‘The Changing Life Trajectories Project’(CLT)

Designing nurse home-visiting services for CALD families who

are experiencing low levels of risk

Dr Wendy Foote Principal Investigator UNSW Ms Jennifer Evans -Communication Matters

Ms Nicole Bechard TIHC&FS

The Infants’ Home Child & Family Services (TIHC&FS)

Providing education, health, support and care for 135 years

Sydney Hope Family Cottage (SHFC) • Day Stay & Home Visiting Service• Infant and maternal/family health services• Child & Family qualified nurses with training in the

Family Partnership Program• High CALD population – 37% in LGA

History & Background

Why this program?

Partnership between three agencies

Health research reference group

United Way Sydney

The vision: social entrepreneurshipThe funding

The submission: 1. A commercially operated profit-making clinic at

TIHC&FS

2. CLT- • The early intervention service • Sustained Nurse HV• first 12 months of a baby’s life

• Wendy Foote - Lecturer, Social Work practice Previously Manager TIHC&FS, involved in

providing early intervention services Continuity of involvement after writing the

original submission

The University of New South Wales

From Submission to Action

Clare Rogers – Director, Prevention & Early Intervention, DoCS Professor Cathrine Fowler- Child &Family Health Nursing Midwifery & Health UTS.Dr Lynn Kemp- Program Manager, Early Childhood Research, Centre for Primary Health Care & Equity UNSW; UTS Honorary Associate (Child & Family Health);Deputy Director, Program Development, Sydney South West Area Health ServiceJennifer Evans –Communication MattersDr Wendy Foote – Principal Researcher, Lecturer, Social Work Practice, UNSW.Nicole Bechard – Manager, TIH C&FS

Reference group Membership:

Significant factors: Scoping the area

• The organisational match• Lit review – unpublished/published/local• Research gap • Local needs • Patterns of service use• Population trends • Experts

Sequence

3 jigsaw pieces

1. Q. The ‘risk’ levels of target group

2. Q. What service model and what data did we want to collect?

3. Research questions, methods and data collection.

Refined Questions & Target Groups

Criteria:• Low risk ie ‘isolation’ • Recent arrival from India, Sri Lanka,

Bangladesh, Pakistan • Proximity to service provider • Good use of English

Aim of the research

• …to investigate the effectiveness of the ‘Changing Life Trajectories’ program.

• The program is designed to improve parent effectiveness in populations where there are low levels of risk.

CLT program

Program Components:

1. Parent craft2. Parenting education 3. Social linking and building 4. Strength based approaches5. Family partnership training (Davis, Day & Bidmead)

6. STEEP program (Martha Erickson)

Research questions:

1. Confidence/responsiveness2. Knowledge of infant/child development3. Mental health: mother/family/child 4. Social isolation5. Social connectedness6. Use of services7. Influence of culture /migration8. Most useful intervention?

Methods

Data will be collected by survey-scales questions from NSW Child Health Survey.

Thematic data will be gleaned from group discussions.

Measures • McMaster Family Assessment Device (section 7 only)• Social support • Edinburgh Depression Scale• ‘Home’- assessment of the environment • Health data• Modified Abidin parenting Stress Index (Life events

inventory)• Parent knowledge of preventive infant care• Parent reports on child abuse reports• Parent reports on utilization of health and parent

support services• Parent knowledge and use of child care

Current stage

• Ethics application in with RPA- followed by approaches to antenatal clinics at Canterbury and RPA hospitals

• Training of staff• Development of survey • Identification of points of referral• Intake Jan 10

Research in Reality

• Challenges• Balance of priorities • Demystifying research • Right people• Ongoing funding• Working within systems• Commitment