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Report of
Ballarat SafeStart
Demonstration Project
September 2002 – April 2004
This report was written by Deborah Greenslade
SafeStart Project Worker for the City of Ballarat
BALLARAT SAFESTART DEMONSTRATION PROJECT
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ACKNOWLEDGEMENTS In mid 2002 a reference group was established to guide the writing of the submissions for SafeStart and Best Start. When Ballarat was successful in obtaining the SafeStart pilot funding, the SafeStart/Best Start Reference group continued to met on a monthly basis to receive progress reports and offer support and guidance to the project worker. The SafeStart project worker wishes to express sincere appreciation to the members of the reference group for their cooperation and practical support. Anne Scott Manager Child & Family Services City of Ballarat Kevin Zibell CEO Ballarat Child & Family Services David Beaver CEO Centacare Glenda Stanislaw CEO Ballarat Community Health Centre Desley Beechey Manager Women’s & Children’s Health Ballarat Health Services Andreana Harrison Regional Drug & Alcohol Coordinator Grampians Region Tom Niederle Manager Public Health Grampians Region Sue Nelson Co-ordinator Central Highlands Primary Care Partnership Judy Rosson Koori Alcohol & Drug Worker, Ballarat and District Aboriginal Co-operative Jim Bond Manager Student Wellbeing Central Highlands Wimmera Region
Department of Education & Training Keryl Thomas Manager Family & Community Support, Community Care and
Housing Department of Human Services Sharelle Knight Senior Project Officer Family & Community Support Community
Care, Department of Human Services Keryn Crebbin Employment & Learning Coordinator Wendouree West Community
Renewal Clare Scharper President Ballarat & District Kindergarten Teachers Association /
Directress Jubilee Kindergarten Anne Campbell Principal Black Hill Primary School Thanks are also due to others who contributed significantly to the project activities and/or provided support and encouragement during the project: Merran Fleming Best Start Community Facilitator Sue Van Styn Maternal & Child Health Co-ordinator, City of Ballarat Lyn Hedger Maternal & Child Health Nurse City, of Ballarat Pat Thurlbeck Maternal & Child Health Nurse, City of Ballarat Glenda Nuriden Maternal & Child Health Nurse Young Parents Program and
Enhanced Home Parenting Program, City of Ballarat Lorraine Gittings Enhanced Home Parenting Program, City of Ballarat Sue McRae Maternity Unit Manager Ambulatory Services Anne McMurray Parent Educator Ballarat Child and Family Services Phil Catterson Nurse Unit Manager Emergency Department Gwynne Brennan Brigade Support Coordinator Country Fire Authority
Midlands/Wimmera Region Louise Chapman Coordinator Wendouree Child Care Centre Dawn Lyons Parent Educator Ballarat Child & Family Services Janet McMurray Ballarat & District Pharmacy Alliance Barbara Minuzzo Community Safety Consultant Safety Centre Royal Children’s
Hospital Jenny Sherrard and Erin Cassell Monash University Accident Research Centre Lisa Gibbs Centre for Community Child Health Lynne Gallanti Hume City Council The project worker gratefully acknowledges the assistance of the residents of Wendouree West who gave generously of their time to assist with the planning, promotion and conducting of the child safety education strategies within their community. And special thanks to the Dandenong and Yarra Ranges SafeStart Project Workers, Karen Mildren and Carol Emanual, for their constant support, cooperation and sharing of ideas and resources throughout the project.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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TABLE OF CONTENTS Acknowledgements ……………………………………………………………… 1 List of Tables …. ………………………………………………………………... 3 List of Graphs …………………………………………………………………… 3 Acronyms …………………………………………………………………………. 3 List of Attachments ………………………………………………………………. 4 Executive Summary ……………………………………………………………… 5 Introduction ……………………………………………………………………… 8 Background ……………………………………………………………………… 8
Unintentional Injury and Children ………………………………………. 8 Unintentional Injuries in the Home ……………………………………… 9 Ballarat – Community Profile ……………………………………………. 12 Unintentional Childhood Injury in Ballarat …………………………….. 14
Methodology - Planning Process ..…………………………………………… 17
Data Collection and Analysis ……………………………………………. 18 Mapping of Existing Services and Gaps ……………………………….. 18 Description of Target/Intervention Group ………………………………. 20 Objectives …………………………………………………………………. 24 Project Strategies …………………………………………………………. 25
Implementation of Strategies ………………………………………………….. 26
Awareness Raising ………………………………………………………… 26 Training and Education for Parents and Carers ………………………... 31 Training and Education for Service Providers …………………………… 37 Increasing Awareness and Access to Safety products and
Promotion of Environmental Changes to Enhance Child Safety ……… 40 Changes in Policy and Procedures ……………………………………….. 46 Resource Distribution ………………………………………………………. 48 Resource Development …………………………………………………….. 49
Sustainability of Strategies ……………………………………………………….. 53 Evaluation Framework ……………………………………………………………… 55
Data Collection ……………………………………………………………….. 55 Education Sessions ………………………………………………………….. 55 Focus Group ………………………………………………………………….. 55
Key Outcomes and Learnings …………………………………………………… 56
Key Outcomes ………………………………………………………………… 56 Learnings …………………………………………………………………….. 58
Recommendations …………………………………………………………………… 60 References ……………………………………………………………………………... 62
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LIST OF TABLES Table 1 – Major Media (Television, newspaper, radio)…………………………. 20 Table 2 – Minor Print Media (Newsletters and information sheets)……………. 21 Table 3 – Displays ………………………………………………………………….. 22 Table 4 – Professional Education for Service provider …………………………. 31 Table 5 – Home Visits to Risk Families ………………...…………………………. 35 Table 6 – Sustainability of SafeStart Strategies …..……………………………... 44
LIST OF GRAPHS Graph 1 – Location of Injury (1999,2000,2001) …………………………………… 6 Graph 2 – Causes of Injury By Age Group ………………………………………… 7 Graph 3 – Ballarat Emergency Department Presentations for Injury …………… 9 Graph 4 – Ballarat Causes of ED Presentations for Injury ………………………. 10 Graph 5 – Ballarat and Victorian Hospitalisation Rates for Injury ……………….. 10 Graph 6 – Causes of Hospitalisations for Injury in Ballarat Children ……………. 11
ACCRONYMS M&CH Maternal and Child Health
CFA Country Fire Authority
DHS Department of Human Services
LGA Local Government Area
VEMD Victorian Emergency Minimum Dataset
VAED Victorian Admitted Episodes Dataset
MUARC Monash University Accident Research Centre
AIHW Australian Institute of Health and Wellbeing
SEIFA Socio Economic Indices For Areas
GEAS Generic Evaluation Assessment System
CCCH Centre for Community Child Health
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LIST OF ATTACHMENTS List of Key Informants ………………………………………… Attachment 1
Needs Assessment …………………………………………… Attachment 2
Program Plan …………………………………………………... Attachment 3
Maternal & Child Health Safety Session ……………………… Attachment 4
Safety Products Provided to M&CH Participants .……….…… Attachment 5
List of Contents of Safety Information packs ………………….. Attachment 6
Wendouree West Program Rationale & Outline ………………. Attachment 7
Evaluation of Wendouree West Program ……………………… Attachment 8
Safety Kitchens – Product Listing & Photographs …………… Attachment 9
Record of Distributed Resources ……………………………… Attachment 10
Evaluation Tool ………………………………………………….. Attachment 11
Collated Evaluations of Sessions ……………………………… Attachment 12
Directions in Wellbeing – Municipal Public Health Plan …….. Attachment 13
Best Start Action Plan – Health & Safety Group ……………… Attachment 14
Pharmacy Promotion Outline and Photographs ……………… Attachment 15
BALLARAT SAFESTART DEMONSTRATION PROJECT
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EXECUTIVE SUMMARY In 2002/2003 the Department of Human Services allocated funding for eighteen
months for the purpose of supporting three local government demonstration sites to
develop, implement and evaluate local action to address targeted child injury issues.
The project aimed to test ways to achieve uptake and support for proven or
promising interventions in a small number of specific child injury areas. In particular,
the project aimed to test the approach of engaging local communities in the
management and implementation of proven interventions as a way to build long term
local government and community level focus and capacity to respond to unintentional
injury issues.
The priority areas were the home and play settings that encompass a range of
unintentional injury issues amongst 0-8 year olds, including unintentional poisoning,
drowning, near drowning, falls and a range of outdoor recreational injuries
encountered during play activities.
The objectives of the Child Injury Demonstration projects included:
Improve local knowledge of risks, barriers and facilitators, and
enhance local capacity to respond to injury issues
Make an impact on injury incidence and/or demonstratable risk for
each of the priority areas
Build sustainable injury prevention responses at a community, service
and local government level
Test specific interventions at local community level with focus on
disadvantaged groups
Build injury prevention into existing programs or plans as key areas for
attention eg local government public health plans or community health
plans
Unintentional injury is a major health issue in Australia and a leading cause of death
and hospitalisation in children. The City of Ballarat has a high incidence of
unintentional injury in children aged 0-8 years, with one in ten children sustaining an
injury requiring hospital treatment every year.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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The City of Ballarat valued the opportunity to secure funding from the Victorian
Department of Human Services, to be a SafeStart demonstration site and the project
has brought many benefits to the LGA, including a raised awareness of unintentional
childhood injury and enhanced capacity within the LGA to respond to the issue.
Key highlights and achievements of the project include:
Incorporation of child injury prevention into the Best Start Action Plan,
ensuring ongoing emphasis on child safety within the LGA and providing a
mechanism for the achievements of the SafeStart project to continue to
benefit the children and families of Ballarat
The development, piloting and independent evaluation of an innovative child
safety education program that was successfully able to target vulnerable and
at risk families and demonstrate lasting changes in knowledge and behaviour
An ability to respond to local community needs by facilitating the development
of an innovative child safety resource for use with the growing number of
parents within the LGA who have an intellectual disability.
Exploration of the benefits of innovative partnerships with organisations
including The Ballarat and District Pharmacy Alliance and the Office of
Housing, to trial new ways of delivering strategies to reduce childhood injury
by awareness raising, community education and environmental change
Formation of a number of partnerships which assisted to progress the work of
the project, facilitated greater awareness of child injury amongst service
providers and lead to the development of stronger working relationships
between staff from agencies within the LGA
BALLARAT SAFESTART DEMONSTRATION PROJECT
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INTRODUCTION In early 2002, twelve Local Government Areas with significantly high rates of
unintentional injury in children aged 0-8 years, were invited to enter a submission to
the Department of Human Services Public Health Group for one of three SafeStart
pilot projects. The successful submissions were the City of Ballarat, the City of
Greater Dandenong and the Shire of Yarra Ranges.
In September 2002, the SafeStart project worker commenced in Ballarat with a
project brief to pilot innovative approaches to reducing unintentional childhood injury
in the local area. The project worker was initially employed at 0.8 EFT, with the
position becoming full time in July 2003.
BACKGROUND
Unintentional Injury and Children Unintentional injury is a major health issue in Australia. It is well documented that the
most common types of childhood injury resulting in attendance at hospital emergency
departments are falls, road traffic accidents, drowning, poisoning and burns. (Paul,
Redman & Evans, 1992). Each year approximately 300 Australian children aged 0-
14 years are killed and 60,000 hospitalised by unintentional injury. There are
significant financial costs associated with these injuries, with estimates placed at 1.5
billion dollars annually (Kidsafe 2000). Child injury can also have enormous costs to
the injured children and their families. Injuries cause pain, suffering and distress to
the injured child and their family, and many injuries require months of ongoing
treatment and cause disruption and added stresses to family life. Disfigurement and
disability caused by injury can also have lasting effects on a child’s development and
future wellbeing. (AIHW: Al-Yaman, Bryant & Sargeant 2002).
