Top PDF The health effects of Sure Start

The health effects of Sure Start

The health effects of Sure Start

Note: Deprivation rank comes from the 1998 Index of Local Deprivation, where lower ranks indicate more disadvantaged local authorities. ‘% low birthweight’ captures the share of babies born weighing less than 2,500 grams. Teen conceptions are measured per thousand women aged 15–17. Male and female earnings are median weekly earnings for full-time work. ‘Jobseeker’s allowance’ is the JSA receipt rate. Population density is measured as the population (in thousands) per square kilometre. ‘% EAL’ refers to the share of primary school pupils with English as an additional language. ‘Children looked after’ is the number of children looked after per thousand children aged 0–4. Jobcentre Plus and GP provision are measured as centres or practices per thousand residents in the local authority. ‘Funded childcare’ refers to the take-up rate of the 3- and 4-year-old free entitlement to part-time funded childcare. District councils refer to lower-level councils while counties are upper-level councils; in unitary authorities and London and metropolitan boroughs, the council counts as both a ‘district’ and a ‘county’. ‘Aligned’ councils are controlled by the same party as the national government. ‘LA district’ fixed effects capture the 323 lower-level local authorities, including single-tier authorities (we exclude the Isles of Scilly, City of London and West Somerset, which are all strong outliers in Sure Start coverage). These fixed effects also capture the deprivation rank, which is constant within LAs over time. Results are estimated for the years 1999– 2010 using linear regression. Standard errors are shown in parentheses. *, ** and *** indicate significance at the 10%, 5% and 1% level respectively. Years of measurement for the local characteristics are available in Appendix B. Each of the variables is measured one year prior to the outcome measure.
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The impact of Sure Start Local Programmes on five year olds and their families

The impact of Sure Start Local Programmes on five year olds and their families

In the evaluation of child and family functioning at 5 years, evidence of 6 beneficial and 2 adverse SSLP effects emerged in this quasi-experimental investigation. Across 21 dependent variables or outcomes evaluated 4 , significant main or across- the-board effects of SSLPs on age-5 functioning emerged in the case of these 8 outcomes after taking into consideration pre-existing family and area background characteristics (in all sets of analyses). There was limited evidence that SSLPs benefited children directly, including in terms of ’school readiness’ (FSP scores). Nevertheless, on the positive front, mothers in SSLP areas reported greater life satisfaction, while engaging in less harsh discipline and providing a less chaotic and more cognitively stimulating home learning environment than their counterparts from the MCS who did not live in SSLP areas. Additionally, children growing up in SSLP areas had lower BMIs, due to the fact that they were less likely to be overweight, and better physical health than those residing in comparison communities. Mothers in SSLP areas, however, experienced more depressive symptoms and were less likely to attend school meetings than those in comparison areas. Finally, no differences emerged between the NESS and MCS groups on 7 measures of cognitive and social development from the Foundation Stage Profile completed by teachers, 4 measures of socio-emotional development based on mothers’ ratings, and mothers’ ratings of area safety.
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Research and Policy in Developing an Early Years’ Initiative: The Case of Sure Start

Research and Policy in Developing an Early Years’ Initiative: The Case of Sure Start

SSLPs were meant to bring “joined-up” services of health, childcare and play, early education and parental support to families with a child under four years of age. SSLPs were to be a completely new way of working for central and local governments. They were to be the glue that would bind together services for families. They were to be based on the best evidence and on experience of what works to give children and families the very best chance to thrive. Programmes were directed to provide outreach for difficult-to-reach families and could add extra services to suit local needs, such as debt counselling, employment, and benefits advice. Community control was to be exercised through local partnerships. Initially, service-provider organisations in a deprived area were invited to submit a bid for Sure Start funding. The invitation indicated that a partnership of local stakeholders had to be constituted and that this partnership needed a plan for a Sure Start programme, nominating a lead agency. These partnerships were to be at the heart of the initiative and bring together everyone concerned with children, including health, social services, education, the private sector, the voluntary sector and parents. Thus, partnerships were to provide local community influence for the design of each SSLP and, as a consequence, even though core services were required, no specification was provided of how they would be delivered, only what they should aim to achieve. Funding was to flow from central government, the SSU, directly to programmes (i.e., not via local government). Programmes could act largely independently of local government, although local departments of education,
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The impact of Sure Start Local Programmes on five year olds and their families

