Supporting Resilient Families within Resilient Communities

1. Supporting Resilient Families within Resilient Communities Jane Drummond Vice Provost Health Sciences Council Healthy Kids Alberta: Stakeholder Forum March 7, 2007

2. “We’re in a new place; • we’re not on the edge of the old place. • We’re not pushing the envelope; • we’re in a totally new envelope. • So the rules have changed. • Every fundamental premise of the old way of thinking no longer applies” Sister Elizabeth Davis Board Chair, Canadian Health Services Research Foundation

3. The Ecological Model: A tool for “the old place” and “the totally new envelope” Seeks to explain individual knowledge, development, and competencies in terms of the guidance, support, and structure provided by society and to explain social change over time in terms of the cumulative effect of individual choices (Berger, 2000).

4. Individuals social competence reading skill sense of responsibility problem solving feelings of control plans for future optimism history of success history of + reinforcement seeks support detaches from conflict Family effective parenting attachment warmth and affection cohesive support structure within the family coping skill + expectations of members good spousal relationships strong extended family extracurricular activities responsibilities outside the home Mangham, C., Reid, G., McGrath, P., & Stewart, M. (1994). Resiliency: Relevance to health promotion. Atlantic Health Promotion Research Centre, Dalhousie University, Halifax, NS. For Alcohol and Other Drug Units, Health Promotion Directorate, Health Canada. On the edge of “the old place” Protective Factors

5. mutual support collective expectation of success in meeting challenges high level of community participation organize cooperatively volunteerism egalitarian treatment of community members optimism empowerment (control over policy) Mangham, C., Reid, G., McGrath, P., & Stewart, M. (1994). Resiliency: Relevance to health promotion. Atlantic Health Promotion Research Centre, Dalhousie University, Halifax, NS. For Alcohol and Other Drug Units, Health Promotion Directorate, Health Canada. On the edge of “the old place” Community Protective Factors

6. On the edge of “the old place” Child and Family Resilience Research Program • Family Protective Processes • flexibility of the family unit • coherent responsiveness to challenging situations • maintenance of stability • support acquisition and maintenance • effective parenting • maintaining responsibilities outside the home Drummond, J., Kysela, G.M., McDonald, L., Alexander, J., & Fleming, D. (1996/7). Risk and resiliency in two samples of Canadian families. Health and Canadian Society 4(1), 117-152.

7. Child and Family Resilience Research Program Developed and tested four family-centred approaches to supporting family resilience Assessment (ongoing approach) Parent-infant interaction (five sessions) Parent-child interaction (twelve sessions) Family communication and problem solving (twelve sessions) Academic Achievements: Effect sizes between .5 and 1.5 SD in changing parent behaviour Mentored numerous research students Published, presented Were promoted on schedule On the edge of “the old place” Kysela, Drummond & McDonald and their students 1994-2005

8. “When a parenting intervention is structured, intensive and focused on behavioural strategies it works” Focus on the positive behaviour you want to build Shorter works better (Can be accomplished in 5-16 sessions) Must create a mirror for the parent so they can identify within themselves what works and what isn’t working Longer, broad-band approaches (important as they are) do not work at improving specific behaviours associated with parental sensitivities Knowledge from the edge of “the old place” Bakermans-Kranenburg MH, van IJzendoorn M, Juffer F. (2003) Less is more: Meta-analyses of sensitivity and attachment interventions in early childhood. Psychological Bulletin; 129(2): 195-215.

9. As an dedicated researcher How do we get appropriate targeted behavioural interventions inside of broad-based support programming? As a member of my community How do we make “evidence-informed” decisions? Since, research is but one input into decisions concerning the health care system How do we create opportunities for meaningful collaboration between experts practitioners in community-based programs, decision makers and academic researchers? Questions that propelled me from the edge of “the old place”

10. The Ecological Model: A tool for “the old place” and “the totally new envelope” Seeks to explain individual knowledge, development, and competencies in terms of the guidance, support, and structure provided by society and to explain social change over time in terms of the cumulative effect of individual choices (Berger, 2000).

