Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia.

child collaborative design critical realism developmental origins of health and disease evaluation families neighbourhood social epidemiology theory translational epidemiology

Journal

International journal of integrated care
ISSN: 1568-4156
Titre abrégé: Int J Integr Care
Pays: England
ID NLM: 101214424

Informations de publication

Date de publication:
25 Jul 2019
Historique:
entrez: 2 8 2019
pubmed: 2 8 2019
medline: 2 8 2019
Statut: epublish

Résumé

Intergenerational cycles of poverty, violence and crime, poor education and employment opportunities, psychopathology, and poor lifestyle and health behaviours require innovative models of health care delivery to break them. We describe a programme of research informed service development targeting vulnerable families in inner metropolitan Sydney, Australia that is designed to build and confirm a "Theory of Neighbourhood Context, Stress, Depression, and the Developmental Origins of Health and Disease (DOHaD)". We describe the development of an intervention design and business case that drew on earlier realist causal and programme theoretical work. Realist causal and programme theory were used to inform the collaborative design of initiatives for vulnerable families. The collaborative design process included: identification of desirable and undesirable outcomes and contextual factors, consultation forums, interagency planning, and development of a service proposal. The design elements included: perinatal coordination, sustained home visiting, integrated service model development, two place-based hubs, health promotion and strengthened research and analysis capability. We demonstrate here the design of interventions for vulnerable families in Sydney utilising translational research from previous realist causal and program theory building to operational service design. We have identified the importance of our earlier analysis of underlying causal mechanisms and related programme mechanisms for identifying the elements for the full intervention design. The application of theory added rigour to the design of the integrated care initiatives. In applying the theory to the local situation the analysis took into account: the role of the local agencies; evidence of program effectiveness; determinants and outcomes for local children and their families; the current deployment of service resources; and insights from front-line staff and interagency partners.

Identifiants

pubmed: 31367208
doi: 10.5334/ijic.3963
pmc: PMC6659580
doi:

Types de publication

Journal Article

Langues

eng

Pagination

9

Déclaration de conflit d'intérêts

The authors have no competing interests to declare.

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Auteurs

John G Eastwood (JG)

School of Women's and Children's Health, The University of New South Wales, Sydney, NSW, AU.
Ingham Institute of Applied Medical Research, Liverpool, NSW, AU.
Charles Perkins Centre, Menzies Centre for Health Policy, Discipline of Child and Adolescent Health, and School of Public Health, University of Sydney, Sydney, NSW, AU.
Sydney Institute for Women, Children and their Families, Sydney, NSW, AU.
Community Health Services, Sydney Local Health District, Level, Camperdown, NSW, AU.

Denise E De Souza (DE)

School of Humanities, Nanyang Technological University, SG.

Miranda Shaw (M)

Community Health Services, Sydney Local Health District, Level, Camperdown, NSW, AU.

Pankaj Garg (P)

School of Women's and Children's Health, The University of New South Wales, Sydney, NSW, AU.
Community Health Services, Sydney Local Health District, Level, Camperdown, NSW, AU.
Discipline of Child and Adolescent Health, School of Medicine, University of Sydney, NSW, AU.

Susan Woolfenden (S)

School of Women's and Children's Health, The University of New South Wales, Sydney, NSW, AU.
Ingham Institute of Applied Medical Research, Liverpool, NSW, AU.
Sydney Children's Hospital Network, Sydney, AU.

Ingrid Tyler (I)

Dana Lana School of Public Health, University of Toronto, Toronto, ON, CA.
Fraser Health Authority, Surrey, BC, CA.

Lynn A Kemp (LA)

Ingham Institute of Applied Medical Research, Liverpool, NSW, AU.
Translational Research and Social Innovation (TReSI), School of Nursing and Midwifery, Western Sydney University, Locked Bag, NSW, AU.

Classifications MeSH