Fuel poverty and child mental health: exploring underlying mechanisms and experiences in order to reduce inequalities

助长贫困和儿童心理健康：探索减少不平等的根本机制和经验

• 批准号: 2890221
• 金额: --
• 依托单位: University of York
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2023
• 资助国家: 英国
• 起止时间: 2023 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2890221
• 关键词: Fuel; poverty; child; mental; health

As the UK experiences the worst cost of living crisis in decades (ONS, 2022) estimates suggest that by January over 50% of households (15 million) will be fuel poor (Bradshaw & Keung, 2022). Definitions of fuel poverty (FP) vary globally (Thomson & Snell, 2016), even within the UK, nations disagree (Hinson & Bolton 2022). In England, officially a household is in FP if it has an energy efficiency rating of band D or below and a disposable income under the poverty line (60% below median household income) after housing and fuel costs (BEIS, 2021). It is intersections of society's most vulnerable, including children who are at the greatest risk of ill health due to FP (PHE, 2017; Liddell & Morris, 2010; Marmot et al 2011).Research suggests links between FP and poor adult mental health (Liddell & Morris, 2010; Marmot at el. 2011) but for children the focus has been on physical health with evidence suggesting an increased likelihood of respiratory problems such as asthma (Mohan, 2021). Emergent literature has linked FP to poor child mental health (CMH) (Oliveras et al., 2021) however mechanisms remain unclear with more research needed to understand UK children's experiences.This research aims to understand what factors explain the relationship between FP and CMH and what can be done to reduce or stop their impact. Findings will provide evidence for policy makers, researchers and practitioners on interventions to use, where to target them and who would benefit from them.Research Questions1. How does FP impact MH trajectories of children?2. What factors explain (mediate or moderate) the relationship between FP and CMH outcomes?3. What is the lived experience of FP for children and their families and how does this relate to CMH?Three linked studies will generate evidence to inform policy and practices to reduce the impact of FP on CMH outcomes. It will be conducted in collaboration with the Bradford Institute for Health Research, using primary (Study 3) and secondary (Study 2) data from the Born in Bradford (BiB) Study. BiB is a large cohort study established in 2007, tracking the development of babies born in the city of Bradford from childhood into adulthood (Wright et al., 2013). It recruited 12,453 pregnant women between 2007 and 2011 capturing information on genetic, nutritional, environmental and social factors with subsets of families contributing to numerous BiB data sweeps since recruitment.Study 1A systematic review will be produced to establish a theoretical framework describing the mechanisms through which FP impacts CMH. Guided by Baxter et al. (2010), a logic model will be developed and tested in Study 2. Understanding factors that mediate and moderate the relationship between FP and CMH provides a rationale guided by theory for policy and practice change.Study 2Little is known about how early life experiences of FP impact the emergence and trajectory of CMH outcomes. Using repeated measures analysis, this study will explore how exposure to FP at pregnancy/birth and early childhood (4/5 years) contribute to the development of CMH symptoms in early and middle childhood. A further analysis will be conducted using structural equation modelling to test hypothesised mediating variables based on literature searches and the logic model. Collectively these analyses will generate evidence on types of interventions to use, where to target them and who would benefit from them.Study 3Interviews will be conducted with fuel poor children from the BiB cohort and their parents. Drawing on Butler and Sheriff's (2017) methodological approach interpretative phenomenological analysis (Smith et al., 2009) will be used to understand how children and their families relate to and make sense of experiences of FP. Findings will be interrogated alongside studies 1&2 producing a theory of change model to inform future policy and practice for children and families living with or at risk of FP.

由于英国经历了几十年来最严重的生活成本危机（ONS，2022），估计到 1 月份，超过 50% 的家庭（1500 万）将缺乏燃料（Bradshaw & Keung，2022）。燃料贫困 (FP) 的定义在全球范围内各不相同（Thomson & Snell，2016），即使在英国，各国也存在分歧（Hinson & Bolton，2022）。在英格兰，如果一个家庭的能源效率等级为 D 级或以下，并且扣除住房和燃料成本后可支配收入低于贫困线（低于家庭收入中位数 60%），则该家庭正式处于 FP 状态（BEIS，2021 年）。它是社会最弱势群体的交叉点，包括因 FP 而面临最大健康不良风险的儿童（PHE，2017；Liddell & Morris，2010；Marmot 等人，2011）。研究表明，FP 与成人心理健康状况不佳之间存在联系（ Liddell & Morris, 2010；Marmot at el. 2011)，但对于儿童来说，重点是身体健康，有证据表明出现呼吸系统疾病的可能性增加。例如哮喘（Mohan，2021）。新出现的文献将 FP 与儿童心理健康状况不佳 (CMH) 联系起来（Oliveras 等人，2021），但机制仍不清楚，需要更多研究来了解英国儿童的经历。本研究旨在了解哪些因素解释 FP 与 CMH 之间的关系，以及可以采取哪些措施来减少或阻止其影响。研究结果将为政策制定者、研究人员和从业者提供关于干预措施的使用、针对何处以及谁将从中受益的证据。 FP如何影响儿童的MH轨迹？2．哪些因素可以解释（中等或中等）FP 和 CMH 结果之间的关系？3.儿童及其家庭的 FP 生活经历是什么？这与 CMH 有何关系？三项相关研究将产生证据，为政策和实践提供信息，以减少 FP 对 CMH 结果的影响。该研究将与布拉德福德健康研究所合作进行，使用来自布拉德福德出生 (BiB) 研究的主要（研究 3）和次要（研究 2）数据。 BiB 是一项于 2007 年建立的大型队列研究，追踪布拉德福德市出生的婴儿从童年到成年的发育情况（Wright 等，2013）。它在 2007 年至 2011 年间招募了 12,453 名孕妇，收集有关遗传、营养、环境和社会因素的信息，自招募以来，家庭子集为大量 BiB 数据扫描做出了贡献。研究 1 将进行系统回顾，以建立一个理论框架，描述孕期怀孕的机制。 FP 影响 CMH。由巴克斯特等人指导。 (2010)，一个逻辑模型将在研究 2 中开发和测试。了解调节和调节 FP 和 CMH 之间关系的因素，为政策和实践变革提供了理论指导的基本原理。研究 2 人们对早期生活经历如何影响知之甚少。 FP 影响 CMH 结果的出现和轨迹。通过重复测量分析，本研究将探讨在怀孕/出生和幼儿期（4/5 岁）接触 FP 如何促进儿童早期和中期 CMH 症状的发展。将使用结构方程模型进行进一步分析，以测试基于文献检索和逻辑模型的假设中介变量。总的来说，这些分析将产生有关使用干预措施类型、针对何处以及谁将从中受益的证据。研究 3 将对 BiB 队列中燃料匮乏的儿童及其父母进行访谈。借鉴 Butler 和 Sheriff（2017）的方法论方法解释现象学分析（Smith 等人，2009）将被用来理解儿童及其家庭如何与 FP 的经历联系起来并理解它们。研究结果将与研究 1 和 2 一起进行审查，产生变革模型理论，为患有 FP 或面临 FP 风险的儿童和家庭的未来政策和实践提供信息。