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Main research and evaluation studies
on the Child Development Programmes

Throughout the existence of the Child Development Programmes, evaluation studies have assessed the outcomes of what is or is not being achieved. Some of the major studies undertaken by the Early Childhood Development Centre are briefly reviewed elsewhere on this page. There have also been a variety of other studies carried out by individuals or groups who have been using the programme, and also by a few groups who had no involvement with or knowledge of the programme but who felt they wanted to do their own evaluations.

Below are listed all the significant studies undertaken, with a brief description of each study’s focus, classified as independent, semi-independent, or by the ECDC in collaboration with participating health authorities.

There are also many hundreds of observational reports from health visitors, community parents and visited parents themselves, describing their experiences and conclusions about the effectiveness of the programmes. It would be impossible to list or categorise the observational reports, other than to say that they offer strong and consistent evidence on positive effects.

As explained in the research studies described in other articles on this page, such reports lack the strength of having compared outcomes with the outcomes on non-programme families. However for the individuals concerned with providing programme visits, the mass of evidence confirmed their own convictions that the programme support offered by the CDP is a worth-while investment of staff resources. Some of the many observations include

Independent studies

Lang, Gillian (1981) Primary health care as an educational framework for the empowerment of communities (M.Ed. dissertation, Faculty of Education, University of Manchester)

Comment: only part of that thesis deals with the CDP, but it is a profound study of the philosophy of the programme

Squire, Anne (1995) An exploration of mothers, mothering skills and empowerment when visited by health visitors carrying out conventional health visiting and the Child Development Programme (Dissertation for the Diploma/MSc in Health Education and Health Promotion, Leeds Metropolitan University)

Comment: a useful and insightful study, looking also at feminist issues in relation to the programme

Hughes, Rosemary (1995) An effective health visiting response to identified health and social need: the Child Development Programme (Armagh and Dungannon Unit of Management)

Comment: a comprehensive report which looked not only at the Programme but also at issues of concern to health visiting management

Stockport Healthcare (1997) First Parent Visiting: Evaluation Study (Primary and Public Health Directorate, Stockport Healthcare Trust)

Comment: an evaluation of the First Parent Visiting model of the Programme, undertaken by a Trust that has had a long involvement in the CDP/span>

Coyle, Breige and Crumlish, Loretta (1997) Audit of Community Mothers Programme (Foyle Health and Social Services Trust)

Comment: a study of the development of the Community Mothers Programme, including information on a variety of positive indicators of child and maternal well-being within the Programme

Emond, A., Pollock, J. et al (2002) An evaluation of the First Parent Visitor Scheme (Arch. Dis. Child. 86, 150-157)

Comment: 40% of families invited to participate refused; the research team found no benefit for the programme; there were fewer accidents but more children on the Child Protection Register; as soon as the report was issued a clerk telephoned the ECDC to say that the three remaining health visitors were immediately ceasing to use the programme

Mason, Carolyn (1998) Review of the Child Development Programme (Eastern Health and Social Services Board)

Comment: a fairly critical study, based on a literature review, meetings with managers from the four EHSSB trusts, focus group sessions with health visitors, written submissions from two Trusts expressing the views of health visitors, discussions with experts and opportunistic conversations

Northern Ireland Forum of the Child Development Programme (1999) Responses to Carolyn Mason’s Review of the Child Development Programme

Comment: this response questioned a number of the criticisms reported in the Review and replied to many of the specific points made in it

British Medical Association (1999) Growing up in Britain: ensuring a health future for our children - a study of 0-5 year olds (publ. BMA)

Comment: chapters 3, 5 and 7 each make brief positive references to the efficacy of the parent support provided by the Programme

Miller, Marian and Hughes, Barbara (1999) A community partnership with parents: investing in the future (Australian Journal of Primary Health Interchange, Vol. 5, No. 4, 28-35)

Comment: an evaluation of a programme based on the principles and practice of the Community Mothers Programme, with training provided by staff of the ECDC during three extended visits to Australia; the report focuses mainly on the many positive changes reported by parents, community mothers and the health authority’s community child health nurses

Semi-independent studies

Johnson, Zacharias, Howell, F. and Molloy, Brenda (1993) Community mothers’ programme: randomised controlled trial of non-professional intervention in parenting (British Medical Journal 306 29 May 1449-1452)

