Engaging families in parent support services: ‘Hard to reach’ families or difficult to access services?

Dr Paul Prichard, Program Manager 

 

How often have you heard colleagues talk about ‘hard to reach’ families? We have to ask ourselves, what is it about families that makes us consider them ‘hard to reach’?

Sometimes the families we know would really benefit from using our services are the ones who are least likely to engage with us.

The Inverse Care Law shines a light on this dilemma. It proposes that medical care and other forms of support tend to be most easily accessible to those in least need. Conversely, those who would benefit most are least likely to access the help they need. It makes sense that confident, mobile, well-resourced parents will often be able to identify and access the services and resources that would benefit their family. However, some parents aren’t able to access services and resources as easily for many reasons.

Parents who experience literacy difficulties, poor access to transport, poverty, social and geographical isolation, a history of negative experiences with services or other risk factors, can find it more difficult to identify and engage with the services that could benefit their children. We know that all parents want to do the best they can to support their children and give them the best start in life. When parents face circumstances that make it difficult for them to engage with services, there is an opportunity for the system and services to identify and address barriers to engagement that enable families to access and more easily navigate the services and supports they need.

Some years ago, I had the great privilege of designing and implementing a multi-year strategy focused on bringing parents, community members and service providers together. That work created a sustained partnership that aimed to co-produce a number of early years focused, integrated Child and Family Centres. The work of facilitating workshops and ongoing negotiations between community members, who often had a history of feeling unheard and disrespected by services, can be likened to a thrilling roller coaster ride. Early in the process, it became very clear that the nature of our relationships mattered to the process. Building a sense of trust, rapport and safety amongst a diverse mix of people who contributed to the process was critical to achieving what we set out to do. A prolonged period of deep listening was necessary to open the door to honest exchanges between parents, practitioners and service managers. The overall experience was a rich learning process about what constitutes authentic engagement. We can think of this as how we deliver the services and supports that families might need.

In one meeting, a community member began referring to the ‘sharp edges’ of services that she had experienced. Her analogy painted a powerful mental picture of parents being repelled and wounded in their attempts to access services. The mental picture of sharp edges of services has proven to be a useful tool in supporting service providers to reflect on the structural, environmental and behavioural aspects of service provision. Those aspects can hinder the opportunity to build and sustain relationships with families who would benefit most from services. These ‘sharp edges’, evident across the service system, are experienced by parents in a variety of different ways. Some families feel that they are not listened to, and their strengths are not acknowledged. Families can also feel that service environments make them feel unwelcome, stigmatised. This can result in families feeling judged and disrespected, despite the good intentions and practices of professional workers. You might notice that what families identified here is not about what was delivered, but about how it is delivered. Those things that present as ‘sharp edges’ in services, when addressed, can potentially help build relationships between parents and professionals.

When we listen to parents describe what they believe makes services engaging, they describe encounters with professionals who are relatable, friendly, caring and who make an effort to find connection with parents. This includes being open, sharing a little about themselves, listening deeply and using language that creates a level playing field. 

Efforts by professionals to casualise their approaches to working with parents are noticed and appreciated by parents. Furthermore, parents appreciate when feedback is provided and invited in ways that are respectful, supportive and constructive. They also value when it is evident that professionals respond to their feedback. 

In the work I mentioned earlier, we asked families ‘What makes a service engaging?’ The most common response parents and community members gave was they wanted to experience places that are ‘warm, welcoming and friendly’ when they visit a service. The strongest predictor of families staying engaged with services are the characteristics of the service itself and how they deliver their services and supports to families. 

Professionals who successfully engage with families work hard at making families feel welcome and comfortable, and bring a substantial body of knowledge, expertise and experience. They want to support families to achieve the best outcomes possible. And we believe that if they had an opportunity to improve the service and support offered to families even more, they would welcome that.

We encourage you to reflect on how you engage with parents, how you build relationships with them and work towards mutual trust and respect. This will support you, your colleagues and families to ensure a continued connection which will, ultimately, support better outcomes for the children and families we all seek to support. 

 

Resources

Our Engaging families workshop is designed to empower you to forge genuine relationships with families.

The availability of good medical care tends to vary inversely with the need for it in the population served. Read more

Tudor, J. (1971). The inverse care law. The Lancet, 297(7696), 405-412.