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: | Journal Article |
| Language: | English |
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2020
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| Online Access: | https://hdl.handle.net/10356/142224 |
| _version_ | 1824453939064471552 |
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| author | Eastwood, John Graeme De Souza, Denise E. Shaw, Miranda Garg, Pankaj Woolfenden, Susan Tyler, Ingrid Kemp, Lynn A. |
| author2 | School of Humanities |
| author_facet | School of Humanities Eastwood, John Graeme De Souza, Denise E. Shaw, Miranda Garg, Pankaj Woolfenden, Susan Tyler, Ingrid Kemp, Lynn A. |
| author_sort | Eastwood, John Graeme |
| collection | NTU |
| 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 | 2025-02-19T03:14:23Z |
| format | Journal Article |
| id | ntu-10356/142224 |
| institution | Nanyang Technological University |
| language | English |
| last_indexed | 2025-02-19T03:14:23Z |
| publishDate | 2020 |
| record_format | dspace |
| spelling | ntu-10356/1422242020-06-17T08:00:32Z Designing initiatives for vulnerable families : from theory to design in Sydney, Australia Eastwood, John Graeme De Souza, Denise E. Shaw, Miranda Garg, Pankaj Woolfenden, Susan Tyler, Ingrid Kemp, Lynn A. School of Humanities Humanities::General Critical Realism Evaluation 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. Published version 2020-06-17T08:00:32Z 2020-06-17T08:00:32Z 2019 Journal Article Eastwood, J. G., De Souza, D. E., Shaw, M., Garg, P., Woolfenden, S., Tyler, I., & Kemp, L. A. (2019). Designing initiatives for vulnerable families : from theory to design in Sydney, Australia. International Journal of Integrated Care, 19(3), 9-. doi:10.5334/ijic.3963 1568-4156 https://hdl.handle.net/10356/142224 10.5334/ijic.3963 31367208 2-s2.0-85070379804 3 19 en International Journal of Integrated Care © 2019 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/. application/pdf |
| spellingShingle | Humanities::General Critical Realism Evaluation Eastwood, John Graeme De Souza, Denise E. Shaw, Miranda Garg, Pankaj Woolfenden, Susan Tyler, Ingrid Kemp, Lynn A. Designing initiatives for vulnerable families : from theory to design in Sydney, Australia |
| 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 | Humanities::General Critical Realism Evaluation |
| url | https://hdl.handle.net/10356/142224 |
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