Evaluation of the 'You First' Programme for Young Parents - Appendices

APPENDIX 1 - YOU FIRST OPERATING SPECIFICATION SUMMARY

You First: A Booster Programme for Young Parents

Summary Operating Specification

Author: Alison McIntyre
Date: 12/07/12

1. Summary

You First is an innovative programme from Barnardo's Scotland which has been designed to increase the support that young, first time parents and their babies receive from their peers, the community and existing local services.

You First is a 'booster' programme that adds value to existing local services by promoting engagement with universal services. The programme uses a mix of financial incentives, group work and one-to-one specialist supports over a 20 week period.

The design principles behind You First draw on direct evidence from Barnardo's Scotland young parent services. The principles draw on approaches from North and South American projects that engage with hard-to-reach groups as well as first-hand input from health, education and policy professionals.

Young parents who engage with You First will have the opportunity to:

• Be better connected with local and universal services
• Receive a direct cash boost to help them and their child
• Have increased peer and community support
• Be financially included and in receipt of the correct welfare supports
• Be more confident and capable new parents
• Receive an SCQF Level 4 qualification

This document sets out the operating specification for the You First programme.

You First will provide participants with a direct grant-incentive - this "positive conditionality" approach has been piloted in a variety of settings with different groups but has yet to be tried with first-time parents.

Two test programmes of You First were delivered in West and Midlothian between October 2009 and March 2010. Following this, a further 10 pilot programmes¹ were delivered across East, West and Midlothian between April 2010 and December 2011. These 10 programmes were externally evaluated by IPSOS Mori, Scotland.

2. Introduction

You First is a 20 week group programme aimed at first time parents. It provides training, peer support, experiential learning and connects young parents with local universal and specialist services. The unique elements of the programme are that it provides all participants with the opportunity to gain a recognised qualification at SCQF Level 4 as well as a boost to their income of approximately £20 per week for the life of the group programme.

The programme is designed for:

• First time parents
• With a first baby under one
• Who are under 21
• Who live in the 15% most deprived areas of Scotland (SIMD, 2006)

The over-arching topics covered within the programme are:

• Health and Wellbeing (of parent and child)
• Child Development
• Financial Capability and Inclusion
• Developing the relationship between parent and child

3. Programme Design Process and Rationale

3.1 Background

The You First programme has been designed by Barnardo's Scotland as part of a response to the Scottish Government's Early Years Framework which aims to "give a renewed focus on giving children the best possible start in life" and has made a strong commitment towards developing more early intervention programmes which invest in the health of pregnant mothers, babies and young children to break the link between early life adversity and adult disease and reduce health inequalities, particularly in the most deprived areas.²

The priorities identified in the framework include: promoting positive parenting approaches, highlighting the importance of place and green spaces for children, committing to the principles set out in "Getting It Right for Every Child" and building the capacity of universal and specialist services to respond to the needs of all children and their families.

3.2 Design rationale

You First is designed to offer short term support to those new parents who are furthest from universal and specialist services to help them identify appropriate supports and engage with them. You First sets out to engage early with new young parents who are statistically more at risk of income deprivation, low employment opportunities, poor health and educational attainment.³

Research undertaken at the Center on the Developing Child at Harvard University underlines that "while good (universal) programs can enhance the performance of all children, current knowledge about brain and child development, as well as empirical data from cost-benefit studies, presents a compelling case for early, public investment targeted preferentially toward those children who are at greatest risk for later failure in school, in the workplace and in society at large."⁴

Barnardo's Scotland uses a five stage development process for all new programmes:

1. Propose (Opportunity / needs assessment)

2. Analyze (Review existing work, internal and external literature, emerging practice)

3. Test (Test the process)

4. Review (Review the test phase)

5. Pilot / Implement. (Full pilot and evaluation)

During the first two stages of the You First development Barnardo's Scotland conducted the following work.

1. Internal consultation among practice managers in family support services and young parent services

2. Literature review of domestic and international parenting programmes and models

3. Review of new practice models for engaging with hard-to-reach groups

4. Secondary consultation with professionals and practitioners working with young parents

3.3 External Evidence and Sources

Case for an Early Years Booster Programme

Evidence from the Early Years framework suggests that we should target resources towards those who:

Have an unsafe start in life:

• 33% of all child protection referrals were for children pre-birth to 4 years. (www.scotland.gov.uk)
• 86% of referrals resulting in case conference highlighted the child's primary known / suspected abuser as the child's Natural Parent. (www.scotland.gov.uk)

Have a poor start in life:

• UK has a higher % of its children living in workless households than any other EU country. (Joseph Rowntree Foundation 2006)
• 1/3rd (35%) of people living in Scotland's 15% most deprived areas were income deprived compared to 10% in the rest of Scotland" (One Scotland, Scotland Index of Multiple Deprivation :2006)
• Significant statistical relationships lie between income deprivation, low employment opportunities, poor health and education attainment. (One Scotland, SIMD: 2006)
• The higher the level of deprivation the lower the level of accessing services (One Scotland, SIMD: 2006)

