Staff Profiles

Postgraduate Teaching:

• MSc Research Supervision – Child Welfare and Wellbeing and SCPHN.
• Co-Lead Applied Health, Nursing and Midwifery (UoA 3) Doctoral Training Programme
• PhD Research Supervision

Supervision

Research Degree Students

Current students:

• Helen Bosley ‘Maternal Attitudes to Antibiotic Use: A Community Based Case Study’. Director of Studies (DoS).
• Sharon Brownie ‘Nursing and Health Service Leadership: The Power to Influenc’ DoS.
• Sam Donohue. ‘What is the experince of professional enjoyment in nursing?’
• Monica Duman ‘How are assessment tools and chronologies used by health and social care professionals to identify child neglect?’ DoS.
• Grace Grove. University of Southampton. ‘Individual and area-based measures of disadvantage for improved risk stratification and possible intervention to improve health and reduce obesity in young families.’ Supervisory team: Prof. Nisreen Alwan, Dr Diana Smith, Prof. Jane Appleton and Dr Nida Ziauddeen
• Josie Jacobs ‘A resilience intervention programme for parents in the 21^st Century: increasing wellbeing and promoting positive coping skills.’ DoS.
• Elizabeth Jestico ‘What are parents’ experiences of being supported by significant others, when faced with making decisions about their child’s cancer case? A phenomenological study’. DoS.
• Karen Lascelles. ‘Experinces and support needs of adult carers of adults at risk of suicide: a mixed methods study.’ DoS .
• Catherine Lowenhoff ‘Moving on from ‘Listening Visits’: a mixed methods, multi-phase study exploring the support that health visitors provide to mothers with mental health problems’. DoS
• Elaine Strachan-Hall. ‘The role of robots in nursing’.
• Suzanne Watts ‘An Exploration of the referral and communication systems between primary health care professionals and children's social care services’ DoS.
• Diana Yardley ‘An exploration of health care professionals’ perceptions of non-medical factors affecting management of Type 1 diabetes in children.’ Co-DoS Dr Olga Kozlowska and Prof. Jane Appleton.

Completed students:

• Georgia Cooke – ‘Parental influences on children’s sleep’. Second supervisor.
• Lauren Harding – ‘How do school nurses identify and work with school-aged children at risk of child abuse and neglect?’ Director of Studies (DoS).
• Briony Enser – ‘Alcohol Driven Harm to Others’ Second supervisor.
• Kimberley Harcourt – ‘Weight loss and weight loss maintenance using exercise, nutrition and behaviour change strategies among overweight men’. Second supervisor.
• Jon Hyslop – ‘How do peer networks enable service users and informal carers to obtain and manage a personal budget?’ DoS.
• Mark Mason. ‘The illegal drug use behaviours and social circumstances of older adult regular Class A drug users’. DoS.

Jane’s programme of research has centred on health visiting and school nursing practice and safeguarding children.  It encompasses a body of work spanning over 25 years, which has had considerable impact across the UK and internationally on public health nurses’ clinical practice in the recognition of children and their families in need of help.  This programme of research has helped to unpack the distinctive contribution of public health nursing in safeguarding and child protection work.   Jane's current research interests include:

• Safeguarding children and child protection
• Professional assessment in public health nursing
• Health visiting practice
• Children and young people's emotional health and wellbeing
• Parenting
• Childhood overweight and obesity

Research group membership

Jane is a member of OxINMAHR - the Oxford Institute of Nursing and Midwifery and Allied Health Research. 

She leads the Faculty Children and Families Research Group and is co-Lead of the cross University Children and Young People Research Network

Externally Jane is an expert nurse member (and vice chair) of Coventry and Warwickshire Research Ethics Committee (NRES). She is a member of the NIHR HS&DR Grant Panel, a review panel member of the HEE/NIHR/NHS Clinical Doctorate Research Fellowship Scheme and the NIHR Pre-doctoral Local Authority (PLAF) scheme.

She is also a Visiting Professor and Member of the Children’s and Young People’s Health in Social Context CYPHiSCO, Faculty of Health Sciences, Kristianstad University, Sweden.

Research grants and awards

Current Research Grants

• Appleton J.V., Aveyard H, Mumby-Croft, K. and Malone M. A synthesis of the evidence for effective parenting support.Public Health England. (Principal Investigator)
• Malone M., Watson E, Appleton J.V., Brett J., Henshall C. et al. Investigating how nurse education prior to and during Covid prepares nurses for the pandemic: an analysis of what works. UKRI/ESRC/COVID- 2020-2022. (Co-investigator)
• Appleton J.V. (PI) Think Baby - Take 2. Oxford Brookes University Central Research Fund. Research Excellence Award.  (Start 2021-2022). (Principal investigator)
• Paavilainen E., Appleton J.V., Baldacchino A. et al. “ERICA-Stopping Child Maltreatment through Pan-European Multiprofessional Training Programme: Early Child Protection Work with Families at Risk”. (RDAP-GBW-AG-2018-2 Domestic violence/European Commission). 2019-2021. (Lead investigator in England, UK).
• Alwan N., Smith D., Roderick P., Vassilev I., Slater K., Appleton J.V. et al…. Combining individual and area-based measures of disadvantage for risk stratification and intervention to improve health in Wessex’s young families: The Wessex FRIEND Toolbox (Family Risk IdEntificatioN and Decision). 2019- Sept. 2021. NIHR ARC Wessex.  (Co-investigator)
• Burch K, Moultrie K, Kerslake A, Daru J, Green C, Sharpe M, Taylor V, Appleton J.V. (2017) Evaluation of the Adoption Support Fund. DfE. 2018-2021. 

Books

• Appleton J, Ed., Child Protection, Public Health and Nursing, Dunedin Academic Press. (2015)
  ISBN: 9781780460451
  
• Walliman N, Appleton J V, Your Undergraduate Dissertation in Health and Social Care, SAGE (2009)
  ISBN: 9781847870704
  Abstract Your Undergraduate Dissertation in Health and Social Care provides a practical step-by-step guide to both the theoretical and practical aspects of the process of doing an undergraduate dissertation, equipping the reader with all the skills necessary to plan, conduct and write up a research project successfully. This is a revised edition of Nicholas Walliman's best-selling Your Undergraduate Dissertation, which has been specially tailored to the needs of those studying health, social care and related subjects. All the central topics are covered, with comprehensive information and guidance on crucial issues such as ethics, research governance and appraising the quality of the evidence. Relevant 'real life' examples are also included, drawn from a wide range of settings. This guide offers a genuinely accessible and supportive source of advice that will be welcomed by undergraduates in working towards their final year dissertation in health and social care. Website 
• Appleton J V, Cowley S, The search for health needs: health visiting research for practice, Palgrave Macmillan (1999)
  ISBN: 9780333721445
  Abstract 'The search for health needs' was first identified in the 1970s as a key principle that informs and underpins the practice of health visiting. This book draws together pertinent research in this area, and presents it in such a way as to draw out the practical implications. The aim is to further good practice from an informed and evidence-based perspective.

Journal articles

• Bekaert S, Bachi B, Cioni RM, Crocamo C, Paavilainen E, Scheke H, Baldeccino A, Jouet E, Zablocka-Zytka L, Carra G, Bartoli F, Appleton JV, 'Family members’ experiences with child protection services, a metasynthesis of the literature'
  Children and Youth Services Review 128 (2021)
  ISSN: 0190-7409 eISSN: 1873-7765
  Abstract

  This metasynthesis brings together what is known about family members’ perspectives of their relationship with social care practitioners as a starting point for developing a pan-European training resource for practitioners.  Four databases were searched for qualitative literature with search terms relating to family members and social care practitioners. After the application of inclusion and exclusion criteria, 35 studies were critically appraised and were included in the metasynthesis. Three broad themes were identified through a thematic analysis of the studies’ findings: family members’ perspectives of the system; perceptions of how they were viewed by their worker; and view of their worker.  The following aspects are discussed: whether partnership between family and worker is possible within a legal framework; the detrimental effects of cultural bias; and practical foundations for building trust.  Recommendations are made for practical support, reflection on cultural practice and broader service provision.

  Website 
• Whittaker K, Appleton J.V., Peckover, S. and Adams C. , 'Organising health visiting services in the UK: Frontline perspectives.'
  Journal of Health Visiting 9 (2) (2021) pp.68-75
  ISSN: 2050-8719 eISSN: 2052-2908
  Abstract

  The organisation of health visitor work is an important part of service design, which can have an impact on when and where services are provided and who gains access. This article reports a 2018 survey of UK health visitors conducted to provide an overview of the range of ways in which health visitor cases and workloads are organised. The 584 respondents confirmed the operation of three broad types of health visitor service delivery models; namely, the individual case, the corporate case and the combination model. Themes that emerged from practitioners' experiences of working with the different models reflected concerns about continuity and staffing, accommodating different needs and different services in different places. Overall, the data indicated a lack of consistency in health visitor service across the UK. The advantages and disadvantages of each workload model are detailed and considered with respect to markers of a quality service, including achieving relationships with clients and sufficient communication within and across teams.
  

