A research evaluation of health support workers in a Sure Start project.

Sure Start is a government initiative aimed at reducing the effects of poverty on pre-school children and their families in deprived areas. Skill mix has been identified in recent policies as a credible way of providing high quality services in a cost effective manner. Health support workers, under the supervision of health visitors, provide support through home visiting, group work and clinics with research identifying that such interventions can have beneficial outcomes for children and their families. This research is part of a larger study that evaluated a Sure Start service in a borough in south Wales, using realistic evaluation. The aim of this aspect of the study was to ascertain the effectiveness and acceptability of the services provided by the health support workers. Qualitative methods included focus group discussions with service providers (10 health visitors and six health support workers) and semi-structured interviews with seven service users. Content analysis inductively developed categories and themes. The main findings show that health visitors and service users valued the input of the health support workers but there were important issues regarding training and supervision that needed to be addressed.