title: Sure start: voices of the 'hard-to-reach'.
abstract: OBJECTIVE
  This research aimed to look in depth at the factors affecting the ability of four Sure Start local programmes, based in a multicultural Midlands city, to engage with 'hard-to-reach' populations.
  
  
  METHODS
  A variety of research strategies and methods were employed. Geographical information systems, participatory research methods and interviews were used in order to understand the extent of the challenge, and hear first hand, why parents may not get involved with Sure Start. The mapping exercise involved collation and mapping of postcode data with respect to boundaries and potential and actual users of Sure Start services. This made possible the identification of any geographical patterning in the distribution of service users and non-users. Participatory research methods were used with parents, enabling them to conduct short interviews within their own communities and make sense of the data collected. Interviews were also conducted with 70 parents across the city, recruited through local schools.
  
  
  RESULTS
  The results indicate that parental decisions regarding Sure Start are the product of a complex interaction between numerous factors which may act as either barriers or facilitators to service utilization.
  
  
  CONCLUSIONS
  The results suggest that a multi-method approach to data collection is useful and appropriate in gaining access to those parents who are non-users of the Sure Start services and enabling their voices to be heard. These findings offer some explanations and insight into the apparent ambivalent attitudes of some families toward Sure Start services. Implications for future practice are discussed.
authors.affiliation: School of Health and Social Studies, University of Warwick, Coventry, UK. c.j.coe@warwick.ac.uk
authors.forename: C
authors.initials: C
authors.lastname: Coe
authors.forename: A
authors.initials: A
authors.lastname: Gibson
authors.forename: N
authors.initials: N
authors.lastname: Spencer
authors.forename: M
authors.initials: M
authors.lastname: Stuttaford
mesh_terms: D000328:Adult; D001294:Attitude to Health; D002662:Child Health Services / Q000458:organization & administration*; D002669:Child Welfare / Q000331:legislation & jurisprudence / Q000523:psychology*; D002675:Child, Preschool; D003256:Community Participation / Q000523:psychology*; D018864:Cultural Diversity; D018479:Early Intervention, Educational / Q000379:methods* / Q000592:standards; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008913:Minority Groups / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D012959:Socioeconomic Factors; D019037:Urban Health Services / Q000458:organization & administration; D055815:Young Adult