  Website 
• Appleton JV, Sidebotham P, 'Editorial: Child protection work: "How can we make it a better experience?"'
  Child Abuse Review 29 (6) (2020) pp.499-504
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton JV, Sidebotham P, 'Editorial: Safeguarding children and young people during the Covid-19 pandemic'
  Child Abuse Review 29 (4) (2020) pp.303-309
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Bosley H, Appleton J, Henshall C, Jackson D, 'The influence of perceived accessibility and expertise of healthcare professionals, and service austerity, on mothers’ decision making'
  Health and Social Care in the Community x (2020)
  ISSN: 0966-0410 eISSN: 1365-2524
  Abstract

  Mothers often make key decisions regarding their children's health. They hold core beliefs and attitudes towards healthcare providers, relying on healthcare services to provide support, advice and reassurance. It is crucial that health providers form authentic relationships with families with young children, in order to effectively provide healthcare, support and information as needed. In this paper, we explore mothers' views on the accessibility and expertise of healthcare professionals caring for their child's health. A case study, using a geographic post code as the case boundary was used. Focus groups and semistructured interviews with mothers of children aged under five years old were conducted. Participants (n = 33) were recruited from local playgroups and six focus groups (19 participants) and 14 individual interviews were conducted. Qualitative data were analysed using thematic analysis. General Practice (including general practitioners [GPs] and practice nurses) was considered to be the preferred option when seeking timely healthcare advice and information. Participant mothers were open to accessing professional advice concerning their child's health, from a range of health professionals and understood the role and potential contribution of various health professionals. However, some factors, influenced mothers' decision-making. These were captured in three themes: maternal perceptions of GPs as accessible experts; practice nurses as approachable and reassuring sources of advice; and difficulty in accessing health visiting services primarily due to service funding cuts. Further investment in primary care services, including expansion of the practice nurse role and an increase in health visiting service provision, may help to provide sufficient support for mothers seeking healthcare advice. In addition, healthcare service strategies, which engage with mothers and ensure nurses are recognised as knowledgeable, accessible, supportive and a suitable alternative to GPs, would be beneficial.
  

  Website 
• Harding L, Bekaert S, Appleton JV, 'Exploring the challenges of using electronic health record systems in nursing research'
  Nurse Researcher 28 (1) (2020)
  ISSN: 1351-5578 eISSN: 2047-8992
  Abstract

  Background: Electronic Health Records (EHR) provide an interesting potential data set for nursing research but can present challenges for data collection and data quality, as health care IT systems are often not designed with research in mind. 
  
  Aim: To present an example of data collection using Electronic Health Records (EHR), conducted as part of a research study into the role of the school nurse in child protection.  
  
  Methods: Descriptive analysis of quantitative, secondary data.
  
  Discussion: Data were successfully obtained from Electronic Health Records (EHR) to understand school nursing caseloads and interventions with vulnerable children and young people. Major limitations included variances in record systems, such as different ‘labels’ used for interventions. These limitations were addressed during data collection by reviewing organisational record keeping guidance and a working knowledge of the different EHR systems. 
  
  Conclusion: Conducting research using Electronic Health Records (EHR) has provided important learning about the potential of this type of data and the promise it holds for future research. 
  
  Implications for Practice: Organisations who wish to engage in research using existing data might consider embedding pathways for data collection that are easy for potential researchers to navigate. Electronic Clinical Record (EHR) systems need to be sensitive for research, but not at the expense of efficiency in clinical practice. 
  

  Website 
• Appleton JV, Sidebotham P, 'Editorial: Driving improvements in child protection and safeguarding practice'
  Child Abuse Review 29 (1) (2020)
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Cook G, Appleton JV, Wiggs L, 'Parentally reported barriers to seeking help and advice for child sleep from healthcare professionals'
  Child: Care, Health and Development 46 (4) (2020) pp.513-521
  ISSN: 0305-1862 eISSN: 1365-2214
  Abstract

  Background. Healthcare professionals (HCPs), largely doctors, paediatricians, health visitors, midwives, and practice nurses, are in a good position to provide information, help, advice, or guidance to parents for child sleep. However, evidence suggests that there is a gap between the number of parents who desire assistance from HCPs and those that make use of these sources, yet very little is known about the reason for this apparent disparity. The aim of this study was to understand the barriers reported by parents to consulting HCPs about child sleep. 
  Method. In this study, 266 U.K.-based parents of children aged 6–36 months old completed an online questionnaire (between October 2015 and October 2016) about their help-seeking behaviours in relation to child sleep. This included reporting perceived barriers to consulting HCPs for child sleep information and advice about problems. 
  Results. Thematic analysis highlighted five themes, which parents reported acted as barriers to them consulting HCPs. Specifically, parents perceived HCPs to have a lack of knowledge or training around the topic of child sleep and that advice would be limited in terms of breadth of information or management options that would be offered. Parents were also concerned about wasting their own or HCPs' time, perceived there was a lack of continuity in the information they received, and held concerns about possible negative consequences for their family if they shared details about any child sleep difficulties. 
  Conclusions. Possible practical approaches to address the barriers reported by parents are highlighted. This includes improving training around the topic of child sleep for HCPs and adapting the content or manner in which the topic of child sleep and any associated issues are addressed with parents.

  Website 
• Appleton JV, Sidebotham P, 'Editorial: The Burden of Maltreatment-related Child Deaths.'
  Child Abuse Review 28 (5) (2019) pp.315-320
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Harcourt K, Hunter L, Appleton JV, Clegg M, 'The influence of social relationships on men's weight'
  Journal of Nutrition Education and Behavior 52 (2) (2019) pp.106-113
  ISSN: 1499-4046
  Abstract

  There is a clear link between the development of obesity with poor diet and exercise behaviours. In the UK, excess weight is more prevalent among men than women: 41% of men and 31% of women are classed as overweight (BMI 25.0 -29.9 kg/m2); 68% and 58% of men and women respectively are overweight or obese (BMI≥ 25 kg/m2). An increase in BMI is also associated with a greater risk of mortality in men than in women however men are under-represented in lifestyle interventions for weight loss: In 2016, 7% of Slimming World members were men. It has been argued that men may perceive larger bodies to be more masculine and more desirable to women. Furthermore, factors contributing to male obesity such as eating large portions and consuming large volumes of alcohol, can be viewed as quintessentially masculine behaviours.

  To promote weight loss and reduce obesity among men, it is useful to understand which social interactions influence male weight loss behaviours. It is known that men in heterosexual relationships often gain weight after getting married, however the extent of women’s influence on men’s food intake and weight is unclear. Research studies investigating the influence that women and female partners have on male dietary and weight loss have been mixed; while some suggests they have a positive impact, other research suggests the impact is mixed or negative. Friends, peers and colleagues are also referenced regarding men’s diet and physical activity behaviours and behavioural intentions. The qualitative literature in the UK which explores how social relationships influence men’s weight and weight-related behaviours is, however, limited, therefore this research study sought to address this literature gap. The primary research question was to explore men’s perceptions and attitudes of dietary and physical activity behaviours in relation to weight and weight management.

  Website 
• Lowenhoff C, Davison-Fischer J, Pike N, Appleton JV, 'Using the TIDieR checklist to describe health visitor support for mothers with mental health problems: analysis of a cross-sectional survey'
  Health and Social Care in the Community 27 (5) (2019) pp.e824-e836
  ISSN: 0966-0410 eISSN: 1365-2524
  Abstract

  At least half of the 20% of mothers who experience mental health problems (MHPs) during pregnancy or after birth are not receiving the help they need that will lead to recovery. In order to identify where improvements need to be made, it is necessary to describe exactly what is being done and the barriers and facilitators that compromise or enhance optimal care. The majority of mothers experience mild to moderate anxiety or depression. The expectation is that primary care professionals, such as health visitors (HVs), can provide the support they need that will lead to recovery. The aim of this study was to explore the views of HVs regarding the content and purpose of an intervention to support mothers with MHPs, described as ‘listening visits’ (LVs). A link to an online survey was offered to the members and champions of the Institute of Health Visiting (n = 9,474) March–May 2016. The survey was completed by 1,599 (17%) of the target population, of whom 85% were offering LVs. The Template for Intervention Description and Replication (TIDieR) checklist was used to provide a framework to describe commonalities and variations in practice. There appeared to be a shared understanding of the rationale for LVs but a lack of agreement about what the intervention should be called, the techniques that should be used and the duration, frequency and expected outcomes of the intervention. Contextual factors such as staff shortages; conflicting priorities; the needs and circumstances of mothers; the capability and motivation of HVs; inadequate training and supervision; and the absence of clear guidance contributed to variations in perceptions and practice. There are many ways in which the HV contribution to the assessment and management of mothers with MHPs could be improved. The intervention delivered by HVs needs to be more clearly articulated. The contextual factors influencing competent and consistent practice also need to be addressed.
  

  Website 
• Appleton JV, 'Editorial: Professional Knowledge, Skills and Beliefs in Safeguarding Children and Young People.'
  Child Abuse Review 28 (2) (2019) pp.91-97
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Peckover S, Appleton JV, 'Health visiting and safeguarding children: a perfect storm?'
  Journal of Health Visiting 7 (5) (2019)
  ISSN: 2050-8719
  Abstract

  Health visitors play an important role in safeguarding and protecting children. In this paper we review current research evidence and professional literature about this aspect of health visiting  and highlight some of the practice challenges in undertaking this work.  Three critical issues are discussed. The invisibility and unquestioned nature of much health visiting safeguarding work; that health visitors with their clinical expertise and accepted home visiting role are well placed to undertake this type of work; and the challenges of ensuring effective safeguarding within the context of economic austerity.  The paper highlights the important contribution of contemporary health visiting to safeguarding children and child protection.  It is important that this role is made explicit to those commissioning health visiting services for children in the early years.

