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Title: Designing initiatives for vulnerable families : from theory to design in Sydney, Australia
Authors: Eastwood, John Graeme
De Souza, Denise E.
Shaw, Miranda
Garg, Pankaj
Woolfenden, Susan
Tyler, Ingrid
Kemp, Lynn A.
Keywords: Humanities::General
Issue Date: 2019
Source: Eastwood, J. G., De Souza, D. E., Shaw, M., Garg, P., Woolfenden, S., Tyler, I., & Kemp, L. A. (2019). Designing initiatives for vulnerable families : from theory to design in Sydney, Australia. International Journal of Integrated Care, 19(3), 9-. doi:10.5334/ijic.3963
Journal: International Journal of Integrated Care
Abstract: Introduction: 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. Methods: 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. Results: 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. Conclusions: 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.
ISSN: 1568-4156
DOI: 10.5334/ijic.3963
Rights: © 2019 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See
Fulltext Permission: open
Fulltext Availability: With Fulltext
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