Better Beginnings, Better Futures

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Better Beginnings, Better Futures

• Purpose
• A 25-year longitudinal prevention policy research
  demonstration project to provide information on
  the effectiveness of prevention as a policy for
  children

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Better Beginnings, Better Futures Goals

• Prevention
• To reduce the incidence of serious, long-term
  emotional and behavioural problems in children
• Promotion
• To promote the optimal social, emotional,
  behavioural, physical and educational development
  in children
• Community Development
• To strengthen the ability of disadvantaged
  communities to respond effectively to the social
  and economic needs of children and their families

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Program Model

• High Quality Programs
• For children from conception to age 4 or from age
  4 to age 8 and their families
• Integrated Programs
• Service organizations and providers blend and
  unite
• Community Involvement
• Parents and other citizens participate as equal
  partners with service-providers in planning,
  designing and carrying out programs for children
  and families in the local community

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Better Beginnings, Better Futures Overall
Project Organization
8 Better Beginnings Project Sites
Research Coordination Unit
Government Committee
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• Younger Child Sites (0-4yrs)
• Guelph Willow Road
• 625 children
• Kingston Northern Area
• 1095 children
• Ottawa Albion- Heatheringrton- Farlea-Ledbury
  
• 690 children
• Toronto Moss/Regent Parks
• 1125 children
• Walpole Island First Nation
• 250 children

• Older Child Sites (4-8yrs)
• Cornwall 4 Francophone primary schools
• 530 children
• Etobicoke Highfield Junior School
• 517 children
• Sudbury Flour Mill/le Moulin à Fleur and
  Donovan
• 503 children

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Key Characteristics Neighbourhoods/Communities

• Increasing Concentrations of disadvantage Haves
  Have Nots
• Stigmatized
• Poor personal evaluations
• Daily distrust and cynicism
• Diversity of attitudes and values
• Tired of fighting hard for resources and supports
  other neighbourhoods take for granted
• Decades of constant government and research
  attention, yet conditions have deteriorated not
  improved

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Child Needs The complex and often chronic needs
of children in high risk communities are
unlikely to be effectively met by any single
support or intervention. They are likely to
require an array of supports and interventions at
multiple levels of different sectors as well as
support from the broader community.
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Major Program Activities

• Each community was encouraged to develop programs
  and activities that would meet local needs
• Substantial site differences in the array of
  programs and activities implemented

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Number of Different Programs Offered

• Younger Sites Average 26
• Range 18-35
• Older Sites Average 16
• Range 12-19
• Larry Schweinhart calls the Better Beginnings,
  Better Futures Project a Meta Program.

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Research Questions

• How do the Better Beginnings communities develop
  and implement programs? Are they characterized
  by
• Parent and community involvement?
• Integration of services?
• High quality programs?
• Project Development Program Model Research

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Research Questions

• Are the Better Beginnings programs effective in
• Preventing serious problems in young children?
• Promoting healthy child and family development?
• Enhancing the abilities of disadvantaged
  communities to provide for children and their
  families?
• Outcome Evaluation Research

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Research Questions

• What are the annual costs of these programs?
• Economic Analysis Research

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Research Questions

• What are the long-term effects and cost-benefits
  for children and their families in terms of
• Educational achievements and high school
  graduation rates?
• Use of special education, health, and social
  services?
• Employment and social assistance?
• Criminal charges and convictions?
• Teen pregnancy?
• Drug and alcohol abuse?
• Long Term Follow-up Research

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Data Collection
Program funding of the eight sites began in April
of 1991. It took 2½ years for local projects and
programs to develop to the point where
valuations could begin in the fall of
1993. Extensive information was collected and
reported by the Research Coordination Unit on
start up processes. Baseline measures on
children, families, and neighbourhoods were
collected in 1992-1993.
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In 1993-94, a longitudinal research group of
1,400 children and their families was recruited
in 8 project and 3 comparison sites.Outcome
measures were collected on these
children/families for 5 years.During this 5
year period, information was also collected
regularly on
Data Collection (continued)

• Project organization
• Local programs
• Resident participation

• Service integration
• Program costs

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KEY SHORT-TERM FINDINGS
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LOCALLY DEVELOPED AND OPERATED ORGANIZATIONS

• Each site successfully developed and operated a
  local organization that delivered a broad range
  of programs for young children and families,
  based on locally identified needs.
• For disadvantaged neighbourhoods, meeting this
  challenge was a major achievement, involving the
  building of community leadership.
• Adequate time, planning, and support were
  required to engage disadvantaged neighbourhoods
  in the process, build trust, and establish stable
  structures, procedures and programs

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CHILDRENS EMOTIONAL HEALTH AND BEHAVIOUR

• A major goal of this project was to reduce
  emotional and behavioural problems in young
  children.
• The strongest improvements occurred in programs
  that were focused, intensive and continuous.
• Where programs for children 0-4 were sustained
  from infancy (home visiting) through the
  preschool period, with parent-child playgroups
  and quality child care, children started school
  with less anxiety, fewer behavioural problems,
  and more ready to learn.

