Challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic

Objective: To analyze the challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic.Methods: This is an online descriptive-exploratory qualitative study. Participants were 28 nursing professionals enrolled in the subject Nursing in Health Care for Children and Adolescents in a graduate program at a federal university in northeastern Brazil. Data collection took place in June 2021 through a conversation wheel and press conference. As instruments, we used Google forms and a semi-structured script. The study was approved by the Research Ethics Committee. As an analysis method, Discursive Textual Analysis (DTA) was used. For data organization, Atlas.ti 8.4.15 software (Qualitative Research and Solutions) was used.Results: Two categories emerged: 1) Impacts of the pandemic on pediatric care and advocacy: child isolation and a health care scenario where children were placed in the background were observed. 2) Existing barriers that worsened with the health crisis: work overload, precarious structure and difficulty in working conditions were identified, which led to violations of children's rights and aggravated the overview of difficulties in the provision of pediatric services.Conclusion: The challenges for exercising health advocacy for hospitalized children during the pandemic, evidenced by the impacts and barriers to care, have expanded health teams' work, making the exercise of advocacy in pediatric care even more difficult. It is necessary to rethink and adjust access and care policies after the pandemic to ensure that child care is not restricted.

Challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic / Challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic / Desafios para o exercício da advocacia em saúde à criança hospitalizada durante a pandemia COVID-19 / Desafíos para el ejercicio de la defensa en salud de niños hospitalizados durante la pandemia de COVID-19

Resumo Objetivo Analisar os desafios para o exercício da advocacia em saúde à criança hospitalizada durante a pandemia COVID-19. Métodos Estudo qualitativo descritivo-exploratório on-line. Participaram 28 profissionais de enfermagem matriculados na disciplina Enfermagem na Atenção à Saúde da Criança e do Adolescente em um Programa de pós-graduação de uma universidade federal do nordeste brasileiro. A coleta de dados ocorreu em junho de 2021 através de roda de conversa e entrevista coletiva. Como instrumentos utilizou-se: o formulário do google forms e roteiro semiestruturado. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Como método de análise, foi empregada a Análise Textual Discursiva (ATD). Para a organização dos dados, utilizou-se o software Atlas.ti 8.4.15 (Qualitative Research and Solutions). Resultados Emergiram duas categorias: 1) Impactos da pandemia para assistência e advocacia pediátrica, constatou-se o isolamento infantil e um cenário de atenção à saúde onde a criança foi colocada em segundo plano. 2) Barreiras existentes que se agravaram com a crise sanitária, identificou-se: sobrecarga de trabalho, precarização da estrutura e dificuldade nas condições de trabalho, que gerou violações nos direitos infantis e agravou o panorama de dificuldades na oferta de serviços pediátricos. Conclusão Os desafios para o exercício da advocacia em saúde à criança hospitalizada durante a pandemia, evidenciados pelos impactos e barreiras para a assistência, ampliaram o trabalho das equipes de saúde tornando o exercício da advocacia no cuidado pediátrico ainda mais dificultoso. Cabe repensar e ajustar políticas de acesso e atendimento após a pandemia para assegurar que o cuidado infantil não seja restringido.

Resumen Objetivo Analizar los desafíos para el ejercicio de la defensa en salud de niños hospitalizados durante la pandemia de COVID-19. Métodos Estudio cualitativo descriptivo exploratorio en línea. Participaron 28 profesionales de enfermería inscriptos en la asignatura Enfermería en Atención a la Salud del Niño y del Adolescente en un programa de posgrado de una universidad nacional del nordeste brasileño. La recopilación de datos ocurrió en junio de 2021 a través de rondas de conversación y entrevista colectiva. Como instrumentos se utilizaron: un formulario de google forms y un guion semiestructurado. El estudio fue aprobado por el Comité de Ética en Investigación. Como método de análisis, se utilizó el Análisis Textual Discursivo (ATD). Para la organización de los datos, se utilizó el software Atlas.ti 8.4.15 (Qualitative Research and Solutions). Resultados Surgieron dos categorías: 1) Impactos de la pandemia en la atención y en la defensa pediátrica, se verificó el aislamiento infantil y un escenario de atención en salud en la que el niño fue colocado en segundo plano. 2) Barreras existentes que se agravaron con la crisis sanitaria, se identificó: sobrecarga de trabajo, precarización de la estructura y dificultad en las condiciones de trabajo, lo que generó violaciones de los derechos infantiles y agravó el panorama de dificultades en la oferta de servicios pediátricos. Conclusión Los desafíos para el ejercicio de la defensa en salud de niños hospitalizados durante la pandemia, evidenciados por los impactos y barreras para la atención, ampliaron el trabajo de los equipos de salud, lo que dificultó aún más el ejercicio de la defensa del cuidado pediátrico. Cabe reflexionar y ajustar políticas de acceso y atención después de la pandemia para asegurar que no se restrinja el cuidado infantil.

