Barlow, Jane, Beake, Sarah, Bick, Debra, Bryson , Caroline, Day, Laurie, Gilby, Nicholas, Glover, Vivette, Knibbs, Sarah, Leyland, Alastair, Lindsay, Geoff, Mathers, Sandra, McKenna, Katharine, Petrou, Stavros, Purdon, Susan, Sylva, Kathy, Summerbell, Carolyn, Tudor, Fiona, Wheeler, Amy and Woolgar, Virginia (2017) Initial protocol for a national evaluation of an area-based intervention programme (A Better Start) on early-life outcomes : a longitudinal cohort study with comparison (control) cohort samples. BMJ Open, 7 (8). e015086. doi:10.1136/bmjopen-2016-015086 ISSN 2044-6055.

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Abstract

Introduction
Pregnancy and the first few years of a child’s life are important windows of opportunity in which to equalize life chances. A Better Start (ABS) is an area-based intervention being delivered in five areas of socioeconomic disadvantage across England. This protocol describes an evaluation of the impact and cost-effectiveness of ABS.

Methods and analysis
The evaluation of ABS comprises a mixed-methods design including impact, cost-effectiveness and process components. It involves a cohort study in the 5 ABS areas and 15 matched comparison sites (n=2885), beginning in pregnancy in 2017 and ending in 2024 when the child is age 7, with a separate cross-sectional baseline survey in 2016/2017. Process data will include a profiling of the structure and services being provided in the five ABS sites at baseline and yearly thereafter, and data regarding the participating families and the services that they receive. Eligible participants will include pregnant women living within the designated sites, with recruitment beginning at 16 weeks of pregnancy. Data collection will involve interviewer-administered and self-completion surveys at eight time points. Primary outcomes include nutrition, socioemotional development, speech, language and learning. Data analysis will include the use of propensity score techniques to construct matched programme and comparison groups, and a range of statistical techniques to calculate the difference in differences between the intervention and comparison groups. The economic evaluation will involve a within-cohort study economic evaluation to compare individual-level costs and outcomes, and a decision analytic cost-effectiveness model to estimate the expected incremental cost per unit change in primary outcomes for ABS in comparison to usual care.

Item Type:	Journal Article
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare
Divisions:	Faculty of Social Sciences > Centre for Educational Development, Appraisal and Research (CEDAR) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Mental Health and Wellbeing Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Child development -- Great Britain, Stress in children -- Great Britain -- Longitudinal studies, Poor children -- Services for -- Great Britain -- Cost-effectiveness, Preschool children -- Services for -- Great Britain -- Cost-effectiveness, Poor children -- Services for -- Great Britain -- Evaluation, Preschool children -- Services for -- Great Britain -- Evaluation
Journal or Publication Title:	BMJ Open
Publisher:	BMJ
ISSN:	2044-6055
Official Date:	1 August 2017
Dates:	Date Event 1 August 2017 Published 28 August 2017 Available 12 June 2017 Accepted 21 March 2017 Submitted
Volume:	7
Number:	8
Article Number:	e015086
DOI:	10.1136/bmjopen-2016-015086
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	12 September 2017
Date of first compliant Open Access:	12 September 2017
Funder:	Big Lottery Fund (Great Britain) (BLF)
Grant number:	BIG001-0398
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID BIG001-0398 Big Lottery Fund http://dx.doi.org/10.13039/501100000385

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