A literature review on supported playgroups

(Photo: Christine Cabalo)

Do supported playgroups actually make a difference? A recent literature review of research on supported playgroups [1] found that, while they are very popular, there is not a strong research evidence base demonstrating their effectiveness. The lack of research evidence appears to be more about the challenges (including the cost) of undertaking high quality research and evaluation rather than indicating that playgroups are ineffective.

Playgroups in Australia

Parent led and managed community playgroups have been around since the 1960s, but began to flourish in Australia in the 1970s. In 1975 the Australian Government started funding playgroups and increased its funding of supported playgroups, which are facilitated by a paid worker, from 2003 [1,2]. Supported playgroups are used extensively by family services as a way of engaging families who otherwise may not access community playgroups or other family services [1].

According to Playgroup Australia,

Playgroup is an informal session where mums, dads, grandparents, caregivers, children and babies meet together in a relaxed environment.

Playgroups are set up and run by parents and caregivers, with children choosing from a range of activities set up to meet their varying needs. Activities at playgroup may include:

• Music and singing
• Imaginative play
• Outdoor and free play
• Art and craft activities
• Outings.

Playgroup can be held anywhere that is safe for children and where groups of people can meet – community and neighbourhood centres, health clinics, women’s centres, preschools and kindergartens, church halls, parks and playgrounds, even in someone’s house.

In a playgroup, parents and caregivers stay to interact with the other adults; and to play with the children.

Supported playgroups are usually established by an external organisation (e.g., a family service) and focus on families experiencing multiple layers or disadvantage or complex needs (e.g., families experiencing domestic violence, drug addiction or homelessness). While community playgroups are set up, facilitated and managed by the parents themselves, supported playgroups are run by an employed worker with skills in working with children and/or families. Supported playgroups often receive state or federal government funding.

The research base

Because of the number of supported playgroups receiving government funding, questions are frequently raised about how effective they are. In a literature review commissioned by the Queensland Department of Education & Training, Williams and her colleagues [1] undertook a systematic literature review of research investigating supported playgroups. After identifying 1801 potential papers, they narrowed it down to 34 papers that met their selection criteria which included that it was primarily a research article, that it focused on group programs (not individual support) and that the programs were directed at “general support for parental wellbeing and social support for parenting” (p. 13).

The papers discussed three types of supported playgroups:

1. Standard supported playgroups that followed “a format widely used across Australia of a two hour, weekly meeting in the same location, and with the same facilitator each week. The delivery of the program was flexible with no specified curriculum content or routine” (p. 15).
2. Mobile playgroups that used specially equipped vans to deliver programs for people living in isolated areas or in temporary accommodation (e.g., caravan parks).
3. Supported playgroups with specific interventions that delivered “specific interventions or curriculum, to groups of parents and their children in play-based activities, and delivered under the leadership of a facilitator” (p. 15).

Williams and her colleagues discuss in some depth how they selected the included papers and the research methods used by the papers they reviewed. They argued that “experimental studies or quasi-experimental research designs set higher standards for evidence, because through the design features and sampling procedures more confidence can be placed in the veracity of the research findings about the effectiveness of an intervention” (pp. 15-16). They also recognised the value of other research methods.

The effectiveness of supported playgroups

Williams and her colleagues essentially argue that limitations in the research available makes it hard to demonstrate the effectiveness of supported playgroups. They conclude that:

Most of the research studies did not provide strong evidence for the effectiveness of supported playgroups for positive change for parents, children, and communities, due to limitations in research design. It was identified from the research studies that the supported playgroup program is highly valued by parents and other key stakeholders. Supported playgroups appear to provide important opportunities for parent learning about child development, addressing social isolation, and linking families with other services (p. 36).

Parents were generally very satisfied with supported playgroups (p. 26) but the actual outcomes are harder to demonstrate. In terms of parenting outcomes, the strongest evidence suggested the impact of playgroups included:

1. Increased facilitation of children’s learning
2. Higher responsiveness, lower directiveness, and higher language facilitation
3. Enhancement of the quality of parent-child interactions and higher quality in caregiving environments
4. More positive parental perceptions of children (p. 24).

There was also some evidence that the impacts on parents included:

1. Improved parent mental health and positive parenting behaviours
2. Growth in parental self-efficacy
3. Increased parenting confidence and decreased stress
4. Increased time in physical play with children
5. Increased parent skills, resilience, social support, and improved parent-child relationships (p. 24).

In terms of child outcomes the strongest evidence suggested the impact of playgroups included improved

1. Child language
2. Cognition
3. Behaviour skills (p. 25).

There was also some evidence that the impacts on children included:

1. Increased child social and emotional skills
2. Significant positive changes over time in child language and social development and attachment status
3. Decreased behavioural problems maintained to 6-month follow-up
4. Increased language gains in children with English as a second language (p.25).

There was little research about community outcomes although there was some evidence that parents increased their knowledge about the availability of other services or viewed playgroups as a gateway to other services and that supported playgroups could support the successful transition to school for Aboriginal and Torres Strait Islander children (pp. 25-26).

