Acting early, changing lives: how prevention and early action saves money and improves wellbeing

Evidence indicates worsening or unacceptably high levels of problems amongst Australia’s children and young people. These problems will not improve – and could get worse – unless we are able to effectively intervene to prevent these problems from occurring in the first place or address the problems early before they become entrenched. This report investigates the potential of early intervention to improve the outcomes of Australian children, especially those children experiencing significant levels of disadvantage, and especially for the long-term (i.e. into adolescence and adulthood). Early intervention is defined in this report as interventions that occur during the early years of an individual’s life (0-5 years of age) in order to prevent a negative outcome or to address an existing problem. The justification for early intervention (i.e. intervention during the early years) rests with the nature of human development and the way in which children develop and learn. The basic foundations for development are laid down during the early childhood years. The prenatal period also plays an important role in an individual’s longterm outcomes.&nbsp

Sustained home visiting for vulnerable families and children: a literature review of effective programs

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 (Attide-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. A research collaboration between the Australian Research Alliance for Children and Youth (ARACY), the Centre for Health Equity Research and Evaluation (CHETRE) and the Centre for Community Child Health (CCCH

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

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

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

Meeting the Intergenerational Needs of Families Where a Parent Has a Mental Illness [English and Spanish versions]

Parental mental illness can have significant psychological, social and economic impacts on families. Because of the potential impact of a parent’s mental illness on children, it can also have an “intergenerational” impact. For example, children may develop a heightened awareness of their parent’s symptoms, become burdened with caring responsibilities and may even develop their own mental health conditions though a mix of genetic and environmental influences. It is important for services to address the intergenerational impacts of parental mental illness. This issue brief is about one program in Australia that may be able to meet the intergenerational needs of families where a parent has a mental illness. A Spanish translation of this publication is available to download under Additional Files

Demonstrating community-wide outcomes: Exploring the issues for child and family services

Investigating some of the issues pertaining to the evaluation of initiatives that seek to have a community-wide impact, this paper considers the impact of neighbourhoods and programs upon children and families. Key messages Area-based (or place-based) initiatives often seek to have a whole-of-community impact. This recognises the way in which neighbourhoods can impact upon the health and wellbeing of children and families. Improvements in the community as a whole, such as increased “child-friendliness”, may improve outcomes for children and families. Measuring the impact of an initiative on an entire community can be challenging. It may take a significant period of time before the impact of an initiative is felt at the community level. It can be difficult to attribute changes in the community directly to a specific initiative. An experimental or quasi-experimental design is the best method to use in order to estimate what the outcomes for children, families and communities would have been in absence of the intervention, however, for community-based agencies, experimental evaluation designs can be difficult to undertake. Methods that can be used to collect data for the purpose of demonstrating the impact of a community-wide initiative include: surveying a representative sample of the community; key informant interviews and focus groups; using secondary source data; and mixed methods research. There is a paucity of practical tools to measure many typical community-wide outcomes such as a child-friendly community and community empowerment. Universal tools for these types of outcomes are often viewed as inappropriate as the concepts are highly context specific

Engaging disadvantaged and socially isolated families with young children in child and family services

Research has demonstrated that involvement in high-quality early childhood and parenting support programs benefits children and families, particularly children from disadvantaged backgrounds. Parents with young children can also benefit from programs, such as parenting support activities, that enable them to socialise with other families, develop support networks and gain confidence in their parenting skills. Although these programs and activities are clearly beneficial, service providers can find it challenging to engage families and often those families who are the most difficult to engage are also the families experiencing disadvantage and/or social isolation. Similarly, in some cases families may find it challenging to engage with services and many of these factors can also be related back to disadvantage and social isolation. The reasons behind these difficulties with engagement are explored further below. Due to the negative impact of disadvantage upon children\u27s development and family functioning, and the relationship between disadvantage, social isolation and lack of engagement, there is a strong incentive for reducing the barriers that inhibit the engagement of families with child and family services

What role can child and family services play in enhancing opportunities for parents and families?

Draws upon research to provide practitioners and policy-makers with ideas about how the concept of social inclusion can be used to plan and deliver child and family services in ways that enhance opportunities for parents and families.   Key messages: * Definitions of social exclusion are often vague and ambiguous however one of the best ways of understanding social exclusion is to explore how it is distinct from poverty and deprivation. Social exclusion is not the equivalent of poverty (i.e., inadequate economic resources) or deprivation (i.e., an enforced lack of socially perceived necessities). Social exclusion, in contrast to poverty and deprivation, is fundamentally about a lack of connectedness and participation. * In the Australian policy context social inclusion is understood as four key "domains" of opportunity. They are the opportunity to: (1) participate in society through employment and access to services; (2) connect with family, friends and the local community; (3) deal with personal crises; and (4) be heard. * There is substantial evidence to demonstrate the negative impact that social exclusion has upon children, parent-child relationships, parenting and family functioning. For example, children who live in a jobless family have a higher risk of behavioural, conduct and peer problems. * Child and family services in Australia can play a key role in promoting the social inclusion of children and families by, for example:      - providing a space for parents and children to meet with one another and develop friendships and informal support networks;      - providing opportunities for parents to take up leadership roles within programs; and      - encouraging parents and children to contribute to decision-making processes in the local community.   Image: Andrew Jeffre

Collecting data from parents and children for the purpose of evaluation

This Practice Sheet outlines the challenges child and family services may face when they seek to collect data directly from parents and children for the purposes of evaluation. It contains some examples of how child and family services can engage children and families in the evaluation process in order to overcome some of those challenges. Image: Tim O\u27Bryan / flick