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National evaluation (2004–2008) of the Stronger Families and Communities Strategy 2004–2009

4. Communities for Children service outcomes

4.1 Availability of services
4.2 Focus of services
4.3 Service capacity
4.4 Service reach: increasing family access and engagement in services
4.5 Challenges in service provision

Communities for Children (CfC) was the most rigorously evaluated component of the SFCS 2004–2009. Sections 4 to 7 of the report describe the outcomes of CfC for families, children and communities, and for services and the early childhood sector. They describe aspects of the model that were instrumental in achieving these outcomes, specifically the Facilitating Partner, the funding and the community focus, and the broader challenges faced by CfC.

CfC resources increased the number, type and capacity of services available to people in the 45 target communities. These resources, coupled with aspects of the model like community consultation and service coordination, helped to enhance the capacity, quality and relevance of services for community members.28

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4.1 Availability of services

As expected, interviews with CfC stakeholders, CfC progress reports and the service mapping all indicate that services increased substantially throughout the program. The Facilitating Partners in the 45 communities reported receiving funding for a total of 641 CfC funded activities (up to December 2007, CfC progress reports). On average, each CfC site funded 14.2 new activities (Table 1).

Table 1: Number of CfC-funded activities in the 45 CfC sites by December 2007
  Activities
Total number 641
Mean per site 14.2
Source: CfC progress report data.  

The finding that services in CfC communities increased was supported by the service mapping exercise. Between December 2005 and November 2007 the total number of services mapped by Facilitating Partners within their communities increased by 12 per cent.29 While some of this increase may have been the result of other funding streams, the figures above (Table 1) demonstrate that CfC made a large contribution to increasing services.

The service coordination survey also indicates growth in CfC-funded services between 2006 and 2008. Agencies that completed the survey were significantly more likely to be receiving CfC funding in 2008 than in 2006 (Table 2). These agencies represent only those services identified in the service mapping and who participated in the survey. They do not represent all services in the CfC communities. When the CfC progress report, service mapping and qualitative interview data are triangulated, however, it is clear that there were substantial increases in service provision as a result of CfC.

Table 2: Service coordination respondents providing services funded by CfC
  Wave 1 Wave 2
(%) n (%) n
All agencies (a) 33 383 51 302
Repeat agencies (b) 32 75 55 75
(a) p<0.001.
(b) p<0.01.

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4.2 Focus of services

Services devoted to 0 to 5 year olds

The proportion of agencies' activities devoted to 0 to 5 year olds and their families remained consistently high throughout the evaluation. Based on the Service Coordination Study,30 between 2006 and 2008 there was a slight increase in the proportion of agencies that provided more than half of their services specifically for 0 to 5 year olds. In 2006, 60 per cent of the 376 agencies who completed the service coordination survey were delivering half or more of their services to children 0 to 5 years. By 2008, this had increased to 63 per cent (n=302; Table 3).

Interestingly, there was a slight decrease in the proportion of agencies who completed surveys in Wave 1 and 2 devoting half or more of their services to 0 to 5 year olds (from 66 per cent to 61 per cent; Table 3). These changes were not significant and so the results are not incompatible with agencies committing consistently high proportions of their services to 0 to 5 year olds. The slight decrease may be the result of sample bias, or of services increasing their age focus beyond 5 years. The qualitative interviews found that some stakeholders believed that CfC did not include prenatal maternal health, and that its scope should have been expanded to include that, and also to include 5 to 8 year olds to incorporate the transition to primary school years.

Table 3: Agency activity in the local government area/CfC site specifically devoted to services for 0 to 5 year olds and their families
All agencies(a) Repeated agencies(a)
  Wave 1 (%) Wave 2 (%) Wave 1 (%) Wave 2 (%)
All or most of it 49 51 52 51
About half 11 12 14 10
Some or very little 40 38 34 40
n 376 302 73 73
(a) Results not significant.
Note: All columns add to 100 per cent except in cases of rounding error.

The proportion of services devoted to children aged 0 to 5 years and their families was similar both for CfC consortium members and for agencies which provided services funded under CfC.31 Interestingly, agencies that were not involved with CfC in any capacity reported a slight, non-significant decrease in the proportion of services devoting half of more of their services specifically for 0 to 5 year olds (repeat agencies, 66 per cent to 61 per cent). The reasons stated above could also apply to this group, but the slight drop might also have been partly the result of shifting the focus to other areas of need, since there was a large local investment into services for 0 to 5 year olds in communities targeted by CfC.

