Summary of the impact

The education gap between children from poor homes and their peers is established before they start primary school. These early inequalities heavily influence children's later outcomes. FAST (Families And Schools Together), is a parenting programme that aims to reduce the educational effects of deprivation and promote family cohesion. We have carried out evaluations of the programme. As a result, the UK government and international agencies have endorsed FAST. Specifically, we carried out research that has identified strategies for effective replication of the programme across a range of disadvantaged communities in different contexts. The research underpinned Save the Children UK's decision to support the roll out of this intervention, with £7M funding from Lloyds Bank and Morrison's grocery chain. Our evaluations of the roll out demonstrate a range of impacts on beneficiaries, namely children and families: increased parental involvement in schools and increased social capital; improved parent to parent support networks, increased parent community leadership, positive child mental health outcomes and increased social skills; improved academic and school behaviour; reduced aggression and anxiety as well as reduced aggressive and delinquent behaviours after eight weeks. The beneficiaries are children, their families and schools, and society at large.

Underpinning research

The studies included in this case study represent the culmination of a three-phase research programme around family interventions. The original studies were developed by McDonald L in 1988, and subsequent randomised controlled trials by groups of US investigators demonstrating FAST's impact were completed before she moved to Middlesex University in 2008. The studies that identified the features that a programme requires in order to be transferrable from one context to another e.g. from Native Americans in the US, to inner cities in the UK, which form the basis of this case study, were completed at Middlesex between 2008 and 2012 by McDonald L and Fitzroy within the Institute of Nursing, Midwifery and Social Work.

Phase 1: Research to identify and develop the design of a theory-based parenting programme with feedback from practitioners and service users, 1988-1996 (local government funding, charity, US government).

Phase 2: Large scale RCTs to test the effectiveness of the programme design in four separate disadvantaged US communities (New Orleans 2001; Native Americans 2004; Mexican American urban immigrants 2006; low income, diverse 2009), with US government research funding.

Phase 3: Studies carried out at Middlesex identifying features underlying effective replication of the parenting programme in terms of sustained parental engagement in different settings and with different populations, 2008-2012. The evaluation studies, using validated psychometric and other measures, revealed that the following strategies could contribute to high retention rates: respect for parents to co-produce the programme; flexibility in implementing core components; providing positive emotion; `foot in the door' recruitment technique; crossing social divides to increase social capital; and systematically reinforcing attendance. The evaluations ran across national boundaries, for example in one study families (n = 403) were recruited into 31 FAST groups: 253 families in the UK, 114 in Germany and 36 in Holland. Attendance was recorded. To graduate a family attended 6 or more of 8 weekly sessions. Results revealed high retention rates; 83% for the UK, 83% for Holland and 89% for Germany.

The phase 3 studies, which this case study focuses on, has been undertaken in response to the needs of i) the UK and US governments to identify a group of effective `evidence-based' parenting interventions and ii) large charities and commercial funders to guide their strategic decisions about which parenting programmes to support. During this period and as a result of our phase 3 research, Save the Children UK took up and rolled out a programme of FAST interventions and raised £7M from non-governmental sources to fund it.

References to the research

The following publications appeared in high quality peer-reviewed journals:

FUNDING and GRANTS

Approximately $19M of research funding has supported the FAST project globally since 2008 (chiefly from US National Institutes of Health Research and US Department of Education). Since 2008 the evaluation programme run at Middlesex has attracted circa £2.4M in income.

Details of the impact

This case study involves two levels of impact: i) the impact that our research has had in providing evidence for Save the Children UK to launch a UK roll-out of FAST and ii) the evidence for replicability has shaped the programme design leading to improved impacts of the programme on families. Governments in many countries have recognised the importance of supporting families with young children, particularly those on low income and from disadvantaged and socially marginalised groups. However, they also require research evidence in order to make choices about which particular programmes to endorse or fund. Increasingly governments and other funders look to the published lists of `evidence based' programmes, tested in randomised controlled trials, to inform their strategic decisions. In order to identify and support evidence-based programmes, researchers, including those at Middlesex, have developed such evidence. However, our own work goes a stage further in having identified the transferable features of these programmes which lead to high levels of participation and low levels of drop-out on the part of socially excluded families. In the challenges of `scaling up' such programmes, we have met the strategic need on the part of funders for predictable rates of completion and consistent child outcomes across diverse settings. This is over and above RCT evidence of programme effectiveness, based on studies conducted in the US.

