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Open access fifty years on: reflections on research on the role of the health visitor, june clark dbe, frcn, faan, professor emeritus, swansea university, wales.

The 1960s and 1970s were exciting times for me on a personal and professional level. My personal and professional lives became inextricably intertwined. In 1962, I graduated with a degree in classics from University College London. I had already decided, much against my parents’ wishes, that I wanted to be a nurse.

Nursing Standard . 35, 10, 15-18. doi: 10.7748/ns.35.10.15.s23

Published: 30 September 2020

As a student nurse I was already regarded as ‘a bit of a troublemaker’ and I became active in the RCN. In 1966 I got married and our children were born in 1969 and 1972. In 1967, I qualified as a health visitor and went to work in Berkshire, where my husband held a university post and we lived on the campus in a university flat. These seemingly irrelevant factors determined the next ten years of my career including, in particular, the development of my research into health visiting.

This study of health visiting in Berkshire was my first attempt at research and was also one of the earliest studies undertaken by any nurse in England. This early study is the focus of my contribution to this RCN Fellow’s 2020 publication, nearly 50 years later.

The role of the health visitor: a study conducted in Berkshire, England

A study of 1057 home visits undertaken by health visitors in Berkshire in 1969 showed that the range of the health visitor’s work was much wider than the stereotype which portrays health visiting as an activity limited to maternal and child welfare and concerned mainly with physical care. The sample was the population of health visitors, 82 in all, employed by Berkshire County Council. The health visitors completed a questionnaire, were interviewed, and recorded their home visits for one week. Seventy per cent of the visits were to households containing a young child, 18% were to the elderly, and 12% to other households. The content of the visits was recorded in terms of the topics discussed. Some topics were essentially medical, and some were within the scope of the stereotype, but many were topics not traditionally associated with health visiting and there was a considerable psychosocial content. Differences were found between visits recorded by younger and recently qualified health visitors and visits recorded by other health visitors.

Clark J ( 1976 ) The role of the health visitor: a study conducted in Berkshire, England. Journal of Advanced Nursing. 1, 1, 25-36. doi: 10.1111/j.1365-2648.1976.tb00425.x

onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2648.1976.tb00425.x

Introduction and background

The 1970s were turbulent or exciting times, whichever way you looked at them. The National Health Service (NHS) was embroiled in preparations for its major reorganisation in 1974 which involved the transfer of community health services, including health visiting, from local government to the newly created health authorities. I was appointed as the nurse member of the Berkshire Area Health Authority, which enabled me to become deeply involved in the development of health and social policy, working with many of the leaders in health care of the day. In 1962, the Health Visiting and Social Work (Training) Act had established the Council for the Training of Health Visitors (CTHV), later extended to include education (CETHV) as the new regulatory body for health visiting. The council established several working parties that attempted to define the future role of the health visitor, and in 1966 a training programme with a new curriculum had been introduced, designed to produce a ‘new breed’ of health visitor with a much broader role ( Clark 1968 ).

I was one of the first to qualify under the new regime. The decade also included the Committee on Nursing (Briggs report) ( HMSO 1972 ) and the 1979 Nursing, Midwives and Health Visitors Act, which replaced the General Nursing Council with the UKCC and abolished the CETHV. The NHS, nursing, and nursing education were turned upside down. Other issues of the day were the development of the primary care team and the attachment of health visitors to general practice, both of which were controversial and were seen by some as a challenge to the autonomy of health visitors. There was tension between health visitors and social workers and the role and status of health visiting was continually challenged.

Already active in the RCN, I found myself involved in numerous working parties and a speaker at numerous conferences. At home with two babies I had the flexibility to serve on lots of committees and task groups. I published articles in the professional press with titles such as That uncertain knock on the door, No new type of visitor, What do health visitors do? The dilemma of identity in health visiting.

I became the health visiting consultant to a popular newsstand publication called Mother and Baby, even acting for several years as the magazine’s ‘agony aunt’. I often thought that I did more and better health visiting in this role than I ever did by knocking on doors – it certainly shattered my complacency about how wonderful health visitors were. I was becoming well known as a ‘champion’ of health visiting.

The trigger for action was the publication of the Report of the Committee on Local Authority and Allied Personal Social Services, The Seebohm Report, in July 1968 ( HMSO 1968 ). The report specifically excluded health visitors from its membership and considerations and stated: ‘In our view the notion that health visitors might further become all-purpose social workers in general practice is misconceived’. It recommended that a new Social Services Department should be set up in each local authority which would undertake the existing work of the children’s department, the welfare department, and parts of the health department. Functions that health visitors had traditionally regarded as theirs were transferred to social workers who would exercise a central role in the new system.

Social workers were delighted but health visitors were furious. They complained that they had been misunderstood, misrepresented, and undervalued. I agreed and stood up on several conference platforms to say so. But I argued that if people did not understand what health visitors did, it was probably because health visitors had not told them. There was a plethora of opinions and recommendations about what the role of the health visitor should be, but a dearth of factual information and evidence about their actual practice. What was needed, I argued, was some proper research.

But who could do the research? At the time, nursing research in the UK was embryonic. There were a few studies using work study methods undertaken by researchers who were not health visitors, which health visitors rejected as contributing to the misunderstandings. Very few nurses or health visitors had a first degree, which was the normal university requirement for undertaking post graduate research.

Almost none had a doctorate, which meant it was very difficult to find nurses who could supervise nursing doctoral students. My husband’s job precluded a move to one of the developing epicentres of academic nursing such as Manchester University. I knew nothing about research methods, and I searched in vain for some kind of course that my family commitments would allow. The mantra of the Briggs Committee on Nursing that ‘Nursing should become a research-based profession’ was still four years in the future ( HMSO 1972 ).

But I did have a first degree, I was living on a university campus, and I was ‘unemployed’ because I was pregnant or occupied with babies. My RCN involvement brought support and mentorship from some wonderful nurse leaders such as Marjorie Simpson, Jean McFarlane, and Grace Owen, who were planting the ‘little acorns’ of nursing research which later grew into oaks. I obtained a grant from the King’s Fund – the first one ever awarded to an individual nurse. I joined the fledgling RCN Research Discussion Group. Professor Peter Campbell, Professor of Politics, and Dr Viola Klein from the sociology department at Reading University agreed to take on the formalities of my registration for a MPhil. At the time, most master’s degrees were research-based degrees rather than taught programmes.

I was introduced to Professor Margot Jefferys, one of the founders of the developing discipline of medical sociology, who encouraged me and became my external examiner. And there were other benefits. I had tremendous goodwill from the health visitor interviewees, and I discovered that being accompanied by a breast-fed baby established an immediate rapport in interviews! I sent a questionnaire to every health visitor in Berkshire, achieving a response rate of 89%; I interviewed 79 health visitors and persuaded 72 to record all their home visits for a week using a recording form that I devised, amounting to 2,057 visits in all.

The interviews were recorded on a reel to reel tape recorder the size of a suitcase. The data was analysed using the (then) new Reading University computer which filled a whole building. The thesis was typed on an old-style typewriter with carbon copies – it was more than a decade before computers and word processing came into common use. In 1972 I graduated with the degree of MPhil. The thesis, suitably edited, was published in book form in 1973 under the title A Family Visitor ( Clark 1973 ) – the first in the series of research monographs published through the 1970s by the RCN in conjunction with the Department of Health and Social Security (DHSS). I participated in a BBC series of television programmes about primary health care ( Bloomfield et al 1974 ), and I spoke at many conferences at which my study was referred to. The study was also published as a series of three occasional papers in the Nursing Times, the newest outlet at the time for academic articles about nursing. The 1976 paper revisited for this article was published in the first issue of the Journal of Advanced Nursing.

Impact and influence

This study was undertaken nearly 50 years ago. The health visitor of the 1960s would hardly recognise health visiting as it is today. The ‘family visitor’ with a caseload that includes people of all ages appears to have become nowadays largely a protocol-driven system of developmental checks on young children – an important function, but not the only one. Health visitors no longer visit older people, and family support is seen as the function of the social worker.

In 1999, I was commissioned by the Welsh government to undertake a review of health visiting in Wales The review found that the number of health visitors in Wales had declined dramatically during the previous decade, that the introduction of general management following the 1983 Griffiths report had diminished the position of the heath visitor in the organisational structure and led to the loss of professional leadership ( Clark et al 2000 ).

The review contained several recommendations, but the report was quietly shelved. The good news, however, was that some of the local directors of nursing supported the report and quietly implemented several of the recommendations within their own management arrangements. Fortunately, during the past decade, perhaps as a result of the renewed importance of public health in government policies, health visiting appears to be experiencing something of a resurgence.

My increasing profile in health visiting and primary health care during the 1970s led directly to my representing the UK in work with the International Council of Nurses and the World Health Organization (WHO) following the WHO Declaration of Alma Ata on Primary Health Care in 1978 and the WHO Global Strategy for Health for All by the Year 2000. My search for others who were researching in the same field led me to Professor Sirkka Lauri in Finland, which I visited on a Council of Europe Fellowship in 1981 and several times subsequently. What I saw in Finland revolutionised my ideas about health visiting and primary health care. I published more articles and spoke at more conferences, but sadly, my proposals – such as visiting by appointment, structured documentation, sharing records with clients, seemed ahead of their time. At that time, they were not popular with UK health visitors.

Now, they are recognised as central to good practice. The Department of Health’s continuing search to understand health visiting practice ( Clark 1982 ) led to a new research project to develop a model for explaining health visiting practice which eventually became my PhD ( Clark 1985 ), and a project to identify the outcomes of health visiting practice ( Clark and Mooney 2001 ). Citations in other people’s work continued well into the 1990s. In 1982, when I was elected Fellow of the Royal College of Nursing, the citation said, ‘for her contribution to the art and science of nursing in the field of health visiting’.

But I can hardly claim that the study itself had any influence on the developments in health visiting in the 1970s, which were largely determined by the introduction of legislation and other external events over which the profession could exercise little control. In particular, the absorption of health visiting into the new framework of the 1979 Nurses, Midwives and Health Visitors Act moved health visitors from having a unique title and professional registration which was mandatory for practice, to recordable with the Nursing and Midwifery Council as ‘specialist community public health nurses’ alongside a variety of other nurses with no such requirements. Midwives retained their specialist identity; health visitors lost theirs. With hindsight, the legislation of the 1970s could be considered as marking the beginning of the demise of health visiting as I had known it.

