{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:38:46Z","timestamp":1792622326044,"version":"4.5.0"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parent carers of children with neurodisability are empowered when they have greater agency and influence over decisions about their child's care. When parent carers are empowered, it benefits both them and their children. Building on previous work, this study aimed to co\u2010produce a Theory of Change (ToC) to inform the development of a new parent carer empowerment intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We convened a group of nine participants (four parent carers, three service providers, one service manager, one service commissioner) to co\u2010produce our ToC. The participatory process consisted of structured workshops co\u2010facilitated by a researcher and a parent carer partner, with iterative phases of data analysis. Analysis drew on behavioural science to develop detailed ToC maps and a provisional intervention plan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Twenty\u2010nine short\u2010term, thirteen medium\u2010term and seven long\u2010term outcomes were identified and incorporated into causal pathways of the ToC. The group prioritised two medium\u2010term outcomes informing the focus of the intervention: (1) Effective two\u2010way information sharing and (2) trusting relationships between service providers and parent carers. Following integration of a behavioural analysis, the new intervention targets change in seven service provider behaviours.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our co\u2010produced, theory and evidenced\u2010based intervention targets change in service provider behaviour by focusing on self\u2010awareness and critical reflection, specifically related to how information is shared\/managed and how interactions with parent carers are framed and performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient\/Public Contribution<\/jats:title>\n                    <jats:p>Our project team includes a group of parent carer research partners. Members of the group have been involved in planning and design, facilitation of workshops and dissemination of findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70871","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:48:46Z","timestamp":1788958126000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Empowering Parent Carers of Children With Neurodisability in Healthcare Settings: Co\u2010Producing a Theory of Change for Intervention Development"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3315-0737","authenticated-orcid":false,"given":"Jim","family":"Reeder","sequence":"first","affiliation":[{"name":"PenCRU (Peninsula Childhood Disability Research Unit), Health &amp; Community Sciences University of Exeter Medical School  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5405-0839","authenticated-orcid":false,"given":"Saira","family":"Minhas","sequence":"additional","affiliation":[{"name":"PenCRU Family Faculty, Health &amp; Community Sciences University of Exeter Medical School  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0952-6650","authenticated-orcid":false,"given":"Erica","family":"Breuer","sequence":"additional","affiliation":[{"name":"Department of Medicine and Public Health The University of Newcastle Newcastle New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5658-9334","authenticated-orcid":false,"given":"Jane R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Exeter Collaboration for Academic Primary Care (APEx), University of Exeter Medical School University of Exeter  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2507-0350","authenticated-orcid":false,"given":"Sally","family":"Kendall","sequence":"additional","affiliation":[{"name":"Centre for Health Services Studies University of Kent  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9916-507X","authenticated-orcid":false,"given":"Christopher","family":"Morris","sequence":"additional","affiliation":[{"name":"PenCRU (Peninsula Childhood Disability Research Unit), Health &amp; Community Sciences University of Exeter Medical School  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.12218"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2016.00226"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-10-21"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2010.111773"},{"key":"e_1_2_11_6_1","unstructured":"United Kingdom Government \u201cThe Children and Families Act \u201d 2014."},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-024-05104-3"},{"key":"e_1_2_11_8_1","volume-title":"Health Promotion Glossary","author":"World Health Organization","year":"1998"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/dmcn.70039"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-018-5168-4"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/1367493520910832"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-015-0907-z"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/medhum-2017-011398"},{"key":"e_1_2_11_14_1","volume-title":"Fit for the Future: The 10 Year Health Plan for England","author":"Department of Health and Social Care","year":"2025"},{"key":"e_1_2_11_15_1","volume-title":"Working in Partnership With People and Communities: Statutory Guidance","author":"NHS England","year":"2022"},{"key":"e_1_2_11_16_1","volume-title":"The NHS Constitution","author":"Department of Health and Social Care","year":"2023"},{"key":"e_1_2_11_17_1","volume-title":"Health Care for Disabled Children and Young People. 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