Information and support services for children aged 9 to 12 years: Children’s experiences with and preferences for support services

Introduction

Children and young people need quality-assured information, guidance, advice and help. Children who need help and information want services that are easily accessible, where the children themselves have control over when and how they make contact, both through digital and non-digital services. There is therefore a need to understand these services better and who uses them. This is the third and final sub-study in a larger three-part research project in which we use different methods to examine support services for children aged 9-12 years. These are services that children can contact, either physically or digitally on various platforms.

Objective

The overall goal of the project was to produce knowledge that will support the public sector's work to develop good, quality-assured services, that can inform, guide and help children in the target group. The project that NIPH has carried out on behalf of the Norwegian Directorate for Children, Youth and Family Affairs (Bufdir) was part of a larger assignment given to Bufdir and the Norwegian Directorate of Health jointly by the Ministry of Health and Care Services and the Ministry of Children and Family Affairs. The project that NIPH carried out consisted of three parts. Substudy I was a mixed methods systematic review that synthesised Norwegian and international research. Substudy II was a mapping of existing services and their use in Norway today. Substudy III is a qualitative study with children and adolescents about their wishes, thoughts and experiences with child support services.

Method

The primary target group in this study was children aged 9-12 years. We conducted qualitative focus group interviews with 92 schoolchildren, aged 9-12 years, from eight different schools across the country. To ensure a broad sample, we created a list of schools based on the size of the school, its location (urban/rural) and the socio-economic status of the area in the regions we planned to visit. To recruit study participants (children and young people), we contacted schools via email and telephone (phone call or SMS). We created age-appropriate, semi-structured interview guides for the interviews with children. All focus group interviews were conducted face-to-face at school, during school hours.

We also conducted interviews with young people who had needed help for various reasons, such as bullying, eating disorders, anxiety or family problems, when they were aged 9-12. We conducted fifteen individual interviews and two group interviews with 20 young people aged 16-19. These young people had different experiences with support services, with different degrees of severity, when they were younger. The purpose of the interviews was to gain insight into what services they knew about, used and were missing when they were aged 9-12, and whether the services would have made a difference. We recruited most young people through youth centres in various locations in Norway. We designed a separate semi-structured interview guide for the interviews. The interviews with young people were conducted either face-to-face or via Teams.

We audio-recorded all interviews to ensure that we documented all relevant information. All consent forms, notes, audio recordings and transcripts were stored in the University of Oslo's secure storage service. The project was approved by the data protection official at the Norwegian Institute of Public Health (eProtocol number 4613-4801).

The analyses were conducted according to the collective thematic analysis model, which consists of six steps: 0) Preparation – everyone reads through their own interviews and make notes, 1) Present their interviews to the others and hang key points on the wall, 2) Map themes in plenary, 3) Grouping of themes/categorization, 4) Outline and work plan – for example, distribute writing in the group, and 5) Analysis after the work meeting. We mainly carried out descriptive analyses, where we described what the children and young people answered. Interpretation of interview data mostly consisted of theme mapping and categorization.

Results

Overall, children had limited knowledge of support services for children that exist today. This generally applied to children aged 9-12, but somewhat more among children aged 9-10. Several of the younger children seemed to particularly associate support services with emergency services, such as the fire department, police and ambulance, and had less knowledge of support services intended to assist children outside of emergency situations. Many children mentioned parents or other adults they trusted when asked where they would prefer to seek help or information. Most of them did not know about child welfare services. The school health service, run by a public health nurse, is probably most easily accessible to children. However, not everyone knew what a public health nurse does and few children had contacted one. There were also children who were unaware that there was a public health nurse at their school. Some of the children knew about a telephone service that children could contact. Among them, the Alarm Telephone for Children and Young People was mentioned most often, but again, the children had limited knowledge of the service. Only a handful of the children had contacted the service themselves or knew other children who had contacted it.

Only a small minority of the children talked about their own help needs, whereas the majority talked about ideas for how a support service for children should be designed. Many children wanted a support service that offered several possible forms of contact, both physical and digital, where the children themselves could choose the form of contact and how the communication should take place, with the opportunity to choose who they talk to, based on gender, age, education and experience. Many children wanted a service that, in addition to offering several possible forms of contact, could also offer step-by-step contact, for example by having digital contact or calling first, and then being able to meet face-to-face via video or physically. Being anonymous was important to many children, with somewhat different reasons for why it was important to them. Some children contrasted the need for anonymity with the desire to know the person they talk to when asking serious questions or raising problems with someone they know and trust. Some children wanted to talk to someone they know in a physical service, where anonymity is less important, while other children wanted to maintain anonymity by contacting a digital service. The young people also viewed anonymity as important, since the helper would not be concerned with the child's past history, but rather see the child and their problems in the present moment. For the vast majority of children, it was important that support services were made available and known to all children, for example by being talked about at school or by being promoted via posters or commercials in places where children are.

Discussion

One of the biggest challenges with today’s support services for children is that neither the physical nor the digital services sufficiently reach children. This applies to children aged 9-12 in general, and probably also affects the more vulnerable children in particular. Children lack knowledge of support services and they lack knowledge of what the services do and how they can be accessed. Meeting the needs of children places great demands on the design of a support service. It is uncertain whether it is possible to design a single support service that can both reach all children and at the same time accommodate all the varied wishes and needs that the children have.

Our findings indicate that existing support services partly meet the children's needs. If the aim of a support service is for children to have the opportunity to approach it on their own initiative, it will be particularly important that they are designed according to the children's needs. Strengthening the visibility of services in schools will be important, but that alone will probably not be enough to meet the needs of all children. Our findings show that children's presence on mobile phones, on the internet and on social media forms a significant part of their everyday life, and much of their communication with others is digital. Many children will therefore prefer or feel more familiar with this format also when they seek out support services. We therefore see a need for services that are based on a holistic perspective of children's lives.

Conclusion

We recognize a need for services that take a holistic approach to children's lives. Children aged 9-12 want flexible support services that can reach all children. It will be important to strengthen the visibility and accessibility of physical services. Additionally, it should be considered whether a digital support service specifically aimed at children aged 9-12 can be developed.