Evidence-based practice

The concept of evidence-based practice is widely referred to in the recent Australian literature. This bibliography presents a selection of this literature, looking at the concept's deployment in a range of contexts.

Public policy

Campbell, A
Evidence based practice: is it good for you?
Australian and New Zealand Journal of Family Therapy v.23 no.4 Dec 2002: 215-217

This article is the first in a series which aim at 'unpacking' some of the concepts and controversies involved in 'evidence based practice' (EBP). It is critically important for clinicians to be able to understand EBR because there is a growing likelihood that the politics of EBP will be used to construct the ways in which they are expected to provide services in their workplaces. Although EBP looks relatively benign, the whole area reveals some very disturbing aspects. The author invites readers of the Journal to begin a dialogue with him and with each other about EBP and whether it is possible, or even desirable, to embrace this practice within a systemic framework. (Journal abstract)

Falk, I
Social Capital Think Tank: a case study of evidence-based public policy development.
Launceston, Tas: Centre for Research and Learning in Regional Australia, University of Tasmania, 2002, 31p, ill. (CRLRA Discussion Paper D2/2002), Online (PDF 115K)
http://www.crlra.utas.edu.au/files/discussion/2002/D2-2002.pdf

This paper provides an explanation and interim evaluation of Australia's Social Capital Think Tank (SCTT) processes as a model for policy development through the presentation of a theory-driven critical case study using ethnographic techniques. A major aim of the SCTT was to investigate the applicability of, and use of the principles of social capital to act as a flexible form of on-going information, knowledge, ideas and advice for policy-developers. The paper reports on the nature and process of the SCTT and the State and Territory implementation strategy. It uses the data available from three years of engagement with the SCTT to present a case study that discusses a model of devolving evidence-based policy development and implementation in the area of community development policies. The case study documents the components and principles of evidence-based policy development while providing an emerging evaluation of the SCTT as a policy development tool.

Latham, M
Myths of the welfare state.
Policy: a Journal of Public Policy and Ideas v.17 no.3 Spring 2001: 40-43, and Online
http:// www.cis.org.au/policy/Spring01/PolicySpring01_9.html

This article commences with the statement that one of the problems with modern politics is its disconnection from the poor. Public life has become abstracted from the day-to-day practice of poverty. The author discusses the myth of government spending, the myth of government intervention, the myth of public administration, and the myth of abstract rights, suggesting that the myths of the welfare state are based on old ideological ways of thinking, a struggle between government-first and market-first policies. He argues that welfare policy makers need to look beyond the old Left and the new Right to those evidence-based policies that can help end the human tragedy of poverty.

Lin, Vivian, ed.; Gibson, Brendan, ed.
Evidence-based health policy: problems and possibilities.
South Melbourne, Vic: Oxford University Press, 2003, 347p, tables, figures

In examining the interplay between evidence gathering and health policy formulation, this book presents case studies and draws on the experience of policy makers in the health sector. The chapters are: Competing Rationalities: Evidence-Based Health Policy? by Vivian Lin; Beyond 'Two Communities' by Brendan Gibson; Evidence-Based Medicine, the Medical Profession and Health Policy by Evan Willis and Kevin White; What is New in Health Information? Evidence for Health Consumers and Policy Making by Sophie Hill; From Evidence-Based Medicine to Evidence-Based Public Health by Michael Frommer and Lucie Rychetnik; 'Mind the Gap': Assessing the Quality of Evidence for Public Health Problems by Anne Kavanagh, Jeanne Daly, Angela Melder and Damien Jolley; Health Policy and Normative Analysis; Ethics, Evidence and Politics by Colin Sindall; The Viagra Affair: Evidence as the Terrain for Competing 'Partners' by Rosalie Aroni, Rebecca de Boer and Ken Harvey; Folate Fortification: Public Health Policy Making in a Food Regulation Setting by Mark Lawrence; The Supply and Safety of Blood and Blood Products - Evidence, Risk and Policy by Albert Farrugia and Liz Furler; The Development of Nurse Practitioner Policy by Tom Keating and Claudia Trasancos; Creating Policy for Oral Health: How was the Evidence Used? by Julie Satur; Regulation of Traditional Chinese Medicine in Victoria by Anne-Louise Carlton; The Victorian Primary Health Care Reforms by Rhonda Jennings and David Legge; Evidence-Based Practice in the Australian Drug Policy Community by John Fitzgerald and Tanya Sewards; Challenging the Evidence - Women's Health Policy in Australia by Karen Willis; Evidence and Aboriginal Health Policy by Ian Anderson; The Limits to Technical Rationality in the Health Inequalities Policy Process by Jane Dixon and Beverly Sibthorpe; Evidence-Based Policy: A Technocratic Wish in a Political World by Jenny M. Lewis; The Community Model of Research Transfer by Anne Mitchell and Jenny Walsh; Getting Research Transfer into Policy and Practice in Maternity Care by Judith Lumley, Stephanie Brown and Jane Gunn; Improving the Research and Policy Partnership: An Agenda for Research Transfer and Governance by Vivian Lin; Framing and Taming 'Wicked' Problems by Brendan Gibson.