Abstract Objective To analyze the challenges for exercising health advocacy to hospitalized children during the COVID-19 pandemic. Methods This is an online descriptive-exploratory qualitative study. Participants were 28 nursing professionals enrolled in the subject Nursing in Health Care for Children and Adolescents in a graduate program at a federal university in northeastern Brazil. Data collection took place in June 2021 through a conversation wheel and press conference. As instruments, we used Google forms and a semi-structured script. The study was approved by the Research Ethics Committee. As an analysis method, Discursive Textual Analysis (DTA) was used. For data organization, Atlas.ti 8.4.15 software (Qualitative Research and Solutions) was used. Results Two categories emerged: 1) Impacts of the pandemic on pediatric care and advocacy: child isolation and a health care scenario where children were placed in the background were observed. 2) Existing barriers that worsened with the health crisis: work overload, precarious structure and difficulty in working conditions were identified, which led to violations of children's rights and aggravated the overview of difficulties in the provision of pediatric services. Conclusion The challenges for exercising health advocacy for hospitalized children during the pandemic, evidenced by the impacts and barriers to care, have expanded health teams' work, making the exercise of advocacy in pediatric care even more difficult. It is necessary to rethink and adjust access and care policies after the pandemic to ensure that child care is not restricted.

In need of what? Section 17 Provision under the Children Act 1989

This article considers Section 17 'child in need' provision under the Children Act 1989, the main legislation governing Children's Services in England. Arguably, Section 17 has never been given the same priority as other statutory requirements under the Act. The intention was to create a broad umbrella provision for children living with their families, but children assessed as 'in need' are not entitled to receive such services unless they are disabled. This exploration is timely given the current Independent Review of Children's Social Care in England, ongoing austerity measures, high rates of child poverty and COVID‐19. Consideration is given to the development of Section 17 and what the future may hold.

Documenting the advocacy experiences among eight Latina mothers of children with intellectual and developmental disabilities

Internationally, it has been recognized that parent involvement is an essential component of the special education process for children with intellectual and/or developmental disabilities (IDD). Parent involvement often includes parents advocating for their children. However, many parents face barriers when advocating to obtain appropriate special education services for their children with IDD. In the United States, Latinx families face greater systemic barriers (e.g., language and cultural differences) to access services for their own children with IDD. To this end, parents may turn to parent advocacy training programs to learn about special education and feel empowered to advocate for school services for their own children and other families of children with disabilities. Yet, it is unclear how Latinx families advocate for services for their own children and for other Latinx families of children with disabilities after attending an advocacy program. We designed a study to explore the advocacy experiences of eight Latinx families one year after attending an advocacy program. Participants reported that they used three advocacy strategies when advocating for their own children with disabilities: knowledge of special education law, non‐adversarial advocacy strategies, and requests for data. Notably, some participants reported not having an advocacy experience due to the COVID‐19 pandemic. Implications for research and practice are discussed.

The Benefits and Challenges of Shifting to Telehealth During COVID-19: Qualitative Feedback from Kentucky's Sexual Violence Resource Centers and Children's Advocacy Centers.

