Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia
Introduction: Intergenerational cycles of poverty, violence and crime, poor education and employment opportunities, psychopathology, and poor lifestyle and health behaviours require innovative models of health care delivery to break them. We describe a programme of research informed service developm...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Ubiquity Press
2019-07-01
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| Series: | International Journal of Integrated Care |
| Subjects: | |
| Online Access: | https://www.ijic.org/articles/3963 |
| _version_ | 1819011560228519936 |
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| author | John G. Eastwood Denise E. De Souza Miranda Shaw Pankaj Garg Susan Woolfenden Ingrid Tyler Lynn A. Kemp |
| author_facet | John G. Eastwood Denise E. De Souza Miranda Shaw Pankaj Garg Susan Woolfenden Ingrid Tyler Lynn A. Kemp |
| author_sort | John G. Eastwood |
| collection | DOAJ |
| description | Introduction: Intergenerational cycles of poverty, violence and crime, poor education and employment opportunities, psychopathology, and poor lifestyle and health behaviours require innovative models of health care delivery to break them. We describe a programme of research informed service development targeting vulnerable families in inner metropolitan Sydney, Australia that is designed to build and confirm a “Theory of Neighbourhood Context, Stress, Depression, and the Developmental Origins of Health and Disease (DOHaD)”. We describe the development of an intervention design and business case that drew on earlier realist causal and programme theoretical work. Methods: Realist causal and programme theory were used to inform the collaborative design of initiatives for vulnerable families. The collaborative design process included: identification of desirable and undesirable outcomes and contextual factors, consultation forums, interagency planning, and development of a service proposal. Results: The design elements included: perinatal coordination, sustained home visiting, integrated service model development, two place-based hubs, health promotion and strengthened research and analysis capability. Conclusions: We demonstrate here the design of interventions for vulnerable families in Sydney utilising translational research from previous realist causal and program theory building to operational service design. We have identified the importance of our earlier analysis of underlying causal mechanisms and related programme mechanisms for identifying the elements for the full intervention design. The application of theory added rigour to the design of the integrated care initiatives. In applying the theory to the local situation the analysis took into account: the role of the local agencies; evidence of program effectiveness; determinants and outcomes for local children and their families; the current deployment of service resources; and insights from front-line staff and interagency partners. |
| first_indexed | 2024-12-21T01:30:06Z |
| format | Article |
| id | doaj.art-0fcbaabe1a6043fa860b97555fce2263 |
| institution | Directory Open Access Journal |
| issn | 1568-4156 |
| language | English |
| last_indexed | 2024-12-21T01:30:06Z |
| publishDate | 2019-07-01 |
| publisher | Ubiquity Press |
| record_format | Article |
| series | International Journal of Integrated Care |
| spelling | doaj.art-0fcbaabe1a6043fa860b97555fce22632022-12-21T19:20:23ZengUbiquity PressInternational Journal of Integrated Care1568-41562019-07-0119310.5334/ijic.39634217Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, AustraliaJohn G. Eastwood0Denise E. De Souza1Miranda Shaw2Pankaj Garg3Susan Woolfenden4Ingrid Tyler5Lynn A. Kemp6School of Women’s and Children’s Health, The University of New South Wales, Sydney, NSW; Ingham Institute of Applied Medical Research, Liverpool, NSW; Charles Perkins Centre, Menzies Centre for Health Policy, Discipline of Child and Adolescent Health, and School of Public Health, University of Sydney, Sydney, NSW; Sydney Institute for Women, Children and their Families, Sydney, NSW; Community Health Services, Sydney Local Health District, Level, Camperdown, NSWSchool of Humanities, Nanyang Technological UniversityCommunity Health Services, Sydney Local Health District, Level, Camperdown, NSWSchool of Women’s and Children’s Health, The University of New South Wales, Sydney, NSW; Ingham Institute of Applied Medical Research, Liverpool, NSW; Community Health Services, Sydney Local Health District, Level, Camperdown, NSW; Discipline of Child and Adolescent Health, School of Medicine, University of Sydney, NSWSchool of Women’s and Children’s Health, The University of New South Wales, Sydney, NSW; Ingham Institute of Applied Medical Research, Liverpool, NSW; Sydney Children’s Hospital Network, SydneyDana Lana School of Public Health, University of Toronto, Toronto, ON; Fraser Health Authority, Surrey, BCIngham Institute of Applied Medical Research, Liverpool, NSW; Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Locked Bag, NSWIntroduction: Intergenerational cycles of poverty, violence and crime, poor education and employment opportunities, psychopathology, and poor lifestyle and health behaviours require innovative models of health care delivery to break them. We describe a programme of research informed service development targeting vulnerable families in inner metropolitan Sydney, Australia that is designed to build and confirm a “Theory of Neighbourhood Context, Stress, Depression, and the Developmental Origins of Health and Disease (DOHaD)”. We describe the development of an intervention design and business case that drew on earlier realist causal and programme theoretical work. Methods: Realist causal and programme theory were used to inform the collaborative design of initiatives for vulnerable families. The collaborative design process included: identification of desirable and undesirable outcomes and contextual factors, consultation forums, interagency planning, and development of a service proposal. Results: The design elements included: perinatal coordination, sustained home visiting, integrated service model development, two place-based hubs, health promotion and strengthened research and analysis capability. Conclusions: We demonstrate here the design of interventions for vulnerable families in Sydney utilising translational research from previous realist causal and program theory building to operational service design. We have identified the importance of our earlier analysis of underlying causal mechanisms and related programme mechanisms for identifying the elements for the full intervention design. The application of theory added rigour to the design of the integrated care initiatives. In applying the theory to the local situation the analysis took into account: the role of the local agencies; evidence of program effectiveness; determinants and outcomes for local children and their families; the current deployment of service resources; and insights from front-line staff and interagency partners.https://www.ijic.org/articles/3963critical realismevaluationtheorydevelopmental origins of health and diseaseneighbourhoodsocial epidemiologytranslational epidemiologycollaborative designchildfamilies |
| spellingShingle | John G. Eastwood Denise E. De Souza Miranda Shaw Pankaj Garg Susan Woolfenden Ingrid Tyler Lynn A. Kemp Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia International Journal of Integrated Care critical realism evaluation theory developmental origins of health and disease neighbourhood social epidemiology translational epidemiology collaborative design child families |
| title | Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia |
| title_full | Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia |
| title_fullStr | Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia |
| title_full_unstemmed | Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia |
| title_short | Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia |
| title_sort | designing initiatives for vulnerable families from theory to design in sydney australia |
| topic | critical realism evaluation theory developmental origins of health and disease neighbourhood social epidemiology translational epidemiology collaborative design child families |
| url | https://www.ijic.org/articles/3963 |
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