Measuring Programme Outcomes and Impact
The Foundation and its affiliates have over many years been monitoring and accumulating data on programme and service impact and outcomes and this evidence has largely been based on recorded observations by Lifestart practitioners, parental self-reports and interviews with independent professionals and others working with parents and/or children whose families have received the Lifestart programme. While this evidence is considerable and much of it has been collected and analysed by independent evaluators (McGuinness, 1990, McNelis & Kelleher,
1995), the methodologies used and the specificity and sometimes small scale and potentially unrepresentativeness of study samples have weakened the perceived credibility of the evaluative evidence. In the light of this the Lifestart Foundation sought and acquired funding from Atlantic Philanthropies under its Children and
Youth Programme to conduct a full-scale empirical study into Lifestart programme and service impact.
The Lifestart Longitudinal Study
The design of the Lifestart study was based on the interim results of a quasiexperimental study also funded by Atlantic Philanthropies and undertaken by a research team based at Queens University, Belfast. A fully experimental research design and logic model was developed by the principal investigators working on the quasi-experimental study, in collaboration with the Lifestart Foundation and with the support of the Dartington Social Research Institute 1 . The logic model was based on a number of key assumptions about how Lifestart works and the expected impact and outcomes:
 Lifestart is a two-generation programme in that there is a focus on both parent/caregiver and child outcomes.
 The primary impact of the programme is on parenting outcomes, which in turn impact positively on child development outcomes.
1 www.dartington.org.uk

 Parents who have received the Lifestart programme are better able to promote, through appropriate care and nutrition, their children’s physical health.
 By knowing how to provide secure attachment, to be emotionally available, to interact with and to be sensitive and attentive to their children’s developmental and learning needs, they are better able to foster their child ’s emotional wellbeing, social skills and behaviours and resilience and coping skills.
 By understanding how to provide suitable stimulation, appropriate developmental experiences, encouragement, reassurance and learning support, parents can promote cognitive development, the acquisition of fine and gross motor skills and language acquisition.
Expected outcomes for children whose parents have taken the Lifestart Programme are: that they are better developed – physically, emotionally, intellectually and socially; tend to have better connections with their peers and their communities; have fewer behavioural problems; are better prepared for formal learning than other children and have improved life chances, especially but not exclusively where economic, social, environmental or other circumstances put children at greater risk of adverse developmental outcomes.
Parent and child outcomes are reinforced through the promotion, in the communities in which Lifestart operates, of a social environment conducive to childhood learning and growth.
The causal relationships between parent and child outcomes are depicted in the
Lifestart programme logic model in figure 2 below.

Figure 2
The Lifestart Study research design incorporated two strands:
1. A multi site randomised controlled trial (RCT) aimed at evaluating the impact of the programme on parent and child outcomes.
2. Qualitative case studies and interviews with parents and stakeholders aimed at understanding the process of programme delivery and exploring parent and child outcomes in more depth.
Recruitment of families to the study began in 2008 and was completed in December
2009. 655 parents contacted the study and 435 met the inclusion criteria and of these 424 parents and children participated in the evaluation; 216 were randomly selected to the intervention group (i.e. to receive the programme and home-visitation service) and 208 were randomly assigned to the control group. Parents and children participating in the study will be tested on outcomes on three separate occasions:
1. When the child enters the evaluation (aged less than one year)
2. When the child is aged 3 years
3. When the child is aged 5 years

The parent and child outcomes and the measures being used to assess them are outlined in table 1 below.
Table 1. Parent and Child Outcomes Measures
Parent Outcomes Parent Measures
Well-being (confidence, stress and TOPSE (Tool to measure Parental fearfulness, social support) Self-Efficacy)
Parenting Skills (parent-child Parenting Stress Index relationship, knowledge of child Knowledge of Child Development development) Index
Embedded-ness in the community
Child Outcomes
Social Capital Measures
Child Measures
Cognitive Skills, fine and gross motor Bayley Scale of Infant Development skills, language acquisition (III)
Non-cognitive skills: emotional wellbeing, behaviour, social development
British Ability Scales (BAS)
Ages and Stages Questionnaire 2
Health Parental Report
Base-line data collection was completed in 2010. Sweep two data collection, using the BAS, began in March 2011. Data collection visits are currently up to date, with families being contacted and visited within 4-6 weeks of the child turning three years of age. Sweep three data collection began when the first child turned five years of age in May 2012. The youngest child in the sample turned five years of age in
November 2014. The final data analysis and the study write-up will take place between November and December 2014 3
The first interim evaluation research report, based on a postal survey and a series of indepth interviews with parents, was also completed in 2010, 10 ½ months after the intervention had begun and one year into the 5 year study. The interim findings indicated positive significant change in parental efficacy.
‘The outcomes and pathways as perceived by parents and described in the interviews are consistent with the theory of change depicted in the
2 Used in parent survey conducted in 2010
3
For further information on the Lifestart Study contact Dr Sarah Miller ( s.j.miller@qub.ac.uk
) or Dr Laura Dunne ( l.dunn@qub.ac.uk
).

Lifestart logic model, which hypothesises that improvement in parent outcomes, arising as a consequence of the programme, mediates the change in child outcomes’ (Miller et al 2010, 3).
The most recent report (May 2013) has indicated an effect size in child behaviour outcomes at age three. However, as yet not all of the measured outcomes have been analysed and additional trajectory and sub group analyse will be conducted when all the data has finally been collected.