Marston, G; Watts, R
Just the facts Ma'am: a critical appriaisal of evidence-based policy.
Just Policy no.30 Jul 2003: 32-46

One trend to emerge in the effort to avoid increased social inequality is evidence based policy making. The authors explore concerns relating to this, including whether empirical research is able to reliably inform policy about the social world, how much weight research evidence should be given in the policy making process, and what kind of evidence is being advocated. They examine the origins and context of evidence based policy, the work of Michael Pusey as an illustration of how too much theory increases fantasy mongering, and look at the case of the Nazi state, which relied on empirical research to justify racial hygiene.

Marston, G; Watts, R
Tampering with the evidence: a critical appraisal of evidence-based policy-making.
The Drawing Board: an Australian Review of Public Affairs v.3 no.3 Mar 2003: 143-163, Online only (254K)
http://www.econ.usyd.edu.au/drawingboard/journal/0303/marston_watts.pdf

Recent enthusiasm for evidence-based policy-making in Australia has many sources. So-called 'managerialist' reforms to public administration have been significant, as has the diffusion of particular bio-medical models of research. However, the meaning and practice of 'evidence-based policy' are contested. The authors offer an account of the design of arguments to identify and critically assess the value of evidence-based claims and their relationship to evidence-based policy. Their critique indicates the very wide range of what can - properly - count as evidence, based on a premise about the irreducible richness and complexity of social reality. They highlight the importance of being thoughtful about the assumptions that shape policy research questions and 'warrant' the conceptual connections that constitute knowledge claims. They illustrate their arguments with a policy research case study on juvenile crime. (Journal abstract)

Nutley, S; Davies, H; Walter, I
Evidence-based policy and practice: cross-sector lessons from the United States.
Social Policy Journal of New Zealand no.20 Jun 2003: 29-48

This paper draws out some of the key lessons that have emerged from the experience of trying to ensure that public policy and professional practice are better informed by evidence than has hitherto been the case. It does this by highlighting four requirements for improving evidence use and considering progress to date in relation to each of these. They are: agreement as to what counts as evidence in what circumstances; a strategic approach to the creation of evidence in priority areas, with concomitant systematic efforts to accumulate evidence in the form of robust bodies of knowledge; effective dissemination of evidence to where it is most needed and the development of effective means of providing wide access to knowledge; and initiatives to ensure the integration of evidence into policy and encourage the utilisation of evidence in practice. An appendix to the paper provides outlines of and web links to specific initiatives across the public sector in the United Kingdom.

Webster, A
Some features of evidence-based policy making for Aboriginal and Torres Strait Islanders peoples.
Journal of Indigenous Policy no.1 2002: 93-103

The author discusses the policy making process in relation to Australian Indigenous affairs. He explains the features of evidence based policy making and considers how this approach can enhance the policy making process. He suggests that an evidence based approach to Indigenous policy making can improve dialogue and partnerships among government policy makers and Indigenous peoples and organisations.

Zussmann, D
Evidence-based policy making: some observations of recent Canadian experience.
Social Policy Journal of New Zealand no.20 Jun 2003: 64-71

David Zussman talks about Canada's experience with evidence-based policy making. He shares three examples of current policy discussions in Canada that illustrate the challenges and problems involved in trying to integrate evidence into the decision-making process. He also describes a Canadian government initiative aimed at creating and sharing an evidential base on its own performance. The project, 'Canada's Performance 2002', provides evidence on how well or how poorly the government is meeting the objectives it has set for itself. (Journal abstract)

Health and mental health

Australian Infant, Child, Adolescent and Family Mental Health Association
Children of parents affected by a mental illness: scoping project report.
Stepney, SA: Australian Infant, Child, Adolescent and Family Mental Health Association, 2001, 68p, and Online
http:// www.aicafmha.net.au/projects/scoping/file/report.htm

