The Kidscope Study: an analysis of a community paediatric development clinic set in a disadvantaged area of Ireland

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dc.check.chapterOfThesisChapter 2 - pages 46 to 57 Chapter 3 - pages 88 to 101 Chapter 6 - pages 200 to 242 Chapter 7 - pages 244 to 263en
dc.check.date2027-12-31
dc.check.infoPartial Restriction
dc.contributor.advisorCurtin, Margaret
dc.contributor.advisorGibson, Louise
dc.contributor.advisorCornally, Nicola
dc.contributor.advisorexternalHarford, Katherine
dc.contributor.authorBuckley, Lynnen
dc.contributor.funderIrish Research Council
dc.contributor.funderHigher Education Authority
dc.contributor.funderChild and Family Agency
dc.contributor.funderCork City Council
dc.date.accessioned2024-09-23T10:43:52Z
dc.date.available2024-09-23T10:43:52Z
dc.date.issued2024
dc.date.submitted2024
dc.descriptionPartial Restriction
dc.description.abstractBackground: Set in the disadvantaged community of Cork city northwest, Kidscope is the only community paediatric development clinic in Ireland to offer assessment, care, and onward referral within a highly vulnerable area. The complex healthcare intervention provides early developmental assessment and care for children aged zero to six years. Disadvantaged communities often experience a lack of empowerment and limited engagement with services, and high-quality services for children can be inconsistent and limited. Ireland’s disjointed disability system sees children from more affluent communities access health and developmental supports faster through paid private assessment. Kidscope attempts to intercept the gap within the system by providing timely and accessible health and developmental care to vulnerable children. A detailed analysis of Kidscope and its value for supporting the health and development of a vulnerable population was warranted. Methods: Analysis of Kidscope was carried out through a retrospective mixed-methods realist evaluation examining if and how engagement with Kidscope supports the health and developmental needs of vulnerable children. ‘Context (c) + mechanism (m) = outcome (o)’ configurations explained under what contexts, for whom, and how Kidscope achieves this. Underpinned by the Ecological Systems Theory and guided by the Medical Research Council Framework for Complex Interventions, realist evaluation involved three phases: 1. Develop initial programme theories (IPTs), 2. Test IPTs, and 3. Refine programme theory. From 2019 to 2023, five studies tested and refined IPTs using multiple data sources and methods of analysis. Results were collated and analysed in a convergent approach to refine programme theory and develop a set of comprehensive findings to answer the research question. Findings: Ten IPTs were tested and refined through a systematic review of international evidence and four Kidscope-specific empirical studies: a stakeholder analysis, process evaluation, experience and meaning study, and comparison study examining models of care employed in Kidscope and a hospital-based equivalent clinic. Kidscope is set in an area of social disadvantage with higher levels of adversity and complex needs. Families encounter multiple barriers to healthcare access. A long history of community collaboration provides solid foundations for implementation, and contextual elements facilitate delivery: an accessible and welcoming space cognisant of community needs; care delivered over multiple touchpoints; and, embedded practitioner training and education. Mechanisms triggering delivery of child health and developmental support include: utilising and enhancing local expertise through Infant Mental Health (IMH) approaches; relational working; timely and coordinated health and developmental assessment, care, and onward referral; care from a range of specialists; innovative and flexible implementation processes; child and family advocacy; and bridging gaps between services and sectors. Kidscope supports the health and developmental needs of vulnerable children by 1. Developing an innovative and responsive, community-driven child and family model of care, 2. Growing a coalition of IMH-informed child development professionals, 3. Building strong relationships, 4. Meaningfully engaging vulnerable families, and 5. Tackling barriers to highquality healthcare access. Conclusions: Kidscope contributes to breaking the cycle of intergenerational poverty by disrupting the impacts of exclusion to healthcare on child development. By examining interrelationships between context, mechanisms, and outcomes using a realist lens, findings explain how engagement with Kidscope supports the health and developmental needs of a vulnerable population. National healthcare policies promising efficient developmental assessment and integrated care have yet to achieve such goals. The research offers important insights into the health needs and values of a vulnerable population that can be used to thoughtfully examine models of care within contemporary child health practices in Ireland and further afield. Findings provide evidence to support implementing similar models of care across disadvantaged areas to benefit the most vulnerable in society.en
dc.description.statusNot peer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationBuckley, L. 2024. The Kidscope Study: an analysis of a community paediatric development clinic set in a disadvantaged area of Ireland. PhD Thesis, University College Cork.
dc.identifier.endpage417
dc.identifier.urihttps://hdl.handle.net/10468/16418
dc.language.isoenen
dc.publisherUniversity College Corken
dc.relation.projectIrish Research Council (Employment Based Postgraduate Programme (EBPPG/2019/197))
dc.relation.projectHigher Education Authority, Child and Family Agency, Cork City Council (Let's Grow Together! Infant & Childhood Partnerships CLG)
dc.rights© 2024, Lynn Buckley.
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/
dc.subjectChild healthen
dc.subjectChild health servicesen
dc.subjectChild developmenten
dc.subjectVulnerable populationsen
dc.subjectDisadvantaged communityen
dc.subjectCommunity healthen
dc.subjectMedical training and educationen
dc.subjectStakeholdersen
dc.subjectStakeholder perspectivesen
dc.subjectCommunity partnershipsen
dc.subjectParent perspectivesen
dc.subjectProcess evaluationen
dc.subjectMixed-methodsen
dc.subjectRealist evaluationen
dc.titleThe Kidscope Study: an analysis of a community paediatric development clinic set in a disadvantaged area of Ireland
dc.typeDoctoral thesisen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnamePhD - Doctor of Philosophyen
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