Current and future relevance

It is hard to think that my research of some 50 years ago might have relevance to current and future researchers or practitioners, but it continues to be cited from time to time. Perhaps, however, any influence I might have had applies more to individuals than to big changes in policy. The outcome of which I am most proud is the number of individuals whose careers I was able to help, many of whom are now the leaders of the profession, just as the great nursing leaders of the 1960s and 1970s supported me. Health visitors I meet at conferences and other meetings often recognise me, and the older ones, that is, my contemporaries in health visiting, who are now, like me, approaching their eighties, often refer to my work in health visiting and in particular to this study. I did not know whether to be flattered or horrified when I discovered quite recently that A Family Visitor was still included in some students’ reading lists!

As my children grew up, I expanded my interests into other fields of nursing – care of older people, nursing education, and standardised nursing terminology for electronic patient records. I am no longer directly involved in health visiting, but with hindsight I can see some relevance of this study to my and others’ later work in other fields. I have been fortunate to be able to combine practice, research, and teaching in my long career ( Clark 2016 ). With hindsight I can see that the methodological approach of trying to capture the essence of health visiting practice through identification and recording of the topics discussed in the home visit, as described in this paper, led directly to my work on the development of a standardised terminology to capture the essence of nursing, the International Classification for Nursing Practice ( Clark and Lang 1992 ), and to make nursing and health visiting visible in electronic patient records. Only now in 2020 do I see the beginnings of understanding among nurses why the use of standardised terminology and structured documentation for nursing practice is important.

Fifty years later I still carry and promote the attitudes and ideas that were born in my health visiting days – the focus on prevention and early intervention, the social determinants of health, public health as opposed to individualised ‘treatment’. The principles of health visiting which were set out in the 1970s ( CETHV 1977 ) apply equally today and to every field of nursing:

» The search for health needs

» Stimulation of awareness of health needs

» Influence on policies affecting health

» Facilitate health enhancing activities.

Health visiting still has much to offer in meeting society’s health needs.

Correspondence

[email protected]

Open Acesss

This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) licence (see https://creativecommons.org/licenses/by-nc/4.0/ ) which permits others to copy and redistribute in any medium or format, remix, transform and build on this work non-commercially, provided appropriate credit is given and any changes made indicated.

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Selection Of 12 Dissertation Topics About Health Visiting

We don’t all go on to get our doctorates, by the ones that do are able to manage a lot of difficult academic tasks. One such task is the dissertation and it has been known to be a challenge to the best students. This is how it was meant to be, research is a serious venture and it must be done to the highest of standards. For the fresh student, this can take some getting used to.

When writing a dissertation, your choice of topic is just as important as your ability to work with it. Be very careful not to select a topic that will only ruin you and believe me a bad topic choice can. A topic must be both interesting and fun to work with, as well as within your practical capabilities. Consider this list of 12 dissertation topics about health visiting.

• What are the effects of having a male nurse attend to the delivery of a baby? Can this difference in gender affect the woman's ability to effectively deliver the child?
• What are the most troubling issues faced by health visitors practicing in developing countries?
• Do persons have the ability to properly check the authenticity of the qualification presented by a health visitor?
• In a world with increasing gender manipulation in both sexes, is it possible that this will soon affect health practice qualification requirements for professionals working on call?
• What are the advantages of having a home delivery supervised by a qualified, practicing nurse?
• In a disaster situation, should it be the choice of the victim to decide whether or not they wish to receive medical attention from a professional due to personal reasons?
• How is the safety of a visiting doctor assured when working in unfamiliar areas ?
• Is sanitation and comfort taken into enough consideration when a doctor is performing an operation outside of hospital facilities?
• The effects of the trauma young children may be faced, with when a visit turns out to be a worse case scenario.
• Can a doctor be irreparably traumatized if placed in a situation where they could have saved a person;s life, if the meeting was taking place at a proper hospital with all the facilities, instead of at an outside location?
• Should a contagious disease be discovered during a house call, does a health professional have the ability to contain the situation without risking their life?
• In what situation is a house call actually necessary?

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Healthcare Dissertation Topics

Published by Carmen Troy at January 4th, 2023 , Revised On August 16, 2023

Health care education brings together the science and arts of medicine along with the practice of general education. Healthcare is an education program that is tremendously significant for humans and society.

Medicine, nursing, and all other related health care fields provide a substantial understanding of living beings, disease trends, treatment, treatment outcomes, functional abilities, disabilities, and much more.

The primary purpose of healthcare is to ensure people’s health, look after the patients, and provide information about health risks and their effects. Health care education provides knowledge and information about life and helps survival, to say the least.

We all rely on the health care system to get physically well and resume the mundane course of life after getting affected by a health risk.

Therefore, studying health care is of immense importance as it offers you the opportunity to serve humanity by looking after their health. If you are studying health care science, you will need to complete a dissertation to complete a degree and practice its laws and principles.

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2022 Healthcare Dissertation Topics

Topic 1: investigating the impact of household air pollution (hap) on the respiratory health of people and recommend measures of intervention.

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• To suggest measure for controlling HAP through intervention with biomass fuels.

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Research Aim: The research aims to conduct an assessment of the bioethics issues arising during medicine development and administration to patients and how ethics of public health can be improved

• To analyse the bioethics challenges associated with medicine development and patent administration.
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• To conduct an assessment of the bioethics issues arising during medicine development and administration to patients and how ethics of public health can be improved

Topic 3: Investigating the present global health security infrastructure and its capacity to detect and prevent the spread of infectious diseases. A case study of the outbreak of Covid-19.

Research Aim: The research aims to investigate the present global health security infrastructure and its capacity to detect and prevent the spread of infectious diseases. A case study of the outbreak of Covid-19.

• To analyse the concept of global health security.
• To determine the current infrastructure of global health security and the position of WHO in detecting and preventing the spread of infectious diseases.
• To investigate the effectiveness of the present global health security infrastructure in dealing with the Coviud-19 pandemic and recommendations for future scenarios.

Topic 4: Investigating the importance of vaccines and childhood nutrition on improving maternal and child health

Research Aim: The research aims to investigate the importance of vaccines and childhood nutrition on improving maternal and child health

• To determine the present challenges of material and child health and its significance in society.
• To analyse the role of vaccines and childhood nutrition on safeguarding the health of the mother and child.
• To recommend the measures to improve maternal and child health for ensuring wellbeing of the families with pre-natal and well-child care for infant and material mortality prevention.

Topic 5: An analysis of the risks of tobacco and second-hand smoke exposure on the cardiovascular health of people in the UK.

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• To contextualise the risk factors of tobacco and second-hand smoke.
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• To recommend measures for reducing and minimising tobacco risks and prevent health impact due to passive smoke.

Topic. 1: COVID-19 and health care system:

Research aim: The prime focus of the research will be analysing the impact of COVID-19 on the health care system and how the health care system was able to handle the health emergency in different regions of the world. The research can pinpoint one location and study its health care system from the perspective of the COVID-19 outbreak.

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Research aim: UN has a major health department that oversees the health sector around the world. United Nations plays an important role in bringing sustainability in human life such physically, economically, and in so many other ways. The main goal of the research will be to understand and analyse the UN health care policy and identify to what extent it is improving health care systems around the world.

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Research Aim:  Olympics were called from July to August in 2021 in Tokyo, Japan, when delta variant had been engulfing lives around the world. While many people opposed the decision of arranging the Olympics, it ended up with flying colours. But it is said that due to the Olympics and Paralympics, in which athletes from all over the world participated, the delta variant transcended easily.

The aim of the research is to find out whether or not the Olympics and Paralympics helped the widespread of the delta variant. 

Topic no. 5: The Covid-19 Vaccination drive and people's response:

Research Aim: There is a large proportion of people who are still unvaccinated against Covid-19 in the world. The aim of the research is to track the covid-19 vaccination drive around the world. The researcher will also find the key motivations behind their denial.

Topic no. 6: Poverty and its impact on childhood diseases:

Research aim: The aim of the research will be to find out the relationship between poverty and childhood diseases. The researcher can conduct quantitative research by finding out the figures of most affected childhood diseases and their financial data in the world.

Topic no. 7: The motivation towards a healthy:

Research Aim: By and large, it is said that people in a few regions in the world are more motivated towards attaining a healthy life than in other places. The purpose of the research is to find relative and varying motivations to live healthy around the world.

Topic 8: Health crisis in warzone countries

Research aim: Children and women are the most suffered creatures in the warzone areas of the world. The purpose of the research is to identify the health crisis of women and children in places where there is no rule of law.

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Also Read: Medicine and Nursing Dissertation Topics

Topic 9: Scope of Health care research

Research aim: The research aims to identify and analyse the significance of health care research and its effects on humans and society. The researcher will identify the necessity of the study in the field and its overall impact. 

Topic 10: The future of telemedicine

Research aim: Telemedicine refers to the use of technology to disseminate medical information, diagnose, or interact with a patient. Currently, it is gaining tremendous importance, especially due to the pandemic, but it is important to figure out how it will work out in the future.

The research aim of the research would be to find the significance of telemedicine and its prospects.

Topic 11: Controlling infectious diseases

Research aim: The research will aim to find out whether or not infectious diseases are difficult to deal with. The paper will identify all the elements responsible for making infectious diseases unstoppable. The researcher can make arguments in the context of the COVID-19.

Topic 12: Effective health care policies around the world

Research aim: Different countries have different health care systems with different policies around the world. The aim of the research will be to find out the most effective health care systems around the world. The research can incorporate both quantitive and qualitative methods for the study.

The researcher can pinpoint a respective area for the study—for example, the health care system of Nigeria, the United States, or South Asia etc.

Topic 13: Technology and health care system

Research aim: The advancements in technology have transformed all aspects of our life, and the health care system is no exception.

The main aim of the research will be to find out the impact of technology on the health care system.

Topic 14: Health care system in 2030

Research aim: The aim of the research will be to identify trends and forecast the future on their basis. The researcher will examine the health care system today and study the elements that may bring about change and may modify it in the future. The projections must base on evidence.

