a different proposal may be awarded this studentship, on condition that the topic directly aligns to the Research Themes and priorities of NIHR CLAHRC West.

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