How outreach facilitates family engagement with universal early childhood health and education services in Tasmania, Australia: an ethnographic study

tTasmanian early childhood services (ECS) are attempting to improve their engagement with vulnera-ble families and increase the uptake of universal health and education services in this population. Thispaper presents qualitative findings from the [name] Study, focusing on the scope and role of outreachin supporting family engagement in the Tasmanian ECS. Using an ethnographic study design, over 100naturalistic observations were recorded in health and education ECS settings in Tasmanian communitiesbetween April 2017 and February 2018. In addition, 42 ECS providers and 32 parents/guardians withpre-school aged children participated in semi-structured interviews. Interview transcripts and obser-vation field notes were analysed thematically, focusing on family engagement and the role of outreachacross three key universal ECS. Outreach was undertaken by all services involved in this study, but var-ied in practice and scope. Outreach was not directed at specific population groups, but was instigatedin response to an identified need with more vulnerable families to address issues of inequity in serviceaccess. Policies and strategic frameworks within services provided little or no guidance about outreachbeyond procedures for conducting home visits. Attending specialised services alongside parents, a strat-egy adopted by one service, was particularly effective for facilitating connection to services for vulnerablefamilies. The capacity of services to offer outreach was constrained by structured service systems, indi-vidual providers’ skills and capability, resource limitations and lack of clarity with respect to policiesand procedures. Outreach activities are occurring within the universal ECS system in Tasmania, facilitat-ing engagement with vulnerable Tasmanian families and children. Flexible service systems, building theskills and capacities of service providers and clearer policies and procedures would enable services tomore fully embed outreach practices within existing ECS.