In 2009 Save the Children UK decided to adopt one evidence-based parenting programme that was focussed on low-income children and schools. They requested the Institute of Education (IoE) to review available research on evidence-based parenting programmes and the IoE recommended FAST, among 7 programmes, based on the quality of the existing evidence. Save the Children subsequently chose FAST as a result of this evidence base and funded a pilot programme in five low-income communities across the UK. Our research into drop-out rates in these sites then provided the research intelligence required by this charity in its decision-making to adopt FAST across the UK with funding from the commercial sector.

A crucial part of their decision to fund was the evidence which indicated not only that FAST was effective on a number of measures but it also led to consistently high rates of completion. Whilst other parenting programmes have been supported by evidence of effectiveness, only our research, to date, adds evidence to improve programme replication, evidence which programme funders require to make decisions about the large scale roll out of any project. Save the Children supported 15 FAST projects in 14 primary schools across the UK between April 2010 and August 2011. Some 338 families attended at least once and 80% of those families attended at least six of the eight sessions and completed the programme. Approximately 85% of families attending had an annual family income of under £20,000. The evidence of low attrition rate is the first level of impact we present here.

The end beneficiaries are children aged 3-8 and families, schools and communities, with a focus on low income and disadvantaged and socially marginalised groups. Our evaluations employing outcome measures with established reliability and validity have guided the design of the programme roll out. These include: the Social Skills Rating System (SSRS) and the Child Behavior Checklist (CBCL) with subscales for social skills, aggression, and academic performance. Using these measures, the programme has been shown in evaluations (see first reference in Section 5) to deliver the following outcomes:

Parent outcomes:

• Increased parental involvement in schools and increased social capital; improved parent to parent support networks, increased parent community leadership
• At two-year follow-up, 86-90 per cent of parents who have completed the programme report continued improved parent to parent support networks
• Improved parent-child bonds.

Child outcomes:

• Positive child mental health outcomes and increased social skills; improved academic and school behaviour; reduced aggression and anxiety
• Parents report small to medium decrease in children's externalizing behaviours
• Teachers report a large decrease in children's externalizing behaviours and small to medium improvements in academic performance
• Decreased family conflict
• Reduced aggressive and delinquent behaviours after eight weeks; both that result and academic outcomes were maintained after two years

Sources to corroborate the impact

In terms of external reports or documents that corroborate the quality of our research and its impact:

1. Lindsay, G., Strand, S., Cullen, M-A., Cullen, S.M., Band, S., Davis, H., Conlon, G., Barlow, J., and Evans, R. (2011), Evaluation of the Parenting Early Intervention Programme, Department for Education, Research Report DfE-RR121 (a), London
2. Statistics on the impact of FAST are at http://www.savethechildren.org.uk/about-us/where-we- work/united-kingdom/fast
3. Save the Children UK: FAST Strategy Manager, Save the Children UK (contact details provided separately)
   Save the Children UK has raised over £7,000,000 to implement FAST across Scotland, Northern Ireland, Wales and England. This organisation can also give contact details of individual families and schools involved in the programmes in UK. Save the Children Website; http://www.savethechildren.org.uk/resources/online-library/bringing-families-and-schools- together-giving-children-high-poverty-areas
4. Head teacher, Chilwell Croft Academy, Birmingham (contact details provided separately)

A range of further internet resources showing the uptake of FAST linked to the findings of our research:

1. Families and Schools Together (FAST) Aggregate FASTUK Evaluation Report of 15 Schools in 15 Local Education Authorities (LEAs) across the UK. October 2010. At http://www.mdx.ac.uk/Assets/MDX%20FASTUK%20aggregate%20evaluation%20Oct%202010. pdf
2. UK Community Care Magazine for Social Workers and Social Care-2011 article on FAST reducing family conflict http://www.communitycare.co.uk/articles/06/12/2010/115952/fast-a-support-programme-to- reduce-intra-family-conflict.htm
3. UK Department for Education Parenting Programme — top ranking four stars 2011 http://education.gov.uk/commissioning-toolkit/Programme/Detail/37