Literature review

Evidence-based service modules for a sustained home visiting program

1 Jul 2013

The Centre for Community Child Health (CCCH) at the Murdoch Childrens Research Institute and the Royal Children’s Hospital has undertaken two literature reviews to inform the design of a sustained home visiting program for vulnerable families with young children; the program is now known as 'right@home'. This project is being led by a collaboration between three organisations: The Australian Research Alliance for Children and Youth (ARACY), CCCH, and the University of New South Wales.

The first literature review undertaken by CCCH (Sustained home visiting for vulnerable families and children: A review of effective programs (McDonald et al., 2012) (hereon in referred to as the Home visiting review of effective programs) sought to answer the question ‘what works in home visiting programs?’ The conclusion reached was that it was not possible to answer the question definitively, either because the evidence regarding the ‘components’ of home visiting programs is contradictory or contested, or the evidence is not available.

As the home visiting review of effective programs focused on what was delivered (ie. the efficacy of different manualised programs), rather than how services were delivered (ie. the effect of the manner in which services were delivered and the nature of the relationships established between service providers and parents), a second literature review was undertaken: Sustained home visiting for vulnerable families and children: A literature review of effective processes and strategies (Moore et al., 2012) (hereon in referred to as the Home visiting review of effective processes and strategies).

The home visiting review of effective processes and strategies identified converging evidence from a number of sources to support the idea that the process aspects of service delivery matter for outcomes – how services are provided is as important as what is provided. A number of key elements of effective service delivery processes have been repeatedly identified in the research literature and these represent the threshold features or bedrock on which all services should be based: if services are not delivered in accordance with these process features, then efforts to change people’s behaviour will be less effective (Moore et al., 2012).

The evidence also indicated that the identification of goals, and of strategies to achieve these goals, needs to be done in partnership with parents. However, while the ultimate choice of strategies should be made by parents, the strategies on offer used must be evidence-based. Therefore, service providers should be able to draw on a suite of evidence-based strategies to address the range of challenges that parents face in caring for their children (Moore et al., 2012). In the light of the findings of this second literature review, it was decided that the right@home home visiting program would not involve the delivery of a manualised program. Rather, service delivery would be based on the processes of effective engagement and partnership, while the content of the program would take two forms: standard modules that are delivered to all participants, and e.g. information on the stages of child development), and evidence-based ‘service modules’ (i.e. specific strategies) that could be deployed to address issues that are of particular concern to individual parents. 

Related identifer: ISSN 2204-3403

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