The Brookline Early Education Project: A 25-year follow-up study of a family-centered early health and development intervention

Heller School for Social Policy and Management, Brandeis University, Волтам, Massachusetts, United States
PEDIATRICS (Impact Factor: 5.47). 07/2005; 116(1):144-52. DOI: 10.1542/peds.2004-2515
Source: PubMed


Clinicians, scientists, and policy makers are increasingly taking interest in the long-term outcomes of early intervention programs undertaken during the 1960s and 1970s, which were intended to improve young children's health and educational prospects. The Brookline Early Education Project (BEEP) was an innovative, community-based program that provided health and developmental services for children and their families from 3 months before birth until entry into kindergarten. It was open to all families in the town of Brookline and to families from neighboring Boston, to include a mixture of families from suburban and urban communities. The goal of the project, which was administered by the Brookline Public Schools, was to ensure that children would enter kindergarten healthy and ready to learn.
Outcome studies of BEEP and comparison children during kindergarten and second grade demonstrated the program's effectiveness during the early school years. The goal of this follow-up study was to test the hypotheses that BEEP participants, in comparison with their peers, would have higher levels of educational attainment, higher incomes, and more positive health behaviors, mental health, and health efficacy during the young adult period.
Participants were young adults who were enrolled in the BEEP project from 1973 to 1978. Comparison subjects were young adults in Boston and Brookline who did not participate in BEEP but were matched to the BEEP group with respect to age, ethnicity, mother's educational level, and neighborhood (during youth). A total of 169 children were enrolled originally in BEEP and monitored through second grade. The follow-up sample included a total of 120 young adults who had participated in BEEP as children. The sample differed from the original BEEP sample in having a slightly larger proportion of college-educated mothers and a slightly smaller proportion of urban families but otherwise resembled the original BEEP sample. The demographic features of the BEEP and comparison samples were similar. The young adults were asked to complete a survey that focused on the major domains of educational/functional outcomes and health/well-being. The study used a quasi-experimental causal-comparative design involving quantitative analyses of differences between the BEEP program and comparison groups, stratified according to community. Hypotheses were tested with analysis of variance and multivariate analysis of variance techniques. Analyses of the hypotheses included the main effects of group (BEEP versus comparison sample) and community (suburban versus urban location), as well as their interaction.
Young adults from the suburban community had higher levels of educational attainment than did those in the urban group, with little difference between the suburban BEEP and comparison groups. In the urban group, participation in the BEEP program was associated with completing >1 additional year of schooling. Fewer BEEP young adults reported having a low income (less than 20000 dollars); the income differences were accounted for largely by the urban participants. The percentage of subjects with private health insurance was significantly lower in the urban group overall, but the BEEP urban group had higher rates of private insurance than did the comparison group. More than 80% of both suburban samples reported being in very good or excellent health; the 2 urban groups had significantly lower ratings, with 64% of the BEEP group and only 41.67% of the comparison group reaching this standard. Overall, suburban participants reported more positive health behaviors, more perceived competence, and less depression. Among the urban samples, however, participation in BEEP was associated with higher levels of health efficacy, more positive health behaviors, and less depression than their peers.
No previous study has focused as extensively on health-related outcomes of early education programs. BEEP participants living in urban communities had advantages over their peers in educational attainment, income, health, and well-being. The educational advantages found for BEEP participants in the early years of schooling included executive skills such as planning, organizing, and completing school-related tasks. It is likely that these early advantages in executive function extended beyond education-related tasks to other activities as participants became responsible for their own lives. The long-term benefits revealed in this study are consistent with the findings of previous long-term studies that indicated that participants in high-quality intervention programs are less likely to cost taxpayers money for health, educational, and public assistance services. The BEEP program appears to have somewhat blunted differences between the urban and suburban groups. The results of this study add to the growing body of findings that indicate that long-term benefits occur as the result of well-designed, intensive, comprehensive early education. The health benefits add a unique and important extension to the findings of other studies.