  Website 
• Hyslop J, Aveyard H, Abreu G, Appleton JV, 'How do peer networks support people with personal budgets? A review of the research evidence from the UK'
  Disability and Society 35 (1) (2019) pp.25-51
  ISSN: 0968-7599 eISSN: 1360-0508
  Abstract

  This literature review was conducted to describe the range of organisations and informal groups providing peer support to personal budget users in the UK between the launch of direct payments in 1997 and 2016. Forty-five research reports included relevant evidence. This has been aggregated to show how peer networks supported individual users, as well as to describe their wider role in policy development and implementation. Despite their diversity, the support they provided often had common characteristics. Peer networks fostered collaboration, enhanced communication, built confidence amongst people who were entitled to a personal budget, and applied specialist knowledge that was often derived from the lived experience of network members. None of these characteristic was exclusive to peer networks. However, they may have been more deeply culturally embedded here than in other settings, which perhaps accounts for the positive experiences of support reported in the research literature.
  

  Website 
• Harding L, Davison-Fischer J, Bekeart S, Appleton JV, 'The Role of the School Nurse in Protecting Children and Young People from Maltreatment: An Integrative Review of the Literature'
  International Journal of Nursing Studies 92 (2019) pp.60-72
  ISSN: 0020-7489 eISSN: 1873-491X
  Abstract

  Objectives. This review aims to describe the role of the school nurse in protecting children and young people from maltreatment by examining the international literature. Child maltreatment is a prevalent issue in global society today and includes physical, emotional and sexual abuse, neglect and exploitation. School nurses are ideally placed to identify and work with children and young people who are at risk of maltreatment through their regular contact with the school community. Design. Integrative literature review incorporating thematic analysis. Data Sources. Electronic databases British Nursing Database, Cumulative Index of Nursing and Allied Health Literature, Medline, PsycInfo, Cochrane Library Database for Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL). Search Terms: Role, School Nurse, Child Maltreatment. Review Methods. Initial title and abstract review of 444 studies resulted in 78 studies for full text review. Additional search strategies identified one relevant study. Inclusion and exclusion criteria were employed as follows; (1) study published in the English language, (2) peer-reviewed, (3) primary research, (4) inclusion of school nurses (or equivalent role internationally) in the study sample, and (5) a focus on the role of school nurses in preventing child maltreatment. Studies were appraised using the Critical Appraisal Skills Programme tool for qualitative studies and the Strengthening the Reporting of Observational Studies in Epidemiology checklist for mixed-methods and quantitative studies. Findings from the studies were identified, summarised and organised into a summary table, before being analysed thematically. Results. 21 studies met inclusion and quality criteria and were included in the review. Key themes that emerged from the analysis were; supporting the child and family, detective work, working with other professionals, training and supervision, barriers to protecting children and young people from maltreatment and trust. Conclusion. International literature highlights the variety of activities that school nurses may undertake in daily practice to protect children and young people from maltreatment. Several challenges to this role are identified, including time management and building relationships with children and young people. Recommendations for practice and further research are made.

  Website 
• Bosley H, Appleton JV, Henshall C, Jackson D, 'Using local communities to establish geographical boundaries for case studies'
  Nurse Researcher 27 (1) (2018)
  ISSN: 1351-5578 eISSN: 2047-8992
  Abstract
  Aim: To discuss using local communities to establish geographical boundaries in a case study approach.
  Background: Case study is widely used in the social sciences to explore complex phenomena within a real-life setting. Applying case boundaries is vital to ensure cases are easily identifiable and similar enough to be treated as instances of the same phenomenon. Discussion: Post codes can be used to define geographical boundaries. A broad range of statistical data is collected from these populations including demographic information, which can assist in identifying communities that have issues or characteristics which may benefit from further research. Data collection from communities allows researchers to access appropriate populations. Conclusion: Using local communities to identify case boundaries helps to provide a clear periphery to the case, and generate local solutions to local problems. Implications for research/practice: Researchers using this approach benefit from being able to immerse themselves in the local community. This close engagement helps to ensure local community engagement with research projects and findings. 
  Website 
• Appleton JV, 'Missed outpatient appointments and unplanned healthcare: the real question is "why?"'
  Developmental Medicine and Child Neurology 61 (7) (2018)
  ISSN: 0012-1622 eISSN: 1469-8749
  Website 
• Appleton JV, Sidebotham P, 'Editorial: Promoting Best Practice in Assessment and Intervention: The Challenges of Working in Times of Cutbacks and Change'
  Child Abuse Review 27 (2) (2018) pp.91-96
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Helen Bosley, Catherine Henshall, Jane V. Appleton, Debra Jackson, 'A systematic review to explore influences on parental attitudes towards antibiotic prescribing in children'
  Journal of Clinical Nursing 27 (5/6) (2018) pp.892-905
  ISSN: 0962-1067 eISSN: 1365-2702
  Abstract Aim: To understand the factors influencing parental attitudes towards antibiotic prescribing.
  
  Background: Overuse of antibiotics and inappropriate prescribing has resulted in rapid development of antimicrobial resistance (AMR), and is significant global threat to patient safety. In Primary Care settings, substantial numbers of antibiotics are prescribed for young children, despite viral nature of illness for which antibiotics are ineffective. Parents, play a vital role in decision making regarding accessing healthcare services and requesting treatment for their children.
  
  Design: A systematic review was conducted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement (Moher et al 2015).
  Methods. The CINAHL, MEDLINE, PsycINFO, The Cochrane Library, BRITISH NURSING INDEX, EMBASE and PUBMED databases were searched for primary research published between 2006-16. All types of primary research were searched and screened against inclusion criteria. The Critical Appraisal Skills Programme tool was used to appraise identified publications. Quantitative data was summarised descriptively and qualitative data was thematically analysed.
  
  Results: A total of 515 publications were initially screened, and 55 full-text articles were eligibility assessed. Twenty papers met inclusion criteria. Four main themes were identified: the quality of relationships with health care providers, dealing with conflicting messages, rationalising antibiotic use and parental practices informed by past experience.
  
  Conclusion: Parents wanted reassurance and advice regarding children's illnesses, had poor antibiotic knowledge and were influenced by personal past experiences. More accessible education, including simple information leaflets, is required. Further research on the influence of culture, ethnicity and socio- economic factors would be beneficial.
  
  Relevance to clinical practice:  Health care professionals must provide adequate time for reassurance and explanations of decision making. Easy to read information regarding appropriate antibiotic usage should be easily accessible for parents.Website 
• Appleton JV, Sidebotham P, 'Editorial: Physical Abuse of Children'
  Child Abuse Review 26 (6) (2017) pp.405-410
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Bradbury-Jones C, Appleton J, Clark M, Paavilainen E, 'A Profile of Gender-based Violence Research in Europe: Findings from a Focused Mapping Review and Synthesis'
  Trauma, Violence, and Abuse 20 (4) (2017) pp.470-483
  ISSN: 1524-8380 eISSN: 1552-8324
  Abstract

  This article reports the findings from a new form of review: a focused mapping review and synthesis. The aim was to create a contemporary, snapshot profile of the nature and scope of gender-based violence (GBV) studies conducted in Europe. GBV is one of the most prevalent human rights violations in the world affecting mainly women and girls. The policy context of GBV in Europe has gathered momentum in recent years, but we do not have a clear picture of how this relates to research activity. Thirteen journals were purposively selected on their likelihood to publish GBV research. All articles published in these journals during 2015 and meeting our inclusion criteria were retrieved. Data were extracted according to (1) types of methodologies used, (2) geographical location of research, and (3) patterns of research activity/interest. Thirty-two articles met the inclusion criteria. Many titles and abstracts were not explicit about the gendered nature of the research which made retrieval and analysis difficult. A range of methodologies were reported, with single-country research conducted more than international collaborations. Intimate partner violence and sexual abuse attracted most research interest. No studies explored female genital mutilation/cutting and only one investigated early and forced marriage. The findings have implications regarding GBV research in Europe, and we explore them in relation to relevant European policy. Researchers can help raise the profile of the gendered nature of most violence-related research by being explicit about this in their publications. Increasing opportunities for cross-national research will help address the global nature of GBV. Tackling GBV requires synergy of empirical evidence and policy to drive the agenda.
  

  Website 
• Lowenhoff C, Appleton JV, Davison-Fischer J, Pike N, 'NICE guideline for antenatal and postnatal mental health: the health visitor role'
  Journal of Health Visiting 5 (6) (2017) pp.290-298
  ISSN: 2050-8719
  Abstract When the NICE guideline for antenatal and postnatal mental health was updated in December 2014, the intervention delivered by health visitors, described as ‘listening visits’, was not included in the recommendations as one of a number of possible, evidence-based options of support. Maternal mental health is one of the six high impact areas designated as a fundamental component of health visiting practice. This review demonstrates how health visitors are uniquely placed to fulfill many of the recommendations in the updated NICE guideline and have a pivotal part to play in prevention, early identification, prompt treatment and improved outcomes for mothers, their partners and their babies. The review also highlights the challenges of delivering the recommended levels of perinatal mental health information, advice and support amidst budget cuts, reorganization of services and conflicting policy priorities.Website 
• Appleton JV, Sidebotham P, 'Editorial: Was not brought : Take note! Think child! Take action!'
  Child Abuse Review 26 (3) (2017) pp.165-171
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton JV, Sidebotham P, 'Editorial: Violence and abuse in children’s lives'
  Child Abuse Review 26 (1) (2017) pp.3-7
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J, 'Editorial: Children and Families and the Care System'
  Child Abuse Review 25 (4) (2016) pp.247-250
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Enser BJ, Appleton JV, Foxcroft DR, 'Alcohol-Related Collateral Harm, the unseen dimension? Survey of students aged 16-24 in Southern England'
  Drugs: Education, Prevention, and Policy 24 (1) (2016) pp.40-48
  ISSN: 0968-7637
  Abstract Aim: To ascertain young adults’ experience of alcohol-related collateral harm (ARC harm). Methods: An on-line survey collected quantitative and qualitative data from a convenience sample of students (N=450) aged 16-24 in Southern England.  Questions and analyses focused on harms they had experienced as a result of alcohol consumption by other people in their family or social circle.  
  