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Unintentional Injuries in the Home The majority of unintentional injuries to children occur in the home. There is reduced
frequency of home injuries as the child ages and an increased frequency of injuries in
other settings, such as playgrounds. This pattern is well documented and is related to
exposure to different hazards in different environments (Routley & Ashby 1997; &
graph1).
Graph 1 – Location of Injury (1999, 2000, 2001)
In the two-year period 1999 and 2000, there were 28 unintentional home injury
deaths in children aged 0-8 years in Victoria, or an average of 14 deaths per year.
Drowning was the most common cause of unintentional home injury deaths with 11
deaths by drowning recorded in 1999 and 2000. Fire, burns and scalds resulted in 9
deaths in children aged 0-8 years with the majority of these being caused by house
fires, (Australian Bureau of Statistics 1999 and 2000).
In the three-year period 1999, 2000 and 2001, there were 61,140 emergency
department presentations for unintentional injury in children aged 0-8 years to the 28
Victorian hospitals that record emergency department presentations due to injury.
(This data forms the Victorian Emergency Minimum Dataset - VEMD). This is an
average of 20,380 presentations a year. Approximately 12% of these presentations
were subsequently hospitalised.
Unintentional Injury by LocationUnintentional Injury in Victorian Children Aged 0-8 Years. VEMD Data 1999-2001
Emergency Department presentations
Home
School, Day Care,Public AdministrationPlace for Sport &RecreationRoad, Street, Highway Other Specified &Unspecified
BALLARAT SAFESTART DEMONSTRATION PROJECT
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The most common causes of emergency department presentations and
hospitalisations due to home injuries are falls, being struck by or colliding with
objects/other persons, poisoning, fire, burns and scalds and cutting and piercing
injuries. Falls are by far the most common reason for injury in all age groups,
accounting for 40% of injuries.
Graph 2 – Causes of Injury By Age Group
The risk of injury is strongly associated with a number of factors including child’s age,
sex, area of residence and socioeconomic status of the family (Al-Yaman, Bryant &
Sargeant 2002). Children under the age of five years are most at risk of unintentional
injury, accounting for almost half of all child injury deaths in children 0-14 years
(Kidsafe 2000). There are also clear patterns associated with age and different types
of injury (see graph 2) and these are linked to mobility, access and developmental
stage. For example hospitalisations due to poisoning are highest in the 1-4 year
group, with rates dropping sharply in children ages 5-9 years. The injury pattern is
also strongly associated with a child’s sex. For most types of childhood injury and all
age groups after 1 year, boys are at higher risk of injury than girls (Al-Yaman, Bryant
& Sargeant 2002).
Top 5 Causes of Injury by Age groupEmergency Department presentations
Unintentional Injury in Victorian Children Aged 0-8 Years. VEMD Data 1999-2001
0100020003000400050006000700080009000
10000
Number of Injuries
0-1 years 6223 2315 868 1302 10132-4 years 9448 4379 1844 1845 6915-8 years 7075 3698 1929 161 322
Falls Struck by collision with Cutting piercing Poisoning Fire/burns/scalds
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Where a child resides also has an impact on the risk of injury. Children living in
remote areas experience the highest rates of injury, followed by children living in rural
areas, while children living in metropolitan areas have the lowest rate. This is likely to
associated with different hazard exposure (Al-Yaman, Bryant & Sargeant 2002).
Other factors strongly associated with childhood injury include poverty, single
parenthood, low maternal education, low maternal age at birth, poor housing, large
family size and parental drug or alcohol abuse. (UNICEF 2001). The link between
socioeconomic status and childhood injury has been well established (Stokes, Ashby
& Clapperton 2001/2002; Faelker, Picket & Brison 2000; Evans & Kohli 1997). It is
not difficult to understand the link between low socioeconomic status and childhood
injury as families living in poverty are unlikely to have access to newer and more
expensive products with enhanced safety features including cars, nursery furniture
and child safety products. Low income families are also more likely to be living in
poorer housing conditions, while social problems associated with poverty further
increase the risk of injury to children (Al-Yaman, Bryant & Sargeant 2002).
However, it appears that socioeconomic status may be involved in more than the risk
of injury. Stokes, Ashby and Clapperton (2001/2002) cite the findings of Girasek
(2001) who reported that socioeconomic status significantly predicted whether or not
respondents believed injuries could be prevented. Low socioeconomic status was
associated with the belief that injuries were inevitable, whereas higher
socioeconomic status was associated with beliefs that injuries were preventable.
Interventions targeting families from low socioeconomic status must address both
change in attitude and the financial barriers to environmental changes within the
home.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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BALLARAT – COMMUNITY PROFILE
GEOGRAPHY AND HISTORY
The municipal district of the City of Ballarat is part of an area of land under the
traditional custodianship of the Wathaurong people and comprises the city of
Ballarat, and the townships of Learmonth, Buninyong, Miners Rest and Cardigan
Village. In all the City of Ballarat has an area of 740 square kilometres.
The City displays a rich variety of topology and natural environment which comprises
rolling hills, granite outcrops, heavily forested areas and numerous bodies of water.
The urban settlement patterns offer a diversity of living environments, including small
villages and country towns, as well as the main cityscape of central Ballarat, which
includes heritage architecture of national significance and international interest..
Ballarat is rich in history, and commands an important place in the story of the
settlement of Australia. Historical remnants include significant indigenous sites, the
distinguished architecture from the gold rush era and the “living” history of Sovereign
Hill and the Eureka rebellion.
Ballarat’s economic base has gone through many changes since white settlement,
from gold mining and farming in its early days to value-added food processing and
manufacture of high-tech machinery components. Of increasing importance is the
service sector, including tourism and information technology services.
DEMOGRAPHICS The percentage of the population under 40 years of age is 57.2% which is similar to
the state average, and over the next 10 years, an increasing proportion of the
population will be aged between 45 and 75 years. Compared with the three other
LGA’s in the Central Highlands of the Ballarat population (Victoria 12%). Although the
number of 0-8 year olds is predicted to fall over the next 10 years, it is difficult to
BALLARAT SAFESTART DEMONSTRATION PROJECT
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validate this given Ballarats current healthy growth rate, which includes an increase
in the number of families with young children relocating to Ballarat.
Ballarat has a higher proportion of people who identify as Aboriginal and/or Torres
Strait Islander (0.9%) compared with the rest of the State (0.3%). Recent data
indicates that approximately 25% of Indigenous people are aged between 0-8.
Although there is a lower proportion of Ballarat residents born overseas (7.6%)
compared with the rest of the State (24.8%) there are approximately 30 different
Countries of origin represented in Ballarat. The greatest numbers in order of the top
10 are United Kingdom, Netherlands, New Zealand, Italy, Germany, Croatia, India,
Greece, Poland and Ireland.
The Socio-Economic Disadvantage Index rates Ballarat at a higher disadvantage
than Victoria as a whole. For example, at the 50th percentile (below the median),
Ballarat had a score of 63% compared with 49.3% for Victoria. This index is derived
from attributes such as income, educational attainment, unemployment or jobs in
relatively unskilled occupations, and is extracted from the Census questions by the
Australian Bureau of Statistics.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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UNINTENTIONAL CHILDHOOD INJURY IN BALLARAT
In Ballarat, there has been a 10% increase in emergency department presentations
due to unintentional injury between 1999 and 2001. Hospitalisations due to injury
have remained fairly constant, averaging 101 per year over the last three years
(graph 3).
Graph 3 – Ballarat Health Services Emergency Department Presentations for
Unintentional Injury in Children aged 0-8 years (Source VEMD Data)
0100200300400500600700800900
100011001200
Year 1999 Year 2000 Year 2001
No E
mer
genc
y D
epar
tmen
t P
rese
ntat
ions
Falls were by far the leading cause of emergency department presentations in
children aged 0-8 years causing almost twice as many presentations than the
second highest cause – struck by or collision with a person or object. The third
highest cause was cuts, followed by injuries due to fire, burns and scalds and
poisoning (graph 4). The top 3 causes are consistent with the Victorian top 3 causes
of injury, but in Ballarat injuries caused by fire/burns & scalds were the 4th highest,
compared with poisoning in Victorian data.
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Graph 4 – Causes of Emergency Department Presentations for Unintentional Injury
in Children Aged 0-8 Years, 1999,2000 and 2001 in Ballarat (Source VEMD Data)
Top 7 Causes of Emergency Department presentations
1080
543
259
118
62
49
39
0 200 400 600 800 1000 1200
Falls
Struck by collision with person or object
Cutting, piercing object
Fire, burns, scalds
Poisoning
Motor vehicle/motorcycle
Pedal cyclist
Number of Presentations
Ballarat’s rate of hospitalisations due to unintentional injury is greater than the
Victorian average, with the Wendouree and Delacombe/Sebastopol postal areas
(3355 and 3356) having the highest rates. The 3350 postcode area which covers
most of the City of Ballarat has a slightly higher rate of hospitalisation for injury than
the state average (graph 5).
Graph 5 – Ballarat and Victorian Hospitalisation Rates for Unintentional Injury in
Children Aged 0-8 Years
Hospitalisations - Comparison With Victorian Rate. VAED Data July 1999 - June 2001. Average annual Rate
0
5
10
15
20
25
30
35
Balla
rat
LGA
3350
3351
3352
3355
3356
3357Ra
te P
er 1
000
Child
ren
0-8
Year
s
Rate per 1000Victoria
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Graph 6 – Causes of Hospitalisations for Unintentional Injury in Ballarat Children
Aged 0-8 Years (Source VAED July 1999 – June 2001)
The leading 3 causes of hospitalisation are falls, collisions and cuts and are the same
as the leading 3 causes of emergency department presentation and consistent with
Victorian data. Poisoning was the 5th highest cause of emergency department
presentation but the 4th highest cause of hospitalisation. This is indicative of the
severity of injuries due to poisoning and of the seriousness with which they are
viewed by hospital staff. Hospitalisations from dog bites ranked 7th and appears to be
a growing health issue (graphs 5 & 6).
Post code areas and causes of injuries focused on in the Ballarat SafeStart project
were selected to address areas of highest need and leading causes of childhood
injury, as highlighted by the data discussed in this section.
Top 7 Causes of Hospitalisation
0 20 40 60 80 100 120 140
Falls
Struck by collis ion 30with person or object
Cutting, piercing object
Poisoning
Fire, burns, scalds
Motor vehicle /motor cycle
Dog related
Number of hospitalisations
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METHODOLOGY - PLANNING PROCESS The SafeStart project worker commenced employment with the City of Ballarat in
September 2002. The first task for the project worker was the completion of a local
based needs assessment into the identified health issue of unintentional injury in
children (see attachment – 2). This component of the project involved three main
tasks which were tackled concurrently during the first four months of the project.
These were:
collation and analysis of demographic data for the LGA and the raw data on
emergency department presentations and hospital admissions
a review of the existing literature on unintentional child injury
a local mapping of existing injury prevention activities and gaps in service
provision.
Analysis of the data confirmed that the three postal code areas highlighted for
attention in the submission had elevated injury incidence and should remain the
focus of the project.
After consulting with the community and key informants it was decided to trial some
interventions with vulnerable and marginalised groups within Wendouree, Delacombe
and Sebastopol, rather than target the whole of those post code areas. These
interventions aimed to address the increased vulnerability to unintentional injury of
children from families with one or more of the following risk factors: poverty, single
parenthood, low maternal education, low maternal age at birth, poor housing, large
family size and parental drug or alcohol abuse.
Strategies for the 3350 post code area were planned to target all parents,
grandparents and carers of young children. The rationale behind this being that
although the incidence of injury is higher in children from disadvantaged
backgrounds, more children from non-disadvantaged backgrounds are actually
injured, because there are more of them.
