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Evaluation of the 0-5 Public Health Investment in England: a mixed methods study integrating analyses of national linked administrative data with in-depth case studies
The first five years of life are important for healthy child development. Supporting children and families in these early years can help ensure every child reaches their potential, including those who need extra help. Health visitors are qualified public health nurses who support families by working with other professionals such as social workers and general practitioners. The government says that every family in England should see a health visitor five times before a child is three years old. We know that the number of times a family sees a health visitor varies across England, with some families not seeing them at all. The types of visits also vary: some families have home visits from a health visitor or another team member, and some see these professionals in a clinic, over the phone or by video call. Each of these is called a health visiting 'contact'. Many professional organisations and researchers think that seeing the same health visitor regularly and face-to-face is the best way of supporting most families. However, there hasn’t been a lot of research into understanding this. There are some things we still don’t know: 1. How much difference does health visiting make to a child’s health? 2. Does the number of visits make a difference to a child’s health? 3. Does it matter which member of the team visits the family? This study aims to answer these and other questions. To do this, we will measure what happens to children’s health according to how often a family sees their health visitor or team member, and according to type of contact. We will use information from hospitals, GPs, schools, and social care in local areas (service data). We will compare the health of individual children whose mothers have similar backgrounds but who receive different numbers or types of contacts (e.g. at home or in clinic). We will also look at whether the average health of children is different between areas with different types of health visiting. We will calculate how much health visiting costs the government and how much money health visiting can save if we find that it improves child health, e.g. by avoiding serious injuries and hospital attendances. We will also interview parents and professionals, to see which aspects of health visiting might be working (or not) and what else might be influencing child health. This study will help the government and professionals decide what health visiting services should look like, and feed into government’s changes to health visiting and ambition to ‘level up’ life chances for children. We have consulted with mothers (and a father) already. We will talk again to three groups of parents (including one group of fathers) during the study This study is funded by NIHR Policy Research Programme
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