Louise Tracey, Sally Barber, and Liz Andrews describe how academics, researchers, council staff, and health staff have been working with parents to improve the health and well-being of families in one city
Born in Bradford (BiB) was born in 2006. Between March 2007 and December 2010, parents attending the main hospital in Bradford, UK, for ante-natal oral glucose tolerance testing were recruited to the study. The aim was to track children born in Bradford from pregnancy, through childhood, and into adulthood. The purpose of the study is to research the many influences that shape our lives and thereby to ameliorate any confounding factors.
|What we know|
|● Disadvantage and lower socioeconomic status are strongly linked with poor health. Health inequalities experienced at the start of life can have a profound effect on the rest of that life.
● The home learning environment is more important for intellectual and social development than parental occupation, education, or income.
● Children’s motor skills at an early age predict cognitive and academic ability in later-childhood and adulthood.
In September 2012, the first of the BiB children started school and the study was widened from a principally health study to encompass education. Health has remained at the project’s core, but this research recognizes the important role that parents and teachers can make in improving children’s life chances and is making important links between health and education. This article discusses the “Starting School” study within the wider BiB project.
In total 13,500 children born in Bradford between June 2007 and June 2011 were recruited to this cohort study, more than 60% of all children born in the city during that time. The oldest children started school in the academic year 2012/13 and the ‘Starting School’ project was developed. Schools from across the city have been approached to take part in the study.
The majority of participating schools are inner-city schools with socio-economic challenges, and were chosen because of the high number of BiB children attending Reception classes (age 4–5). However, when a school agreed to participate, the parents of all children – not just the BiB children – in the Reception year were asked to allow their children to undertake the Starting School assessments. In the first year of the project (2012/13) 49 schools were recruited and 2,902 children assessed. In this second year, the project has recruited 48 schools and 2,933 children so far, and anticipates assessing 5,325 children, 2,315 of whom will be from the BiB cohort, by July 2014.
Changing the city
The original aim of the BiB project was to improve health within the city, and work so far has led to a number of significant developments, including improvements in the reporting and treatment of maternal depression and creating firm links between air pollution and birth weight (results which have had international impacts). The Starting School study aims to build on these earlier, successful results. Children’s outcomes in terms of education have already been strongly linked to the characteristics of parents – what they do as well as who they are. Health, health inequalities, and literacy can be strongly linked to determinants of social disadvantage including socio-economic status and ethnicity. However, we also know that the home learning environment is more important for intellectual and social development than parental occupation, education, or income.
This study will provide an insight into these links, as well as the way they differ between different socio-economic and ethnic groups. Bradford is interesting as Pakistani-origin children will soon represent more than 50% of children in primary schools across the city. Pakistani-origin children are also the largest minority ethnic group in schools in the UK.
Our research builds on previous results and explores the interaction of findings within the overall context (including families, health, and education services), and engages with the complexities of children’s lives.
The Starting School study measures three different aspects of children’s development:
- Social and emotional well-being (as measured by a teacher-completed questionnaire for BiB children only);
- Physical development, in particular their fine motor skills; and
- Literacy development, using measures relating to their receptive vocabulary and early reading skills.
Each measure has been linked to children’s future outcomes, and the three measures are already proving to be interlinked. What is unique about the Starting School project is the way in which it is engaging stakeholders across the city and combining health, wellbeing, and educational measures. By doing so, it can explore these relationships, and we anticipate that the subsequent findings can be used to improve outcomes for children in Bradford and beyond.
One of the strengths of the BiB project has always been its ability to involve the community, through regular engagement with parents (eg, through newsletters, photographs and poetry, yearly birthday cards, an annual teddy bears’ picnic) and the wider community to share its findings. The Starting School project has built on that by holding a number of conferences for schools to discuss the issues most pertinent to teachers surrounding the children and parents they work with.
We are pleased with the large number of schools that have agreed to take part in the project, and with the number of parents who have been happy for their children to be involved, not only those from the Born in Bradford cohort, but also the parents of the other Reception class children recruited to the study. This is a great example of a city undergoing change, and of the community working together to contribute to that change.
This study could not have taken place (or continue to take place) without the willingness of parents, health services, children’s centres, community workers, and now schools. It will continue to grow as children reach different milestones in their lives, and as more and more people are aware of the potential of this project and become involved. However, research in itself is not sufficient, we hope that we are not only providing a valuable picture of the lives of children in one city, but are helping to ensure that these, and the lives of children like them, are improved.
Results from this stage of the project will not be available until 2015, but we are already working with schools to implement new programs and to address their current challenges. Bradford is continuing to provide a hub of research activity, demonstrating that while research is valuable, informed change is even more so. Future work relating to this project, and extending its remit outside Bradford, includes:
- Work to evaluate the impact of a new intervention to improve children’s fine motor skills;
- Research on evaluating educational interventions nationally (but including Bradford primary schools), in particular relating to children’s literacy;
- A study to encourage physical activity among preschool children using school playgrounds;
- An evaluation of parenting programs provided within the city; and
- Research into the impact of, and the barriers to, vision screening of children within the city.
For further information about the project, please see www.borninbradford.nhs.uk.
About the authors
Louise Tracey is a Research Fellow in the Institute for Effective Education at the University of York. Her research interests include research methods, professional development, early years education, and literacy. Her current projects include working with BiB to monitor children’s educational progress.
Sally Barber is a Principal Research Fellow at the Bradford Institute for Health Research. Sally’s interests are physical activity for health, sedentary behaviour, and childhood obesity prevention. She is the operational lead for the UK National Institute for Health Research ‘CLAHRC’ Maternal and Child Health Theme, and within this manages the BiB Starting School project.
Liz Andrews is a Senior Research Fellow at the Bradford Institute for Health Research, working on the BiB Starting School project. She has a background in health psychology and cognitive psychology, completing a PhD examining the links between ageing and cognitive performance (and driving performance).
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