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DATA COLLATION AND ANALYSIS Emergency department presentation and hospital admissions data from VISAR was
collated and analysed by the project worker and utilised to build a picture of the
incidence of childhood injury in Ballarat. The data revealed that the incidence of
injury per 1000 children was significantly higher for Ballarat than for Victoria (see
discussion under ‘Background’).
The two postcode areas that were identified as having the highest incidence of
childhood injury per 1000 children as compared to Victoria, were Wendouree and
Delacombe/Sebastopol. The 3350 post code area, where 58% of the population of
Ballarat resides, was also found to have a higher incidence, although not as high as
the other two postcodes.
Review of the one line descriptions completed by hospitals about each injury
presentation provided an added dimension to the data and a greater understanding
of how injuries were occurring and therefore what interventions could prevent them.
For example rather than just see that two children had been admitted for poisoning
during a certain period of time, we are told of a child who ate rat-sack he found under
the stove and of one who ate 2-3 antidepressants from her mother’s handbag.
Analysis of the data took a number of weeks but was time well spent as it provided a
solid foundation for program planning. A sound understanding of the data was also
essential when meeting with key informants and the data for Ballarat was certainly a
powerful tool for enlisting support for the SafeStart project.
MAPPING OF EXISTING SERVICES AND GAPS The project worker conducted approximately 30 interviews with the key informants
listed in Appendix-1 and focus groups with teenage parents and Maternal and Child
Health Nurses. The main aims of the interviews were to conduct a mapping of
existing injury prevention activities and gaps in service provision, identify areas of
high priority, canvas ideas from service providers for effective interventions and
identify individuals who may assist in delivery of interventions. Broadly speaking,
existing injury prevention strategies in the LGA were able to be classified into three
main categories: Intensive intervention
Part of regular work with target group
Broad based community education programs
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Intensive intervention - one on one injury prevention delivered as part of
intensive interventions with families experiencing problems is carried out by
organisations including Child & Family Services, Child Protection, Centacare,
Ballarat Health Services Domiciliary Care and some special programs run by
The City of Ballarat Maternal and Child Health program. Staff from these
services report high incidence of injury causing hazards in many of the
homes they visit, with knowledge, finance, attitude and poor literacy identified
as barriers to reduction. The ability of programs to access brokerage to
address child safety hazards in the home varies depending on the program’s
budget, with some organisations able to supply and install heater guards,
safety gates and various other small safety devices in the homes of the
clients they work with. Other projects do not always have access to
brokerage money and express frustration at not being able to address
identified hazards. One service has a comprehensive display of available
safety products in the bathroom and kitchen areas, which provide learning
opportunities for clients using the service.
Part of regular work with target group - Maternal and Child Health Nurses
and Antenatal Parent Education classes carry out injury prevention delivered
as a component of existing programs. Maternal and Child Health Nurses
reported handing out poisons information brochures and stickers and the
Kidsafe Ages & Stages sheets on a regular basis with mixed levels of
response from parents. Each year M&CH run first time mothers programs
and approximately half of the nurses reported covering safety as a
component of these programs.
Broad based community education programs - state and Australian wide
campaigns run periodically with the aim of raising awareness of particular
causes of unintentional child injury. Campaigns around water safety and road
safety are recent examples. These campaigns serve as very useful tools in
increasing community awareness and knowledge around child injury
prevention strategies. When coupled with legislation and on the ground
interventions, these campaigns have the potential to assist to change
community attitude to undesirable behaviours as evidenced in many of the
road safety campaigns.
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DESCRIPTION OF TARGET/INTERVENTION GROUP The target group for the SafeStart intervention was children aged 0-8 years residing
in Wendouree West, Delacombe/Sebastopol and the 3350 postcode area. The 2001
ABS census data recorded 4,555 families with a child/ren 0-8 years residing in the
four areas and a total of 7,625 children 0-8 years. Although some program activities
were addressed at the target group (especially children of school age), the majority of
the activities were aimed at the intervention group (parents/carers of children 0-8
years) and professionals working with them.
Wendouree West Children 0-8 years – 522 Families with children 0-8 years – 299 Wendouree West is part of the Wendouree postcode area 3355 and was chosen as a
target for project activities due to the high incidence of unintentional child injuries and
high levels of social and economic disadvantage. The area is ranked in the bottom
10% of the state in the Socio Economic Indices For Areas, Australian Bureau of
Statistics. Socio-Economic Indexes For Areas (SEIFA) is a series of indexes for
geographic areas based on data derived from the 1996 Census of Population and
Housing. The Index of Relative Socio-Economic Disadvantage is derived from
attributes such as low income, low educational attainment, high unemployment or
jobs in relatively unskilled occupations. Therefore areas with a low score occur when
there are many low income families and people with little training and in unskilled
occupations.
Wendouree West is an area with high levels of public housing (37.7%) and a high
proportion of families headed by a single parent (48%). The area also has a high
percent of young children, with children aged 0-8 years comprising 18.3% of the
population compared to 12.5% across the LGA.
Wendouree West has a centrally located community house which runs a range of
programs and residents can also use it as a drop in centre. The community house
was an excellent community resource for the SafeStart project providing a venue for
demonstrating safety products and a centrally located venue for meetings with
residents.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Recent local and government initiatives in Wendouree West include the Wendouree
West Community Renewal Project and Strengthening Generations, Communities
That Care Program. Both programs work closely with local residents to enact long
lasting structural and social improvements in the area.
In Wendouree West, the Community Renewal was an excellent support for the
SafeStart project, providing significant support with program promotion, advice and
guidance. Involvement in the Health and Safety Sub-committee provided the project
worker with networking opportunities with workers and residents in the area and lead
to the partnership with the CFA which provided additional funding and expertise for
program activities (see discussion under Parent and Carer Education and Training).
Delacombe/Sebastopol Children 0-8 years – 1623 (Delacombe - 592, Sebastopol - 1031) Families with children 0-8 years – 955 (Delacombe – 338, Sebastopol – 617) Delacombe and Sebastopol cover most of the 3356 postcode area. The Jesuit Social
Services study, ‘Unequal in Life’ which examined the distribution of social
disadvantage in Victoria and new South Wales, ranked the 3356 postcode
(Sebastopol & Delacombe) 27 out of Victoria’s 622 postcode areas.
Delacombe - The suburb of Delacombe comprises 1135 homes with a large public
housing development of 148 residences (13%). The majority of the remaining
housing (72%) is owned or being purchased and includes a number of new housing
developments.
The area also has a high percent of young children, with children aged 0-8 years
comprising 18.4% of the population compared to 12.5% across the LGA. Twenty-six
percent of families are headed by a single parent which is comparable to the rate
across the LGA but higher than the Victorian rate. Families residing in the Public
Housing estate were the main focus of the SafeStart project due to the high
incidence of unintentional child injuries and high levels of social and economic
disadvantage.
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A number of community picnics held in the in the public housing estate during late
2002 and early 2003 were attended by the SafeStart project worker. The picnics
were funded by the City of Ballarat Community Development team and provided
opportunities early in the project to meet local residents and workers and to trial
displays and competitions promoting child safety messages.
The Strengthening Generations, Communities That Care Program is also operating
in Delacombe and involvement in the Action Group enabled the SafeStart project
worker to build relationships with local residents and staff working with families in the
area.
One of the main challenges faced when working in the Delacombe community was
the lack of a central venue for activities. There are no local shops within the housing
estate and although a number of agencies work with the community, none have local
offices. A working group has been established under the Strengthening Generations
program to establish a Community House in the estate and this would greatly assist
future programs by providing a focus for project activity and opportunities to consult
with residents.
Sebastopol - Sebastopol is an established suburb within Ballarat, which is experiencing some new
housing developments on the outskirts. Children aged 0-8 years comprise 13% of the
population which is comparable to the 12.5% across the LGA. Thirty-seven percent
of families are headed by a sole parent, which is significantly higher than the state
and the LGA. There are 3156 homes in Sebastopol, of which 270 (8.6%) are public
housing properties.
The Ballarat Community Health Centre has a large facility in Sebastopol and there
are a number of businesses including two supermarkets in the area. However, the
central business district is spread out over a number of sites, giving a rather
disjointed feel to the community.
Project activities were limited in Sebastopol, as the project plan was overly ambitious
given the relatively short duration of the project.
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3350 POSTCODE AREA Children 0-8 years – 5480 Families with children 0-8 years – 3301 The 3350 post code covers a large area including central Ballarat and residences to
the East and West of the city. Fifty-eight percent of Ballarat’s 80,045 residents reside
in this area and 11.8% of them are aged 0-8 years. The 3350 area is well serviced
with many community organisations and service providers located centrally.
Twenty-nine percent of families residing in this area are headed by a sole parent,
which is higher than the Victorian average 14%. Of the 17,933 homes in this area,
687 (3.8%) are public housing properties, with many of these located in estates in
Mount Pleasant and Ballarat East.
Interventions in the 3350 postcode area targeted the broad community and were
aimed at all parents, grandparents and carers of young children.
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Objectives The following objectives were developed for the Ballarat SafeStart project. Refer to
attachments 2 and 3 for a copies of the needs assessment and program plan.
OBJECTIVE 1 - To increase parent/community injury prevention knowledge and intention to act to install safety products and reduce hazards in the home and at play.
SUB-OBJECTIVES -
To increase parent/community awareness & knowledge of childhood injury
To increase the access of parents in the target group to education sessions
about hazard identification, elimination and management.
To increase the awareness and use of child safety products & low cost
alternatives within the community.
To acquire support, including financial & labour, from service clubs to obtain
services & install safety products in the homes of economically
disadvantaged families.
To increase parent/community awareness of safety requirements associated
with new/second hand nursery furniture.
OBJECTIVE 2 - To increase the level of health promotion activity directed at the prevention of unintentional injury in children aged 0-8 years within Ballarat LGA.
SUB-OBJECTIVES - To raise awareness & knowledge amongst health professionals & other
workers about child injury & effective interventions.
To increase availability of injury prevention resources for health
professionals.
To provide access to health professionals to professional development in
childhood injury prevention strategies in Ballarat LGA.
To inform key personnel in the serious and growing issue of unintentional
injury in children and advocate for the integration of childhood injury
prevention into local programs & plans for key attention.
To formalise child injury prevention into policy & protocol of departments
within council & organisations within broader community
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OBJECTIVE 3 - To increase access of parents with a child aged 0-8 years to paediatric first aid training.
SUB-OBJECTIVES To increase parent/community awareness of importance of applying
appropriate first aid treatment to reduce severity of child injuries. Increase parent/carer access to paediatric first aid training.
Strategies Many countries including America, Sweden and Australia have demonstrated the
significant reductions in childhood injuries are possible. The strategies which have
proven to be effective are education and publicity, safer products and surroundings,
promoting public policy, enforcement, data collection, research and evaluation and
empowerment. A combination of strategies is most effective (Victorian Department
of Human Services 2000; Hemmo-Lotem & Danon 2003). Listed below are the
range of strategies that were planned for the Ballarat SafeStart project to achieve the
stated objectives. (See attachment 3 for further details as per the program plan.)
1. Awareness raising of child safety issues
2. Parent and carer education and training 3. Professional education for service providers of family and children’s services
4. Increasing awareness/access to safety products and promotion of environmental
changes to enhance child safety
5. Changes in policy and procedures
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IMPLEMENTATION OF STRATEGIES 1. AWARENESS RAISING OF CHILD SAFETY ISSUES A variety of media activities were used to deliver injury prevention messages to the
community. In the initial stages of the project the focus was on raising the profile of
the SafeStart project. Later media activities focused around specific project activities
such as the launch of the brochure display at Ballarat Health Services and the
childhood poisoning prevention promotion through local pharmacies.