This scoping study regarding services for children with parents affected by mental illness was commissioned and endorsed by the Mental Health and Special Programs Branch of the Department of Health and Aged Care. The project brief was to identify current major State and Territory evidence-based initiatives in relation to how each jurisdiction is addressing the needs of children of parents with a mental illness, and future plans for work in this area. Information was gathered via: consultation with the project reference group, which included representatives from all States, and further individual consultations with other State and Territory contacts that developed through networking of the project; consultation with professional and consumer groups when opportunities arose; and wide distribution of a questionnaire seeking information about programs as required by the project brief. The report presents an overview of key Australian reports on the topic, and describes the study, its methodology and findings. Recommendations are presented on the basis of information gathered so far by the scoping project. Appendices include the questionnaire, the results of the stocktake of programs, and an annotated bibliography and resources.

Butler, H; Bond, L; Glover, S; Patton, G
The Gatehouse Project: mental health promotion incorporating school organisational change and health education.
In: Rowling, L., Martin, G. and Walker, L., eds. Mental health promotion and young people. Sydney, NSW: McGraw Hill, 2002, p128-141, figure

This chapter describes the Gatehouse Project designed to promote emotional well being through secondary schools. The authors comment on the links between social environment and adolescent health, noting that school represents an important part of the social environment. The Gatehouse Project provides schools with conceptual and operational frameworks to enhance understanding of adolescent mental health needs, and an evidence based process for planning, implementing and evaluating a customised intervention. The process uses school profiles to allow schools to identify local priorities and adapt preventive strategies to individual contexts. The authors believe that the project has contributed to a shift of the mental health issue in schools, so that it is viewed as a whole school concern rather than just a welfare concern.

Centre for Adolescent Health (Melbourne, Vic)
Evidence-based health promotion: resources for planning - No.2 Adolescent health.
Melbourne, Vic: Health Development Section, Department of Human Services, 2000, 39p, Online
http://www.dhs.vic.gov.au/ph d/0003097/

This document reports on a review which aimed to ascertain the efficacy of health promotion interventions targeted at adolescents. Program evaluations were organised according to the health promotion strategy represented. Interventions included in the review addressed six adolescent health outcome areas: depression, suicidal behaviour, alcohol and drug use, tobacco use, crime and antisocial behaviour, and sexual risk-taking behaviour. A study team reviewed 178 research articles according to three areas of evaluation: process evaluation (practical implementation), intermediary outcomes (the impact on risk and protective factors) and health outcomes (effectiveness). This report considers each of the articles with reference to the main health promotion strategy adopted and the adolescent health outcome targeted for prevention.

Charman, D
Paradigms in current psychotherapy research: a critique and the case for evidence-based psychodynamic psychotherapy research.
Australian Psychologist v.38 no.1 Mar 2003: 39-45

Psychotherapy research that compares one treatment with another has resulted in anomalies. First, treatments appear to be equivalent and second, therapist effects appear to be stronger than treatment effects. In order to make progress these anomalies need to be addressed. The ways in which research is proceeding can be conceptualised as following different paradigms, each one having convictions about what are the rules and standards for scientific practice. In particular, efficacy researchers advocate the gold standard to be the randomised controlled trial. Alternative and emerging paradigms for psychotherapy research are identified and briefly outlined. The problems and pitfalls of each one are summarised. It is argued that one of the paradigms, which is centered on understanding psychotherapy process and referred to in the paper as 'back to the phenomena', offers the greatest potential for evidence-based psychotherapy practice. It is argued that future psychotherapy research should be based on theory based process research. Psychodynamic psychotherapy process research is well established and examples of the findings of this type of research and their relevance to future research and practice are provided. (Journal abstract)

Dixon, Lisa B; Goldman, Howard H
Forty years of progress in community mental health: the role of evidence-based practices.
Australian and New Zealand Journal of Psychiatry v.37 no.6 Dec 2003: 668-673

In this article, the authors discuss the origins of the community mental health movement and elaborate on the next turning of the cycle of reform, from the late 1970s until the present. They focus on the community support reforms that re-emphasised the care of individuals with severe and persistent mental illness, and examine the community support program, evidence based practices and assertive community treatment.