Activities and priority areas

CfC activities focused on a range of areas, but were specifically targeted to tackle the SFCS priority areas. Analysis of the CfC progress report data found that the proportion of CfC-funded activities was fairly evenly divided across priority areas (Table 4). The greatest focus for activities was on creating child-friendly communities (24 per cent). The other priority areas each attracted just over one-fifth of the activities (20 to 22 per cent). The exception was 'family and children's services work effectively as a system', which consisted of 13 per cent of all activities. This was understandable, since most CfC sites were working collaboratively to address the other priority areas rather than making collaboration and coordination a particular activity in itself. It should also be noted that many of the funded activities covered more than one priority area.

Table 4: Proportion of activities by priority area
Priority area Proportion of total activities (%)
Child-friendly communities 24
Supporting families and parents 22
Early learning and care 21
Healthy young families 20
Family and children's services work effectively as a system 13
Total 100

Services focused on target groups

A number of programs funded by CfC were either developed or expanded specifically for Indigenous families and children. Increases were accounted for by new services, the expansion of existing services, and the re-establishment of services disbanded through lack of funding prior to CfC (see Flaxman, Muir & Oprea 2009). Similarly, service providers interviewed for the Engaging hard-to-reach families and children and Engaging fathers in child and family services studies reported that SFCS had increased services specifically tailored for people from disadvantaged and marginalised groups, and for fathers (Berlyn, Wise & Soriano 2008; Cortis, Katz & Patulny forthcoming).

Box 1: Examples of CfC activities around Australia

Community nutrition initiative, Inala to Goodna, Queensland
A community garden was developed to engage families from culturally and linguistically diverse (CALD) backgrounds around health and nutrition. This activity attracted almost 300 participants and was reported to increase knowledge about nutrition and its benefits, and to improve social connectedness in the community.

Strengthening attachment and bonding, Lismore, News South Wales
This activity built community-based supports to strengthen attachment and to ensure that early professional support was available for parents suffering attachment difficulties such as ante or post-natal distress, or relationship difficulties. Most participants reported getting out of the house more often and becoming more involved in activities with their baby: 'I feel like a good mum for the first time in six months'.

Outreach nurse, Miller and surrounds, New South Wales
This activity provided access to early childhood nurse support and information through attendance at a playground within the CfC site. Taking the practitioner to an informal child-friendly setting was a common, successful soft entry practice used by CfC-funded Community Partners. The outreach nurse in Miller increased the number of children 0 to 5 years having regular assessments by a child and family nurse.

'HIPPY', Burnie and surrounds, Tasmania
An evidence-based, structured program that provided intensive education and support to parents with children 0 to 5 years. Parents learnt to spend time with their children in activities that enhanced cognitive and social–emotional development. Positive parent–child interactions occurred and parents were encouraged to perceive themselves as the primary educators of their children 0 to 5 years.

Early learning Warmun, East Kimberly, Western Australia
This activity supported the Warmun Early Learning Centre to develop evidence-based programs to achieve positive educational outcomes for children 2 to 5 years. Reports have stated that the activity has assisted Indigenous children's transition to school and contributed to children's ability to communicate in both standard and Aboriginal English.

Linking families and services, Onkaparinga, South Australia
This project linked high-needs groups (such as homeless families, families where a family member has a disability, and recently settled migrants and refugees) into mainstream services like playgroups and kindergartens. The project also established a playgroup for male carers and their children.

Aboriginal dads project, Port Augusta, South Australia
This project developed culturally appropriate ways of working with new and young Aboriginal fathers to increase father involvement in the lives of their children (0 to 5 years) and demonstrate the effect of father involvement on the wellbeing of children.

Transition from schools to hubs, Bendigo, Victoria
This project promoted the development of school hubs within the CfC site area and developed partnerships between a range of service providers working for different agencies in the early childhood sector. It also worked to engage families in CfC activities in the area.

The library has legs, Cranbourne, Victoria
An early years literacy and language librarian/outreach worker provided language and literacy programs to children, parents and care givers in different locations using the most appropriate strategies. The approach was tailored for each group, but was especially targeted towards disengaged families, as well as for children 0 to 5 years in child care centres, kindergartens, playgroups and other locations where children and families gather.

