title: Health visitors' experiences of child health promotion policy reform in England.
abstract: Child health promotion services in England have been revolutionised in the last decade, with a shift from a low-threshold universal service to a more highly targeted programme. This has affected health visitors' preventive healthcare work with families. This paper draws on findings from the qualitative arm of a mixed-methods study that aimed to explore how child health promotion reform has been implemented. The particular focus of this paper is on health visitors' experiences of the process of policy reform. In-depth semi-structured telephone interviews were conducted with 25 health visitors working in urban areas in England, and data were analysed thematically. Health visitors described policy change as being enforced, but views on the new programme were coloured by the extent to which practitioners retained the autonomy to offer a service according to their professional judgment. Where practitioners retained professional autonomy, services were adequately staffed and there was a functional working environment, then interviewees were positive about child health promotion reform. Where health visitors felt they could not offer an appropriate level of health promotion services, they had grave concerns about the impact on child public health.
authors: University of the West of England, Bristol. louise.condon@uwe.ac.uk
authors: Louise
authors: L
authors: Condon
mesh_terms: D001291:Attitude of Health Personnel; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D003152:Community Health Nursing / Q000458:organization & administration*; D004739:England; D018166:Health Care Reform; D019538:Health Care Surveys; D006284:Health Plan Implementation; D006293:Health Promotion / Q000458:organization & administration*; D006297:Health Services Accessibility; D006801:Humans; D017009:Professional Autonomy; D016526:Workload