Does screening or routine enquiry for adverse childhood experiences (ACEs) meet criteria for a screening programme? A rapid evidence summary.

BACKGROUND: Adverse childhood experiences (ACEs) are traumatic events in childhood that can have impacts throughout life. It has been suggested that ACEs should be 'screened' for, or routinely enquired about, in childhood or adulthood. The aim of this work is to review evidence for this against the United Kingdom National Screening Committee (UKNSC) programme criteria. METHODS: A rapid review of evidence on ACEs screening was conducted using the approach of the UKNSC. RESULTS: Good quality evidence was identified from meta-analyses for associations between ACEs and a wide range of adverse outcomes. There was no consistent evidence on the most suitable screening tool, setting of administration, and time or frequency of use. Routine enquiry among adults was feasible and acceptable to service users and professionals in various settings. A wide range of potentially effective interventions was identified. Limited evidence was available on the potential for screening or routine enquiry to reduce morbidity and mortality or possible harms of screening. CONCLUSIONS: Based on the application of available evidence to UKNSC screening criteria, there is currently insufficient evidence to recommend the implementation of a screening programme for ACEs. Further research is needed to determine whether routine enquiry can improve morbidity, mortality, health and wellbeing.

How can we achieve impact from public health research? A meta-ethnography of case studies.

BACKGROUND: Generation of public health impact from research is challenging. Research of similar quality often has differential uptake and there is considerable lag time between initiation and uptake of research. Improving understanding of how research impact can be achieved may identify areas stakeholders could target. METHODS: This work uses meta-ethnography to synthesize 21 case studies exploring how researchers have generated public health policy impact. RESULTS: Eight constructs were identified: expertise; motivation; practical solutions to important problems; support structure and funding; collaboration; wide dissemination and use of media to contribute ideas to the wider narrative; understanding the policy realm; and models of impact. The constructs were combined in a lines-of-argument synthesis, producing a model that seeks to illustrate the diffuse, complex and dynamic nature of the process of generating impact from research. CONCLUSION: Achieving research impact involves seeking to shape wider debates, building relationships with policy makers, becoming a trusted collaborator and being available to provide relevant and practical solutions to questions of concern to policy makers at the appropriate time.

Effectiveness of a voluntary family befriending service: a mixed methods evaluation using the Donabedian model.

OBJECTIVES: Voluntary befriending schemes operate in many countries, promoting public health by supporting vulnerable individuals and families. Use of third sector and voluntary services to complement health and social care provision is increasingly important globally in the context of economic and demographic challenges, but the evidence base around such collaborations is limited. This article reports the results of operational evaluation research seeking to use robust routine work to generate transferable findings for use by those commissioning and providing services. The subject of our evaluation research is 'Home-Start Suffolk' (HSS) in Suffolk County, UK, an example of a third sector organisation commissioned to support the public health offer to local families. STUDY DESIGN: This evaluation research used the Donabedian framework, which assesses the structure, process and outcome in delivery of health services. METHODS: Methods included a cross-sectional stakeholder survey with qualitative and quantitative elements (n = 96), qualitative interviews (n = 41) and quantitative analysis of the service's routine data (5740 visits) for the period from 01 July 2014 to 01 July 2016. RESULTS: Triangulation of data from each component revealed that HSS was perceived by diverse stakeholders to successfully support families in need of additional help. HSS service users perceived the service to offer greater flexibility, to be tailored to their needs and to be more trustworthy and supportive than statutory services. Volunteering with HSS enabled people to feel productive in their community and gain new skills. Managers of social care services perceived that HSS activity decreased burden on their staff. These benefits were facilitated through a long-standing organisational HSS structure and relationships between HSS and social care. Challenges posed by service provision by a third sector organisation included the need for volunteers to negotiate the boundary between being a friend and a professional outside of a professional framework. Quantitative analysis of impact was limited by the poor quality of routinely collected administrative data, highlighting the importance of planning processes for data collection with evaluation in mind. CONCLUSION: We believe that the results of this evaluation research provide transferrable lessons. They demonstrate how a third sector organisation with a long-standing structure and relationships with statutory services was able to reduce perceived service burden while also offering support in a more flexible and tailored way greatly valued by service users.