Evaluation of the 'You First' Programme for Young Parents

7 HOW CAN PARENT RETENTION RATES BE IMPROVED?

Attendance rates

7.1 Table 7.1 and Figure 7.1 show the variation in attendance across the nine programmes. At the top end of the scale, in Programme 8, 94% of the 80 potential sessions (5 parents multiplied by 16 weeks) that could have been attended were attended. In contrast, only 46% of sessions were attended in Programme 2 and Programme 9.

7.2 Programme 8 also had the highest completion rate. All 5 parents who started the programme completed it¹⁷. In contrast, just 3 of the 9 parents (33%) who started Programme 2 went on to complete it. The variation in attendance at the individual parent level is shown in Figure 7.2. It shows the number of parents who attended all 16 sessions, the number who attended 15 sessions and so on. As illustrated, several of the 77 parents were regular attendees: 6 parents had attended all 16 sessions and 10 attended 15 sessions. Others attended fewer sessions (31 parents had attended 10 or fewer sessions), sometimes stopping before the programme had finished and other times attending throughout the course of the programme, but not regularly. Parents who completed the programme attended an average of 13 sessions while parents who did not complete it attended an average of 5 sessions.

Table 7.1 Attendance rates

Programme	Financial incentive?	Overall % of total sessions attended	Number of parents	Number of parents who completed	% who completed	Average number of sessions attended by those who did not complete
Programme 1	Yes	53	11	6	55	5
Programme 2	Yes	46	9	3	33	5
Programme 3	Yes	79	10	9	90	9
Programme 4	No	70	8	6	75	4
Programme 5	Yes	66	11	6	55	6
Programme 6	Yes	79	10	9	90	10
Programme 7	Yes	63	7	4	57	6
Programme 8	Yes	94	5	5	100	-
Programme 9	No	46	6	4	67	2
Overall		66	77	52	68	5

Figure 7.1: attendance rates

Figure 7.2: number of parents who attended x number of sessions

7.3 The main reasons reported by parents for missing a session were that they were ill or their baby was ill. Other reasons included going on holiday, going back to work or having other important things to do. Facilitators were unsure as to why some programmes were better attended than others. However, there may be a link to the deprivation status of the parents attending, discussed in Chapter 6. None of the parents attending Programme 8 lived in the 15% most deprived areas and facilitators noted that they were the group who appeared to be least in need of the support provided by You First. This supports the discussion in Chapter 6 around ensuring that the programme is targeted at those who need it most. Furthermore, there appeared to be a link between the extent to which the group bonded and the attendance rate. Evidence from the facilitators and the parents suggested that parents in Programmes 2 and 9, the two programmes with the lowest attendance rates, had not formed close friendships, as parents in other programmes had. As discussed in Chapter 3, spending time with other parents was one of the things that parents most enjoyed about attending You First. While the direction of the relationship between attendance and the extent to which the group bonded is unclear, it may become a vicious circle; if attendance is low at the beginning, parents may be less likely to form friendships and then be less inclined to attend each week as there is not the same incentive of seeing their friends.

7.4 The impact of the financial incentive on recruitment and retention is discussed below. However, it is worth noting that the programme can be well attended without it, as illustrated by the attendance rate of 70% in Programme 4, the fourth highest attendance rate of the 9 programmes.

7.5 Despite the inconsistent attendance across the programmes, the You First management felt that the attendance was, on the whole, pleasing and was higher than they would have expected on the basis of their previous experience of similar programmes. They commented that the effort that it takes for a parent to get organised and out of the house to attend the programme should not be underestimated. They suggested that the higher than anticipated attendance may be linked to the fact that the level of engagement that the facilitators have with parents, for example phoning them in advance of each session, is higher than it would normally be.

Parents' motivation for attending You First

7.6 As mentioned in Chapter 3, the main reason given by parents for choosing to attend the programme was the opportunity to meet other parents of a similar age. The fact that everyone would start and finish the group at the same time also appealed to parents. As discussed previously, even after having a positive experience at You First, parents lacked confidence to go to other groups that were already established.

7.7 To a lesser extent, parents reported that they were also attracted by the crèche. One parent commented that being able to have a break from her baby for a short time was appealing while another thought it would be good for her to have the experience of leaving her baby in the crèche so that she knew she would be able to do so in future.

7.8 Health visitors and other professionals also identified factors that they thought had played a part in parents' decisions to go to You First. These were:

• the fact that the facilitators had visited each of them at home before the programme
• the way in which the facilitators described the programme and the fact that they focused on elements which would appeal to parents - one professional commented that if it was advertised it as a programme about healthy eating and budgeting parents would not have wanted to attend
• that parents can choose what to cover at the programme
• that referral is undertaken by health visitors who know each parent and know how to approach it with them.

7.9 The You First management also felt that it was important that the programme was presented to parents as an opportunity, rather than something that they should attend because they have done something wrong or because they 'needed' it.

7.10 Parents continued to attend You First because they enjoyed it. In particular, they enjoyed getting out of the house and seeing people each week. They also felt that their babies were enjoying it and that it was good for them to be interacting with other babies.

