How outreach facilitates family engagement with universal early childhood health and education services in Tasmania, Australia: An ethnographic study

Kim Jose,Catherine L Taylor,Alison Venn,Rachael Jones,David Preen,Paula Wyndow,M’Lynda Stubbs,Emily Hansen

doi:10.1016/j.ecresq.2020.05.006

Abstract

Tasmanian early childhood services (ECS) are attempting to improve their engagement with vulnerable families and increase the uptake of universal health and education services in this population. This paper presents qualitative findings from the Tassie project, focusing on the scope and role of outreach in supporting family engagement in the Tasmanian ECS. Using an ethnographic study design, over 100 naturalistic observations were recorded in health and education ECS settings in Tasmanian communities between April 2017 and February 2018. In addition, 42 ECS providers and 32 parents/guardians with pre-school aged children participated in semi-structured interviews. Interview transcripts and observation field notes were analysed thematically, focusing on family engagement and the role of outreach across three key universal ECS. Outreach was undertaken by all services involved in this study, but varied in practice and scope. Outreach was not directed at specific population groups, but was instigated in response to an identified need with more vulnerable families to address issues of inequity in service access. Policies and strategic frameworks within services provided little or no guidance about outreach beyond procedures for conducting home visits. Attending specialised services alongside parents, a strategy adopted by one service, was particularly effective for facilitating connection to services for vulnerable families. The capacity of services to offer outreach was constrained by structured service systems, individual providers’ skills and capability, resource limitations and lack of clarity with respect to policies and procedures. Outreach activities are occurring within the universal ECS system in Tasmania, facilitating engagement with vulnerable Tasmanian families and children. Flexible service systems, building the skills and capacities of service providers and clearer policies and procedures would enable services to more fully embed outreach practices within existing ECS.

Highlights

This study found that, while variable in practice, all early childhood services (ECS) in Tasmania were offering outreach activities as part of their universal service system and that outreach strategies were facilitating engagement with more vulnerable families
The focus was on increasing engagement with all families presenting as vulnerable or for whom access and engagement with their service was limited or had decreased
Despite outreach being offered by all services, and comprising a significant proportion (30–50%) of Child and Family Centres (CFCs) activity, a documentation review revealed that there was no guidance about the role of outreach in the practice frameworks for any of the three services resulting in a lack of clarity for service providers about the role of outreach within their practice

Summary

Introduction

In recent decades advances in neuroscience, biology, genetics and epigenetics have increased our understanding about brain development in the early years (Black et al, 2017; Shonkoff et al, 2012) These new insights have reinforced the importance of nurturing care, supportive environments and enriching experiences in the critical time windows in early childhood that affect human capability formation across the life course (Black et al, 2017; Caspi et al, 2016; Shonkoff et al, 2012).

Methods

Results

Conclusion