Theme 6: Opportunities in place | Centre for Community Child Health

Co-authored by Jamie Gamble, Penny Hagen, Kate McKegg and Sue West.

This blog post is the sixth in a series of posts exploring themes of systems and community change resulting from the Innovate for Impact symposium, hosted by the Murdoch Children’s Research Institute in 2018. Check out the introduction to the Innovate for Impact blog series here.

“A sense of place matters” [1]

“Place has a significant impact on individual wellbeing” [2]

As a means for addressing complex and entrenched issues for families and communities, we are increasingly seeing a shift to place-based approaches which focus on improving outcomes of particular communities in place. Responses are intended to address the specific needs and underlying causes in each location.

While evidence is still emerging about the effectiveness of place-based work, there is growing interest globally in such approaches [3]. This is in part because services framed in orthodox ways are struggling to respond effectively to meet the needs of families and children experiencing the impacts of racism, inequity and disadvantage.

Many of the program and policy issues we have highlighted in previous blogs are exacerbated by the distance between policy and practice and a “one size fits all” population-level approach. Decision-making and planning becomes divorced from the effects it has on people’s lives. As an approach that offers collaborative, participative, developmental forms of working to address unique local issues and needs, place-based approaches offer an alternative.

The purpose and features of place-based approaches can vary greatly:

“Over the years in Australia, place-based approaches have been used to improve program or service delivery, build citizen engagement and participation in governance, decentralise government decision-making, and address complex issues such as concentrated disadvantage in a community. Place-based approaches vary in: the extent of citizen involvement and ownership; breadth of local stakeholder involvement; focus on people versus place; and the number, type and complexity of issues being addressed.” [4]

Within a systems change context, a key challenge we see is that a focus on place can just mean a focus on better coordination of services within a geographic boundary, or on change and action within local communities without means for shifting the systems that hold community conditions in place. These interpretations of place-based are not enough to meaningfully shift system conditions and outcomes for child and family wellbeing.

Rather than replicate the extensive material that already exists on place-based work, this blog highlights three opportunities offered by working in place that we have observed through practice and that engage the dynamics of community, place and systems. These are

A holistic view of wellbeing
Connections between people and place
Localisation of policy in place.

While the examples used are not all from large or ongoing place-based initiatives we believe they each provide learning about engaging deeply in aspects and potential of working in place. We also reflect on some of the challenges to realising these opportunities and ways in which the practices of co-design and developmental evaluation are evolving to support work in place.

Opportunities of working in place

A holistic view of wellbeing

A key challenge with conventional models of service delivery is that people’s lives become siloed in ways that are not reflective of how people and families experience things in the real world. Agencies are organised around issues and responses, for example, education, health, justice and employment are dealt with by different departments. Within each, there are many programs, targets and funding streams that are costed and measured, often with little connection built between them.

In addition, responses to child, youth or family wellbeing issues typically come in the form of funding for interventions, services and programs, aimed at populations of young people and families, and delivered at an individual level. While many of these services deliver important support, as we noted in our second blog – Moving away from just programs and services, services with an expert and “delivery” mindset may do little to build up the capacity or capability of families or communities receiving services. Relying on services and programs can also perpetuate a focus on interventions and treatment rather than investment in prevention or attention to the broader systemic environments and structures that hold the current conditions in place. So many conditions and influences for child and family wellbeing outcomes are set at structural and environmental levels.

For example, the ways that policies are shaped, or streets and neighbourhoods are designed promotes protective factors to a greater or lesser degree, and reinforces inequity, privilege and structural racism. While a health provider might be engaged to deliver a health service for young people to address a particular aspect or issue, there are many other local, commercial, and government institutions within a community that also play a significant role in shaping wellbeing outcomes for children and young people.

Working in place offers the potential to be more holistic, bringing together the broader ecosystem of existing networks and resources that are already in place or close to communities around a shared wellbeing goal and exploring how they can be better aligned, connected or strengthened to address the issues at hand.

Place-based example: Lifehack

A small scale example of this approach was demonstrated by Lifehack, a four-year systems-level prevention project funded by the New Zealand Government to reduce mild to moderate mental health issues in young people aged 12 to 19. [5]

Between 2013 and 2017, Lifehack experimented with various kinds of interventions to determine which approaches were most effective at creating wellbeing impact.

Overtime Lifehack’s focus moved from national capability programs and individual youth ventures to cross-sector initiatives that helped build up capability and connection in a specific geographic community. Lifehack found that while it was possible to connect and catalyse a national youth workforce around different ways of working, in order for that potential to be realised as significant changes for young people at scale, it needed to go beyond individual practitioners, organisations or interventions, and be grounded in place and the influencing structures, relationships, entities and culture that were already embedded in a community.

