Evidence-based service modules for a sustained home visiting program

The Centre for Community Child Health (CCCH) at the Murdoch Childrens Research Institute and the Royal Children’s Hospital has undertaken two literature reviews to inform the design of a sustained home visiting program for vulnerable families with young children; the program is now known as \u27right@home\u27. This project is being led by a collaboration between three organisations: The Australian Research Alliance for Children and Youth (ARACY), CCCH, and the University of New South Wales. The first literature review undertaken by CCCH (Sustained home visiting for vulnerable families and children: A review of effective programs (McDonald et al., 2012) (hereon in referred to as the Home visiting review of effective programs) sought to answer the question ‘what works in home visiting programs?’ The conclusion reached was that it was not possible to answer the question definitively, either because the evidence regarding the ‘components’ of home visiting programs is contradictory or contested, or the evidence is not available. As the home visiting review of effective programs focused on what was delivered (ie. the efficacy of different manualised programs), rather than how services were delivered (ie. the effect of the manner in which services were delivered and the nature of the relationships established between service providers and parents), a second literature review was undertaken: Sustained home visiting for vulnerable families and children: A literature review of effective processes and strategies (Moore et al., 2012) (hereon in referred to as the Home visiting review of effective processes and strategies). The home visiting review of effective processes and strategies identified converging evidence from a number of sources to support the idea that the process aspects of service delivery matter for outcomes – how services are provided is as important as what is provided. A number of key elements of effective service delivery processes have been repeatedly identified in the research literature and these represent the threshold features or bedrock on which all services should be based: if services are not delivered in accordance with these process features, then efforts to change people’s behaviour will be less effective (Moore et al., 2012). The evidence also indicated that the identification of goals, and of strategies to achieve these goals, needs to be done in partnership with parents. However, while the ultimate choice of strategies should be made by parents, the strategies on offer used must be evidence-based. Therefore, service providers should be able to draw on a suite of evidence-based strategies to address the range of challenges that parents face in caring for their children (Moore et al., 2012). In the light of the findings of this second literature review, it was decided that the right@home home visiting program would not involve the delivery of a manualised program. Rather, service delivery would be based on the processes of effective engagement and partnership, while the content of the program would take two forms: standard modules that are delivered to all participants, and e.g. information on the stages of child development), and evidence-based ‘service modules’ (i.e. specific strategies) that could be deployed to address issues that are of particular concern to individual parents.  Related identifer: ISSN 2204-340

Primary schools as community hubs: a review of the literature

Considerable work has been undertaken over several years to establish primary schools as community hubs in the City of Hume through the Hubs Strategy Group for the Hume Communities for Children Initiative and, more recently, the Supporting Parents Developing Children project. This work has highlighted the need for a primary school community hub toolkit. The purpose of this review is to inform the development of a resource (e.g. a toolkit) that can be used by other schools so that they can also establish themselves as community hubs. An agreed definition of schools as community hubs within the literature has not been reached. Rather, the notion of schools as community hubs seems to be understood in a variety of ways. For the purposes of this review we will draw on the definitions provided by Black (2008) and the Hubs Strategy Group for the Broadmeadows Communities for Children Initiative (2009). Black (2008) describes hubs as involving \u27collaboration between school education systems and the other sectors (community, business, local government and philanthropy) to support the learning and wellbeing of young people, especially those facing disadvantage\u27 (p. 6). These collaborations can range from sharing, co-locating or joint use of physical facilities, through to schools as the centre of a hub or precinct that offers multiple services for the whole community. In the City of Hume, the Hubs Strategy Group have conceptualised a hub as, a welcoming place for families that engages key service providers to work collaboratively. A hub can be a single location or a network of places working together to provide services, such as schools, kindergartens, maternal and child health, and other relevant agencies. Hubs facilitate connections between key services and professionals and represent a paradigm shift in the planning and practice of service provision. Services and their staff are required to rethink existing practice to move to an inclusive practices framework at a professional and community level. &nbsp

Sustained home visiting for vulnerable families and children: a review of effective processes and strategies

Parenting young children has become a more complex and stressful business, especially for those families in our community with the least resources (Grose, 2006; Hayes et al, 2010; Poole, 2004; Richardson & Prior, 2005; Trask, 2010). A widening gap exists between families that function well and those that are vulnerable. The paradox of service delivery for children and families is that vulnerable families – that is, those families with the greatest needs – are also the least likely to be able to access those services (Ghate & Hazel, 2002; Fram, 2003). A range of barriers exist for vulnerable and at risk families in making use of services (Carbone et al, 2004). One of the key barriers to vulnerable families accessing services is that many find it difficult to relate to the formal service system and are easily alienated by practices others find acceptable. Research regarding parents’ experiences of support services suggests that parents want services where they are simultaneously cared for and enabled in their role as parents, and to receive services characterised by empathy, competence, functionality, respect, flexibility and honesty (Attride-Stirling et al, 2001; Winkworth et al, 2009). Vulnerable parents fear a loss of autonomy in their interactions with support services and want services that are non-judgemental and that provide continuity of care (Ghate & Hazel, 2002; von Bultzingslowen, 2006). In addition to the barriers faced by vulnerable and marginalised families in accessing services, the system does not work in an integrated or coherent fashion to ensure that all children and families needing support receive it. Furthermore, the vast majority of services for children and families in Australia do not have an outreach function, that is, a means of engaging these vulnerable and at risk families who are in need of support but use services inconsistently or not at all. In short, the service system was not designed to meet the needs of vulnerable families within the context of a rapidly changing social and economic climate. Therefore, many families requiring support are not receiving it. Related identifier: ISSN 2204-340