Study shows Sure Start program in England gives benefits to children and their families

November 06, 2008

The Sure Start Local Programmes (SSLP) in England lead to children having better social development and more positive social behaviour. Also, parents in SSLP areas showed less negative parenting and provided a better home-learning environment. These are conclusions of an Article in this week's Social Determinants of Health Special Issue of The Lancet, written by Professor Edward Melhuish, Institute for the Study of Children, Families and Social Issues, Birkbeck, University of London, UK, and colleagues from the National Evaluation of Sure Start Research Team.

SSLPs are area-based interventions to improve services for young children and their families in deprived communities, promote health and development, and reduce inequalities. The research team compared 5883 3-year-old children and their families from 93 disadvantaged SSLP areas with 1879 controls from 72 deprived areas not receiving SSLP. They studied 14 outcomes -- children's immunizations, accidents, language development, positive and negative social behaviours, independence, parenting risk, home-learning environment, father's involvement, maternal smoking, body-mass index, life satisfaction, family's service use, and mother's rating of area.

The study's main findings were that, after controlling for background factors, SSLP showed benefits for five of the 14 outcomes. Children in SSLP areas showed better social development*, more positive social behaviour, and less negative social behaviour. Parents also showed less negative parenting and provided a better home-learning environment. Families in SSLP areas used more services for supporting child and family development than did controls not living in SSLP areas. Furthermore, the effect of SSLPs seemed to apply to all subpopulations** and SSLP areas.

The authors conclude: "Children and their families benefited from living in SSLP areas. The contrast between these and previous findings on the effect of SSLPs might indicate increased exposure to programmes that have become more effective. Early interventions can improve the life chances of young children living in deprived areas."

In an accompanying Comment, Dr Penny Kane (now retired, formerly University of Melbourne, Australia), discusses the problems of effectively monitoring the Sure Start programme, which commenced without an inbuilt plan for evaluation. She discusses the frequent reorganising of priorities since the programme's inception, and says these need careful monitoring. She concludes: "The [UK] Department for Children, Schools and Families, which funded the research, ruled out a randomised trial...The rejection of a randomised trial has made interim evaluations difficult and -- despite the sophisticated efforts of the current team -- less comprehensive than they could or should be."
-end-
Professor Edward Melhuish, Institute for the Study of Children, Families and Social Issues, Birkbeck University of London, UK T) +44 (0) 7855 309427 e.melhuish@bbk.ac.uk

Dr Penny Kane (now retired, formerly University of Melbourne, Australia) contact by e-mail only E) pskane@braidwood.net.au

Notes to editors: *see panel, p1642 of full paper for full description of the 14 measured indicators

**subpopulations are boys and girls, lone parents and dual parents, workless households and working households, different ethnic groups, teen parents and non-teen parents, the most economically deprived and not so-economically deprived.

Full Article and Comment: http://press.thelancet.com/surestart.pdf

Lancet

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