Kwanlin-Dun First Nations Healthy Families project

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Categories associated with best practice:

  • Community
  • Health Equity
  • Individual
  • Organization
  • wtt_ico
  • Infancy (ages 0-2) icon
  • Early Childhood (ages 3-5) icon
  • Children (ages 6-12) icon
  • Teens (ages 13-18) icon
  • Young Adult (ages 19-24) icon
  • Adult (ages 25-64) icon
  • Seniors (ages 65+) icon
  • Canada
  • English

Overview

Intense home visits with parents of children aged 0-6 who were considered at high risk for future criminal behaviour and victimization.

The vision of the Healthy Families America program is to offer all new parents support when their babies are born and to offer those parents facing the greatest challenges intensive home visitation services. The program emphasizes the importance of collaboration and integration with, and building onto, existing service delivery systems.

Healthy Families America is an intensive family visitor program designed to aid new parents in helping to ensure that their children have a healthy start. The home visits are tailored to the needs of each family, conducted by family support workers. Each visit consists of three major components: parenting, child development and parent-child interaction.

The program promotes positive parenting and child health and development, thereby preventing child abuse and other poor childhood outcomes. The program targets overburdened families with economic, social, language or cultural barriers and helps them to achieve optimum development and health. It focuses on identifying “at risk” families in need of support, based on a screening process for new mothers. The aim is to reduce the multiple risk factors associated with anti-social behaviour, delinquency and criminal behaviour, child abuse, neglect, poor parenting skills, exposure to domestic violence and parental criminality.

Kwanlin-Dun First Nations Healthy Families program started accepting referrals in March 1999. The Healthy Families program is part of the First Nation Health Programs, which are under the umbrella of the First Nation administration. The programs in this area and under the same manager include the Community Health Nursing Program, the Community Health Representative Program, the Daycare, a Headstart Program, and the Wellness Centre, which includes drug and alcohol, individual and family counseling services, as well as residential school survivor interventions. There are two family support workers and a co-ordinator. The co-ordinator has a Bachelor’s degree in education as well as background in administration and criminology; she is in the last year of studies for Bachelor of Social Work degree; and in addition, she has over 10 years of work experience.

Kwanlin Dun offers a universal program assuming all First Nations clients with new babies need the services. Families already involved in Child Welfare are also involved on a case-by-case basis. Community health nurses or physicians refer clients during pregnancy. In some cases, the family support workers hear about pregnancies or new people moving into the community through word of mouth. Potential clients are then approached and, if they are interested, the screen is completed.

The Kwanlin-Dun First Nations Healthy Families program is wholistsic in that the focus on Mind includes: parenting, child development and parent-child interaction; Body includes: morbidity, physical gains, immunization, preventative health; Emotion includes: systematically assess families of newborns for strengths, needs, and risks, and refer as needed; Spirit includes: enhance family functioning by building trusting relationships, teaching problem solving skills, and improving the family’s support system; Environments include: school referrals, participation in community systems, home visiting; Nature of Target is extensive: children, youth, parents, families, family connections to other organizations; and Cross Sector focus is on family planning, education, employability, complex assessment of child.

The client population is all parents of newborns living in the First Nation community or First Nation people outside the community. The program is universal; it is offered to all families regardless of their risk level because, at the proposal stage, it was decided that all families in the client group were at a significant level of risk and that the numbers were low enough to accommodate all interested families. The Yukon program makes the decision to include families with Child Welfare involvement on a case-by-case basis, depending on where the child is to be provided care, the status of the file, and the probability of early return of the child among other factors. So far, no family has had service discontinued as a result of Child Welfare involvement (unless the child has been permanently removed from the home). Community health nurses or physicians refer clients during pregnancy. In some cases, the family support workers hear about pregnancies or new people moving into the community through word of mouth. Potential clients are then approached and, if they are interested, the screen is completed.