  
  Findings:  64% of participants experienced ARC harm, including 50% of non-drinkers.  In logistic regression analysis, ARC harms were associated with being female (OR=1.62, 95% CI 1.01-2.62) family members who drank every day (OR=2.65, 95% CI 1.49-4.69) being influenced by others’ drinking (OR=2.03, 95% CI 1.32-3.10) being older (OR=2.61 95% CI 1.57-4.34).  No significant associations were found with high or low self-reported levels of alcohol consumption. Using qualitative descriptors, the ARC harms reported were classified into a novel taxonomy comprising eight categories: Nuisance/frustration/exasperation, Tolerance/adjustment/accommodation, Pressure into unwanted situations, Unsought/inappropriate responsibility, Psychological harm; Physical harm/acute risk of physical harm, Relationship harm, and Undisclosed harm.
   
  Conclusions: A high level of ARC harm was reported and experience of ARC harm was linked to several predictors.  Further work is required to validate the proposed taxonomy, and to promote consideration of the phenomenon of ARC harm in alcohol policy.
   
  Website 
• Perryman SM, Appleton J, 'Male victims of domestic abuse: implications for health visiting practice'
  Journal of Research in Nursing 21 (5-6) (2016) pp.386-414
  ISSN: 1744-9871
  Abstract Domestic abuse is a significant public health issue globally. Although it is recognised that both sexes may be victims of domestic abuse, the phenomenon is commonly understood from the perspective of male to female violence, supported by a substantial body of research and policy focusing on female victims of domestic abuse. However, evidence shows that significant numbers of men are victims of female-perpetrated violence, but as the issue is under-explored, the extent and effects of abuse are poorly understood. For health visitors working within communities in the United Kingdom, knowledge of all aspects of domestic abuse is vital in the delivery of evidence-based practice. A systematically conducted critical literature review aimed at establishing the current body of knowledge on male victims of domestic abuse was undertaken, and implications for health visiting practice considered. Nineteen primary research studies were included in the review. A thematic analysis identified four themes: ‘violent relationship’, ‘harms and behaviours’, ‘risk’ and ‘seeking help’. Results show that men reported being victims of female-perpetrated physical, emotional, psychological and sexual abuse, with some experiencing severe aggression, control and fear. Health visitors have an important role to play in influencing policy and in practice addressing the health and social care needs of male victims of domestic abuse and their families.Website 
• Appleton J, Powell C, Coombes L, 'Children's missed healthcare appointments: professional and organisational responses'
  Archives of Disease in Childhood 101 (9) (2016) pp.814-818
  ISSN: 0003-9888
  Abstract Aim. This National Society for the Prevention of Cruelty to Children (NSPCC) funded UK study sought to examine organisational and professional responses to children's missed healthcare appointments.
   
  Design/methods. The study comprised two parts: phase I was a web-based scoping and systematic analysis of UK National Health Service healthcare organisations' internal policies on missed appointments. Phase II involved a case study of how missed appointments were managed within one hospital trust, including interviews with hospital-based staff, review of organisational data and examination of policies and ‘systems’ in place.
   
  Results Policies. accessed were of variable quality when benchmarked against a predetermined set of evidence-based standards. Additional material (eg, board minutes) gleaned through the searches found an apparent disconnect between nationally determined safeguarding requirements and strategies to reduce the cost pressures arising from missed appointments. Findings from the case study included the continuing use of the adult-centric term ‘did not attend’ (DNA), the challenges that may be inherent in attending appointments (with concomitant sympathy for parents) and a need to further explore general practitioner responses to DNA notifications, particularly given the acknowledged association between missed appointments and child maltreatment.
   
  Conclusions. The web-based scoping exercise yielded a small number of organisational policies. These were of variable quality when rated against predetermined standards. Other material gathered through the search strategy found evidence that ‘missed appointment’ strategies aimed at reducing costs did not always acknowledge the discrete needs of children. The case study findings contribute to an understanding of the complexities and challenges of responding to a missed appointment and the importance of taking a child-centred approach.
  Website 
• Bradbury-Jones C, Appleton JV, Watts S, 'Recognising and responding to domestic abuse: the role of public health nurses'
  Community Practitioner 89 (3) (2016) pp.24-28
  ISSN: 1462-2815
  
• Appleton JV, 'Editorial: Working Alongside One Another'
  Child Abuse Review 24 (5) (2015) pp.313-316
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton JV, Terlektsi E, Coombes L, 'Implementing the Strengthening Families approach to Child Protection Conferences'
  British Journal of Social Work 45 (5) (2015) pp.1395-1414
  ISSN: 0045-3102 eISSN: 1468-263X
  Abstract

  The Strengthening Families (SF) child protection conference model attempts to address some of the weaknesses of traditional conferences by helping families participate more easily and by enhancing risk assessment. This study examined the impact and feasibility of implementing the SF model across one local authority. A mixed-methods design was adopted. Data collection included: semi-structured interviews with professionals and parents; non-participant observation of SF and traditional conferences; and anonymised child protection plans. Interviews and observation data were analysed thematically using NVivo8 software. Study findings indicated problems with the roll-out of training for the SF approach, yet model fidelity was largely adhered to during SF conferences. Most professionals reported initial child protection conferences (ICPCs) to be working well and they were perceived as constructive places for addressing child protection issues. While the majority of parents described their pre-conference preparation as good, many still felt disempowered by the child protection process. Thought is needed about how to tackle the perception amongst families that they are judged and that they are powerless during the ICPC process, particularly as our observations of SF conferences revealed that parents were active in their contributions to meetings.

  Website 
• Roe MFE, Appleton JV, Powell C, 'Why was this child not brought?'
  Archives of Disease in Childhood 100 (6) (2015) pp.511-512
  ISSN: 1468-2044
  Abstract EditorialWebsite 
• Moffat P, Appleton JV, 'Getting Published in Community Practitioner'
  Community Practitioner 88 (1) (2015) pp.16-18
  ISSN: 1462-2815
  Abstract

  Writing for publication is a good way of being part of a forum and a community where you can reach people you may not normally get the chance to speak to. Polly Moffat and Jane Appleton explain how to share your thoughts with colleagues in the form of a journal article, to inspire others and challenge them to learn from your experiences.

• Appleton JV, Sidebotham P, 'Editorial: The Child at the Centre of Care'
  Child Abuse Review 24 (2) (2015) pp.77-81
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton JV, 'Editorial: Child Sexual Exploitation, Victimisation and Vulnerability'
  Child Abuse Review 23 (3) (2014) pp.155-158
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Sidebotham P, Appleton JV, 'Editorial: From 2014 to 2015 and Beyond: Using Evidence to promote the protection of Children Worldwide.'
  Child Abuse Review 23 (1) (2014) pp.1-4
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton JV, Sidebotham P, 'Editorial: Children Looked After'
  Child Abuse Review 23 (6) (2014) pp.383-386
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton JV, Harris M, Kelly C, Huppe I, '‘Think Baby’: online learning for student health visitors'
  Community Practitioner 87 (6) (2014) pp.20-23
  ISSN: 1462-2815
  Abstract 'Think Baby' is an innovative online learning resource which has been developed to help student health visitors (and other specialist community public health nurses) build their skills in observing and assessing mother-infant interactions. The project's development and pilot work was funded by a small grant from the Higher Education Academy. It builds on the findings of the team's previous research, which found health visitors' initial training had left them ill-prepared to assess the intricacies of mother-infant relationships. The 'Think Baby' project sought to develop online training resources for student health visitors using video footage of mothers and babies to illustrate different types of interactions. A small group of student health visitors were engaged in reviewing and evaluating the materials and considering their acceptability. Once developed, the materials were piloted with student health visitors from three universities, community practice teachers and a health visitor academic, and they were then adapted for wider roll out. 'Think Baby' enables student health visitors to develop their core skills in assessment, which is really important in identifying when early help and support are needed for mothers and infants.
• Appleton JV, Coombes L, Terlektsi E, 'The use of sociograms to explore collaboration in Child Protection Conferences'
  Children and Youth Services Review 35 (12) (2013) pp.2140-2146
  ISSN: 0190-7409
  Abstract The Strengthening Families child protection conference model attempts to empower parents' participation in conferences and to enhance collaboration between conference participants. This paper, which is part of a broader study looking at the implementation of the Strengthening Families model across a county council in England, UK, explored the use of ‘power’ and ‘mutual interaction’ in both traditional and Strengthening Families child protection conferences. Data was collected using sociograms which were recorded during observations of the two types of conferences. Sociograms were analysed in order to identify patterns in terms of ‘power’ and ‘communication’ together with the use of the ‘group cohesion index’ which enabled us to draw conclusions about the degree of interaction between conference participants.
   
