Seminar on Evidence Based Policy Making

Professor Michael Little, Dartington Social Research Unit

&

University of Chicago

24 July 2006

Improving Outcomes for Ireland’s Children

• Trends in the well-being of children• Potential causes of impairment to children’s development• The value of prevention• ‘What Works’ evidence• Current trends in children’s services in Europe• Applying the ideas and evidence to Ireland

Trends in the well-being of children

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10

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70

EducationWealthBehaviourHyperactivity

Potential causes of impairment to children’s

development

• Inequality of wealth

• Stress on children

• Family structure

• Environmental stressors

• Quality of children’s services

• G x E

The Value of Prevention

• Population wide

• Targeted prevention

• Mixed portfolio

Population Wide Prevention: Alcohol Intake in the US

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10

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30

40

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60

US

Population Wide Prevention: Alcohol Intake in the Ireland

and US

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10

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30

40

50

60

USIreland

‘What Works?’

• Proven Models– What do we mean by proven?– How many models and where do we find

them?– Examples of proven models

‘What Works?’

• Proven Models– What do we mean by proven?

• Evaluated by experimental methods– How many models and where do we find them?

• 100-200• Database designed for Ireland• Other sources

http://www.colorado.edu/cspv/blueprints/index.html– Examples of proven models

• E.g. Incredible Years; Big Brother, Big Sisters• New/adapted services based on ‘what works e.g.

Tallaght West, Ballymun, Northside

Current Trends in Children’s Services in Europe

• Outcome driven• Needs led• Integrated provision• Evidence based• Balance of ‘thick’ and ‘thin’ services• Common language• Child’s voice• Local innovation and ownership

Applying the Ideas and Evidence to Ireland

• The use of ‘logic models’

• The logic behind investments in planning

• Methods underpinning the investments

• How will we know whether these investments have led to improved outcomes?

The Use of Logic Models

• Oc A I Ot

versus

• I A Ot-- -- -- -- Oc

The Logic Behind Atlantic Investments

• Support for Community Engagement and Innovation Sites

• To design, implement and rigorously evaluate new services

• Will produce improved outcomes in the sites where investments are made

• And models that can be used by other communities in Ireland and internationally

• Leading to improved health, learning and commitment to community outcomes for children on the island

Methods Underpinning Investments

• Strategy Development

• Service Design

• Manual Preparation

• Evaluation Strategies

Methods Underpinning Investments

• Strategy Development– Good Epidemiology– Close consultation with consumers of services– Good fit with national policy– Analysis of ‘what works’ evidence– Strong evaluation strategy– Strong local ownership

• Service Design• Manual Preparation• Evaluation Strategies

How will we know whether these investments have led to

improved outcomes?

• Longitudinal Study

• Child Indicators

• Annual analysis of need

• 35-50 rigorous evaluations

• Heckman/Pritzker Consortium

Use of RCT’s as part of Mixed Evaluation Portfolio

• Randomised Control Trials (RCT’S) provide the most robust form of evidence on outcomes

• Ethics and tools to minimise problems of RCT implementation

• Qualitative methods – use of ethnography, implementation evaluation etc

Issues in Conclusion

• Some early results (08 – 09) but long term effects take time

• ‘Bends in the road’ – spirit of partnership with sites and patience required

• New way of working – service managers and deliverers will need continuous support and development