National work The Parents 1st Community Parent model: an example of Social Prescribing during Pregnancy, Birth and Beyond Parents 1st has 30 years’ experience of developing successful Community Parent peer support programmes across the UK. Their model is unique, effective and solidly based in evidence. Over-arching aims The best start in life for the babies and children of vulnerable parents Resilient parents and communities that are less dependent on limited professional resources What are Community Parents? Community Parents are volunteer and paid peer supporters with specific personal qualities who are drawn from the local community. They offer informal support to women and their partners starting as early as possible in pregnancy. They walk the journey with parents through pregnancy, labour and birth, and the early months of parenthood, particularly those who feel vulnerable. Community Parents: Nurture emotional and physical wellbeing Assist pregnant women and their partners to confidently prepare for birth and becoming parents Encourage and enable parents to build their own local support networks Provide personal support to help parents navigate maternity and other services and communicate effectively with professionals Encourage sustained breastfeeding, and warm and confident parenting. Some Community Parents are also “birth buddies”: “The feedback we get from midwives on the labour wards is that having that extra support there in the form of a Birth Buddy, makes their job a lot easier. They can do what they need to do and focus on what their specialism is. And Birth Buddies actually make that easier for them, as the anxiety of that family may have been lessened.”(Hannah Yeomans, Community Parent Coordinator, Ripplez CIC, Derby) Key features of the model: what makes it work? Trusting peer relationships are at the heart of the model. Volunteers must be recruited for specific personal qualities, relevant life experience and credibility within the community. Their relational capability enables them to nurture each parent’s resilience and helps them prepare for changes ahead. A series of informal but focused one-to-one home visits is the core feature. Informal support in a parent’s home, creates a safe environment and respects parents as experts in their own lives. A semi-structured approach gives a focus and purpose to each visit to enable parents to set and review self-selected goals. A continuum of reliable, regular, and consistent support delivered through a trusting parent-to-parent relationship is vital to success. This strengths-based, flexible, informal support, (including in hospital) is adapted to suit the unique circumstances of each parent. Volunteers are drawn from the heart of communities, and ideally from the same community as the parents they support. This gives them credibility with parents, and means they are best placed to build trusting, supportive relationships with those who may be wary of professionals. Early prevention is crucial. The transition to parenthood is a window of opportunity when people are particularly open to change. We start building relationships with parents as early as possible in pregnancy. Peer support volunteers are key beneficiaries. They have ongoing high-quality training, an enjoyable group learning experience and skilled supervision, they gain new friends, have increased confidence, new life skills, accredited learning and pathways to employment. A mixed volunteer and employment model means that opportunities are offered to experienced volunteers to become paid peer support workers and programme development workers. The model builds bridges between parents and professionals. Peer supporters are intermediaries between vulnerable parents and professionals. They enable parents to benefit from services they may otherwise be unaware of or reluctant to use. Improves outcomes for the wider community. The model builds on existing strengths in the community and gives high-quality training for volunteers. This in turn, builds the programme’s capacity to deliver, and brings employment to the area. Programmes are facilitated by experienced health professionals and collaborate closely with maternity, perinatal mental health, safeguarding and healthy child programme services. There are strong relationships at every level. This includes relationships between: peer supporters and parents; programme coordinator and peer supporters; peer supporters with each other; programme coordinator and local professionals; peer supporters with professionals on the ground (building trust and confidence); programme staff and the host organisation (they need to understand and sign up to the programme’s ethos). The programme coordinator role is the lynchpin of a successful programme. The role is a social prescribing link worker role: Theories that underpin the Parents 1st model The following theories underpin the model: Theory of change. This clearly sets out ultimate goals, assumptions, intermediate outcomes, programme activities and how these achieve impact for beneficiaries. Adult learning theory. The model is based on a set of assumptions about how volunteers and parents learn e.g. bringing lived experience and knowledge to learning; learning by doing; learning better when you feel appreciated and respected. Social learning theory. People learning from each other, through observation, imitation and modelling. Self-efficacy theory (Bandura). Community Parents help build parents’ self-efficacy by focusing on strengths, what is working and helping parents to find their own solutions. Bio-ecological theory (Bronfenbrenner). How different systems (individual, family, community, wider systems) interact and impact on a child’s development. Evolutionary theory. In particular, the powerful and deep bio-energetic drives that motivate parents to care for their children. Community Parents connect into this motivation. Social capital theory (Bourdieu). The collective / economic benefits that result from building strengths in communities through cooperation between individuals and groups. How the Parents 1st model evolved 1990 First NHS Community Parent pilot1995 Provided NHS training nationally1999 Identified as one of six national models of good practice by the Health Education Authority and Mental Health Europe2005 National Research: 10 community parent programmes across the UK2006 Pilot programmes show independence from the NHS is needed2008 Formed independent social enterprise to further develop Community Parents: Parents 1st2015 NESTA provides seed funding to establish new Parents 1st licensed affiliate programmes2019 New Open Access website created to share the Community Parent model Evidence-based and award-winning The model is based on extensive evidence of what works. Further information can be accessed here:https://www.essex.parents1st.org.uk/research-and-evaluation Ten research studies have shaped the programme to become an award-winning model, a few arelisted here: 2006: Leading Practice Through Research Award (the Health Foundation) 2013: Big Venture Challenge Award (UnLtd) 2015: Social Action Innovation Award (NESTA) ‘A highly successful application of community development theory and practice in the healthempowerment field that provides personal skills and employment benefits to volunteers as well asadvice and befriending services to parents.’External Evaluation of Thurrock Community Mothers, University of Essex (Davison and Garlick 1999) ‘A highly successful, cost-effective and easily transferable model of service user involvement with acentral role to play in the future provision of services to families living in deprived areas and animportant means of reducing social inequalities and promoting social cohesion.’External Evaluation of Thurrock Community Mothers, Anglia Ruskin University (DeBell 2003) ‘Parents 1st is having highly statistically significant impact on parents’ resilience during pregnancy,birth and early parenting, and is giving them a sense of progress about issues they are worriedabout.’Evaluation report based on the support of the NESTA Centre for Social Action Innovation Fund forParents 1st (Renaisi 2016)