Linking prevention science and community engagement: a case study of the Ireland Disadvantaged Children and Youth Programme

Abstract

Randomised controlled trials (RCTs) are acknowledged to provide the most reliable estimate of programme effectiveness, yet relatively few are undertaken in children's services. Consequently, there are few models with a demonstrated impact on child well-being, leading to a concern not only that services may frequently be ineffective but also that some may be harmful. This article considers how this state of affairs has come into being and discusses potential remedies for improving both the knowledge base and the quality of interventions. It focuses on ‘operating systems’ that link prevention science and community engagement and so help communities, agencies and local authorities to choose effective prevention, early intervention and treatment models. Specifically, it describes an attempt in Ireland to implement a robust programme of research into children's health and development, to rigorously design new services, evaluate their impact to the highest standard (using RCTs)and integrate the results into the policy process. Based on the authors' extensive first-hand experience of supporting the work, and the advice of international experts, the article reflects critically on the unforeseen challenges and offers lessons for others starting a similar enterprise.