The impact of Sure Start Local Programmes on five year olds and their families

negative effects were that mothers experienced more depressive symptoms and parents in SSLP areas were less likely to attend school meetings. No SSLP effects emerged in the case of “school readiness”, defined in terms of children’s early language, numeracy and social skills needed to succeed in schools, as measured by the Foundation Stage Profile. This may be due to high levels of participation in the 3 and 4 Year Old Free Entitlement to pre-school education across England, which has resulted in many of the MCS children also benefitting from early years learning opportunities.
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Sure Start Collingwood and Stepney Local Programme Midwifery Project Evaluation

Sure Start Collingwood and Stepney Local Programme Midwifery Project Evaluation

There were specific questions on smoking and breastfeeding reflecting the public health importance of these two issues and their direct relevance to the work of Sure Start midwives. We did not anticipate many Bangladeshi women (the majority of service users) to be smokers, though a question regarding smoking was asked of all women. In addition to this, we also asked a question regarding chewing of Paan or betel nut and “Darza”, a product believed to be contain tobacco. This is thought to be more prevalent amongst Bangladeshi women than smoking, and may have implications for the uptake of breastfeeding and the women’s and babies’ health. Recent research in Tower Hamlets indicates that the prevalence of Paan chewing amongst Bangladeshi women of 48.5% compared to a smoking prevalence of 4% amongst the same women(4).
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The impact of Sure Start local programmes on three year olds and their families

The impact of Sure Start local programmes on three year olds and their families

variations account for the differences in findings across the two phases of the NESS impact evaluation, it seems eminently possible that the contrasting results accurately reflect the contrasting experiences of SSLP children and families in the two phases. Whereas those 3-year-olds enrolled in the first phase were exposed to relatively immature programmes—and probably not for their entire lives—3 year old children and their families participating in the second phase were exposed to more mature and better developed programmes throughout the entire lives of the children. Also these latter children and families were exposed to programmes that had the opportunity to learn from the results of the earlier study, especially with respect to the need for greater effort to be made to reach the most vulnerable households. In sum, differences in the amount of exposure to these programmes and the quality of SSLPs may well account for both why the first phase of impact evaluation revealed some adverse effects associated with SSLPs for the most disadvantaged children and families and why the second phase of evaluation reveals beneficial effects for almost all children and families living in SSLP areas.
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The impact of Sure Start local programmes on seven year olds and their families

The impact of Sure Start local programmes on seven year olds and their families

development at three years of age, being on average roughly one standard deviation below the population mean (NESS 2005). This indicates that the average child in an SSLP area was functioning at about the level of the 15 th percentile which represents a very substantial developmental handicap. This is likely to have profound consequences not just for the children but for their families, communities, and for society at large. SSLPs not only aimed to enhance health and well-being during the early years, but also to increase the chances that children entered school ready to learn, would be
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The impact of Sure Start local programmes on seven year olds and their families

The impact of Sure Start local programmes on seven year olds and their families

The NESS research team faced methodological challenges and these are outlined here and in more detail later in the main report. These issues place some limits on the study’s ability to afford strong causal inferences about effects of SSLPs on children and families. Early decisions not to undertake a randomised control trial and to double the number of SSLPs (reducing the opportunity to identify suitable comparison areas) meant that the evaluation had to use the MCS cohort as a source of comparison data. This resulted in a two year gap between SSLP and comparison data such that any SSLP-comparison group differences might be due to time effects. This limitation was overcome by the research team with respect to education outcomes such as KS1 scores. Despite methodological challenges a great deal has been learnt over the years from the many reports provided by NESS, and these have clearly influenced policy. This report shows how some of those changes have had a positive impact, for instance on improving the reach and impact on the most vulnerable families, and there are no longer any negative effects associated with Sure Start programmes. While bearing in
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Evaluating bilingual peer support for breastfeeding in a local Sure Start

Evaluating bilingual peer support for breastfeeding in a local Sure Start

Table 3 shows when breastfeeding support was received and from whom. All women received breastfeeding support at some stage of their maternity care. Women received more support postnatally, and less support during their hospital stay. More of them received support from the support worker both antenatally and postnatally than from other health professionals. The “Other” category represents women who received antenatal support but were unable to remember which health professional gave it. Those who received support during hospital stay had received support from the hospital nurse on duty.
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Promoting speech and language : a themed study in fifteen Sure Start local programmes

Promoting speech and language : a themed study in fifteen Sure Start local programmes

Books were used in many SSLPs in Stay and Play groups (encouraging parents to use strategies to promote their child’s language) – for example, as a resource in the free play time in groups or modelled during a rhyme or story time. Among the most popular schemes is Book Start, promoted by a wide range of staff. Health Visitors took Book Start packs to families but often there was no time for them to model and explain early book use with young babies. Some nurseries and SSLPs had very good library facilities – parents appreciated suggestions about the creative use of books with very young children.
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The Manchester and Salford Sure Start Plus pilot programme: A baseline evaluation  SCNMCR Report: 12

