Families First Edmonton
Principal Investigator: Jane Drummond
Principal Investigator - Collaboration: Maria Mayan
Research Team: Jeff Bisanz, Gina Browne, Robin Everall, Konrad Fassbender, Richard Feehan, Erin Gray, Terry Klassen, Kathy Kovacs-Burns, Maria Mayan, Ron McCraville, Barb Paulson, Linda Reutter, Laurie Schnirer, Berna Skrypnek, John Spence, Deanna Williamson, Natasha Wiebe, Douglas Wilson
Partners: City of Edmonton, Alberta Human Resources and Employment, Alberta Children's Services, Alberta Health and Wellness, Alberta Mental Health Board, Capital Health, Edmonton and Area Child and Family Services - Region 6, Edmonton Community Foundation, Edmonton Aboriginal Urban Affairs Committee, Quality of Life Commission, United Way of the Alberta Capital Region
Key Funders: City of Edmonton, Alberta Human Resources and Employment, CIHR, Alberta Heritage Foundation for Medical Research, Canadian Health Services Research Foundation.
Duration: 2005-2012
Note: Although the original project has ended, the data continues to be mined to provide important evidence for continued research in this area.
Families First Edmonton (FFE) is a longitudinal, community-based, collaborative research project that explored how to better connect families with low incomes to existing services. Community agencies and researchers knew from anecdotal experience that families with low incomes face numerous challenges, and that children living in poverty are more likely to experience health, educational and behavioural issues. FFE was based on the belief that a coordinated, targeted proactive intervention may create healthier families by exploring how service delivery level can be improved and how systems can work together more effectively (efficiently).
In March 2002, Dr. Gina Browne, was invited to speak in Edmonton about her award-winning research entitled When the Bough Breaks: Provider-initiated comprehensive care is more effective and less expensive for sole support parents on social assistance. Browne et al., (2001) found that providing families with proactive comprehensive services resulted in substantial short-term and long-term financial gains, increased family health, and societal benefits.In 2003, CUP was asked to develop the FFE project. A research team consisting of 19 members from across the country was assembled, and a logic model and conceptual framework was developed. Research questions and associated design issues were finalized. Families First Edmonton was designed to examine the comparative effects and expense of proactively offering an integrated mix of health and social services versus self-directed, single provider-initiated health and social service packages to parents and their children. In March and April of 2005, CUP secured the full amount of funding needed to implement FFE and was officially launched in November 2005. The project involved 1200 families, numerous community and government agencies, nearly 20 university researchers and a budget of 9.9 million over six years.
CUP's role in FFE was to facilitate and coordinate the research component. This included the study of the nature and effectiveness of the FFE collaboration at the policy, planning, and service-delivery levels. It also included the coordination of the research team and all research administration including the hiring of the research coordinator, research administrator, research assistants, data collection supervisor, data collectors, and interpreters for data collection. Through this research FFE aimed to:
2. Determine the relative cost-effectiveness of service delivery
3. Increase our understanding of the collaboration among systems involved in service delivery
4. Describe evidence-based practices supporting program delivery
The goal was to recruit 1200 families and randomly assign them to one of the four service-delivery models. The four service-delivery models were:
1. Family Health Lifestyle group - families could access any available service and a Family Support Coordinator helped them solve problems and link them to education, health, and social services.
2. Recreation Coordination group - families could access any available service and a Recreation Coordinator helped place children into recreational programs provided free of charge.
3. Comprehensive group - families could access any available service and are linked to both education, health, and social services by a Family Support Coordinator. Families also received help from a Recreation Coordinator to place children into recreational programs.
4. In the Self-Directed group - families could access any available service on their own.
After 10 years of planning, data collection, and service delivery, the Families First Edmonton partnership was ready to put their research to work and began to analyze the data. Focus was shifted from committee-focused work to meeting one-on-one with government and community organizations to discuss how the FFE data could help with policy and program development. The data provided important snapshots about the life circumstances of FFE families, including specific determinants of health such as employment and education, social supports, and housing. Researchers worked closely with community partners to answer questions that were being asked in the community. Partner organizations are able to use baseline data to help change service delivery practices, better connect-low income families to services, and improve collaboration within and across systems.
To share the results of the research with community stakeholders, a series of interactive workshops were held.
1. Service to Low-Income Families: The practices of FFE service delivery workers and the effect of those practices were shared, along with considerations for how policymakers and program planners could make more impact in their work with low-income families.
2. Using Today's Evidence to Support Tomorrows Families: Early childhood findings from the FFE data were shared (focused on children 2 to 6 years), including key factors related to child outcomes.
3. Pathways out of Poverty: key findings using the Families First Edmonton data: information on the depth of poverty for FFE families at the beginning of the study and examination of the factors that influence a family's depth of poverty.
4. Accessibility of Services: information on the depth of poverty for FFE families at the beginning of the study and examination of the factors that influence a family's depth of poverty.
Several research publications were developed:
- Study Protocol: The protocol for the Families First Edmonton trial (FFE): a randomized community-based trial to compare four service integration approaches for families with low-income
- Project Charter: This Project Charter (June 2003) provides an overview of the research design, approach, objectives and stakeholders involved.
- Fast Facts publications were based upon preliminary data from the project.
- Putting the Research to Work Project Charter: This project charter details the approach and implementation plan for knowledge transfer in 2010-2012.
- Putting the Research to Work
- Profile of Low-Income Families: The Families First Edmonton (FFE) Research Study
- Working together: Building Successful Partnerships - summarized the findings from four annual self-assessment questionnaires completed by FFE partners. This report details critical elements necessary to promote and sustain a complex, long-term, cross-sectoral collaboration.
- Photovoice - Bureaucrazy Training Film and Discussion Guide
- Recruiting and Engaging Low-income Families
- Service Delivery Took Kit - This is used to share information about the service delivery component with other organizations that may wish to undertake similar projects.
- Service-integration approaches for families with low income: a Families First Edmonton, community-based, randomized, controlled trial
- What Families First Edmonton Families Had to Say About the End Poverty Edmonton Strategy
- The Top Five Needs of 100 Families Living in Poverty in the City of Edmonton September 2015
- Supporting Low-Income Transitional Aboriginal Families in Edmonton, Alberta: Implications for Practice
- Social Determinants of Health for the Aboriginal families who participated in the Families First Edmonton study
- Resiliency Resolve Results: FFE Collaboration Handbook
- Housing (In)Stability
- How Community Support Workers facilitate Transitional Aboriginal Families' Access to Health, Family Support, and Recreation Services - read report