Frommer, M S; Rubin, G L
Evidence-based health care.
In: Bloom, A. L. ed. Health reform in Australia and New Zealand. South Melbourne, Vic: Oxford University Press, 2000, p307-324, tables

Evidence based health care refers to policy, public health practice or clinical practice that makes use of knowledge derived from scientific research. This chapter explains why evidence based health care has emerged as a major theme, how evidence based health care is implemented and what the limitations are of evidence based health care. The challenge of evidence based health policy and management; the link between effectiveness and efficiency; the impact of evidence based health care; and evidence based health care in Australia are discussed.

Garrard, Jan
Evidence and public health: data, discourses, and debates.
In: Keleher, Helen and Murphy, Berni, eds. Understanding health: a determinants approach. South Melbourne, Vic: Oxford University Press, 2004, p260-268, tables

Evidence based medicine (EBM) has come to be the dominant focus for understanding public health. The author discusses the concept and development of EBM, the types of data available and how data can be used in answering questions, and some of the problematic issues associated with EBM such as validity of data. The use of evidence to evaluate interventions is examined, drawing on cannabis use as an example.

Gardner, H, ed.; Barraclough, S, ed.
Health policy in Australia.
South Melbourne, Vic: Oxford University Press, 2nd ed., 2002, 362p, tables, figures

This second edition of Health policy is Australia is predominantly new. It provides details of the health system and of the main political influences and the theoretical and conceptual underpinnings for decisions and trends in health and health care. The emphasis is on national policies, and the book comprises two sections: The Australian health system; and Case studies of the health policy process. Chapters include Evidence-based health: three cheers for noncompliance, by Jeanne Daly, Emma Hughes and Corinne op't Hoog.

Glasziou, P; Longbottom, H
Evidence-based public health practice.
Australian and New Zealand Journal of Public Health v.23 no.4 Aug 1999: 436-440

This article illustrates how to incorporate evidence-based decision making into public health practice. Skills necessary to practice evidence-based health are discussed, as are study design, and sources of high quality evidence in relation to frequency / burden of illness, intervention, aetiology and risk, screening, and test accuracy.

Hill, S; Stoelwinder, J
Communicating with consumers: the development of an evidence-based research agenda in chronic illness research.
Australian Journal of Primary Health v.9 no.2 and no.3 2003: Special Issue: The Management of Chronic Disease in Primary Care Settings: 218-222

Cochrane Collaboration is an example of an international organisation that is assembling and reviewing the effectiveness of many clinical interventions. This article reports on an analysis of trials of patient education and skills training for health conditions that are Australian health priorities. It has been undertaken to stimulate interest in the task of systematically reviewing this work and to identify areas where further research is needed. Despite the concern that systematic reviews may ignore or downplay research appropriate to assessing communication, there still exists the opportunity to identify areas where communication interventions are working and benefiting consumers. The databases of Cochrane review groups participating in the activities of the Cochrane Collaboration is one such place, and is examined in this article.

McDonald, J
Implementing evidence-based health care: a new model for rural areas.
In: Good Health - good country: from conception to completion: proceedings of the 6th National Rural Health Conference, Canberra, March 2001. Deakin West, ACT: National Rural Health Alliance, 2001, 11p, Online only
http://nla.gov.au/nla.arc-10767-20020417-www.ruralhealth.org.au/sixthc onf/mcdonaldpaper.htm

A new model to understand factors influencing the adoption of evidence based health care (EBHC) in rural Australia is proposed in this paper. EBHC refers to the use of evidence to inform decisions about health at a public health level and the organisation and delivery of the health care system, and includes evidence based medicine (EBM) or practice that uses evidence and clinical expertise to make decisions about the care of individual patients. The focus is on the use of EBM in rural areas, with data examined from two sources: critical analysis and extrapolation of empirical evidence about the implementation of EBM; and the identification and critique of four orthodox models of implementation. Factors reported to influence the adoption of EBM in rural areas are identified and interpretivist approaches to the adoption of EBM in rural health are explored.

Miller, Scott D; Duncan, Barry L; Hubble, Mark A
Beyond integration: the triumph of outcome over process in clinical practice.
Psychotherapy in Australia v.10 no.1 Nov 2003: 32-41,73-80, figures

The empirically validated, integrative and evidence-based practice movements share in the belief that specific therapeutic ingredients, once isolated and delivered in reliable and consistent fashion, will work to improve outcome. Yet research and clinical experience indicates otherwise. How best to proceed in the light of such findings? The authors argue that the best hope for integration of the field is a focus on the common goal of change and the use of outcome to inform the clinical process. Significant improvements in client retention and outcome have been shown where therapists have feedback on the client's experience of the alliance and progress in treatment. Rather than evidence-based practice, therapists tailor their work through practice-based evidence. (Journal abstract)