Topic 15: The emotional impacts of COVID-19

Research aim: The COVID-19 affected normal life significantly. People were locked in the homes, and the roads and streets were empty. In that perspective, it is significant to understand how(if it did) affected people emotionally.

The main aim of the research will be to find out how and to what extent COVID-19 affected people emotionally. 

Topic 16: Beauty standards and how they impact the health of humans

Research aim: Neither being skinny is healthy, nor starvation is the solution to getting a perfect body shape. The standard beauty standards have persistently put social pressure on individuals to become as per se. Otherwise, they will be neglected or segregated. The research will aim to find out how people who try to meet the standard beauty standards affect their health. 

Topic 17: Depression and anxiety in adults in developed countries

Research aim: Depression and anxiety are some common instances that occur to almost all people. It may apparently look like people in developed countries, having access to their basic needs, must not have anything to worry about. It might not be what looks from the outside. The research will measure the rate of increase or decrease in depression and anxiety in adults in developed countries and identify the key determining factors.

Topic 18: Creating awareness of Breast cancer in third world countries

Research aim: The aim of the research will be to identify why it is important to create awareness about breast cancer in third-world countries and identify how to do so.

Topic 19: Gene therapy for hemoglobinopathies

Research aim: Haemoglobinopathies are genetic problems that affect the structure or formation of haemoglobin. One recent research identifies gene therapy as a solution to the disorders. The research will aim to identify how effective gene therapy is and in what capacity it can be used in medicine in the future.

Topic 20: The unspoken problems of health care managemnt

Research aim: While it is so much it is stressed on ensuring the treatment of patients and advancing healthy life of humans in generals; there is a very little say about what problems, who are responsible for managing, may face. The research aims to identify the undiscussed problems faced by health care management to ensure a healthy life for people.

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How to find healthcare dissertation topics.

To find healthcare dissertation topics:

• Examine emerging health issues.
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• Consider policy or technology impacts.
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• v.18(6); 2015 Dec

‘These places are like a godsend’: a qualitative analysis of parents' experiences of health visiting outside the home and of children's centres services

Sara donetto.

1 National Nursing Research Unit, King's College London, London, UK

In 2011–2012, we carried out a programme of research to inform the Department of Health's strategy for strengthening health visiting services in England. Our research included a study of parents' views of their experiences with health visiting services in two geographical areas in England. Here, we draw upon data from this work to illustrate valuable aspects of family support outside the home reported in parents' accounts of their experiences of health visiting. We also explore the usefulness of relational autonomy as a theoretical lens for understanding the mechanisms through which this support operates.

We draw upon data from semi‐structured interviews with 44 parents across two ‘Early Implementer Sites’ of the ‘new service vision’ in England. Our thematic analysis of the data was informed by grounded theory principles.

Findings and discussion

Parents valued being able to attend child health clinics and group activities outside the home; this helped them to avoid social isolation and to identify, choose and use the forms of advice and support that best suited them. We suggest that health visiting outside the home and children's centres services may also foster parental autonomy, especially when this is understood in relational terms.

Conclusions

Health visiting outside the home and children's centres services are an important complement to health visiting in the home; both dimensions of family support should be available in the community. Relational readings of autonomy can help illuminate the ways in which these services can foster (or undermine) parents' autonomy.

As part of a broader research undertaking commissioned by the Department of Health's Policy Research Programme, in 2012 we carried out a study of parents' views of health visiting services in two sites in England. 1 The study aimed to inform the implementation of the new service vision for health visiting set out in the Health visitor implementation plan 2011–2015: A call to action 2 , and it shed light on the relational and organizational features of health visiting that contribute to a provision that is perceived as enabling and supportive by parents. In this paper, we focus on one of the themes from our data analysis: the value for parents of drop‐in child health clinics and group activities at children's centres. 1 Evidence on effective partnership working across statutory services for children is currently limited; 3 community‐based family support is often discussed and evaluated in the policy and social work literature 4 , 5 , 6 but remains largely under‐theorized in the health visiting literature. 7 In view of this and of the on‐going review of children's centres, 8 below we examine our data on parents' experiences of community centre‐based services through the theoretical lens of relational autonomy to explore the ways in which health visiting outside the home and children's centres services can complement health visiting in the home and contribute to effective support for parents and young children. We refer to ‘health visiting services’ inclusively, as in the NHS Operating Framework for England, 9 which includes in this definition the leadership and delivery of the Healthy Child Programme for under 5‐year‐olds in collaboration with maternity services and children's social care. 7 Although we focus here on the UK context, our discussion also has relevance for service provision in other countries whose health‐care systems have similar public health nursing roles (e.g. Australia, Denmark, Finland, Ireland, New Zealand, Norway, Sweden and USA).

In 2011, the Health visitor implementation plan 2011–2015 2 set out the government's strategy to strengthen and rejuvenate health visiting services in England (for a review of progress, see Ref. 10 ). With some NHS trusts, designated as Early Implementer Sites (EISs), being responsible for leading the implementation of the new strategy, services began to be reorganized around four levels of ‘family offer’: ‘community’ and ‘universal’ levels for the fundamental health and social support needs of all families with children under 5 years of age, and ‘universal plus’ and ‘universal partnership plus’ for families requiring additional support for health and parenting issues in the short or long term, respectively. Collaborating closely with other health‐care professionals and community practitioners – including midwives, nursery nurses, general practitioners and staff at children's centres 11 , 12 – health visitors lead and coordinate a variety of services for preschool children and their families across these four levels of ‘family offer’ to put into place an ‘effective and high‐quality preventive programme in childhood’ as ‘the foundation of a healthy society’. 13 This collaboration can take various forms: health visitors can hold regular child health clinics at a local health centre or children's centre; they can be directly involved in children's centres activities (e.g. breast‐feeding support groups) or even be based within a children's centre (for a recent collection of examples of successful approaches to integrated service delivery see Ref. 14 ). A recent narrative review of the literature on health visiting highlighted how research in this area is characterized by small‐scale, single studies which are often under‐theorized and do not really constitute a coherent body of work, with a noticeable paucity of research on key areas of health visiting including skillmix, teamworking and organizational arrangements. 7 To contribute to understanding and theorizing the ‘community’ ‘universal’ and ‘universal plus’ dimensions of the health visiting ‘family offer’, we illustrate parents' accounts of their experiences of community centre‐based services and suggest that relational readings of autonomy can offer further insights into the mechanisms through which health visiting outside the home and children's centres services play a role in effective family support.

The concept of individual autonomy occupies a central place in moral and political philosophy and its dimensions and boundaries represent a key concern in biomedical ethics, 15 , 16 where personal autonomy is a core principle alongside beneficence, non‐maleficence and justice. 17 In discussions around health and health‐care, it is most often invoked to refer to patients being in a position to make their own decisions in matters relating to their care. 16 As a consequence, traditional autonomy theory as applied to the context of health‐care ethics has often focused on the factors that interfere with autonomy, such as coercion, internal compulsion and ignorance. 18 However, conceptualizations of autonomy which limit it to autonomous decision making are reductive and potentially misleading. 16 As Sherwin points out, the narrow focus of this traditional understanding of autonomy ‘obscures our need to consider questions of power, dominance, and privilege in our interpretations and responses to illness and other health‐related matters as well as in our interpretations of the ideal of autonomy’ 19 (p. 31). In particular, the focus on individual decision making that can characterize narrow readings of autonomy obfuscates the social relationships in which the conditions for autonomous deliberation are embedded. Although autonomy and choice are interdependent, in this paper we do not discuss choice per se . Here, we wish to foreground the possible ways in which the conditions for autonomous choice may be enabled and fostered through health visiting practices outside the home and other support services at children's centres.

The need for relational (in the sense of socially situated or contextualized proposed by Sherwin 19 ) conceptualizations of autonomy emerged from feminist critiques of the masculine character ideals permeating the concept, and from concerns about the inattention to oppressive social relationships fostered by individualistic and rationalistic understandings of autonomy. 20 The relevance of relational accounts of autonomy for clinical practice has been recently re‐examined by Entwistle and colleagues, who have highlighted how these accounts ‘de‐emphasize independence and facilitate well‐nuanced distinctions between forms of clinical communication that support and that undermine patients' autonomy. p. 741. 16 Relational accounts of autonomy take into account the effects of social forces and practices on the circumstances that support or restrict an individual's ability to exercise choice autonomously. They highlight that an agent requires a degree of self‐trust and self‐worth to be autonomous, which emphasizes the importance of self‐identities and self‐evaluations for autonomy. 18 In our case, they can help us to shed light on how, by fostering parental self‐trust and self‐worth, health visiting practices outside the home and activities at children's centres can contribute to supporting parental autonomy.

We draw upon semi‐structured interviews with parents who had experienced some sustained contact with the health visiting team – that is, beyond the first health visitor's visit or occasional or routine checks – at two EISs in England. Both EISs were located in socio‐economically mixed geographical areas, including urban, suburban and rural locations, and both deprived districts and pockets of affluence. We interviewed a total of 44 parents (42 mothers and two fathers; eight telephone interviews, all the others face‐to‐face) of children aged between 0 and 5 years, recruited to the study with the help of the health visiting team (for participants' characteristics, see Table  1 ). All but one interview were audio‐taped (one parent declined to be recorded and notes were taken during and immediately after the interview) and transcribed verbatim. Our data analysis was informed by grounded theory coding strategies: 21 a preliminary phase of open coding (carried out by three researchers, including the authors, who met regularly to discuss early themes and impressions from the data) was followed by more focused coding, with revision of existing codes and addition of new ones. Memos were used throughout the analysis to capture ideas and insights into discussion and further elaboration. Codes were clustered under categories, and emerging themes were shared and discussed by team members for further insights (for example, early codes such as ‘being listened to’ and ‘being given time’ were clustered under the ‘good experiences of care’ category; these and other codes and categories led to discussion of the features of ‘enabling relationships’ as an analytical theme). Prominent themes and those that had specific relevance to the policy questions underpinning the study were foregrounded and developed in the study report. 1 In this paper, we further develop a theme from the original study relating to parents' experiences of the support they received from health visitors, their teams and children's centres’ staff beyond the home visits. The study was approved by the relevant ethics committee (Ref. No. 12/NE/0067). To preserve participant anonymity, we use pseudonyms throughout the paper and provide very little organizational detail about the teams, the services they provide and any identifiable aspects of parents' experiences.

