Developing a more integrated approach to evaluating multi-sectoral interventions and policies to improve health outcomes for adolescents.

Development work questions The proposed development work will inform a future Programme Grant to improve adolescent health outcomes through interventions and policies that support more integrated, effective working between health, children s social care, and education. It will particularly focus on two exemplar groups for whom multi-professional, intersectoral support is a recognised priority (young people who experience physical/sexual harm and those who are persistently absent or excluded from school) and two cross-cutting issues (Special Educational Needs & Disabilities and inequalities related to deprivation and ethnicity). In each case, key development questions will be: Which interventions show most promise? What combination of agencies and professionals are needed to deliver them? What are the core outcomes that should be used to evaluate their impact? How can they be adapted/co-developed to further increase impact? What are the most feasible ways to implement and evaluate these interventions? Background Health outcomes for adolescents in the UK have long lagged behind comparable countries, with high rates of avoidable mortality, inequalities, and poor reported experience of healthcare. These outcomes have further worsened during the pandemic period, including a worsening crisis in mental health problems and long delays in accessing key services. Health challenges are exacerbated by parallel reported crises in children s social care and persistent school absence/exclusion. This clustering of challenges at population level, is reflected at individual level – with many of the most vulnerable YP affected by physical/mental health problems alongside experience of abuse/violence and/or poor engagement at school. There is a consensus among young people, parents/carers, professionals and policymakers that a more joined up approach would be both more effective and efficient in improving health outcomes. However, progress has been limited by siloed working among both professionals and researchers, and a lack of research to evaluate the multi-sectoral impact of interventions and policies in each sector. Evaluations of many integrated care interventions within the health sector focus on short-term impact on healthcare activity and emphasise the implications for a local business case over generalisable findings. Development work plan WP1. (Months 1-7) Synthesise evidence and work with multi-professional stakeholder networks, children and young people (CYP) and their families to identify and prioritise candidate interventions/policies. WP2.(Months 4-12) Adapt and co-develop selected 3-4 interventions for future Programme Grant application. Wp3. (Month 5-9) Undertake modified Delphi exercises to develop Core Outcome Set for multi-sectoral evaluation of adolescent interventions. Wp4. (Months 6-12) Investigate the feasibility of implementing and evaluating selected interventions. This will include identifying and addressing any necessary data linkage or other research infrastructure. WP5 (Months 1-12) Capacity building work to understand and address barriers to multi-sectoral working, in partnership with a range of local and national networks of young people, parents/carers, professionals and researchers. Anticipated impact and dissemination We expect to publish a review article and our Core Outcome Set. We will present findings at 2 national conferences and one international meeting. The findings will inform a Programme Grant proposal to implement and evaluate the co-designed interventions and policies.