Remove barriers to participation

Flexible activity

Evidence Review:

Preventing child maltreatment: Evidence review

Core Component:

Engagement

Practitioners should actively work with families to overcome barriers to participation. Potential barriers could include:

logistical barriers (e.g. service locations and transport)
language barriers
psychological barriers (e.g. ambivalence, apathy, resistance).

Ensure services are delivered in accessible locations and remove logistical barriers.

How can it be implemented?

There are many different barriers to participation that clients may face. Below are some examples of how we can remove potential barriers to participation. The techniques adopted will depend on the barriers individual clients or families face.

Practitioners should discuss potential barriers to participation with their clients and identify the best possible resolution to ensure the client can continue to receive the support they need.

Provide services online: this can remove any geographical or transport barriers clients may face.

Provide services in central locations: ensure activities are available to a large amount of people and may be close to public transport.

Provide services in spaces clients already access: e.g. the local GP or hospital. The removes the need for clients to find the service.

Provide child care: enable parents with caring responsibilities to participate in activities and receive the services they need.

Provide transportation: this could include picking up and dropping off clients directly or providing a bus or car pool service. It could also include providing clients with vouchers for public transport, taxi etc.

Offer services in multiple languages and translate resources: enables clients who speak and/or read languages other than English to access to same resources. Practitioners who speak the same languages as clients can foster positive relationships.

Motivational interviewing: can help participants identify their own reasons for participating in a program. Motivational interviewing is a client-centred counselling style for eliciting behaviour change by helping clients to explore and resolve ambivalence. It can help clients identify their own personal barriers to accepting or receiving support and better enable them to engage with support services.

What should I consider when working with Aboriginal people and communities?

A lack of cultural safety can be a particular barrier to participation for Aboriginal people and communities. Lack of cultural safety, racism and fear can prevent Aboriginal people from accessing essential services. Adopting a whole of organisation approach to cultural safety requires consideration of the policies and focus of the service, the physical location and environment, management and governance systems, human resources, and organisational processes. Cultural safety should be embedded into the organisation’s way of working and not be an add-on component of practice.

A successful strategy to promote service access is also co-designing programs with Aboriginal community members to ensure that their needs are met. Inflexibly delivering externally developed programs that do not respond to local service needs was described in the literature as culturally unsafe (Freeman et al, 2014).

The Cultural Safety and Wellbeing Evidence review identified six critical elements and associated example implementation activities that were common across the evidence to ensure the cultural safety and wellbeing of Aboriginal children, young people, families and communities in early support services. These are summarised as follows:

Critical elements	Example Implementation Activities
Recognising the importance of culture	Acknowledge Aboriginal and Torres Strait Islander peoples as the traditional owners of the lands and waters of Australia.
Recognising the importance of culture	Mark organisational spaces and services as valuing First Nations cultures and welcoming to Aboriginal and Torres Strait Islander clients by displaying for example Aboriginal signage and artwork; incorporating Aboriginal history, language, stories and songs into services where appropriate.
Self-determination	Cultural safety initiatives are directed and guided by Aboriginal and Torres Strait Islander practitioners and others with local cultural expertise and/or authority.
	Co-design services with the local Aboriginal community to ensure that their cultural knowledge, values and beliefs are embedded in service offerings, and that community support needs are addressed.
	Seek feedback from Aboriginal clients on their experience of receiving support and feelings of empowerment.
Workforce development	Recruit Aboriginal staff and volunteers and actively support them through ongoing training, mentoring and career progression strategies.
Workforce development	Provide all staff with ongoing cultural safety training and reflection opportunities to provide them with the skills and knowledge required to engage safely and competently with Aboriginal children, families and communities.
Whole of organisation approach	Conduct a cultural safety audit of organisation (governance, mission, management, staff, partnerships, service offerings/programs, information management/data collection) to identify any workplace deficiencies and/or gaps in services.
	Respond to audit findings by developing and implementing cultural safety action plans to address identified issues.
	Develop services that are known to be culturally safe and implement new services according to cultural safety guidelines.
Leadership and partnership	Organisational leaders make a commitment to improving the long-term outcomes of Aboriginal and Torres Strait Islander children, young people, families and communities through prioritising their participation in accessible, high-quality early support that is trauma-informed and culturally-safe, and targeted to the specific needs of the client.
	Organisational leaders commit to enhancing the cultural safety of clients and actively model cultural safety expectations and behaviours for all staff.
	Recognise sectoral and organisational leaders of cultural safety and highlight their activities and share best-practice initiatives across the sector and organisation.
	Organisational leaders to adequately fund investment and resourcing for cultural safety initiatives and related service improvements including ongoing staff training and reflection, and conduct of a cultural safety audit.
	Seek, establish and maintain meaningful partnerships with local Aboriginal and Torres Strait Islander communities to support ongoing communication and the provision of services that address local needs.
Research, monitoring and evaluation	In consultation with Aboriginal staff and community representatives, co-design indicators of cultural safety for Aboriginal children and families accessing services, as well as mechanisms to collect data to assess if cultural safety outcomes are being achieved.
	Undertake assessment activities or evaluations of staff cultural safety training programs to determine their effectiveness in increasing staff knowledge, changing attitudes, and ability to deliver culturally safe programs and care. This should be done on an ongoing basis.
	Support knowledge transfer and the development of evidence-based sectoral practice by sharing examples of organisational and program success within your organisation.

Organisations and practitioners should consider these critical elements and example implementation activities in the design and delivery of services in order to ensure there are no potential barriers to participation through a lack of cultural safety. See the Cultural Safety and Wellbeing Evidence Review for more information.

Who was the target group?

This flexible activity has been implemented with a number of different target groups, key characteristics include:

Mothers of newborn infants
Parents of children aged up to 4 years old
Parents of adolescents aged up to 16 years old
Parents with children aged 12 years and younger
Families already in contact with the child protection system

What programs conduct this activity?

The e-PALS Baby Net program is delivered online in an attempt to reduce geographical barriers to accessing the intervention.
In the First Steps program, a brief in-person initial visit with the mother is conducted in their hospital room. This removes the need for mothers to find the service. Telephone or mail follow up was included if the mother desired.
In the Group Teen Triple P program, sessions were delivered in community locations across Auckland. This was to accommodate parents’ preferences in location and increase accessibility.
The Incredible Years Parenting Training Program was delivered in a central location for parents and included child care, dinner, and transportation. This helped remove many of the logistical barriers to attendance that disadvantaged parents often experience. The program was also translated and offered in languages other than English.
The Relief Nursery program delivers small group based parenting classes. They provide childcare and snacks at the classes to increase attendance levels. They also provide transportation to and from other services as needed.
The Supporting Fathers Involvement Intervention provides onsite childcare and family meals to support parents’ consistent attendance.

The e-Parenting Program and SafeCare+ both used motivational interviewing to help participants identify their own reasons for participating in the program.

What else should I consider?

While online/digital programs can reduce geographical or transportation barriers, financial barriers may still exist. Organisations would need to ensure clients have the technology needed to participate in online activities (e.g. devices, internet, software).