Characteristics of participants in the study

Our wider study illuminated various aspects of health visiting practice that parents considered crucial to their feeling supported. 1 More specifically, it drew attention to the value and characteristics of one‐to‐one relationships with health visitors and other early years workers which were perceived as supportive and enabling (for example, the importance of feeling ‘known’ and listened to); the potentially long‐lasting effects of unsatisfactory experiences with health visiting services (for example, feeling judged about parenting approaches or lifestyle choices); and the importance of the backstage work that health visitors did to ensure effective coordination of care and support (for a more extensive discussion of the wider study findings see Ref. 1 ). When discussing the aspects of health visiting that they had found valuable, parents commented extensively on the support they were offered outside the home and the ways in which this had proved important to them. Although we asked parents about their experiences with the health visitor and the health visiting team, it emerged from our data that boundaries between teams and services were not necessarily know by parents or even relevant to them. With a view to illuminating the potential mechanisms through which community‐based support for families provided by health visitors and other early years workers operates, in this paper we focus upon this aspect of parents' experience of support. Firstly, we discuss how engagement in activities at community centres helped parents to avoid becoming isolated and enabled them to identify, choose and use the forms of help that best suited them; secondly, we utilize the theoretical lens of relational autonomy to understand in more depth how health visiting practice and other activities in community and children's centres may be supporting parents.

Meeting other parents who are ‘going through the same things’

Most parents attended either a health centre or their local children's centre for child health clinics (better known by parents as ‘baby clinics’) and, in the case of children's centres, also for other activities such as parent and baby/toddler groups, baby massage classes, ‘messy play’ groups, breast‐feeding support groups. Several participants stressed how useful they found being able to access these centres and activities to connect with other parents (mainly mothers). Roxanne, for example, commented on how attending the children's centre helped her to feel less isolated; contact with other mothers and with professionals who could answer her questions had been ‘a big help’ for her:

But the children's centres I think are really good. When you have a baby it can be sometimes quite a lonely time. […] if you haven't had any other children and you haven't had a lot of experience you can kind of be like, ‘Help, what do I do?’ Or if your friends haven't got children as well, it's just nice to have the support and to know that other people are going through the same things that you are, and to have people to answer any questions however silly you might think they are. It's been a big help for us. (Roxanne, mother of one)

Knowing that other people were ‘going through the same things’ and being able to access a range of tips and suggestions for coping with everyday problems proved helpful also for Lynda:

…you kind of got a different perspective of everything. Like, you get different tips and different ways of doing things and you're not alone because there are other parents that are out there that do find things a little difficult. (Lynda, mother of two)

This sense of not being alone and the opportunity to compare notes and normalize one's experience applied also to more specific maternal issues. Breast‐feeding can prove difficult and stressful to new mothers. Naomi, a mother of one, found informal advice from other mothers helpful in coping with her breast‐feeding problems:

It gives you a bit of confidence with regards to breastfeeding to know that if you are having problems, you're not the only one. Some support and advice on a professional level from the health visitors has been useful, but also informally, just meeting other mums and chatting to them and just knowing that you're all going through the same thing, because nobody tells you if you're doing it right or you're doing it wrong, but to know that you're kind of doing it the same way as everybody else.… (Naomi, mother of one)

The possibility for socialization that the children's centres offered was generally appreciated by mothers. Meeting other parents allowed for the sharing of ‘informal’ advice and reassured these mothers that they were not the only parents who were finding looking after their young child challenging at times. These forms of reassurance (particularly when complemented by the reassurance and praise provided by health visiting practitioners in one‐to‐one encounters) were perceived by parents as directly helpful. In addition, they have the potential to positively influence parents' perceptions of self and of their new or renewed parent identities, thus also supporting autonomous agency.

Lorraine's description below captures a view of the children's centre as a friendly and welcoming environment, which was a common thread throughout our data:

It's just meeting other people and you can talk about everything and getting out of the house, really, because it was all a bit scary to begin with, knowing what to do and how to do things, and actually getting out of the house. But yeah, so we came here and met our two friends that we do everything with, so if I hadn't had this facility then we wouldn't have obviously made them friends. The baby group was just nice because you could see that your baby was the same as everyone else's baby, just a bit louder. (Lorraine, mother of one)

Having somewhere to go to meet other people and distance oneself from the stress of the home was perceived as beneficial by Lorraine, and other mothers – like May, below – pointed out how this was particularly valuable for single parents:

… these places are like a godsend, because if you are a single parent you don't have loads of money to go and do stuff… I go to all these things because it gets me out of the house. I'm not just sitting around on my own. You meet other people. (May, mother of one)

Louise lived with her partner and their four children, but she echoed May's comments, above, having met several single mothers at the centre:

… a lot of the women I speak to would be on their own and I think it was invaluable for them […] to have somewhere to go for starters and to know that when they got here they were welcome no matter who they were, what they do or anything like that, you know, how their lives were, you were all the same in this room. […] You weren't being judged, nothing like that. You come here, have a natter, have a laugh and you're all welcome, […] and I think that's important, you know? Because you don't get a lot of people who don't judge you and they don't here. (Louise, mother of four)

By allowing parents to spend time and share their experiences with other parents in an environment where social asymmetries are not foregrounded – in Louise's words, ‘you were all the same in this room’ – children's centres may also be contributing to supporting parents' self‐confidence. They can represent spaces where parents can come to terms with their new identities unconstrained by pre‐existing experiences of being judged or criticized by others. Not only do health visiting teams often have a role in coordinating how these spaces operate, but through their work at the 'community' level of the family offer they also contribute to ensuring parents are aware of their availability and able to access them. Health visitors and other members of the health visiting team are ideally placed to suggest and gently encourage attendance at the centre, and this can prove particularly helpful when a mother is experiencing mood difficulties and acute isolation. Denise, a mother of one, told us that she had felt extremely isolated having moved to the area shortly before the birth of her baby. She had finally shared her sense of loneliness with her health visitor at a 12‐week routine visit. It was through the support of health visitor and family support worker that she was able to access and make the most of her local children's centre:

Because I went through a stage where I didn't want to go out of the house. […] I was nervous to come down here on my own to the [baby class]. […] [The family support worker] met me at my house and actually walked me down here […] and she came in with me. […] Without that I would never have got out and I wouldn't have got the friends that I've got now so… (Denise, mother of one)

Mothers who feel isolated or overwhelmed by their transition to being a parent might not feel able to seek support themselves. At the ‘community’ level, health visiting ensures that information about support in the community is available to all mothers and that parents who need additional encouragement to access these resources receive it promptly.

Identifying and developing more satisfactory relationships with health professionals

Routine weight, health and developmental checks for young children are usually carried out by health visitors at child health clinics. These most often operate as drop‐in clinics and are hosted within a health centre or a children's centre. Regular clinics – regardless of frequency – were important to parents as they represented an easily accessible point of contact with the service when there were health concerns or needs for reassurance and/or advice. Together with group activities at children's centres, clinics also enabled parents to seek alternative sources of advice when they were not entirely satisfied with the support they had already received. Most participants in our study were happy with the health visitor they saw more regularly and the advice and help they provided. Occasionally, however, unsatisfactory interactions led parents to seek alternative sources of advice or to form a relationship with another member of the health visiting team. In view of the long‐lasting effects of unsatisfactory interactions with health visiting services, 1 this finding – although relevant to a minority of parents in our study – is worthy of attention. Child health clinics and group activities at children's centre can offer parents the opportunity to have more informal contact with various members of the health visiting team. This can encourage them to explore new relationships with health visiting practitioners and to identify and cultivate more satisfactory forms of interaction between advice and support. Florence, a mother of two, found consulting some of the health visitors at the child health clinic unhelpful because she found their advice restrictive. At one of the group activities, however, Florence had met health visitor Sharon, whose advice to the group she trusted and respected. From that point onwards, when concerned about her daughter's health, she would approach Sharon:

Well, it's because I talked to my partner about it and I was saying, ‘Oh, we could go to the clinic, but then you don't know who you're going to get at the clinic, or I could talk to Sharon because I'd seen her that many times at the group that I knew that she was, like, a decent person. She wasn't someone who is full of misinformation or that kind of thing, which you do get. I mean, you get that in all jobs though, there's going to be people who don't have as much information as others. I knew she was good so I kind of trusted her enough to mention it to her. (Florence, mother of two)

Here, the group acted as a catalyst for Florence to be able to identify a practitioner she felt she could trust. Having found the advice she had received from other members of the health visiting teams unhelpful in the past, it proved useful to her to meet a professional she felt she could approach when she had a serious concern. Like many other health‐care workers, health visitors face incredible work pressures and cannot always accommodate changes in allocation of cases on the basis of parental preference alone. However, in some cases, it is possible for parents to develop supportive relationships with practitioners with whom they feel more in tune. Susanne, below, appreciated the advice she received from the health visitor she saw at home visits, but she found more reassurance in consulting a second health visitor – Melissa – she had met at one of the groups at her local centre:

As I said, I felt really supported with the group here and they do seem quite a close‐knit group. I think that my health visitor in particular was new, so in that respect I felt possibly that she maybe she wasn't as experienced, but then I think that she is a mum herself so that's all the experience that you need really. And so that is one of the reasons that I quite liked Melissa [a different health visitor]. Because, as I said, she is a little bit more experienced, and I just felt that they'd been there before and could give you a little bit more reassurance. (Susanne, mother of one)

Mother of one Lydia also said she found the whole team at the clinic very kind and supportive, although perhaps too focused on encouraging breast‐feeding. She preferred the approach of one particular professional –Terry– she had met at the child health clinic. In the quote below, Lydia explains how at her local child health clinic she would ask to see Terry to have her queries addressed:

And then I became attached to one particular health visitor who I saw each week. And she was helping me through it all, so the original health visitor who I saw I didn't see any longer because the other one kind of took over; because we'd sort of got a bond together and anything I needed I preferred to see her, which was nice. […]…when I went over to the desk to ask for [my daughter] to be weighed I'd ask if Terry was there, because the other ones, they were all lovely but they tended to talk mostly about breast‐feeding and there were other things that I wanted to talk about. (Lydia, mother of one)

Lydia here refers to Terry as a health visitor; however, later in her interview, she explained that Terry was, in fact, a nursery nurse. Her story is an example of how access to the wider health visiting team can maximize opportunities for developing effective relationships with different members of the team. As well as contributing to making parents feel more supported in their parenting role, these opportunities can also enable them to rehearse agency and judgement, thus supporting autonomy. We discuss this to greater length below.

