Transcript Slide 1

Supporting Resilient Families
within Resilient Communities
Jane Drummond
Vice Provost
Health Sciences Council
Healthy Kids Alberta: Stakeholder Forum
March 7, 2007
“We’re in a new place;
we’re not on the edge of the old place.
We’re not pushing the envelope;
we’re in a totally new envelope.
So the rules have changed.
Every fundamental premise of the old way
of thinking no longer applies”
Sister Elizabeth Davis
Board Chair, Canadian Health Services Research Foundation
The Ecological Model:
A tool for “the old place” and
“the totally new envelope”
Seeks to explain
individual
knowledge,
development, and
competencies in
terms of the
guidance, support,
and structure
provided by society
and to explain
social change over
time in terms of the
cumulative effect of
individual choices
(Berger, 2000).
On the edge of “the old place”
Protective Factors
Individuals
Family
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social competence
reading skill
sense of responsibility
problem solving
feelings of control
plans for future
optimism
history of success
history of + reinforcement
seeks support
detaches from conflict
effective parenting
attachment
warmth and affection
cohesive support
structure within the family
coping skill
+ expectations of members
good spousal relationships
strong extended family
extracurricular activities
responsibilities outside the home
Mangham, C., Reid, G., McGrath, P., & Stewart, M. (1994). Resiliency: Relevance to health promotion. Atlantic Health Promotion Research
Centre, Dalhousie University, Halifax, NS. For Alcohol and Other Drug Units, Health Promotion Directorate, Health Canada.
On the edge of “the old place”
Community Protective Factors
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mutual support
collective expectation of success in meeting challenges
high level of community participation
organize cooperatively
volunteerism
egalitarian treatment of community members
optimism
empowerment (control over policy)
Mangham, C., Reid, G., McGrath, P., & Stewart, M. (1994). Resiliency: Relevance to health promotion. Atlantic Health Promotion Research
Centre, Dalhousie University, Halifax, NS. For Alcohol and Other Drug Units, Health Promotion Directorate, Health Canada.
On the edge of “the old place”
Child and Family Resilience Research Program
Family Protective Processes
 flexibility of the family unit
 coherent responsiveness to challenging situations
 maintenance of stability
 support acquisition and maintenance
 effective parenting
 maintaining responsibilities outside the home
Drummond, J., Kysela, G.M., McDonald, L., Alexander, J., & Fleming, D. (1996/7). Risk and resiliency
in two samples of Canadian families. Health and Canadian Society 4(1), 117-152.
On the edge of “the old place”
Child and Family Resilience Research Program
Developed and tested four family-centred approaches
to supporting family resilience
 Assessment (ongoing approach)
 Parent-infant interaction (five sessions)
 Parent-child interaction (twelve sessions)
 Family communication and problem solving (twelve sessions)
Academic Achievements:
 Effect sizes between .5 and 1.5 SD in changing parent
behaviour
 Mentored numerous research students
 Published, presented
 Were promoted on schedule
Kysela, Drummond & McDonald and their students 1994-2005
Knowledge
from the edge of “the old place”
 “When a parenting intervention is structured, intensive
and focused on behavioural strategies it works”
 Focus on the positive behaviour you want to build
 Shorter works better (Can be accomplished in 5-16 sessions)
 Must create a mirror for the parent so they can identify within
themselves what works and what isn’t working
 Longer, broad-band approaches (important as they are) do not
work at improving specific behaviours associated with parental
sensitivities
Bakermans-Kranenburg MH, van IJzendoorn M, Juffer F. (2003) Less is more: Meta-analyses of sensitivity
and attachment interventions in early childhood. Psychological Bulletin; 129(2): 195-215.
Questions that propelled me
from the edge of “the old place”
As an dedicated researcher
 How do we get appropriate targeted behavioural
interventions inside of broad-based support programming?
As a member of my community
 How do we make “evidence-informed” decisions?
 Since, research is but one input into decisions concerning the
health care system
 How do we create opportunities for meaningful collaboration
between experts practitioners in community-based programs,
decision makers and academic researchers?
The Ecological Model:
A tool for “the old place” and
“the totally new envelope”
Seeks to explain
individual
knowledge,
development, and
competencies in
terms of the
guidance, support,
and structure
provided by society
and to explain
social change over
time in terms of the
cumulative effect of
individual choices
(Berger, 2000).
“A totally new envelope”
 Linking organizations
Community-University Partnership for the Study of
Children Youth and Families
Alberta Centre for Child Family and Community
Research
 Community-based research
Families First Edmonton
We can make it a reality
Community-University Partnership
For the Study of Children, Youth, and Families
www.cup.ualberta.ca/
We can make
it a Mission
reality
CUP’s
The Community-University Partnership for the Study of Children, Youth, and
Families (CUP) is committed to improving the health and well-being of children,
youth, families, and communities by:
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generating and sharing new knowledge
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identifying and promoting the use of best practices
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nurturing a culture, both in the community and the University, in which
rigorous, evidence-based research are valued
We can make it a reality
Developing Projects
Developing the Partnership
2 to 3
years
Research
Planning
Project
Management
RESEARCH PROJECT
Communications
We can make it a reality
Developing the
Partnership
Lessons Learned:
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Recruit the right people and the right organizations.