  Findings indicated a difference between the use of power in traditional and Strengthening Families conferences. In traditional conferences the power was mostly static (held by the chair), and in the Strengthening Families conferences power was shifted from the leader of the collaboration (chair) to the people who administer the collaboration (conference participants). Also, in the Strengthening Families model more interaction between conference participants and better group coherence were evident; however, in both types of conference communication was limited between the professionals. Sociograms proved a useful method for exploring group dynamics in the context of child protection conferences. It is suggested that a broader understanding of the underpinning principles of the Strengthening Families model is needed to successfully empower parents' participation in conferences and to enhance collaboration between conference participants.
  Website 
• Appleton JV, 'Editorial: Child Maltreatment: International and Legal Issues.'
  Child Abuse Review 22 (6) (2013) pp.381-385
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Kendall S, Bloomfield L, Appleton J, Kitaoka K, Petrie J, 'Efficacy of a group-based parenting program on stress and self-efficacy among Japanese mothers: A quasi-experimental study'
  Nursing and Health Sciences 15 (4) (2013) pp.454-460
  ISSN: 1442-2018
  Abstract Early child development and the impact of parenting on later life are of global concern. The rise in child abuse and maltreatment in Japan suggests that measures to increase self-efficacy and reduce stress would benefit Japanese parents. In this study, we explored if Japanese parents attending a 123Magic parenting program reported reduced stress and enhanced self-efficacy. Questionnaire data were collected from 49 mothers attending a parenting program conducted in public nursery schools in one prefecture in Japan. There were significant changes in parenting self-efficacy scores (P < 0.001) and parenting stress scores (P < 0.01). Focus groups with 16 parents also found that there were benefits to parents in terms of increased confidence and less stress. The findings provide support for the role of public health nurses in delivering group-based parenting support in Japan.Website 
• Appleton JV, 'Editorial: Safeguarding in Education'
  Child Abuse Review 22 (2) (2013) pp.75-79
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J V, Harris M, Oates J, Kelly, C , 'Evaluating health visitor assessments of mother-infant interactions: a mixed methods study'
  International Journal of Nursing Studies 50 (1) (2013) pp.5-15
  ISSN: 0020-7489
  Abstract Settings
  Two universities and two primary care trusts.
  Participant
  In Phase One 17 first-time mothers and their 6- to 16-week-old infants were recruited. In Phase Two, a sample of 12 health visitors participated.
  Methods
  The study incorporated two data collection phases. In Phase One, each mother's interaction with her baby was video-recorded for 20min in an observation laboratory. The video-recordings were coded and resultant data were analysed to derive a number of quantitative measures of interaction quality, including mothers' responsiveness and sensitivity to their infants as rated by the Global Ratings Scales (GRS) of Mother-Infant Interaction. In Phase Two, 12 health visitors rated and assessed 9 clips of the video-recorded mother-infant interactions. The rationales for their ratings were then explored through in-depth interviews. Health visitor ratings of the video clips were compared to the GRS ratings. The relationship between the main focus of each health visitor rating, as reported in the interview, and the consistency of ratings with the GRS ratings were then investigated.
  Results
  Correlations between individual health visitors' ratings and the GRS ratings ranged from .17 to .83 and were statistically significant in only four cases. There was a weak relationship with health visitors' years of experience (rs=.47, NS). When explaining their judgements, health visitors tended to comment on the mother's behaviours or the relationship between the mother and baby and often ignored the behaviour of the baby. There was a highly significant relationship between the consistency of health visitor/GRS ratings and the number of references to the baby in the health visitors' explanations (rs=.75, p=.005).
  Conclusion
  This study contributes to the understanding of how health visitors make assessments of mother-infant interactions. The frequent lack of attention and reference to the baby's behaviour suggests an area for further training.Website 
• Appleton J, 'Editorial: Perspectives of Neglect'
  Child Abuse Review 21 (2) (2012) pp.77-80
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J V, 'Delivering safeguarding children services in primary care: responding to national child protection policy.'
  Primary Health Care Research & Development 13 (1) (2012) pp.60-71
  ISSN: 1463-4236
  Abstract AIM: This study set out to examine how Primary Care Organisations (PCOs) in England manage, organise and deliver their safeguarding children responsibilities.BACKGROUND: In the light of changing organisational configurations across primary care, a wealth of policy directives and a climate of extensive media attention around child protection, this paper focuses on how PCOs respond to national policy and deliver safeguarding children services.METHOD: This study, based in England, United Kingdom (UK), used a telephone survey method incorporating semi-structured qualitative interviews with Designated Child Protection Nurses. A maximum variation sampling strategy was used to identify two to three PCOs within each of the original 28 Strategic Health Authority sites. From the 64 PCOs approached, 60 Designated Nurses or their representatives agreed to participate in the research, with a response rate of 94%. Data analysis was informed primarily by Lincoln and Guba's (1985) three stages of a) unitising, b) categorising and c) pattern search.FINDINGS: The findings outline how and to what extent PCOs respond to the national policy and organise and deliver their child protection services. The paper highlights some of the key challenges facing PCOs, in particular, safeguarding moving off the primary care agenda, child protection staff recruitment difficulties, a proliferation and overload of policy, resource implications for additional staff training, challenges to collaborative working, high referral thresholds to social care services and cutbacks in public health nursing services. This paper concludes by offering some suggestions about how child protection services could be improved as primary care faces another major reorganisation with the demise of Primary Care Trusts in April 2013.Website 
• Sidebotham P, Appleton JV, 'Editorial: Revolutions in Safeguarding?'
  Child Abuse Review 21 (1) (2012) pp.1-6
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Cowley S, Kemp L, Day C, Appleton JV, 'Research and the organization of complex provision: conceptualising health visiting services and early years programmes'
  Journal of Research in Nursing 17 (2) (2012) pp.108-124
  ISSN: 1744-9871
  Abstract This paper developed from discussions about the possible implementation and trial of an Australian maternal and early childhood sustained home visiting programme (MECSH), into a United Kingdom (UK) context. There are many similarities in services in the two countries, but some differences. To summarise and illustrate the complex and interconnected way that early years and preventive health services are specified, a diagram was developed, which provides a framework for this paper. The paper describes a health visiting service that encompasses universal, indicated and selective forms of prevention, with some embedded evidence-based programmes, forming part of a proactive and preventive service that is, itself, embedded within a wider resource system. Policy-driven terms derived from the English Health Visitor Implementation Plan have been used, but translated into the generic language of prevention (universal, indicated and selective), as a basis for future research. The place for different types of practitioner and needs of families with different levels of personal capacity or resource are also considered.
  Increased understanding about how social determinants affect the whole population across a gradient has drawn attention to the need for more universal prevention, to tackle health inequalities. The components of successful early intervention programmes are well established, but more information is needed to support universal preventive services, which are delivered in a way that is proportionate to need. This paper, including the diagram that summarises its contents, is presented to stimulate discussion as well as guide future research and service development.
  Website 
• Appleton JV, Sidebotham P, 'Editorial: Child Protection and Mental Health'
  Child Abuse Review 21 (3) (2012) pp.153-156
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Sidebotham P, Appleton JV, 'Editorial: Understanding Complex Systems of Abuse: Institutional and Ritual Abuse'
  Child Abuse Review 21 (6) (2012) pp.389-393
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Powell C, Appleton JV, 'Children and young people’s missed health care appointments: Reconceptualising ‘Did Not Attend’ to ‘Was Not Brought’ - a review of the evidence for practice.'
  Journal of Research in Nursing 17 (2) (2012) pp.181-192
  ISSN: 1744-9871
  Abstract The issue of wastage caused by missed appointments features prominently at a time when cost-saving measures become ever more important in the health care economy. Missed appointments are said to cost the NHS in the region of £600 million per annum. Various strategies are being tried and tested to ensure that people attend their appointments (or are in for domiciliary visits) including texting and phoning reminders. Clearly, attending for health care is generally in a person’s best interests. However, in the UK, if appointments are missed, then the usual outcome is a ‘three (or even two) strikes and you are out’ approach with a notification to the General Practitioner.
  In this paper we will argue that the seemingly widespread ‘Did Not Attend’ (DNA) routine described above is not appropriate where children and young people are concerned. The issue here is that the child or young person ‘Was Not Brought’ (WNB) to their appointment, rather than the fact that they DNA. This is important, because not only is access to health care their fundamental right (United Nations Convention on the Rights of the Child, 1989: Article 24), but failure to attend for health care is recognised as a child protection issue within statutory definitions of neglect. Failings in presenting children for health care is also known to feature prominently in cases that have reached the threshold for Serious Case Reviews, and this paper summarises the evidence in this respect. We conclude the paper by suggesting that reconceptualising child and young person DNA as WNB will lead to positive interventions to safeguard and promote the welfare of children that go beyond the missed appointment to a move towards the child-centric practice described in recent key reviews.
  Website 
• Coombes L, Appleton J V, Allen D, Yerrell P, 'Emotional Health and Well-being in Schools: Involving Young People'
  Children & Society (2011) pp.1-13
  ISSN: 0951-0605
  Abstract

  Prevalence studies of emotional health and well-being (EHWB) of young people indicate that that there is cause for concern. Very few studies have examined EHWB from the perspective of young people. This study examined the views of young people about their EHWB in the context of secondary education in the UK. Eight focus groups were conducted in five secondary schools with pupils in year 10 (aged 13-14). The findings suggested that whilst pupils thought some aspects of EHWB are well provided for in the school curriculum, there were problems with coherence of EHWB policy. Mental health topics were thought to be neglected in the EHWB curriculum especially in relation to self-harm. Three problems regarding talking about EHWB were identified. Firstly, the quality of EHWB lessons depended on the enthusiasm and creativity of the teacher taking the lesson. Secondly, pupils were concerned about confidentiality. Thirdly, many pupils preferred to talk to friends about EHWB issues. The findings of the study suggest a need for greater involvement of young people in the planning, implementation and evaluation of the EHWB curriculum.

