Integrated models of community service delivery for children and young people in coastal regions of England: A Realist evaluation

Research question

What integrated community service models (ICSMs) work best for children and young people (CYP) living in deprived coastal communities of England, under what circumstances and at what cost? Background

Coastal communities in England have some the highest indices of multiple deprivation in the country. CYP growing up in such communities, face challenges to their futures. Ensuring that community services are available and accessible to all CYP is likely to make a difference to inequalities in outcome.

Some ICSMs targeted at CYP are emerging. In these contexts, understanding the protective and asset enhancing features of the setting and the challenges, is important for development of services. Currently, there is insufficient evidence on the organisation and delivery of ICSMs for CYP in coastal communities or how they can be improved and at what cost.

Aim

To examine in depth a range of ICSMs on the coast of England and their impact on the experiences and health and social care consequences for CYP and their families. Objectives 1. Examine the current range of evidence of different ICSMs for CYP in coastal communities. 2. Examine how ICSMs are accessed, attended and used by CYP and their families/carers.

3. a. Explore how CYP and their families experience ICSMs

b. Understand what difference it might make to CYP and their families being able to access and use ICSMs in a coastal community 4. Examine the provider and commissioner perspectives on ICSMs in the coastal communities of England 4. Assess the costs and benefits of ICSMs for CYP, and produce evidence on the economic case for investment

5. Converge data from four sites to provide a programme theory that contributes to an ideal model of ICSMs for CYP in coastal communities. Methods

A mixed method realist evaluation (RE) approach1 to explain what works for whom, under what context and circumstances and cost in relation to ICSMs across four coastal towns in England. Data themes will be brought together in Context, Mechanism, Outcome (CMO) configurations in five work packages:

WP1 A scoping review to identify and describe the range of existing evidence on ICSMs for CYP, focusing on coastal communities.

WP2 A survey across four seaside towns of both CYP and families/carers to gain a broad picture of the community services that CYP have experience of. Local administrative data will provide a context on services provision and delivery.

WP3 A qualitative study, using interviews with CYP and their families/carers to reach a deeper understanding of the experiences of CYP of the community services. Focus groups with health and social care staff will discuss types of ICSMs available in their community, how they work and workload implications. Data will be analysed following a grounded theory approach, to produce the CMO configurations.

WP4 A realist economic evaluation of the ICSMs and their impact on investment, cost and benefit to CYP in coastal communities. WP5 Data will be converged culminating in a programme theory for ICSMs for based on the CMO configurations.

Supported by two public engagement co-ordinators a lived experience group of CYP will be consulted at every stage of the research. Dissemination

Outputs will be reports, publications and conference presentations. Impact will be via personal communication with ICSs, social media and project website metrics. Timeline Over 30 months, each WP will be led and managed by a Co-applicant to achieve its objectives.