Gill Kelly

Background: Childhood immunisations protect communities against preventable and infectious diseases. Coverage for childhood immunisations in the UK is declining and coverage for the MMR vaccine stands at 85.5%, significantly below the target set by the Department of Health and Social Care to achieve herd immunity and prevent sustained disease transmission. Methods: Three medical databases were searched using PICO, supported by the application of inclusion and exclusion criteria and critical appraisal. Results: Reminder and recall activities are identified as a cost-effective method for improving childhood immunisation uptake but targeted, individualised and family-centred interventions should be utilised to promote access to childhood immunisations for underserved populations. Vaccination data should remain up to date and a child's vaccination status should be reviewed and meaningfully discussed at every healthcare contact and staff involved in immunisation should have access to appropriate education, training and support. Recommendations: Understanding how to provide services and improve vaccine coverage for patients who frequently are not brought is identified as an opportunity for further research, as well as analysing the role of public health teams in identifying local inequalities and supporting GP practices to design and deliver bespoke interventions for their community. It is recommended that communication emphasises the safety and effectiveness of vaccines, while highlighting a child's susceptibility or risk to developing complications. Further research is needed to evaluate how best to communicate this to ensure that the information provided is clear and factual and comprehensible to all parents and carers.

Allied Health Professionals (AHPs) have the capacity to promote healthy behaviours in young children through routine ‘contact points’, as well as structured weight management programmes. This scoping review aims to evaluate the impact of AHPs in the prevention of obesity in young children. Databases were searched for relevant evidence between 1st January 2000 and 17th January 2022. Eligibility criteria included primary evidence (including, but not limited to; randomized controlled trials, observational studies, service evaluations) evaluating the impact of AHPs on the primary and secondary prevention of obesity in young children (mean age under 5 years old). AHP-related interventions typically demonstrated improvements in outcomes such as nutritional behaviour (e.g. lower sweetened drink intake), with some reductions in screen time. However, changes in weight outcomes (e.g. body mass index (BMI) z-score, BMI) in response to an AHP intervention were inconsistent. There was insufficient data to determine moderating effects, however tentative evidence suggests that those with a lower socioeconomic status or living in an underprivileged area may be more likely to lose weight following an AHP intervention. There was no evidence identified evaluating how AHPs use routine ‘contact points’ in the prevention of obesity in young children. AHP interventions could be effective in optimizing weight and nutritional outcomes in young children. However, more research is required to determine how routine AHP contact points, across the range of professional groups may be used in the prevention of obesity in young children.