Proportionate universalism in action – an early intervention program to explore a mix of universal, selected and indicated approaches to child wellbeing and mental health

Research problem and questions

The first five years of life are crucial for child health and provide a basis for mental health over the course of life. Prevention of mental health problems is therefore one of the most important public health challenges. Parenting support is important to promote young children’s psychological development and already during the first years of life is there a social gradient in how parents’ economic position influences parenting and child mental health. Despite the broad agreement on the importance of the concept of proportionate universalism (services available to everyone), the literature states that improved cross-sectoral collaboration and monitoring of parental support is needed and that research on how interventions on different levels could be combined is lacking. In this programme we intend to fill these knowledge gaps. The overarching aim of the research programme “Early Equity” is to support child wellbeing and mental health through developing, evaluating and implementing feasible and effective interventions within and between the existing health care and municipality services for pregnant couples and families with 0–5-year-old children.

Data and methods

We adapt or develop interventions on the universal, selective and indicated levels. The origin for these interventions is research on early child development and parenting strategies, from our group and the international literature. We create new interventions and adapt evidence-based methods together with practitioners in health care and municipality services to ensure feasibility and early implementation.

A prerequisite for application of the concept of proportionate universalism is an infrastructure for systematic identification of needs and risk factors and for evaluation of results in relation to social determinants. Here we expand existing medical registers of parent reported data, including validated instruments on wellbeing and mental health, that allows such identification and evaluation from mid pregnancy to child age 4 years. We use a research design including pilot and feasibility studies as well as randomised controlled trials. We apply both qualitative and quantitative statistical methods to evaluate feasibility and effects of the interventions in relation to social determinants. Moreover, we conduct psychometric studies on measurements of parenting strategies as well as child wellbeing and mental health.

Programme realisation

This research programme is based on collaboration between several research groups, combining several disciplines and expertise from various fields. We have close links to clinical practice and with the civil society. We aim at presenting how far we are in our development of research on promotion and prevention during the first years of life.