“A science-informed approach specifically refers to understanding how problems develop”

Dr Nick, Axford Senior Researcher and Head of What Works, Dartington Social Research Unit

Researcher Nick Axford reflects on the reasons why vulnerable groups have been the most jeopardised by the reduction in aid programmes motivated by the economic crisis.

In his opinion, decision-making when creating aid policies for people in a situation of social exclusion is too heavily influenced by political criteria. Furthermore, such proposals are drawn up without involving the people they are intended to benefit, which means that many of the resources allocated fail because they lack effectiveness.

Parliamentary politicians who design these programmes tend to lack a strong scientific background, which means that their understanding of available evidence is quite limited. Trying to ensure, from the start, that the services we implement are underpinned by science and evidence is extremely important.

 

The economic crisis in Europe has led to cuts in policies and programmes: what have been its worst effects on the ability to meet children’s needs?

I think the worst effects of the economic crisis on being able to attend to children’s necessities, to their needs, in the UK at least has been increased rates of hardship, of financial hardship for families, of poverty. Certainly there has been a much greater use of food banks. I don’t know if you have those here in Spain, but places where families can go for free or very cheap food. I think for service providers and for policymakers, they are faced with very difficult decisions about which services to continue with and which services to cut. And, increasingly people are having to cut services that are maybe more prevention and early intervention, because they’re needing to try and maintain the services that are for families with a higher level of need and making sure that families in crisis are helped. So that’s obviously a very challenging time for everyone.

 

Why are programmes promoting child-parent attachment so important for children’s wellbeing and have they been affected by the economic crisis?

I don’t know if the economic crisis has had a particular impact on those kinds of programmes – programmes for children and supporting their attachment. The reason it’s very important, I think, is because it’s the foundation of a lot of what children go on to do, it’s a foundation for, obviously, their relationship with their parents, for their behaviour, for their own emotional wellbeing and so on. And we know that children who don’t attach well to their parents have various problems both in childhood but also potentially in later life. Obviously that’s not set in stone; these things are not deterministic, things can change later, but that’s why it’s so important. And as you say, there are numerous programmes that exist to try and help parents and children to build those important bonds in the early years.

 

What has the greatest influence on policymakers when defining priorities relating to children’s wellbeing: scientific evidence, cost-benefit analysis or polls?

I think the way policymakers decide these things is influenced by various factors. Sometimes I think it’s just influenced by what they are particularly interested in or by some experience that they have had personally or maybe people that they’ve been speaking to. So often policymakers or politicians in particular will, if they speak to members of the public and particular issues are mentioned, then that becomes a priority. I think, other things that they will take into account, sometimes of course research evidence although I think that that is less than we would like. And certainly in the UK, a lot of policymakers and politicians there, politicians in particular in parliament, they don’t have a particularly strong scientific background, so their understanding of evidence is often quite limited, so that’s a problem. Polls I think, yes for sure, and consumer opinion must influence things. But certainly, we as an organisation are keen that these decisions are influenced more by evidence of what works, what doesn’t work, and of course, by studies that are done either at a local level or at national level that illustrate what the particular needs of families are in a particular area.

 

Many current examples and experiences aimed at improving education outcomes for children from poor backgrounds are local in scope: could they also be applicable on a national level?

It’s an interesting question. People often say this; that policies or programmes work at a local level and maybe not at a national level. Firstly, I think that it’s important that things are developed and tested locally and I think certainly there are sometimes local contexts that are important. And I think the idea of designing interventions or programmes and policies in context and taking into account the situation where they are going to be delivered is very important. And therefore, involving people in the design of those interventions and services, whether they are local practitioners, teachers, health workers, social workers or service users or potential service users, I think that’s very important and helpful. And there’s a danger if we don’t do that,that we design things that people will never use or they’ll never implement. At the same time, I do think sometimes that this idea that children or families in a particular area are somehow different to children or families elsewhere, is exaggerated. We know that the kind of factors that influence child wellbeing and child behaviour and so on, they’re fairly common from place to place. So, sometimes people in the UK will say “Well, my children...” or “The children in my area won’t benefit from this” and I don’t always buy that. I think that’s not quite right. There is a challenge in our field though as well, in terms of the transportability of interventions and often people think about that in terms of the transportability of interventions from one country to another and whether something developed in one country will work in another. But you could potentially, I guess, apply that at a local level as well, or going from local to national. There are some programmes, I think, that transport very well and there are some that transport less well and I think we need to do more research in that area.

 

Your paper, “Children’s services in Spain”, states that Spain is lacking “overall reflection on the concept of quality services for children”: What would your main recommendations be here?