Comment: this is a well-known and convincing study which can speak for itself

Lee, Pauline (1988) The effects of a nutrition intervention programme on the nutritional status of pre-school children in disadvantaged areas of Dublin (PhD thesis, University of Dublin, Division of Nutritional Sciences)

Comment: the author was employed by the ECDC to undertake the nutritional evaluation, using weighed intake and other methods to determine whether the Child Development Programme had an impact on the quality of diets in a large Dublin sample, comparing these with controls in a randomised controlled study; the conclusions were positive

Lewis, Eleri (1989) The dietary patterns and growth of disadvantaged infants and young children and the effects of nutrition intervention (PhD thesis, University of Wales)

Comment: this study, whose author was also employed by the ECDC to undertake the nutritional evaluation, ran in parallel with the study in Dublin, with similar randomised controlled samples; it looked at other programme outcomes, including anthropometric data gathered at the beginning, middle and end of the two-year intervention and found positive results

Johnson, Zacharias, Molloy, Brenda et al (2000) Community Mothers Programme - seven-year follow-up of a randomised controlled trial of non-professional intervention in parenting (Journal of Public Health Medicine, 22, 3 337-342)

Comment: a follow-up to the 1993 study that established the effectiveness of community mothers in supporting parents; the authors traced one-third of the original randomised controlled groups of intervention and control parents, and found on almost every indicator that there were meaningful and in many cases significant improvements in the intervention families compared with controls.

Studies undertaken by the Early Childhood Development Centre, in most cases in collaboration with participating health authorities

1988 Barker, W. and Anderson, R. The Child Development Programme: an evaluation of process and outcomes. A detailed statistical analysis of the programme outcomes (Early Childhood Development Unit, Department of Social Work, University of Bristol)

Comment: this report on the two-year pilot intervention study was based on randomised controlled samples in six urban centres in England, Wales and the Republic of Ireland; the six intervention and six control samples totalled over 1,000 families

1991 Barker, W. Empowering parents - the evolution, expansion and evaluation of a Program (Zero to Three April pp. 8-15 National Center for Clinical Infant Programs, Arlington, USA)

Comment: this report, in one of the leading early childhood journals in the US, was written at the request of the editors

1992 Barker, W. Health visiting: action research in a controlled environment (International Journal of Nursing Studies 29 3 251-259)

Comment: this report looked at some of the complexities of undertaking action research in a controlled sample

1992 Early Childhood Development Unit Birth and Early Childhood in Trafford: Epidemiological and Programme Findings - Evaluation Document No. 13 (ECDU and Department of Social Work, University of Bristol)

Comment: analyses undertaken on field data collected by programme and non-programme health visitors in Trafford, using the Early Health and Development Monitor to record data on nearly 5,000 children and their environments

1992 Barker, W., Anderson, R.M. and Chalmers, C. Child Protection: the impact of the Child Development Programme - Evaluation Document No. 14 (Early Childhood Development Unit, Department of Social Work, University of Bristol)

Comment: this study on over 30,000 children whose parents had been involved in the Child Development Programme, showed the powerful influence of the programme in bringing about a 50% reduction in physical abuse and a 40% reduction in placement on the CPR, comparing sample areas (all disadvantaged) with the surrounding health authority areas; out of 24 authorities participating, in only three authorities were the CDP figures higher for physical abuse, and in only four were the CDP placements on the CPR higher

1994 Barker, W., Anderson, R. and Chalmers, C. EHSSB: Health Trends over time and major outcomes of the Child Development Programme - Evaluation Document No. 15 (Early Chldhood Development Centre, Bristol, and Eastern Health and Social Services Board, Belfast)

Comment: this study on 9,400 children born in the EHSSB area between 1989 and 1993 compared intervention and control children on a variety of indicators, showing the programme children scoring higher on almost every major outcome of the programme

Studies on programme samples in other health authorities/trusts have also been undertaken, both by the ECDC in collaboration with the authorities, or independently. In most cases these other studies examined only programme children and were unable to evaluate control children.

Dr. Walter Barker, BSc, MA, PhD Director, Early Childhood Development Centre

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