The effects of an area-based intervention on the uptake of maternal and child health assessments in Australia: A community trial

Kelaher, Margaret; Dunt, David; Feldman, Peter; Nolan, Andrea; Raban, Bridie

doi:10.1186/1472-6963-9-53

Cited by 7 publications

(14 citation statements)

References 21 publications

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“…Of the 12 initiatives included for analyses, there were five national initiatives: one in Australia, Communities for Children [ 10 , 37 – 39 ]; one in Ireland, the Area Based Childhood (ABC) Programme [ 40 ]; and three in the UK, Sure Start [ 8 , 41 – 46 ], Neighbourhood Nurseries Initiative [ 47 ] and Flying Start [ 48 – 51 ]. There were four state or regional initiatives: one in Australia, Best Start [ 52 – 54 ]; and three in the USA, First Steps (First Steps) to School Readiness [ 55 , 56 ], Smart Start [ 57 , 58 ] and Georgia Family Connection [ 59 ]. The remainder were national or state demonstration projects which were smaller in scope: one in Canada, Toronto First Duty [ 60 – 63 ]; one in Ireland, National Early Years Access Initiative (NEYAI) [ 64 ]; and one in Scotland, Starting Well [ 65 , 66 ].…”

Section: Resultsmentioning

confidence: 99%

“…The remainder were national or state demonstration projects which were smaller in scope: one in Canada, Toronto First Duty [ 60 – 63 ]; one in Ireland, National Early Years Access Initiative (NEYAI) [ 64 ]; and one in Scotland, Starting Well [ 65 , 66 ]. Five initiatives commenced between 1990 and 2000 (Sure Start [ 8 , 41 – 46 ], First Steps [ 55 , 56 ], Smart Start [ 57 , 58 ], Georgia Family Connection [ 59 ], Starting Well [ 65 , 66 ]); five between 2001 and 2009 (Communities for Children [ 10 , 37 – 39 ], Neighbourhood Nurseries Initiative [ 47 ], Flying Start [ 48 – 51 ], Best Start [ 52 – 54 ], Toronto First Duty [ 60 – 63 ]); and two after 2010 (ABC Programme [ 40 ], NEYAI [ 64 ]). Key characteristics of the 12 included initiatives are summarised in Table 2 and the initiatives are described in Table 3 .…”

Section: Resultsmentioning

confidence: 99%

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Place-based approaches to improve health and development outcomes in young children: A scoping review

et al. 2021

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This scoping review examines the strength of evidence for the effectiveness of public policy-led place-based initiatives designed to improve outcomes for disadvantaged children, their families and the communities in which they live. Study designs and methods for evaluating such place-based initiatives were assessed, along with the contexts in which initiatives were implemented and evaluated. Thirty-two reports relating to 12 initiatives were included. Eleven initiatives used a quasi-experimental evaluation to assess impact, although there were considerable design variations within this. The remaining initiative used a pre- and post- evaluation design. Place-based initiatives by definition aim to improve multiple and interrelated outcomes. We examined initiatives to determine what outcomes were measured and coded them within the five domains of pregnancy and birth, child, parent, family and community. Across the 83 outcomes reported in the 11 studies with a comparison group, 30 (36.4%) demonstrated a positive outcome, and all but one initiative demonstrated a positive outcome in at least one outcome measure. Of the six studies that examined outcomes more than once post baseline, 10 from 38 outcomes (26.3%) demonstrated positive sustained results. Many initiatives were affected by external factors such as policy and funding changes, with unknown impact on their effectiveness. Despite the growth of place-based initiatives to improve outcomes for disadvantaged children, the evidence for their effectiveness remains inconclusive.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Place-based approaches to improve health and development outcomes in young children: A scoping review

et al. 2021

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“…To put some of these findings in context, the World Health Organization (WHO) has promoted the importance of early area-based interventions in health and educational attainment worldwide [34] , leading to community-based initiatives to improve developmental outcomes among socio-economically disadvantaged children [35] – [37] . These initiatives reflect the WHO's principles of the Health for All (HFA) [34] .…”

Section: Discussionmentioning

confidence: 99%

“…For example, the Best Start project in Australia aims to improve the overall health, development, learning and wellbeing of Victoria's young children and their families in some of the most socially disadvantaged communities through local partnerships and improved service co-ordination [38] . After several years, the findings suggest that improvements in access to services in disadvantaged areas can be achieved by area-based interventions, such as optimising the use of existing resources, and that the potential health benefits of area-based interventions might be better assessed by examining steps along the pathway between intervention and outcome [35] [39] . In the UK, improving education and skills is one of the five priority goals of the National Strategy for Neighbourhood Renewal and the New Deals for Communities Programme.…”

