CHILDS Research Group: applied child health systems and policy research

Childhood is the optimal time for establishing good health and preventing illness to enable children to reach their maximal potential for life-long benefit. Child health in the UK is not as good as it could be - or should be. Child survival is the ultimate measure for how well children fare. Infant mortality is a marker of societal health used globally. After decades of reductions year on year, infant mortality is rising and is highest among families living in poverty. Child survival in the UK is worse than other European and high-income countries, and the gaps are widening. Health and care systems for children are the universal lens through which social, economic, environmental, commercial, and political determinants of health are experienced. Health and social care systems are also determinants of health and well-being from prevention to early intervention and care, rehabilitation, and palliation. The CHILDS research group is dedicated to improving outcomes for child health, by working at the intersection of paediatrics, public health, health systems, and policy.

Health systems and policy need to evolve to meet needs, ensuring better prevention and early intervention, precision health and integrated care models, joined-up physical and mental healthcare, and tailored care for children with medical complexity. There are intergenerational effects associated with poor child health outcomes, so a life-course approach to prevention and care is needed. Adverse childhood experiences are common and can synergise to worsen outcomes when they cluster together. These complex problems require transdisciplinary approaches to secure effective solutions. However, there is a lack of high-quality evidence about healthcare and health systems interventions, with additional challenges in translation, implementation, and scale-up into frontline care and policy.

The CHILDS research group strategy focuses on health system strengthening by investigating the causes of poor health and healthcare outcomes for children and applying knowledge to design and test interventions including innovative healthcare pathways and health systems interventions to improve outcomes and enhance equity. CHILDS conducts research to improve health, for each child, and for all children. Our group is grounded in public health sciences and uses quantitative and qualitative methods for theoretically underpinned research into health systems and healthcare. Our mixed methods research includes evidence synthesis, clinical and hybrid trials of healthcare models and complex interventions, with nested qualitative and process studies.

CHILDS brings together academics, researchers, clinicians, service users and community groups across King’s Faculties of Life Sciences and Medicine, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Institute of Psychiatry, Psychology, and Neuroscience, Faculty of Social Sciences and Public Policy, and King’s Health Partners including Evelina London Children’s Hospital and King’s College Hospital. We collaborate nationally, for example within the NIHR Applied Research Collaboration network, and internationally with child health systems researchers in Australia, and the US, and with WHO Europe.

Methods

Our strategy currently focuses on three areas: health systems and services for children with complex needs and disabilities, healthcare for children with long-term conditions, and child population health. Cross-cutting themes include experimental health systems strengthening studies, population health medicine in healthcare, and system-level evaluation with pragmatic trials. Our group is involved in research infrastructure grants across health and social care and public health.

Improving health care and health systems for children

Integrated care for children with common and long-term conditions (cluster RCT)	Professor Ingrid Wolfe Professor Raghu Lingam
Improving support for children with complex needs with family support workers and specialist medical care (intervention design and evaluation) (NIHR ARC)	Professor Ingrid Wolfe Professor Lorna Fraser
Technology-enhanced integrated care for children with asthma (RCT)	Professor Ingrid Wolfe Professor Jonathan Grigg
JuSTage - Towards a Just Stage-of-Life Allocation of Resources, considering how stages of life should feature in healthcare policy decision-making	Professor Ingrid Wolfe Dr Sapfo Lignou
A Learning Health Systems approach to using linked data to identify inequalities and unmet need in healthcare to enable targeted early intervention	Professor Ingrid Wolfe Dylan Clarke (Doctoral student, applied statistical modelling and health informatics)
A Learning Health Systems approach to predicting need for speech and language therapy for children	Professor Ingrid Wolfe Olivia Dann (Doctoral student, Speech and Language therapist)
An assets-based healthcare model for children with serious illness	Professor Ingrid Wolfe Paola Rosati (Doctoral student, Paediatrician)
Childhood vaccination - opportunities to support uptake in the antenatal period: a mixed methods study in South-East London	Professor Ingrid Wolfe Dr Lucy Pickard (Doctoral student, Paediatrician)
Developing and feasibility testing model of care for young adults with cerebral palsy	Professor Ingrid Wolfe Susie Turner (NIHR Clinical Pre-Doctoral Fellow)
Models of Child Health Appraised (MOCHA) EU Horizon 2020	Professor Ingrid Wolfe Professor Mitch Blair

Child population health

Early identification and intervention for children at risk of low school readiness (analysis and intervention design) (NIHR ARC)	Professor Ingrid Wolfe Professor Raghu Lingam
OveRcoming Adverse ChiLdhood Experiences (ORACLE)	Professor Ingrid Wolfe Professor David Taylor Robinson Professor Eileen Kaner
A child’s lifecourse journey in data	Professor Ingrid Wolfe

Research Infrastucture programmes

Director, NIHR Applied Research Collaboration South London	Professor Ingrid Wolfe
Theme Lead for Children and Young People, NIHR Applied Research Collaboration South London	Professor Ingrid Wolfe Professor Lorna Fraser
NIHR Health Determinants Research Collaboration (Lambeth HEART)	Professor Ingrid Wolfe