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Engaging hard-to-reach families and children

Executive summary

This report documents one of three themed studies undertaken as part of the national evaluation (2004–2008) of the Stronger Families and Communities Strategy (SFCS) 2004–2009 for the Department of Families, Housing, Community Services and Indigenous Affairs (FaHCSIA). The study explores how Communities for Children, Invest to Grow and Local Answers projects and activities have engaged clients who may be considered hard-to-reach. Using interviews with key informants in a sample of projects, the report explores the key research questions:

A background literature review shows the term hard-to-reach does not have precise meaning, but tends to be used in three ways to refer to:

The success of strategies that service providers use to engage and retain these three groups of hard-to-reach clients is important to evaluators, policy makers and service providers because these marginalised groups are often the main intended beneficiaries of interventions. It is also important to know who benefits from interventions because programs may achieve their goals by improving the wellbeing of those populations easiest to assist. Programs may therefore improve aggregate wellbeing but may exacerbate inequality if hard-to-reach populations are left behind. Another important reason for studying engagement with hard-to-reach families is to improve program design to meet the needs of the most vulnerable more effectively.

Background literature

A review of background literature highlights the individual, provider, program, neighbourhood and social factors affecting access and engagement of hard-to-reach groups in the early intervention field. Individual factors affecting service readiness and refusal include:

In terms of the provider factors that make a difference to reach and engagement, previous studies identify that service promotion strategies matter, along with appropriate outreach and entry points, staffing, and client-centred practice approaches in which relationship building plays a central role.

In terms of program factors, existing literature identifies funding and funding structures as most pertinent to engaging hard-to-reach groups. Whereas adequate, stable and long-term funding promotes smooth service delivery and reduces staff turnover, short-term funding can contribute to program instability which risks disrupting processes of relationship building with hard-to-reach groups. Other factors considered important include:

Literature also identifies neighbourhood and social factors as impacting on services for hard-to-reach families. Social norms and expectations, social disorganisation and poor social capital in a community can impede engagement, as can social and geographical isolation (and associated transport difficulties), the absence of a service network or ‘initiative fatigue’ in a community.

Who is hard-to-reach?

Most of the interview participants from Communities for Children, Invest to Grow and Local Answers identified Indigenous families as the most hard-to-reach group,1 along with young parents, fathers, and those not using other services. However, participant responses show that defining which groups are considered hard-to-reach depends on the context. Community context is especially important. In non-metropolitan settings, for example, isolated families and those with transport difficulties were identified as particularly hard-to-reach. Staffing resources and context also matter, with the presence of a liaison officer or outreach worker helping ensure that the intervention is able to engage with target populations. Some participants were also reluctant to label any groups as hard-to-reach, feeling the label detracts from the notion that client engagement is a responsibility of services not individuals.

Other factors that influence the specific definition of hard-to-reach concerns the groups that services are aimed at and how clients are recruited. Those targeting activities to the mainstream tended to find several groups underrepresented, including Indigenous people, young mothers and fathers. Many targeting particular populations (for example, culturally and linguistically diverse families or young parents) found subgroups within their target group to be hard-to-reach (for example, Afghan mothers or young fathers). In some instances, participants considered populations not part of the target group to be hard-to-reach. For example, in a project primarily (but not exclusively) targeting Indigenous young parents, non-Indigenous young parents were considered difficult to engage.

Strategies

Participants identified several strategies for engaging hard-to-reach families. These can be understood in three general categories:

In the first category, ensuring interventions were fulfilling relevant needs in the community emerged as important, along with effective outreach and promotion; ensuring non-stigmatising entry points and the use of natural gathering places; providing food and incentives; and spending the time required to build relationships with vulnerable groups. Networks and partnerships were also important for identifying needs, finding and reaching clients, building capacity, and ensuring continuity. In terms of staffing, strategies included employing community members and ensuring staff were appropriately skilled. For Communities for Children, participants believed the inclusive ethos of the program helped enable activities to be well adapted to meet community needs.