The media was also utilised to promote key child safety messages associated with
various causes of injuries, such as water safety and falls prevention. A summary of
local media activity is provided in tables 1, 2 & 3.
Table 1 – Major Media (Television, Newspaper & Radio)
Title and type of material Target group % of target reached
Time period of distribution
Distribution
3BA Radio program – Health Matters (different from above) 1 x ten minute discussion by local GP
Parents/ carers & Grandparents children 0-8yrs
40% of target April Estimated 45,000 listeners in Ballarat & surrounding area
ABC Regional Radio 1 x 5 minute discussion about SafeStart & display launch at hospital
Health Professionals/Parents & Grandparents children 0-8yrs
10% of target May 13th 2003
Over 40,000 listeners
Ballarat Courier Article on launch of hospital display
Health Professionals/Parents & Grandparents children 0-8yrs
Majority of families in Ballarat – 70%
21 may 2003
20,400
WIN Television News Footage of launch and program details?
Health Professionals/Parents & Grandparents children 0-8yrs
Majority of adult population – 80%
May 13th 2003
Number of viewers across regional Victoria = 150,000 In Ballarat =50,000
My Ballarat – City of Ballarat Newsletter SafeStart – preventing childhood poisoning
Parents, grandparents & Carers of young children
100% October 2003
37000 copies produced, distributed to all Ballarat Homes (35,000), 1500 businesses & 50 schools
Ballarat Courier Medicine Campaign Targets Children
Parents, grandparents & Carers of young children
63% of Ballarat homes Friday 29/10/03
22,000 copies distributed
The Advocate Learn about poisons – and save a child
Parents, grandparents & Carers of young children
15/10/03
Ballarat News Prevent childhood poisoning – return unwanted medicines
Parents, grandparents & Carers of young children
100% 15/10/03 Free paper distributed to all Ballarat homes & businesses
ABC Regional Radio 5 minute interview on poison prevention promotion
Parents, grandparents & Carers of young children
21/10/03 Number of listeners
3BA Radio News bulletin item throughout the day on poison prevention promotion
Parents, grandparents & Carers of young children
23/10/03 Number of listeners
My Ballarat – City of Ballarat Newsletter SafeStart – water safety
Parents, grandparents & Carers of young children
100% October 2003
37000 copies produced, distributed to all Ballarat Homes (35,000), 1500 businesses & 50 schools
Ballarat Courier Article discussing child safety & SafeStart program
Parents, grandparents & Carers of young children
63% of Ballarat homes 21/4/04 20,400
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Table 2 – Minor Print Media (Newsletters And Information Sheets)
Title and type of material Target group % of target reached
Time period of distribution
Distribution
Health Matters - Newsletter of BHS SafeStart Program overview + photo
Staff, Parents & carers of children 0-8
difficult to estimate April-May 2003
2000+ Staff from BHS
Health Matters - Newsletter of BHS Preventing scalds from hot tap water
Staff, Parents & carers of children 0-8
difficult to estimate April-May 2003
2000+ Staff from BHS
Health Matters - Newsletter of BHS Falls & bumps inside the home
Staff, Parents & carers of children 0-8
difficult to estimate April-May 2003
2000+ Staff from BHS
Health Matters - Newsletter of BHS Launch
Staff, Parents & carers of children 0-8
difficult to estimate April-May 2003
2000+ Staff from BHS
Health Matters - Newsletter of BHS Launch + photo
Staff, Parents & carers of children 0-8
difficult to estimate April-May 2003
2000+ Staff from BHS
Health Matters - Newsletter of BHS Water Safety + launch photo
Staff, Parents & carers of children 0-8
difficult to estimate April-May 2003
2000+ Staff from BHS
City of Ballarat Guide to Family & Children’s Services - Promotion of program & parent information sessions
Health Professionals/ Parents & Grandparents children 0-8yrs
Provided to every new mother in hospital (1000 per year) & distributed to Maternal & Child health, Childcare centres, Little Clinic
1500 annually
Ballarat Healthy Community Program newsletter Photo + article on program, recent activities & contact details for information sessions
Health Professionals/ Parents & Grandparents children 0-8yrs
All households in Delacombe (50% of 3356 postcode) + 500 agencies & individuals associated with Healthy Communities Program
Autumn 2003
3000
City of Ballarat - Customer & City Services News In Brief
All staff & Councillors difficult to estimate July 2003 Distributed to 600 Council staff & Councillors
Parent Talk – M&CH Newsletter Water Safety Article
Parents & Carers Oct/Nov 2003
300 copies distributed to date via M&CH centres
Human Services News Photo & article on SafeStart
Health Professionals and other organisations funded by DHS
Nov’ 2003
Information sheet – child injury prevention tips. Distributed with Family & Children’s Services Parent Survey. (a basket of safety products was also provided as a prize to encourage families to return their surveys)
Parents & carers October 400 distributed
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Table 3 – Displays
Activity/event Primary target group
Reach to target
Time period of activity
Associated benefits
Safety display at Wendouree West Healthy Kids Carnival
Parents and children aged 0-8
Target 299 families. Reach 90 adults -30%
13/11/2002 3 hours
65 competition entries – spot the hazard. 90 thermometers distributed to families. + 305 brochures/booklets
Safety Display – Delacombe Community Picnic
Parents and children aged 0-8
Sunday 16/2/03 – 3 hours
Staff networking
Safety Display – Delacombe Community Picnic
Parents and children aged 0-8
Sunday 6/4/03 – 3 hours
Networking with staff from other services & agencies. Awareness raising
Safety Display – Ballarat & District Aboriginal Cooperative
Parents and carers of young children
11/4/03 – one day
Awareness raising
Safety products display boards
Parents and carers of young children
Rotating display at sites in Ballarat (3-4 wks at each)
Locations: Paediatric Ward of BHS, Barkly Street & Cooinda M&CH, Family Day Carer induction training, SafeStart safety sessions
Safety Display – Ballarat & District Aboriginal Coop, NAIDOC week
Koori parents & grandparents
July 9th – one day
Display on prevention of poisoning & competition for a poisons cabinet. 21 competition entries, 20 brochures & stickers distributed.
Display of Safety products – Family Day Carers Induction
Family Day Care Providers
Eight new carers
30/6 & 1/7/2003 - 2 days
Safety product awareness raising
Display of Safety products – Family Day Carers Induction
Family Day Care Providers
Seven new carers
19th Sep 2003 1 day
Awareness raising of availability of safety product and installation
SafeStart/Best Start Display. Wendouree Village during Purple Clover Week
Parents and carers of young children
Engaged with 14 families
Sep 11th 2003 – 3 hours
A basket of safety product was awarded to the competition winner & 86 resources distributed.
Static display, Central Square shopping centre for Purple Clover Week
Parents and carers of young children
Five days Awareness raising & networking with staff from local agencies
SafeStart/Best Start static display. Show & Shine
Parents and carers of young children
Sunday 9th Nov 2003
Negligible
Combined SafeStart Display – Injury Prevention Week launch
Parents and carers of young children & those working in the field of injury prevention
19/10/03 Awareness raising and opportunities to network.
Combined SafeStart Display – VSCN
Those working in the field of injury prevention
31/10/03 Good level of interest show in the display and opportunities to network with others in injury prevention field.
18 x displays on prevention of childhood poisoning held in Ballarat and district pharmacies
Parents, grandparents and carers of young children
Injury Prevention week & the week following Oct 20th – 31st
Awareness raising and staff education
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Outcomes - Media Previous experience by Council has demonstrated a high level of response by the
community when utilising the local media and so local media was thought to have the
potential to be an effective means of disseminating key child safety messages during
the project. Twenty-four newspaper, radio and newsletter items were published
during the project and some of these media items had the potential to reach many
1000’s of households.
Child safety was viewed favourably by most local media and generally a positive
response was received to press releases. The local free press newspaper, which is
delivered to all households, was thought to provide an excellent opportunity for
reaching low income families. However, although the project worker received ante
dotal feedback to support this assumption, it was not formally tested during the
project. The heavy reliance of the free press on paid advertising was a barrier to
having items published, with the paper giving preference to paid advertisements and
editorials. Council’s bi-monthly newsletter to all residents in the LGA, adopted a
more community focused approach to the publication in late 2003. This enabled a
number of child safety articles be published and was an excellent method of
reaching the whole population.
The largest identified barrier to utilising the media was the substantial time involved
in researching and preparing press releases and preparing for interviews. As a
consequence, opportunities to involve the media were not always able to be explored
and developed. The transient nature of most media forms also meant many
messages were short lived within the community.
Outcomes - Displays Thirty-one displays were held during the SafeStart project. Displays have the
potential to be an effective awareness raising strategy, but require careful planning to
ensure they reach the target audience and deliver simple key messages. The use of
small promotional items such as pens and thermometers and activities such as
competitions were found to be an effective strategy for engaging with parents and
carers during displays.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Utilising local businesses to host child safety displays was trialled in Ballarat during
Injury prevention Week in 2003, when SafeStart, in partnership with the Ballarat and
District Pharmacy Alliance, conducted displays in local pharmacies (see attachment
15 for proposal outline and photographs). The benefits demonstrated by this strategy
were in the areas of community awareness and engagement of the Pharmacists.
Eighteen local pharmacies were involved in this promotion which involved in store
and window displays promoting safe storage of medications, the return of unwanted
medications service provided by pharmacies and the poisons information line.
Colouring competitions were run by some pharmacies with local primary and pre-
schools, while other pharmacies held competitions where adults could win a poisons
medication cabinet. The project worker provided the display materials, prizes for
competitions and information packs for each pharmacy. Displays remained in stores
for up to two weeks, enabling the key messages to be delivered simultaneously
across Ballarat at a number of locations. Local media was also used to promote the
poisoning prevention messages throughout this time.
It is not usual for Pharmacists to actively promote injury prevention, but with data
demonstrating medications as the agent involved in of 70% of childhood poisoning it
is a logical strategy to seek support from these health professionals. The Ballarat
project encountered a high level of support and enthusiasm for the project from the
pharmacists and interest was expressed by the Pharmacy Alliance in continuing
their involvement by promoting the return of unwanted medications on an annual
basis.
There are few ready made displays on child injury prevention available and the time
spent sourcing and preparing of display materials reinforced the benefits that could
be conferred on local injury prevention campaigns by the provision of displays and
information at a state wide level. Arranging, setting up and staffing displays is also
very time consuming and the benefits have to be weighed against the substantial
time investment required.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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2. PARENT AND CARER EDUCATION AND TRAINING Approximately 50 parent information sessions were conducted during the project.
Sessions ranged in length from ½ - 1½ hours depending on group requirements. All
information sessions aimed to:
Increase awareness of unintentional child injury as a serious health issue
Increase knowledge of child injury risk factors and prevention strategies
Raise awareness of the wide range child safety products available to
enhance home safety
inform parents/carers of local and metropolitan retail outlets for child safety
products
The following lists the various sessions that were undertaken:
a. First Time Parents’ Program - Maternal and Child Health At the commencement of the SafeStart project the Ballarat Maternal and Child Health
Nurses already possessed a positive attitude towards child safety, but it was just one
of many topics they addressed within their role and many of the Nurses reported a
lack of interest in child safety amongst parents. Child safety, as a component of the
First Time Parents’ Program was only covered by approximately 50% of nurses, with
those that covered safety reported devoting between 40 – 90 minutes (½ - 1 full
session) to the topic. Encouraging all M&CH nurses to conduct one full session of
child safety with all First Time Parent Groups was seen as an effective and
sustainable method of educating 400 families a year.