Our analysis suggests that activities at community centres involving, or integrated with, health visiting provision can counteract social isolation and promote access to other services through contact with other parents and health visiting practitioners within environments that can be perceived by parents as welcoming and non‐judgemental. They can also enable the development and consolidation of more effective relationships with members of the health visiting team other than those encountered through routine allocation. Our study showed that where parents had had prior unsatisfactory encounters with the service, they had sometimes become reluctant to continue to engage with it or generally sceptical and negative towards it. 1 Informal encounters with members of the health visiting team at group activities or at routine checks at the child health clinic allowed some parents in our study to exercise agency in identifying forms of support that felt more in tune with their lifestyles and health choices. Whilst we are in no way suggesting that group activities can or should replace home visits or outreach programmes, our findings highlight some of the mechanisms through which they contribute to effective early years support for families. In this sense, they point to the importance for policymakers of ensuring that health visiting and early years services are able to offer an adequate combination of home‐based and community centre‐based support. Of course, attendance at group activities might not appeal to all parents, especially to those who are already socially isolated, or find social situations intimidating due to cultural or language barriers, or complex social problems such as substance addiction or domestic violence. However, these activities can significantly contribute to the health promoting support to which health visiting services aspire.

By facilitating socialization with other parents and the exploration of new relationships with health visiting practitioners, activities at community centres can actively support parental autonomy. This is particularly evident if we understand autonomy relationally, that is, if we foreground the social relations that contribute to making decision making possible rather than focus purely on decision making itself. Broadly speaking, relational readings of autonomy can ‘encourage us to look behind and beyond decision situations in which patients are (or might be) presented with options relating to their health care, and to see a broader range of ways in which health services can constrain or undermine’ – or, we would add, support – ‘patients' autonomy’ 22 (p. 26). The two dimensions of engagement with early years and health visiting support outside the home discussed in this paper encourage parents' autonomy by fostering self‐trust and creating the conditions for practising autonomy skills. Connecting with other parents helped participants in our study to cope with the challenges of parenthood and feel less lonely. By providing friendly and non‐judgemental spaces where informal communication with staff and other parents is possible and where parents (mostly mothers, in our sample) can share experiences and common difficulties with parenthood, community centres can positively influence parents' sense of individual self‐worth. Due to the self‐selecting nature of our sample, we do not know whether other parents found group activities intimidating, or perhaps stigmatizing. However, where peer environments are experienced as non‐judgemental, they can positively influence self‐worth and therefore prove enabling for parents from disadvantaged groups (especially single mothers) who may be experiencing social discrimination or stigmatization in their daily lives. Also, child health clinics and group activities at children's centres made it possible for parents to identify the health visiting team worker with whom they trusted, or felt most comfortable and ‘in tune’. Activities in community centres that foster more satisfactory relationships with health visiting practitioners can enable parents to distance themselves from forms of professional advice that are perceived as uncomfortable or undermining – and, in this sense, oppressive – and to pursue interactions that are more likely to build and reinforce self‐trust. As Entwistle and Cribb point out when discussing relational autonomy in the context of the care of long‐term conditions: ‘…health services structures and the particularities of healthcare encounters (including relationships with staff) are themselves influential contexts for patients. They can have significant implications for who patients can be and what they can do within them’ 22 (p. 36). Professional advice that more closely matches, or is more welcoming of, parental lifestyles and views on childrearing and feeding is also likely to create more conducive conditions to practising judging, evaluating, and trusting one's judgment as a parent, which all reinforce parental autonomous agency. Although our discussion focuses on relational autonomy, other theoretical tools – such as theories of social capital and social support, 23 , 24 , 25 , 26 self‐efficacy 27 and self‐determination theory 28 – might also contribute, in analogous ways, to richer conceptualizations of health and social care for young children and their families. We call for health visiting research to engage to a greater extent with these theoretical lenses to generate more robust and critical analyses of its own practices.

We acknowledge that parents volunteering to participate in our study are most likely to be those who have had positive experiences with the service and that the ethnic background of our sample is very homogenous. Our data are unlikely to capture the experiences of parents who have stopped engaging with the services following negative experiences or of those from ethnic minorities. However, our analysis offers useful insights into the experiences of parents who are willing to engage with services in areas where implementation of the new service vision is already in progress.

By illuminating the mechanisms through which community centre‐based early years and health visiting provision contributes to effective family support, our analysis underscores the complementarity and potential for mutual reinforcement of home visits and health visiting and other early years support outside the home. At present, budget cuts to local authorities raise significant challenges for the sustainability of community spaces in which support can be accessed by parents in the ways explored in this paper. 29 Policymakers, commissioners, and health visiting service managers therefore need to be mindful of the importance, for the health and well‐being of families with young children, of ensuring that effective combinations of different forms of early years and health visiting support are available in the community.

When concerns around the physical and psychological safety of a child are not an issue, health visitors and their teams, in collaboration with early years staff at children's centres, aim to enable parents to make healthy choices for themselves and for their children's health and well‐being in the respect and support of people's autonomy. 30 , 31 We suggest that relational readings of autonomy can illuminate the ways in which health visiting and children's centres services can promote parents' self‐trust and self‐worth, foster the development of non‐oppressive relationships with peers and/or health‐care professionals and enable the rehearsing of agency, thus supporting parental autonomy. We therefore suggest that health visiting research would benefit from applying this theoretical lens, along with other potentially complementary lenses, to the study of its own practices and of early childhood services inside and outside the home.

Sources of funding

The study this manuscript draws upon was commissioned and supported by the Department of Health in England as part of the work of the Policy Research Programme. The views expressed are those of the authors and not necessarily those of the Department of Health.

Conflicts of interest

Acknowledgements.

This paper builds upon a study of parents' views of health visiting services. The authors are grateful to Jane Hughes and Mary Malone for the discussions around some of the themes presented in this paper. The authors also wish to thank Alan Cribb and Glenn Robert for their very helpful comments on earlier versions of this paper.

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A multiple perspective exploration of health visitors’ family focused practice with mothers with mental illness and their families

• Rachel Leonard
• School of Nursing and Midwifery

Student thesis : Doctoral Thesis › Doctor of Philosophy

• maternal mental illness
• health visiting
• family focused

File : application/pdf, 2.12 MB

Type : Thesis

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Prize : Prize (including medals and awards)

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The marcia mackie studentship 2018-19.

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Burrell, Jane. "Whither health visiting ... again?" Thesis, University of East Anglia, 2011. https://ueaeprints.uea.ac.uk/48121/.

Clark, Jenny. "The process of health visiting." Thesis, London South Bank University, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.354898.

Robinson, K. S. M. "The social construction of health visiting." Thesis, London South Bank University, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.379049.

Mason, Carolyn Anne. "Problems of health visiting : an anthropological study." Thesis, Queen's University Belfast, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.253295.

While, Alison E. "Health visiting and health experience of infants in three areas." Thesis, King's College London (University of London), 1985. https://kclpure.kcl.ac.uk/portal/en/theses/health-visiting-and-health-experience-of-infants-in-three-areas(99101213-0e09-4343-8ac0-9b2b90e321e8).html.

Goding, Lois. "An investigation into intuition and health visiting practice." Thesis, University of Reading, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367383.

Pearson, P. H. "Clients' perceptions of health visiting in the context of their identified health needs : An examination of process." Thesis, Northumbria University, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.381573.

Williamson, Kathleen M. "Home health care nurses' perceptions of empowerment." Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 150 p, 2005. http://proquest.umi.com/pqdweb?did=954038861&sid=5&Fmt=2&clientId=8331&RQT=309&VName=PQD.

Cuesta, C. de la. "Marketing the service : basic social process in health visiting." Thesis, University of Liverpool, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316547.

Bouman, Anneke Ida Emilie. "Home visiting program for older persons with poor health status." Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Universiteit Maastricht [host], 2008. http://arno.unimaas.nl/show.cgi?fid=11314.

Cowley, Sarah Ann. "A grounded theory of situation and process in health visiting." Thesis, University of Brighton, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.305154.

Machin, Alison Isabel. "Role identity in a turbulent environment : the case of health visiting." Thesis, University of Newcastle upon Tyne, 2009. http://hdl.handle.net/10443/3972.

Young-Murphy, Lesley. "A social and cultural exploration of health visiting and nursery nurse teams." Thesis, University of Newcastle Upon Tyne, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.430343.

Kenyon, Lynn. "The culture of community engagement from participant perspectives : implications for health visiting." Thesis, Sheffield Hallam University, 2014. http://shura.shu.ac.uk/9940/.

Almond, Palo. "A study of equity within health visiting postnatal depression policy and services." Thesis, University of Southampton, 2008. https://eprints.soton.ac.uk/58902/.

Brind'Amour, Katherine. "Maternal and Child Health Home Visiting Evaluations Using Large, Pre-Existing Data Sets." The Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1468965739.

Kendall, Sally. "An analysis of the health visitor-client interaction : the influence of the health visiting process on client participation." Thesis, King's College London (University of London), 1991. https://kclpure.kcl.ac.uk/portal/en/theses/an-analysis-of-the-health-visitorclient-interaction--the-influence-of-the-health-visiting-process-on-client-participation(f8c15627-cbdf-4c34-a681-b27df3cff770).html.

King, Caroline Anne. "From normality to risk : a qualitative exploration of health visiting and mothering practices following the implementation of Health for all Children." Thesis, University of Edinburgh, 2013. http://hdl.handle.net/1842/8198.

Pritchard, Jacqueline Edith. "Public, private and personal : a qualitative study of the invisible aspects of health visiting." Thesis, University of Warwick, 2001. http://wrap.warwick.ac.uk/3103/.

