The Life Course Intervention Research Network was recently honored to co-host with Cincinnati Children’s Hospital the 13th Annual Workshop of the International Network for Research into Inequalities in Child Health (INRICH). Over three days in June we heard from international leaders in child health equity research on the workshop theme of Building Adaptive Interventions to Achieve Health Equity Across the Life Course. Neal Halfon, PI of the LCIRN, Director of the UCLA Center for Healthier Children, Families and Communities and Professor of Pediatrics, Public Health and Public Policy at UCLA, together with Rob Kahn, Professor and Associate Chair of Community Health, University of Cincinnati Department of Pediatrics, Executive Lead Population and Community Health and All Children Thrive (ACT) Cincinnati opened the workshop with an Introduction to the Life Course Health Development Approach to Interventions.
The LCIRN has developed a framework showing how key characteristics of life course interventions can be incorporated across all stages of the research process to guide intervention development, testing and evaluation with the aim of finding ways to improve health trajectories. Characteristics included co-design of interventions with family and community engagement, strengths-based interventions focused on health optimization and interventions that were developmentally focused and strategically timed. Multi-level interventions, integrated across sectors that target upstream factors including social and structural determinants of health and that address emerging health development capabilities hold promise for health trajectory impacts.
Presentations on Day 1 addressed Working towards Shared Frameworks and Shared Metrics for Child Equity and on Day 2 Adaptive Multi-Level Approaches to Interventions to Improve Equity. The concluding interactive session on Day 3 on Aligning Rhetoric and Research to Impact Global Child Health Equity drew together common themes from the conference presentations and began to consider practical next steps towards applying the most recent research findings to developing and implementing actionable interventions. A full report from the conference will be released later this year, however some highlights included:
John Wright, Director, Bradford Institute for Health Research, Bradford, UK presented on “A Little Less Association, A Little More Action” new approaches to implementing and evaluating early life interventions. John reported on their findings that many determinants of children’s health are socially patterned, and that poverty and inequalities are persistent and hard to change. Children’s lives are not being shaped by individual risk factors but by the streets they play on, the houses they live in, the quality of schools, food options- in other words by complex, interactive, systems factors.
Bradford City Collaboratory aims to have a cumulative effect by implementing public health interventions in one place where they are most needed. Key tenets include co-production with communities; harnessing and connecting routine data; and translating evidence into policy.
Kate Pickett, Professor of Epidemiology, University of York, UK & David Taylor-Robinson, Professor of Public Health and Policy, Institute of Population Health, University of Liverpool, UK presented on Deep causes of inequality, and why are multi-level, comprehensive interventions necessary.
David presented data from their recent Child of the North Report explaining that the north/south divide in child health in the UK explains the north/south divide in adult health. To ensure an adequate quality of life for all families with children requires action and putting children at the heart of intervention development and government policy. Children’s voices need to be at the center of this conversation.
Cynthia Rayner, Adjunct Lecturer & Senior Researcher, Bertha Centre for Social Innovation, University of Cape Town Graduate School of Business, South Africa gave a presentation entitled Systems Work: Harnessing Connection, Context & Power to Create Equitable Systems for All. Based on her book The Systems Work of Social Change co-authored with Francois Bonnici, Cynthia’s presentation explored how the ideas in the book might be applied to child health equity.
- We are the systems we seek to change. By participating in them, we maintain and extend them.
- How can we explore the day-to-day practices, beliefs and behaviors, values and assumptions about how systems work in order to change them?
- Adopting a systems approach means not just analyzing the system in “industrial” terms but also acquiring an in-depth understanding of the human relationships between the people within the systems.
- This approach reconfigures power towards those with lived experience of an issue, and who are part of the communities who are seeking change.
Two prizes were awarded for poster presentations:
Saltanat Childress, University of Texas Arlington School of Social Work and LCIRN Scholar
Shuang Zhou, Erasmus Medical Center, Rotterdam, The Netherlands, School of Public Health, Peking University, Beijing, China
The full workshop program can be found on the INRICH website and you can watch all of the speakers and poster presentations on YouTube. LCIRN members are invited to consider joining INRICH. Next year’s workshop will be held in Paris, France.
We’re continuing our deeper dive into HRSA/MCHB’s strategic paradigm “Accelerate Upstream Together”. This newsletter we’re exploring how the LCIRN is moving interventions “upstream” to either prevent the development of health challenges, or address and reverse them as soon as they occur. Upstream interventions are more likely to be successful than interventions that are applied only after conditions are well established.