The onset of the COVID-19 pandemic presented novel challenges for service providers addressing mental health issues with a large shift to the utilization of telehealth. While previous research has examined the benefits and challenges of providing mental health and crisis services remotely through telehealth, little research exists examining the use of telehealth in children's advocacy centers (CACs) and sexual violence resource centers (SVRCs). CACs and SVRCs are multi-disciplinary agencies taking a holistic approach to addressing interpersonal violence, making them unique in that they provide a range of direct services beyond mental health counseling (e.g., legal advocacy, medical exams, and prevention education) but all geared toward public health and safety. The current study explored the experiences of direct service providers in Kentucky CACs and SVRCs and their opinions about the most significant challenges and benefits of adapting their practices at the onset of the COVID-19 pandemic. A total of 118 providers participated in the study, and 88 reported using telehealth (defined as communicating with clients via technology such as videoconferencing, phone calls, or email) since the onset of COVID-19. Qualitative data from those 88 respondents regarding the challenges and benefits of using telehealth were collected and coded using a thematic content analysis. 78.6% of the sample indicated that they served primarily rural areas. Benefits noted included increasing treatment access, increasing treatment flexibility, and advancing continuity of care, while challenges included difficulties with technology, client engagement, privacy, and logistical challenges. Responses highlighted that telehealth presented both a number of advantages and difficulties and that more formal guidance for providers at CACs and SVRCs was desired.

"At One Point We Had No Funding for Paper": How Grants and the Covid Crises Have Shaped Service Provision in Child Advocacy Centers

The confluence of the two major challenges has combined to create special challenges for rural nonprofits serving victims of crime: the fluctuation of federal funding, and the Covid-19 pandemic. We discuss the challenges faced by Child Advocacy Centers in northwestern South Carolina in the context of these shifting challenges. From qualitative interviews conducted at 14 centers in this primarily rural region, we explain the challenges they face and the potential effects on the communities they serve interpreted through the lens of Resource Dependence Theory, which predicts that organizations reduce uncertainty of funding through increasing their partnership bonds with cooperative entities.

For the Parent, by the Parent: Creating a Program to Empower Parents of Refugee Background Using Novel Participatory Approaches

BACKGROUND: With more than 28 million individuals of refugee or asylum-seeking background globally, the current situation has been described as one of the largest humanitarian crises of all time. Families of refugee background have complex, multigenerational mental health and developmental needs that are not accounted for in current programming frameworks. Difficulties in resettlement have been further compounded by COVID-19-related lockdowns, straining parental mental health and placing children at an increased risk for developmental or behavioural problems. Providing appropriate support services and educational resources that address the multigenerational concerns of families of refugee background will address these challenges, allowing for improved parental mental health, family cohesion, and developmental outcomes for children. OBJECTIVE(S): To gather data about the experiences, resources, referral pathways and barriers that impact the experience of parents of refugee background in the Greater Toronto Area (GTA) and to develop a novel, multi-dimensional parenting program model using Community-Based Participatory Research (CBPR) principles. DESIGN/METHODS: This was a qualitative community-based participatory study using a formative research framework, in accordance with COREQ guidelines. In-depth interviews (IDIs) were conducted with parents of refugee background and care providers that work closely with this population. Data were recorded, transcribed, and coded using deductive and inductive coding methods by two independent coders. RESULT(S): A total of 20 IDIs were conducted (7 parents and 13 care providers). The main topics that were identified to be incorporated into the program include features of child development, how to address resettlement issues, child advocacy, and parenting in the Canadian context. Participants felt that tackling the language barriers, addressing the overlapping responsibilities of the mothers attending the sessions, providing incentives, increasing awareness of the program, and using an anti-racist and anti-oppressive approach is key to the program's success. Participants emphasized the need for trauma-informed mental health support within the program model. CONCLUSION(S): This study describes the key considerations for a novel parenting program for families of refugee background, by engaging them as key stakeholders in the program design process. Future iteration of this project would involve a pilot and evaluation of the program.

