Born in Bradford’s Better Start: an experimental birth cohort study to evaluate the impact of early life interventions

Abstract

BackgroundEarly interventions are recognised as key to improving life chances for children and reducing inequalities in health and well-being, however there is a paucity of high quality research into the effectiveness of interventions to address childhood health and development outcomes. Planning and implementing standalone RCTs for multiple, individual interventions would be slow, cumbersome and expensive. This paper describes the protocol for an innovative experimental birth cohort: Born in Bradford’s Better Start (BiBBS) that will simultaneously evaluate the impact of multiple early life interventions using efficient study designs. Better Start Bradford (BSB) has been allocated £49 million from the Big Lottery Fund to implement 22 interventions to improve outcomes for children aged 0–3 in three key areas: social and emotional development; communication and language development; and nutrition and obesity. The interventions will be implemented in three deprived and ethnically diverse inner city areas of Bradford.MethodThe BiBBS study aims to recruit 5000 babies, their mothers and their mothers’ partners over 5 years from January 2016-December 2020. Demographic and socioeconomic information, physical and mental health, lifestyle factors and biological samples will be collected during pregnancy. Parents and children will be linked to their routine health and local authority (including education) data throughout the children’s lives. Their participation in BSB interventions will also be tracked. BiBBS will test interventions using the Trials within Cohorts (TwiCs) approach and other quasi-experimental designs where TwiCs are neither feasible nor ethical, to evaluate these early life interventions. The effects of single interventions, and the cumulative effects of stacked (multiple) interventions on health and social outcomes during the critical early years will be measured.DiscussionThe focus of the BiBBS cohort is on intervention impact rather than observation. As far as we are aware BiBBS is the world’s first such experimental birth cohort study. While some risk factors for adverse health and social outcomes are increasingly well described, the solutions to tackling them remain elusive. The novel design of BiBBS can contribute much needed evidence to inform policy makers and practitioners about effective approaches to improve health and well-being for future generations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3318-0) contains supplementary material, which is available to authorized users.

Assessing community readiness for early intervention programmes to promote social and emotional health in children

“…The housing estate is highly diverse in terms of ethnicity with a mixture of White working‐class households and minority ethnic communities many of which are of Pakistani heritage with more recent arrivals coming from Eastern European countries. The community is located within a catchment area of the Better Start Bradford programme, a 10‐year Big Lottery funded initiative to deliver interventions to address a range of health and social disparities affecting children's development . The interventions delivered to support the development of social and emotional health for children include support for teenage mothers, a befriender scheme for all mothers affected by or at risk of post‐natal depression, healthy lifestyle advice and a range of targeted and universal parenting programmes.…”

Growing up in Bradford: protocol for the age 7–11 follow up of the Born in Bradford birth cohort

“…As well as promoting collective responsibility for the success of the BiB project, our collaborative approach has also increased receptiveness to the evidence that emerges from BiB. This inclusive approach is in line with our longer term ambition to establish a 'city of research' which unites our multiple cohorts [1,52] with citizen science, city-wide linked datasets, intervention research and policy engagement. As a result of close integration of our research with organisations within the city, BiB and partners have been able to attract additional investment into the city to implement and evaluate evidence based interventions to improve health outcomes including 'Better Start Bradford' [53], a Sport England funded local delivery pilot [54] and the Department for Education Bradford Opportunity Area [55].…”

Lifestyle intervention strategies in early life to improve pregnancy outcomes and long-term health of offspring: a narrative review

“…An example of this approach is the experimental birth cohort design in the Born in Bradford's Better Start Study, in which the effect of multiple early life interventions on children's social and emotional development, communication and language development, and nutrition and obesity risk are assessed within a birth cohort design. 69 Third, future randomized controlled intervention trials need to carefully consider the population they are targeting. Thus far, most randomized controlled intervention trials have focused on selected populations, such as obese women or women who previously delivered an infant with macrosomia.…”