That’s a very big question, so: how to improve the quality of services. I think there are various things, I mean I think, first of all there’s just the general design of services for children and families, and I think clearly that needs to be influenced by evidence of how children develop and evidence of what works and I think we are certainly doing work in that area and many other people are as well. So, trying to make sure that in the first place the services e implement are underpinned by science and evidence, that’s very important. I’ve said already, it’s important that they are influenced by the people who are going to use them and the people who are going to implement them, that they have a say in the design of services as well. We clearly need to test what we do and find out what’s working and what’s not working and we can, having done that we can make improvements, so whether, for example, maybe programmes are not being delivered or interventions are not being delivered in the right way or by the right people or to the right length and we need to gather that kind of data and reflect on it on a regular basis, not just wait until the end of the intervention but continually reflect on it, so I think that’s important as well. Those would be some key recommendations.

 

How do you view the fact that in Spain, pre-school education is not compulsory or free, and in many regions prices are unaffordable for many families?

Well, clearly, families play a critical role in the early education of children. And children spend most of their time with their families and that’s really important. And so, anything we can do to promote families’ interaction with their children is clearly very important. But we also know that pre-school education is important, particularly for more disadvantaged children I think. The evidence is strong on that, in terms of the way it can help to improve their development, all aspects of their development: social, emotional, physical and so on. So I think that’s clearly very important and there’s also evidence that it can have longer term benefits. So I think it’s a getting a good balance between pre-school education and supporting families in looking after their children at home. And of course a lot of programmes increasingly are not just about helping the child but also helping the family as a whole and helping the parents to interact well with their children.

 

Dartington Social Research Unit stands for a science-informed approach to service design: is this the most useful approach to service design in public systems?

Yes, so you would think that a science-informed approach would be common. I think it’s less common, much less common than you would think. And I guess what we’re talking about when we talk about a science-informed approach is particularly, I think, understanding how problems develop, so understanding what we sometimes call the risk and protective factors that are involved in the development of problems. Risk factors are the things that make poor outcomes more likely; protective factors are things that operate in the context of risk to try and protect children and families against those risks. And there’s a lot of very good research about the factors that cause problems and how they interact. And so a more science-informed approach to developing services would be based on that understanding, would be saying: well, what do we know is effective about addressing certain risk factors? What about promoting certain protective factors? And as I said earlier, a science-informed approach would also be taking into account what practitioners think and what service users think. I don’t think we should necessarily see those things as different, that can all be part of a science-informed approach.

 

What is Dartington’s most significant contribution towards change in refocusing children’s services design?

I guess the thing that we are doing particularly at the moment which is interesting is that we are thinking more about how to adapt programmes and also how to do rapid testing of interventions. So, as well as helping people to design new interventions or adapt existing interventions, whether by taking on board the science or taking on board the views of implementers or service users. We are very interested now in testing those things and gathering data and reflecting on it quite quickly. So instead of waiting until the end of the intervention or the end of the service and finding out whether it worked or what people liked and so on, we are interested in gathering that data in real time and looking at it in real time – so for example, every week or every month – and potentially making changes as we go. So I think that’s something that we’re doing a lot of work on at the moment and particularly in relation to one programme called Family Nurse Partnership (FNP) which is a home visiting programme for disadvantaged young mothers.

 

You emphasise the need to do research with data in a way that is easy to interpret. Do you think social researchers communicate clearly enough?

I think it depends, I think some social workers do communicate their research very clearly and others don’t. Sometimes I open a journal and I don’t understand the title of half of the articles in the journal, and I’m someone who works in the field: that’s a bit worrying! I think things have got better in recent years. Academics are more aware that they need to communicate things in plain English. So often you will find research findings communicated in quite technical terms but then there will be a kind of plain English summary alongside. I think, increasingly researchers are translating their research into a form that can be understood by service users and will disseminate their research results in that way. And of course there are more innovative ways of disseminating information, so it’s not just through written products. I think increasing them through the use of more visual means: data visualisation, I think, is an area that’s really developing, and the use of interviews and videos, those kinds of things as well. So I think we are getting better but I think there’s a long way to go.

 

Can you explain your main lines of work and projects right now: Do you envisage new research findings in the near future?

I think the main things I’m doing at the moment: I’m finishing some randomised control trials that we’ve been doing as a unit over the last few years and they’re in the area of, kind of, preventing anti-social behaviour and crime. So for example, there’s a dating violence prevention programme in schools: We’re looking at that. And a parenting programme, and another programme which is a mentoring programme for young people, so those will all report next year. We also recently completed the trial of a school-based bullying prevention programme from Finland which was implemented for the first time in the UK. And that was particularly interesting, because the programme focuses on the role of the bystander, not on the bully and not on the victim but really on the bystander and how they can encourage or discourage bullying. So that’s an interesting study. The other thing we are working on is some work on this programme called Family Nurse Partnership which is an evidence-based home visiting programme for disadvantaged young mothers and last year it was evaluated in the UK, not by us but by another centre. It was a randomised control trial and it found no impact, or next to no impact. So we are working with the FNP to adapt parts of their programme, both clinical content but also the way in which the programme is implemented more widely. And we are testing that, both for its impact on outcomes but also for how users find it, how the clients find it, but also how well the nurses implement the adapted version. So that’s a really exciting project for us and it’s also a project where we’re gathering the data and looking at it on a regular basis, in a kind of iterative way. 

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