In England, the Sure Start Local Programmes (SSLP) have been associated with children with better social development and more positive social behaviors, according to an article released on November 7, 2008 in the The Lancet. Additionally, the study showed that parents in the SSLP areas show less negative parenting and provide a better home-learning environment.

The SSLPs are intervention programs to encourage services for young children and their families in deprived communities in order to improve health and development and reduce inequalities in certain areas.

To investigate the effects of the SSLPs on their target population, Professor Edward Melhuish, Institute for the Study of Children, Families and Social Issues, Birkbeck, University of London, UK, and colleagues from the National Evaluation of Sure Start Research Team examined 5,883 children age 3 and their families from 93 disadvantaged SSLP areas, comparing them to 1,879 controls in 72 deprived areas that did not receive SSLP. In total, they examined 14 separate outcomes: children’s immunizations, accidents, language development, positive and negative social behaviours, independence, parenting risk, home-learning environment, father’s involvement, maternal smoking, body-mass index, life satisfaction, family’s service use, and mother’s rating of area

In analyzing the data and controlling for background factors such as parents’ occupation and education, the authors found that SSLP was beneficial for five of the 14 examined outcomes. In SSLP areas, children showed better social development, more positive social behavior, and less negative social behaviors. Parents tended to show less negative parenting and created a better home-learning environment. Child and family development services were more widely utilized by families in SSLP areas. This comparison to controls was true within all identified subpopulations and areas.

In conclusion, the authors made positive inferences about the SSLP programs: “Children and their families benefited from living in SSLP areas. The contrast between these and previous findings on the effect of SSLPs might indicate increased exposure to programmes that have become more effective. Early interventions can improve the life chances of young children living in deprived areas

Dr Penny Kane, formerly of University of Melbourne, Australia, contributed an accompanying comment which examines potential shortfalls found in monitoring interventions like the Sure Start Program, which were not initially planned with provisions for evaluation. Notably, as the program has developed, there have been many changes in the programs’ priorities, each of which require adequate monitoring. In conclusion, she says: “The [UK] Department for Children, Schools and Families, which funded the research, ruled out a randomised trial…The rejection of a randomised trial has made interim evaluations difficult and — despite the sophisticated efforts of the current team — less comprehensive than they could or should be.”

Effects of fully-established Sure Start Local Programmes on 3-year-old children and their families living in England: a quasi-experimental observational study
Edward Melhuish, Jay Belsky, Alastair H Leyland, Jacqueline Barnes, and the National Evaluation of Sure Start Research Team*
Lancet 2008; 372: 1641-47
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Written by Anna Sophia McKenney