The implementation evaluation involves two key components:
- Phase 1 - Profiling of the structure and services being provided in the 5 ABS sites focusing in particular on issues such as ‘connectivity’ between services, and ‘pathways’ at baseline; and the way in which this provision changes over the course of the next five years, using conversations with key members of staff and both data and documentary analysis;
- Phase 2 - The collection of core process data from the sites regarding the participating families, and the services that they receive, using: i) routinely collected data from the sites; ii) researcher telephone interviews with key stakeholders.
During the setup of the programme, evaluators have been working alongside the A Better Start areas to ensure that their models of delivery are functioning optimally and to maximise the future effectiveness of the programme.
Three reports have been published so far that summarise the implementation of the programme to date. The first report looks at the process by which grant funding was awarded to the five sites, while the second looks in detail at the set-up phase. Report three examines system level and organisational change that had occurred in the transition period from set up to early delivery.
Groups of families in each of the five areas (Blackpool, Bradford, Lambeth, Nottingham, Southend-on-Sea) are being tracked and compared with similar families in 15 carefully selected comparison areas. This will tell us about the level of impact that A Better Start has had on families in the programme areas. We will look at short, medium and long term changes experienced by individuals (parents and children) in the three key A Better Start outcomes. These are:
Social and emotional health
Diet and nutrition
Communication, speech and language
We will use a large scale survey – the You and Your Child survey – to collect most of this data.
In addition to the survey data on individuals, we will be able to use publicly available data to observe any changes in outcomes that happen at a population-level in the A Better Start areas.
There are several small subgroups being studied alongside this largescale work. For example, biometric (laboratory) data is being collected for a small group of children, and some parent-infant interactions are being studied in the home learning environment.
Once we have gathered information on the outcomes of the programme, we can begin to develop an idea of the cost-effectiveness of the programme. This will feed into an economic evaluation of A Better Start (see below).
Two economic evaluations will be undertaken: (i) a within cohort study economic evaluation will compare individual-level costs and outcomes using propensity score techniques to construct the programme and comparison groups, and (ii) a decision analytic cost-effectiveness model will be used to estimate the expected incremental cost per unit change in primary outcomes for ABS in comparison to usual care. The economic evaluation will be led by Professor Stavros Petrou, based at the University of Warwick.
Experts have come together from a number of universities and research organisations, bringing subject and methodological expertise to successfully study A Better Start and communicate their findings.
You can see who is in the evaluation team here.