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CHILDRENS EMOTIONAL HEALTH AND BEHAVIOUR

• For the older group (age 4 to 8), major
  improvements were achieved in childrens
  emotional health and behaviour at the sites that
  used educational assistants to work with children
  in th eclassroom continuously from Junior
  Kindergarten to Grade 2.
• However, it is not possible to predict what
  longer-term child outcome may be achieved at
  sites that focus more of their program on
  parental support or community development.

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SPECIAL EDUCATION AND SCHOOL-FAMILY RELATIONS

• Special education placements decreased in schools
  where educational assistants worked with children
  in classrooms.
• Parental satisfaction with the teacher and the
  school increased when the educational assistants
  actively reached out to parents to forge
  connections with the school and involve them in
  their young childrens education.

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CHILDRENS PHYSICAL HEALTH

• Childrens nutritional intake was acceptable,
  unlike findings in several U.S. studies of
  preschoolers.
• During the first two years of the project, there
  was a general increase in consumption of
  nutritious food by children at the older child
  sites, likely because of emergency food cupboards
  and other food resources set up at the sites.
• The energy and nutrient intake of eight-year-olds
  improved significantly.

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CHILDRENS PHYSICAL HEALTH

• More than 20 of the children at the sites were
  overweight.
• Since their fat intake was not excessive, an
  important factor was likely to be too little
  physical activity.
• Other studies have shown that children from
  disadvantaged neighbourhoods are far less likely
  to participate in recreational activities than
  other children.

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CHILDRENS PHYSICAL HEALTH

• At the younger sites
• children had more timely immunizations at 18
  months than the comparison neighbourhood
• parents felt they had better access to
  professionals, such as doctors and social
  workers, for their children
• In the older child sites
• parent ratings of their childrens health
  improved.

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PARENT HEALTH ANDWELL-BEING

• Smoking by mothers and others in the home
  decreased at all of the project sites.
• In the younger child sites, smoking rates among
  mothers dropped by 10 and in the older child
  sites by 20.
• May have been influenced by increased
  opportunities to get involved in community
  activities, especially in situations that
  discourage smoking.

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PARENT HEALTH ANDWELL-BEING

• In the younger child comparison site
• women reported increased monthly breast
  self-examination,
• higher rates of breastfeeding at birth than at
  the project sites (which were around the
  provincial average), and
• comparable smoking rates to the Better Beginnings
  sites.
• These results suggest that a longstanding and
  well-organized maternal health program in the
  comparison site is having an impact.

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PARENT HEALTH AND WELL-BEING

• Intake of necessary nutrients from fresh fruits
  and vegetables and dairy products by
  breastfeeding mothers was below recommended
  levels at all the younger child project sites and
  in the comparison site.
• Programs that promote breastfeeding among
  low-income women should include strategies to
  ensure their access to these foods.

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PARENT HEALTH ANDWELL-BEING

• There were strong effects at one site where
  parents reported
• lower stress levels
• more social support
• increased satisfaction with their marriage and
  their role as parents
• less hostile-ineffective parenting
• This group of parents, like their children, were
  the focus of more frequent and intensive
  attention from Better Beginnings, Better Futures
  than those at any other site.

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NEIGHBOURHOOD QUALITYOF LIFE

• At the younger child sites, parents reported
  increased safety in the neighbourhood when
  walking at night.
• Parents in two of these sites reported a general
  improvement in their neighbourhoods, including
• increased community cohesion
• less deviant activity (alcohol and drug use,
  violence and theft)
• increased satisfaction with their housing.

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NEIGHBOURHOOD QUALITYOF LIFE

• At one of the younger child sites, parents felt
  the neighbourhood was going downhill.
• The ratio of welfare recipients to other families
  is highest in this neighbourhood.
• This neighbourhood also experienced a severe
  deterioration in police-community relations.

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NEIGHBOURHOOD QUALITYOF LIFE

• In the three older child sites, parents reported
  greater satisfaction with the general quality of
  their neighbourhood, and the condition of their
  housing.
• At two sites, children made much more use of
  playground equipment and recreational facilities.

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PARTNERSHIPS

• The locally-run Better Beginnings, Better Futures
  organizations became successful catalysts for
  voluntary collaboration among service agency
  partners.
• This resulted in
• improved service availability and accessibility.
• leveraging of additional resources for the
  disadvantaged neighbourhoods.

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PROJECT DEVELOPMENT

• Research on project development at the 8 Better
  Beginnings, Better Futures sites identified the
  following
• allow enough time to build trust and develop
  programs (at least three years for complex
  projects)
• provide support to communities to help with
  planning and organizational development
• give communities a guidepost for local
  involvement (Better Beginnings, Better Futures
  called for a minimum of 50 resident members on
  all key committees)
• allow considerable local control and flexibility
  to tailor the organization and its programs to
  local needs
• balance local control with clear project ground
  rules to avoid confusion and potentially
  conflicting priorities.

