Harkness Project Title:
Improving Policy and Practice in Early Childhood Intervention Projects: Lessons from a Well-Evaluated Program in the United States
Mentor: Marie McCormick, M.D., Sc.D.
Placement: Harvard School of Public Health
Biography at time of Harkness Fellowship: Ronald Gray, a 2002-03 Commonwealth Fund Harkness Fellow in Health Care Policy and Practice, was formerly a specialist registrar in public health medicine, a consultant psychiatrist, and Honorary Research Fellow in Public Health at the University of Glasgow. His research interests include child public health policy, mental health policy, and the evaluation of early childhood intervention programs. He has a background in clinical psychiatry and health service management. In the past, he has held clinical, managerial, and honorary academic appointments. Most recently, he has been working with the Scottish Executive Health Department on child health policy. On his return to the United Kingdom, he will take up a new position as a Senior Clinical Research Fellow at the National Perinatal Epidemiology Unit at the University of Oxford.
Project: Gray’s project examined how clinically significant behavioral problems among children can be predicted by certain characteristics, including the mother’s marital status, mental health and smoking during pregnancy, and whether the child had previously exhibited such behavioral problems. He used data collected during the Infant Health and Development Program, a multi-site randomized controlled trial of the effect of early childhood support and education.
Career Activity Since Fellowship
- Honorary Consultant Psychiatrist, Oxfordshire and Buckinghamshire Mental Health Partnership NHS Trust, 2007
- Senior Clinical Research Fellow in Epidemiology and Consultant Clinical Epidemiologist, National Perinatal Epidemiology Unit, University of Oxford, 2003
Current Position: Consultant Clinical Epidemiologist, National Perinatal Epidemiology Unit, Oxford University. (Updated 1/2014)
E-Mail: [email protected]
Selected Publications
Alati R, Davey Smith G, Lewis SJ, Sayal K, Draper ES, Golding J, Fraser R, Gray R. Effect of Prenatal Alcohol Exposure on Childhood Academic Outcomes: Contrasting Maternal and Paternal Associations in the ALSPAC Study. PLoS One 2013;8(10):e74844.
Gray R. Low-to-moderate alcohol consumption during pregnancy and child development - moving beyond observational studies. BJOG 2013;120(9):1039-41.
Gray R. Life stage: Pre-conception and pregnancy. In: Lemer C, Todd K, editors. Annual Report of the Chief Medical Officer 2012, Our Children Deserve Better: Prevention Pays. London: Department of Health; 2013.
Kelly Y, Iacovou M, Quigley M, Gray R, Wolke D, Kelly J, Sacker A. Light drinking versus abstinence in pregnancy - behavioural and cognitive outcomes in 7-year-old children: a longitudinal cohort study. BJOG 2013;120(11):1340-7.
Nair M, Ariana P, Ohuma EO, Gray R, De Stavola B, Webster P. Effect of the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) on Malnutrition of Infants in Rajasthan, India: A Mixed Methods Study. PLoS One 2013;8(9):e75089.
Redshaw M, Malouf R, Gao H, Gray R. Women with disability: the experience of maternity care during pregnancy, labour and birth and the postnatal period. BMC Pregnancy Childbirth 2013;13:174.
Sayal K, Draper ES, Fraser R, Barrow M, Davey Smith G, Gray R. Light drinking in pregnancy and mid-childhood mental health and learning outcomes. Arch Dis Child 2013;98(2):107-11.
Zuccolo L, Lewis SJ, Smith GD, Sayal K, Draper ES, Fraser R, Barrow M, Alati R, Ring S, Macleod J, Golding J, Heron J, Gray R. Prenatal alcohol exposure and offspring cognition and school performance. A "Mendelian randomization" natural experiment. Int J Epidemiol 2013.
Kelly YJ, Sacker A, Gray R, Kelly J, Wolke D, Head J, Quigley MA. Light drinking during pregnancy: still no increased risk for socioemotional difficulties or cognitive deficits at 5 years of age? J Epidemiol Community Health 2012;66(1):41-8.
Lewis SJ, Zuccolo L, Davey Smith G, Macleod J, Rodriguez S, Draper ES, Barrow M, Alati R, Sayal K, Ring S, Golding J, Gray R. Fetal Alcohol Exposure and IQ at Age 8: Evidence from a Population-Based Birth-Cohort Study. PLoS One 2012;7(11):e49407.
Sumilo D, Kurinczuk JJ, Redshaw ME, Gray R. Prevalence and impact of disability in women who had recently given birth in the UK. BMC Pregnancy Childbirth 2012;12:31.
