Evaluation of the Nottinghamshire Healthy Families Programme Parent/Infant relationship initiative

Evaluation in progress. Expected completion date April 2024.


What does the research mean for Local Authorities?

This mixed methods project will evaluate the Nottinghamshire Healthy Families Programme Parent/Infant relationship initiative (PIRi). The PIRi offers a short one-to-one intervention with families identified as being in need of support around developing interaction and connection in parent-infant relationships.

Locally, the findings will help shape the current and future service delivery of the PIRi and help influence future commissioning intent. More broadly, the findings will have the potential to inform service delivery in other areas, by exploring what contributes to the perceived feasibility, acceptability and effectiveness of services delivering interventions with families, from the perspectives of practitioners and service users.

What does the research evaluation mean for the Public?

This evaluation will help inform and improve how the Nottinghamshire Healthy Families Programme Parent/Infant relationship initiative (PIRi) is delivered. We will be looking at the perspectives of professionals delivering the PIRi, as well as members of the public who are receiving support. This will allow the views of different people to be heard and considered, and allow service improvements to be informed by a range of perspectives.

This will benefit the people receiving the PIRi and may enable more flexible support to be offered, helping people better access and engage in support, and ultimately improving children’s health and wellbeing.

How are the public involved in the evaluation?

We undertook three workshops with a variety of local stakeholders to help design the research project. These stakeholders included commissioners from the local council, managers and practitioners from the PIRi service, and service partners from the NHS and Health Family Programme team. We will undertake further workshops to feedback on emerging research findings towards the end of the project.
Our project partners at Nottinghamshire County Council have organised colleagues and service users not involved in the research to review key study information documentation (information sheets, consent forms, topic guides). This is being used to help comprehension and accessibility of study information for potential participants, and to ensure interview questions and information is appropriate and sensitive.

Lay summary of research

It is widely recognised that the first 1001 days of a child’s life, from conception to two, are a critical period of development. Parents who are aware of, and able to respond to their baby’s needs sensitively in an appropriate and timely way, support early development. In recent years there has been an increased understanding of the wider and long-term impacts of parenting support interventions aimed at improving the health and wellbeing of young children. In the aftermath of COVID-19 policies and restrictions, and the adverse impact this had on child wellbeing and development, Nottinghamshire County Council identified an opportunity to increase capacity and expertise to support the parent-infant relationship, through the introduction of a bespoke parent/infant interaction team, housed within the existing integrated 0-19 Healthy Families Programme.

The aim of the Nottinghamshire Healthy Families Programme Parent/Infant relationship initiative (PIRi) is to support parents with identified need to strengthen their relationship with their baby. The PIRi involves the identification of families in need of support, following the completion of a Brazelton Newborn Behavioural Observation (N-BO) assessment, at either the mandatory new birth visit or 6-8 week development review, by health visitors. The initiative provides up to 6 support sessions over a range of areas around infant development, responsive parenting, parents’ emotional health and wellbeing, parent-infant relationship, depending upon the specific needs of the family.

The focus of this project will be on evaluating the perceived feasibility, acceptability and effectiveness of the PIRi. The evaluation consists of a mixed methods approach.
We will collect primary qualitative data from interviews with service staff delivering the PIRi and other key stakeholders (including service providers, managers, commissioners, Parent-Infant Relationship Practitioners, Health Visitors, associated health care service staff), and interviews with service users who have received the PIRi programme. These interviews will explore perspectives and experiences of the PIRi service.
We will use routinely collected PIRi service data to undertake descriptive data analysis of service outputs and outcomes. Descriptive statistics will be produced to explore the extent involvement in the PIRi programme has had on reported parent-infant relationship outcomes for service users. The qualitative and quantitative data will be brought together to help draw out learning points.
The findings of the project will help inform the future delivery and commissioning of the PIRi.


Research team

Professor Elizabeth Goyder – University of Sheffield

Dr Hannah Fairbrother – University of Sheffield

Dr Nicholas Woodrow – University of Sheffield

Local Authority/Partner(s)

Helena Cripps – Nottinghamshire County Council

Kerrie Adams – Nottinghamshire County Council