National Health and Medical Research Council (Australia)
Using socioeconomic evidence in clinical practice guidelines.
Canberra, ACT: National Health and Medical Research Council, 2003, 96p, Online (PDF 311K)
http://www.nhmrc.gov.au/publications/synopses/cp89syn.htm

Australian and international research has demonstrated that people who experience social and economic disadvantage (due to for example, low levels of income, lack of social support, poor education and housing) have poorer health outcomes in terms of morbidity and mortality. Clinical practice guidelines (CPGs) are systematically developed statements that assist clinicians, consumers and health service decision-makers to make appropriate health care decisions. CPGs provide statements of 'best practice' based on a thorough evaluation of the current evidence on the outcomes of treatment or other health care procedures. This handbook provides information to assist developers of CPGs in summarising the evidence of the effects of socioeconomic position (SEP) and other markers (or descriptors) of disadvantage, on health outcomes and health care delivery.

Stiefel, I; Renner, P; Riordan, D
Evidence based: crossing the great divide between research and clinical practice.
Australian and New Zealand Journal of Family Therapy v.24 no.1 Mar 2003: 49-50

This article examines the term 'evidence based practice', and looks at the wide gap between family therapy practice and research. The authors provide the following categories in order to explain the term 'evidence': high quality scientific research; multiple source information; practical clinical experience; and evidence stemming from client feedback.

Slaven, J; Kisely, S
The Esperance primary prevention of suicide project.
Australian and New Zealand Journal of Psychiatry v.36 no.5 Oct 2002: 617-621

Suicide has been a major community concern in Esperance, a geographically isolated port on the south coast of Western Australia. The aim of the project reported in this article was to evaluate the effect of three evidence-based initiatives for the primary prevention of suicide: 1) providing suicide awareness sessions for staff members in health, education and social services; 2) limiting the sale of over the counter analgesics (aspirin and paracetemol) to packets containing less than the minimum lethal dose; and 3) implementing Commonwealth media guidelines in the reporting of suicides by media. The study methodology and results are set out, and it is concluded that local initiatives can improve the awareness and knowledge of staff in the assessment of suicide risk, as well as of local media. These need to be complemented by initiatives at State or Commonwealth level to produce change in statewide media, or sales of over the counter analgesics. (Journal abstract, edited)

Social work

Gibbons, J
Effective practice: social work's long history of concern about outcomes.
Australian Social Work v.54 no.3 Sept 2001: 3-13

Many social workers may believe that their profession has been behind the eight ball in practice research. They may see that the thrust for measuring effectiveness and the learning of research skills that has occurred over the last decade is a new direction for the profession. An examination of social work history in Britain and the USA indicates that an interest in assessing the effectiveness of social work interventions, an 'empirical' approach to practice, has existed almost in parallel with the development of the profession. This paper examines social work's interest in effectiveness research within the context of its history and reflects on its record of practice evaluation. It does not attempt to engage in the debate about the value of empirical research or evidence based practice in social work. It makes the assumption that assessing the effectiveness of their practice is a valuable and achievable task for social workers. An awareness of social work's history in assessing the effectiveness of its practice can provide useful guidelines for future research practice. (Journal abstract)

Gibbs, A
Social work and empowerment-based research: possibilities, process and questions.
Australian Social Work v.54 no.1 Mar 2001: 29-39

Social work research, emphasising the use of rigorous, scientific and evidence-based approaches, has a tendency to exclude the subjects or participants of research, from either acting in co-researcher capacity, or from significantly influencing the course that research involving them will take. This article highlights the need for an inclusive approach with an aim to empower participants, through their greater participation in and decision-making control over research. Three specific research strategies are discussed to illustrate empowerment-based research in social work: action research, collaborative enquiry, and kaupapa Maori research (where Maori self-determination and constructions of knowledge are the starting points for research). The article discusses the possibilities and process of empowerment-based research in social work and highlights the emerging issues for researchers using this approach. (Journal abstract)

McDonald, C
Forward via the past? Evidence-based practice as strategy in social work.
The Drawing Board: an Australian Review of Public Affairs v.3 no.3 Mar 2003: 123-142, Online only (246K)
http://www.econ.usyd.edu.au/drawingboard/journal/0303/mcdonald.pdf

