Feasbility and acceptability pilot of a public health intervention delivered in the paediatric emergency department

Aim Paediatric Emergency Departments (PEDs) are well-placed to deliver public health interventions. Whilst numerous studies describe the effectiveness of a range of ED-based interventions for adults, less has been done to assess interventions for Children and Young People (CYP). Every year in England, millions of CYP attend hospital, often with relatively minor illnesses/injuries, which sometimes result in long waits – time that could be used to improve wider health and wellbeing. This pilot study assessed the acceptability and feasibility of delivering a public health intervention in the PED of a busy district general hospital. Methods Full prospective ethical approval was obtained. Participants were CYP and their carers attending a PED in England. An opportunistic sampling strategy was used, with a focus on recruiting those who had a wait whilst in the department. The intervention was a consultation delivered by a public health specialist, based around the “Screening, Brief Intervention, and Referral for Treatment” (SBIRT) model and focussed on: household smoking, vaccination status, dental health, and frequent attendance. Quantitative outcome data (e.g. registering with dentist) were collected by phone at one week and then one, three, and six months post-enrolment (where indicated). Qualitative data came from engaging with participants and completion of a field diary by the public health specialist (primary researcher). Results Thirty participants were recruited over the two-week pilot, with 50% of CYP participating in the consent process. Twenty participants (67%) triggered at least one screening question, with dental health and (household) smoking being the most common triggers. Four participants were lost to phone follow-up at one week and a further five were “thanked and discharged” as they had not triggered any of the categories during screening. Of the remaining participants, five had taken action as a result of the study and others had plans, all relating to dental appointments. Conclusion The PED offers an under-utilised opportunity to deliver public health interventions. Findings from this study will be used to refine the intervention before an assessment of its effectiveness is made, using an appropriate study design. Acknowledgements This study was funded by a grant from the Sir Halley Stewart Trust