‘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 entrepreneurship The 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

The University of New South Wales

• Wendy Foote - Lecturer, Social Work practice Previously Manager TIHC&FS, involved in providing early intervention services Continuity of involvement after writing the original submission

From Submission to Action

Reference group Membership:

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 Service Jennifer Evans –Communication Matters Dr Wendy Foote – Principal Researcher, Lecturer, Social Work Practice, UNSW.

Nicole Bechard – Manager, TIH C&FS

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• • • • • • • The organisational match Lit review – unpublished/published/local Research gap Local needs Patterns of service use Population trends Experts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 craft 2. Parenting education 3. Social linking and building 4. Strength based approaches 5. Family partnership training (Davis, Day & Bidmead) 6. STEEP program (Martha Erickson)

Research questions

:

1. Confidence/responsiveness 2. Knowledge of infant/child development 3. Mental health: mother/family/child 4. Social isolation 5. Social connectedness 6. Use of services 7. Influence of culture /migration 8. 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