Developing theories of change for social programmes: co-producing evidence-supported quality improvement

Deborah Ghate

doi:10.1057/s41599-018-0139-z

Abstract

For much of the past two decades, expensive and often imported evidence-based programmes (EBPs) developed by clinician-researchers have been much in vogue in the family and parenting support field, as in many other areas of social provision. With their elaborate infrastructures, voluminous research bases and strict licensing criteria, they have seemed to offer certainty of success over less packaged, less well-evidenced locally developed approaches. Yet recently, evaluation research is showing that success is not assured. EBPs can and regularly do fail, at substantial cost to the public purse. In times of severe resource pressure, a pressing question is, therefore, whether lower cost, home-grown, practitioner-developed programmes—the sort often overlooked by policy-makers —can deliver socially significant and scientifically convincing outcomes at lower cost and at least on a par with their better resourced cousins. This paper shows how the application of techniques increasingly used in implementation science (the science of effective delivery) could help level the playing field. Processes for doing this including co-produced theory of change development and validation are illustrated with reference to the Family Links Ten Week Nurturing Programme (FLNP-10), a popular manualised group-based parenting support programme, designed and disseminated since the 1990s by a UK-based purveyor organisation. The paper draws out general principles for formulating and structuring strong theories of change for practice improvement projects. The work shows that novel application of implementation science-informed techniques can help home-grown programmes to compete scientifically by strengthening their design and delivery, and preparing the ground for better and fairer evaluation.

Highlights

Background to the FLNP10 The Family Links 10-Week Nurturing Programme (FLNP-10)1 is a 10-week community-based, ‘purveyor-supported’2 parenting support programme, designed to be delivered by trained parent group leaders who are employed by or contracted to provider agencies
Provider agencies are predominantly local authorities, with some voluntary organisations and independent consultancies trained by Family Links to deliver the programme. 10-Week Nurturing Programme courses are usually delivered within community-based venues such as children’s centres and schools
Originating in a US-developed intervention known as the Nurturing Parenting Programmes3, the FLNP10 has been adapted and developed independently over many years by practitioners at Family Links for delivery in the UK

Summary

Introduction

10 The Family Links 10-Week Nurturing Programme (FLNP-10) is a 10-week community-based, ‘purveyor-supported’ parenting support programme, designed to be delivered by trained parent group leaders who are employed by or contracted to provider agencies. Provider agencies are predominantly local authorities, with some voluntary organisations and independent consultancies trained by Family Links to deliver the programme. Originating in a US-developed intervention known as the Nurturing Parenting Programmes (see Bavolek, 2000), the FLNP10 has been adapted and developed independently over many years by practitioners at Family Links for delivery in the UK. It ranks, as an indigenous programme rather than an import from the canon of international off-the-shelf EBPs. returns for pre-specified results. A veritable commissioning ‘bandwagon’ (Dick et al, 2016) has resulted, but—as it is slowly Evidence status of the FLNP-10 becoming clear—often with mixed or outright disappointing The UK programme has been the subject of a number of research results in replication in new settings

Objectives

Conclusion