During 2003, the project worker conducted sixteen first time parent sessions, trialling
a number of resources and activities (some from existing kits and some new) aimed
at conveying maximum information and increasing the interest level of participants
and facilitators. With the assistance of a small working group of interested nurses, a
standard safety session was then developed (see attachment 4). From February
2004, this session has been delivered by the M&CH Nurses.
This was a successful strategy that built on an existing framework and the existing
skills and knowledge of the nurses. Presentation of local and state child injury data
helped to raise the profile of child safety within the Maternal and Child Health
Program. The project worker conducted the first time parent’s safety sessions during
BALLARAT SAFESTART DEMONSTRATION PROJECT
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much of 2003 and this enabled the project worker to establish a good working
relationship with many of the nurses and develop a session that was interesting to
deliver and informative to participants.
In order to further increase interest in the sessions and provide participants with
additional safety information, eight hundred items of safety product and eight
hundred safety information packs were purchased through the SafeStart program
(see attachments 5 and 6). The resources will be distributed via the first time parent
safety sessions over the next two years. Maternal and Child Health staff plan to seek
further funding at this time, to replenish stocks. During the next twelve months the
Maternal and Child Health Program will be aiming to develop policy documents
relating to orientation of new staff and content of the First Time Parents program. The
SafeStart project worker has been informed that child safety will be included in both
these documents, ensuring long term focus on child injury prevention by all M&CH
staff.
b. General Child Safety information Sessions
These were presented by the project worker to a range of community groups and
organisations including Young Mum’s Antenatal Groups, Neighbourhood Watch, The
Breast Feeding Association, Foster Care Parents, parenting groups, parenting
mentors groups and playgroups. Each session covered a range of child safety
issues and was tailored to the age of the children. It was important to maintain
flexibility when dealing with community groups and seize the opportunity when it
presented itself and adapt the session to the time the group had available, even if it
wasn’t ideal.
The project worker found the Kidsafe quiz on child injury to be an excellent
introductory activity for information sessions as it generated interest in the topic and
helped to establish that unintentional child injury is a serious health issue. This quiz
was subsequently integrated into the M&CH First Time Parents’ session. Other
activities which were well received were the video ‘Child Safety Made Easy’ and
small group activities where the participants brainstormed risks and preventative
strategies for different causes of injury. Hands on demonstrations of child safety
product were also an effective strategy, with many parents reporting that they had not
seen many of the products presented.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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The use of giveaways and resource materials were also useful to add interest and
create a more lasting memory of the information presented. Participants were often
provided with a pack of safety information and sample products. One useful strategy
to encourage participants to take some action after the presentation was to provide a
take home task to the group such as completion of a home safety checklist, checking
the temperature of the hot tap water or conducting a medications audit. A prize (e.g.
a gift basket of safety product) was left with the group for a lucky ticket draw for all
those who completed the task.
c. First Aid Training Early in the project a two hour first aid information session was trialled in
Delacombe. The course was held at the local primary school and attended by 16
parents. The session demonstrated that there was great interest amongst parents in
gaining first aid knowledge, but that a two hour session was too brief as attempts to
try to condense a lot of information into two hours resulted in ‘information overload’
with some participants. From this it was ascertained that it would be better use of the
resources to offer level one first aid courses, even though this would reduce the
number of sessions offered. Sessions were planned to target low income families.
Provision of child care during sessions was considered essential as a lack of child
care was identified as a barrier to attendance by many parents. However, this
became a challenge for the project, as the provision of child care was expensive and
incredibly time consuming. In order to keep courses accessible to residents who had
transport issues, local venues such as schools were more appropriate. When child
care was provided in venues such as school halls the project worker had to hire staff
and transport toys and other equipment to the venue. As a consequence less places
were provided than initially planned and other options were explored towards the end
of the project.
In the last month of the project the final thirty places for level one first aid were
offered to residents in the Delacombe Housing Estate as part of the SafetStart /
Office of Housing Project. Two level one first aid training sessions were offered as a
full day session on a Saturday. The venue used was a local child care centre and
centre staff were contracted to provide the child care. The courses were promoted to
residents during the safety surveying and via a mail out to all residents. Incentives
such as first aid kits, lunch and transport were provided.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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A total of twenty parents, grandparents and carers of young children participated in
the training, however only fifteen came from the Delacombe Estate. Although those
that participated were very happy with the course and delighted to be able to access
level one first aid for only $10.00, it was disappointing that not all places were filled. It
is the belief of the project worker that the response from the community would have
been better if the community had been more involved in the planning of the first aid
courses and if the venue was within the local community.
d. Wendouree West Community Education Strategies These programs, ‘Safety It’s Child’s Play’ and ‘Shed & Tool Safety Know How’, which
were piloted in Wendouree West, were developed in partnership with the Country
Fire Authority (CFA) and with support from the Wendouree West Community
Renewal. Funding was provided by the CFA from a grant received from the
Department of Justice to be expended in Wendouree West. The funding source
dictated why these programs were trialled in Wendouree West. While the
demographics of the community determined the content of the programs developed.
Both programs were very successful and much of this was due to the excellent links
the project was able to make with the community and existing projects, in particular
the Wendouree West Community renewal.
i. Safety It’s Child’s Play This program consisted of four, two hour sessions that addressed causes and
prevention strategies for common childhood injuries (see attachments 7 and 8 for
copies of the program rational and outline and evaluation). Programs were held in
August 2003 and March 2004 and were attended by 30 parents and carers of
children under five years. A working party comprising local residents and
representatives from the CFA and the SafeStart project worker met on a regular
basis to plan the content and promotion of the program. A number of incentives
were offered to participants including free child care, free lunch each week, a
celebratory meal at the conclusion of the program. Free safety product valued at
$70.00 for each participant attending at least three sessions was also provided as
the cost of devices for preventing childhood injuries is a barrier to reducing
hazards within the home (Paul, Redman & Evans 1992).
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Developed resources used in the delivery of the program are listed below. A more
detailed discussion regarding each resource is included on page 34.
Home Safety Kits
Safety Product Resource Kit
Safety Product Display Boards
Set of Safety Lock Demonstration Cabinets
Written evaluations revealed a high level of satisfaction with the program and
attendance was excellent with only one participant missing one of the four
sessions during the first program and three participants missing a session during
the second program. Anecdotal feedback from community members and staff
working with some of the participants gave examples of changes in knowledge
and behaviour and satisfaction with the course. Follow up evaluation in the form
of a focus group was conducted with participants from the first program six month
later. (see attachment 8)
Involvement of residents was a crucial factor in the success of the program
enabling content and delivery methods to be tailored to the needs and
requirements of the local community. Those on the planning committee became
active in the recruiting of participants and those with young children also attended
themselves. Another factor judged to be important was the emphasis on the social
aspects of the program. Each session began with an informal half hour lunch and
the use of fun quizzes and group activities encouraged social interaction. A warm
relationship formed between participants and between participants and facilitators
and this also contributed to the success of the program. The content of the
program was tailored to meet the needs of all group participants, in particular,
those participants who had some level of intellectual disability and those with low
literacy.
The cost of this program was approximately $170.00 per participant (excluding
staff time) and as such is reasonably expensive when compared to single
sessions delivered to the broad community. However, many of the participants of
this program were of very high risk and the children of some families had already
experienced severe injuries due to unintentional injury and one child had died.
Therefore, although expensive, the cost of the program could be recouped by the
avoidance of just a few emergency department visits or one hospitalisation due to
unintentional injury.
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The project worker, with the assistance of members of the Best Start Health and
Safety Working Group, is currently investigating the feasibility of this program
being taken on by another organisation. If successful this will enable ongoing
delivery of this intervention to targeted communities within the Ballarat community.
ii. Shed and Tool Safety Know-How This consisted of a single session aimed at addressing safe use of power tools,
safe chemical storage, electrical safety and correct use and storage of a fire
extinguisher. Guest speakers were sourced from Bunnings, the CFA, Sovereign
Fire protection and the local community. While initial thoughts were to market this
session as a men only event, the residents recruited to assist with planning and
promotion felt this was discriminatory and given the high percentage of
households headed by a sole female, the session should be open to all residents.
Incentives offered to participants included a free barbeque meal, a fire
extinguisher, tickets in the door prize raffle and a show bag of safety information
and small promotional products. Sessions were held in March and April 2004 and
were attended by 36 local residents. Written evaluations completed by participants
showed a high level of satisfaction with the content and presentation of the
session.
The venue for the session was the local community house and this was also
where bookings were taken. The course proved very popular and the first session
booked out quite quickly. Unfortunately this led to anger amongst a few residents,
even when a waiting list was started for a second course. Although this seems to
have been a reflection of other issues within the community, rather than directly
caused by missing out on the first course, it still caused quite a bit of stress prior to
the session. We were also surprised when a few teenagers attended the first
session, as they weren’t our target group and we hadn’t expected the session
would appeal to them (but perhaps the fire extinguishers did!). As a consequence
the booking system was revised for the second session.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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3. PROFESSIONAL EDUCATION FOR SERVICE PROVIDERS OF FAMILY AND CHILDREN’S SERVICES Working to increase knowledge of injury prevention risks and prevention strategies
amongst staff who interact with families and children was considered an important
strategy for the SafeStart project in Ballarat. This took many forms including provision
of twelve professional education sessions and presentations to groups of workers
about the issue of child hood injury (see table 4). There were also numerous one-on-
one and small group discussions around causes of injuries and prevention measures.
Table 4 – Professional Education for Service Providers Training intervention Participants Focus or purpose of training Facilitator/Date
Maternal & Child Health Nurses Local & Victorian child injury
data & using Child Safety
product Kit
Maternal & Child Health
Nurses
10 participants
To enhance & increase number
of M&CH child injury prevention
education sessions to parents. Project Worker
20/2/2003
Maternal & Child Health Nurses Child injury risk factors &
prevention strategies using
Child Safety Resource
Manual & Child Safety
Made Easy video
Maternal & Child Health
Nurses
13 participants
To enhance & increase number
of M&CH child injury prevention
education sessions to parents. Project Worker
17/4/2003
Kidsafe Training
Injury prevention data &
interventions & group
facilitation skills
Maternal & Child Health,
Paediatric Nurse, Enhanced
Home Parenting Worker,
Family Day Care
Coordinator, Parent
Assessment & Skills
Development program
worker, SafeStart project
worker
6 participants
To deliver child safety training
to Ballarat Service Providers
Kidsafe Staff and
consultant
12/2/2003
Child restraint train the trainers session & distribution of flip charts
Maternal & Child Health
Nurses
13 participants
To enable Nurses to deliver a
safety session on child
restraints
Graham Day – VIC
Roads
July 3003
First Time Parents Session
Maternal & Child Health
Nurses
11 participants
To enable Nurses to deliver a
uniform child safety session to
participants in first time parent
groups
Project Worker
19/2/04
1 hour
Unintentional Poisonings Focus Group
Pharmacist, GP, Family Day
Care, Ambulance service,
Maternal & Child Health,
SafeStart
6 participants
Childhood poisoning Lisa Gibbs
29/4/2003
1 ½ hours
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Training intervention Participants Focus or purpose of training Facilitator/Date
Family Services Forum
Staff working with families &
young children
12 participants
Program overview, discussion
of local child injury data
Project Worker
11/2/2003
20 minutes
Pharmacy Alliance Meeting
12 participants Pharmacists
Unintentional poisoning in
young children – local and state
data, prevention strategies and
available educational materials
Project Worker
6/5/2003
½ hour
Ballarat Early Childhood Network Meeting
Staff working with families &
young children
9 participants
Program overview, discussion
of local child injury data +
display of safety products
Project Worker
3/6/2003
45 minutes
Ballarat Child & Family Services Safety Session – 1st Mentor’s Grp
Mentor’s working with
families in need of support
5 participants
Injury prevention education
session range of issues
Project Worker
15/10/03
1 ½ hours
Staff Information Session - Daylesford Pharmacy
Pharmacists & pharmacy
staff participating in Injury
prevention Week promotion
8 participants
Poisoning causes & prevention
Project Worker
16/10/03
20 minutes
Ballarat Child & Family Services Safety Session – 2nd Mentor’s Grp
Mentor’s working with
families in need of support
6 participants
Injury prevention education
session range of issues
Project Worker
1/12/03
1 ½ hours
The demonstration project was able to provide a number of successful programs,
raising the profile of child injury amongst service providers and enabling workers with
the skills to deliver child safety sessions to their clients. During the demonstration
project the following factors were identified that functioned as barriers or facilitators to
engaging service providers:
- kits and tools to assist the delivery of education sessions were found to
be an incentive. Where there are no user friendly resources staff are less
inclined to cover childhood injury. The SafeStart project worker developed a
number of resources for use by service providers including a resource
manual, session outline and child safety cards. Development and
distribution of high quality and current resources on a state-wide or national
level is one method of encouraging more services to deliver child safety to
their clients. The importance of training as a tool to motivate and instruct
staff on the use of any resources developed cannot be underestimated.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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- high quality speakers were found to be an incentive for workers to attend
training and had the potential to motivate staff to increase their focus on
child safety (for example the presentation to M&CH by Graham Day on car
restraints and the workshop facilitated by Rebecca Hicks on the Keep Me
Safe cards for staff working with parents with an intellectual disability).
