Skip to main content

Advertisement

SpringerLink
Log in

Evaluating “Starting Well,” the Scottish National Demonstration Project for Child Health: Outcomes at Six Months

  • Published:
Journal of Primary Prevention Aims and scope Submit manuscript

Abstract

This paper presents early findings from the evaluation of Starting Well, an intensive home visiting program aimed at improving the health of pre-school children in disadvantaged areas of Glasgow, Scotland. Using a quasi-experimental design, detailed survey, observation and interview data were collected on a cohort of 213 intervention and 146 comparison families over the first six months of the child’s life. After controlling for relevant background characteristics, multivariate regression analysis revealed higher child dental registration rates and lower rates of maternal depressive symptoms in the intervention cohort. Findings are interpreted as positive evidence of early program impact. Implications, limitations and future plans for analysis are discussed.

Editors’ Strategic Implications: Starting Well draws on elements of an Australian parent education program and an American home visitation model. The authors demonstrate how the program implementation, research questions, and measurement are designed to fit their Glasgow population and the Scottish public health system. Their quasi-experimental data suggest that this primary prevention program is a promising strategy for improving maternal and child health outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Barlow, J., Kirkpatrick, S., Stewart-Brown, S., & Davis, H. (2003). ‘Hard-to-reach’ or ‘out-of-reach’: Reasons why vulnerable women refuse to take part in interventions designed to help and trials to assess their impact (working paper). University of Oxford, Health Services Research Unit, Institute of Health Sciences, Department of Public Health.

  • Bradley, R. H. (1993). Children’s home environments, health, behavior and intervention efforts: A review using the HOME Inventory as a marker measure. Genetic, Social and General Monographs, 119(4), 439–491.

    Google Scholar 

  • Bradley, R. H., & Caldwell, B. M. (1979). Home observation and measurement of the environment: A revision of the preschool scale. American Journal of Mental Deficiency, 84, 235–244.

    PubMed  Google Scholar 

  • Bradley, R. H., & Caldwell, B. M. (1988). Using the HOME Inventory to assess the family environment. Pediatric Nursing, 14, 97–102.

    PubMed  Google Scholar 

  • Bradley, R. H., Colwyn, R. F., & Whiteside-Mansell, L. (1996). Life at home: Same time, different places—an examination of the HOME inventory in different cultures. Early Development and Parenting, 5(4), 251–269.

    Article  Google Scholar 

  • Broadhead, W. E. (1988). The Duke-UNC Functional Social Support Questionnaire. Medical Care, 26(7), 709–721.

    PubMed  Google Scholar 

  • Bull, J., McCormick, G., Swann, C., & Mulvihill, C. (2004). Evidence briefing summary: Ante- and post-natal home visiting programs: A review of reviews. London: Health Development Agency.

    Google Scholar 

  • Caldwell, B. M., & Bradley, R. H. (1984). Home observation and measurement of the environment. Little Rock, AR: University of Arkansas at Little Rock.

    Google Scholar 

  • Clifford, C., Day, A., Cox, J., & Werrett, J. (1999). A cross-cultural analysis of the use of the Edinburgh Postnatal Depression Scale in health visiting practice. Journal of Advanced Nursing, 30(3), 655–664.

    Article  PubMed  Google Scholar 

  • Connell, J. P., & Kubisch, A. C. (1998). Applying a theory of change approach to the evaluation of comprehensive community initiatives: Progress, prospects and problems. In A. Fulbright-Anderson, A. C. Kubisch, & J. P. Connell (Eds.), New approaches to evaluating community initiatives: Theory, measurement and analysis (pp. 15–44). Washington, DC: Aspen Institute.

    Google Scholar 

  • Cooper, P. J., & Murray, L. (1998). Postnatal Depression. British Medical Journal, 316, 1884–1886.

    PubMed  Google Scholar 

  • Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.

    PubMed  Google Scholar 

  • Davies, J. A. (1999). Enhancing dental attendance rates for children from deprived areas in the UK. British Dental Journal, 187(6), 323–326.

    Article  PubMed  Google Scholar 

  • Elliott, S. (1996). A model of multi-disciplinary training on the management of postnatal depression. In Postnatal depression: focus on a neglected issue. Papers from the HVA/NCT national conference, London, 18 April 1996. London: Health Visitors’ Association/National Childbirth Trust.

    Google Scholar 

  • Elkan, R., Kendrick, D., Hewitt, M., Robinson, J. J. A, Tolley, K., Blair, M., et al. (2000). The effectiveness of domiciliary health visiting: A systematic review of international studies and a selective review of the British literature. Health Technology Assessment, 4, 13.