Gibson J, Gray R. Epidemiology of maternal mental health disorders. In: Martin C, editor. Perinatal Mental Health: A Clinical Guide. Keswick: M&K Publishing; 2012.
Gray R. Commentary: Sullivan on the offspring of the female criminal alcoholic. Int J Epidemiol 2011;40(2):289-92.
Hollowell J, Kurinczuk JJ, Brocklehurst P, Gray R. Social and Ethnic Inequalities in Infant Mortality: A Perspective from the United Kingdom. Semin Perinatol 2011;35(4):240-4.
Hollowell J, Oakley L, Kurinczuk J, Brocklehurst P, Gray R. The effectiveness of antenatal care programmes to reduce infant mortality and preterm birth in socially disadvantaged and vulnerable women in high-income countries: a systematic review. BMC Pregnancy Childbirth 2011;11(1):13.
Violato M, Petrou S, Gray R, Redshaw M. Family income and child cognitive and behavioural development in the United Kingdom: does money matter? Health Econ 2011;20(10):1201-25.
Allen F, Gray R, Oakley L, Kurinczuk JJ, Brocklehurst P, Hollowell J. Inequalities in infant mortality project evidence map report 4. Technical guide to the infant mortality evidence map: systematic reviews of interventions targeting major potentially modifiable risk factors for infant mortality. Oxford: NPEU 2011.
Kurinczuk JJ, Hollowell J, Boyd PA, Oakley L, Brocklehurst P, Gray R. Inequalities in infant mortality project briefing paper 4. The contribution of congenital anomalies to infant mortality. Oxford: NPEU 2010.
Burns E, Gray R, Smith LA. Brief screening questionnaires to identify problem drinking during pregnancy: a systematic review. Addiction 2010;105(4):601-14.
Gibson J, McKenzie-McHarg K, Shakespeare J, Price J, Gray R. A systematic review of studies validating the Edinburgh Postnatal Depression Scale in antepartum and postpartum women. Acta Psychiatr Scand 2009;119(5):350-64.
Gray R, Bonellie SR, Chalmers J, Greer I, Jarvis S, Kurinczuk JJ, Williams C. Contribution of smoking during pregnancy to inequalities in stillbirth and infant death in Scotland 1994-2003: retrospective population based study using hospital maternity records. Br Med J 2009;339:b3754.
Gray R, McCormick MC. Socioeconomic inequalities in survival in neonates. BMJ 2009;339:b5041.
Gray R, Mukherjee RAS, Rutter M. Alcohol consumption during pregnancy and its effects on neurodevelopment: what is known and what remains uncertain. Addiction 2009;104(8):1270-3.
Kelly Y, Sacker A, Gray R, Kelly J, Wolke D, Quigley MA. Light drinking in pregnancy, a risk for behavioural problems and cognitive deficits at 3 years of age? Int J Epidemiol 2009;38(1):129-40.
Sayal K, Heron J, Golding J, Alati R, Smith GD, Gray R, Emond A. Binge Pattern of Alcohol Consumption During Pregnancy and Childhood Mental Health Outcomes: Longitudinal Population-Based Study. Pediatrics 2009;123(2):e289-e96.
Violato M, Petrou S, Gray R. The relationship between household income and childhood respiratory health in the United Kingdom. Soc Sci Med 2009;69(6):955-63.
Zuccolo L, Fitz-Simon N, Gray R, Ring SM, Sayal K, Smith GD, Lewis SJ. A non-synonymous variant in ADH1B is strongly associated with prenatal alcohol use in a European sample of pregnant women. Hum Mol Genet 2009;18(22):4457-66.
Kurinczuk JJ, Hollowell J, Brocklehurst P, Gray R. Inequalities in infant mortality project briefing paper 1: Infant mortality: overview and context. Oxford: NPEU 2009.
Allen F, Gray R, Oakley L, Kurinczuk JJ, Brocklehurst P, Hollowell J. The effectiveness of interventions targeting major potentially modifiable risk factors for infant mortality: a user's guide to the systematic review evidence. Inequalities in Infant Mortality Project Evidence Map Report 3. Oxford: NPEU 2009.
Allen F, Gray R, Oakley L, Kurinczuk JJ, Brocklehurst P, Hollowell J. Inequalities in Infant mortality project evidence map report 2. Technical guide to the infant mortality evidence map: systematic reviews of interventions targeting infant mortality. Oxford NPEU 2009.
