A randomised controlled trial and process evaluation of the Lifestart parenting programme. Interim report

This paper presents the methodology and interim process evaluation findings from an on-going randomised controlled trial evaluation of the Lifestart parenting programme. Lifestart is a structured child-centred programme of information and practical activity for parents of children aged from birth to five years of age. It is delivered to parents in their own homes by trained, paid Family Visitors and it is offered to parents regardless of social, economic or other circumstances. The evaluation comprises two strands: a randomised controlled trial (RCT) to evaluate the effectiveness of the programme and a process evaluation, which documents programme delivery and is a qualitative exploration of parent and child outcomes. 424 parents and children are participating in the RCT: 216 in the intervention group and 208 in the control group. Parent outcomes include: parental efficacy, stress, social support, parenting skills and social capital. Child outcomes include cognitive, language and motor development and social-emotional and behavioural development. Both groups are tested at four time points during the evaluation: pre-test (when children are less than 1 year old), two mid points and finally at post-test (when children are aged 5). Data are collected during a home visit, which takes approximately two hours. The process evaluation consists of interviews and focus groups with parents (n=11), Lifestart Coordinators (n=9) and Family Visitors (n=24). The purpose of this strand of data collection is to provide a commentary on the process of the evaluation; qualitatively test the theory hypothesised in the Lifestart logic model and explore parental satisfaction and engagement with the Lifestart programme. Quantitative findings from the RCT are not yet available however interim findings from the qualitative process evaluation have highlighted important issues and challenges related to conducting trials of this magnitude and design in the general population. Parents reported that a key incentive to take part in study was receiving feedback from the developmental assessment, which is part of the data collection for the RCT. This highlights the potential importance of appropriate incentives in terms of recruitment and retention of participants. The interviews with intervention parents indicated that one of the first changes they are experiencing as a result of the Lifestart programme is increased knowledge and confidence in their parenting ability. The outcomes and pathways as perceived by parents and described in the interviews are consistent with the theory of change depicted in the Lifestart logic model, which hypothesises that improvement in parental outcomes, arising as a consequence of the programme, mediates the change in child outcomes. Parents receiving the Lifestart programme reported great satisfaction with and commitment to the programme, with the role of the Family Visitor being identified as one of the key components of the programme. The study is due to be completed in 2014 with the final report available after this time