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#evidence4impact
Chris Cuthbert
Director of Development, A Better Start, UK
#ABetterStart
A Better Start
Sir Michael Marmot
58.5
25.4
50
33.1
37.8
41.8
31.5
53.7
27
60.7
0
10
20
30
40
50
60
70%
Source: Dearden, L. (2010)
Most deprived 2nd 3rd 4th Least deprived
Inequalities emerge early
Social & Emotional Difficulties at age 5
by family income
Sources: Millennium Cohort Study
Bottom 40% on British Ability Scale
at age 3, by SEP
A Better Start
Ten-year investment:
focus on conception to 4th birthday
Early childhood development
IMAGE FOR NUTRITION IMAGE FOR SOCIAL
AND EMOTIONAL DEVELOPMENT
IMAGE FOR COMMUNICATIONS/ SPEECH & LANGUAGE
System reform
Improved diet and
nutrition
Improved social and
emotional development
Improved communication
and language
Outcomes
IMAGE FOR NUTRITION IMAGE FOR SOCIAL
AND EMOTIONAL DEVELOPMENT
IMAGE FOR COMMUNICATIONS/ SPEECH & LANGUAGE
System reform
Improved diet and
nutrition
Improved social and
emotional development
Improved communication
and language
Outcomes
Shifts in thinking
‘Old think’ ‘New think’
Isolated programmes Place-based strategies
Achieving positive outcomes
National Implementation Research Network
Shifts in thinking
‘Old think’ ‘New think’
Isolated programmes Place-based strategies
Competing agendas Common purpose and collaboration
Shifts in thinking
‘Old think’ ‘New think’
Isolated programmes Place-based strategies
Competing agendas Common purpose and collaboration
Picking up the pieces Focus on prevention
Shifts in thinking
‘Old think’ ‘New think’
Isolated programmes Place-based strategies
Competing agendas Common purpose and collaboration
Picking up the pieces Focus on prevention
Parent v. child focus ‘Think Family’
Shifts in thinking
‘Old think’ ‘New think’
Isolated programmes Place-based strategies
Competing agendas Common purpose and collaboration
Picking up the pieces Focus on prevention
Parent v. child focus ‘Think Family’
Community v. expert Coproduction of evidence based services
Shifts in thinking
‘Old think’ ‘New think’
Isolated programmes Place-based strategies
Competing agendas Common purpose and collaboration
Picking up the pieces Focus on prevention
Parent v. child focus ‘Think Family’
Community v. expert Coproduction of evidence based services
Reactive interventions Pathways supporting prevention
Shifts in thinking
‘Old think’ ‘New think’
Isolated programmes Place-based strategies
Competing agendas Common purpose and collaboration
Picking up the pieces Focus on prevention
Parent v. child focus ‘Think Family’
Community v. expert Coproduction of evidence based services
Reactive interventions Pathways supporting prevention
‘Professional gift’ Sharing power and building capabilities
Shifts in thinking
‘Old think’ ‘New think’
Isolated programmes Place-based strategies
Competing agendas Common purpose and collaboration
Picking up the pieces Focus on prevention
Parent v. child focus ‘Think Family’
Community v. expert Coproduction of evidence based services
Reactive interventions Pathways supporting prevention
‘Professional gift’ Sharing power and building capabilities
Data for compliance Data for learning and improving
A Local Example
Life course approach
Focused intervention
4 Cornerstones
Change for a population (public health approach)
Community Resilience • Parks and safe play • Children’s Centres • Activity cards • Community Connectors • Baby Rover, Food Banks • EPEC
Public Health Campaigns • Social, emotional & language • Alcohol exposed pregnancies
• Oral health
Enhanced Universal Offer • Baby Steps
• Health Visiting transformation • Perinatal Mental Health Pathway
• Workforce Development • Common Language (Frameworks)
Change for a population (public health approach)
Community Resilience • Parks and safe play • Children’s Centres • Activity cards • Community Connectors • Baby Rover, Food Banks • EPEC
Public Health Campaigns • Social, emotional & language • Alcohol exposed pregnancies
• Oral health
Enhanced Universal Offer • Baby Steps
• Health Visiting transformation • Perinatal Mental Health Pathway
• Workforce Development • Common Language (Frameworks)
Targeted/Specialist • Parents Under Pressure
• Safecare • Video Interaction Guidance
• Survivor Mums • Family Nurse Partnership
Adapt • Steps to Safety • Making it REAL
• SALT
Change for those with
additional needs
Amplifying learning
Focus Better Start funding on identified wards
Use leveraged funding to improve the lives of babies across the town
Research and development in the Centre to tell us what works and what might be replicated in other areas.
Work with others to share learning and allow more families to benefit.
Implementation
Impact
• Prospective cohort
• 5 test; 15 control areas
• Pregnancy – age 5
• Cost effectiveness
Dissemination
Evaluation
Learning together
“Tell me and I forget,
Teach me and I may remember,
Involve me and I learn”
Benjamin Franklin
www.abetterstart.org.uk