Create a shared vision
Work incessantly to build trust
Begin to outline responsibilities and commitments
Ensure that sufficient project development resources are in
place
• AHRE
• City of
Edmonton
• Children’s
Services
• Capital Health
• Edmonton &
Area CFSA
What is the best approach to
integrate services for lowincome families with children?
• CUP
• ECF
• Quality of Life
• AMHB
• EAUAC
• Health &
Wellness
• United Way
• Families Matter
Funded by CIHR,
AHFMR, CHSRF
www.familiesfirstedmonton.ualberta.ca/
History of FFE
• AHRE
• City of
Edmonton
• Children’s
Services
• Capital Health
• Edmonton &
Area CFSA
• CUP
• ECF
• Quality of Life
• AMHB
• EAUAC
• Health &
Wellness
• United Way
• Families Matter
PARTNERSHIP
DEVELOPMENT
PROJECT
DEVELOPMENT
• December 2000
• Sept-Dec 2002
– release of “Listen to the
Children” by Quality of
Life Commission
• June 2001
– decision to focus on
improving existing
service
– Families First
Edmonton Steering
Committee established
– co-lead organizations
named
• January 2003
– CUP was invited to
coordinate the study
• July 2003
• March 2002
– workshop on “When the
Bough Breaks”
– selection of PI and
begin writing proposals
• April 2005
– research funding
secured
2006 Families First Edmonton
Governance Structure
Steering Committee
Executive Subcommittee
• AHRE
• City of
Edmonton
Sounding Board
Project Management Team
• Children’s
Services
Operations Committee
• Capital Health
• Edmonton &
Area CFSA
Communications
Subcommittee
Research Committee
Ad Hoc
Subcommittees
(as required)
Co-Investigator
Subcommittee
• CUP
• ECF
• Quality of Life
Service Delivery Coordination
Families Matter
Program Manager,
Program Supervisors, and
Program Coordinators
• AMHB
• EAUAC
• Health &
Wellness
• United Way
• Families Matter
Legend
Works With
Reports to
Service
Delivery
Committee
Research Coordination
Research Coordinators,
Research Assistants, and
Data Collectors
NOTE: The membership lists for the
Sounding Board, Steering Committee,
Executive Committee and Operations
Committee are on pages 26-29 in the
approved Charter
• AHRE
• City of
Edmonton
• Children’s
Services
• Capital Health
• Edmonton &
Area CFSA
• CUP
• ECF
• Quality of Life
• AMHB
• EAUAC
• Health &
Wellness
• United Way
• Families Matter
Families First Edmonton:
A new approach to reducing
barriers to service integration
• Intersectoral partnerships
– between government agencies, nongovernmental organizations, and community
service providers
• Building family capacity
– Family-centred service delivery practices that
enhance family problems solving, relational
advocacy, reducing isolation
• Community-based transdisciplinary research
– the public sector must be assured that changes to
service spending will improve family health
outcomes in a cost-effective manner.
Research Projects
• AHRE
• City of
Edmonton
• Children’s
Services
• Capital Health
• Edmonton &
Area CFSA
• CUP
• RCT (short term outcome and the policy relevant question)
• Child Health (long term outcome)
• Family Health (long term outcome)
• Community Engagement (medium term outcome)
• ECF
• Quality of Life
• AMHB
• EAUAC
• Health &
Wellness
• United Way
• Families Matter
• Service Integration Best Practices
(program development outcome)
• Collaboration (what are the elements of “the new envelope”)
Results will provide critical
information about
• AHRE
• City of
Edmonton
• Children’s
Services
• Capital Health
• Edmonton &
Area CFSA
• CUP
• ECF
• Quality of Life
• AMHB
• EAUAC
• Health &
Wellness
• United Way
• Families Matter
• the knowledge, skills and attitudes of service
integration (family, agency and policy level)
• appropriate front-line service integration
practice
• effective system collaboration
• optimizing cost effectiveness for public systems,
• the long-term effects on the health and wellbeing of family members,
• mechanisms that intervene between the
interventions and their effect on the health and
well being,
• building on previous research and on
community-based initiatives, and
• promoting knowledge transfer.
“A totally new envelope”
 What’s new?
 Independency to interdependency
 Interdisciplinary
 Intersectoral
 Centralized to distributed
 Community-based
 “Connected to the world”
 Network of responsibility/accountability
 Expert driven to equality of participants
 Primacy of relationships >> partnership
 Boundary spanning leadership
 Valuing diversity
 Pipe line dissemination to knowledge mobilization
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Participatory research
Joint decision of what will be the knowledge outcomes
Inclusion of and resourcing of detailed communication plan in projects
Training for “the new envelope”
 Simple to complex
 Multi focus (cost, outcome, collaboration, best practice)
 Attempting to describe the “whole”
“A totally new envelope”
The HealthyKidsAlberta question
 How can our community, including the research
community, support children and families to
achieve wellness through:
Healthy eating
Active living
Successful responding to life’s challenges?