The key issue underlying the Healthy Families project is whether early experiences and intervention make a difference to later occurrence of delinquency or crime. According to a review of developmental and early approaches conducted in Australia, there is evidence to support this assertion. The results of Healthy Families and other home visitation programs, however, have been less clear. This may be due to the reality that programs based on the same model may implement service differently or find it more difficult to engage families over long periods of time thus hindering effectiveness (Behrman, 1999; Duggan et al., 1999). Further, according to Gomby (1999), the very nature of these early intervention programs can make them difficult to evaluate. Gomby (1999) suggests the tailoring of service content and delivery that occurs in home visitation programs may obscure differences across a group of individuals, because, in fact, the group is not receiving the same treatment.

Primary Source Document

Sherry Elnitsky, M.A.; Joseph P. Hornick, Ph.D.; Lorne D. Bertrand, Ph.D.; Michael C. Boyes, Ph.D.; Heather Wagner, B.A.; P. Gaye Hanson, B.Sc.N, M.P.A.; Brenda Bradford, B.A.; Canadian Research Institute for Law and the Family, EVALUATION OF HEALTHY FAMILIES PROGRAMS IN SELECTED SITES ACROSS CANADA Canadian Research Institute for Law and the Family (CRILF)

Contact information of developer(s) and/or implementer(s)

Canadian Research Institute for Law and the Family, Tel: 403-216-0340; Email: crilf@ucalgary.ca; Calgary, Alberta, Canada

Intervention Focus

Intervention Goal / ObjectiveLevel(s) TargetedEquity Focus
Education/skill development
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Social environmental support
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.
Tailored family home visits
  • Individual level
  • Interpersonal level
People living in conditions of disadvantage are explicitly stated to be a target population of the intervention.

Health Issue(s) that is/are addressed by the Intervention

Health Promotion

    Risk Reduction

      Specific Activities of the Intervention

      • Advocacy for policy or policy changes
      • Educational health information offered
      • Training offered to deliver the intervention
      • Partnership development

      Priority/Target Population for Intervention Delivery

      Life Stage

      • All ages

      Settings

      Educational Settings

        Community Setting

          N/A

          Outcomes

          Outcomes and Impact Chart
          Level of ImpactDescription of OutcomeEquity Focus
          Individual Level35% of the comparison group reported child welfare involvement during the time of the study compared to only 5% of Best Start clients.Outcomes reported for people living in conditions of disadvantage are compared to outcomes for people living in more advantaged conditions.
          Individual LevelParents felt that social support they received did help them become more child-focused, strengthened their ability to cope and helped them build relationships with others.Outcomes reported for people living in conditions of disadvantage are compared to outcomes for people living in more advantaged conditions.
          Interpersonal LevelFour of the five sites demonstrated improvements in family functioning. The data showed that parents’ expectations of their children, their levels of empathy and beliefs about punishment changed across all programs.Outcomes reported for people living in conditions of disadvantage are compared to outcomes for people living in more advantaged conditions.
          Interpersonal LevelParents felt that the best parts of the program were learning about child development and parenting; learning about and gaining access to community services; and their relationship with the family support worker.Outcomes reported for people living in conditions of disadvantage are compared to outcomes for people living in more advantaged conditions.

          Adaptability

          Implementation History

          • Multiple implementations - Different settings/populations/providers - The intervention showed significant adaptability as it has been implemented in different settings or with different populations or by different provider(s). This can include multiple implementations during the same time period. Each implementation of the intervention must have been substantially the same and must have demonstrated positive results for the primary objectives of the intervention.

          Expertise Required for Implementation within the Context of the Intervention

          • Specialized skills training provided as part of the Intervention - The intervention does not require individuals or groups with highly specialized training, but requires that individuals or groups be trained as part of the implementation of the intervention.

          Are there supports available for implementation

          Yes. Kwanlin Dun accessed funding from the regional government

          Are there resources and/or products associated with the interventions

          Yes. Training guides, implementation guides