    Google Scholar 

  • Field, T. M., Widmayer, S. M., Greenberg, R., & Stoller, S. (1980). Effects on parent training on teenage mothers and their infants. Pediatrics, 69, 703–707.

    Google Scholar 

  • Fulbright-Anderson, A., Kubisch, A. C., & Connell, J. P. (Eds.). (1998). New approaches to evaluating community initiatives: Theory, measurement and analysis. Washington, DC: Aspen Institute.

    Google Scholar 

  • General Register Office (Scotland). (2003). Scottish census results on-line (SCROL). Retrieved August 14, 2003 from http://www.scrol.gov.uk/scrol/common/home.jsp.

  • Gerard, J., Holden, J., Elliott, S., McKenzie, P., & Cox, J. (1993). A Trainer’s perspective of an innovative program teaching health visitors about the detection, treatment and prevention of postnatal depression. Journal of Advanced Nursing, 18, 1825–1832.

    Article  PubMed  Google Scholar 

  • Gerrard, J. (2000). Postnatal Depression. London: Emap Healthcare.

    Google Scholar 

  • Holden, J., Sagovsky, R., & Cox, J. (1989). Counseling in a general practice setting: A controlled study of health visitor intervention in treatment of postnatal depression. British Medical Journal, 298, 223–226.

    PubMed  Google Scholar 

  • Judge, K., & Bauld, L. (2001). Strong theory, flexible methods: Evaluating complex community-based initiatives. Critical Public Health, 11(1), 19–38.

    Article  Google Scholar 

  • Judge, K., & Mackenzie, M. (2002). Theory-based evaluation: New approaches to evaluating complex community-based initiatives. In J. Mackenbach & M. Bakker (Eds.), Reducing Inequalities in Health: A European Perspective (pp. 300–312). London: Routledge.

    Google Scholar 

  • Kitzman, H., Olds, D., Henderson, J., Hanks, C., Cole, R., & Tatelbaum, R. (1997). Effect of prenatal and infancy home visitation by nurses on pregnancy outcomes, childhood injuries and repeated childbearing. Journal of the American Medical Association, 278, 644–652.

    Article  PubMed  Google Scholar 

  • Korfmacher, J. Kitzman, H., & Olds, D. (1998) Intervention processes as predictors of outcomes in a preventive home-visitation program. Journal of Community Psychology, 26(1), 49–64.

    Article  Google Scholar 

  • Larson, C. P. (1980). Efficacy of prenatal and postpartum home visits on child and health development. Pediatrics, 66, 191–1977.

    PubMed  Google Scholar 

  • Launguni, P. (1997). Mental illness in India and Britain: Theory and practice. Medical Law, 16, 509–540.

    Google Scholar 

  • Launguni, P. (2000). Postnatal depression across cultures: Conceptual and methodological considerations. International Journal of Health Promotion & Education, 38(3), 86–94.

    Google Scholar 

  • Mantle, F. (2003). Developing a culture-specific tool to assess postnatal depression in the Indian community. British Journal of Community Nursing, 8(4), 176–180.

    PubMed  Google Scholar 

  • Morrison, J. J., Macpherson, L. M. D., & Binnie, V. I. (2000). A qualitative investigation of the perceived barriers to and inducements for the early registration of infants with general dental practitioners. International Journal of Health Promotion and Education, 38(1), 4–9.

    Google Scholar 

  • Murray, L. (1992). The impact of postnatal depression on infant development. Journal of Child Psychology and Psychiatry, 33, 543–561.

    PubMed  Google Scholar 

  • Murray, L., & Carothers, A. D. (1990). The validation of the Edinburgh Postnatal Depression Scale on a community sample. British Journal of Psychiatry, 157, 288–290.

    PubMed  Google Scholar 

  • Murray, L., & Cooper, P. J. (1997). Postpartum depression and child development. Psychological Medicine, 27, 253–260.

    Article  PubMed  Google Scholar 

  • Murray, L., & Cartwright, W. (1993). The role of obstetric factors in postpartum depression. Journal of Reproductive and Infant Psychology, 11, 215–219.

    Google Scholar 

  • Murray, L., Fiori-Cowley, A., Hooper, R., & Cooper, P. J. (1996). The impact of postnatal depression and associated adversity on earlier mother-infant interactions and later infant outcomes. Child Development, 67, 2512–2526.

    PubMed  Google Scholar 

  • National Children’s Homes Scotland. (2002). Factfile 2002: Facts and figures about Scotland’s children, London: NCH.

    Google Scholar 

  • National Health Service Scotland, Information and Statistics Division. (2003). Scottish health statistics. Retrieved August 14, 2003 from http://www.show.scot.nhs.uk/isd/

  • Office of National Statistics. (2002). The national statistics socio-economic classification user manual. London: The Stationery Office.

