Nadia Mantovani

Tackling the problem of teenage pregnancy in looked-after children: a peer mentoring approach

ABSTRACT Teenage pregnancy is associated with adverse health and social outcomes, even after adjusting for prior disadvantage, and is recognized as a major public health issue. Rates of teenage pregnancy in the UK are among the highest in Europe. Interventions introduced in the past decade to address the problem, such as improved sex and relationships education in schools, have been accompanied by a fall in teenage pregnancy rates in the UK. However, this decline has not been mirrored among looked‐after children. In this paper, we discuss why this may be the case. We suggest that a system of peer mentoring, involving a young person, whose experience of life post‐care has been positive, may be an effective approach to tackling the problem of pregnancy in this group. Peer mentoring has the potential to assist young people in developing self‐esteem, confidence and in making choices regarding their education, personal development and relationships.

Exploring the relationship between stigma and help‐seeking for mental illness in African‐descended faith communities in the UK

Stigma related to mental illness affects all ethnic groups, contributing to the production and maintenance of mental illness and restricting access to care and support. However, stigma is especially prevalent in minority communities, thus potentially increasing ethnically based disparities. Little is known of the links between stigma and help‐seeking for mental illness in African‐descended populations in the UK.

Developing and piloting a peer mentoring intervention to reduce teenage pregnancy in looked-after children and care leavers: an exploratory randomised controlled trial

BACKGROUND Looked-after children (LAC) are at greater risk of teenage pregnancy than non-LAC, which is associated with adverse health and social consequences. Existing interventions have failed to reduce rates of teenage pregnancy in LAC. Peer mentoring is proposed as a means of addressing many of the factors associated with the increased risk of teenage pregnancy in this group. OBJECTIVE To develop a peer mentoring intervention to reduce teenage pregnancy in LAC. DESIGN Phase I and II randomised controlled trial of a peer mentoring intervention for LAC; scoping exercise and literature search; national surveys of social care professionals and LAC; and focus groups and interviews with social care professionals, mentors and mentees. SETTING Three local authorities (LAs) in England. PARTICIPANTS LAC aged 14-18 years (mentees/care as usual) and 19-25 years (mentors). INTERVENTION Recruitment and training of mentors; randomisation and matching of mentors to mentees; and 1-year individual peer mentoring. MAIN OUTCOME MEASURES PRIMARY OUTCOME pregnancy in LAC aged 14-18 years. SECONDARY OUTCOMES sexual attitudes, behaviour and knowledge; psychological health; help-seeking behaviour; locus of control; and attachment style. A health economic evaluation was also carried out. RESULTS In total, 54% of target recruitment was reached for the exploratory trial and 13 out of 20 mentors (65%) and 19 out of 30 LAC aged 14-18 years (63%) (recruited during Phases I and II) were retained in the research. The training programme was acceptable and could be manualised and replicated. Recruitment and retention difficulties were attributed to systemic problems and LA lack of research infrastructure and lack of additional funding to support and sustain such an intervention. Mentees appeared to value the intervention but had difficulty in meeting weekly as required. Only one in four of the relationships continued for the full year. A future Phase III trial would require the intervention to be modified to include provision of group and individual peer mentoring; internal management of the project, with support from an external agency such as a charity or the voluntary sector; funds to cover LA research costs, including the appointment of a dedicated project co-ordinator; a reduction in the lower age for mentee recruitment and an increase in the mentor recruitment age to 21 years; and the introduction of a more formal recruitment and support structure for mentors. CONCLUSIONS Given the problems identified and described in mounting this intervention, a new development phase followed by a small-scale exploratory trial incorporating these changes would be necessary before proceeding to a Phase III trial. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 85. See the NIHR Journals Library website for further project information.

Drug use among British Bangladeshis in London: a macro-structural perspective focusing on disadvantages contributing to individuals’ drug use trajectories and engagement with treatment services

Abstract Aims: The main aim of our study was to produce an understanding of factors contributing to drug-using trajectories among men and women from a Bangladeshi background living in East London. Methods: Fifteen semi-structured, one-to-one interviews were conducted with male and female Bangladeshi drug users accessing treatment services. A macro-structural lens was adopted to interpret participants’ accounts of their drug use and explored the intersecting factors that at a micro, meso, and macro level impacted on their drug-using trajectories. Findings: Problem drug use (heroin and crack cocaine) among participants was the result of inter-related factors such as their friendship networks and the embeddedness of drugs in drug-using networks, the structural disadvantages participants experienced, and the need for concealment of their drug use which impacted on participants’ effective utilisation of drug treatment services. Problem drug use was a functional way of responding to and dealing with social, economic, and cultural disconnection from mainstream institutions as participants faced severe multiple disadvantages engendering stigma and shame. Conclusions: We propose a ‘life-focused’ intervention aimed at creating extra opportunities and making critically-needed resources available in the marginalised environment of the study’s participants, which are key to restoring and maintaining agency and sustaining well-being.

'I've had a wake-up call and his name is my son.' Developing aspiration and making positive choices - does government policy acknowledge young parents' perspectives?

Whilst the numbers of young people who become parents in their teenage years is declining, there remains a stigma associated with young parenthood. Young parents disrupt socially constructed ideas of the family and challenge ideals of childhood. It is common for young parents to have experienced social exclusion and poverty as well as to have relatively low educational achievement prior to parenthood. Less common though is the idea that becoming a parent in late teenage years may enable the development of aspiration, promote maturity, responsibility and potentially lead to enhanced life chances for these young people. This paper draws on interview data with ten young women and five young men who were parents and aged between 16-19 years. In addition findings from interviews carried out with a range of professionals working in the field of teenage pregnancy inform this paper. Young people describe the transformative effect of parenthood on their young lives and challenge accepted views of negative impact of becoming a young parent.