Satherley Rose-Marie, Newham James, Cecil Elizabeth, Forman Julia, Kelly Clare, Wolfe Ingrid, Lingam Raghu
School of Psychology, Department of Psychological Interventions, University of Surrey, Guildford, UK.
Department of Women and Children's Health, School of Life Course and Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK.
Arch Dis Child. 2025 Jul 18;110(8):603-611. doi: 10.1136/archdischild-2024-327664.
A process evaluation of the Children and Young People's Health Partnership (CYPHP) model of integrated care for the interpretation of trial findings and building evidence on the implementation of integrated care for children.
A mixed-methods process evaluation.
CYPHP was implemented at scale across two inner-city London boroughs in South London, England, as a pragmatic cluster-randomised controlled trial involving nearly 98 000 children, with a nested process evaluation.
Linked data were available from 73 000 participants. Qualitative data collection was through 102 interviews (group and 1:1) and observations.
Local child health clinics delivered by paediatricians and general practitioners and a nurse-led early intervention service for children with tracer conditions (asthma, eczema and constipation), decision support, a primary care hotline, self-management support and health promotion.
Five domains of the RE-AIM implementation framework: Reach, Effectiveness, Adoption, Implementation and Maintenance.
Implementation varied depending on resource availability, competing priorities and natural changes over time. Successful implementation drivers included cohesive interprofessional and partnership collaboration.
Integrated care for children can be implemented at scale, but variability, particularly low reach, may limit measurable impact at the population level. Significant health system strengthening, implementation plasticity and contextual tailoring are crucial for ensuring the efficacy and sustainability of impactful integrated care for children.
NCT03461848.
对儿童和青少年健康伙伴关系（CYPHP）综合护理模式进行过程评估，以解读试验结果并积累儿童综合护理实施方面的证据。
混合方法过程评估。
CYPHP在英国伦敦南部的两个内城区大规模实施，作为一项实用的整群随机对照试验，涉及近98000名儿童，并进行了嵌套式过程评估。
可获取来自73000名参与者的关联数据。定性数据收集通过102次访谈（小组访谈和一对一访谈）及观察进行。
由儿科医生、全科医生提供的当地儿童健康诊所，以及针对患有特定疾病（哮喘、湿疹和便秘）儿童的护士主导的早期干预服务、决策支持、初级保健热线、自我管理支持和健康促进。
RE-AIM实施框架的五个领域：覆盖范围、有效性、采用情况、实施情况和维持情况。
实施情况因资源可用性、相互竞争的优先事项以及随时间的自然变化而有所不同。成功的实施驱动因素包括紧密的跨专业和伙伴关系协作。
儿童综合护理可以大规模实施，但变异性，尤其是低覆盖范围，可能会限制在人群层面的可衡量影响。显著加强卫生系统、实施灵活性和因地制宜的调整对于确保对儿童有影响的综合护理的有效性和可持续性至关重要。
NCT03461848。