  Website 
• Appleton JV, Sidebotham P, 'Editorial: Making an Impact for Children.'
  Child Abuse Review 20 (6) (2011) pp.391-394
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J, Stanley N, 'Editorial: Physical Abuse and Corporal Punishment'
  Child Abuse Review 20 (1) (2011) pp.1-5
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Coombes L, Appleton JV, Allen D, Yerrell P, 'Emotional health and well being in schools: Involving young people.'
  Children & Society 27 (3) (2011) pp.220-232
  ISSN: 0951-0605
  Abstract Prevalence studies of emotional health and well-being (EHWB) of young people indicate that that there is cause for concern. Very few studies have examined EHWB from the perspective of young people. This study examined the views of young people about their EHWB in the context of secondary education in the UK. Eight focus groups were conducted in five secondary schools with pupils in year 10 (aged 13–14). The findings suggested that whilst pupils thought some aspects of EHWB are well provided for in the school curriculum, there were problems with coherence of EHWB policy. Mental health topics were thought to be neglected in the EHWB curriculum especially in relation to self-harm. Three problems regarding talking about EHWB were identified. Firstly, the quality of EHWB lessons depended on the enthusiasm and creativity of the teacher taking the lesson. Secondly, pupils were concerned about confidentiality. Thirdly, many pupils preferred to talk to friends about EHWB issues. The findings of the study suggest a need for greater involvement of young people in the planning, implementation and evaluation of the EHWB curriculum.Website 
• Appleton JV, 'Safeguarding and protecting children: where is health visiting now?'
  Community Practitioner 84 (11) (2011) pp.21-25
  ISSN: 1462-2815
  Abstract This paper aims to reinforce the importance of a well funded health visiting service in safeguarding and protecting children. While the issues involved in safeguarding and child protection have not really changed in essence, in recent years the practice context, organisational climate and policy drivers have. This paper briefly outlines health visitors' work with children and families, reiterating the profession's track record in safeguarding and protecting children work and discussing how important the health visitor role is and how eroded it has become. The small body of research evidence in this area is discussed, current policy drivers examined and obstacles to good safeguarding practice described. Health visitors' work in child protection is important, and part of a continuum of public health activity including universal preventative work, identifying and working with vulnerable children and their families, and protecting children from abuse and neglect.
• Appleton J V, Stanley N, 'Communicating with children's social services and reporting systems: editorial'
  Child Abuse Review 19 (3) (2010) pp.153-157
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J V, 'Researching childhood harm: methodological issues: editorial'
  Child Abuse Review 19 (1) (2010) pp.1-4
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J, Stanley N, 'Editorial: Looked after Children and the Care System'
  Child Abuse Review 19 (6) (2010) pp.383-386
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J V, 'Identifying the evidence base for safeguarding practice: editorial'
  Child Abuse Review 18 (5) (2009) pp.293-296
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J V, Stanley N, 'Learning and training in safeguarding work: editorial'
  Child Abuse Review 18 (3) (2009) pp.147-150
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J V, Glaser D, 'Suspecting child maltreatment'
  Community Practitioner 82 (9) (2009) pp.34-35
  ISSN: 1462-2815
  Abstract The new National Institute for Health and Clinical Excellence (NICE) guidance 'When to suspect child maltreatment' aims to raise healthcare professionals" awareness of the alerting features of child abuse and neglect. It will be particularly useful for frontline community practitioners who have key responsibilities for child protection, as well as for professionals who are less experienced and not specialists in this area. Background As all community practitioners are only too aware, child maltreatment is a major public health problem, yet it is widely acknowledged that child abuse and neglect are neither always recognised nor reported to children" s social care services. The new NICE guidance summarises some of the obstacles facing healthcare professionals in identifying child maltreatment: -Fears about damaging a positive working relationship with a family already under the professional" s care -Discomfort about suspecting, disbelieving, thinking ill of, or wrongly blaming a parent or carer -Worries about missing a treatable disorder -Divided responsibilities toward adult and child, and concerns about breaching confidentiality -Having an understanding of the reasons why the maltreatment might have occurred, and a belief that there was no intent to harm the child -Stress -Worries about losing control over the child protection process and doubts about its benefits -Fears about personal safety -Worries about complaints -Being unclear about when to mention a suspicion.
• Appleton J V, Stanley N, 'Editorial: Childhood Outcomes'
  Child Abuse Review 18 (1) (2009) pp.1-5
  ISSN: 0952-9136 eISSN: 1099-0852
  Website 
• Appleton J V, Cowley S, 'Health visiting assessment principles - unpacking critical attributes in health visitor needs assessment practice: a case study'
  International Journal of Nursing Studies 45 (2) (2008) pp.232-245
  ISSN: 0020-7489 eISSN: 1873-491X
  Abstract Background Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. Objectives The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. Design A case study design informed by a constructivist methodology was used to examine health visitors" professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. Settings The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Methods and participants Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. Results/conclusions The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors" assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.Website 
• Wills W J, Appleton J V, Magnusson J, Brooks F, 'Exploring the limitations of an adult-led agenda for understanding the health behaviours of young people'
  Health and Social Care in the Community 16 (3) (2008) pp.244-252
  ISSN: 0966-0410
  Abstract Public health and health promotion agendas are usually determined by adults, even when the"target" population is children and young people. Adult-centred frameworks for health maintenance and the promotion of well-being risk ignoring young people's conceptualizations and experiences of health and health-relevant behaviours. However, the current policy emphasis in the UK and elsewhere apparently seeks to position young people at the centre of their own health-related decisions. Building on the United Nations Convention on the Rights of the Child, this paper examines and critiques policies relating to young people in UK, European and worldwide contexts. This paper then introduces data from two qualitative studies conducted in the UK. These studies illustrate that young people's definitions of health often run counter to prevailing public health and health promotion discourses. Young people do, however, often exhibit strategies for managing their health, even though they are frequently restricted by the perceptions that adults have about their lives and behaviour. This paper argues that the new policy discourse is not yet being systematically turned into action to give all young people a voice. This is important to begin to understand young people's perspectives about what matters to them and what really influences their health behaviours.Website 
• Mackereth C , Appleton J V, 'Social networks and health inequalities - the evidence for working with disadvantaged groups'
  Community Practitioner 81 (8) (2008) pp.23-26
  ISSN: 1462-2815
  Abstract This paper examines the growing body of research that identifies links between poverty and ill health, and the evidence that social factors do affect health. Epidemiological studies clearly demonstrate links between inequality, poor social networks and ill health. This paper critically examines these core public health concepts and provides a way for practitioners to demonstrate to managers and commissioners that community work which aims to build social networks and address health inequalities should be properly funded. In terms of practice, there is evidence that there is still a lot of work that can be undertaken at a local level that can help to address issues of social isolation and promote social networks. Epidemiological evidence can be used by community practitioners to identify public health work at a local level and to demonstrate the worth of existing local projects.
• Appleton J V, Cowley S, 'Health visiting assessment processes under scrutiny: a case study of knowledge use during family health needs assessments'
  International Journal of Nursing Studies 45 (5) (2007) pp.682-696
  ISSN: 0020-7489 eISSN: 1873-491X
  Abstract Background: Accurate assessment of family health need is a core health visiting skill, requiring considerable knowledge and expertise. To date, there has been only limited empirical examination of the types of knowledge and ways of knowing which are likely to influence health visiting practice during family health needs assessments. Objectives: This paper will present a detailed analysis of health visiting assessment processes and will explicate some of the many elements associated with the processes of identifying and assessing family health needs. Design: An in-depth case study was undertaken to explore health visiting practice across three study sites. The focus of interest was to attempt to understand the factors that may influence a health visitor in making a professional judgement to offer a family extra support. Settings: The study was conducted in three community Trust case sites in England, UK. Methods and participants:The study was informed by a constructivist methodology. Data collection took place during 56 observed home visits to families receiving increased health visiting support and intervention. Following the home visits separate in-depth interviews were undertaken with the health visitors and the clients. Results/Conclusions:This paper will explicate some of the many elements associated with the processes of identifying and assessing family health needs. It endeavours to unravel some of the complexity and intricacies of these processes and provide insights into health visitors" practical"know-how" .Website 
• Appleton J V, Caan W, Cowley S, Kendall S, 'Busting the bureaucracy: lessons from research governance in primary care'
  Community Practitioner 80 (2) (2007) pp.29-32
  ISSN: 1462-2815
  Abstract This article provides a critical discussion of the research governance approval processes faced in a nationally-funded primary care health service survey. The study is investigating how a range of English primary care organisations are addressing child protection and safeguarding children responsibilities in the light of a wealth of policy directives following the publication of Lord Laming's inquiry into the death of Victoria Climbie in 2003. Following multi-centre research ethics committee approval, a whole catalogue of difficulties emerged in gaining research governance approval for this study from primary care organisations. These challenges and lessons for primary care are outlined in an organisational case study with the intention of generating debated around this fundamental state in the research process. With the current restructuring of primary care, the authors argue that the time is right to streamline research governance procedures.
• Goodman-Brown J, Appleton J V, 'How do health visitors perceive their public health role?'
  Community Practitioner 77 (9) (2004) pp.333-337
  ISSN: 1462-2815
  Abstract Report on a small qualitative study in a PCT in the south of England which aimed to ascertain how health visitors perceive their public health role, including what they understand by the term 'public health' and how they view their role in the future. The constructivist methodology is explained and key findings are presented. The findings are discussed using Lewin's force field analysis to describe the drivers and resistors for developing the public health role. Results suggest that health visitors in this PCT are willing and able to develop their public health role, but organisational constraints need to be addressed first.
• Appleton J V, Cowley S, 'The guideline contradiction - health visitors use of formal guidelines for identifying and assessing families in need'
  International Journal of Nursing Studies 41 (7) (2004) pp.785-797
  ISSN: 0020-7489
  Abstract The aim of this paper is to examine health visitors' use of formal guidelines in identifying health needs and prioritizing families requiring extra health visiting support. With the increasing emphasis on targeted health visiting, a case study was used to explore the extent to which health visitors in three case sites use needs assessment guidelines in the assessment of family health need. The findings indicate how the presence of core visiting protocols hints at elements of control by managers, leading to conflicts in the relationship between professional judgements and official guidelines. Despite a management ethos of guideline formulation, several contradictions exist for which these guidelines are a focus. These include: little involvement of health visitors in guideline development, some staff not informed about the existence of formal guidelines, little evidence of guidelines contributing to improved client outcomes and their limited use by many health visitors in practice. Thus, even when guidelines exist, no accurate predictions can be made about health visitors' knowledge of or use of such guidelines in practice.Website 
• Appleton J V, Cowley S, 'Valuing professional judgement in health visiting practice'
  Community Practitioner 76 (6) (2003) pp.215-220
  ISSN: 1462-2815
  Abstract Current health and social care policy highlights the importance of accurately identifying children in need and the needs of their families. This paper reports on one aspect of a study undertaken to examine health visitors' use of professional judgements and formal guidelines for identifying families requiring extra health visiting support. The paper focuses specifically on health visitors' use of professional judgement in the assessment of family health need. A case-study strategy informed by a constructivist methodology was adopted to examine health visiting practice across three study sites. The focus of interest was to attempt to understand the factors that may influence a health visitor in making a judgement to offer a family extra support. Data collection took place during 56 visits to families receiving increased health visiting support and intervention. Following these home visits separate in-depth interviews were undertaken with health visitors and clients. A key feature of the analysis was the fact that even when guidelines exist, in reality most health visitors use their own professional judgement in making family assessments. It is hoped that the paper will contribute to the knowledge base of health visiting by attempting to unpack some of the elements of professional judgement and consider its value in health visiting practice. 1 fig. 35 refs.
• Appleton J V, 'Critiquing approaches to case study design for a constructivist inquiry'
  Qualitative Research Journal 2 (2) (2002) pp.80-97
  ISSN: 1443-9883
  
