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Building Systems for Effective Early Intervention and Support for Parents: Extending the Lets Start Program to Aboriginal Families & communities Gary Robinson,

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Presentation on theme: "Building Systems for Effective Early Intervention and Support for Parents: Extending the Lets Start Program to Aboriginal Families & communities Gary Robinson,"— Presentation transcript:

1 Building Systems for Effective Early Intervention and Support for Parents: Extending the Lets Start Program to Aboriginal Families & communities Gary Robinson, Yomei Jones, Anita D’Aprano, Kate McGuinness, Roger Tipungwuti, Sven Silburn, Steve Zubrick, Bill Tyler, Carolin Stock, Carmen Cubillo. Menzies School of Health Research

2 What is Let’s Start? Trial of a targetted intervention for Indigenous parents and 4-6 y.o. children at risk o Funded by FaHCSIA, CRCAH, NTG, ARC Funding extended to 2012 by FaHCSIA under FSP & NT Emergency Response Sites to 2009: Malak, Palmerston, Nguiu, Milikapiti, Pirlangimpi, Palumpa, Jabiru Further trials of a redesigned program: pilots from July 2010, implementation in partner sites from 2011

3 Trained Indigenous group leaders

4 Work in Groups Interactive: children playing with parents; parents in control, leaders assist, manage transitions Child: peer play, feelings, stop-think-do, etc. Parents: observe, discuss parenting, child behaviour, strategies, family of origin etc.

5 Working with differences

6 Parent & child responsiveness

7 Works with her dad …

8 Repairing relationships, supporting families

9 Evaluation Sample Total Referrals Included in Evaluation Sample N = 225 Participated in ≥ 1 Sessions = 48 Participated in ≥ 1 Sessions = 15 Participated in ≥ 1 Sessions = 47 Completed ≥ 4 Sessions = 36 Completed ≥ 4 Sessions = 40 Completed ≥ 4 Sessions = 10 Tiwi Indigenous = 77Urban Indigenous = 49 Non Indigenous = 99

10 Problems at referral

11 Findings Engagement strategies need to be tailored for different contexts to improve participation and retention Important differences: urban Aboriginal kids Improved parenting & reduced stress: large effect size K6 measure of parents’ psychological distress Reduced behavioural problems in primary and preschool children: o Moderate-large effect sizes at program end, larger effects at 6 months, program outcomes not only sustained but increase Dose-response effect: the more people attend the better the outcomes Variable response to treatment according to gender and Aboriginality: need to revise aspects of intervention strategy The challenge of developing the evidence base is to contextualize process and research strategies while retaining fidelity: structure, intensity & quality

12 Service learning Evidence-based programs for remote centres, “hubs”: o It is possible to support evidence-based interventions in diverse contexts o By developing local partnerships, “integration” with health & education services o With centrally provided professional training, support & supervision

13 Directions Develop SEWB protocols for CQI Screening & assessments (d’Aprano) Identify referral pathways for SEWB Redesigning Let’s Start: Parents talk & Interact: a focus of parent mental health and parent-child interaction for 4-8s Imagining my child: early years intervention to strengthen attachment for 0-4s Parenting support from birth to young adulthood

14 Building systems for delivery of professionally supported programs Training & capacity- building Research & evaluation Program delivery Assesment, referral & intake; datagathering & analysis; verification of quality, feedback. Community setup: leadership; capacity assessments; agreement between agencies; teambuilding; training; location & resources Ongoing professional support for community team to guide practices of engagement with families and maintain practice standards

15 Models for integration: CQI & systems of practice Wellbeing and early intervention program 1. Imagining my child 0-4 year olds 2. Let’s Start 4-8 y.o. 3. Adult and child wellbeing services Program intake &/or ffurther referral. Community child health care Well child checks, healthy under 5s: audit of services according to CQI cycle developed for SEWB, behavioural development & parenting Menzies CRCATSIH One21Seventy 1. Review and trial of audit protocols and guidelines: queries about behaviour, social- emotional development & family support. 2. Pilot of assessment and referral to early intervention programs. Evaluation, feedback & practice support  One21seventy: Continuous quality improvement audit and feedback cycle  Let’s Start evaluation program: evaluation and clinical support  Developmental screening and assessment pilots  Imagining my child: An early intervention to assess and to support early mother-child attachment  AEDI:: community level developmental status data on NT children

16 Research and evaluation outputs Evaluation Report: Robinson, G., Zubrick, S. R., Silburn, S., Tyler, W., Jones, Y., D’Aprano, A., Cubillo, C., McGuinness, K., Bell, M., Stock, C., 2009, “Let’s Start: Exploring Together. An Early Intervention program for Northern Territory Children and Families. Final Evaluation Report”, Darwin: School for Social and Policy Research, Institute of Advanced Studies, Charles Darwin University. evaluation-report-2010.pdf evaluation-report-2010.pdf Let’s Start: Parents talk & Interact. Manual and guidelines - a program for Aboriginal parents and communities (June 2010) Let’s Start working with kids: capacity assessment, training and community engagement (June 2010) Imagining my child: An early intervention trial (2011) Systems for integrated child and family support: Protocols & instruments for SEWB in primary health care (2010/2011)


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