21 Reads
  • Source
    • "Second, can such programs be scaled up such that they perform as well as experimental programs (Glennan et al., 2000)? The smaller cognitive improvement associated with Head Start relative to PPP, ABC, CPC, or BEEP raises questions about whether tightly managed and well funded pre-kindergarten programs can be successfully scaled up to the national level (Campbell et al., 2002; DHHS, 2012; Palfrey et al., 2005; Schweinhart et al., 2005). However, a bigger concern, at least for universal pre-kindergarten programs, is that these programs scale poorly not because of poor management or scarcity of resources, but rather because the results of pre-kindergarten studies may not be generalizable to the broader US population. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Recent research has found that children who attended pre-kindergarten programs in childhood were more likely to be healthy as adults. One intuitive way of improving population health and longevity may therefore be to invest in pre-kindergarten programs. However, much of the research linking pre-kindergarten programs to health is very recent and has not been synthesized. In this paper, I review the mechanisms linking pre-kindergarten programs in childhood to adult longevity, and the experimental evidence backing up these linkages. I conclude with a critical exploration of whether investments in pre-kindergarten programs could also serve as investments in public health.
    Social Science & Medicine 08/2014; 127. DOI:10.1016/j.socscimed.2014.08.033 · 2.89 Impact Factor
  • Source
    • ") and adult outcomes (Palfrey 2005; Temple and Reynolds 2007), by addressing one or more of the following key issues: breastfeeding , early identification of developmental delays, child care, early childhood education, nutrition, parenting, community strengthening and institutional capacities such as instructional and training programs. In Canada, the list of barriers of access to quality programs includes both geographical and non-geographical factors, for instance, local availability, cost, transportation, time offered, language offered and distrust between parents and service providers. "
    [Show abstract] [Hide abstract]
    ABSTRACT: What happens to children in their earliest years is critical for their development throughout the life course. The years from zero to school age are foundational for brain and biological development. Attachment and face recognition; impulse control and regulation of physical aggression; executive function in the prefrontal cortex and focused attention; fine and gross motor functions and coordination; receptive and expressive language; and understandings of quantitative concepts are all established during this time and become embedded in the architecture and function of the brain (Doherty 1997; Kolb 2009; McCain and Mustard 1999). Brain and biological development are in turn expressed through three broad domains of development of the whole child: physical, social-emotional and language-cognitive, which together are the basis of "developmental health" (Keating and Hertzman 1999). Developmental health influences many aspects of well-being, including obesity and stunting, mental health, heart disease, competence in literacy and numeracy, criminality and economic participation throughout life (Irwin et al. 2007). Accordingly, developmental health is the central concern of this article.
    Healthcare quarterly (Toronto, Ont.) 10/2010; 14 Spec No 1(sp1):32-40. DOI:10.12927/hcq.2010.21981
  • Source
    • "In turn, the limited educational achievement of children from socially disadvantaged families is likely to limit their life course opportunities and those of their offspring. These problems of the linkages between family SES and educational achievement have long been recognized in developed societies, and a wide range of mechanisms have been put in place to mitigate the educational disadvantage faced by children from socially disadvantaged backgrounds (Blanden & Gregg, 2004; Palfrey et al., 2005; Reynolds, Ou, & Topitzes, 2004; Reynolds, Temple, Robertson, & Mann, 2001). However, the development of policies in this area has been limited by a lack of understanding of the processes that underlie the association between family SES and the educational achievement of offspring. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The present study examines the linkages between family socioeconomic status (SES) in childhood and educational achievement in young adulthood using data from a 25-year longitudinal study of a birth cohort of over 1000 New Zealand children. Structural equation modeling of the association between latent SES at birth and educational achievement by age 25 years showed evidence of a strong association between latent SES and later educational achievement. Much of this association was mediated via two pathways relating to child cognitive ability and family educational aspirations; family economic resources and school factors did not mediate the association. However, even when the major theoretical pathways were taken into account, a substantial component of the latent SES/educational achievement correlation remained unexplained.
    Research in Social Stratification and Mobility 09/2008; 26(3-26):277-295. DOI:10.1016/j.rssm.2008.05.001 · 1.12 Impact Factor
Show more