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Physical and mental health for young children
Physical and mental health for young children

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4 Identifying the aims and drivers of the health promotion intervention

After completing Step 2, there may be a main reason for selecting an intervention that is selected to support children’s health. As Nicola and Karen explained in the video, they were motivated to look at ways to support children to eat healthily. Step 3 is to support practitioners and parents to identify the main aim of the intervention. It can also help to think of the primary drivers, meaning what are the reasons for focusing on the aim. The questions can also provoke thinking about the secondary drivers of the health promotion intervention.

The following section is a case study of how Step 3 can be used to identify the primary and secondary drivers behind the aim of a health promotion intervention. The case study focuses on how Ayeesha, the manager of a large nursery used Step 3 to identify the reasons why she needed to tackle the amount of sickness caused by communicable diseases in her setting.

Case study: using Step 3 to reduce the incidence of communicable diseases

Ayeesha is the manager of a large nursery. She has noticed that there is an increasing number of absences among the children and the staff in the setting. This is causing concern because it’s affecting everyone in the nursery and also the parents.

When Ayeesha looks into the cause of absences, she realises that the main causes are communicable diseases, such as viral illnesses causing common colds and tummy upsets. There are also cases of hand, foot and mouth infections and conjunctivitis.

The nursery is in an area close to the centre of a large city. The children and families who attend the nursery are ethnically, socially and economically diverse. About a third of the parents work in professional roles in the business area of the city. Many of the children live in a council housing estate which has benefited from regeneration but most of the families live in poverty.

Many of the children who attend the nursery have pre-existing health conditions: in particular, about 10% have asthma. There are four children with complex medical needs. a significant number of children belong to families who have recently arrived in the UK and are in temporary housing while their immigration status is decided.

Ayeesha realises that she needs to look at ways to reduce the incidence of communicable diseases that are causing so much absence. She also realises that she needs to be able to demonstrate to the staff and families the benefits of doing so.

Figure 2 is an example of how Ayeesha can use Step 3 to think about how the aim of the intervention can help her to identify the primary and secondary drivers which will benefit the children’s and adults in the setting.

Take a look at Table 3 and the points made in boxes 2 and 4, and make some notes about your thoughts about the benefits of the primary and secondary drivers.

There are boxes of text under three categories. The first category is ‘Aims’ and the text in the box reads: ‘reducing the incidence of communicable diseases’. The second category is ‘Primary drivers’ and the text in the boxes read: ‘reduce absences of children and staff because of communicable diseases’ and ‘increased children and staff wellbeing’. The third category is ‘Second drivers’ and the text in the boxes read: ‘policy drivers: promote children’s confidence in selfcare and increase their school-readiness’ and ‘safeguarding children’s health: protect those who are vulnerable to infection, children with chronic and complex medical needs’.
Figure 2 Illustrative Driver Diagram for Child Health Promotion Activity (adapted from Bryk et al., 2010)

Take a look at the comments in the right hand side of Table 3 for more explanation about the aim of the chosen intervention.

Table 4 Primary and secondary drivers of Ayeesha’s health promotion aim
Aim: Reducing the incidence of communicable diseases Comment
Primary drivers:
  • reduce absences of children and staff because of communicable diseases
  • increase children and staff wellbeing.

Frequent absences are causing problems for all the adults. Many parents rely on the care the nursery provides. Many families are vulnerable and find it hard to cope with unexpected absences. Working parents find it difficult to find emergency childcare and are concerned about the impact on their work commitments. Staff absences put additional stress on colleagues, as well as financial strain on the setting because of the need to employ temporary staff so that the staff to child ratios are legal.

Reducing the children’s absences means they are accessing their early education and not missing out on opportunities to progress their development. This is especially important fo the children of the families who are regarded as being vulnerable and benefit from attending the setting.

Not feeling unwell because of a common cold or other infection helps children’s wellbeing and emotions and helps them to be able to concentrate and interact in positive ways with others

Regular attendance and regular and predictable routines with familiar adults help to improve children’s wellbeing.

If staff are feeling well, they too will have improved attendance and be able to do their job well.

Secondary drivers
  • policy drivers: promote children's confidence in self-care and increase their school-readiness
  • safeguarding children's health: protect those who are vulnerable to infection, children with chronic and complex medical needs.

Supporting children’s to learn about hygiene, and teaching them about how they reduce the spread of infection, especially effective handwashing at appropriate times will mean that gain confidence in their ability to self-care. This is an advantage for when they move to school.

Common cold viruses can be especially problematic for children with a chronic health condition. The virus that causes colds can provoke an asthma attack. Children with complex medical needs can become very unwell with infections.

The comments on the right hand side of Table 3 are just a few ideas of the primary and secondary drivers of the aim to reduce the incidence of communicable diseases. You may have thought of other drivers.

Activity 3 Using Step 3

Timing: 15 minutes

As you’ve read through the content of this session, and following completion of Steps 1 and 2, you may have identified an intervention to put in place to help support and promote the health of the children in your setting. To help you to assess the primary and secondary drivers of the intervention, have a go at answering the questions in relation to what you have selected.

Questions to guide your thinking:

  1. What is the overall aim of the intervention?
  2. What are the primary drivers, or the main reasons, for selecting the intervention?
  3. What are the secondary drivers, or other reasons, for the chosen intervention?
  4. How can the health promotion intervention improve quality in your setting?
Figure 3 template to use for identifying aims and divers for health promotion intervention
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Interactive feature not available in single page view (see it in standard view).

Discussion

Now that you have learned about Steps 1, 2 and 3, you may be ready to put your ideas into practice. To help do this, it will be important to identify key dates as discussed in the following section.