“At One Point We Had No Funding for Paper”: How Grants and the Covid Crises Have Shaped Service Provision in Child Advocacy Centers

The confluence of the two major challenges has combined to create special challenges for rural nonprofits serving victims of crime: the fluctuation of federal funding, and the Covid-19 pandemic. We discuss the challenges faced by Child Advocacy Centers in northwestern South Carolina in the context of these shifting challenges. From qualitative interviews conducted at 14 centers in this primarily rural region, we explain the challenges they face and the potential effects on the communities they serve interpreted through the lens of Resource Dependence Theory, which predicts that organizations reduce uncertainty of funding through increasing their partnership bonds with cooperative entities. [ FROM AUTHOR] Copyright of Human Service Organizations: Management, Leadership & Governance is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The role of advocacy in improving access to care for children with mental illness

Across the country, most professionals caring for children have likely seen an increase in mental illness. Even prior to the COVID‐19 pandemic, there was already a trend of increasing rates of depression and suicidal ideation in American youth (Mojtabai et al., 2016). Since then, the problem has only worsened, as the collective mental health needs of children have been rising rapidly. A combination of factors, from isolation related to school closure and social distancing, to the traumatic effects of losing a parent, have contributed to this dramatic rise in distress (American Academy of Pediatrics, 2021). The CDC reported that the proportion of mental health‐related ED visits increased abruptly after the beginning of the pandemic, with increases of 24% among children aged 5–11 years and 31% among adolescents aged 12–17 years, compared with the same period in 2019 (Leeb et al., 2020). These changes have been widely publicized, and in response to this national crisis, the American Academy of Pediatrics (AAP), American Academy of Child and Adolescent Psychiatry (AACAP), and the Children's Hospital Association (CHA) jointly declared a national state of emergency in October 2021 and created a 10‐point outline for meaningful change in the recognition, prevention, and treatment of childhood mental illness (American Academy of Pediatrics, 2021). In addition, the United States Surgeon General issued an advisory on protecting youth mental health in December 2021 (Department of Health and Human Services, 2021).

[Response to the COVID-19 Pandemic in Chile, Colombia, and Peru from a children's rights perspectiveResposta à pandemia de COVID-19 no Chile, Colômbia e Peru com foco nos direitos da criança]. / Respuesta con enfoque de derechos de la niñez frente a la pandemia por COVID-19 en Chile, Colombia y Perú.

OBJECTIVE: Describe the strategies established by Chile, Colombia, and Peru during the first year of the COVID-19 pandemic and compare them from a children's rights perspective. METHODS: A qualitative study with comparative analysis of public policies was conducted around seven cat-egories constructed by the Latin American Chapter of the International Society for Social Pediatrics and Child Health, based on the Convention on the Rights of the Child. Country documents were selected based on convenience sampling and were analyzed in deliberative dialogues. RESULTS: 173 documents from the three countries were reviewed. There was convergence around: prioritization of prevention of community transmission of the virus over promotion of the exercise of children's rights; lack of participation of children and adolescents in the process of developing public policies; and lack of progress in the recognition and protection of the exercise of children's rights overall. There were no major divergences beyond identified inequality gaps grounded in the reality of each country. CONCLUSION: The pandemic has affected the functioning of the economic, social, health, education, environmental, and governance systems in these three countries. While this study shows progress in the inclusion of the children's rights approach in formulated policies, the recognition of children and adolescents as holders of social and political rights could allow the construction of collective alternatives that guarantee health and well-being for all people throughout the life course.

OBJETIVO: Descrever as estratégias que foram utilizadas por Chile, Colômbia e Peru durante o primeiro ano da pandemia de COVID-19 e compará-las a partir da perspectiva dos direitos da criança. MÉTODOS: Realizou-se um estudo qualitativo de análise comparativa de políticas públicas, tomando como eixo sete categorias construídas pelo Capítulo Latino-americano da International Society for Social Pediatrics & Child Health a partir da Convenção sobre os Direitos da Criança (CDC). A seleção de documentos dos países foi feita por conveniência, e sua análise ocorreu mediante diálogos deliberativos. RESULTADOS: Foram revisados 173 documentos dos três países. A prioridade da prevenção da transmissão comunitária do vírus destaca-se por sua convergência, em detrimento da promoção do exercício dos direitos da criança, da falta de participação de crianças e adolescentes no processo de formulação de políticas públicas e da falta de progresso no reconhecimento e proteção da efetivação de todos os seus direitos. Não houve grandes divergências além das lacunas de desigualdade identificadas com base na realidade de cada país. CONCLUSÕES: A pandemia afetou o funcionamento dos sistemas econômico, social, de saúde, educação, meio ambiente e governança desses três países. Embora este estudo mostre avanços na inclusão da perspectiva dos direitos da criança e do adolescente nas políticas formuladas, a compreensão deles como sujeitos sociais e políticos titulares de direitos pode permitir a construção de alternativas coletivas que garantam saúde e bem-estar a todas as pessoas ao longo do curso da vida.