Section: Discussionmentioning

confidence: 99%

Local Modelling Techniques for Assessing Micro-Level Impacts of Risk Factors in Complex Data: Understanding Health and Socioeconomic Inequalities in Childhood Educational Attainments

et al. 2014

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Although inequalities in health and socioeconomic status have an important influence on childhood educational performance, the interactions between these multiple factors relating to variation in educational outcomes at micro-level is unknown, and how to evaluate the many possible interactions of these factors is not well established. This paper aims to examine multi-dimensional deprivation factors and their impact on childhood educational outcomes at micro-level, focusing on geographic areas having widely different disparity patterns, in which each area is characterised by six deprivation domains (Income, Health, Geographical Access to Services, Housing, Physical Environment, and Community Safety). Traditional health statistical studies tend to use one global model to describe the whole population for macro-analysis. In this paper, we combine linked educational and deprivation data across small areas (median population of 1500), then use a local modelling technique, the Takagi-Sugeno fuzzy system, to predict area educational outcomes at ages 7 and 11. We define two new metrics, “Micro-impact of Domain” and “Contribution of Domain”, to quantify the variations of local impacts of multidimensional factors on educational outcomes across small areas. The two metrics highlight differing priorities. Our study reveals complex multi-way interactions between the deprivation domains, which could not be provided by traditional health statistical methods based on single global model. We demonstrate that although Income has an expected central role, all domains contribute, and in some areas Health, Environment, Access to Services, Housing and Community Safety each could be the dominant factor. Thus the relative importance of health and socioeconomic factors varies considerably for different areas, depending on the levels of each of the other factors, and therefore each component of deprivation must be considered as part of a wider system. Childhood educational achievement could benefit from policies and intervention strategies that are tailored to the local geographic areas' profiles.

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“…Initiatives such as Sure Start in the UK and Best Start in Australia focus on innovations and extensions of services across a wide front [1,[4][5][6][7]. The evaluation of Sure Start local programs suggested that the program resulted in improved parenting and better social functioning in children among non-teenage mothers but poorer social functioning among the children of teenage mothers and lower verbal ability among children of single parents who did not work [1].…”

Section: Introductionmentioning

confidence: 99%

How Significant is Partnership Formation in Area-Based Projects to Increase Parental Attendance at Maternal and Child Health Services?

Kelaher

Dunt

Nolan

et al. 2013

Int. J. Child Health Nutr.

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Objectives: In this study, we assess the importance of area-based partnerships in an initiative to improve access to Maternal and Child Health (MCH) services (known as Best Start) in socially disadvantaged communities in Victoria, Australia. Methods:The study assessed changes in MCH attendance rates, parental attitudes and local partnership formation before and after the introduction of Best Start projects. Partners involved in Best Start projects were surveyed regarding the extent of local partnership formation (before 54; after 84). Data was collected for MCH attendance using routine records for Best Start with MCH projects (before 1,739; after 1437) and the rest of the State (before 45,497; after 45,953). Two cross-sectional surveys of parents of 3-year old children were used to assess changes in parent's knowledge about, and confidence in using relevant services as well as parental confidence more generally (before 1666; after 1838).Results: Best Start was significantly associated with improving:• levels of partnership formation (5 of 7 relevant factors)• attendance at the 3.5 year MCH visit in Best Start Sites with MCH projects between 2001/02-2004/05.• parent's access to information (partnership effect);• confidence about attending the 3.5 year MCH visits (partnership effect); and• overall parental confidence (project effect only). Conclusion:Best Start improves participation in the MCH attendance. This is related most directly to improving parent's access to information and overall parental confidence either through local partnership or direct project effects.

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The effects of an area-based intervention on the uptake of maternal and child health assessments in Australia: A community trial

Cited by 7 publications

References 21 publications

Place-based approaches to improve health and development outcomes in young children: A scoping review

Place-based approaches to improve health and development outcomes in young children: A scoping review

Local Modelling Techniques for Assessing Micro-Level Impacts of Risk Factors in Complex Data: Understanding Health and Socioeconomic Inequalities in Childhood Educational Attainments

How Significant is Partnership Formation in Area-Based Projects to Increase Parental Attendance at Maternal and Child Health Services?

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