• Appleton J V, King L, 'Journeying from the philosophical contemplation of constructivism to the methodological pragmatics of health service research'
  Journal of Advanced Nursing 40 (6) (2002) pp.641-648
  ISSN: 0309-2402 eISSN: 1365-2648
  Abstract

  Aim. This paper presents our journey through a contemplation of the philosophical origins of constructivism to consider its role as an active methodology in qualitative research. Method. The first part of the paper summarizes the philosophical background of constructivism and the five principles underpinning this paradigm as described through the works of Guba and Lincoln. The philosophical roots of constructivism are then compared with postpositivism, critical realism and participatory inquiry. The paper moves on to consider their common methodological steps, before examining how the constructivist research strategy is being adopted and adapted within the pragmatics of health service research. Recent studies will be drawn upon to illustrate the use of constructivist methodology. Conclusion. Questions are raised about the role of philosophy and the extent to which it should or does underpin or influence qualitative research strategies. We believe that if researchers gain an understanding of both philosophy and methodology a richer and more robust study is likely to result.

  Website 
• De St Paer A, Appleton J V, 'Nurse referrals of children to Social Services'
  British Journal of Community Nursing 6 (4) (2001) pp.201-206
  ISSN: 1462-4753
  Abstract This literature review examines current referral systems and processes used by community nurses when making referrals of children in need and children in need of protection to social services departments. The problems surrounding definitions of need, children in need and children in need of protection are considered. The ambiguity of the language used and the difficulties encountered by community nursing staff in trying to identify criteria and thresholds for referral are highlighted. The review focuses on research exploring the assessment and referral processes used by community nurse, in particular by health visitors, and draws attention to the lack of research concerning these areas. Government recognition of the problems encountered by agencies working in this field is acknowledged in recent Department of Health publications.
• Duke S, Appleton J, 'The Use of Reflection in a Palliative Care Programme: a Quantitative Study of the Development of Reflective Skills Over An Academic Year'
  Journal of Advanced Nursing 32 (6) (2001) pp.1557-1568
  ISSN: 0309-2402 eISSN: 1365-2648
  Abstract The use of reflection in a palliative care programme: a quantitative study of the development of reflective skills over an academic year Reflection has gained a reputation for encouraging the integration between theory and practice within professional education. However, this reputation is based on an evidence base that mostly consists of theoretical debate. The aim of this study was to test our experience that the ability to reflect is developmental and that some reflective skills are harder to achieve than others. The research was undertaken by assessing the degree to which registered nurses achieved reflective criteria within assignments submitted for a variety of palliative care undergraduate modules. A total of 160 assignments were analysed using a marking grid constructed from a literature review and the results were compared between students and across academic terms. The results suggest that students are able to describe their practice but find it harder to analyse knowledge, the context of care and to action plan. Nevertheless, reflective abilities developed over time with significant developments made between each term. However, the development of skills indicative of critical reflection was less evident and confined to the ability to raise implications for future learning. The lack of multivariate analysis limits the study. However, the findings build on previous research and prompt questions for future work, particularly with respect to the process of reflection and how this can be supported in order to encourage the development of critical reflective skills.Website 
• King L, Appleton JV, 'Fourth Generation Evaluation of Health Services: Exploring a Methodology which Offers Equal Voice to Consumer and Professional Stakeholders'
  Qualitative Health Research 9 (5) (1999) pp.698-710
  ISSN: 1049-7323
  Abstract

  This article explores the need for a clear understanding of fourth generation evaluation as a necessary requirement for those hoping to achieve an effective analysis of health services. The weaknesses of the traditional approaches to evaluation are fully examined so that an effective choice of evaluation methodology can be made. Current health service thinking highlights the need to recognize the importance of both consumer and professional stakeholders, allowing each an equal voice. The authors aim to assist evaluators to select a methodology that will be the most effective medium for allowing this to occur.

