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. 2019 Jul 25;19(3):10.
doi: 10.5334/ijic.3980.

Designing an Integrated Care Initiative for Vulnerable Families: Operationalisation of Realist Causal and Programme Theory, Sydney Australia

John G Eastwood  1   2   3   4   5 , Miranda Shaw  4   5 , Pankaj Garg  1   2   5 , Denise E De Souza  6 , Ingrid Tyler  7   8 , Lauren Dean  9 , Morag MacSween  9 , Michael Moore  10
Affiliations

Designing an Integrated Care Initiative for Vulnerable Families: Operationalisation of Realist Causal and Programme Theory, Sydney Australia

John G Eastwood et al. Int J Integr Care. .

Abstract

Introduction: In July 2015 Sydney Local Health District (SLHD) implemented an integrated care initiative for vulnerable families in the Inner West region of Sydney, Australia. The initiative was designed as a cross-agency care coordination network that would ensure that vulnerable families: had their complex health and social needs met; kept themselves and their children safe; and were connected to society. We will describe the development of the design that drew on earlier realist causal and program theoretical work.

Methods: Realist causal and program theory were used to inform the collaborative design of an initiative for vulnerable families. The collaborative design process included: identification of desirable and undesirable outcomes and contextual factors, stakeholder consultation, interagency planning, and development of a service proposal.

Results: The design elements included: identification of vulnerable family cohorts; care coordination; evidence-informed intervention(s); general practice engagement and support; family health improvement; placed-based neighbourhood initiatives; interagency system change and collaborative planning; monitoring of individual and family outcomes; and evaluation.

Conclusions: The design study described advances toward the implementation of a whole-of-government integrated health and social care initiative. The initiative was designed as a cross-agency care coordination network that would ensure that vulnerable families: had their complex health and social needs met; kept themselves and their children safe; and were connected to society. In so doing we aim to break intergenerational cycles of poverty, violence and crime, poor education and employment opportunities, psychopathology, and poor lifestyle and health behaviours, through strengthening family resilience, improving access to services, and addressing the social determinants of health and wellbeing.

Keywords: Child and Family; Critical Realism; Design; Integrated Care.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
Summary of Research Programme.
Figure 2
Figure 2
Research Map [11].
Figure 3
Figure 3
Theory of Change – Early Intervention and Clinical Elements.
Figure 4
Figure 4
ToC Logic Model.
See this image and copyright information in PMC

References

    1. Eastwood, JG, Kemp, BA and Jalaludin, BB. Realist theory construction for a mixed method multilevel study of neighbourhood context and postnatal depression. SpringerPlus, 2016; 5: 1081 DOI: 10.1186/s40064-016-2729-9 - DOI - PMC - PubMed
    1. Eastwood, J. Designing initiatives for vulnerable families: from theory to design in Sydney, Australia. International Journal of Integrated Care, 2017; 17(5). DOI: 10.5334/ijic.3540 - DOI - PMC - PubMed
    1. Eastwood, J, De Souza, D, Shaw, M, Garg, P, Woolfenden, S, Tyler, I, et al. Designing initiatives for vulnerable families: from theory to design in Sydney, Australia. Int J Integr Care, 2019; 19(3): 9, 1–11. DOI: 10.5334/ijic.3963 - DOI - PMC - PubMed
    1. Morgan, K, Eastwood, J and Faniran, S. Headline population indicators data report 2009: A report for the South West Sydney region on key statistics relating to the health and wellbeing of its children and families Liverpool, NSW: Karitane & Sydney South West Area Health Service; 2009.
    1. Alexander, K, Brown, M, Halim, S, Hendry, A and Eastwood, J. Child and Family Health Indicators Report: Inner West Sydney 2013 Sydney, NSW: Sydney Local Health District; 2015.

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