| Project Objectives / Summary:
The overall aim of this project was to identify, develop, implement and evaluate a sustainable health-promoting strategy for vulnerable young families in Western Sydney. The strategy would build on and create synergies between existing networks and services provided by Western Sydney Community Health Services, general practitioners and other relevant agencies.
The aims of the project were to:
- Identify some of the major issues in child development in the family context with a specific focus on risk and protective factors;
- Critically appraise the current literature on health promoting interventions for young families, identifying the features of effective and ineffective interventions;
- Identify ways to use both the present strengths of General Practice and also its potential to support young families; and
- Outline an integrated, evidence-based early intervention for young families who visit General Practitioners to be tested by an RCT in a later phase of this project.
Project Collaboration:
- Department of General Practice, University of Sydney (Westmead Hospital)
- Centre for Clinical Epidemiology and Effectiveness, University of Sydney (Westmead Hospital)
- Western Sydney Area Health Service
Project Outcomes:
The literature review highlighted the potential value of programs to support families as they confront a range of problems that impact on young children's health. The review demonstrated that General Practice has the potential to be linked into and enhance the delivery of such programs.
Evaluation
The findings from a range of research and program evaluations strongly suggested that well-planned interventions can be effective in promoting protective factors and modifying risk factors for young children in a family context. The findings demonstrate that programs can deliver positive outcomes such as: improved child cognitive and general development, and lower incidence of child abuse; reduced incidence of maternal depression and increased periods of breast feeding; and enhanced parenting skills and family function.
However, the evidence from the evaluations of early intervention programs do not provide a definitive blueprint of what works and what does not. The complexities of family life provide many variables that are not readily comparable or are too subtle for one particular intervention program to influence. Often it is not clear what feature if any, in a program resulted in what changes within families. Not all programs have the same goals, limiting comparison with other programs.
Some basic principles of successful models identified in the literature:
- Targeted programs where appropriate
- Provided as a combination of strategies
- capable of addressing a broad range of issues
- provided as part of a coordinated service network
- adequately resourced
- culturally appropriate
- realistic expected outcomes
- support and involvement of target groups
Recommendations:
- That future early intervention programs involve GPs in their development and delivery.
- That early intervention programs be appropriately targeted, culturally appropriate, realistic in terms of expected outcomes and have the support and involvement of the target groups.
- That early intervention programs address a broad range of issues, aimed at helping families cope with the risk factors in their environment, enhancing parents' childrearing skills and promoting health enhancing behaviours by family members.
- That early intervention programs be provided as part of a coordinated service network involving a broad range of relevant agencies.
- That early intervention programs incorporate a strong evaluation strategy, addressing both process and outcomes.
- That further research be conducted into the elements of early intervention programs that are necessary for success.
- That the intervention outlined in this report be developed and tested in a randomised controlled trial.
Disseminating Project Information:
Resources:
A Directory of Western Sydney Support Services for Young Families (including government and non government) was compiled and distributed to GPs within the Western Sydney Division of general Practice
Lessons / Assessment:
The Division was successful in obtaining funding through Round Two of the Innovations Funding Pool for a follow up project "The Young Families" project. |