The concept of evidence-based practice is enjoying resurgence across the applied social sciences. This paper examines the concept's deployment in social work, an activity that exemplifies the optimistic institutionalisation of the applied social sciences within post war welfare states. Employing the notion of the professional project, the author charts the development of Australian social work in the 20th century, noting the ambiguities and tensions of working in a humanist profession acting on behalf of the state. Evidence-based practice is one way some social workers have attempted to manage these tensions, a means congruent with the professional project. As the welfare state is destabilised, and in response to managerialist-inspired modes of reform, evidence-based practice has been revitalised. The author assesses the capacity and merit of evidence-based practice as a political strategy articulated by sections of a destabilised occupational group to promote the goals of social work in a context of institutional upheaval. (Journal abstract)

Children and families

Cadd, M
Working with Indigenous children and families: what do services need to know to provide effective support to protect Indigenous children, provide care and strengthen Indigenous communities.
In: What Works? Evidence Based Practice in Child and Family Services - ACWA Conference, September 2002, proceedings. Bondi Beach, NSW: Association of Childrens Welfare Agencies, 2002, 8p, Online only (MS Word 68K)
http://w ww.acwa.asn.au/Conf2002/Conf_proceedings/MCadd.doc

The author argues that the most effective way to protect Aboriginal and Torres Strait Islander children is to strengthen their families and develop Indigenous communities so that Indigenous children can expect to grow up in an environment that meets their developmental needs. Reforms are needed to shift the systems of child protection from their narrow risk and resiliency focus to a broader more holistic focus based around community development and family support. The view of the Secretariat of the National Aboriginal and Islander Child Care (SNAICC) is that mainstream child welfare agencies should not set out to provide programs and services for Indigenous children unless and until they have well established relationships with Indigenous families and communities. There exists a role for mainstream agencies to assist Indigenous agencies develop capacity building through a collaborative approach. Indigenous agencies are significantly under-resourced, have limited management infrastructure and are mostly small, localised services. Mainstream agencies' starting point should be that the best way to provide services to the Koorie community is through the development of well-funded and strong Indigenous agencies. There is a clear role for a partnership approach through activities such as staff exchanges, training and at times mentoring. Strengthening Indigenous organisations allows them to develop the expertise required to develop alternative models.

Cashmore, J
Linking research, policy and practice: including children's input.
Childrenz Issues v.7 no.2 2003: 12-17

The link between research, policy and practice is the foundation of evidence-based practice. This paper outlines the need for a more collaborative process between researchers, policy makers and practitioners to set the research agenda and interpret the findings and work out the implications for policy and practice in relation to better outcomes for children. It also argues for including children's voices in this process, using examples of the role of children's perceptions in understanding the impact of policy changes and practice. It takes as a case study the development of after-care services in New South Wales (NSW), Australia, exploring the role of research in advocating and developing services for young people leaving care. (Journal abstract)

Dixon, D; Morwitzer, J
Evidence-based practice in out-of-home care: presenting new solutions or resurrecting age old dilemmas?
In: One child's reality, everyone's responsibility: proceedings, 8th Australasian Conference on Child Abuse and Neglect. Melbourne, Vic: Department of Human Services, 2001, CD-ROM, 15p

The authors report on a study examining the extent to which senior managers and team leaders in out of home care agencies for children and young people assess and utilise research evidence in adopting new case management approaches. Government and non government agencies in NSW, ACT, and Western Australia participated in the study. The UK Looking After Children system, an evidence based case management tool for use with children and young people in out of home care, is used as an illustrative practice example. Services for at risk families are affected by trends towards privatisation and competitive tendering in the search for welfare reform. The authors argue that evidence based practice can be used to serve multiple purposes. Whilst some see using evidence as a positive means of producing good outcomes for children and families, others believe that it reduces professional autonomy and decision making. (Author abstract, edited)

The Early Development Instrument (EDI) is a teacher-completed checklist that measures five developmental domains: social competence, emotional maturity, language and cognitive skills, physical health and wellbeing, and communication skills/general knowledge. The EDI reflects the influence of experiences of the first five years of life. The results of the behavioural checklist are combined to develop an index for a suburb. The aim is for these results to be disseminated across suburbs thereby assisting with evidence based planning to enhance the factors that influence early life. This report explains the importance of preconception to five years of age, and provides results of use of the Early Development Index (EDI) in north metropolitan Perth. The EDI indicates that of the 4,300 children that were observed in the north metropolitan area, 26% are vulnerable in one or more of the EDI domains and 13% are at high risk of having learning difficulties as they performed within the bottom 10% in two or more of the developmental domains.