For the parent, by the parent: Defining the characteristics of a novel program to empower parents of refugee background using the participatory approaches

BACKGROUND: With more than 28 million individuals of refugee or asylum-seeking background globally, the current situation has been described as one of the largest humanitarian crises of all time. Families of refugee background have complex, multigenerational mental health and developmental needs that are not accounted for in current programming frameworks. Difficulties in resettlement have been further compounded by COVID-19-related lockdowns, straining parental mental health and placing children at an increased risk for developmental or behavioural problems. Providing appropriate support services and educational resources that address the multigenerational concerns of families of refugee background will address these challenges, allowing for improved parental mental health, family cohesion, and developmental outcomes for children. OBJECTIVES: To gather data about the experiences, resources, referral pathways and barriers that impact the experience of parents of refugee background in the Greater Toronto Area (GTA) and to develop a novel, multi-dimensional parenting program model using Community-Based Participatory Research (CBPR) principles. DESIGN/METHODS: This was a qualitative community-based participatory study using a formative research framework, in accordance with COREQ guidelines. In-depth interviews (IDIs) were conducted with parents of refugee background and care providers that work closely with this population. Data were recorded, transcribed, and coded using deductive and inductive coding methods by two independent coders. A peer debriefing strategy was used to verify the coding approach and interpretation of findings in accordance with the RATS (relevancy, appropriateness, transparency and soundness) guidelines for qualitative research. RESULTS: A total of 20 IDIs were conducted (7 parents and 13 care providers). The main topics that were identified to be incorporated into the program include features of child development, how to address resettlement issues, child advocacy, and parenting in the Canadian context. Participants felt that tackling the language barriers, addressing the overlapping responsibilities of the mothers attending the sessions, providing incentives, increasing awareness of the program, and using an anti-racist and anti-oppressive approach is key to the program's success. Participants emphasized the need for trauma-informed mental health support within the program model. CONCLUSION: This study describes the key considerations for a novel parenting program for families of refugee background, by engaging them as key stakeholders in the program design process. Future iteration of this project would involve a pilot and evaluation of the program.

Impact of COVID-19 pandemic on child abuse and neglect: A cross-sectional study in a French Child Advocacy Center.

OBJECTIVE: This study aimed to describe the impact of the first COVID-19 lockdown in France on the activity of a Child Advocacy Center. METHODS: This cross-sectional, observational study included all children involved in the activity of the CAC during the first lockdown, from March 16 to May 10, 2020 and the next 3 months and the corresponding periods in 2018 and 2019. Cases were considered severe when a hospitalization, social alert and/or judicial report to the prosecutor was decided. RESULTS: Data for 1583 children were analyzed. During the lockdown, the global center activity decreased with 26.4 consultations per 100.000 children in 2018, 46 in 2019 and 20.7 in 2020 (p < 0.001). Judicial activity decreased (forensic examinations and child forensic interview recordings), whereas assessment consultations increased. Cases were more severe during the lockdown than in 2019 and 2018 (12.3, 9.4 and 6.04/100.000 children, respectively, p < 0.0001). The global activity of the center increased in the 3 months after the lockdown as compared with during the lockdown (38.2/100.000 versus 20.7/100.000, respectively, p < 0.001) but did not differ from activity in 2018 and 2019. Severe cases were more frequent in the 3 months after the lockdown than the previous years (13.7/100.000 in 2020, 9.62 in 2019 and 8.17 in 2018, p = 0.0002). CONCLUSION: The CAC activity decreased during the lockdown in France but the increase in incidence of severe abuse cases during the lockdown and the next 3 months confirm the need for optimal screening, care and support of child abuse and neglect victims even in the context of health crisis.