Where communities are able to access specialised speakers at an
affordable cost, opportunities for child injury professional development are
likely to be enhanced. In the Ballarat demonstration project this proved a
barrier to providing more professional education. It was difficult to identify
appropriate speakers and when identified they were often found to be
prohibitively expensive.
- competing demands of other training appeared to be a barrier to
engagement of some services in professional education training, with a
couple of agencies expressing interest in professional development of staff,
but finding difficulty to commit staff time to additional professional education.
It is envisaged that these barriers would have been overcome if the
SafeStart project was resourced for a longer duration as it seemed to be a
matter of just chipping a way at management by periodically making the
offer to provide training and encouraging staff to lobby management for the
training.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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4. INCREASING AWARENESS / ACCESS TO SAFETY PRODUCTS AND PROMOTION OF ENVIRONMENTAL CHANGES TO ENHANCE CHILD SAFETY Safety Product Demonstration Kitchens
During the planning stages of the project it became apparent that many parents lack
awareness of the range of safety products available to address hazards within the
home. Installing safety products in the kitchens of facilities frequently used by parents
with young children was seen as one method of addressing this issue.
It was initially planned to resource three demonstration kitchens in each of the three
postcode areas with elevated levels of child injury. Two sites were readily identified
as suitable in the 3350 (Ballarat) and 3355 (Wendouree) post code areas. However,
a suitable kitchen was unable to be located in the 3356 post code area (Sebastopol
and Delacombe). Factors considered in determining sites for the demonstration
kitchens were location of existing infrastructure and current utilisation of sites by
parents/community groups. Sites chosen were the Eureka Family Resource Centre
and the Wendouree West Community House. The Eureka Family Resource Centre
is a Council owned building which is currently used by seventeen different parent
groups a month, many of these use the centre on a weekly basis.
Products installed included a poisons cabinet, oven and stove guards, heater guards,
finger safe guards on door jams and various appliance and cabinet safety locks.
Signage conveying simple safety messages and explaining the products was also
provided. (For a complete listing of products and photographs see attachment 9).
The kitchens have been a successful strategy and the project worker has received
numerous enquiries and comments from parents and staff regarding the products
displayed. They have been especially useful in raising awareness of products not
widely available or not stocked locally, such as stove and oven guards, and finger
safe guards . The kitchens have also proved an excellent testing ground for the
durability of safety products, with some products breaking within days of installation
and others still functioning well after over twelve months of use.
Sponsorship and Additional Funding Sponsorship and the securing of additional funding for the project enabled the
Ballarat SafeStart project to resource additional programs and increase access to
BALLARAT SAFESTART DEMONSTRATION PROJECT
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child safety products to both the general community and targeted families from
socioeconomically disadvantaged areas.
Funding of $7500 was provided to the project by the CFA from a grant received from
the Department of Justice. This money was used to develop and trial the education
strategies in Wendouree West which reached 66 residents (see Training and
education of parents and Carers). Thirty-six fire extinguishers, thirty-fire blankets and
child safety product to the value of $1500 was distributed as part of the strategy.
Two companies who manufacture child safety products, Safety 1st and Tee-Zed
(brand name Dream Baby) both supported the project by donating products. Tee-Zed
donated two large display boards of safety product and Safety 1st donated a range of
products including kitchen and bathroom safety kits and different safety latches. Both
companies also sold product to the project at cost price, which enabled the project to
purchase large numbers of small safety items for distribution to group participants.
The project worker was able to alert other Ballarat services to the opportunity to
purchase safety product at cost price.
The Ballarat Apex Club donated $1000 towards the purchasing of safety product for
families living in the Delacombe Public Housing Estate. The donation was used to
purchase twenty poisons cabinets which will be installed by the Office of Housing in
the homes of families with young children. It is planned to write to families during
August inviting them to indicate if they would like one of the cabinets.
Home visits to high risk families The project worker carried out a small number of home visits during the course of the
project. Provision of these visits could have easily consumed a large proportion of the
project resources, both financial and project worker hours, so the strategy was limited
and only provided in special circumstances, see table 5. However, these visits were a
very effective means of providing information and assisting parents to identify and
address child safety hazards within their home. They also enabled the project worker
to further explore the issue of child safety and to build relationships with staff from
other services. Safety product such as door barriers, fire blankets and safety locks
was provided to the families (see table 5), especially in earlier visits.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Table 5 – Home visits to high risk families
Type Description Date Provision of safety products to
low income families
The project worker & Council’s Respite Care Coordinator visited
the home & discussed safety issues after the children were
identified by Respite Child Care workers as being at high risk of
unintentional injury due to aspects of the housing and the four
year old child’s behavioural problems. A number of changes
were recommended including removal of CD player and large
vase from a bench above a portable cot, removal of a thick
mattress which was smaller than base from portable cot, locking
away of electrical appliances. The family was provided with the
following safety products – a safety gate, poisons latch, power
point covers, cupboard & drawer child resistant latches. A home
safety checklist and a number of printed resources were also
provided. Latches were installed by Public Housing maintenance
staff. A Follow up letter was sent to cover legal issues.
Feb 2003
Provision of safety products to
low income families
The Project worker & the Respite Care Coordinator visited a
home & discussed safety issues after the children were identified
by workers as being at high risk of unintentional injury due to
poor quality housing. A child safety checklist was discussed as
we walked through the home. The family was provided with the
following safety products – a safety gate, poisons latch,
cupboard & drawer child resistant latches, power point covers,
door knob covers, along with a home safety checklist and a
number of printed resources. The latches & gate were installed
by the Office of Public Housing. A follow up letter was sent to
cover legal issues. The parent participated in the 4 week safety
program.
March 2003
Provision of safety products to
low income families
The project worker & a case worker visited a home & discussed
safety issues. A number of changes were recommended
including removing a timber barricade from hallway, emptying
nappy bucket of water, safer storage of poisons & removal of
vaporiser from the floor. The family was provided with following
safety products – a fire blanket, stove guard, door knob covers &
a number of adhesive latches along with a safety checklist and a
number of printed resources. A Follow up letter was sent to
cover legal issues.
May 2003
Family living in emergency
accommodation
Visited a family living in emergency accommodation at request of
Enhanced Home Parenting worker to discuss safety concerns.
Agency provided a number of latches as an interim measure.
April 2003
Family with a child diagnosed as
having autism
Visited a family living in their own home at the request of the
Enhanced Home Parenting worker to discuss safety concerns. A
safety information pack was provided and using the Safety
Centre checklist as a guide, strategies to reduce risks discussed.
October
2003
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Type Description Date Family living in rental
accommodation
Visited a family living in rental accommodation at request of
Enhanced Home Parenting worker to discuss safety concerns. A
safety information pack was provided along with some child
safety latches & power point plugs.
Dec 2003
Family of children burned late in
2003. Family has 6 children
under 6. Two of the children
were burned when petrol they
were playing with in the lounge
room was ignited by a heater
Visited a family living in rental accommodation at request of their
case workers & Enhanced Home Parenting worker to assist
parents to complete a home safety checklist. Met with case
worker to discuss possible items that could be purchased for the
family and safety issues that the landlord could be asked to
address. Showed case worker safety products displayed in the
Eureka Family Resource centre and discussed options for more
safety education with other case workers. Invited parents to
attend a 4 week safety program in March. A safety information
pack and power point plugs were provided. Parents attended the
4 week program.
Jan 2004
Mother with a 2 year old living in
public housing
Visited the mother with her parenting worker. There were a
number of concerns raised by the mother who is hearing
impaired and concerned that her child will slip out of the house
unnoticed. Also issues with cupboards, stove etc. Provided
worker with some sample safety products and a home safety
checklist to be used on a follow-up visit
Jan 2004
Encouraging Enhancement of Child Safety in Emergency Accommodation
Staff working with families reported that they had observed a number of safety
hazards in the homes of their clients living in emergency accommodation. These
mothers and their children were often escaping domestic violence and emotionally
traumatised. Understandably, this at times resulted in behavioural issues with the
children and reduced levels of parental supervision. It was felt that these women had
enough to worry about in their lives without the added worry of child safety, so it was
important to minimise all child safety hazards within these homes. The use of child
safety products within emergency accommodation was also an excellent awareness
raising strategy providing parents with information about various products that they
may then choose to purchase when they moved into their own home.
The project worker held meetings with staff from three services that provide
emergency accommodation to women and children and briefed staff on key child
safety issues. Safety check lists and other safety information was also provided and
BALLARAT SAFESTART DEMONSTRATION PROJECT
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the project worker assisted two agencies to complete safety checks on some of their
premises. Written reports containing recommendations were then provided to each
agency.
WRISC Domestic Violence Support Service reported that they had forwarded the
report to the body that maintains their property and were awaiting notification of
which areas they would be prepared to address. The Salvation Army reported that
they had made some changes to the seven units, including installing mag-locks,
power point plugs and other safety latches.
Oleander Trees The project worker approached one of the City of Ballarat Horticulturalists to conduct
an information session for Family Day Care Providers on poisonous plants. In
preparation for the session the horticulturalist was collecting samples from Ballarat
gardens when he discovered 76 Oleander trees in nature strip plantings. Council is
planning to remove the trees and replace them with non-poisonous varieties.
Delacombe Public Housing Estate Project
Research suggests that there is a need for targeted injury prevention efforts among
children from socioeconomically disadvantaged populations (Faelker, Pickett &
Brison 2000) and the most successful programs to reduce unintentional injuries are
those that use a combination of approaches including education and environmental
modification (Evans & Kohli 1997). With this in mind, SafeStart formed a partnership
with the Office of Housing with the view to enhancing the safety of homes in the
public housing estates and increase residents’ skills and knowledge around child
safety.
Initially, the two housing estates considered for this project were Delacombe and
Wendouree West. However, consultation with the Office of Housing revealed a
feeling by staff that it would be good to focus on the Delacombe housing estate as
the Wendouree West community had received significant benefits through the
Renewal project including housing upgrades, training opportunities etc. Examination
of the data revealed there to be 138 Office of Housing properties in Delacombe and
over half of the homes were occupied by families with young children.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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The aim of the project was to undertake a survey of the homes to establish and
prioritise the safety requirements of each property. Identified safety issues could then
be addressed, subject to budget feasibility, by the Office of Housing. In addition,
financial support provided by the Ballarat Apex Club was able to finance additional
safety products to address identified priorities. A show bag containing safety
information, small safety products and other promotional items was provided to each
household at the time of surveying and 30 training places for level one first aid, with a
child safety component, were offered to residents at a nominal cost of $10.00.