Core of life, Katherine, Northern Territory
This was a life education program that helped teenagers understand the realities of becoming pregnant, giving birth and parenting a newborn baby.

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4.3 Service capacity

The interviews conducted with CfC stakeholders indicated that CfC had not only increased service provision, but also improved service capacity. It had allowed providers to address some service gaps in their communities. For example, they were able to establish preventative services (such as including therapists in mainstream services), trial innovative programs (such as professional development for early years staff to work with vulnerable families), establish new ways of delivering services (such as locating family centres on public school grounds), and complement state-funded services.

Many CfC stakeholders working in communities with high proportions of Indigenous families reported that CfC had improved the relevance and quality of some services. This was because CfC enabled service providers to collaborate, implement cultural change, listen to and focus on community needs and deliver services with great flexibility (Flaxman, Muir & Oprea 2009). Similarly, there were benefits from SFCS for services working with marginalised and disadvantaged communities, and those working with fathers (as shown in the other themed studies) (Berlyn, Wise & Soriano 2008; Cortis, Katz & Patulny forthcoming).

The nature of the model had also enabled joint service provider and community member decision-making in program development, increased the focus on the aims and goals of activities and on strengths-based and community development models of working, and provided small organisations with experience in applying for government funding and implementing activities.32

Importantly, the increases in service provision and capacity were accompanied by an improvement in service access by families and children from groups considered hard-to-reach, or who were previously disengaged from early childhood services.

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4.4 Service reach: increasing family access and engagement in services

Recruitment and engagement of families by services was generally successful within CfC. Factors that contributed to this success were the:

These findings are based on the 222 interviews with CfC stakeholders and the themed studies (Berlyn, Wise & Soriano 2008; Cortis, Katz & Patulny forthcoming; Flaxman, Muir & Oprea 2009).

Consultation

The consultation process assisted Facilitating Partners and Community Partners to understand the needs and aspirations of community members and to design programs and implement services that supported these needs.

Funding

The funding for CfC was a critical component of its ability to increase service provision and engage families. Funding non-government organisations (NGOs) as Facilitating Partners and allocating the service funding to Community Partners may have played a pivotal role in the recruitment of some families. This is because families who fear removal of their children are more likely to engage with NGOs than with government providers (Cortis, Katz & Patulny forthcoming).

The SFCS funding also assisted families to overcome financial and attitudinal barriers to accessing services. There were reports from CfC stakeholders in many different communities that there was a widespread lack of understanding of the importance of early childhood, which hindered service access and outcomes. Coupled with the financial cost of early childhood services, this may have prevented some families from accessing services. The provision of free or very low-cost early childhood services through SFCS 2004–2009 may have assisted in demonstrating the value of these services to families.

Service coordination

The strong focus on service coordination was very important for increasing people's access to services. It allowed services to recruit people through single entry points and helped them find clients through interorganisational referrals. This was particularly useful in increasing access to services for people from specific groups who generally have poor levels of service use, such as Indigenous Australians (Flaxman, Muir & Oprea 2009).

CfC stakeholders maintained that referrals between organisations were working effectively. Trust in service providers was the most important factor for ensuring that referrals resulted in actual take-up of services. It may not be enough for a service provider to simply refer a family or individual to another service. Additional support, such as transportation or accompanying the family members to the appointment or service, might also be required.

Service providers, however, should be aware that staff who are trusted by specific families can easily become overburdened with the responsibility of facilitating relationships with other service providers. This is likely to occur in communities where there is only one outreach worker assisting a large hard-to-reach group (such as Indigenous families).

Targeted and universal services

SFCS 2004–2009 benefited from having both targeted and universal services. Some CfC funding was allocated to develop and deliver early interventions for people from specific groups. These types of targeted programs and activities provided safe, welcoming service environments.

Universal services within the disadvantaged CfC communities were also important in increasing widespread access to services. Increases in service use were hindered, however, when large proportions of a community's population perceived the service as inaccessible or unwelcoming. This occurred when mainstream programs did not develop strategies for including people from diverse backgrounds. Service providers in a number of CfC communities, for example, explained that Indigenous families were aware of new programs in their community, but did not access them because they were not seen as culturally appropriate and, consequently, Indigenous families perceived them as unsafe or uncomfortable.

