Table 2.5.

Primary care in a child centred ecological model and MOCHA.

ChildFamilySchool/Community/Peers/Extended Family/CarersHealth and Social Care Services, Secondary Care, Tertiary Care, Social CareSocial and Political Context, Media
Identification of models (WP1)Case study focusCase study focusCase study focus – overlaps with WP3Case study focus – overlaps with WP2Workstream on social and political context
Interface with secondary care for children needing complex care (WP2)Uses case studies – child focus (overlap with WP1)Case study focus complex care and family; social care perspective; child protection (connects to WP1)Case study focus – extended family and external carers; social care context, education (Connects to WP1)Focus on interaction between primary and secondary/tertiary care; interaction with social care services 
School and adolescent health (WP3)Adolescent care – focus on empowerment of child; accessibility; autonomy in decision-makingFamily relationship with school?School health focus; peer influence on health, autonomy in adolescence and greater influence of friends.Structure and function of school health servicesSocial media
Family relationships (problematic?) in terms of well-being in adolescence?Alternative focus of services for appropriate and accessible adolescent health careSocial acceptance of school health services
Encouragement for adolescents to use outreach/other adolescent-specific services
Quality measures and outcomes (WP4)Child vaccinations, conditionsFamily involved in service, engaged in serviceHealth system appropriate for community needs/settingGood communication and coordination between different services and modelsSocial acceptance of quality
Good understanding of quality evidence base
Social agreement on what is a good outcome
Use of large datasets (WP5)Consent for data to be collected and usedAcceptance of need for data, consent for child and family data to be collected and usedData availability and use in community services.Data availabilitySocial acceptance of data collection and use
Use of data to inform service structure and communication needs
Economic and skill set evaluation and analysis (WP6)Appropriate workforce for child’s needs (skilled)Communication between family and health workforce to common aim (good outcome)Accessible and appropriate workforce in community settingsMotivated and skilled workforce in health system(Earned) Respect for health workforce
Accessible (friendly, knowledgeable) workforceWorkforce communication between primary, secondary, tertiary care etc.
Equity (WP7)Child is able and willing to access and engage with health serviceFamily is able and willing to access and engage with health serviceCommunity access equitable to allEquity of access to health service (based on clinical/social need?)Social context taken into account to adapt health service so that all populations can access if needed
Electronic records (WP8)  Sharing of eHealth records across disciplines and services (when appropriate)Sharing of eHealth records across disciplines and services (when appropriate) 
Optimal models (WP9)Child centredness taken into account in optimum model recommendations; positioning of the health system in wider ecological model

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