This project was initiated in mid 2003 and was due to be completed by early 2004.
Although initial progress was delayed, the project worker was keen to pursue this
strategy and the Office of Housing agreed to commence the project in April 2004.
The City of Ballarat agreed to provide funds to enable the project worker to stay on to
complete the project and the Office of Housing provided resources to employ staff to
assist with compiling of the show bags and collation of the surveys. Surveying of the
properties was undertaken by the SafeStart project worker and the Family Day Care
Coordinators from the City of Ballarat.
The surveying was completed in late June, and 50% of properties were surveyed.
The data is currently being collated by the Office of Housing and arrangements have
been made for the data to be presented to staff involved in the surveying and for
recommendations to be made to the Office of Housing regarding priority issues
identified during the surveying. In addition, twenty poisons cabinets have been
purchased with the funds donated by the Ballarat Apex Club and two level one first
aid courses were offered to residents. The project has also been incorporated into
the Best Start Action Plan and ongoing coordination will be through the Best Start
Health and Safety working group.
The level of community involvement in the project activities in Delacombe was
limited. This was primarily due to a reluctance on the part of the project worker to
engage with the local community and raise expectations when it was uncertain if the
project would proceed. When the project was confirmed there were very tight time
lines which restricted the ability of the project to involve and work with the local
community. This impacted on project outcomes with fewer residences electing to
attend provided training opportunities. The lack of an appropriate training venue
within the local community was also a barrier to attendance as bookings and training
were provided at an unfamiliar location outside of the community.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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5. CHANGES IN POLICY AND PROCEDURES Best Start Action Plan
Strong links between SafeStart and Best Start were established from the very
beginning in Ballarat when a joint SafeStart/Best Start Reference group was
established with representatives from Council, key agencies, the Department of
Human Services and the Department of Education and Training. The reference
group oversaw the development of the submission/expression of interest for the two
projects and once successful was responsible for providing ongoing direction and
guidance to each project.
It was always acknowledged by Council and the Reference Group members that
there was a direct link between SafeStart and Best Start and that the projects would
work in parallel to one another. As a consequence, SafeStart was able to strongly
influence the Best Start Action Plan and Best Start has been able to adopt learnings
from SafeStart and build on the project’s successful strategies.
Child injury prevention has been incorporated into the Best Start Action Plan with
three of the four projects listed for the Health and Safety working group aiming to
continue the work of the SafeStart project or intending to include child safety as a
focus (see attachment 14). These are:
- Enhance the safety of the children within the Delacombe Public
Housing Estate
- Develop strategies to sustain the successes of the SafeStart project
- Organise a Family Play Day
Currently the Health and Safety working group is supporting the Delacombe Housing
project and considering education interventions which could build on the initial
project. The group is also examining the option of Ballarat Community Health Centre
incorporating the delivery of the child safety program developed and trialled in
Wendouree West into its health promotion program for the coming financial year.
Other Best Start projects, including the current development of an antenatal
information kit for parents, have also been influenced by the SafeStart project with
the incorporation of a child safety component. The forthcoming employment of the
SafeStart project worker on a short term contract to work on an Children’s and Family
Services Directory will further cement the relationship between the two projects and it
is planned to include child injury prevention tips in the directory.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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Municipal Public Health Plan The issue of child safety has been integrated into Directions in Well-being, the City
of Ballarat’s Municipal Public Health Plan. The issue of unintentional injury to children
is discussed in detail in two main sections of the plan, ‘Basic Needs’ and ‘Safety and
Security’. See attachment 13. There was no specific focus on child injury prevention
in the previous Municipal Public Health Plan and inclusion of it in the current plan
demonstrates a commitment to child injury prevention by Council.
Maternal and Child Health First Time Parents Program A working group was established to develop a child safety session for delivery to all
first time parent groups. The program was trialled by the project worker during 2003
and has been delivered by the M&CH Nurses since February 2004. Prior to the
SafeStart project, delivery of child injury prevention sessions by M&CH was
inconsistent. Child safety has now been adopted as a consistent, ongoing part of the
First Time Parents Program.
Early Years Plan Staff in Family and Children’s Services are currently developing the Municipal Early
Years Plan. This is a new document and the work of the SafeStart project has
contributed to the awareness of the health issue of child safety and ensured it will be
incorporated into the document.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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RESOURCES DISTRIBUTED AS A RESULT OF
THE STRATEGIES During the Ballarat SafeStart project just under 40,000 child safety brochures,
booklets and flyers were distributed (see attachment 10 for a complete listing of
resources distributed). Management and collation of these resources was a large
part of the project worker’s role. Large scale resource distribution requires significant
investments of time to locate, order and collate resources, significant storage space
and an ability to transport numbers of often quite heavy boxes.
The large number of excellent child safety brochures and information sheets
available on various aspects of child injury prevention have the potential to provide
invaluable information to parents, carers and service providers. However, there is
often no way of knowing if resources distributed to service providers are distributed to
parents and carers or if distributed resources are actually read by parents and carers.
Current child safety resources do not always cater well for minority groups within our
community, with the information in many brochures excluding parents with low
literacy, intellectual disability or parents from a non English speaking background.
This issue is further discussed within the resources developed section.
One strategy utilised to encourage parents/carers to retain distributed resources was
to compile information into child safety information packs (see also discussion under
Resources Developed). Durable plastic envelopes were used for these packs. The
packs were large enough to hold up to twenty brochures as well as samples of safety
product and other small promotional items such as pens, magnets and
thermometers.
The packs were easy to transport and distribute and were well received by parents
and carers, especially when additional items such as a pen or thermometer were also
included. When compiling packs it was important to ensure, where possible, that the
information was appropriate to the age/developmental stage of the child. However,
this had to be balanced with fact that the parents may receive little additional safety
information from other sources in the months and years following the presentation.
So it was also important to also provide information in the packs related to later
developmental stages over the next couple of years.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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RESOURCES DEVELOPED AS A RESULT OF
THE STRATEGIES Careful consideration should be given to embarking on any resource development
as it can be more complex and time consuming than first anticipated. However, the
rewards can be significant and the ability to develop resources in response to
identified local needs can be an excellent strategy to engagement of the community
and service providers. Other benefits are the bringing together of workers from
different sectors with a common purpose during the development process and the
ability of a well developed resource to focus and guide workers into consistently
addressing child safety with their clients.
In the Ballarat demonstration project consultation with service providers and parents
identified the need for a number of resources. As a consequence of this consultation,
the following resources were developed:
a. Resource Manuals Whilst there is a wide range of child safety resources available, a lack of awareness
of these resources amongst service providers was identified as an issue. In an effort
to address this barrier, a comprehensive resource folder was developed, based on
one developed by Hume City Council. The contents of the manual included:
- A copy of all current child safety brochures
- Statistics on injury incidence
- Key points on injury causes and prevention strategies
The manuals were produced by the project worker and distributed to staff working
with children and families.
b. Home Safety Kit This resource was developed for parents and carers of children aged 0-5 years who
participated in the Wendouree West Child Safety program, and aimed to provide a
lasting resource on child safety for the members of the program. At the first session
each participant was provided with a folder to which was added a plastic envelope of
resources each week relating to the topics covered that day. The kits proved very
popular with participants and were brought back to the sessions each week .
BALLARAT SAFESTART DEMONSTRATION PROJECT
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c. Safety Product Resource Kit A kit of child safety products was developed for use by the project worker and other
service providers when facilitating groups and holding displays. The kit proved to an
excellent resource assisting to raise awareness of the range of safety products
available and adding a visual interest to group presentations. It was considered
important to have products priced and to provide information regarding the use of
each product to enable those less familiar with the kit to still use it effectively.
d. Safety Product Display Boards Two display board featuring a range of safety products were donated by Tee-Zed
who manufacture Dream Baby safety products. The boards were used for displays
and during presentations to raise awareness of available safety products.
e. SafeStart Logo, Tee-shirts and Pens
A small amount of the budget was used to resource the development of a SafeStart
logo which was then printed onto tee-shirts and pens. These promotional products
proved popular with the public at displays and group presentations and assisted to
raise awareness of the project.
f. Safety Information Packs Information packs were developed for distribution to parents attending safety
sessions. Each pack contained sixteen child safety resources including a home
safety checklist, a thermometer and a pen (see attachment 6 for a listing of contents).
Although time consuming to compile, the kits were relatively inexpensive to put
together as most of the materials were donated. The packs proved popular with
parents, generated interest during presentations and provided a handy and lasting
reference to most child safety issues. An additional eight hundred safety information
packs were produced to provide the Maternal and Child Health Program with a two
year supply for distribution to participants in the First Time Parents Groups. The
compiling of these kits was contracted out at a small additional cost to each kit.
g. Set of Safety Lock Demonstration Cabinets A small Perspex fronted cabinet containing 9 drawers/cupboards & fitted with a range
of child safety locks was developed to promote appropriate use of safety latches
amongst parents & staff working with children. The cabinet enabled the project
worker to clearly demonstrate the variety of safety latches available and the varying
level of resistance provided by each style of latch. A clear Perspex front on the
BALLARAT SAFESTART DEMONSTRATION PROJECT
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cabinet enabled parents and service providers to see how latches were installed and
was particularly useful to demonstrate how latches can be installed on frameless
drawers. Although well received by parents and workers, the cabinets developed
were quite heavy and this restricted their usefulness.
h. Staff Information Pack - Prevention of Childhood Poisoning Promotion An information pack was developed for the staff of pharmacies participating in the
Poisoning Awareness project held during Injury Prevention Week. The pack was
developed to provide information to staff prior to the promotion, particularly those not
participating in a staff information session. Contents of the pack included:
Answers to frequently asked questions
brochures on poisoning prevention
a project outline
an evaluation questionnaire
i. Pictorial Child Safety Resource Consultation with service providers identified the need for a pictorial based child
safety resource for use with parents with an intellectual disability. Staff working with
these parents identified child safety as a major health issue and as their client
numbers have increased substantially in recent years, so it was felt the relatively
expensive cost of developing the resource was justified.
A working group was formed comprising the SafeStart project worker, staff from
Ballarat Health Services Domiciliary program , Maternal and Child Health Enhanced
Home Visiting program and Child and Family Services’ Parenting Assessment and
Skills Development program. The group met regularly from mid 2003 and after
discussion and research decided to develop and a set of 40 cards depicting
photographs of child injury prevention strategies and simple text supported by
symbols and colour to enhance understanding by non-literate parents.
Development of the resource proved to be a more time consuming and complex task
than was initially identified. It was a great benefit having staff who would use the
resource actively involved in the process of development as they were able to
provide ongoing feedback and this enabled the resource to be tailored to the needs
of their client group. However, development of the captions for each photograph
proved very difficult and the decision was taken to hire a consultant to assist with this
stage of the development. Purchasing assistance to develop the captions and assist
BALLARAT SAFESTART DEMONSTRATION PROJECT
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with training and development of the training notes proved to be an excellent use of
resources, enhancing the quality of the resource and training package. In late June,
seventeen service providers attended a half day training workshop to introduce them
to using the cards with their clients. Evaluations showed a high level of satisfaction
with both the training and the resource.
Other positive outcomes were that the resource development brought staff from
different agencies together to discuss how they currently deliver safety education to
their clients and as a flow on from this gaps and inconsistencies were identified.