The importance of multiple entry points—that is, both targeted and universal programs—should not be underestimated. Access to both service types will increase the likelihood of service use (where one is favoured over the other), help ensure that families have equal access to a variety of services (especially where a mainstream provider has increased resources or expertise), and assist in building social capital (by creating opportunities for people from different backgrounds to meet and engage in formal and informal settings).

CfC intervention design and practice

The design of services was essential for recruiting and engaging participants. In many locations, CfC stakeholders believed the initiative was successful in engaging families who were historically unlikely to access services, and attributed that success to the widespread use of soft entry points.

Soft entry points refer to ways of introducing families to services in informal environments within their own communities. Rather than expecting families to come to services, soft entry approaches take traditionally formal services into familiar, non-threatening locations where families are used to gathering. Examples of such approaches used by CfC service providers included introducing playgroups in local parks, having health professionals attend playgroups, setting up community centres on public school grounds, collocating CfC services with established services such as a public libraries, and advertising services and collecting family contact details in places where people from all backgrounds gathered, such as shopping centres, sporting fields and maternity wards.

CfC stakeholders reported soft entry approaches to be very successful, although data problems with the CfC progress reports makes it difficult to assess the proportions of people from specific backgrounds who accessed CfC services and activities. Over time, it appears that the formal service delivery within informal settings increased in popularity as word-of-mouth spread and demand from community members increased.

The soft entry approach was closely tied to networking between service providers and to referrals. Parents became engaged via soft entry approaches and were then linked to other service providers within CfC and other organisations. A health worker employed as part of a soft entry CfC activity for example, discovered a life-threatening health problem in a child whose parents had had no previous connection to health services.

Staffing is critical in either facilitating or hindering engagement. Employing people with links to local communities increased the credibility of CfC services and activities. Having at least one project or outreach worker of a similar background to the target group and ensuring staff were appropriately skilled were also important. In contrast, many services were hindered by ongoing difficulties recruiting and retaining staff, as already mentioned.

Effective outreach and promotion in the appropriate locations, spending time to build relationships with people from vulnerable groups, providing incentives and supports such as food, transport and child care, and having flexible hours of operation, also worked well to engage families.

Designing services and engagement strategies for families from a range of backgrounds had positive results. Not only did Facilitating Partners and service providers report that people from diverse backgrounds received services, the Stronger Families in Australia (SFIA) findings (see Section 6) also demonstrate that CfC was beneficial for families and children from a range of backgrounds, including those traditionally regarded as hard-to-reach.

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4.5 Challenges in service provision33

Some CfC sites faced challenges in providing services, especially finding suitable service providers and staff, and tailoring services to better meet the needs of target families. A small number of planned activities were not implemented because of the lack of suitable service providers, the lack of capacity within a community organisation, or poor budgeting (by both Facilitating Partner and Community Partner organisations).34 Poor budgeting was sometimes addressed by reconsidering the aims, objectives, scope and resources required for an activity. Difficulties with staffing had a marked impact on CfC service delivery and capacity.

Other activities were discontinued because they did not meet contractual requirements. Again, there were only a small number of these. In most cases where services and activities could not meet their obligations to FaHCSIA, Facilitating Partners worked with Community Partners to refocus activities rather than discontinue them.

The themed studies also uncovered a range of challenges service providers faced in providing services to Indigenous families and children, fathers, and families from hard-to-reach groups (Berlyn, Wise & Soriano 2008; Cortis, Katz & Patulny forthcoming; Flaxman, Muir & Oprea 2009; Soriano, Berlyn & Wise 2008). The complexity of client needs and circumstances remains a challenge, despite the range of strategies employed by early intervention and prevention programs like CfC. Family breakdown, homelessness, housing instability or poor living conditions, domestic violence, substance use, severe socioeconomic disadvantage and mental illness, for example, are immediate and serious issues that understandably hinder some families in their ability to make use of early childhood intervention and prevention services. If early intervention and prevention initiatives are to have positive outcomes for people or communities in considerable distress, other social issues must also be addressed. Long-term government involvement and funding is also necessary to realise potential benefits and sustain positive outcomes of the program. Short-term initiatives are not only inadequate, they also build distrust in people when services they have come to rely on are withdrawn.

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