Measuring success: program fidelity of Queensland’s child health home visiting services. A document analysis
Nicole Latham
A B , Jeanine Young C D * , Josephine Wilson C and Michelle Gray B E
A Digital Health, Sunshine Coast Hospital and Health Service, Birtinya, Qld 4575, Australia.
B School of Health, University of the Sunshine Coast, Sippy Downs, Qld 4556, Australia.
C School of Health, University of the Sunshine Coast, Petrie, Qld 4502, Australia.
D Sunshine Coast Health Institute, Birtinya, Qld 4575, Australia.
E Edith Cowan University, Joondalup, WA 6027, Australia.
Australian Journal of Primary Health - https://doi.org/10.1071/PY23002
Submitted: 7 January 2023 Accepted: 30 June 2023 Published online: 20 July 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: The Family CA.R.E. (Community-based Assistance Resourcing and Education) program was introduced in Queensland two decades ago. It aimed to redress health inequalities for infants from families experiencing specific social stressors. The program has been locally adapted over time and has not been evaluated against the original program. This study assessed the extent to which selected hospital and health services in Queensland, Australia have modified the original Family C.A.R.E. program.
Methods: Altheide’s model was used to facilitate a critical document analysis of policies and guidelines for adapted Family C.A.R.E. home visiting programs in use by hospital and health services (target n = 7).
Results: Five of seven eligible services provided service model documentation. There was low alignment with the original Family C.A.R.E. program across four of the five participating services. While the program delivered within Service 4 was highly aligned to the structure and intent of the original model, variation to the program was still evident. Importantly, four of the five participating programs were not collecting evaluation measures.
Conclusions: Health services have adapted the original Family C.A.R.E program format to ‘fit’ the local service environment but have largely failed to collect data to facilitate evaluation. Inability to evaluate the program leads to uncertainty about program success and benefits as well as any unintended consequences for families engaging in unevaluated home visiting programs. This study highlights the importance of monitoring program fidelity and evaluating success given the potential ramifications for this vulnerable cohort and for health service delivery.
Keywords: care co-ordination, child health services, community health: nursing, document analysis, family C.A.R.E program, family health, maternal-child health, nurse home visiting.
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