    Google Scholar 

  • O’Hara, M. W. (1997). The nature of postpartum depressive disorders. In L. Murray & P. J. Cooper (Eds.), Postpartum Depression and Child Development (pp. 3–31). New York: Guilford.

    Google Scholar 

  • O’Hara, M. W., Schlechte, J. A., Lewis, D. A., & Varner, M. W. (1991). A controlled prospective study of postpartum mood disorders: Psychological, environmental and hormonal variables. Journal of Abnormal Psychology, 100, 63–73.

    Article  PubMed  Google Scholar 

  • Olds, D. L., Eckenrode, J., Henderson, C. R. Jr., Kitzman, H., Powers, J., Cole, R., et al. (1997). Long-term effects of home visitation on maternal life course and child abuse and neglect: 15-year follow-up of a randomized trial. Journal of the American Medical Association, 278(8), 637–643.

    PubMed  Google Scholar 

  • Olds, D. L., Henderson, C. R. Jr., Cole, R., Eckenrode, J., Kitzman, H., Luckey, D., et al. (1998). Long-term effects of nurse home visitation on children’s criminal and antisocial behavior: 15-year follow-up of a randomized control trial. Journal of the American Medical Association, 280(14), 1238–1244.

    PubMed  Google Scholar 

  • Osofsky, J. D., Culp, A. M., & Ware, L. M. (1988). Intervention challenges with adolescent mothers and their infants. Psychiatry, 51, 236–241.

    PubMed  Google Scholar 

  • Pitts, N. B. (1997). Do we understand which children need and get the appropriate dental care? British Dental Journal, 182, 273–278.

    PubMed  Google Scholar 

  • Ray, K. L., & Hodnett, E. D. (1997). Caregiver support for postpartum depression (Cochrane Review). Chichester, UK: John Wiley & Sons Ltd.

    Google Scholar 

  • Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Sanders, M. R. (1999). The Triple P-Positive Parenting Program: Towards an empirically validated multilevel parenting and family support strategy for the prevention of behavior and emotional problems in children. Clinical Child and Family Psychology Review, 2, 71–90.

    PubMed  Google Scholar 

  • Scottish Executive Central Research Unit. (2002). The 2000 Scottish crime survey. Edinburgh: The Stationery Office.

    Google Scholar 

  • Scottish Executive Health Department. (2000). The 1998 Scottish health survey. Edinburgh: The Stationery Office.

    Google Scholar 

  • Scottish Executive Health Department. (2003). National health demonstration projects. Retrieved September 29, 2003 from http://www.show.scot.nhs.uk/demonstrationprojects

  • Scottish Executive. (2003). Towards better oral health in children: A consultation document on children’s oral health in Scotland. Retrieved August 15, 2003 from http://www.scotland.gov.uk/consultations/health/ccoh-03.asp

  • Seeley, S., Murray, L., & Cooper, P. J. (1996). Health visitor intervention in postnatal depression. An evaluation of the outcome for mother and babies. Health Visitor, 69(4), 135–238.

    Google Scholar 

  • Shapiro, C. (1995). Shortened hospital stay for low-birth-weight infants: Nuts and bolts of a nursing intervention project. Journal of Obstetric, Gynecologic and Neonatal Nursing, 24(1), 56–63.

    Google Scholar 

  • Sharp, D., Hay, D., Paulby, S., Shmacher, G., Allen, H., & Kumar, R. (1995). The impact of postnatal development on boys’ intellectual development. Journal of Psychology and Psychiatry, 36(13), 1315–1337.

    Google Scholar 

  • Wasik, B. H., Ramey, C. T., Bryant, D. M., & Sparling, J. J. (1990). A longitudinal study of two early intervention strategies: Project CARE. Child Development, 61, 1682–1696.

    PubMed  Google Scholar 

  • Watt, R. G. (2000). A national survey of infant feeding in Asian families: Summary of findings relevant to oral health. British Dental Journal, 188(1), 16–20.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Law, University of Manchester, Manchester

    Jonathan L. Shute

  2. Health Promotion Policy Unit, Public Health and Health Policy Section, Division of Community Based Sciences, University of Glasgow, Glasgow

    Ken Judge

  3. School of Law, University of Manchester, Room 4.50, Williamson Building, Manchester, M13 9PL, United Kingdom

    Jonathan L. Shute

Authors
  1. Jonathan L. Shute
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ken Judge
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan L. Shute.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shute, J.L., Judge, K. Evaluating “Starting Well,” the Scottish National Demonstration Project for Child Health: Outcomes at Six Months. J Primary Prevent 26, 221–240 (2005). https://doi.org/10.1007/s10935-005-3601-9

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10935-005-3601-9

Keywords

Search

Navigation