Who are the most vulnerable:

• Teenage Pregnancy Rates linked to areas of Multiple Deprivation (ISD Scotland 2006)
• Scotland has a higher rate of teenage pregnancy than most other Western European countries. (ISD Scotland 2006)
• A strong deprivation gradient, the most deprived groups have approximately 10 times the birth rate than the least deprived (ISD Scotland 2006)

3.4 Case for an alternative approach

• The You First programme has been designed to respond to the needs of the participants based on their individual circumstances.
• 'Helping' services (e.g. directive services) didn't meet parents' own idea of their needs. They offered what service providers think they want or should want, rather than what would really be of use' (Ghate, D. and Hazell, N. (2000), Parenting in Poor Environments Department of Health 2000 cited by Mary Crowley in Reaching Hard to Reach Parents, parenting UK 2005).
• 'A critical requirement for reaching the most disadvantaged families is an understanding of poverty and disadvantage' (Capacity & Esmee Fairburn Foundation, 2007)
• 'An element of confusion also pervades much of the policy and guidance- which emphasises the need to reduce poverty and inequality but often emphasises parental deficit- those parents who have lost, or never had, the capacity to parent responsibly- without placing this in the broader context of unemployment and/or poor skills and the resulting effects on family well being' (Capacity & Esmee Fairburn Foundation, 2007)

3.5 Barnardo's experience

Barnardo's Scotland has extensive experience of working alongside young people, new parents and families to support them through transitions and help them overcome barriers. Barnardo's Scotland has more than 65 services working with some of the hardest to reach children and families. Our work covers three themes:

1. Helping families become stronger

2. Protecting and caring for children

3. Helping young people get on in life

3.6 Systems and Solution Focused Practice

Our family support services use systems and solution focused approaches to support young people and their families. The foundation of our work with families is based on a Systemic Family Approach as this enables individuals and families to build on strengths and participate in resolving their own challenges.⁵ Particular practice evidence has been referenced in the design of You First from our existing early years and new parenting services. This includes our Barnardo's Paisley Threads Service which assists young parents in the Renfrewshire area to take control of their own lives by building parenting capacity, peer support networks, and helping young parents recognise their strengths and skills as well as providing access to appropriate universal and specialist supports.⁶ Staff within the Paisley Threads Service were involved in the design and initial delivery of the You First Programme.

The Systemic Family Approach firmly places the young person and their family at the centre of any work being undertaken and uses such tools as Eco-maps, Geno-grams, Scaling and "Miracle" questions to enable clear evaluation of the needs and aspirations of the family. Using this approach is both inclusive and participative. It enables families to recognise their own strengths, coping strategies and support networks whilst experiencing a sense of choice and ownership of any work undertaken and is both inclusive and participative. The use of scaling also enables families to undertake self-evaluation and recognize the distance travelled.

The target of intervention for any area of the system e.g. the child, the parent, the wider community will undoubtedly have an impact on the care and wellbeing of the children.

3.7 Public agency references and input

The You First programme has been designed in conjunction with the Scottish Government Health, Education, Poverty and Early Years teams as well as in consultation with partner professionals within the NHS Lothian delivery areas.

The programme team at Barnardo's worked closely with the Health Visitor teams in the local areas to ensure the programme added value to their objectives and did not duplicate effort or existing delivery.

4 Programme

4.1 Key Elements

The programme is a well structured group-led activity that includes:

• a blend of experiential group work and parent/child activities
• in-group crèche support during parent-only sessions
• a cash grant of £20 per week to support the building of financial capacity⁷
• a qualification at SCQF Level 4 through the development of a personal "handbook" of participant experience throughout the life of the programme
• Topics to include: Financial capability and income maximisation, household budgeting and planning, experiential learning through grocery shopping, cooking and meal planning, the importance of play and baby development, child and parent health

4.2 Programme stages

The programme has four discrete stages:

1. Induction: Week 1-2

2. Group Programme: Week 3-18

3. Future Planning: Week 19-20

4. Review: 6 months later

4.3 Programme Structure

4.3.1 Induction Process (Week 1-2)

During this 2 week period, each participant (or potential participant) will have an individual session with facilitators. During this session the following will be covered:

• Finding out what they already know (from the Health Visitor) and why it might be of interest to them.
• The Purpose of the Group
• The topics the group might cover

If the individual parent agrees to take part, the topics are broken down into a variety of sub-topics with some space for "anything else" so that there is room for individuals to identify topics specific to them. Once this has been completed for each participant, the ensuing results will be shared with the group at the first session to plan the structure of the programme.

