This blog is based on an article in Social Policy and Society by Ira Malmberg-Heimonen and Anne Grete Tøge. Click here to access the article.
The Background
The background for the study is increasing child poverty, which has led to international and national policies to improve children’s future possibilities and reduce risks of the intergenerational transmission of poverty. These policies are also a part of the European Union´s recommendation against child poverty. The recommendation includes several interventions, such as improving parental employment, improved benefits and services to families, and enhancing families’ access to affordable housing. As a result, countries have developed various family intervention projects with the aim to alleviate child and family poverty. Much of the knowledge base for family intervention projects in a European context derives from the UK, where national programmes such as Family Intervention Projects and the Troubled Families Initiative have been implemented and evaluated in larger scales. The results from these evaluations seem to indicate that the families were satisfied with the services they received, but that the effects on parental employment were modest.
Characteristics of these family intervention projects are: a key worker with a low caseload; a whole family perspective; and the coordination of services, with the aim of improving families’ life on several target areas, such as housing, parental employment, and the children’s situation. Based on existing knowledge, a family intervention model was developed by the Norwegian government through the manualised HOLF model, which also included schemes, tools, and supervision structures aimed to further systematise the family intervention.
In a cluster-randomised design our study compared the effects of the manualised HOLF model with locally developed family intervention practices. The results showed no differences between offices that had implemented the manualised model compared those that had developed local family intervention practices. However, families in both groups significantly improved their financial situation and the children became more included in social activities, suggesting that family interventions where the staff know their target groups, have low caseloads, and are motivated and skilled seem to contribute to favourable changes among vulnerable families.
Method and Findings
We assessed the effects of the HOLF model during the years 2016 and 2019 and compared it with locally developed family intervention practices, with a hypothesis of that the manualised HOLF model would be more efficient than the locally developed family intervention practices. Of 29 labour and welfare offices nationwide in Norway, 15 implemented the HOLF model, while 14 implemented local family intervention practices. The allocation of the offices into the two groups was randomised, and we only found minor differences between families from offices randomised to implement the HOLF model and offices that developed local family intervention practices.
We measured the families’ situation on four target areas at baseline, prior to participating in the family interventions, and 12 months later. This research design allowed us to assess improvements for families from both groups of offices. The four target areas we assessed were parental employment, housing and financial situations, and the social inclusion of the children. While the families’ situations improved somewhat on all target areas, the improvement was significant for two of them, that is the financial situation and children’s social inclusion. Nevertheless, there were no differences between families from offices that had implemented the manualised HOLF model and those that had developed local family intervention practices (see Table 1).
Table 1 Means, number of observations (N) and p-values for change for baseline and T2 in the four target areas separately for parents within the HOLF-model and local family intervention practices.
What our study first and foremost showed was that the manualised HOLF model with its tools and schemes did not improve families’ situation more than the local family intervention practices. Both interventions seem to improve the financial situation and contribute to more social inclusion of children. While our study cannot determine the mechanisms contributing to the improvements, we interpret the result as that it was elements common to both groups of interventions that contributed to the positive developments, rather than the specific elements of the HOLF model. Common elements to both groups of interventions were a family coordinator with a low caseload, the coordination of the families’ services, a whole family perspective and that the family coordinators in both groups aimed at a trustful and empowering relationship with the families. The specific, and what seems to have been less efficient elements of the HOLF model were manuals, tools, and schemes aimed at further structuring the family intervention. The results also pinpoint that the family coordinators that developed local practices already had the competence needed to serve the participating families. In this setting, local competence about target groups, low caseloads and motivated and skilled professionals are in a key role in ensuring optimal services for vulnerable families.
About the authors
Ira Malmberg-Heimonen is a professor in Social Work at Oslo Metropolitan University, Department of Social Work, Child Welfare and Social Policy. She has a lead several randomised controlled trials within the social and educational fields. Her interest areas are intervention studies, program theory and fidelity, and the implementation of evidence-based practices. Follow her research through the homepage https://www.oslomet.no/om/ansatt/iram/ and Research Gate: https://www.researchgate.net/profile/Ira-Malmberg-Heimonen
Anne Grete Tøge is a senior researcher at Oslo Metropolitan University and holds a PhD in Social Work and Social Policy. She has been engaged in several randomised trials in Norway, investigating the effects of interventions aimed at improving the service for low-income families, reducing school dropouts and improving interprofessional collaboration.
Follow her research at Publons: https://publons.com/researcher/2948670/anne-grete-tge/
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