title: Reassurance or judgement? Parents' views on the delivery of child health surveillance programmes.
abstract: BACKGROUND
  The first year of a child's life is a crucial time for child development. Current guidance about child health surveillance and health promotion programmes emphasises a partnership approach between health professionals and parents when it comes to child health care. Parents' voices have been largely absent from discussions about local child health programmes. For partnership working to be effective and for local services to be able to evolve effectively parents' views are vital.
  
  
  OBJECTIVE
  This study aimed to explore parents' views on the child health surveillance and health promotion programmes offered during the first year of their child's life. The study aimed to be consumer-led through the involvement of lead parents in all stages of the research process.
  
  
  METHODS
  This study employed a qualitative methodology of focus groups and individual interviews. 35 participants were drawn from three general practices using a snowball sampling technique. Eligibility was determined as parents with a child under the age of one year or expecting a baby within the study timescale and registered at one of the 3 general practices. Focus groups were led by three 'parent-researchers' and individual interviews were conducted by a researcher. All focus groups and interviews were tape-recorded, transcribed and analysed using Atlas.Ti.
  
  
  RESULTS
  Several main themes were identified in this study. Firstly, when discussing scheduled health checks for children under one year of age parents expressed more positive feelings for the eight-week check which was seen to be comprehensive and informative rather than the eight-month check which was viewed as bureaucratic and less reassuring. Secondly, parents clearly articulated a need for reassurance and support from health professionals involved in child health surveillance and health promotion programmes. Thirdly, a crucial professional in the delivery of these programmes was the health visitor. Whilst parents expressed support for the concept of health visitors some health visitors were seen as bureaucratic and as making judgements of need based on socio-economic factors. Finally, some parents spoke of feeling excluded from accessing support as they were deemed not to be 'in need'.
  
  
  CONCLUSIONS
  Wider concepts of partnership working between health professionals and parents, and, needs assessment are important to this study. Crucial elements of the partnership appear to be missing and this coupled with needs assessments that leave parents feeling excluded mean that there are discrepancies between expectations and experiences of parents. These issues require consideration in order to improve services and experiences.
authors.affiliation: BRG--Wandsworth Primary Care Research Centre, Wandsworth PCT, Bolingbroke Hospital, London, UK.
authors.forename: Brenda
authors.initials: B
authors.lastname: Roche
authors.forename: Sarah
authors.initials: S
authors.lastname: Cowley
authors.forename: Niki
authors.initials: N
authors.lastname: Salt
authors.forename: Amy
authors.initials: A
authors.lastname: Scammell
authors.forename: Mary
authors.initials: M
authors.lastname: Malone
authors.forename: Philippa
authors.initials: P
authors.lastname: Savile
authors.forename: Daphine
authors.initials: D
authors.lastname: Aikens
authors.forename: Susan
authors.initials: S
authors.lastname: Fitzpatrick
mesh_terms: D001294:Attitude to Health; D002657:Child Development; D002662:Child Health Services; D003152:Community Health Nursing; D017144:Focus Groups; D006293:Health Promotion; D006801:Humans; D007223:Infant; D020380:Needs Assessment; D016487:Parenting; D010290:Parents / Q000523:psychology*; D011368:Professional-Family Relations