Association for Young People’s Health

ObjectiveIn 2021, centres across all seven NHS-England regions were selected to develop pilot clinics with the aim of treating children and young people (CYP) living with complications relating to excess weight (CEW). We led a process to develop core outcomes to enable the evaluation of these clinics.MethodsA two-round Delphi process, virtual steering group meetings and two patient representation workshops were used to agree the most important outcomes for both clinicians/allied professionals and representative prospective service users.ResultsA total of 119 clinicians/allied professionals were invited to contribute to the Delphi process: 62 (52%) agreed and completed round 1 and 47 of these (76%) went on to complete round 2. Six young people (age range 13–17 years) and six parents were involved in two patient representation workshops and their experiences fed into virtual steering group meetings, via a representative.There were 44 outcomes assessed in round 1 and 21 outcomes assessed in round 2. There were 16 core outcomes selected: anthropometric, glucose tolerance/insulin resistance/type 2 diabetes, blood pressure, lipid profile, breathing problems, identification of aetiology, non-alcoholic fatty liver disease, idiopathic intracranial hypertension, anxiety, depression, self-esteem, quality of life, school attendance, dietary habits including disordered eating, exercise and activity habits.ConclusionsUse of an online Delphi process, patient representation workshops and virtual steering group meetings has enabled the development of core outcomes for clinical obesity services with eight physical health, five mental health and three self-management outcomes. Further work is needed to develop outcome measures to complete a core outcome set. These will be used to guide the evaluation of novel regional clinics for the treatment of complications of excess weight.

ObjectiveThis study examines whether there is an independent association between mental difficulties in adolescence and educational attainment at age 16.DesignLongitudinal study.SettingNationally representative data from the UK Household Longitudinal Study (UKHLS) were linked to the National Pupil Database for England.ParticipantsRespondents (N=1100) to the UKHLS between 2009 and 2012 were linked to the National Pupil Database to investigate longitudinal associations between mental difficulties at ages 11–14 and educational attainment at age 16 (General Certificate of Secondary Education (GCSE)).Primary outcome measureNot gaining five or more GCSE qualifications at age 16, including English and maths at grade A*–C.ResultsAn atypical total mental health difficulty score measured using the Strengths and Difficulties Questionnaire at ages 11–14 predicted low levels of educational attainment at age 16 (OR: 3.11 (95% CI: (2.11 to 4.57)). Controlling for prior attainment and family sociodemographic factors, happiness with school (/work) and parental health, school engagement and relationship with the child partially attenuated the association, which was significant in the fully adjusted model (2.05, 95% CI (1.15 to 3.68)). The association was maintained in the fully adjusted model for males only (OR: 2.77 (95% CI (1.24 to 6.16)) but not for females. Hyperactivity disorder strongly predicted lower attainment for males (OR: 2.17 (95% CI: (1.11 to 4.23)) and females (OR: 2.85 (95% CI (1.30 to 6.23)).ConclusionMental difficulties at ages 11–14 were independently linked to educational success at age 16, highlighting an important pathway through which health in adolescence can determine young people’s life chances.

Purpose Developing youth-friendly, flexible primary care is important because young people have specific health needs but often feel nervous and uneasy when seeking appropriate help. The Well Centre in South London is an innovative adolescent health one-stop-shop, jointly designed and developed by Redthread (a youth work charity) and the Herne Hill Group Practice (general practitioners). The purpose of this paper is to summarise the experiences of implementing the model and provides a description of a sample of clients. Design/methodology/approach Drawing on routine data from the Well Centre’s medical and youth work data systems, a service description and audit of patients using the centre during the three years from October 2011 to December 2014 was provided, with a particular focus on the 368 new patients aged 13-20 years attending between January and December 2014. Findings Results demonstrated the Well Centre’s success in drawing in patients from deprived backgrounds who were less likely to be engaged with other health services, and who reflected a high level of mental health problems. The Well Centre model tested the benefit of an integrated approach in recognising and meeting the needs of young people. The real strength of the model lay in the good communications with schools and the voluntary sector in the area. Originality/value The Well Centre is a unique intervention with potentially wide ramifications for how primary health care is delivered to young people in inner city areas, and this paper represents the first published information about its working methods and clientele.