A mixed-method evaluation of Cradle to Kinder: An Australian intensive home visitation program for families experiencing significant disadvantage

Abstract

Cradle to Kinder is an Australian intensive, long-term, home visitation program that supports young families experiencing multiple stressors, including poverty, family violence, mental illness, substance use, childhood trauma, intellectual disability, child projection involvement, teenage pregnancy, or social isolation, which places them at high risk of child removal. The program adopts a multidisciplinary, whole-of-family and trauma-informed approach to provide families with long-term case management, practical support and evidence-based therapeutic parenting interventions from pregnancy for up to four years to address these underlying risk factors. The aim of this study was to evaluate: (1) the extent to which families experienced improvements in family, caregiver and infant wellbeing outcomes after 24 months engagement; and (2) caregivers’ experiences of the program. A mixed-method evaluation was employed, which included two components: (1) uncontrolled pre-post quantitative assessment for 57 families using the North Carolina Family Assessment Scale and Brigance Early Child Development Assessment, completed every six months; and (2) qualitative interviews with 14 caregivers engaged in the program. The quantitative findings showed significant improvements in key domains of family functioning, parenting capabilities, infant development, and family preservation. The qualitative results validated these findings as caregivers reported favourable outcomes via participation in the program, including improved parenting skills and confidence, personal wellbeing, and child development. Suggestions for program development included greater support for fathers, increased cultural awareness, and consistency in workers. This mixed-methods study provides support for Cradle to Kinder as a promising model of family support that can improve family functioning, caregiver and child wellbeing, and prevent child removal among families experiencing significant disadvantage. These findings support the ongoing delivery of Cradle to Kinder in Australia to ensure families at greatest risk receive the support they urgently need.