  Website 
• King L, Appleton J V, 'Intuition: A critical review of the research and rhetoric'
  Journal of Advanced Nursing 26 (1) (1997) pp.194-202
  ISSN: 0309-2402
  Abstract This paper will explore the concept of intuition in nursing from an acute care and community nursing perspective. It will consider definitions of intuition and examine the research which can inform our understanding of this important component of decision making. In the current health service climate, which demands measurable research-based evidence, the involvement of intuition as an element of judgement is often denigrated. The result is that many nurses are being forced to be covert in their use of this crucial aspect of judgement and focus solely on the conscious elements of decision-making. However, research evidence would suggest that intuition occurs in response to knowledge, is a trigger for action and/or reflection and thus has a direct bearing on analytical processes in patient/client care. The authors therefore argue that the essential nature of intuition cannot be ignored in the practice, management, education and research of nursing.Website 
• Appleton J V, 'Establishing the validity and reliability of clinical practice guidelines used to identify families requiring increased health visitor support'
  Public Health 111 (2) (1997) pp.107-113
  ISSN: 0033-3506
  Abstract One of health visitors' main roles is that of case finding and actively searching for health needs. This paper describes part of the findings of a study evaluating the clinical practice guidelines issued to health visitors to assist them in identifying families requiring increased health visitor support. A postal questionnaire was distributed to all Community Trust Chief Nurses in England (179), employing health visiting staff. The aim of the questionnaire was to assess the extent to which clinical guidelines are used throughout the country to identify families requiring extra health visiting support and to examine their validity and reliability. The survey results confirm the widespread existence of clinical guidelines in England to assist health visitors in identifying vulnerable families requiring extra support. The study provides evidence that the guidelines are largely subjective and invalid in nature. Questions are raised about the relationship between clinical guidelines and professional judgements.Website 
• Appleton J V, Cowley S, 'Analysing clinical practice guidelines. A method of documentary analysis'
  Journal of Advanced Nursing 25 (5) (1997)
  ISSN: 0309-2402 eISSN: 1365-2648
  Abstract This paper will describe a method of documentary analysis used in a study examining the validity of clinical guideliness issued to health visitors to assist them in identifying families requiring increased health visitor support. This forms the preliminary work for a wider study examining how health visitors decide to increase support to vulnerable families. Although a number of published research texts dicuss the value of records and documents as important data sources for health service researchers, there is relatively little information avialable about the processes of documentary analysis. This paper offers one method for analysing clinical practice guidelines, it describes the development of a critique and analysis tool and expolres the strengths an weaknesses of this particular analysis instrument.Website 
• Appleton J V, King L, 'Constructivism: a naturalistic methodology for nursing inquiry'
  Advances in Nursing Science 20 (2) (1997) pp.13-22
  ISSN: 0161-9268
  Abstract This article will explore the philosophical underpinnings of the constructivist research paradigm. Despite its increasing popularity in evaluative health research studies there is limited recognition of constructivism in popular research texts. Lincoln and Guba's original approach to constructivist methodology is outlined and a detailed framework for nursing research is offered. Fundamental issues and concerns surrounding this methodology are debated and differences between method and methodology are highlighted.
• Appleton J V, 'Working with vulnerable families - a health visiting perspective'
  Journal of Advanced Nursing 23 (5) (1996) pp.912-918
  ISSN: 0309-2402 eISSN: 1365-2648
  Abstract The aim of this paper is to describe part of the findings of a research study which explored the health visitor's role in identifying and working with vulnerable families in relation to child protection. One objective of the study was to describe and analyse the work which health visitors undertake with vulnerable families aimed at preventing crisis, ill-health and child abuse. This paper outlines this aspect of the research and looks specifically at health visitors' perceptions of their work and interventions with vulnerable families and children. Health visitors working in an inner city area and a suburban area were sampled and pilot work was undertaken in a third suburban area. Stage one involved a postal survey of 102 health visitors, in which a response rate of 58 (57%) was obtained. Stage two involved 12 in-depth interviews with health visitors. One major finding of this study highlighted the fact that the health visitor's role when working with vulnerable families appears to be one of diversity and conflict. In the light of the current National Health Service reforms it seems of paramount importance that health visitors illustrate to others, both managers and other health/social service professionals alike, the important function of their work with these vulnerable groups. This is essential to ensure that health visitors' work with vulnerable families in relation to child protection is understood and valued and that the needs of vulnerable families continue to be identified. This paper contributes to the knowledge base of health visiting and raises some important issues for professional health visiting practice.Website 
• Appleton J V, 'Health visitor assessment of vulnerability'
  Health Visitor 68 (6) (1995) pp.228-231
  ISSN: 0017-9140
  Abstract Reports on a study to investigate how health visitors reach decisions on a family's vulnerability. The study showed that health visitors frequently rely on their own professional judgement, rather than on official guidelines or checklists, indicating that such guidelines are an inadequate measure of families' needs.
• Appleton J V, 'Analysing qualitative interview data - addressing issues of validity and reliability'
  Journal of Advanced Nursing 22 (5) (1995) pp.993-997
  ISSN: 0309-2402 eISSN: 1365-2648
  Abstract Over the last 20 years qualitative research methods have increased in popularity in the field of nursing research, yet critical issues of validity and reliability are often overlooked in published research reports. Thus, the aim of this paper is to describe the steps which the author followed to address issues of rigour in one qualitative research study. The study was conducted to explore the health visitor's role in identifying and working with vulnerable families in the community in relation to child protection. This paper will focus on how issues of validity and reliability were addressed in terms of qualitative interview data.Website 
• Appleton J V, 'The role of the health visitor in identifying and working with vulnerable families in relation to child protection: A review of the literature'
  Journal of Advanced Nursing 20 (1) (1994) pp.167-175
  ISSN: 0309-2402 eISSN: 1365-2648
  Abstract This paper presents an overview of the research surrounding the role of the health visitor in identifying and working with vulnerable families in relation to child protection Only a limited number of empirical studies have been completed within the field of health visiting, so this review draws on most of the literature published over the last 15 years, which is mainly British in origin No previous reviews have focused on this specific area of health visiting Clearly with the recent increase in public and official recognition of child protection issues and the continuing debate of health visitor involvement within this area, this review takes a significant step forward in drawing together relevant research The review focuses on research within three main areas Firstly, the health visitor's role in working with vulnerable families in relation to child protection is explored The clients" perceptions of this role are also explored Secondly, the identification of vulnerable families by health visitors and non-health visitors is explored Within this area a number of studies by non-health visitors investigating screening approaches to child abuse have been reviewed, because they play such a major role in the literature and appear to have influenced subsequent health visitor research Thirdly, a review of health visitors" preventive work with vulnerable families is completedWebsite 
• Appleton J V, 'The concept of vulnerability in relation to child protection: health visitors' perceptions'
  Journal of Advanced Nursing 20 (6) (1994) pp.1132-1140
  ISSN: 0309-2402 eISSN: 1365-2648
  Abstract The aim of this paper is to describe part of the findings of a study which explored the health visitor's role in identifying and working with vulnerable families in relation to child protection The study was conducted using a broadly qualitative approach A two-stage approach was undertaken to explore the concept of vulnerability and to assess health visitors" work in this area of practice In stage one a postal survey of 102 health visitors was conducted with a response rate of 58 (57%) In stage two 12 m-depth interviews were completed with health visitors This paper outlines one major aspect of the findings and focuses specifically on health visitors" perceptions about the concept of vulnerability and its relevance to child protection work The analysis suggests that vulnerability is a nebulous, transient and complex concept influenced by multiple interacting factors The existence of a continuum of vulnerability is clearly evident It appears that families move in and out of vulnerability at various stages of the life cycle and this is largely dependent on-˜internal" and-˜external" stress factors and coping ability This paper contributes to the knowledge base of vulnerability and raises a number of issues for health visiting practiceWebsite 

Book chapters

• Bekaert S, Appleton JV, 'Intimate Partner Violence in Teen Relationships' in Shackelford TK (ed.), The SAGE Handbook of Domestic Violence, Sage (2021)
  ISBN: 9781526494863 eISBN: 9781529742336
  Website 
• Appleton JV , Harrison J, Mumby-Croft K, 'Safeguarding Children: A public Health Imperative.' in Cowley S. and Whittaker K (ed.), Community Public Health in Policy and Practice: a Sourcebook (3rd ed), Baillière Tindall. (2021)
  ISBN: 9780702079443
  Abstract

  All children and young people have a right to be safeguarded and their welfare promoted.  In its broadest sense ‘safeguarding’ encompasses a wide spectrum of activity to enable every child to have the best outcomes (HM Government, 2018).  It includes the prevention of impairment of children’s health and development, the maximization of children’s potential through stimulation, play and education, protection from disease via immunisation, prevention of harm from accidents, through to protection from abuse, neglect and exploitation.  The terms ‘early help’, ‘safeguarding’, ‘vulnerable children’, ‘child(ren) in need’ and ‘child protection’ will be used throughout the chapter as these reflect terms used in current practice.  Identification of child welfare needs, through services that are developed from sound public health principles, is of paramount importance for the wellbeing of all children in our society.  Themes will be developed through the chapter to illustrate the public health basis of safeguarding work and its significance to health inequalities and childhood outcomes.  These themes will be examined within the context of current policy developments and contemporary community public health practice.

  Policy and the discourse pertaining to child welfare has altered dramatically over the last four decades.  In the 1980’s and early 1990’s the concept of ‘protecting children’ came to the fore with much work centered around the child and family.  There was a shift in emphasis to one of protection, from the narrower historical one traditionally associated with child abuse.  “Child protection was not only concerned with protecting children from danger but also protecting the privacy of the family from unwarrantable state interventions” (Parton 2006 p 36) with an emphasis on state agencies increasingly working in partnership with parents and carers.  Following publication of the Children Act (2004) the discourse shifted again, reflecting changes in law and policy to that of safeguarding and promoting children and young people’s welfare.  The focus on safeguarding reflects a much broader focus and as well as protection, encompasses prevention and an emphasis on all children’s safety, not just those in need and suffering, or at risk of harm.  In recent years there has been increasing interest in contextual safeguarding as an approach to understanding young people’s experiences of harm beyond their families (Firmin, 2017a; 2017b; HM Government, 2018).

  Website 
• Appleton J, Whittaker K, 'Assessing the Health Needs of Children, Chapter 15' in Jan Horwath and Dendy Platt (ed.), The Child’s World. Third Edition. The Essential Guide to Assessing Vulnerable Children, Young People and their Families, Jessica Kingsley Publishers (2019)
  ISBN: 9781785921162
  Website 
• Appleton J V, Clemerson-Trew J, 'Safeguarding Children' in Cowley S (ed.), Community Public Health in Policy and Practice, Bailliere Tindall (2008)
  ISBN: 9780702028083 eISBN: 9780702037450
  
• Appleton J V, 'Vulnerable children' in Public health practice and the school-age population, Hodder Arnold (2008)
  ISBN: 9780340907207 eISBN: 3.40907207E8
  
• Appleton J V, 'Starting a new research project' in Research methods for health and social care , Palgrave Macmillan (2008)
  ISBN: 9780230500785 eISBN: 2.30500781E8
  
• Appleton J, 'Ethical Issues in Narrative Research in Palliative Care' in Twohig PL, Kalitzkus V (ed.), Making sense of Health, Illness and Disease, Rodopi (2004)
  ISBN: 9789042011199
  
• Appleton J V, Clemerson J, 'Child protection as a public health issue' in Cowley S (ed.), Community Public Health in Policy and Practice, Bailliere Tindall (2002)
  ISBN: 0702023175
  
• Appleton J V, 'Assessing vulnerability in families' in Research issues in community nursing , Palgrave Macmillan (1999)
  ISBN: 9780333735046 eISBN: 3.33735048E8
  
• Appleton J V, Clemerson J, 'The roles and responsibilities of health service personnel' in Working for Children on the Child Protection Register: An Inter-agency Practice Guide, Ashgate (1999)
  ISBN: 9781857423679 eISBN: 1.857423674E9
  

Membership of professional bodies

Professional Body and Organisational Memberships:

• Nursing and Midwifery Council (August 1986-date)
• Honorary contract, Oxford Health NHS Foundation Trust
• Fellow of the Institute of Health Visiting (August 2014-date)
• Royal College of Nursing (RCN) (August 1986-date)
• Community Practitioners’ and Health Visitors’ Association (CPHVA) (Sept. 1989-date)
• HEA – Fellow of the Higher Education Academy (August 2001-date)

Committees and Board Memberships:

• National Institute for Health Research (NIHR) – HS&DR Grant Prioritisation Committee since 2019.
• Health Education England/NIHR/NHS – Review panel member Clinical Doctorate Research Fellowship Scheme 2018-ongoing.
• NIHR Pre-doctoral Local Authority Fellowship (PLAF) Scheme Selection Committee since 2021.
• Global School Nurse Research Consortium
• Vice-chair alternate and expert nurse/HV member of Coventry and Warwickshire NRES Research Ethics Committee. Jan 2016 – Date.
• Association of Child Protection Professionals (AoCPP) Anne Paterson Research Award Scheme

Editorial Boards and Expert Panels

• Co-Editor Child Abuse Review (journal website).
• Previous expert nurse/HV member to the National Collaborating Centre for Women’s and Children’s Health (NCC-WCH) Guideline Development Group on When to Suspect Child Maltreatment for the National Institute for Health and Clinical Excellence (NICE).