Implementation, Mechanisms of Effect and Context of an Integrated Care Intervention for Vulnerable Families in Central Sydney Australia: A Research and Evaluation Protocol

John G Eastwood; Susan Woolfenden; Erin Miller; Miranda Shaw; Pankaj Garg; Hueiming Liu; Denise E De Souza; Roelof G A Ettema

doi:10.5334/ijic.4217

Implementation, Mechanisms of Effect and Context of an Integrated Care Intervention for Vulnerable Families in Central Sydney Australia: A Research and Evaluation Protocol

Int J Integr Care. 2019 Jul 25;19(3):11. doi: 10.5334/ijic.4217.

Authors

John G Eastwood^{1

2

3

4

5}, Susan Woolfenden¹, Erin Miller⁴, Miranda Shaw⁴, Pankaj Garg^{1

2

6}, Hueiming Liu⁷, Denise E De Souza⁸, Roelof G A Ettema^{9

10}

Affiliations

¹ School of Women's and Children's Health, The University of New South Wales, Sydney, NSW, AU.
² Ingham Institute of Applied Medical Research, Liverpool, NSW, AU.
³ Charles Perkins Centre, Menzies Centre for Health Policy, Discipline of Child and Adolescent Health, and School of Public Health, University of Sydney, NSW, AU.
⁴ Community Health Services, Sydney Local Health District, Level Camperdown, NSW, AU.
⁵ Sydney Institute for Women, Children and their Families, Camperdown, NSW, AU.
⁶ Discipline of Child and Adolescent Health, School of Medicine, University of Sydney, NSW, AU.
⁷ The George Institute for Global Health, The University of New South Wales, AU.
⁸ School of Humanities, Nanyang Technological University, SG.
⁹ Knowledge Centre Healthy and Sustainable Living, University of Applied Sciences, Utrecht, NL.
¹⁰ University Medical Centre, Utrecht, NL.

Abstract

Introduction: In March 2014, the New South Wales (NSW) Government (Australia) announced the NSW Integrated Care Strategy. In response, a family-centred, population-based, integrated care initiative for vulnerable families and their children in Sydney, Australia was developed. The initiative was called Healthy Homes and Neighbourhoods. A realist translational social epidemiology programme of research and collaborative design is at the foundation of its evaluation.

Theory and method: The UK Medical Research Council (MRC) Framework for evaluating complex health interventions was adapted. This has four components, namely 1) development, 2) feasibility/piloting, 3) evaluation and 4) implementation. We adapted the Framework to include: critical realist, theory driven, and continuous improvement approaches. The modified Framework underpins this research and evaluation protocol for Healthy Homes and Neighbourhoods.

Discussion: The NSW Health Monitoring and Evaluation Framework did not make provisions for assessment of the programme layers of context, or the effect of programme mechanism at each level. We therefore developed a multilevel approach that uses mixed-method research to examine not only outcomes, but also what is working for whom and why.

Keywords: complex intervention; critical realism; process evaluation; theory driven evaluation; translational social epidemiology.