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Objectives for the Medium-Term Follow-up Research
(2000-2005)

• Objective 1 to determine impacts of the Better
  Beginnings programs on children,their families
  and communities over a five-year period as
  children develop into adolescence
•  Objective 2 to relate short-term program costs
  to medium-term potential cost- savings
•  Objective 3 to evaluate the sustainability and
  on-going effectiveness of the eight local
  Better Beginnings projects

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Objective 1 Follow-up Research Designs

• 1. Comparison Site Design
• Continue to follow the focal cohort of children
  and families in the eight Better Beginnings
  project sites.
• Add following cohort (year younger) in each of
  the 8 project sites to increase sample size
• Comparison sites in Ottawa-Vanier, in Etobicoke,
  and in Peterborough (supplemented with 50 cases
  from Hamilton to improve the demographic match)

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Follow-up Research Designs (contd)

• In the younger cohort sites, data will be
  collected from parents and teachers when children
  are in Grades 1 and 3
• In the older cohort sites, data will be collected
  from youth, parents and teachers when the youth
  are in Grades 6 and 9.

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Follow-up Research Designs (contd)

• 2. Comparisons with the National Longitudinal
  Survey of Children and Youth (NLSCY) data for
  Ontario.

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Objective 2 Potential Cost Savings

• Determine whether children from the Better
  Beginnings programs show fewer grade repetitions,
  require fewer special education services, show
  less delinquent behaviour requiring social and/or
  correctional services than comparison children
• Estimate average costs associated with required
  services
• Calculate cost savings associated with outcome
  differences between Better Beginnings project and
  comparison children

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Objective 3 Project Sustainability and
On-Going Effectiveness

• The eight locally developed and operated
• Better Beginnings, Better Futures
• organizations represent one of the most
• important short-term outcomes of this
• Ontario Government initiative. Follow-up
• research will

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• Examine the stability of project achievements and
  further contributions to the communities
• Examine changes in programs, partnerships,
  management structure, resident involvement and
  community context
• Include periodic snapshots of children living
  in the project and comparison sites. In the
  younger cohort sites, information will be
  collected from SK teachers, and in the older
  cohort sites from Grade 3 teaches in 2002 and
  2005.

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Update of Data Collection Winter Spring
2001Year 1 of Follow-Up Research

• 901 interviews completed with families with Grade
  1 or Grade 6 children 87 completion rate
• 97 of families interviewed in our last wave of
  data collection (in 1998) agreed to be
  interviewed again in 2001
• Youth self report forms were completed by 80 of
  our Grade 6 cohort (n332 forms completed).
• 1380 teacher report forms were completed this
  spring.(86 completion rate). 1600 forms were
  sent to 329 schools across the country.

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KEEPING IN TOUCH WITHOUR RESEARCH FAMILIES

• Staying in touch with research families is one of
  the most important goals of long-term research.
• Every year, we mail 3 cards to our research
  families. A birthday card to the research child,
  his/her parent and a Seasons Greeting card.
• Every time we interview a family, we leave a gift
  with our Better Beginnings logo and telephone
  number on it (such as fridge memo board,
  keychain, cup, Frisbee, pencil case, bookmark)
• About 60 of our research families still live in
  the research neighbourhoods.
• Last year, about 20 of families moved at least
  once.

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FINDING OUR RESEARCH FAMILIES

• We have over 20 strategies to help us stay in
  touch with families and find families if they
  move.
• These strategies have helped us keep in touch
  with about 91 of our families since we began our
  longitudinal research in 1993.
• Finding families requires effort and support from
  many sources.

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FINDING OUR RESEARCH FAMILIES

• Each time we interview a family, we ask
  permission to contact the following sources in
  case the family moves and we cant find them
• Relatives
• Friends
• Childs School
• Family Doctor
• Employer
• Better Beginnings program staff
• Neighbours
• It takes a lot of hard work to find families.
  Last year, our researchers made more than 1100
  attempts to locate missing families.

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CELEBRATING OUR SUCCESSESYEAR ONE OF
OURMEDIUM-TERM FOLLOW-UP

• In the winter and spring of 2001, over 900
  families with children in Grades 1 or 6 were
  interviewed and over 1,300 teacher report forms
  were collected.
• 93 of families who were interviewed
  approximately 3 years ago agreed to participate
  again in our 2001 data collection. Our range was
  from 77 to 100.
• Familiarity is important! Sites with the highest
  participation rates had the longest employed Site
  Researchers. For example, Cornwall, Highfield
  and Peterborough had from 97 to 100 of their
  research families agree to be interviewed in our
  most recent data collection.