Transcript Document

What works? Improving labour market
outcomes and early childhood
development for Indigenous Australians
Improving labour market
outcomes through education and
training
Dr Tom Karmel (formerly Managing Director
NCVER) and Dr Josie Misko (NCVER)
For a copy of the Improving labour market
outcomes through education and training
slides please contact the Closing the Gap
Clearinghouse
[email protected]
Panel discussion and Q&A session
Dr Tom Karmel and Dr Josie Misko
Review of early childhood
parenting, education and health
intervention programs for
Indigenous children and families
in Australia
Professor Jennifer Bowes (Macquarie
University) & Dr Rebekah Grace (University
of NSW)
Aim of issues paper
• Review of intervention programs (in the context
of other more universal services)
• Early childhood years: prior to school entry
• Range of available early childhood programs
• Evidence base for programs and quality of
research
• Parenting, early childhood education, health
Background
• Evidence for gaps related to parenting, early
childhood education and health in early years
• Foundation for gaps in wellbeing, education and
health in later years
• Research base largely descriptive
• Need for longitudinal research and research on
urban Indigenous families
Parenting
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Rates of substantiated abuse and neglect
Children over-represented in out-of-home care
Intergenerational effects of stolen generations
Strong families reported in Footsteps in Time
High unemployment, low education among
parents, high exposure of children to major life
events
Early childhood education
• A third of children in LSIC infant sample
attended some form of child care in their first
year
• Similarly a third attended a playgroup with a paid
facilitator
• Policy for preschool with an early childhood
qualified teacher for all Indigenous children in
remote communities
Health
• Higher rates of still birth, low birth weight and
prematurity
• Lower rates of breastfeeding in urban areas
• Immunisation less likely to be on time
• More hospital admissions for illness and injury
• High rates of pyoderma
• High rates of hearing and dental problems
Method
• Criteria for selection of programs
• Locating relevant literature
• Determining the primary focus of programs
• Assessing the quality of research design
NHMRC levels of evidence
Table 7 - NHMRC designation of levels of evidence (NHMRC 2000:8)
Level
Designation
Level I
Evidence obtained from a systematic review of all relevant randomised controlled trials.
Level II
Evidence obtained from at least one properly designed randomised controlled trial.
Level III-1
Evidence obtained from well-designed pseudo-randomised controlled trials (alternate
allocation or some other method).
Level III-2
Evidence obtained from comparative studies (including systematic reviews of such studies)
with concurrent controls and allocation not randomised, cohort studies, case-control studies,
or interrupted time series with a control group.
Level III-3
Evidence obtained from comparative studies with historical control, two or more single arm
studies, or interrupted time series without a parallel control group.
Level IV
Evidence obtained from case series, either post-test or pretest/ [and] post-test.
Parenting programs
• Mainstream programs for disadvantaged
families e.g. Communities for Children
• Indigenous-specific programs e.g. Let’s Start
• Home visiting programs e.g. HIPPY
Evidence base for parenting
programs
• Of the 13 parenting programs reviewed, 7 were at Level IV or below
• More rigorous research designs for Brighter Futures, Communities
for Children, Indigenous Triple P, Let’s Start, Men in Families, and
HIPPY
• Outcomes for parents more often involved improved knowledge and
attitudes rather than improved skills or behaviour (except for
programs focused on children’s challenging behaviour)
• All programs reviewed had been well received and Indigenousspecific programs had all involved community consultation
Early childhood education
• Mainstream intervention programs
e.g. Brighter Futures in NSW
• Indigenous-specific programs
e.g. Families as First Teachers in NT
• Programs on specific aspects of learning
e.g. Early Start in NT (challenging behaviour)
• Specific formats for ECE programs
e.g. Playgroups, Transition to School programs
Evidence base for ECE
programs
• Of the 10 programs, 7 were at Level IV or below
• More rigorous designs were for Communities for
Children, HIPPY and Let’s Start
• Outcomes found for children in the research were
behavioural rather than learning outcomes
• Within the ECE programs reviewed, Indigenous-specific