4.3.2 Group Work Programme (Week 3-18)

The structure for each session will be as follows (approximate times) and the topic agreed for each session will be planned after the individual topic selection exercise is completed and the results and planning are agreed by the group.

0930	Set up (facilitators/crèche workers)
1000	Arrival Settle babies Breakfast (Healthy Snack options/tea/coffee etc) Check In: Individual - Personal Project/Group - Highs & Lows of previous week Icebreaker
1100	Subject Input (facilitators or visiting professionals)
1200	Lunch/End of Crèche
1300	Afternoon Session: Check In - Group Icebreaker for parent/baby group Activity (related to morning input)
1500	Reflection Personal Learning Log Check In - Group Arrangements for next week
1530	Close

During the programme, there will be some opportunities to re-negotiate the planned topics if further relevant issues or topics arise within the group. At the mid-point of the programme, the group will undertake an assessment - as at the start to take account of progress during the programme to that date. At this stage, possible links and supports for participants for any topics selected that are not being covered in the programme will be established.

4.3.3 Action Plan (Week 19-20)

At the end of the group work programme each participant will again have an individual session with the group facilitators. At this point, the assessment will be completed for a third time enabling a reflective discussion of progress made by each participant. At this stage, each participant will be asked to identify future plans in any of the key areas and an Action Plan will be drawn together outlining this.

If any local universal, statutory or community based resource or service is identified by the participant, this will be identified in the action plan and include dates, times and contact details. Providers of any service identified will also be informed of participant's interest and details will be shared (with participant's consent). If the service required is unavailable, the reasons for this will be established (e.g. a waiting list or a gap in service provision) and alternative support sought elsewhere if possible. This information will also be fed back to lead officers and strategic managers in the area.

This Action Plan will be completed by participant and group workers and shared formally with the Health Visitor, with the agreement of the participant. The Action Plan will form the basis for the Review.

4.3.4 Review and Reunion

After a period of time (between 3 - 6 months), each participant will be invited to a "group reunion" where any issues arising from individual Action Plans will be shared, a final self-assessment will be undertaken and the group will have a chance to reflect on their experience and re-establish contact with each other.

Any issues arising from this meeting will be shared with Health Visitors or other identified professionals as appropriate.

5 Programme Outcomes and Measurement Process

At a national level, the programme will contribute to meeting the following Scottish Government National Outcomes:

• We have improved the life chances for children, young people and families at risk
• Our children have the best start in life and are ready to succeed
• We have strong, resilient and supportive communities where people take responsibility for their own actions and how they affect others
• We live longer, healthier lives
• Our young people are successful learners, confident individuals, effective contributors and responsible citizens
• We have tackled the significant inequalities in Scottish society

The You First programme will aim to deliver the following Programme Outcomes

• Identify the available supports and networks within the local community (including financial support)
• Establish a link between available supports/networks and group participants
• Enable group participants to Identify barriers that prevent them from engaging in already existing community activities
• Create a model of ongoing peer support for group participants
• Gaining a qualification at SCQF Level 4

The Individual Outcomes for each participant taking part in the You First Programme have been identified using Barnardo's Scotland Outcomes Framework which is directly linked to the Getting it Right for Every Child framework. Each participant in the programme will complete a process of Self-Assessment that maps directly onto the Barnardo's Outcomes framework and takes place at:

1. The outset of the groupwork programme (Week 1/2 of group sessions)

2. The mid-point of the groupwork programme (Week 8/9 of group sessions)

3. The end of the groupwork programme (Week 15/16 of the group sessions)

4. At the Review/Reunion session (Approximately 3-6 months after the group sessions have ended)

This self-assessment exercise is undertaken individually be each participant but with the support and input of the group facilitators. Each participant is encouraged to be as realistic as possible about their current situation and the results are used at each point of the programme to ensure that they are receiving help and support in the areas that they have identified as pertinent to them.

Programme Outcome		Getting it right for every child/Barnardo's Outcomes
Outcome		Level 1	Level 2	Level 3
1	Parents are supported to engage with universal and specialist services	Nurtured	Have security, stability and be cared for	Family has access to support services Family has increased awareness of rights Family has access to information on housing, health benefits, rights or support needs
2	Parenting capability and confidence is improved	Healthy	Mentally and emotionally healthy	Enhanced parent-child relationships Increased confidence Family less isolated
3	Parents have a local network of peer support	Active	Achieve personal and social development and enjoy recreation	Development through new experiences Carers promote children's play and learning Positive socialisation with peers
4	Parent and baby are less isolated	Responsible	Develop positive relationships and choose not to bully or discriminate	More positive social networks
5	Parents are more financially stable	Not disadvantaged by poverty	Live in households free from low income	Full receipt of entitlements and grants Increased understanding of personal finance Open and maintaining a saving account