Characteristics of successful supported playgroups

Because playgroups can vary so much – for example the nature of families and staff, the different models of support and the diversity in session content (p. 35) – evidence of impacts in one context does not guarantee the impact will be replicated in another context. This makes researching playgroups that much harder. It is thus important to document the characteristics of successful playgroups. Williams and her colleagues discuss some of these characteristics including:

1. Novel and stimulating program content
2. A welcoming and comfortable environment
3. Strong links with the local community
4. A facilitator skilled in conducting difficult conversations and putting families at ease
5. Cultural sensitivity and cultural competence (p. 27).

Higher levels of attendance appears to be associated with improved outcomes for families (p. 26) and thus it is important to consider how to engage families, particularly those families in the greatest need (p. 26). While it appears that supported playgroups are successful in attracting a diverse range of families (p. 30) Williams and her colleagues reported that “there was little information contained in the research studies about the recruitment strategies used to reach the targeted populations or how programs were able to retain these typically hard to reach families” (p. 36). This represents a significant gap in the literature about effective practices which may lead to better outcomes.

One of the things that providers of supported playgroups can do to increase the likelihood of success is to develop a more explicit theory of change:

Adopting a theory of change is important in building capacity and program sustainability so that the program activities are meaningful in the context of the program; plausible in that they have face validity and are aligned with the intentions of the program; are doable in the program settings with the level of resources available; and, are ultimately testable to establish effectiveness. (p. 35)

Some concluding comments

The review highlights some of the challenges of evidence-based practice in working with families. Because family work is very complex and all families are different, identifying evidence-based programs and practice in family work may need to involve different research processes to those common in some other fields, such as medicine. As Williams and her colleagues suggest:

Random assignment experimental studies are often challenging to implement, expensive, and time-consuming to conduct. They have a very specific purpose to provide strong causal evidence about whether the program has an impact and the magnitude of that impact on the targeted population. However, the randomised experiment by itself may provide little information about the program elements, processes, and implementation efforts which may be key issues to organisations which operate programs or individuals who work in programs. (p. 16).

While the literature review did not find strong evidence about the effectiveness of supported playgroups, this was largely due to the nature of the research not necessarily the playgroups themselves. Research into the experience of families and practitioners in playgroups in diverse settings could enhance the evidence base available to policy makers and funders. There may not currently be strong evidence about the effectiveness of supported playgroups, but this does not mean that there is evidence that they are ineffective. The experience of many families and family workers suggest they do play an important role in supporting families – children and parents.

Williams and her colleagues call for more research that:

1. Identifies the specifics features of supported playgroup that provide the impetus for change in parent, child, and community outcomes (i.e., a theory of change about processes that make a difference in the delivery of programs)
2. Articulates program goals in measurable units of change for example in parental attitudes, behaviours, and knowledge, as well as for child behaviours
3. Uses established measures to enable greater confidence about the measurement of desired outcomes and provide comparability of the findings across studies, as well as use of repeated measures across time to consider maintenance of effect (p. 37).

Family workers could help develop an evidence base about practice in playgroups by:

1. Critically reflecting on their practice and not just do things because they have always done it like that.
2. Developing a program logic or theory of change for supported playgroups (and other programs they deliver) so they are clear about why they run playgroups and what they can reasonably expect as outcomes.
3. Thinking about and documenting measures that show how they make a difference and not just relying anecdotal evidence.
4. Collaborating with researchers to improve the evidence base.

Note: Please don’t rely on my summary but have a look at the original report which is freely available from http://eprints.qut.edu.au/91439/.

This post came from a project I’m working on supporting nine children and parenting support programs in regional and rural NSW to enhance their capacity to implement evidence-based programs and practice. The project was funded by the Department funded by the Department of Social Services through the Children and Families Expert Panel. You can see other posts relating to this work at https://sustainingcommunity.wordpress.com/resources-for-students/expert-panel-caps/.

If you liked this post please follow my blog (top right-hand corner of the blog), and you might like to look at:

1. Playgroups as a foundation for working with hard to reach families
2. 9 principles for supporting families and communities
3. “I try and make it feel more like a home” – families living in caravan parks
4. A resilience practice framework by the Benevolent Society
5. Childhood trauma and brain development
6. What are program logic models?

References

1. Williams, K. E., Berthelsen, D., Nicholson, J. M., & Viviani, M. (2015). Systematic literature review: Research on supported playgroups. Brisbane: Queensland University of Technology. Available from http://eprints.qut.edu.au/91439/
2. Cahir, P. (2013). Community Playgroups: Building children and parents capacity and sense of community. In P. Australia (Ed.), 40 years of playgroup: Celebrating our story of connecting communities. Canberra: Playgroup Australia. Available from http://www.playgroupaustralia.org.au/What-is-Playgroup/40-years-of-playgroup.aspx
3. Milne, C., Schofield, K., Delaney, M., Hart, K., Merlene, M., Yorkston, E., & Jacobso, C. (2008). Evaluation of the Playgroup Program: Final Report to the Communities Division of the NSW Department of Community Services. Sydney: ARTD Consultants. Available from https://www.playgroup.org.au/site/DefaultSite/filesystem/documents/Research/FINAL%20ARTD%20Playgroup%20Evaluation%20Report%20October%202008.pdf