ADBB Phase Two Study : A mixed methods evaluation of the expansion of the m-ADBB and ADBB training programme within health-visiting teams across the UK

Background

In August 2023, following the Princess of Wales’ observation of the use of the Alarm Distress Baby Scale (ADBB) by health visitors in Denmark, The Royal Foundation Centre for Early Childhood commissioned the iHV to conduct a study to explore the acceptability and feasibility of using the ADBB and m-ADBB to identify social withdrawal in babies as part of routine 6-8-week visits carried out by health visitors. The study was carried out in partnership with Professor Jane Barlow from the University of Oxford.

This mixed methods feasibility and acceptability study was successfully completed in February 2024. The findings suggested that the ADBB and m-ADBB training enhanced health visitors’ observational skills for assessing signs of social withdrawal in babies and it was feasible to incorporate the m-ADBB within routine 6-8-week health visitor contacts.

In October 2024, The Royal Foundation Centre for Early Childhood agreed further funding for the iHV, in collaboration with the University of Oxford, to conduct a second phase of work to address several of the recommendations for policy, practice and further research, as outlined below.

Aims:

To develop and implement the expansion of the m-ADBB and ADBB training programme within health visiting teams across the UK.
To evaluate the impact of the above expansion on practice, outcomes of referrals, and acceptability to parents.

Objectives:

Consider the findings of the initial feasibility study to inform the expansion of the m-ADBB and ADBB training, including any additional resources needed to align to UK health visiting practice
Deliver and evaluate the revised training programme across a range of UK health visiting sites
Evaluate the impact on health visitor practice and outcomes of referrals made
Compare the rate of concerns identified in babies at 6-8-weeks by health visitors
Follow-up of the outcomes for babies when concerns are identified at 6-8-weeks by health visitors trained in m-ADBB/ADBB compared with those who are not
Explore the acceptability of the scale to parents
Engage stakeholders to create a clear plan for future embedding and sustainability
Make recommendations for implementation of the ADBB in practice and future sustainability of the UK-based training offer and learning opportunities through a Community of Practice.

Study design:

A mixed methods evaluation.

Study participants:

The study will involve health visitors and student health visitors across the UK in the following NHS settings:

Ayrshire & Arran Health Board
Cwm Taf Morgannwg UHB
Hampshire & Isle of Wight Healthcare
Humber Teaching NHS Foundation Trust
Northern H & SC Trust
RDaSH –North Lincs
RDaSH –Doncaster
South Warwickshire University NHS Foundation Trust

Planned study period:

September 2024 – March 2026 (18 months)

Expert Advisory Group

An Expert Advisory Group comprising senior academics, government officials and key stakeholders will provide expert advice, scrutiny and challenge on the study to enrich and enhance the project’s rigour and support dissemination of the learning in line with the national ambitions to ‘give every child the best start in life’.

Members of the Expert Advisory Group: