Those involved in setting-up a baby-box scheme should consider the following recommendations that are based on the issues revealed by this evaluation.
Determine what type of scheme is being proposed (see Fig. 1a-d). Type-2 and Type-4 are entirely commercial.
Identify measurable outcomes that are meaningful in the context of the community that will be served by the scheme. Produce a logic model that details the anticipated pathway from box-provision to intended outcomes.
Avoid all claims of SIDS-reduction and avoid comparisons with Type-1 (government-run) schemes unless you are implementing a Type-1 scheme.
Conduct a robust risk assessment around protection of parents’ data and marketing by third parties, paying particular attention to General Data Protection Regulation requirements.
If boxes are provided by a commercial partner, establish a process for regularly monitoring the boxes and free products provided to parents for quality, quantity, and substitutions.
Require advance notification of any proposed changes to the box, its contents, any education platform, its presentation to parents, third party partners, data usage etc.
If online education is involved in the scheme, consider who writes scripts for this education, where information is sourced from, and how much time is allocated to this. If using secondary video resources, scrutinise their content and confirm they are a good fit for your needs.
Decide whether you are happy for parents to receive boxes without viewing the educational videos – if not ensure they must be viewed in full before launching the scheme.
Consider whether safety information should be printed on the inside of the box and what written information will be provided with the box.
a. Explain to parents why certain safety features are important e.g. lack of lid and handles.
b. Explain to parents why certain practices (e.g. replacing the mattress) are unsafe.
Determine how boxes will be made available to parents and for what duration, with regular review. If the outcomes of the scheme rely on face-to-face collection of the box, ensure parents will not be offered delivery options for the duration of the scheme.
If boxes must be collected face-to-face, consider where boxes will be stored (space required as well as environmental suitability) and who will give them out. Assess how much time should be allocated to do this, bearing in mind that restricting availability will reduce uptake.
Establish a mechanism for practitioners and parents to report adverse events (AEs) associated with box-use in a timely manner. Maintain a central repository of AEs with regular review.
Regularly review the box provider’s parent-facing website and ensure educational materials are monitored on a regular basis
a. Check the range of educational materials online available to parents in your region
b. Agree a regular programme of updates to the educational materials you provide
c. Identify any changes in presentation of the programme to parents
Formalise any agreements with co-partner organisations (e.g. local authorities) and ensure there is clarity about what happens to the scheme should one of you decide to terminate involvement.
Secure resources to undertake a rigorous evaluation after an initial pilot phase, benchmarked against the agreed measurable outcomes. Appoint an independent chair for a review committee that oversees the evaluation.
Ensure full transparency to parents and staff regarding any commercial provider(s), their interests in establishing the scheme, who will receive parent-data and for what purposes, and the role of the health-provider organisation facilitating the scheme.