BetterStart Group

Supporting children, young people and families for better starts to life and better outcomes.

BetterStart Group is an interdisciplinary team trained in epidemiology, public heath, biostatistics, psychology, and social work. Our expertise spans the first 1,000 days, early childhood education and care, child maltreatment, justice systems, housing and homelessness, mental health, substance misuse, domestic, family and sexual violence, and social and economic inequalities.

BetterStart Group has extensive experience of partnering with the government and non-government sector and using the BEBOLD-PLIDA platform to inform policy, practice, service delivery and system improvement. A Paul Ramsay Foundation grant supports partnering with the non-government sector to generate evidence of what investments and programs are effective at improving outcomes for populations experiencing disadvantage.

BetterStart Group is co-directed by Associate Professor Rhiannon Pilkington, Alicia Montgomerie, Associate Professor Catia Malvaso and Professor John Lynch.

Explore the BetterStart Group

Research capabilities 1
Research impact 2
Our people 3
Our partners 4

We undertake quantitative and qualitative research that is useful for improving policy, practice and service delivery. Our capabilities span population‑level epidemiology, advanced linked‑data analytics using the BEBOLD-PLIDA platform, rigorous program evaluation, and research to improve outcomes for disadvantaged children, young people, families and communities. We work closely with government, non-government and community partners to understand what drives early‑life outcomes, evaluate what works in real‑world settings and translate evidence into practical, scalable solutions.

Population patterns

Incidence, prevalence, pathways

Priority populations

Understanding service contact patterns, estimated levels of need

Risk stratification

Aligning services to needs, risk prediction

Data enhancement

Building evidence data infrastructure (EDI)

Return data to source

Engaging stakeholders with data insights

Service systems

Service delivery patterns, characteristics of frequent service users

Service design

Social impact bonds, pay be results, contracted services, new models of care

Intervention innovation

Effectiveness evaluation, quasi-experimental studies, pragmatic RCTs

BEBOLD-PLIDA Platform

The platform is a series of open electronic cohorts that follows all South Australian (SA) birth cohorts (~ 20,000 births per year) from 1991 onwards. The BEBOLD platform is updated as data including new birth cohorts and data sources become available. Children born outside SA come into the platform if their families move to SA and use services. There are ~1.5 million children and families represented in BEBOLD, up to their 30s for those born in or after 1991. Family files link children and parents to examine intergenerational contact with systems including child protection and Centrelink.

BEBOLD is one of the richest linked data sources of child and family life-course information in Australia. It includes de-identified information about child protection contact, pregnancy, early development, well-being in childhood and adolescence, education, youth justice, corrections, hospital admissions, emergency presentations, drug and alcohol services, housing and homelessness, community mental health, and Centrelink welfare payments.

The SA BEBOLD platform is linked to the Australian Bureau of Statistics (ABS)-hosted ‘Person Level Integrated Data Asset’ (PLIDA). This results in a South Australian State and Commonwealth de-identified linked data platform including Commonwealth data on healthcare (MBS, PBS, NDIS), higher education and training (e.g. VET, University admissions), Centrelink, ATO, and Census, among other data sources.

We strive to generate evidence that is useful for informing policy and practice innovations. We strive to communicate with and positively influence the real world outside the academy so we can inform the policies, practices, and systems that lead to better outcomes for disadvantaged children, young, people, families and communities.

Early childhood education and care

Investigate the risk and protective factors across the life course and the role of early childhood education and care on later life outcomes, including the recent policy innovation to roll out 3-year-old preschool in SA.

Health in the first 1,000 days

Examine the foundational period which shapes key aspects of biological and social development and wellbeing of a child’s life from conception to two years of age. This includes factors relating to perinatal health such as prematurity, health and development during infancy including nutrition and serious illness, parental physical and mental health during pregnancy.

Child and young people health and wellbeing 

Better understand the transitions from childhood to adolescence with a focus on the mental and physical health and wellbeing of young people.

Child protection

Investigate the precursors and consequences of child maltreatment ranging from intergenerational and familial history of child maltreatment and welfare experience through to child outcomes including development, health, education, justice system contact, welfare receipt, poverty and homelessness.

Justice systems

Explore opportunities for early investment, diversion and prevention by understanding the precursors and consequences of offending behaviour and criminal justice system contact.

Housing and homelessness

Examine the precursors, service pathways, and outcomes associated with housing instability and homelessness, including interactions with health, justice, welfare, and social service systems.

Domestic, family and sexual violence

Investigate the experiences of children and families affected by domestic and family violence, including interactions with child protection and other service systems such as housing, justice, health, and community services, to better understand service responses and longer-term outcomes.

Substance use

Understand patterns of substance use and related harms, including the health, social, and service system impacts associated with alcohol and other drug use.