Reasons for not completing You First

7.11 As Table 7.1 above illustrates, around a third of parents did not complete the programme (defined as attending one of the last two sessions). Facilitators were aware of the reasons why some parents did not complete the programme. These tended to be positive reasons (e.g. returning to work or starting a college course) or practical reasons (e.g. parents moving out of the area). They also mentioned that one parent, who was very nervous about attending as she did not like group environments, did attend the first session but was clearly very uncomfortable and did not return.

7.12 However, there were also parents who stopped attending You First without informing the facilitators that they were going to do so. Although, the facilitators would try to contact these parents after they had missed a session to see why they hadn't attended and to encourage them to return, they were sometimes unable to make contact with them and were, therefore, unclear as to why they had stopped attending. Three such parents were interviewed as part of the evaluation and each had different reasons for stopping attending.

7.13 One parent reported that she had missed a few sessions for personal reasons. Although she had received a text message from the facilitators to see if she was going back the next week, she had not spoken to them on the phone. She did not respond to the text message and said that, after a while, the facilitators stopped texting her, making her unsure whether it was okay for her to return. This illustrates the importance of parents feeling wanted at the group. This parent was neutral about the programme. While she enjoyed it to an extent, she had not become particularly friendly with the other parents and already felt well supported by family and friends.

7.14 The other two parents were more negative about the programme. One felt that the group was for parents who required a higher level of support than she did. She was already attending other groups, with mums of all ages, had already established a good routine and felt that she was managing well. Neither of these parents had become particularly friendly with the other parents in the group and both felt that there was a lot of 'bitching' at the group. In terms of the delivery of the programme, one parent commented that the morning, parent only, sessions were late in starting as other parents were late, and that this left little time to actually do anything. She also reported finding the programme 'a bit boring'. The other parent felt that the sessions involving both parents and babies did not work particularly well; they were too long and the other parents didn't really do what the facilitators wanted them to do, they just did their own thing. She also reported that the finish time of the group kept changing and that this caused problems for her getting home. Both parents reported that they were made to feel that they were doing things wrong. For one, it tended to be the facilitators who made her feel this way; she felt that, if her way of doing something wasn't exactly what they advised, she was made to feel that her way was wrong. For the other parent, it was the advice of other parents that was unwelcome; she didn't like the fact that they questioned the brands of things such as nappies and baby food that she chose to buy. Both parents reported that the only benefit they had experienced from attending was that, as a result of using the crèche, they felt more confident about leaving their babies in the future.

Practical barriers to attendance

7.15 During the pilot there was little evidence of practical barriers preventing parents from attending the programmes. Parents received £5 per week to cover any travel expenses. In the vast majority of cases, this was sufficient and parents had no difficulties getting to the venues. However, one parent, who lived in a more rural area, was finding it difficult to attend due to the fact she had to take two buses to get to the venue. In the event, she moved to another local authority before the situation was resolved. The programmes delivered as part of the pilot were in predominantly urban areas. Should programmes run in more rural communities in future, there may be more issues related to travel.

The impact of the financial incentive on initial recruitment/retention

7.16 As discussed previously, parents attending programmes offering the financial incentive were given £20 per week for attending (which many deferred until the end of the programme). All parents were also given £5 per week to cover any travel expenses incurred. This section considers the £20 payment only; the impact of the travel expense payment on attendance was not specifically explored.

7.17 As discussed in section 3.37, the financial incentive played an important role in giving parents experience of saving money. In terms of recruitment and retention, however, it appeared that the financial incentive was an 'added bonus' of attending the programme rather than a reason for deciding to, or continuing to, attend it. Parents reported deciding to attend You First for the reasons described above in this chapter and continuing to go because they enjoyed it. If anything, the money was more of an incentive at the initial referral stage and became less important as parents started to experience the other benefits of the programme. However, health visitors and facilitators made sure that they did not make this the main selling point of the programme and only mentioned it at the end of the conversation, by which time parents tended to already be interested. Both parents and health visitors felt that there were some parents for whom the financial incentive was the reason for going but they were considered the exception rather than the rule. That parents were not turning up each week simply to collect their £20 is supported by the fact that many (28 out of 42) chose to defer payment of the financial incentive until the end of the programme.

7.18 The extent to which it is possible to use the programme attendance rates to consider the effect of the financial incentive is limited by the fact that just two of the nine programmes were delivered without the incentive and that the groups differed in other ways, for example, different locations, different facilitators, different programme structures and so on. As shown in Table 7.1 above, one of the programmes delivered without a financial incentive was the fourth best attended programme. This shows that it was possible, in this case, to deliver a well attended programme in the absence of the financial incentive. The other programme to run without a financial incentive was less well attended. In fact, it had the lowest attendance rate in terms of the overall number of sessions attended. However, this group was also one in which the parents did not seem to 'gel'. This, and other individual or group factors that we are not aware of, could also have contributed towards the poor attendance of this group.

7.19 Given that the financial incentive comprises a substantial proportion of the cost involved in running You First, it is our view that there is not sufficient evidence to justify the expense of providing it.