Chalmers, Karen I. "Preventative work with families in the community : a qualitative study of health visiting practice." Thesis, University of Manchester, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.303521.

Recchia, Natasha. "The use of a telephone interpreter service in health visiting : an action research study." Thesis, University of Nottingham, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.662198.

Grindle, Norma. "The role of the arts in teaching caring : an evaluation." Thesis, University of Ulster, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.365919.

Maxwell, Jennifer. "The social construction of work and occupations : health visiting as a case study of women's health and welfare work." Thesis, University of Nottingham, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297759.

Montañez, Daniela Marie. "Exploring a Trainee's Response to Visiting Refugees in Jordan: A Bifocal Art Exploration." Digital Commons at Loyola Marymount University and Loyola Law School, 2015. https://digitalcommons.lmu.edu/etd/147.

Appleton, Jane Victoria. "An examination of health visitors' professional judgements and use of formal guidelines to identify health needs and prioritise families requiring extra health visiting support." Thesis, King's College London (University of London), 2002. https://kclpure.kcl.ac.uk/portal/en/theses/an-examination-of-health-visitors-professional-judgements-and-use-of-formal-guidelines-to-identify-health-needs-and-prioritise-families-requiring-extra-health-visiting-support(ca51ddec-dab0-4f85-b817-da01454eece4).html.

Burns, Diane Sutton. "A financial analysis of a Southern California Coalition of Visiting Nurse Associations." CSUSB ScholarWorks, 1994. https://scholarworks.lib.csusb.edu/etd-project/922.

Strouse, Robert J. III. "The relationships between smoking cigarettes and drinking alcohol and visiting the emergency department in the past 12 months." Thesis, California State University, Long Beach, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1526958.

Two key issues in healthcare today are the over-utilization of emergency departments (ED) and the lack of preventative care participation. Successful preventative care can help to reduce ED utilization and harmful behaviors such as drinking and smoking.

Exposing patients to the benefits of preventative or primary care benefits could start in the ED. This report sought relationships between ED utilization for personal health and smoking cigarettes or drinking alcohol in a 12 month period. This study utilized the CHIS 2011-2012 data set to find such a relationship. A relationship was found between smoking and drinking during a 12 month period and visiting the ED for personal health.

This report identifies an opportunity for improvement within health benefit utilization. Smokers and drinkers can be exposed to cessation programs in the ED, while also helping to encourage patients to better utilize primary and preventative services.

Twinn, Sheila Frances. "Change and conflict in health visiting practice : dilemmas in the assessment of professional competence in the education of student health visitors." Thesis, University College London (University of London), 1989. http://discovery.ucl.ac.uk/10006553/.

Kelsey, Amanda. "The evolving and uncertain role of health visiting in England and Wales in the twentieth century." Thesis, London School of Economics and Political Science (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313047.

Strömberg, Gunvor. "Serious mental illness : early detection and intervention by the primary health service." Doctoral thesis, Umeå universitet, Psykiatri, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-312.

Fraser, Jennifer Anne, and n/a. "The Role of Home Visiting as an Early Intervention Strategy for Prevention of Child Abuse and Neglect." Griffith University. School of Applied Psychology, 2000. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20050915.140055.

Farrin, Jane Mary. "A comparison of the health beliefs, attitudes and behaviours of clients visiting a general practitioner and a naturopath /." Title page, contents and abstract only, 1997. http://web4.library.adelaide.edu.au/theses/09PM/09pmf246.pdf.

Mumby-Croft, Kathryn Joy. "Defining 'hard to reach' : the work of health visitors with vulnerable families." Thesis, University of Hertfordshire, 2015. http://hdl.handle.net/2299/16333.

Sarsby, Norma Jennifer. "Representing others : an exploration of health visiting practices to address domestic violence and abuse in black and minority ethnic communities." Thesis, University of Brighton, 2016. https://research.brighton.ac.uk/en/studentTheses/f2451a70-4a53-475b-b3d3-4d3c19b1ab00.

Pound, Robyn. "How can I improve my health visiting support of parenting? : the creation of an alongside epistemology through action enquiry." Thesis, University of the West of England, Bristol, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.271051.

Alfredsson, Jonas, and Jakob Attin. "Tooth loss: The Impact on the Quality of Life for patients visiting Kantipur Dental College and Hospital, Kathmandu, Nepal." Thesis, Malmö högskola, Odontologiska fakulteten (OD), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-19821.

Hogg, Rhona. "An analysis of parents' experience of parenthood and of the health visiting service, from the perspectives of parents of young children." Thesis, University of Edinburgh, 2002. http://hdl.handle.net/1842/24702.

Le, Var Rita Maria Hannele. "An investigation of the perceived significance of staff : student ratios in nursing, midwifery and health visiting education in the context of standards approval." Thesis, University of Bristol, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297855.

Eckert, Chantel Marie. "Reducing Child Maltreatment Through Prevention." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6785.

Evaldsson, Caroline, and Mia Sörensen. "Barn som närstående : Betydelsen av att vara delaktig och besöka närstående som vårdas på sjukhus." Thesis, Högskolan i Borås, Institutionen för Vårdvetenskap, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20240.

Durandt, Nicola Estelle. "Outcome of a home-visiting intervention to improve social withdrawal assessed with the m-ADBB in six-month old infants in Khayelitsha, Cape Town : a cluster randomised controlled trial." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/96009.

Olsson, Cecilia, and Malin Ringström. "Barnhälsovårdssjuksköterskors och familjestödjares upplevelser av att i samverkan arbeta med utökade hembesöksprogram." Thesis, Högskolan Väst, Avdelningen för omvårdnad - avancerad nivå, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-15294.

Johnson, Kimberly S. "Effecting Change in High Risk Families through Home Visiting. An Analysis of Clients’ Perceived Value of the Process Based on Professional Attire Worn by Home Visitor; White Coat vs. Business Casual." Youngstown State University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ysu1558882770959141.

Astbury, Ruth A. "What processes will support effective shared decision making when health visitors and parent are planning to improve the wellbeing of babies and children within the context of the Getting It Right For Every Child (GIRFEC) policy framework?" Thesis, University of Stirling, 2014. http://hdl.handle.net/1893/22356.

Nixon, Ashley E. "The impact of fidelity and innovations on Healthy Families America programs." [Tampa, Fla.] : University of South Florida, 2007. http://purl.fcla.edu/usf/dc/et/SFE0001988.

Senate, University of Arizona Faculty. "Faculty Senate Minutes January 22, 2018." University of Arizona Faculty Senate (Tucson, AZ), 2018. http://hdl.handle.net/10150/626508.

Koon, Kathleen Arganbright. "Maternal-child home visiting : elements of a public health nursing program /." 1991. http://wwwlib.umi.com/dissertations/fullcit/9218730.

Cloonan, Patricia A. "A study of care coordination provided by home health nurses /." 1990. http://wwwlib.umi.com/dissertations/fullcit/9100767.

Kuan-Pin, Lin, and 林冠品. "Self-Care Behaviors and Related Factors in Public Health Nurses'' Home Visiting Diabetes Mellitus Cases." Thesis, 1999. http://ndltd.ncl.edu.tw/handle/74046279677419924300.

Chang, Ren-Shen, and 張仁山. "A Study on the Association of Chronic Patient's Health Literacy and Visiting to the Travel Medicine Services." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/njj94p.

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These are published research papers that iHV has been involved with:

ADBB Study: A mixed-methods feasibility and acceptability study of using the Alarm Distress Baby Scale (ADBB) within universal health visiting practice in England (April 2024)

Dr. Sharin Baldwin, Dr. Michael Fanner, Hilda Beauchamp, Vicky Gilroy, Professor Jane Barlow

Babies are born with amazing social abilities. They are ready to relate and engage with the world around them, communicating how they feel through their behaviours. It is normal for babies to use withdrawal behaviours (such as looking away, closing eyes, sneezing) to control the pace of social engagement. Sustained social withdrawal behaviours, however, could suggest an ‘early alarm signal’ for relational challenges and a coping mechanism that babies may use if their initial protests are not responded to.

The Alarm Distress Baby Scale (ADBB) is an observation aid, validated by research, used to observe how babies are interacting with the world around them and to assess for social withdrawal. The short version of the scale (the m-ADBB) allows babies who may be in need of a more thorough assessment and support to be quickly identified. We carried out a mixed methods study to explore the acceptability and feasibility of using the full ADBB and the modified ADBB (m-ADBB) as part of routine health visiting practice in England.

Feasibility and acceptability of using the Alarm Distress BaBy (ADBB) scale within universal health visiting practice in England: a mixed-methods study protocol (November 2023)

Sharin Baldwin, Nafisa Insan, Hilda Beauchamp, Vicky Gilroy, Alison Morton, Jane Barlow

Abstract Introduction  The Alarm Distress BaBy (ADBB) scale developed by Guedeney and Fermanian in 2001, is a validated screening tool designed for use by healthcare practitioners to identify infant social withdrawal. This study will explore the acceptability and feasibility of the use of the full ADBB scale and a modified ADBB (m-ADBB) scale as part of routine health visiting visits in England.

BabyBreathe trial: protocol for a randomised controlled trial of a complex intervention to prevent postpartum return to smoking (August 2023)

Caitlin Notley, Tracey J Brown, Linda Bauld, Allan B Clark, Sharon Duneclift, Vicky Gilroy, Tess Harris, Wendy Hardeman, Richard Holland, Gregory Howard, Mei-See Man, Felix  Naughton, Dan Smith, David Turner, Michael Ussher

Many people quit smoking during pregnancy, but postpartum smoking relapse is common. Maintaining smoking abstinence achieved during pregnancy is key to improving maternal and child health. There are no evidence-based interventions for preventing postpartum smoking relapse. This trial aims to determine whether an intervention to prevent postpartum relapse is effective and cost-effective.

