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Living in an area with high levels of child poverty predisposes children to poorer mental and physical health. ActEarly is a 5-year research programme that comprises a large number of interventions (>20) with citizen science and co-production embedded. It aims to improve the health and well-being of children and families living in two areas of the UK with high levels of deprivation; Bradford in West Yorkshire, and the London Borough of Tower Hamlets. This protocol outlines the meta-evaluation (an evaluation of evaluations) of the ActEarly programme from a systems perspective, where individual interventions are viewed as events in the wider policy system across the two geographical areas. It includes investigating the programme's impact on early life health and well-being outcomes, interdisciplinary prevention research collaboration and capacity building, and local and national decision making. The ActEarly meta-evaluation will follow and adapt the five iterative stages of the 'Evaluation of Programmes in Complex Adaptive Systems' (ENCOMPASS) framework for evaluation of public health programmes in complex adaptive systems. Theory-based and mixed-methods approaches will be used to investigate the fidelity of the ActEarly research programme, and whether, why and how ActEarly contributes to changes in the policy system, and whether alternative explanations can be ruled out. Ripple effects and systems mapping will be used to explore the relationships between interventions and their outcomes, and the degree to which the ActEarly programme encouraged interdisciplinary and prevention research collaboration as intended. A computer simulation model (\"LifeSim\") will also be used to evaluate the scale of the potential long-term benefits of cross-sectoral action to tackle the financial, educational and health disadvantages faced by children in Bradford and Tower Hamlets. Together, these approaches will be used to evaluate ActEarly's dynamic programme outputs at different system levels and measure the programme's system changes on early life health and well-being. This meta-evaluation protocol presents our plans for using and adapting the ENCOMPASS framework to evaluate the system-wide impact of the early life health and well-being programme, ActEarly. Due to the collaborative and non-linear nature of the work, we reserve the option to change and query some of our evaluation choices based on the feedback we receive from stakeholders to ensure that our evaluation remains relevant and fit for purpose.

Background In the United Kingdom, local government is well placed to conduct and apply research regarding the wider determinants of health. However, local authorities often lack sufficient research infrastructure to support research capacity, capability and culture. Since 2022, the UK National Institute for Health and Care Research has funded 30 Health Determinants Research Collaborations (HDRCs) to develop this infrastructure. HDRCs are hosted by local authorities collaborating with universities and other partners to strengthen a culture of evidence-informed decision-making. HDRCs are conducting local evaluations, including baseline assessments of local authority research capacity, capability and culture. Methods A national peer-support group was formed to support shared learning amongst teams evaluating HDRCs. Here, as embedded evaluators from 10 HDRCs, we present reflections on the planning, delivery and interpretation of baseline assessments. Reflections were gathered via group discussions and written submissions. All 10 HDRC baseline assessments explored local authority research capacity, capability and culture, and two also studied early HDRC team collaboration. Results Competing priorities during early HDRC implementation called for pragmatic and timely baseline assessment methods. Most HDRCs developed baseline surveys, though interviews and focus groups were conducted by some. Despite similar aims, methods varied substantially according to local contexts. Evaluators often adapted existing validated survey tools, for example, from health settings, as none were identified for use across local government. Definitions of research also ranged from academic definitions to broader notions of evidence. Useful insights were gathered across diverse samples to aid implementation locally, however, low response rates were received to all-staff surveys and heterogeneous approaches limited comparison across HDRCs. Findings contributed to recommendations for evaluating and developing HDRC activities (e.g. communications and training provisions) appropriate for local authorities with stretched resources. Where measured, collaborations were functioning well, with recommendations to enhance communication. Conclusions The early contexts and challenges of HDRCs influenced pragmatic baseline assessments. Methods were often chosen to capture baseline contexts rapidly, and they will be refined and complemented by additional evaluation methods as HDRCs progress. Developing new validated measures and an agreed definition of research for local authorities may strengthen understanding of research capacity, capability and culture across local government.