programs, supported playgroups and transition to school
programs offer most promise for early learning of
Indigenous children (outside the home)
Health
• Interventions targeting particular disorders and
diagnoses
New treatment methods e.g. swimming pools in WA, SA and NT
Encouraging treatment compliance e.g. Healthy Skin program in NT
• Community-embedded maternal and infant health
programs
e.g. Mums and Babies program in Queensland
• Broad health interventions
e.g. The Family Well Being Program is in Adelaide and North Queensland
Evidence base for health
programs
• Of the 21 programs reviewed, 9 were at Level IV or below
• The most effective programs were those that responded to a
need identified by the community, and that took into account
issues of sustainability
• There is a growing evidence base for the impact of
appropriate maternal and infant health programs – moving
them out of clinics to culturally safe places and including
Indigenous professionals and paraprofessionals
• There is a clear need for high quality programs and research
addressing the social determinants of health
Program implementation
Safe people
Safe places
Safe programs
Community leadership
and endorsement
Strength based, familycentred approach
Employment and
capacity building
Flexibility and
sustainability
Non-Indigenous
program staff
Adaptation to local
needs
Service integration and
collaboration
Discussion
• High quality research for a strong evidence base
• Implementation
• Workforce safety, support and professional
development
• Program fidelity and adaptations of programs
Conclusions
• Evidence-based programs improve chances of positive
outcomes for families and children
• Adaptations of programs essential for Indigenous
communities
• Decisions about adaptations need to be made with the
community
• Adaptations should not compromise core program
elements
• Need for professional development of service providers
Improving the early life outcomes
of Indigenous children:
implementing early childhood
development at the local level
Dr Sarah Wise
University of Melbourne &
Berry Street Childhood Institute
Presentation overview
• What we know about early life outcomes for
Indigenous children & the context for Indigenous
ECD
• Localised ECD as a strategy to close the gap
– What it is
– Why it works
– Associated conditions and activities
– Change outcomes
• Broad strategies that fit within a local ECD
change agenda
What we know about early life
outcomes for Indigenous children
• Gaps in mortality rates, physical health,
emotional & behavioural disorders, language &
cognitive skills
• Young Indigenous children over-exposed to risk
factors
• Normal processes of child development
compromised
What we know about the context for
Indigenous ECD in Australia
• Unprecedented level of
investment & activity in
services, policy & national
co-operation
• Layers of complexity
– Child development
– Community
– Indigenous culture &
history
– Funding
What is localised ECD?
• A set of conditions & activities that occur within a
specific place to achieve change within the local
service system & broader community
• Analogous to ‘community development’
‘collective impact’ & ‘community action’
approaches
• Aligned with initiatives that address the social
determinants of health
How does localised ECD work?
Layers of
complexity
Challengs for
Indigenous ECD
Conditions
& activities
for
localised
ECD
Change in
local
service
system &
broader
community
Reduced
inequalities
in
Indigenous
National
impact
ECD
Conditions & activities for
localised ECD
Shared sense of need for change
• Communicating the science of ECD
• Communicating community-level ECD data
Community organisation & engagement
• Establishing a lead convener
• Establishing a governance group
• Consultation & continuous communication
Flexible funding
• Mobilising funding
Indigenous capacity for ECD
• Building Indigenous organisation capacity
• Building Indigenous workforce capacity
• Building Indigenous leadership & governance capacity
Strategic action framework
• Identifying community problems or needs
• Developing a local ECD agenda & outcome targets
• Assessing progress & continuous learning
Change outcomes
from localised ECD
• Multiple levels of intervention
• Coordinated activity
• Tailored approaches
• Valuing & including Indigenous perspectives
• Indigenous capacity building & empowerment
• Sustainable programs & services
Broad strategies that fit
within a local ECD agenda
• Enhancing mainstream
health, early learning &
childcare programs
• Increasing parent
education & family
support
• Addressing
fragmentation & gaps
Panel discussion and Q&A session
Professor Jennifer Bowes,
Dr Rebekah Grace & Dr Sarah Wise