The Manchester and Salford Sure Start Plus pilot programme: A baseline evaluation SCNMCR Report: 12

Evidence confirms that teenagers from socially deprived backgrounds are the least likely to have healthy babies and health lifestyles. The reasons included early life deprivation, which affects birth weight and growth and can cause Coronary Heart Disease in later life, housing, culture and ethnicity which may influence physical, mental and emotional well being, and smoking, alcohol and drugs, all of which are known to affect growth and mental and physical well being in many ways both during and after pregnancy. Family breakdown and domestic abuse also play a significant role in mental health breakdown in this already vulnerable group. Literature also focused on prevention of pregnancy and choices in early pregnancy. This included education, access to contraceptive services, the age of onset of sexual intercourse and factors influencing the choice to terminate a pregnancy, all of which are less available to young people with complex social needs.
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England’s Sure Start Pre School Child Care Centres: Public Policy, Progress and Political Change

England’s Sure Start Pre School Child Care Centres: Public Policy, Progress and Political Change

Specialist child care centres focusing on urban areas in which significant numbers lived in poverty were part of policies to reduce chronic poverty and disadvantage, and associated negative behaviours and achievements in children and young people. They were initiated by the New Labour government in the late 1990s, and evolved in various ways as Sure Start centres, and Early Childhood Care Centres. Methodologi- cally sophisticated evaluation has shown that these interventions have been partially successful in various ways, particularly with regard to preschool children’s behaviour and adjustment, and parent-child interactions. When early interventions were linked to health programmes, and to teacher-led initiatives, the programmes were most successful. Nevertheless, the programmes failed to reach some 5 percent of those identified as most in need, for whom profound and chronic poverty was the cause of parental problems, and dysfunctional parent-child interactions. When programmes for such families were reduced because of changes in the manner and amount of funding, outcomes for the very poor families and their children were significantly worse. The Sure Start programmes were, in the final analysis, underfunded and sub- ject to political change and interference, and hardly dented the chronic disadvantages imposed by England’s system of class division.
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An evaluation of maternity care provided in three Sure Start Local Programmes in Islington. Summary report

An evaluation of maternity care provided in three Sure Start Local Programmes in Islington. Summary report

Most women interviewed appreciated the importance of breastfeeding and expressed a wish to breastfeed. The post-partum period was particularly important in influencing and establishing breastfeeding. Many women did not receive access to Sure Start support for breastfeeding until 2 or 3 weeks after the birth. The findings suggest that support is required much earlier within the first 24 hours of birth and quite intensively during the first month following birth. Breastfeeding support needs to be responsive to each womens’ individual needs and difficulties. There is a definite role here for a trained Maternity Health Care Assistant. At the time of interviewing Maternity Health Care Assistants had not yet received training in breastfeeding assistance, although they had completed other training courses. Also, at this time Maternity Health Care Assistants were usually only visiting the women postnatally, normally two weeks after giving birth.
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An evaluation of maternity care provided in three Sure Start Local Programmes in Islington. Final report

An evaluation of maternity care provided in three Sure Start Local Programmes in Islington. Final report

Limited data were recorded for pre and postnatal depression, and data recorded were of questionable validity. Data were recorded for one year only based on RICHS data, with extremely low numbers of women with postnatal depression identified. The extremely low numbers recorded are thought to undercount the prevalence of postnatal depression in the Islington population, and suggest problems may exist either in the use of the Edinburgh Postnatal Depression Scale and identification of postnatal depression, or in the recording of this information routinely. It was anticipated that this information would be collected by health visitors who may use this scale with women as an initial assessment of postnatal depression. The issue of collection of data relating to postnatal depression is discussed in the results section. No data were recorded on smoking during pregnancy, reflecting in part the limited routine collection of these data. While the Whittington Hospital has incorporated collection of data on smoking during pregnancy in its Patient Administration System, these data have not been incorporated into birth notification form data available within the CHIA child health system.
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Sure Start Little Hulton 39 week evaluation report