The iHV Emotional Wellbeing at Work Champions Programme: Building capacity to protect and enhance the emotional wellbeing of the health visiting workforce in the UK (June 2022)

Sharin Baldwin, Rachel Stephen, Patricia Kelly, Philippa Bishop

The Institute of Health Visiting (iHV) Emotional Wellbeing at Work Programme was developed during the COVID-19 pandemic to support the health visiting services to deal with the increased demands placed on them. This paper discusses the development of the iHV Emotional Wellbeing at Work (EWW) Champions Programme, which has built on the original model to enable the creation of EWW Champions. The iHV has a good track record of building leadership and capacity for rolling out training and development on a wider scale using the iHV Champions model of training. The portfolio currently includes a range of Perinatal and Infant Mental Health Champions (Baldwin and Kelly, 2016; Baldwin et al., 2018) [ 1 , 2 ], Research Champions (Mugweni et al., 2019) [ 3 ], Delivering Different News Champions, Healthy Weight and Healthy Nutrition Champions, Changing Conversations: Autism Ambassadors, and Neonatal Families Ambassadors. This paper discusses how the EWW programme was further developed to create this Champions’ model to enable other experienced and skilled health visitors to become EWW facilitators. Through this model, trained health visitors can support their colleagues in the workplace, protecting and enhancing their emotional wellbeing at work and broadening access to support services and resources.

Evaluation of an emotional wellbeing at work programme for supporting health visiting teams during COVID-19 (October 2021)

The coronavirus disease 2019 (COVID-19) pandemic has had and continues to have a huge effect on the health and wellbeing of children and families in the UK. Health visitors have been at the forefront of providing support and care to these families, which has been challenging and has resulted in increased levels of stress among the workforce. For health visitors to have the capacity to support families adequately, it is important that they focus on their own wellbeing.

This article describes the Emotional Wellbeing at Work virtual programme for health visitors developed by the Institute of Health Visiting and funded by the RCN Foundation. It also discusses the early evaluation findings and learning points, and considers how the programme has developed.

Improving the Delivery of Different News to Families by Healthcare Professionals: The DDN Study 2 Report (September 2021)

Dr Esther Mugweni, Tamsyn Eida, Tracy Pellat-Higgins, Melita Walker, Angie Emrys-Jones, Sabrena Jaswal, Professor Sally Kendall

The first 1001 days covering from pregnancy to the time that a child is two years old are critical for their physical, emotional and cognitive development. There is increased vulnerability for babies and their families during this period when congenital anomalies are identified. The diagnostic process has significant implications for parent and child emotional and mental wellbeing. In this study, we refer to this diagnostic process as delivering different news (DDN). Ineffective delivery of different news (DN) and the DN itself can result in chronic stress, depression, anxiety or other mental health conditions in parents. In the first 1001 days of life, this may impair parenting ability which potentially has a direct immediate and long-term impact on the infant’s physical, cognitive, emotional and social development. Parents must receive DN from healthcare professionals (HCPs) with skills to deliver the news sensitively and compassionately. Currently, not every family has access to such HCPs due to a lack of standardised training or policy to guide professionals on how to effectively deliver DN. Providing communication skills training can potentially minimise the negative psychological impact of the news, maximise the psychological wellbeing of the whole family and reduce staff burnout.

Read the Easy Read version of the report

Also read iHV Policy Brief – Improving the way healthcare professionals inform parents about their child having congenital anomalies in the first two years of life

Development of the Emotional Wellbeing at Work Virtual Programme to support UK health visiting teams (December 2020)

Sharin Baldwin, Rachel Stephen, Philippa Bishop, Patricia Kelly

Abstract The COVID-19 pandemic has changed the way in which health visiting services are delivered in the UK. Health visitors are now having to work more remotely, with virtual methods for service delivery as well as using personal protective equipment where face-to-face contacts are necessary. This rapid change has resulted in many health visiting staff working under greater levels of pressure, feeling isolated, anxious and unsettled. This article discusses a virtual programme that has been funded by the RCN Foundation and developed by the Institute of Health Visiting to support the emotional wellbeing of health visiting teams in the UK. It outlines the background to the project, the theoretical underpinnings to inform the programme model and the evaluation process that will be used to further refine the programme before wider implementation.

Barriers and facilitators to health visiting teams delivering oral health promotion to families of young children: a mixed methods study with vignettes (September 2020)

Sally Weston-Price, Julia Csikar, Karen Vinall-Collier, Philippa Bishop, Donatella D’Antoni, Cynthia Pine

Objective: To explore the potential barriers and facilitators to health visiting (HV) teams delivering oral health promotion during the 9-12-month old child mandated visit in Ealing, England.

Background: HV schemes and their counterparts worldwide share similar priorities to discuss oral health at 6-12 months of age. The HV programme in England stipulates at 9-12 months old, diet and dental health should be discussed. HVs believe dental decay is important however oral health knowledge is varied.

Perceived facilitators: good levels of knowledge and skills, sense of professional role, emotions, belief in capability, organisational structure and resources.

Perceived barriers: gaps in knowledge, conflicting advice from other professionals, conflicting issues for parents/ carers, use of interpreters.

Conclusions: These findings can be harnessed to support oral health promotion delivered by HV teams.

The feasibility of a multi‐professional training to improve how health care professionals deliver different news to families during pregnancy and at birth (February 2020)

Esther Mugweni, Catherine Lowenhoff, Melita Walker, Sabrena Jaswal, Angela Emrys‐Jones, Cheryll Adams, Sally Kendall

Background:  In the United Kingdom, pregnant women are offered foetal anomaly screening to assess the chance of their baby being born with eleven different conditions. How health care professionals (HCPs) deliver news about a child having a congenital anomaly affects how it is received and processed by parents. We refer to this news as different news.

Conclusions: The significant improvements in confidence and skills reported by HCPs suggest that the training may be effective in equipping HCPs to minimize the distress, anxiety, and depression associated with receiving different news. This represents a key aspect of the prevention of mental ill health across the life course.

Journal of Mental Health: “I’ll look after the kids while you go and have a shower”: an evaluation of a service to address mild to moderate maternal perinatal mental health problems (April 2019)

Esther Mugweni , S. Goodliffe , C. Adams , M. Walker  & S. Kendall

Background:  Perinatal mental health (PMH) problems are a major public health concern because they may impair parenting ability which potentially has an immediate and long-term impact on the physical, cognitive and emotional health of the child.

Aims:  We evaluated a Perinatal Support Service (PSS) which supports positive attachment between mothers with PMH problems and their child, to evidence its impact on maternal mental health and maternal-infant interaction.

Results: We found significant improvement in anxiety after the PSS. Anxiety post service was lower than baseline anxiety. Receiving emotional and practical support contributed to improvements in mental health and mother–child interaction.

Conclusion:  Given the paucity of PMH services in the UK, it is imperative that services such as the PSS continue to receive funding to address unmet PMH needs.

Improving the Delivery of Different News to Families by Healthcare Professionals - Report (March 2019)

Esther Mugweni1, Melita Walker1, Samantha Goodliffe1, Sabrena Jaswal2, Catherine Lowenhoff3, Cheryll Adams1, Angie Emrys-Jones & Sally Kendall1,2

• Institute of Health Visiting
• University of Kent
• Oxford Brookes University

The way healthcare professionals deliver “different news” is an important factor in how it is received, interpreted, understood and processed by parents. The term “different news (DN)” is used in this study to describe the process of imparting and receiving information relating to an unborn or newly born child being diagnosed with a condition associated with a learning disability. Parents may experience a range of emotions immediately after receiving DN including significant distress, fear, grief, depression, anxiety and chronic stress.

Published March 2019

Journal of Health Visiting: Supporting women with eating disorders during pregnancy and the postnatal period

Journal of Health Visiting › May 2018 › Volume 6 Issue 5

Amanda Bye,  Nicola Mackintosh,  Jane Sandall,  Abigail Easter,  Melita Walker

Published May 2018

The transition to motherhood can be challenging for many women due to the changes that are common to pregnancy, such as changes in appetite and body shape and weight. These challenges can be particularly pronounced for women with eating disorders. There is growing evidence that eating disorders can be associated with adverse maternal and infant outcomes; and given the elevated risks, early identification and tailored antenatal and postnatal care are highly important. This article examines the role of the health visitor in supporting women with eating disorders during pregnancy and the postnatal period.

British Journal of Obstetrics and Gynaecology: Eating Disorders and Pregnancy training resources

Insights from outside BJOG

Journal of Health Visiting: Implementing a Perinatal Mental Health Champion programme in north-west London

Journal of Health Visiting › April 2018 › Volume 6 Issue 4

Sharin Baldwin, Patricia Kelly, Melita Walker

Published April 2018

The transition to parenthood can be a challenging time for parents and during the perinatal period some parents may experience mental health difficulties. The Institute of Health Visiting (iHV) Perinatal Mental Health Champions training programme addresses the fundamental requirements that are necessary for health visitors to manage anxiety, depression and other perinatal mental illnesses, to understand the impact of these conditions on the infant, family and society, and to know when to refer on. This article evaluates the implementation of the training programme in a Trust in north-west London.

Public health Nursing: Knowledge, attitude and practice among Health Visitors in the United Kingdom toward children’s oral health

Oge OA, Douglas GVA, Seymour D, Adams C, Csikar J. Knowledge, attitude and practice among Health Visitors in the United Kingdom toward children’s oral health.

Public Health Nurs. 2018;00:1–8. https://doi. org/10.1111/phn.12381

Published 2018

Objectives: The purpose of this study was to determine knowledge, attitude, and practical behavior of health visitors regarding children’s oral health in the United Kingdom (UK). Methods: A web-based self-administered survey with 18 closed and 2 open ended questions was distributed to a convenience sample of approximately 9,000 health visitors who were currently employed in the United Kingdom and a member of the Institute of Health Visiting. (PDF) Knowledge, attitude and practice among Health Visitors in the United Kingdom toward children’s oral health . Available from: https://www.researchgate.net/publication/322659836_Knowledge_attitude_and_practice_among_Health_Visitors_in_the_United_Kingdom_toward_children%27s_oral_health [accessed Jun 19 2018].

