Early life, childhood and adolescence

There is a wealth of evidence about the importance of supporting the healthy development of children. 

Difficulties in early life (including poor diet and substance abuse during pregnancy; and exposure to domestic violence and mental health problems during childhood) are known to produce a cascade of complex biological consequences that impact the processes of childhood growth and development. Associated environmental and genetic influences result in widespread changes in gene expression affecting metabolism and neurobiological function. The latter, in turn affect resilience, ability to communicate, readiness to learn, behaviour and educational performance at school; and risk of low self-esteem, problematic substance use, criminality, poor health and employment status during adulthood. 

Plymouth Institute of Health and Care Research (PIHR) aims to better understand these risk factors, identify theory-based prevention interventions and develop evidence on best practice in the care of children and young people.

Preconception care

The role that pre-conception life plays in shaping future health chances is increasingly recognised.

PREPARE, a programme of research and education in perinatal care run by Jill Shawe aims to improve outcomes for women planning pregnancy. This large programme of work ranges from preconception care for women with chronic health conditions (Maslin, Hopper) and infertile couples, sexual and reproductive healthcare for people experiencing homelessness (Paisi), men's preconception health knowledge and behaviour to research on how people use technologies when trying to conceive.

Care during pregnancy

Factors such as maternal obesity, excess gestational weight gain, stress and smoking in pregnancy present risks to the developing foetus.

Our research includes an evaluation of eHealth tools in supporting women who have experienced Gestational Diabetes Mellitus in the interconception and postpartum periods (Edwards, Shawe, Maslin, Andrade, Jones).

We have investigated care and support of expectant women with asthma (Williamson) and diabetes (James, Redfern), maternity high dependency care in obstetric units remote from tertiary referral units (James, Endacott) and organisational interventions to reduce caesarean section (Kent).

We are also involved in global research on maternal and child health, including interventions to reduce exposure to biomass smoke among pregnant women in Uganda (Callaghan) and to support neonatal life support in Cambodia (Westlake).

Work within psychology has focused on the role of post traumatic stress symptoms following pregnancy and the need for ongoing support post-Partum (Baptie, Bacon, Andrade, Norman).

Childhood

We have a longstanding interest in the long-term outcomes of nutritional exposures in infancy and childhood, e.g. through our work on developing allergies (Maslin).

PIHR hosts the EarlyBird study, which developed a unique childhood cohort examining insulin resistance among children and which is now offering opportunities to investigate the longer-term implications of metabolic variations for health (Pinkney, Hoskins). Meinhert is leading the evaluation of two Apps designed to promote the prevention and management of childhood obesity.

Dental health is an area that we have found to be particularly subject to social inequality in childhood and we specialise in developing community-based interventions to promote children’s oral health in UK and internationally e.g. United Arab Emirates (Kay, Paisi, Nasser, Witton, Callaghan).

Spanning a wide range of issues, including anti-social behaviour, bullying, child maltreatment, early childhood development and social-emotional learning, we conduct research on how to improve child psychosocial outcomes, interventions including ADAPT, a home visiting programme for young mothers and Chance UK adaptation, a mentoring programme for children with behavioural and emotional difficulties (Axford).

We also have significant research expertise in paediatric nursing, streams including child and family centred care (International Network for Child and Family Centred Care, co-Chaired by Neill), patient and family witnessed resuscitation, end-of-life care, paediatric sepsis, patient and family reported outcome measures and clinical care improvement (Latour); and the presentation and management of acute childhood illness in children under five years of age, predominantly in the home and in first contact health services, such as primary care and urgent and emergency care (Neill).

PIHR hosts ASK SNIFF, a programme of research developing video based information resources to help families with young children understand signs and symptoms of acute illness so that they can spot when their child is sick.

The institute also incorporates multi-disciplinary research into children with long term and acquired neurological conditions including Down Syndrome, Cerebral Palsy, Ataxia and Posterior Fossa Tumour (Marsden, Bunn). NIHR funded research, partnering with Alder Hey (the ASPECT trial) has acted to validate outcome measures for use in rehabilitation of balance (Bunn) and evaluate a ‘hospital to home’ exergaming intervention (collaborating across 5 NHS sites before and during the COVID19 pandemic). A large multi-disciplinary team are currently engaged in co-producing guidelines for allied health and nursing care of children with a rare neurological condition called Ataxia Telangiectasia (Bunn).

Adolescence

It is at this stage of the life-course that some of the outcomes of early childhood adversity manifest.

We have produced evidence of a shift in childhood disadvantage and associated problems of low educational attainment and high rates of hospitalisation for self-harm, alcohol and substance use among young people from inner cities to Britain’s coastal areas (Asthana, Gibson).

We explore the role of education, school-based emotional learning and resilience building as modifiable risk factors for health inequalities (Asthana, Axford, Welbourne). Brennan investigates young people, technology and online behaviour (such as sexting and revenge pornography) and has advised the Technology Coalition of major tech companies on combatting online child sexual abuse.

Close and Lloyd are investigating the interface between online gaming and gambling and its impact on wellbeing in in adolescents and young adults to inform national policy.

We have explored metabolic impact of puberty and weight gain on child health (Pinkney) and pioneered the development of Apps and online resources for young people with diabetes (Pinkney, Jones). We also undertake important research supporting the psychosocial health of teenagers, such as those living with HIV (Hoard), living with cancer or other long-term health conditions such as endocrine conditions (Norman) and cleft lip and palate (Norman) or facing end of life (Pearce), or experiencing bereavement (Stedmon).