McIntosh, Jennifer
Children living with domestic violence: research foundations for early intervention.
Journal of Family Studies v.9 no.2 Oct 2003: 219-234

The impact of violence between parents or caregivers on a child's inner world is complex. Over recent years, researchers have gained vital knowledge about the workings of trauma in children induced by family violence. Of particular power has been definitive evidence about the potential for interspousal trauma to disrupt neurological and biochemical pathways in the developing child. From their respective vantage points, clinicians and researchers name the imperative for the early identification of children traumatised by domestic violence, in the service of preventing acute trauma symptoms from becoming embedded in development, at all levels of the child's functioning. This paper reviews recent evidence about the developmental impact on children of living in violent homes, with the aim of establishing a research-based rationale for early intervention. (Journal abstract)

Ryan, B A
Service integration: a policy paradox.
Childrenz Issues v.7 no.2 2003: 36-42

Integrated services for children and families are more effective. While this claim is rarely questioned, there is actually very little objective evidence that integrating services leads to measurable changes for people. In an era of evidence-based practice, this constitutes a paradox. The roots of this paradox and its implications for service delivery and policy are explored in this paper. (Journal abstract)

Tomison, A
Are we meeting family needs in Australia?
In: 8th Australian Institute of Family Studies Conference, Melbourne, 12-14 February 2003: proceedings. Melbourne, Vic: Australian Institute of Family Studies, 2003, 21p. Online only (PDF 59K)
http://www.aifs. gov.au/institute/afrc8/tomison.pdf

The increasing expansion and identification of social ills or issues (e.g. child abuse and parenting problems, youth suicide, bullying, domestic violence, substance abuse, relationship breakdown etc.), combined with a greater focus on the quality of family life, and the health and wellbeing of family members, has produced significant demand for assistance as families and communities seek external support to assist them in achieving and maintaining a 'reasonable' standard of living, health and wellbeing. This has occurred as traditional forms of support provided by extended family and/orfriends and neighbours have been decreasing. As a consequence families have turned to governments and a range of professional supports to assist them to deal with the changing nature of society and the specific issues they may face. Which leads to the question: are we meeting family needs in Australia? More specifically, is the family support system meeting the needs of Australian families? Do our current approaches work? And if so, how do we know? What is good practice in supporting families? This paper will discuss the benefits of adopting an evidence-based practice approach and provide a brief overview of some of the current trends in service provision that have been developed to meet identified needs, and some promising areas that would benefit from further exploration. (Author abstract)

Child protection

Darlington, Y; Osmond, J
Facilitating the use of evidence based practice in child protection.
In: One child's reality, everyone's responsibility: proceedings, 8th Australasian Conference on Child Abuse and Neglect. Melbourne, Vic: Department of Human Services, 2001, CD-ROM, 4p

The authors introduce a process developed to assist child protection workers to make better use of research based knowledge. They provide a brief introduction to evidence based practice and a rationale for using this approach in child protection, followed by a brief description of the Using Knowledge in Practice (UKIP) program model. The importance of contextualising learning, working critically with workers' existing knowledge and skills, and striving towards best practice, are issues of particular focus. Some evaluative material from the UKIP workshops is also introduced in order to further illustrate the use of particular techniques. (Author abstract, edited)

Tomison, A M
Child protection: getting the most out of research.
Melbourne, Vic: Australian Institute of Family Studies, Conference papers and presentations - invited presentation to the Queensland Child Protection Symposium on Evidence-Based Practice, hosted by the Department of Family, Youth and Community Care and the University of Queensland, Brisbane, November 2000, 9p, Online only (35K)
http://www.aifs.gov.au/institute/pubs/papers/tomison6.html

Australian research into aspects of child protection practice has been hampered for a number of reasons, including: a lack of resources; agency culture; and the difficulties associated with investigating such complex, highly sensitive, real world phenomena. The author contends that the complexities of child protection work require the adoption of methodological flexibility and the use of a variety of approaches in order to better understand the child protection system. These include: case tracking, multiple methods, case studies and action research and the incorporation of a variety of perspectives where possible. In the second half of the paper the author explores issues affecting the collaboration between researchers and child protection departments and ways to facilitate better partnerships and ensure policy and practice are informed by research. Issues identified include: access to information; agency defensiveness; the need for a truly collaborative partnership between child protection and research; intellectual property and tailoring research messages for child protection policy and practice; and the effective utilisation of research once it is completed. The paper concludes with a brief discussion of some methods that may facilitate child protection departments' use of existing external research capacity and knowledge. (Author abstract, edited)

