However, we are still some way off the point where evidence-based parenting interventions are available in sufficient quantities to ensure that they are easily accessible for economically disadvantaged families. To effectively scale parenting interventions in the UK, it is important to understand what has driven or impeded the scale up of parenting interventions in recent years.

We carried out this research project to generate useful and usable insights about the experiences of different organisations that have scaled-up parenting interventions in the UK and comparable contexts. Learning from this project will inform Nesta’s a fairer start mission’s strategy for scaling parenting interventions, as well as informing the work of others working in this field.

We commissioned The Behavioural Insights Team to conduct a rapid literature review and a series of expert interviews. The rapid literature review identified 93 potential articles and included 19 for analysis. The team also conducted semi-structured interviews with 23 experts, including those who have developed, implemented and scaled parenting interventions, and experts involved in research and policy related to scaling parenting interventions. Findings from the literature review and expert interviews were combined to identify enablers and barriers for scaling parenting interventions in the UK.

• Research evidence was discussed as being important, but research on parenting interventions has overwhelmingly focused on early pipeline impact and process evaluations, rather than focusing on how to effectively implement interventions at scale.
• Interviewees stressed the importance of building infrastructure to support the scale up of parenting interventions, such as a national unit to oversee and provide support on delivery, monitoring, and evaluation of each intervention in multiple locations.
• Interviewees highlighted the importance of providing clear guidance on delivering an intervention and ensuring its fidelity, while also giving commissioners and implementers the opportunity to tailor aspects of the intervention to their local needs. This flexibility can increase a sense of ownership, both among the commissioners who appraise the community’s needs, and facilitators who appraise parents’ needs.
• Sufficient funding to support implementation was emphasised both in the literature and by the interviewees as a barrier to scaling parenting interventions. When funding is insufficient and/or inconsistent, implementers and commissioners can become locked in a cycle of trade-offs, for example, hiding challenges for fear that failing to achieve the next funding milestone will result in further financial reductions, or delivering poorly evidenced activities with unqualified and insufficiently trained staff.
• Intervention implementers regarded long-term funding arrangements as being important, as this can support honest conversations about challenges and concerns in delivery. Long-term funding for implementation facilitates problem-solving to address the creative tension between fidelity and local adaptation.
• Creating the right partnerships was identified by interviewees as their top lesson learnt from scaling. Having honest discussions about the fit between an intervention and local realities, and clear communication about responsibilities among different players could help build effective partnerships and avoid misalignment.
• Insufficient quantity and quality of facilitators to deliver the intervention with caregivers were identified as critical challenges for scaling. Providing facilitators with high-quality training, continuous supervision, and accreditation, and ensuring that facilitators understand the cultural backgrounds of the parents, were cited as important enablers for scaling.
• Perceived stigma was cited by interviewees as a crucial barrier to securing parents’ participation in parenting interventions. Developers and implementers, and government officials, called for a national campaign to raise awareness of the challenges of parenting, and normalise asking for help.
• Effective outreach requires information that resonates with parents and does not exacerbate perceptions of parental ineptitude. Implementers can encourage programme uptake via partner referrals who have existing trusting relationships built with parents, and providing the option to deliver programmes in a convenient setting where parents are already accessing support in health, education and social services.

• We included four case studies to describe the scaling journeys of four interventions in the UK, including Empowering Parents, Empowering Communities (EPEC), Triple P (Positive Parenting Programme), Video Interaction Guidance (VIG), and Family Nurse Partnership (FNP)

The report provides a template strategy as a tool to guide future consideration for scaling parenting interventions. Examples of findings from interviews and the literature review are used to explain the multiple perspectives in the template strategy:

• “Elements of scaling up” include five elements (ie, context, resource team, the intervention, the recipients, and strategy) discussed in the key findings as enablers and barriers to successfully scaling parenting interventions.
• “Strategic choice areas” include options and trade-offs that implementers make. These often vary location-to-location and/or model-to-model.
• “Mechanisms” refer to how the different plans and activities expect to work.