This book presents findings from studies evaluating Sure Start programmes in North-East England. Announced in 1998, Sure Start is a large-scale cross-departmental Government effort to enhance the health and development of children and their families in socially deprived communities in England. From 2007. Sure Start children's centre services should become permanent mainstream community services, with the active involvement of parents/carers and the local community. Section I examines the policy background, evaluation framework and key concepts underpinning the programme: social exclusion, family support, inter-professionalism and parent participation. Section II draws upon findings from the evaluation of five Sure Start programmes presented under three headings: facilitating access to services for children and families, parental involvement and participation, and inter-professionalism and changes to professional roles. Section III presents evaluation findings from a linked national programme, Sure Start Plus, based within five Local Authorities. This programme is designed to provide inter-agency, inter-professional support to pregnant teenagers and young parents. The evaluation considers the role of specialist advisers supporting young people, the views of young people themselves, mainstream professionals' perspectives and working towards targets and objectives. Section IV examines two propositions: Firstly, that local programmes should deliver better outcomes for children and families if they are proficient, as measured by engaging service users, multi-agency working, leadership and ethos, and secondly, that local programmes provide a foundation for delivering the five outcomes set by the Labour Government Green Paper Every Child Matters (2003): be healthy, stay safe, enjoy and achieve, make a positive contribution, and achieve economic well-being. Nigel Malin is Professor in Health and Social Care at the University of Sunderland Gillian Morrow is Senior Research Officer at the University of Sunderland