The Role of Structured Social Relationships in Supporting the Health Service Engagement of Isolated or Marginalised Families of Young Children in Australia

Introduction: Up to one third of parents with young children reportedly experience prolonged periods of emotional distress and feelings of isolation (Strange et al., 2014). Previous research demonstrates the fundamental importance of belonging and community connection to health and wellbeing (Holt-Lunstad et al., 2010), and the increased risk of poor health outcomes for families who are marginalised or at high risk of social isolation, such as those who are new arrivals to a country (Amigo, 2012) or include children with disabilities (Grace et al., 2008). This paper describes a place-based intervention strategy designed to reduce the isolation and barriers to health and community service engagement of marginalised families with young children. Trained community volunteers were matched with families in need of support. They provided weekly home visits for between 3 and 12 months, with the aim of promoting good parenting practices and connecting families with local services. Facilitating service engagement is key to addressing health disparities for community members who are isolated.

Methods: A randomised controlled trial was conducted in seven sites across four states of Australia (N = 313). The research explored the effectiveness of manual-guided volunteer home visiting as a place-based strategy for strengthening inclusive community networks, both social and professional, for those who reported feeling isolated or marginalised. Families self-referred or were referred to the study by local service professionals, such as GPs or Child and Family Health Nurses. Families did not qualify for the study if they required tertiary level service support (e.g. there was uncontrolled mental illness or child protection concerns). Data was collected every three months, from Baseline to 15 months post program entry.

Results: The participant group included families from culturally and linguistically diverse backgrounds (24.6%), Indigenous families (4.8%), and families of children with high support needs (15.7%). The intention to treat analysis demonstrated a significant increase for the intervention group in parenting sense of competence (p < 0.02), and in parent reports of guidance available to them (p < 0.01). Good effect sizes were demonstrated on measures of community connectedness and social support. This presentation will draw on both qualitative and quantitative data, giving particular focus to the impact of this program on engagement with health services.

Conclusions: This study supports the role of community volunteers in supporting improved outcomes for families who are isolated or marginalised, particularly as this relates to addressing barriers to engagement with health and other services.