Options for facilitating broader distribution of this resource are currently being
explored and St Luke’s Innovative Resources have expressed interest in publishing
the cards in the future as has a local service provider. A prior necessity to any
republishing would be an evaluation of the resource with the staff and clients
currently using it. The importance of training to assist staff to utilise the resource
effectively was also identified during the development of the Keep Me Safe Cards.
BALLARAT SAFESTART DEMONSTRATION PROJECT
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SUSTAINABILITY OF SAFESTART STRATEGIES Some of the piloted strategies will have medium to long term sustainability, while
other components of the project will not be sustainable without the provision of at
least a minimum of resources to provide for the ongoing coordination of project
activities. In particular, the targeting of high risk families was found to be resource
intensive, but if we want to minimise injuries in this target group it must be
acknowledged that ongoing funding is necessary.
Table 6 below describes the strategies which will have ongoing impact in the medium
(M) term (1 – 2 years) and long (L) term (3 – 5 years) within the community, and
those where the impact is considered by the project worker to be short (S) term.
Table 6 – Sustainability of SafeStart Strategies Which Will Continue After the Project
Strategy
S
M
L
Comment
Maternal & Child Health First Time
Parents Safety Session
Strong support for intervention amongst staff
including program coordinator. All current staff in
serviced in session delivery. New staff have
laminated training cards & current staff as a
resource. Policies to be developed will further
reinforce child safety.
Safety It’s Child’s Play Program
Options currently being explored for another
organisation (Community Health) to coordinate
this program and seek funding to deliver twice
annually.
Focus group evaluation has shown participants of
program retain knowledge and share with family
& friends
Safety Product Demonstration
Kitchens Long term benefits to community as both sites
will be maintained by managing bodies
Enhancement of Child Safety in
Emergency Accommodation
Changes to buildings have potential to provide
long term safety benefits. Effects of education
remain with staff for 1-2 years.
Delacombe public housing Estate Involvement of Best Start Health & Safety
Working Group in project will provide ongoing
involvement with this community
Resource manuals
Resource manuals will remain current for a
minimum of two years. Possibility of an update
being provided in the future as a task for a
student on placement
Home Safety Products Kit Two yearly review and updating of kit contents to
be carried out by M&CH program staff
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Safety information packs
Current supplies sufficient to resource First Time
Parents Program for two years. All information
required to assemble additional stocks recorded
and transferred to M&CH Admin Officer. Ability to
secure additional funding will determine long term
sustainability.
Pictorial Child Safety Resource
Resource has potential to be sustainable in the
long term. Sufficient produced to allow for wear
and tear, training will be provided in a train-the-
trainer style to enable agencies to provide their
own ongoing training to staff. Options of
republishing rights being provided to a resource
publishing company.
Community & Professional
Education
Effects of educations sessions delivered by
project worker will remain within community for 1-
2 years. Evaluation of Wendouree group 7
months post intervention showed retention of
knowledge and ongoing education of friends &
family by participants
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EVALUATION FRAMEWORK External evaluation - the contract for the evaluation and support of the three
projects was awarded by DHS to a partnership between Monash University Accident
Research Centre (MUARC) and the Centre for Community Child Health at the Royal
Children’s Hospital (CCCH). Each project was required to provide regular data input
about its planning, strategies and activities using the Generic Evaluation
Assessment System (GEAS). Staff from MUARC and CCCH conducted pre and post
project interviews with the project workers, managers and key informants in each
Local Government Area and held focus groups with program participants and key
informants at the conclusion of the project. A report of the process and impact
evaluation of the SafeStart projects are due to be submitted to DHS at the end of
June 2004.
Data Collection Generic Evaluation Assessment System – initially developed by MUARC for the
evaluation of the Foothold on Safety projects, the GEAS was modified to suit the data
collection requirements of the SafeStart projects. The GEAS required SafeStart
project workers to complete comprehensive six-monthly reports and provide
supporting data for all project activities. Project activities recorded by the GEAS
included media, resource distribution, education sessions, partnerships, awareness
raising and changes to policy and environments. Project data from the GEAS and
other local based evaluation was used in preparing this report.
Education Sessions – 90% of participants attending sessions delivered during the
Ballarat SafeStart project were asked to complete a written evaluation (see
attachment 11). The evaluation tool was developed by MUARC and CCCH and
focused on process evaluation and intention to act to reduce household hazards after
the session. A summary of some of the evaluations completed is contained in
attachment 12.
Focus Group – the Centre for Community Child Health was commissioned by the
Ballarat SafeStart project to conduct a focus group with the first participants from the
four-week child safety program developed and trialled in Wendouree West. The
evaluation was carried out by staff not involved in the overall SafeStart evaluation.
The aim of the evaluation was to gauge the impact of the program in relation to
behaviour change amongst participants and to explore further why the program was
so popular with participants. A copy of the report is provided in attachment 8).
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KEY OUTCOMES The SafeStart project strategies and activities provided considerable outcomes to the
Ballarat community, including the target population and service providers.
Increased awareness of child safety issues and injury prevention strategies
amongst parents and carers on children 0-8 years as measured by the
evaluations from the education sessions (see attachment 12)
Increased awareness of child safety issues and injury prevention strategies
amongst service providers working with families and children
The development of resources in response to identified local needs.
Resources developed include the Keep Me Safe Cards (a set of 41 cards for
teaching child safety concepts to parents with an intellectual disability/low
literacy), a child safety resource manual for service providers, a kit of safety
products for group education and a cabinet for displaying the various uses of
child safety locks
Establishment of two safety product demonstration kitchens to assist to raise
community awareness of the wide variety of safety products available for
reduction of hazards in the home. The kitchens are located within a well
utilised community house and a Council venue utilised for before school care,
playgroups and training of Family Day Care providers
Development, trialling and evaluation of a four-session education package
targeting high risk families and development and trialling of a single session
child safety information session for use by M&CH with First Time Parents
groups
Collaborative partnerships developed between SafeStart and a number of key
service providers including Maternal and Child Health, Best Start, Child and
Family Services, Ballarat Health Services, the Office of Housing and The
Country Fire Authority
Implementation and evaluation of child safety information sessions for parents,
grandparents and carers of children 0-8 years
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Inclusion of child safety in the Municipal Public Health Plan for the first time
Provided increased awareness and hazard reduction in some properties used
for emergency accommodation, child care centres and the homes of some
socioeconomicly disadvantaged families
Collation of 800 child safety information packs to be distributed to first time
parents via Maternal and Child Health, including child safety information,
sample safety product, a home safety checklist and a hot water thermometer
Surveying of 50% of public housing properties in the Delacombe Housing
Estate to identify priorities for enhancing the safety of the homes for young
children, provision of poisons cabinets to 20 households
Improved focus on injury prevention in general and within Council
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LEARNINGS Relationships – the Ballarat project worker found that good outcomes in the
demonstration project were linked to positive relationships with the community and
workers. Development of these relationships can take time, especially if the
workers/community do not initially see child injury as a pressing health issue or part
of their core business. The longer a project can be resourced, the greater the
opportunities for relationship building and achieving of project objectives. However, in
situations where time is limited, it is recommended that only the most receptive
communities and workers be engaged in order to maximise returns from available
project time
Community Infrastructure and Support Systems - The level of community
involvement in the project activities was found to have significant impacted on project
outcomes. Evaluations revealed greater community consultation and involvement in
planning and implementing of SafeStart strategies resulted in greater involvement in
project activities by community members. The SafeStart activities in Delacombe area
can be contrasted with the Wendouree community where time, existing community
infrastructure and the presence of other projects enabled more community
consultation and engagement prior to commencing project activities. The community
education programs in Wendouree were very well attended while those targeting the
Delacombe community had a poorer response.
Sustainability of Project Activities – In general, short term approaches tend to
have short term outcomes, and the longer a project is able to be resourced the
greater the likelihood of strategies becoming part of the regular and ongoing work of
services. The project worker found achieving sustainability of project activities to be
a complex issue which required consideration during the planning stages. However, it
was also discovered that sometimes sustainability can only be achieved after a
strategy has been developed and tested and shown to be of worth. The four session
program developed to target at risk families and the Keep Me Safe cards are two
examples of this. When they were just a concept there was limited interest from other
agencies in taking on these projects, but with a tangible product, interest has
increased significantly.
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Targeted Interventions – child injury is a very broad area with numerous causes
and risk factors for each age group. When planning a program it is important to
prioritise interventions based on community/worker receptiveness, community risk
profile and availability of time and other resources. Selecting fewer, more targeted
interventions is likely to be more effective.
Displays – holding displays can be a useful promotional strategy, but given the time
involved in development and staffing it may be more effective to prioritise other
strategies. If display materials were able to be provided/loaned via a clearing house,
it would significantly enhance opportunities for other workers to conduct displays
Media – some components of media promotion were found to be very time
consuming and resource intensive, but despite this the media was found to be a
useful strategy for raising community and worker awareness. Although not trialled in
Ballarat, the formation of a promotions working party may have assisted to spread
the work load of promoting child injury in the LGA. Provision of media releases on
various causes of injury, with accompanying photographs, via a centralised clearing
house or website would be a useful support for workers conducting injury prevention
strategies and may lead to more media coverage of the issue of unintentional child
injury
User Friendly Resources – where there are current, user friendly resources readily
available (eg teaching kits, giveaways, information packs, displays and other
promotional items) workers are more inclines to address child injury. Where there are
competing health issues demanding of a worker’s time it is often the
sessions/strategies that are easiest to implement and most enjoyable that will be
taken up. As most workers do not have the time or motivation to spend hours
searching for resources it appears necessary to make this process as straightforward
as possible in order for unintentional child injury to be taken up.
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RECOMMENDATIONS The following recommendations are made by the Ballarat SafeStart Project:
1. That any future child safety projects funded by the Department receive longer
period financial support to enhance sustainability of project interventions
2. That a centralised clearing house be established to distribute child safety
information resources throughout the State. This could be readily achieved by
increasing resources to existing services. This would assist to address the
issue of service providers lacking awareness of available resources and
where to access them. The majority of service providers who address child
safety issues do so as one small part of their work load and rarely have the
motivation or luxury of time to track down resources. If we want service
providers to discover and distribute resources we need to make obtaining
them a simple, one stop shop approach
3. That the Department of Human Services Public Health Group investigate the
feasibility of forming partnerships with businesses to promote and sell child
safety products in outer metropolitan, rural and remote areas
4. That the Department of Human Services Public Health Group investigate the
feasibility of providing age appropriate child safety information packs to all new
parents via the Maternal and Child Health Service or hospital system. This
could be undertaken in partnership with manufacturers of child safety product
and sponsorship could be sought to support the proposal
5. Consideration be given to the development of an ongoing media campaign to
raise the profile of child injury within the general community and service
providers and address the attitudes that ‘accidents’ are a normal part of
growing up and either unavoidable or not an issue for their children
6. Examine the option of establishing links with organisations such as Workcover
and Trade Unions to extend the key Occupational Health and Safety
messages into the home environment and apply them to child safety
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7. Development of bright, ready made, lightweight displays that can be easily
accessed to community groups and service providers for information days,
community events and festivals. (make it as easy as possible for people to
conduct health promotion in the area of child safety)
8. Establishment of links with other Departments on a State-wide level e.g. Office
of Housing and Family and Community Support Community Care to promote
child safety to staff, clients and funded organisations
9. Develop targeted child safety programs for low income families. This could
include a training manual with suggestions for arranging and promoting the
course, ideas for guest speakers, session content etc. All participant could be
provided with a centrally developed kit of child safety products
10. Explore possibilities to roll out child safety training and resources to service
providers across the State. The Ballarat SafeStart project piloted a number of
resources which showed potential and subject to further evaluation and
development could be suitable. These include the Keep me Safe Cards, a four
session program targeting low income and high risk families and a session for
first time parents to be delivered by Maternal and Child Health
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