Sure Start Little Hulton 39 week evaluation report

This period has been a difficult one for the Health Visiting team. A severe staffing shortage in other areas of Salford necessitated the transfer of one the team, reducing the available Health Visitor hours almost to the pre-Sure Start level. Although this situation has reportedly been resolved, the service is still understaffed due to maternity leave. In addition, it has proved difficult to recruit and retain the adequate administrative support in Little Hulton. Under these circumstances, the team has obviously been handicapped in delivering its Sure Start services and evaluation efforts have unfortunately been given a low priority. However, the staff nurse role has continued to develop and the team has reported on this and other activities.
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Building Firm Foundations Sure Start Mellow Valley Evaluation Report 2005/ 2006

Building Firm Foundations Sure Start Mellow Valley Evaluation Report 2005/ 2006

Early results from the BUSS and Stakeholder Survey show that Sure Start Mellow Valley was meeting the needs of families from a very early stage (see boxes 3 & 4). Families involved with the Sure Start programme reported being very satisfied with the support and activities provided. The primary purpose of the Baseline User Satisfaction Survey was to obtain views from 120 parents on local services and support available to families with children under 4 years. The Stakeholder Survey looked at the development and contribution of the programme to local needs. Some early achievements were captured (see box 4). Evidence from team evaluations has shown that groups such as the Bosom Buddies breast feeding group, ante-natal groups, parenting groups, play in the home scheme and the Home Safety equipment scheme have been successful in providing access to health information and
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Evaluation of Sure Start on the Ocean bilingual breastfeeding support work. Final report

Evaluation of Sure Start on the Ocean bilingual breastfeeding support work. Final report

 It is clear that the support worker has had some influence on women’s decision to breastfeed. In order for more women to benefit from this kind of support and for women in general to recognise this unique scheme, we suggest that work of this kind be promoted across Tower Hamlets. The aim of Sure Start is that the work should come from the local community and be sustainable once Sure Start finishes. In order to implement this, we suggest the health services employ more local women from different ethnic backgrounds to work across Tower Hamlets. In particular, they should work with the community so that women see the support worker as an expert in breastfeeding; who can give information and support about breastfeeding as well as any doctor or midwife or health visitor and should be the first port of call for women with breastfeeding difficulties.
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Constructions of 'gendered agency' : Perspectives from a multi ethnic Sure Start programme

Constructions of 'gendered agency' : Perspectives from a multi ethnic Sure Start programme

The function of the home visiting service and of childcare provision in facilitating the ability of women to ‘get out’ or to have ‘time for themselves’ has already been described in this chapter. In addition, women accessed a range of group activities such as Mother and Toddler, regular Health Visitor-run post-natal groups, ‘Cook and Eat’ and other topic-focused sessions. Below, Amina, who at 26 has four children, compares her current levels of activity and positive state of mind with her inactivity and unhappiness in the period before this provision existed, when her other children were young. Here she emphasises the impact of the programme on her own well-being and that of others - increased confidence, new friendships and greater connections in the area - gained from services which facilitate contact between mothers. These same elements are contained in the extract from Zainab - herself both a parent and a worker - whose account illustrates the scope of provision now available, and also emphasises the wider benefits gained from services which have a focus on social interaction at their centre.
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Sure Start Little Hulton evaluation report for the period April   December 2005

Sure Start Little Hulton evaluation report for the period April December 2005

Programme management has taken a pro-active approach to these problems and with support from the evaluation team has prepared a system for continued project evaluation in the coming years. Introduction to Evaluation in Children's Centres,written by M. Allen of the Salford University evaluation team, is included as Appendix 1 of this report. The introduction is suitable for giving to projects as a guide to the system. Sure Start Little Hulton programme management hold pro formas for reporting by the following projects: Bookstart; Family Support; Health Visiting; Language Development; Midwifery; Parental Development; Perinatal Depression; Portage.
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Understanding the contribution of Sure Start local programmes to the task of safeguarding children's welfare

Understanding the contribution of Sure Start local programmes to the task of safeguarding children's welfare

SSLP staff saw co-working arrangements as providing an opportunity to work with other professionals who they may not have encountered before. Co- working arrangements might include two or more professionals working innovatively to jointly deliver a service. For example, the Citizen’s Advice Bureau (CAB) and Health Visitor might team up to provide advice about negotiating with aspects of the NHS. Practitioners working alongside colleagues in this way reported that it gave them a broader perspective and better understanding of each other’s work. Co-working arrangements also came to be seen as a way of addressing the issue of duplicate visits, which could overwhelm families being visited by too many professionals, especially where there was a child protection concern. “Everyone works well together. The health visitors have recently wanted to become involved with us a lot more – if we want to go on a home visit with them, we can now. It might be because of Children’s Centres and they see in the future we’re all going to have to work together more. I’ve seen a recent shift in position, which is wonderful” (Family Social Worker).
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