Use of progression criteria to support monitoring and commissioning decision making of public health services: lessons from Better Start Bradford.
BACKGROUND
Commissioning and monitoring of community-based interventions is a challenge due to the complex nature of the environment and the lack of any explicit cut-offs to guide decision making. At what point, for example, is participant enrolment to interventions, course completion or satisfaction deemed to be acceptable or sufficient for continued funding? We aimed to identify and quantify key progression criteria for fourteen early years interventions by (1) agreeing the top three criteria for monitoring of successful implementation and progress; and (2) agreeing boundaries to categorise interventions as 'meeting anticipated target' (green); 'falling short of targets' (amber) and 'targets not being met' (red).


METHODS
We ran three workshops in partnership with the UK's Big Lottery Fund commissioned programme 'Better Start Bradford' (implementing more than 20 interventions to improve the health, wellbeing and development of children aged 0-3) to support decision making by agreeing progression criteria for the interventions being delivered. Workshops included 72 participants, representing a range of professional groups including intervention delivery teams, commissioners, intervention-monitoring teams, academics and community representatives. After discussion and activities, final decisions were submitted using electronic voting devices. All participants were invited to reconsider their responses via a post-workshop questionnaire.


RESULTS
Three key progression criteria were assigned to each of the 14 interventions. Overall, criteria that participants most commonly voted for were recruitment, implementation and reach, but these differed according to each intervention. Cut-off values used to indicate when an intervention moved to 'red' varied by criteria; the lowest being for recruitment, where participants agreed that meeting less than 65% of the targeted recruitment would be deemed as 'red' (falling short of target).


CONCLUSIONS
Our methodology for monitoring the progression of interventions has resulted in a clear pathway which will support commissioners and intervention teams in local decision making within the Better Start Bradford programme and beyond. This work can support others wishing to implement a formal system for monitoring the progression of public health interventions.
['Bryant|M|M|http://orcid.org/0000-0001-7690-4098', 'Dharni|N|N|', 'Dickerson|J|J|', 'Willan|K|K|', 'McEachan|R|R|', 'Duffy|J|J|', 'Howell|M|M|']
D000067576:Child Health D002675:Child, Preschool D003659:Decision Making, Organizational D005260:Female D006293:Health Promotion D006801:Humans D007223:Infant D007231:Infant, Newborn D011247:Pregnancy D011635:Public Health Administration D011795:Surveys and Questionnaires D006113:United Kingdom
Monitoring Early years intervention Implementation Child health Emotional Language Obesity Social