PT  - JOURNAL ARTICLE
AU  - Carly Molloy
AU  - Meredith O'Connor
AU  - Shuaijun Guo
AU  - Colleen Lin
AU  - Christopher Harrop
AU  - Nicholas Perini
AU  - Sharon Goldfeld
TI  - Potential of ‘stacking’ early childhood interventions to reduce inequities in learning outcomes
AID  - 10.1136/jech-2019-212282
DP  - 2019 Dec 01
TA  - Journal of Epidemiology and Community Health
PG  - 1078--1086
VI  - 73
IP  - 12
4099  - http://jech.bmj.com/content/73/12/1078.short
4100  - http://jech.bmj.com/content/73/12/1078.full
SO  - J Epidemiol Community Health2019 Dec 01; 73
AB  - Background Early childhood interventions are critical for reducing child health and development inequities. While most research focuses on the efficacy of single interventions, combining multiple evidence-based strategies over the early years of a child’s life may yield greater impact. This study examined the association between exposure to a combination of five evidence-based services from 0 to 5 years on children’s reading at 8–9 years.Methods Data from the nationally representative birth cohort (n=5107) of the Longitudinal Study of Australian Children were utilised. Risk and exposure measures across five services from 0 to 5 years were assessed: antenatal care, nurse home-visiting, early childhood education and care, parenting programme and the early years of school. Children’s reading at 8–9 years was measured using a standardised direct assessment. Linear regression analyses examined the cumulative effect of five services on reading. Interaction terms were examined to determine if the relationship differed as a function of level of disadvantage.Results A cumulative benefit effect of participation in more services and a cumulative risk effect when exposed to more risks was found. Each additional service that the child attended was associated with an increase in reading scores (b=9.16, 95% CI=5.58 to 12.75). Conversely, each additional risk that the child was exposed to was associated with a decrease in reading skills (b=−14.03, 95% CI=−16.61 to −11.44). Effects were similar for disadvantaged and non-disadvantaged children.Conclusion This study supports the potential value of ‘stacking’ early interventions across the early years of a child’s life to maximise impacts on child outcomes.