Parenting

Lambert, V; Zubrick, S R; Silburn, S R
Prevention and intervention in parenting: a policy and literature review: reviewing the evidence.
Perth, WA: Family and Children's Services, 1999, various pages, tables, figures

This report was commissioned to assess the evidence base underpinning current WA Family and Children's Services (FCS) policies and programs that target the development, improvement and maintenance of parenting practices conducive to appropriate child rearing. An extensive national and international literature review of significant English-language publications from 1980 onwards was an important part of the research project. Extensive consultation and discussion also took place with FCS at both the executive and field level. The report is presented in three parts: implications for policy, research and direction; a review of evidence based prevention in parenting intervention programs; and summary of the evidence base. The review indicates that, in particular, parent skilling programs such as Triple PPP, Parent Link, Early Education Services, Home School Support and Best Start have particular strength and support from the existing scientific evidence base. Recommendations are presented.

Sanders, Matthew R
The translation of an evidence-based parenting program into regular clinical services.
Australian e-Journal for the Advancement of Mental Health (AeJAMH) v.2 no.3 Nov 2003: 4p, Online only (PDF 25K)
http://auseinet.flinders.edu.au/journal/vol2iss3/sanderseditorial.pdf

It is widely accepted that dysfunctional parenting practices and family conflict are generic risk factors related to a wide variety of behavioural and emotional problems in children and adolescents. The guest editor of this issue of the journal states that the papers presented show that not only can evidence based programs be successfully implemented across different services and delivery contexts, but that ongoing evaluation can demonstrate that outcomes achieved can be comparable to those achieved in clinical trials. These programs combined with existing research trials show that Triple P is a powerful population level intervention supporting parents to more confidently raise their children.

Sanders, Matthew R
Triple-P Positive Parenting Program: a population approach to promoting competent parenting.
Australian e-Journal for the Advancement of Mental Health (AeJAMH) v.2 no.3 Nov 2003: 17p, table, Online only (PDF 111K)
http:/ /auseinet.flinders.edu.au/journal/vol2iss3/sanders.pdf

Family conflict and poor parenting are generic risk factors associated with a wide variety of adverse developmental outcomes in children including increased risk for conduct problems, drug abuse, delinquency and academic underachievement. This paper makes the case for a multi level population based approach to the development of parental competence. Evidence is reviewed showing that while parenting interventions based on social learning approaches are effective, they have significant limitations in achieving a level of population reach that will do enough to decrease the prevalence of dysfunctional parenting. A case is made for a contextual approach targeting the media, primary care services, schools, and work sites as basic institutions within the community which can potentially support the task of disseminating more widely evidence based approaches to parenting intervention. Evidence is reviewed for the efficacy and effectiveness of the Triple P-Positive Parenting Program as a comprehensive, multilevel system of parenting and family intervention. The evidence reviewed shows significant effects across several trials on both child and parent mental health outcomes. Challenges in disseminating empirically supported interventions and possible future directions for family intervention research are discussed. (Journal abstract)

Crime prevention

Blackshaw, J; Walker, N
What have we learnt? Using evidence-based practice when working with Aboriginal and Torres Strait Islander young offenders.
In: What Works? Evidence Based Practice in Child and Family Services - ACWA Conference, September 2002, proceedings. Bondi Beach, NSW: Association of Childrens Welfare Agencies, 2002, 13p, Online only (MS Word 49K)
http://www.acwa.asn.au/Conf2002/Conf_proceedings/26%20Blackshaw%20 Walk er.doc

The authors, who are practitioners in the area of child protection and juvenile justice, provide practice and policy advice to staff who work directly with young offenders. They also aim to ensure that practice is conducted within an evidence based framework, and keep track of trends in youth offending. However, they argue that there is a lack of evidence in this area and research needs to be undertaken so that practitioners within Australia who work with Aboriginal and Torres Strait Islander young offenders can have access to interventions that work. This article looks at the principles of service provision and what makes Indigenous young offenders different to non Indigenous offenders.

Day, A; Howells, K
Psychological treatments for rehabilitating offenders: evidence-based practice comes of age.
Australian Psychologist v.37 no.1 Mar 2002: 39-47, tables

Recent years have seen a resurgence of interest in psychological approaches to offender rehabilitation. In this paper, the authors present an overview of the literature regarding the effectiveness of such approaches and discuss how the research literature has helped to begin to define best practice in this area. Finally, the implications of this work for psychologists working with offenders are discussed. (Journal abstract)