11. Linking organizations Community-University Partnership for the Study of Children Youth and Families Alberta Centre for Child Family and Community Research Community-based research Families First Edmonton “A totally new envelope”

12. We can make it a reality Community-University PartnershipFor the Study of Children, Youth, and Families www.cup.ualberta.ca/

13. We can make it a reality CUP’s Mission The Community-University Partnership for the Study of Children, Youth, and Families (CUP) is committed to improving the health and well-being of children, youth, families, and communities by: • generating and sharing new knowledge • identifying and promoting the use of best practices • nurturing a culture, both in the community and the University, in which rigorous, evidence-based research are valued

14. We can make it a realityDeveloping Projects Developing the Partnership 2 to 3 years Research Planning Project Management Communications RESEARCH PROJECT

15. We can make it a realityDeveloping the Partnership Lessons Learned: • Recruit the right people and the right organizations. • Create a shared vision • Work incessantly to build trust • Begin to outline responsibilities and commitments • Ensure that sufficient project development resources are in place

16. What is the best approach to integrate services for low-income families with children? Funded by CIHR, AHFMR, CHSRF www.familiesfirstedmonton.ualberta.ca/

17. PARTNERSHIP DEVELOPMENT December 2000 release of “Listen to the Children” by Quality of Life Commission June 2001 decision to focus on improving existing service March 2002 workshop on “When the Bough Breaks” PROJECT DEVELOPMENT Sept-Dec 2002 Families First Edmonton Steering Committee established co-lead organizations named January 2003 CUP was invited to coordinate the study July 2003 selection of PI and begin writing proposals April 2005 research funding secured History of FFE

18. 2006Families First Edmonton Governance Structure Steering Committee Executive Subcommittee Sounding Board Project Management Team Operations Committee Research Committee Communications Subcommittee Ad Hoc Subcommittees (as required) Co-Investigator Subcommittee Service Delivery Coordination Families Matter Program Manager, Program Supervisors, and Program Coordinators Service Delivery Committee Research Coordination Research Coordinators, Research Assistants, and Data Collectors NOTE: The membership lists for the Sounding Board, Steering Committee, Executive Committee and Operations Committee are on pages 26-29 in the approved Charter Legend Works With Reports to

19. Families First Edmonton: A new approach to reducing barriers to service integration • Intersectoral partnerships • between government agencies, non-governmental organizations, and community service providers • Building family capacity • Family-centred service delivery practices that enhance family problems solving, relational advocacy, reducing isolation • Community-based transdisciplinary research • the public sector must be assured that changes to service spending will improve family health outcomes in a cost-effective manner.

20. Research Projects • RCT (short term outcome and the policy relevant question) • Child Health (long term outcome) • Family Health (long term outcome) • Community Engagement (medium term outcome) • Service Integration Best Practices (program development outcome) • Collaboration (what are the elements of “the new envelope”)

21. Results will provide critical information about • the knowledge, skills and attitudes of service integration (family, agency and policy level) • appropriate front-line service integration practice • effective system collaboration • optimizing cost effectiveness for public systems, • the long-term effects on the health and well-being of family members, • mechanisms that intervene between the interventions and their effect on the health and well being, • building on previous research and on community-based initiatives, and • promoting knowledge transfer.

22. What’s new? Independency to interdependency Interdisciplinary Intersectoral Centralized to distributed Community-based “Connected to the world” Network of responsibility/accountability Expert driven to equality of participants Primacy of relationships >> partnership Boundary spanning leadership Valuing diversity Pipe line dissemination to knowledge mobilization Participatory research Joint decision of what will be the knowledge outcomes Inclusion of and resourcing of detailed communication plan in projects Training for “the new envelope” Simple to complex Multi focus (cost, outcome, collaboration, best practice) Attempting to describe the “whole” “A totally new envelope”

23. How can our community, including the research community, support children and families to achieve wellness through: Healthy eating Active living Successful responding to life’s challenges? “A totally new envelope” The HealthyKidsAlberta question