Initial protocol for a national evaluation of an area-based intervention programme (A Better Start) on early-life outcomes: a longitudinal cohort study with comparison (control) cohort samples

Barlow, J. et al. (2017) Initial protocol for a national evaluation of an area-based intervention programme (A Better Start) on early-life outcomes: a longitudinal cohort study with comparison (control) cohort samples. BMJ Open, 7(8), e015086. (doi: 10.1136/bmjopen-2016-015086) (PMID:28851771) (PMCID:PMC5724149)

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Introduction: Pregnancy and the first few years of a child’s life are important windows of opportunity in which to equalise life chances. A Better Start (ABS) is an area-based intervention being delivered in five areas of socioeconomic disadvantage across England. This protocol describes an evaluation of the impact and cost-effectiveness of ABS. Methods and analysis: The evaluation of ABS comprises a mixed-methods design including impact, cost-effectiveness and process components. It involves a cohort study in the 5 ABS areas and 15 matched comparison sites (n=2885), beginning in pregnancy in 2017 and ending in 2024 when the child is age 7, with a separate cross-sectional baseline survey in 2016/2017. Process data will include a profiling of the structure and services being provided in the five ABS sites at baseline and yearly thereafter, and data regarding the participating families and the services that they receive. Eligible participants will include pregnant women living within the designated sites, with recruitment beginning at 16 weeks of pregnancy. Data collection will involve interviewer-administered and self-completion surveys at eight time points. Primary outcomes include nutrition, socioemotional development, speech, language and learning. Data analysis will include the use of propensity score techniques to construct matched programme and comparison groups, and a range of statistical techniques to calculate the difference in differences between the intervention and comparison groups. The economic evaluation will involve a within-cohort study economic evaluation to compare individual-level costs and outcomes, and a decision analytic cost-effectiveness model to estimate the expected incremental cost per unit change in primary outcomes for ABS in comparison to usual care. Ethics and dissemination: Ethical approval to conduct the study has been obtained. The learning and dissemination workstream involves working within and across the sites to generate learning via communities of practice and a range of learning and dissemination events.

Item Type:Articles
Keywords:Early childhood, evaluation, intervention, pregnancy, protocol
Glasgow Author(s) Enlighten ID:Leyland, Professor Alastair
Authors: Barlow, J., Beake, S., Bick, D., Bryson, C., Day, L., Gilby, N., Glover, V., Knibbs, S., Leyland, A., Lindsay, G., Mathers, S., McKenna, K., Petrou, S., Purdon, S., Sylva, K., Summerbell, C. D., Tudor, F., Wheeler, A., and Woolgar, V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > MRC/CSO SPHSU
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN (Online):2044-6055
Published Online:28 August 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in BMJ Open 7(8):e015086
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
727651SPHSU Core Renewal: Measuring and Analysing Socioeconomic Inequalities in Health Research ProgrammeAlastair LeylandMedical Research Council (MRC)MC_UU_12017/13IHW - MRC/CSO SPHU