Evaluation of an assertive outreach intervention for problem families: intervention methods and early outcomes

Families who experience a chronic complex of socio-economic and psycho-social problems are hard to reach with mainstream care. Evidence exists that the core of this problem lies in a problematic interaction between this type of family and current systems of care. The adults and children involved have needs in multiple domains, while the care system is fragmented and highlights well-defined requests for help. To improve access to this target group, an assertive outreach intervention was implemented into the preventive child healthcare system in The Netherlands. Evaluation research was carried out to get a detailed insight into the content of this intervention. Also, early outcomes were examined. Information was gathered by interviews, attending meetings on method development, analysing registration forms and a survey on client satisfaction. Five intervention stages were identified: case finding, making contact, sustaining contact, developing a family plan and linking (arranging for services to be delivered). Practical support was used to build rapport and clear the way to the uptake of follow-up help. The professionals delivering the intervention need a broad range of competencies to establish a working relation with the families and to link them to care and services. A good care network across professionals from various organisations must exist to provide a variety of linking options. Early outcomes indicate that professionals were able to get in touch with the families within a mean of 13.2 days. Goals of the intervention were mainly practical support (73%), starting new assistance for a child (63%) and starting new assistance for a parent (43%). Linking to care and services was attained in the majority of the cases and parents expressed satisfaction. The findings indicate that the studied intervention is a promising one. Some potent components can be indicated: the outreach approach, practical support, maximising participation of the family and building bridges between the family and (in)formal support and assistance.