Gray R, Headley J, Oakley L, Kurinczuk JJ, Brocklehurst P, Hollowell J. Inequalities in infant mortality project briefing paper 3.Towards an understanding of variations in infant mortality rates between different ethnic groups in England and Wales. Oxford: NPEU 2009.
Gray R, Hollowell J, Brocklehurst P, Graham H, Kurinczuk JJ. Inequalities in infant mortality project briefing paper 2. Health inequalities infant mortality target: technical background. Oxford: NPEU 2009.
Oakley L, Gray R, Kurinczuk JJ, Brocklehurst P, Hollowell J. A systematic review of the effectiveness of interventions to increase the early initiation of antenatal care in socially disadvantaged and vulnerable women - Final Report. Oxford: NPEU 2009.
Hollowell J, Allen F, Gray R, Oakley L, Kurinczuk JJ, Brocklehurst P. Inequalities in infant mortality project evidence map report 1.The effectiveness of interventions targeting infant mortality: a user's guide to the systematic review evidence. . Oxford: NPEU 2009.
Bonellie S, Chalmers J, Gray R, Greer I, Jarvis S, Williams C. Centile charts for birthweight for gestational age for Scottish singleton births. BMC Pregnancy Childbirth 2008;8(1):5.
Gray R, Bonellie SR, Chalmers J, Greer I, Jarvis S, Williams C. Social inequalities in preterm birth in Scotland 1980–2003: findings from an area-based measure of deprivation. Br J Obstet Gynaecol 2008;115(1):82-90.
Gray R, Francis E. The implications of US experiences with early childhood interventions for the UK Sure Start Programme. Child Care Health Dev 2007;33(6):655-63.
Gray R, Mukherjee R. A psychiatrist's guide to fetal alcohol spectrum disorders in mothers who drank heavily during pregnancy. Advances in Mental Health and Learning Disabilities. 2007;1(3):19-26.
Gray R, Petrou S, Hockley C, Gardner F. Self-reported health status and health-related quality of life of teenagers who were born before 29 weeks' gestational age. Pediatrics 2007;120(1):e86-93.
Gray R, Quigley MA, Hockley C, Kurinczuk JJ, Goldacre MJ, Brocklehurst P. Caesarean delivery and risk of stillbirth in subsequent pregnancy: a retrospective cohort study in an English population. Br J Obstet Gynaecol 2007;114(3):264-70.
Henderson J, Gray R, Brocklehurst P. Systematic review of effects of low-moderate prenatal alcohol exposure on pregnancy outcome. Br J Obstet Gynaecol 2007;114(3):243-52.
Henderson J, Kesmodel U, Gray R. Systematic review of the fetal effects of prenatal binge drinking. J Epidemiol Community Health 2007;61(12):1069-73.
Petrou S, Kupek E, Gray R. Income inequalities and self-reported maternal health status: cross-sectional national survey. Br J Obstet Gynaecol 2007;114:1018-22.
Gray R, Francis E. “The Implications of US Experiences With Early Childhood Interventions For the UK Sure Start Programme,” Child Care Health Dev. 2007; 33(6):655-63.
Gray R, Henderson J. Report to the Department of Health: Review of the fetal effects of prenatal alcohol exposure. Oxford: NPEU 2006.
* Gray R, McCormick MC. “Early Childhood Intervention Programs in the US: Recent Advances and Future Recommendations,” Journal of Primary Prevention 2005; 26(3):259–275
Petrou S, Gray R. “Methodological Challenges Posed by Economic Evaluations of Early Childhood Intervention Programmes,” Appl Health Econ Health Policy 2005; 4(3):175–181.
Gray R, McCormick MC. Early childhood intervention programs in the US: Recent advances and future recommendations. The Journal of Primary Prevention 2005;26(3):259-75.
Petrou S, Gray R. Methodological challenges posed by economic evaluations of early childhood intervention programmes. Applied Health Economics and Health Policy 2005;4(3):175-81.
* Gray RF, Indurkhya A, McCormick M. “Prevalence, Stability, and Predictors of Clinically Significant Behavior Problems in Low Birth Weight Children at 3, 5, and 8 years of Age,” Pediatrics 2004;114(3):736-743.
Gray RF, Indurkhya A, McCormick MC. Prevalence, stability and predictors of clinically significant behaviour problems in low birthweight children at 3, 5 and 8 years of age. Pediatrics 2004;114(3):736-43.
Kurinczuk JJ, Gray R, Brocklehurst P. Risk of stillbirth after previous caesarean section. The Lancet 2004;363(9406):402.