Social and health inequality

Research the role of social determinants and their impacts on health, wellbeing, welfare and justice outcomes. Social determinants include poverty, access to secure and safe housing, employment, education, social inclusion, and intergenerational disadvantage.

Reports

We have generated over 150 reports for government and non-government organisations. Many of these are not released publicly. Selected examples that are public:

Gillard Royal Commission into Early Childhood Education and Care
Holding on to Our Future. The Final Report of the Inquiry into the application of the Aboriginal and Torres Strait Islander Child Placement Principle in the removal and placement of Aboriginal Children in South Australia, May 2024.
With courage: South Australia’s vision beyond violence. Royal Commission into Domestic, Family and Sexual Violence Report. South Australia, August 2025
Uniting Communities Ruby’s Reunification Program: Quasi-experimental investigation of long-term outcomes. BetterStart Group, Adelaide University. 2025
Family-by-Family Outcomes Report. The Australian Centre for Social Innovation (TACSI). Adelaide 2026.

Publications

We have published hundreds of peer-reviewed journals in epidemiology, paediatrics, public health, child development, general medicine, and nutrition.

Presentations

We have delivered hundreds of presentations across different academic forums (conferences, workshops, webinars, etc.) and to government and non-government agencies.

BetterStart Group is located within the School of Public Health, College of Health at Adelaide University.

Associate Professor Rhiannon Pilkington, Co-Director, BetterStart Group, Co-Lead Thriving Families Adelaide University
Associate Professor Catia Malvaso, Co-Director, BetterStart Group
Alicia Montgomerie, Analytics Lead, Co-Director, BetterStart Group
Professor John Lynch, Co-Director, BetterStart Group, Co-Lead Thriving Families Adelaide University
Ashum Owen, Director, Aboriginal Leadership, Thriving Families
Dr Alisa Willis, Director, Thriving Families
Associate Professor Catherine Chittleborough
Dr. Angela Gialamas, Senior Lecturer
Dr Matthew Kaesler, Researcher Associate
Gene Mercer, Research Associate
Jessica Dobrovic, Research Associate, PhD candidate
Nadia Di Girolamo, Research Associate
Eleonora Dal Grande, Research Associate
Justin Lokhorst, Lead Data Integration Projects
Beth Clennell, Project Lead, More Time to Thrive
Dr Claire Murray, Research Associate, More Time to Thrive
Dr Jessica Judd, Research Associate
Anna Kalamkarian, PhD Candidate
Kimberly Klassman, PhD Candidate
Dr Razlyn Rahim, PhD Candidate
Cherise Fletcher, PhD Candidate
Jacqueline Aldis, Senior Research Coordinator

We have received funding from:

National Health and Medical Research Council (NHMRC) Australia Fellowship (570120)
NHMRC Partnership Project Grant (APP1056888)
NHMRC Centre for Research Excellence (APP1099422)
NHMRC Clinical Trials and Cohorts Studies Grant (APP1187489)
Medical Research Future Fund (MRFFFRDII000104)
SA Department of the Premier and Cabinet
SA Department of Treasury and Finance
SA Department for Health and Wellbeing
SA Department for Education
SA Department for Child Protection
SA Department of Human Services
The University of Adelaide
The Paul Ramsay Foundation
Eureka Benevolent Foundation
SA Office for Early Childhood Development.

Major collaborative projects examples

Preschool plus – More time to thrive is funded by the Eureka Benevolent Foundation and SA Office for Early Childhood Development

Our Preschool Plus initiative More Time to Thrive, done in collaboration with the Eureka Benevolent Foundation and the SA Government, offers an additional 30 hours of preschool a week for children aged 3 and 4 who need extra support. Delivered by a mix of quality government and non-government Flying Start Partner Services including through Integrated Hubs, we’re evaluating delivery of additional hours of preschool in areas where there are high levels of developmental vulnerability.

Connecting community data – Funded by the Paul Ramsay Foundation

Connecting Community Data is an initiative focused on building data capability in the non-government sector. We partner with community-based organisations to strengthen their data collection and management, to help turn data into insights for stronger services. We use the BEBOLD-PLIDA platform and organisations’ own data to better understand the people their programs reach, explore opportunities to strengthen or scale programs, and investigate longer-term outcomes for clients through quasi-experimentally designed comparisons.

Thriving families – Funded by Adelaide University and SA Dept Human Services

Thriving Families 2025 – 2045 is an ambitious generational vision to deliver better outcomes for South Australian children, young people, families and communities. We provide preventative and early intervention support for families experiencing challenges that are getting in the way of being able to parent to the best of their ability, and strive to shift the focus from reactive crisis management to proactive prevention, coordinator and early intervention.

Contact us

BetterStart Group

Location
BetterStart Group
Adelaide University
Level 4, Rundle Mall Plaza
50 Rundle Mall Adelaide SA 5000

Phone: +61 8 8313 8147

Email: jacqueline.aldis@adelaide.edu.au