Supporting the case for “progressive universalism” in health visiting: Scottish mothers and health visitors’ perspectives on targeting and rationing health visiting services, with a focus on the Lothian Child Concern Model.

Aims. To explore parents and professionals’ experience of family assessment in health visiting (public health nursing), with a focus on the Lothian Child Concern Model (LCCM). Background. Health visitors (HVs) currently assess families as requiring core, additional or intensive support, and offer support at a corresponding level. The majority of families are assessed as core and receive no pro-active support beyond the early days. Previous assessment tools, consisting of checklists, have been criticised as being ineffective in identifying a range of health needs and unacceptable to parents and HVs. The LCCM model was developed and introduced in the study area to promote a partnership approach with parents and assess strengths as well as difficulties in parents’ capacity to care for their child. Methods. Qualitative methods were used. Ten mothers and twelve HVs took part in individual semi-structured interviews. Results. Most mothers were aware of the assessment process but some felt that they were not involved in the decision making process. Explaining the assessment process to parents is problematic and not all HVs do so. The assessment process was stressful for some mothers. HVs find the model useful for structuring and documenting the assessment process. Many believe that most families benefit from some support, using public health approaches. Families are often assessed as core because there are insufficient resources to support all those who meet the criteria of the additional category, and managers assess caseloads in terms of families with child protection concerns. Conclusions. The study findings support the concept of “progressive universalism” which provides a continuum of intensity of support to families, depending on need. Mothers would like better partnership working with HVs. Relevance to clinical practice. The study endorses proposed policy changes to re-establish the public health role of HVs and to lower the threshold for families to qualify for support.

A module-based approach to foster and document the intercultural process before and during the residence abroad.

This article contributes to the debate on what form of preparation and support can enhance the intercultural student experience during the Year Abroad. It presents a credit-bearing and multi-modal module at a UK university designed to both prepare students prior to departure through a series of workshops and activities on an e-portfolio and help them engage in meta-reflection on intercultural issues during their stay. The presentation of the curricular components of the course and instances extracted from student blogs are contextualised within theoretical considerations on intercultural education and a holistic approach to student development. The longitudinal evolution of the module is presented in the context of an iterative approach leading to a cycle of revisions and amendments. With its pragmatic stance this article aims to address one of the concerns recently expressed about intercultural education, namely that although intercultural theories are suitably incorporated in the latest thinking on communicative competence, there is a lack of evidence-based practice.