Kelaher 2009.
| Methods |
Study design: controlled before‐after study (independent samples) Sampling frame: all children 1 to 2 years in Victoria with active maternal and child health records for breastfeeding (n = 48,533) or age 3 for MCH visit outcome Sampling method: all eligible persons included Collection method: routinely collected by maternal and child health clinics Description of the community coalition: Best Start is an area‐based initiative that provides funding to engage and support families, local services, and local government in a local partnership responsible for overseeing all phases of the project. Partnerships vary by site but must include representation of 6 essential partner groups: parents/elders, local government, health services, education services, family/community support services, and community organizations. Additional partners may include representatives from housing, law enforcement, and specialist services. Partnership must be representative of key stakeholders within the community, including Aboriginal networks and ethnic organizations where applicable. Agencies are nominated as the facilitating partner and the fund holder; a community facilitator is appointed to manage administration of the project on behalf of the partnership. The partnership is expected to establish subcommittees to accomplish its action plan |
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| Participants |
Communities: urban and rural regions of Victoria Country: Australia Ages included in assessment: 0 to 4 Reasons provided for selection of intervention community: Sites were selected by the Department of Human Services on the basis of social and health disadvantages and lack of existing partnerships Intervention community (population size): Best Start sites (1,117,511) Comparison community (population size): the remainder of Victoria (3,536,269) |
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| Interventions |
Name of intervention: Best Start Theory: not reported Aim: to improve the health, development, learning, and well‐being of all Victorian children age 0 to 8 years through better access to child and family support, health services, and early education; improvements in parents’ capacity, confidence, and enjoyment of family life; and communities that are more child and family friendly Description of costs and resources: Costs and resources vary by site Components of the intervention: Components of intervention vary by site and may include community outreach, peer support, education for health professionals, and established evidence‐based initiatives Start date: 2002 Duration: ongoing |
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| Outcomes |
Outcomes and measures:
Time points: pre‐intervention (2001 to 2002) and during intervention (2004 to 2005) |
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| Notes | Outcomes measured at the population level Funding source: Victorian government |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | High risk | Intervention not randomly assigned |
| Allocation concealment (selection bias) | High risk | No allocation concealment |
| Baseline outcome measurement similar | High risk | Intervention sites selected for poor outcomes relative to comparison group at baseline |
| Baseline characteristics similar | High risk | Intervention sites selected for disadvantaged status relative to comparison group at baseline |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | Statewide maternal child health records |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Outcomes derived from independent samples, statewide records |
| Blinding of participants and personnel (performance bias) All outcomes | Low risk | Outcomes derived from statewide records, probably not susceptible to lack of blinding |
| Protection against contamination | Unclear risk | Comparison sites proximate to intervention sites, no protection from contamination |
| Selective reporting (reporting bias) | Low risk | Main outcomes reported |