Journal of Human Vaccines & Immunotherapeutics - Vaccination in pregnancy: Attitudes of nurses, midwives and health visitors in England

Bhavita Vishram, Louise Letley, Albert Jan Van Hoek, Louise Silverton, Helen Donovan, Cheryll Adams, David Green, Angela Edwards, Joanne Yarwood, Helen Bedford, Gayatri Amirthalingam & Helen Campbell

Published online: 27 Nov 2017

Objective : To examine amongst healthcare professionals in England; knowledge of vaccinations in pregnancy, their perceived roles in these programmes and whether they recommend scheduled vaccines to pregnant women.

Poster - Liaison Health Visitors are they an undervalued resource in local child safeguarding?

Key messages from a Liaison Health Visitor Survey (November 2017)

Authors: Anne Byrne 1 , Mary Boullier 2 , Cheryll Adams 3 , Mitch Blair 2

• 1 – Liaison Health Visitor, London North West Healthcare NHS Trust.
• 2  – River Island Paediatric Academic Unit, London, North West Healthcare NHS Trust
• 3 – Institute of Health Visiting

British Journal of General Practice, Health visiting in primary care in England: a crisis waiting to happen?

Rosamund Mary Bryar, Dame Sarah Ann Cowley, Cheryll Mary Adams, Sally Kendall, Nigel Mathers

Published March 2017

When did you last see a health visitor? When did you last communicate with a health visitor? These seem apt questions given the evidence from a recent survey of health visitors by the Institute of Health Visiting (iHV); (Working with GPs Survey, unpublished, London, 2016. For further information contact Dr C Adams, Director, iHV). The evidence shows great variability in contact between health visitors (HVs) and GPs in England: of 1179 respondents, 23% of HVs saw a GP at least once a week; 33% 1–2 times a month, and 33% less frequently or hardly ever. In this editorial we review the recent history of health visiting and how, in particular in England, we have arrived at the current situation where HVs, once considered essential members of the wider (non-practice employed) primary health care team (PHCT), 1  are now so detached that at a recent meeting (ICCHNR Symposium, University of Kent, September, 2016), a GP could say that they, HVs, are ‘out there somewhere’ but where seemed to be a mystery to him and possibly others.

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30 Public Health Dissertation Topics Ideas & Samples

Research is always about the interest of the researcher. If a person starts researching an area he is not interested in, then chances for success become very negligible. This is because interest of the individual will be zero. Same is the case with the domain of public health. Public health dissertation topics are usually confused with community health topics. However, these two are somewhat different areas, as can be seen from their different research scopes. Dissertation topics on public health covers different health-related issues at the public level.

Best Public Health Dissertation Topics Examples

Public health research topics have been presented in the form of the following list that is quite exclusive and interesting at the same time. Have a look and let us know if you find something interesting:

• Challenges in public health sector: a review of literature.
• Public health and alcohol: a systematic analysis.
• Public health ethics and individual rights: a descriptive approach.
• Is rationing vaccines an ethical approach during public health emergencies? A critical analysis.
• Studying the strategies employed for enhancing public health awareness among general public: a descriptive analysis.
• Law enforcement and public health issues: a review of literature.
• Investigation of the correlation between public health law, public health officer and public health practices.
• Role played by technology and innovation in the progress of global public health domain.
• Association between public health and criminology: focus on youth violence prevention programs.
• Global health governance: a public health perspective.
• Studying the role played by public health campaigns in the promotion of public health disparities: a systematic analysis.
• Challenges faced by public health workers: developed versus developing economies of the world.
• Public health approaches towards palliative care: a review of literature.
• Integration of behavioral science theory into public health interventions: a systematic review.
• COVID-19 pandemic and public health interventions: a meta-analytic study.
• Postabortion syndrome – a novel arrival within the context of public health concerns.
• Why childhood obesity is increasing in USA? A public health perspective.
• Investigating the role played by nurses in the domain of public health: a review of literature.
• Public health nursing: an ethical investigation.
• Evaluation of public health programs for pregnant women in developing countries of the world: a descriptive study.
• Public health and gerontology: reviewing literature from the last two decades.
• Resource-limited countries of the world and pharmacovigilance: a public health perspective.
• A comparative analysis of public health programs in the developed and the developing countries of the world.
• Utilization of social media platform by public health professionals to raise awareness about Thalassemia: a systematic review.
• Social work, psychology and public health workers: a multidisciplinary approach.
• Social determinants of dying at the end-of-life stages: a public health perspective.
• Studying the factors that promote the partnership between public health and primary care domains.
• Resources for public health workers: separating theory from reality.
• Tobacco control policy within the context of public health interventions: a study from Australia.
• Sport as a public health intervention: a UK-based research study.

These are 30 Public Health Dissertation Topics Ideas & Samples also check related posts for Dissertation Topics In Community Health and Environmental Health Dissertation Topics.

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Health systems management and health sector reform

• Performance-Based Payments, Provider Motivation and Quality of Care in Afghanistan
• Health Systems Strengthening in Post-Conflict Settings: Employee and Patient Satisfaction in Hospitals in Afghanistan
• The Use of Clinical Practice Guidelines to Improve Provider Performance of Well-Child Care in Armenia
• Quality Improvement and Its Effect on Patient Perceptions and Demand for Health Services-Evidence from Uttar Pradesh, India
• The Perception of Quality Among Users of Commune Health Centers and Users of Private Providers in Northern Vietnam

Health financing

• National Health Insurance in Ghana: Politics, Adverse Selection, and the Use of Child Health Services.
• Evaluating the Effectiveness of User Fee Increase in Improving The Quality of Care: Government Primary Health Care Services in Indonesia
• The Impact of Community-Based Health Insurance on Health Care Utilization and Financial Sustainability: The Example of Rwanda
• Impact of Health Insurance on Health Care Utilization in Vietnam
• Stimulating Demand:  An Assessment of the Conditional Cash Transfer Project in Afghanistan

Health policy and resource allocation

• Exploring Attitudes and Perceptions of Policymakers and Health Researchers Towards Evidence-Based Health Policymaking in Argentina: A Mixed Methods Approach
• Dual Practice in Kampala, Uganda: A Mixed Methods Study of Management and Policy
• Understanding Political Priority Development for Public Health Issues in Turkey: Lessons from Tobacco Control & Road Safety
• Academic Knowledge Brokers in Kenya: A Mixed Methods Study of Relationships, Characteristics and Strategies
• Decision-Making for Allocation of Public Resources in Decentralized District Health Systems in Uganda

Maternal, neonatal and child health

• Antenatal and Delivery Care in Afghanistan Knowledge and Perceptions of Services, Decision Making for Service Use, and Determinants of Utilization
• Early Maternal Morbidity and Utilization of Delivery Services by Urban Slum Women of Dhaka, Bangladesh
• An Assessment of Maternal Health Service Needs of Immigrant Women Living in East Calgary, Canada
• Health Seeking Behavior of Women and Their Families During Pregnancy, Delivery and Postpartum Period in Nepal

Evaluation of health programs

• Comparison of Biomarker Surveillance of Measles Immunity to Conventional Indicators of Vaccination Coverage
• Qualitative Research to Develop a Framework for Evaluating the Sustainability of Community-Based Child Health Programs Implemented by Non-Government Organizations
• Evaluating the Delivery Huts Program for Promoting Maternal Health in Haryana, India
• Evaluating the Scale-Up of Community Case Management in Malawi: Health System Supports, Health Worker Attitudes, and Equity of Service Provision

Refugee and humanitarian assistance

• Family Relationships and Social Interaction in Post-Conflict South Kivu Province, Eastern Democratic Republic of Congo A Mixed Methods Study with Women from Rural Walungu Territory
• Utilization of Health Services for Children after the Tsunami in Aceh, Indonesia
• Factors Affecting School Enrollments in a Post-Repatriation Context: A Study of Household Roles, Attitudes and Forced Migration Processes in Urban Somaliland
• A Balanced Scorecard for Assessing the Quality and Provision of Health Services in UNHCR Refugee Camps

Injury prevention and control

• Road Traffic Injuries In China: Time Trends, Risk Factors and Economic Development
• Evaluating an Intervention to Prevent Motorcycle Injuries in Malaysia: Process Performance, and Policy
• Injuries and Socioeconomic Status in Iganga and Mayuge, Uganda: Inequities, Consequences and Impacts
• A neglected epidemic of childhood drowning in Bangladesh: Epidemiology, risk factors and potential interventions

Equity and fairness in distribution of health services

• Gender and Access to DOTS Program (Directly Observed Treatment, Short-Course) in a Poor, Rural and Minority Area of Gansu Province, China
• Empowering the Socially Excluded: A Study of Impact on Equity by Gender, Caste and Wealth in Access to Health Care in Rural Parts of Four North Indian States
• Gender, Empowerment, and Women's Health in India: Perceived Morbidity and Treatment-Seeking Behaviors for Symptoms of Reproductive Tract Infections among Women of Rural Gujarat
• Trust in Maternity Care:  A Contextual Exploration of Meaning and Determinants in Peri-Urban Kenya
• The Effect of Contracting for Health Services on the Equity of Utilization and Out-of-Pocket Health Expenditure in Rural Afghanistan

Health economics

• The Equity and Cost-Effectiveness of HIV Voluntary Counseling and Testing in Tanzania
• Hospital Coding Practice, Data Quality, And DRG-Based Reimbursement Under the Thai Universal Coverage Scheme
• Willingness-to-Pay and Cost-Benefit Analysis on Introducing HIB Conjugate Vaccine into the Thai Expanded Program on Immunization
• Economic Evaluation of the Costs and Cost-Effectiveness of the Diarrhea Alleviation through Zinc and Oral Rehydration Therapy Program at Scale in Gujarat, India
• The Economics of Non-Communicable Diseases in Rural Bangladesh: Understanding Education Gradients in Mortality and Household Wealth Impacts from an Adult Death

Health outcomes and burden of disease methods

• Measuring the Burden of Disease: Introducing Healthy Life Years
• Measuring the Burden of Injuries in Pakistan Epidemiological and Policy Analysis
• Strengths and Limitations of Population-Based Health Surveys in Developing Countries: A Case Study of National Health Survey of Pakistan: 1990-94
• Approaches to Measuring Non-Fatal Health Outcomes: Disability at the Iganga-Mayuge Demographic Surveillance System in Uganda
• A National Burden of Disease Study for The United Arab Emirates (UAE): Quantifying Health Differentials Between Nationals and Migrants

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