Challenges

Despite the strategies employed, several challenges to reach and engagement remained. Interview participants from Local Answers and Invest to Grow projects identified a series of factors that continue to impede their attempts to engage hard-to-reach populations. Some were finding it difficult to identify and reach clients, given their invisibility in services and in the community. Many also found the complexity of client needs and circumstances presented challenges to engagement, including family breakdown, homelessness, lack of education, family violence and substance use. Participants also highlighted perceptions and social stigma as barriers to engagement, along with transport, especially in non-metropolitan areas.

Staffing remains an outstanding challenge. Many services required outreach workers, and although they tried to ensure staffing difficulties did not affect service quality, there were ongoing difficulties in recruiting and retaining both generalist and specialist workers. Some felt these were exacerbated by the short-term nature of the projects. These shortages appeared more acute outside of metropolitan areas.

The short-term nature of funding also emerged as a challenge for how services could build relationships with hard-to-reach groups. Indigenous families and young people in particular were seen as requiring extra time to build rapport and trust. Extra funding to support after-hours work was seen as necessary for services seeking to engage fathers, whose working patterns meant services were required in the evening, which could strain staffing resources. Interview participants also described how initiative design and challenges in working with other services could also impact on hard-to-reach groups, with some new services in an area requiring extra time to build cooperation with local providers.

Overcoming challenges

In terms of additional supports required to overcome challenges, adequate and ongoing funding were seen as integral for properly serving hard-to-reach groups. Insecure, short-term funding was seen to contribute to staffing insecurity and risk disrupting relationship building. Participants also felt short-term funding and staffing instability constrained the commitment their services could make to vulnerable clients and the community. Many felt the timeframes expected of them were inadequate for building trust and relationships, and ensuring sustainable outcomes for the most vulnerable.

Overall effectiveness

Overall, interviewees from Local Answers, Invest to Grow and Communities for Children identified similar groups to be hard-to-reach, with participants from all programs highlighting that who is considered hard-to-reach depends largely on context. Many of the strategies employed to engage hard-to-reach groups were similar, such as employing outreach workers, using soft entry points, and collaborating with services working more closely with target groups. Challenges unresolved by the SFCS model include inadequate time to affect change, and staff shortages or instability which could disrupt relationship building.

Importantly, while these challenges are not fully resolved by the SFCS model, they cannot be clearly attributed to the SFCS programs. Rather, challenges of reach and engagement are likely to characterise services for families and children more generally. While it is difficult to compare each part of the strategy due to differences in research methodology used for each, evidence did not emerge suggesting Communities for Children, with its place-based and collaborative ethos, is vastly superior for reaching and engaging hard-to-reach groups. The recommendations arising relate to activities within all strategy programs and to the child and family service sector more generally, including the need for longer-term, more sustainable funding arrangements to minimise disruption to relationship building processes, promote staffing stability, and support specialist outreach workers.

Impact of Communities for Children on hard-to-reach families and children

In addition to the qualitative analysis outlined above, the Stronger Families in Australia (SFIA) dataset was analysed to assess the relative impact of Communities for Children on hard-to-reach and other families (who might not be considered hard-to-reach). Overall, the findings for both these groups were consistent with the main findings of SFIA—that the Communities for Children initiative had small but important positive impacts in most domains, with a few negative impacts, mainly in the physical health domain (possibly attributable to increased parental sensitivity to their children’s physical health issues). Hard-to-reach families were more likely to participate in community activities of various types, a particularly positive finding for Communities for Children. Parents who were not hard-to-reach, on the other hand, were much more likely to report increases in unmet service needs. These findings indicate that Communities for Children was equally effective for the general population in Communities for Children sites, hard-to-reach and not-hard-to-reach families. This confirms that the efforts of Communities for Children sites to engage with hard-to-reach families seem to have been effective.

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