22nd June 2026

The REACH Study – Building research capacity and capability within health visiting through an NIHR-funded study

This Voices blog by Dr Sharin Baldwin (Institute of Health Visiting) and Professor Sally Kendall (University of Kent) shares details of a new research study that aims to better understand how health visiting support can be made more equitable, accessible and effective for all families. 

Health visitors play a vital role in improving outcomes for babies, children and families, particularly those facing additional challenges. Yet despite the significant contribution health visiting makes to public health, there remains a need for more evidence about how interventions work for diverse populations and how services can best reduce inequalities in access and outcomes. This is one of the reasons we are delighted to be leading the REACH Study (Reducing inequalities through Engagement, Access and Culturally responsive Health Visiting), a National Institute for Health and Care Research (NIHR)-funded study that aims to better understand how health visiting support can be made more equitable, accessible and effective for all families. 

The study focuses on the Maternal Early Childhood Sustained Home Visiting (MECSH) programme, a structured home visiting intervention – embedded within health visiting services and delivered by health visitors – to provide targeted support for families who may benefit from additional help during pregnancy and the first two years of a child’s life. MECSH was first introduced in the UK in 2013 and is now delivered across a number of sites in England and the Channel Islands. However, it has not yet been evaluated in relation to how it works for families from Black and Asian backgrounds in the UK. 

This is an important gap in our knowledge. Research consistently shows that barriers to accessing parenting and family support services disproportionately affect disadvantaged and vulnerable families. This includes families from Black and Asian minority ethnic groups, who make up about 14% of the UK population¹, those with limited English proficiency², and non-birthing parents like fathers, kinship and foster parents³. Existing interventions are not always sufficiently tailored to meet the needs of these groups, which can leave families feeling excluded or underserved and contribute to inequalities in access and outcomes.

Through the REACH Study, we aim to better understand whether Black and Asian families are able to access, engage with, remain involved in, and benefit from the MECSH programme in the same way as other families in England. Taking a realist approach⁴ and using questionnaires, interviews and service data, we will explore not only whether MECSH works, but how it works, for whom it works best, and what improvements may be needed to ensure support is culturally responsive and accessible. 

One of the greatest strengths of the study is its commitment to co-production. Parents and carers have been involved from the outset, helping to shape the research and ensure it remains grounded in lived experience. Families from Black and Asian communities and those with experience of the MECSH programme are represented through a dedicated service user involvement group. 

Led by Dr Sharin Baldwin, Senior Health Visitor Research Lead at the iHV and Professor Sally Kendal, Professor of Community Nursing and Public Health at the University of Kent, the REACH Study brings together a multidisciplinary group of researchers, practitioners, and subject experts from London South Bank University, the University of Edinburgh, Western Sydney University, Central London Community Healthcare NHS Trust, and Bradford District Care NHS Foundation Trust. Together, we share a commitment to reducing inequalities, improving access to support and strengthening the evidence base for health visiting practice. 

Alongside generating evidence about reducing inequalities, the REACH Study also provides an important opportunity to strengthen research capacity and capability within health visiting. Despite nurses and health visitors representing the largest workforce group within healthcare⁵, they remain underrepresented in research leadership. A recent review of the NIHR Research for Patient Benefit (RfPB) programme found that nurses and midwives accounted for only 8% of successful applicants in lead and co-applicant roles, compared with 41% who were medically qualified professionals⁶. We believe it is essential that health visitors are supported to lead and undertake research. Those working directly with babies, children and families bring valuable insights into the challenges families face and the changes needed to improve outcomes. Strengthening research capacity within the profession is therefore critical to ensuring that future policy and practice are informed by both evidence and frontline experience. 

In addition to a Health Visitor Research Associate post, the study includes dedicated research development opportunities that enable practising health visitors to remain in clinical practice while gaining valuable experience in research delivery, leadership and development. By investing in the next generation of health visitor researchers, we hope to strengthen the profession’s ability to generate high-quality evidence, influence policy, and drive improvements in services for babies, children and families.  

Ultimately, the REACH Study is about more than evaluating a programme. It is about understanding how health visiting services can become more culturally responsive, how inequalities in access and engagement can be reduced, and how every family can receive the support they need to thrive. At the same time, it is about investing in the future of health visiting research and creating opportunities for practitioners to develop the skills, confidence and experience needed to lead the next generation of evidence-informed practice. 

To find out more about the REACH Study visit: https://ihv.org.uk/our-work/research/research-studies/current-research-studies/the-mecsh-study/ 

Dr Sharin Baldwin (Institute of Health Visiting) and Professor Sally Kendall (University of Kent)

References 

1. NIHR (2023) Toolkit for Increasing Participation of Black Asian and Minority Ethnic Groups in Health and Social Care Research. https://arc-em.nihr.ac.uk/clahrcs-store/increasing-participationblack-asian-and-minority-ethnic-groupshealth-andsocial-care 
2. Hughson, J., Marshall, F., Daly, J.,Woodward-Kron, R., Hajek, J., Story, D. (2018) Health professionals’ views on health literacy issues for culturally and linguistically diverse women in maternity care: Barriers, enablers and the need for an integrated approach. Australian Health Review, 42(1), 10–20. https://doi.org/10.1071/AH17067. 
3. Early Intervention Foundation (2019) Engaging disadvantaged and vulnerable parents, An evidence review. https://www.eif.org.uk/report/engaging-disadvantaged-and-vulnerable-parents-anevidence-review 
4. Pawson, R., Tilley, S. (1997) Realistic Evaluation. London: Sage. 
5. NHS Digital. NHS workforce statistics. 2023. https://digital.nhs.uk/data-and-information/publications/statistical/nhs-workforcestatistics 
6. National Institute for Health Research. RfPB Under-represented disciplines and specialisms highlight notice: Nurses and Midwives – Call Specification. 2024. https://www.nihr.ac.uk/documents/rfpb-under-represented-disciplines-and-specialisms-highlightnotice-nurses-and-midwives-call-specification-stage-1/32050