Healthy child development relies on families providing a safe and nurturing environment for their child. Research indicates that to improve outcomes for children, educating parents is more effective than intervening directly with children (Kendrick et al., 2000; Sweet and Applebaum 2004; Flett 2007; Phillips and Eustace 2008; Rushton et al., 2009). It is with this in mind that we present the results of a randomised controlled trial (RCT) 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 old. It is provided by trained, paid family visitors and offered to families regardless of circumstance. The study aimed to determine whether the programme is effective in improving parent and child outcomes.
424 parents and children aged less than twelve months were recruited from across Ireland via a coordinated and multistranded recruitment campaign in 15 Lifestart project areas. The campaign involved: distribution of a leaflet advertising the study, advertising through local media and ‘on the ground’ awareness raising. Once parents consented to take part they were randomly assigned to either the intervention group (n= 216), who received the programme for five years, or the control group (n=208) who did not receive Lifestart. Both groups completed outcome measures at three time points: pre-test, mid-point (aged three years) and post-test (aged five years). A qualitative process evaluation was conducted alongside the RCT.
Intervention parents reported lower levels of parenting stress (ES=-.220; p=.045), greater knowledge of child development (ES=.277; p=.016) and higher levels of parenting confidence (efficacy) (ES=.213; p=.047). There were no differences between the control and intervention groups in community participation (social capital).
Small, positive changes were observed in four of the five child outcomes: better cognitive development, increased prosocial behaviour, decreased difficult behaviour and fewer referrals to speech and language therapy. Effect sizes ranged from .07 to .16 and were not statistically significant.
The findings from the process evaluation indicated that families greatly enjoyed the programme. Some parents reported an improved relationship with their child, attributed to having better ideas for play activities and communication. A number of parents noted that the programme had extended their child’s learning, contributing to their preparedness for school. The relationship with the family visitor was identified as a key factor in the successful long-term acceptability and enjoyment of the programme.
This study shows that Lifestart works as intended and is effective in improving parent outcomes. These findings are consistent with the wealth of evidence which shows that home based parenting programmes like Lifestart are an effective (and cost effective) way of improving parent and child outcomes in the short and long term (Sweet and Applebaum 2004; Kaminski et al., 2008; Filene et al., 2013).