A Cost-Benefit Analysis of Early Childhood Intervention: Evidence from an Experimental Evaluation of the Incredible Years Parenting Program.

A number of researchers and policy makers have recently argued that the most effective way of dealing with long-run disadvantage and the intergenerational transmission of poverty is through early childhood intervention and in particular policies aimed at supporting the family. This study was part of a randomised evaluation of the Incredible Years Program, which is aimed at improving the skills and parenting strategies of parents who have children with conduct problems. The results show that the treatment significantly reduced behavioural problems in young children. Furthermore our detailed cost analysis, when combined with a consideration of the potential long-run benefits associated with the programme, suggest that the long-run rate of return to society from this program is likely to be relatively high.

A Cost-Benefit Analysis of Early Childhood Intervention: Evidence from an Experimental Evaluation of the Incredible Years Parenting Program.

A number of researchers and policy makers have recently argued that the most effective way of dealing with long-run disadvantage and the intergenerational transmission of poverty is through early childhood intervention and in particular policies aimed at supporting the family. This study was part of a randomised evaluation of the Incredible Years Program, which is aimed at improving the skills and parenting strategies of parents who have children with conduct problems. The results show that the treatment significantly reduced behavioural problems in young children. Furthermore our detailed cost analysis, when combined with a consideration of the potential long-run benefits associated with the programme, suggest that the long-run rate of return to society from this program is likely to be relatively high

The impact of three evidence-based programmes delivered in public systems in Birmingham, UK

The Birmingham Brighter Futures strategy was informed by epidemiological data on child well-being and evidence on “what works,” and included the implementation and evaluation of three evidence-based programmes in regular children’s services systems, as well as an integrated prospective cost-effectiveness analysis (reported elsewhere). A randomised controlled trial (RCT) of the Incredible Years BASIC parenting programme involved 161 children aged three and four at risk of a social-emotional or behavioural disorder. An RCT of the universal PATHS social-emotional learning curriculum involved children aged four–six years in 56 primary schools. An RCT of the Level 4 Group Triple-P parenting programme involved parents of 146 children aged four–nine years with potential social-emotional or behavioural disorders. All three studies used validated standardised measures. Both parenting programme trials used parentcompleted measures of child and parenting behaviour. The school-based trial used teacher reports of children’s behaviour, emotions, and social competence. Incredible Years yielded reductions in negative parenting behaviours among parents, reductions in child behaviour problems, and improvements in children’s relationships. In the PATHS trial, modest improvements in emotional health and behavioural development after one year disappeared by the end of year two. There were no effects for Triple-P. Much can be learned from the strengths and limitations of the Birmingham experience

Targeted vs universal provision of support in high-risk communities: comparison of characteristics in two populations recruited to parenting interventions

Purpose – To compare the characteristics of parents and children recruited for two randomised-controlled trials (RCTs) of parenting support in disadvantaged communities in Wales in order to explore the effects of community-based vs individual-based targeting in early prevention. Design/methodology/approach – Parents from high-risk disadvantaged communities in Wales, where additional early intervention services were targeted as part of a Welsh Government early intervention strategy, were recruited to two RCTs of parenting interventions. In the first study parents of targeted three- and four-year-old children, who were screened, and deemed at risk of long-term problems, were recruited from Sure Start (SS) areas in Wales. In the second study parents of one- and two-year-old children living in disadvantaged Flying Start (FS) areas were recruited, with residence within the FS area being the only recruitment criterion. Findings – FS areas are more strategically targeted as communities with a greater percentage of families with high levels of socio-economic disadvantage and associated risk than SS areas. Families in the toddler parenting trial based in FS areas, recruited without any additional screening, were experiencing higher levels of socio-economic deprivation, mental health problems and parenting stress as well as other known risks to child outcomes than the general population. However, when compared with the individually targeted population recruited for the SS study, they were shown to be experiencing significantly lower levels of these and other risks factors for poor child outcomes than the sample recruited for the SS trial where recruitment was based on known child risk factors. The paper discusses these findings and explores the implications of targeting by geographical area (community level targeting) alone vs targeting individual families by known risk factors. The findings suggest that screening measures would identify children at greatest risk of poor outcomes and whose families might benefit from additional targeted services. Suggestions for possible screening measures are also made. Originality/value – This paper contributes to discussion about effective ways of allocating limited resources to best effect. </jats:sec

Prevalence, trajectories, and determinants of television viewing time in an ethnically diverse sample of young children from the UK

BACKGROUND: Excessive screen viewing in early childhood is associated with poor physical and psycho-social health and poor cognitive development. This study aimed to understand the prevalence, trajectory and determinants of television viewing time in early childhood to inform intervention development. METHODS: In this prospective longitudinal study, mothers of 1558 children (589 white British, 757 Pakistani heritage, 212 other ethnicities) completed questionnaires when their children were approximately 6, 12, 18, 24 and 36 months old. Mothers answered questions about their own and their child's TV-time. TV-time trajectories were estimated by linear longitudinal multilevel modeling, potential determinants were considered in models. RESULTS: The modelled trajectory estimated that 75% of children aged 12 months exceeded guidelines of zero screen-time. At 12 months of age an accelerated increase in TV-time was observed (2 h/day by 30 months old). For every hour of mothers' TV-time and every hour the TV was on in the home, children's TV-time was 8 min and 1 min higher respectively at 6 months old (P < 0.05), and 15 min and 3 min higher respectively at 36 months old (P < 0.05). Children whose mothers did not agree that it was important their child did not watch too much TV, had 17 min more TV-time than their counterparts (P < 0.05). Children of first time mothers had 6 min more TV-time (P < 0.05). At 12 months of age, children of mothers experiencing stress watched 8 min more TV (P < 0.05). By 36 months, children of Pakistani heritage mothers had 22 min more TV-time than those of white British mothers (P < 0.05), and an additional 35 min of TV-time if their mother was not born in the UK (P < 0.05). CONCLUSIONS: High levels of TV-time were prevalent. Intervention developers should consider targeting interventions before 12 months of age. Modifiable determinants included mothers' own TV-time, the time the television is on in the home and mothers' attitude towards child TV-time. These behaviours may be key components to address in interventions for parents. Mothers experiencing stress, first time mothers, and Pakistani heritage mothers (particularly those born outside of the UK), may be priority groups for intervention

Incredible Years parenting programme: cost-effectiveness and implementation

Purpose – There is growing interest in the economic evaluation of public health prevention initiatives and increasing government awareness of the societal costs of conduct disorder in early childhood. The purpose of this paper is to investigate the cost-effectiveness of the Incredible Years (IY) BASIC parenting programme compared with a six-month waiting list control. Design/methodology/approach – Cost-effectiveness analysis alongside a pragmatic randomised controlled trial of a group-parenting programme. The primary outcome measure was the Strengths and Difficulties Questionnaire (SDQ), a measure of child behaviour. Findings – The IY programme was found to have a high probability of being cost-effective, shifting an additional 23 per cent of children from above the clinical concern to below the cut-off on the SDQ compared to the control group, at a cost ranging from £1612-£2418 per child, depending on the number of children in the group. Originality/value – The positive findings of this study have led to ongoing implementation of the IY programme and is therefore an example of commitment to evidence-based service provision and investment in prevention initiatives