{
  "abstract": "Background/rationale\n\nChildren and young people in residential care often face multiple, complex traumas, including the distress of being removed from familiar environments. Trauma-responsive care (TRC) offers a framework for understanding and responding to these experiences, yet there is no standardised TRC intervention specifically designed for children's homes in the UK. This lack of tailored guidance contributes to inconsistent care quality and limited support for staff and service providers.Objectives/aims\n\nThe NEST Study aims to co-produce, pilot, and evaluate a trauma-responsive care intervention for children's homes through co-production and realist methods. NEST seeks to understand how, when, and why TRC interventions work for cared-for children and to develop an implementation toolkit that supports sector-wide improvement.Study design overview\n\nThis multi-phase realist co-production study comprises three workstreams: 1. A Rapid Realist Review to develop an initial programme theory of TRC in residential settings. 2. Experience-Based Co-Design (EBCD) with children, staff, and stakeholders to co-create the intervention, in alignment with the programme theory. 3. A Realist Evaluation of the intervention across six children's homes in Northern England, followed by refinement of the implementation toolkit.Methods\n\nUp to 150 children and young people, 60 staff, and 30 stakeholders will participate. Mixed methods will include qualitative interviews, creative participatory techniques, and validated and adapted quantitative measures (e.g., SDQ, RCADS, ProQOL). Quantitative data will be analysed using descriptive statistics and regression modelling. All data will be analysed using realist logic to identify, refine and test context-mechanism-outcome configurations. The intervention will be piloted over 12 months. The interpretation of emerging findings will be supported by a Lived Experience Advisory Group and Stakeholder Advisory Board.Key outcomes and analyses\n\nAnticipated outcomes include a refined realist programme theory of TRC in homes for cared for children and an implementation toolkit for care providers to use. Wellbeing and quality of life measures will provide insights into the impact of the pilot for the children, young people and staff who experience the trauma-responsive care pilot throughout the evaluation process.Clinical trial registration\n\nidentifier ISRCTN17921858.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.",
    "Pennine Care NHS Foundation Trust, Manchester, United Kingdom.",
    "Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.",
    "Faculty of Health & Education, Manchester Metropolitan University, Manchester, United Kingdom.",
    "Stockport Metropolitan Borough Council, Greater Manchester, United Kingdom.",
    "The Care Leavers' Association, Manchester, United Kingdom.",
    "Manchester Metropolitan University, Manchester, United Kingdom.",
    "University of Cumbria, Ambleside Campus, Cumbria, United Kingdom."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Sarah Parry"
    },
    {
      "affs": [
        2
      ],
      "name": "Geoff Wong",
      "orcid": "0000-0002-5384-4157"
    },
    {
      "affs": [
        1
      ],
      "name": "Steven Ariss"
    },
    {
      "affs": [
        1
      ],
      "name": "Sadie Rodell"
    },
    {
      "affs": [
        3
      ],
      "name": "Elaine Craig"
    },
    {
      "affs": [
        4
      ],
      "name": "Emma Ford"
    },
    {
      "affs": [
        5
      ],
      "name": "David Graham"
    },
    {
      "affs": [
        6
      ],
      "name": "Zarah Eve"
    },
    {
      "affs": [
        7
      ],
      "name": "Joy Duxbury"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/98fps73hw7hy0.bib",
  "cited_by": 0,
  "doi": "10.3389/frcha.2026.1816036",
  "fulltext_url": "https://europepmc.org/articles/PMC13686996",
  "id": "98fps73hw7hy0",
  "issns": [
    "2813-4540"
  ],
  "landing_url": "https://europepmc.org/article/MED/42923167",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3311|Child Welfare and Adoption"
    ]
  ],
  "openalex": "W7220967133",
  "pdf_url": "https://europepmc.org/articles/PMC13686996?pdf=render",
  "pmcid": "PMC13686996",
  "pmid": "42923167",
  "published": "2026-10-08",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/98fps73hw7hy0.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:36Z",
      "native_id": "MED:42923167",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42923167"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:3203|Child and Adolescent Psychosocial and Emotional Development",
      "subfield": "psychiatry"
    }
  ],
  "title": "Nurturing environments for shaping trauma-responsive care and recovery: a realist coproduction study protocol.",
  "title_text": "Nurturing environments for shaping trauma-responsive care and recovery: a realist coproduction study protocol.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:36Z",
  "url": "https://research.draconitic.com/paper/98fps73hw7hy0",
  "venue": "Frontiers in child and adolescent psychiatry",
  "versions": []
}