“Lifehack’s place-based interventions engaged individual practitioners, organisations, local young people and other community members at the same time. This created a collective group with significant influence over conditions for wellbeing of young people in that community. Such groups were able to identify and respond to issues that were important and relevant to young people, in ways that were appropriate to the local context. And they could act together relatively quickly to make change [because of their local connections].” [6]

Place-based example: Oro

A small-scale example of this was Oro, an intergenerational place-based community collaboration focused on youth wellbeing. [7] The core of the collaboration was shaped around a six week co-design program which identified and responded to issues that were important and relevant to young people in that community. It resulted in three youth-led prototypes (which gained access to funding) as well as significant changes in practice and motivation for those involved.

This included new partnerships between local organisations, an outcome of which was the continuation of more co-design events lead by community. There was a significant shift in thinking in local council around the potential and role of youth programming and decision-making, leading to the development of ongoing peer-led youth initiatives. New local connections lead to better use of existing or latent resources already available within the community, such as asset sharing between groups and support to access funding pools.

There was also a shift for participating organisations in how young people were perceived. They were invited into the role of experts in shaping and leading responses with local organisations, enabling the promotion and prioritisation of youth and family wellbeing in policy development and decision-making.[8]

Other place-based examples

The holistic view offered by place is also demonstrated in a different way through the place-based approaches used by The Southern Initiative and Healthy Families South Auckland. Both initiatives have taken an integrated economic, health and social view and approach to change. They are seeking to deliver multiple kinds and levels of outcomes connected to broader wellbeing, beyond the focus of a particular program or delivery domain such as health or education. Both are also examples of where efforts to respond to complex health, social and economic challenges are underpinned by a connection to and focus on cultural, ecological, environmental and spiritual restoration and wellbeing. This rightly reflects the inseparable role of the environment and culture to health, wealth and wellbeing of people. Notably, a holistic understanding of wellbeing that incorporates all these dimensions is inherent within many indigenous world views and central to indigenous-led design and innovation practices.

This is illustrated in the example of Healthy Families South Auckland which has moved beyond a human centred design or co-design approach which starts with people, to practice a wairua [9] centred approach which takes a broader view of wellbeing that includes listening to the needs of the whenua (land) as a starting point.

“A strong aspect of this approach is connecting with the environment, with maunga (mountains), moana (oceans), whenua (land), awa (rivers)…A wairua-centred approach is about developing a wider, inclusive eco-system for health, using the knowledge of past generations to support the generations to come.” [10]

For example, in one local community, community members chose to start a revitalisation of community spaces and places with stream restoration, rather than the usual planning response, which was to start with a playground. A holistic view of people and place is not just then the services in location, but the understanding of the local ecosystems as part of a greater whole, connected to both history and future. It is possible that such a holistic view offered by working in place could also inform more holistic ways of thinking and doing across other parts of government.

Connections between people and place

The history of place and people’s connection to it is also an important part of understanding, healing, and preparing for new directions. “Ka mua, ka muri” is a Māori whakatauki (proverb) that can be translated as ‘walking backwards into the future’. An interpretation is that it acknowledges that we must look to the past to inform how and where we go next. The lens of place grounds us, literally, in the history and stories of whenua (land) and people.

Many efforts of social innovation and change are targeted at communities with brutal histories, marked by separation from land facilitated by past and present government policy. Many such communities remain dispersed and disconnected from whenua. In places such as Australia and New Zealand that have experienced colonisation, a place-based approach is a means to recognise and acknowledge that history and its ongoing effects on the challenges and structural disparity families experience today. These stories deeply shape our response to current issues.

The Southern Initiative, mentioned above, draws on co-design, indigenous knowledge systems, tikanga Māori (Māori protocol and principles) and ecological place practices such as regenesis [11] as part of working in place. Different groups come together to work on a shared goal, with family and community members playing a key role or leading the co-design process.

Early work within a community to build connections, trust and readiness for working together in ways that might be unfamiliar often involves creating or engaging in ‘story of place’.[12]

Such engagement involves creating ways for people to tell their story and see themselves reflected in the space, in a way that people have some ownership of that story telling. Such processes can connect people to each other and to the place, contributing to a sense of belonging. It is also a poutama (symbolising levels of learning) – a collective space for creative and cultural practice and learning. How it happens is flexible and can be applied in different ways in different communities. It might mean just using a map to let people talk into their relationship to the space or place as part of whakawhanaungatanga (creating relationships and connections). It could involve creating a temporary wall of stories where community tell about their relationship to place or the history of a place. In some cases, it has meant working together to develop a physical representation of that story, such as through art work or murals that can be installed in place. When captured visually it produces physical changes in a space that reflects and connects the people of that community, as well as revealing aspects of the history and the underlying story of what is going on for people and place.

Even when the stories of place are very tough stories, owning and creating these with and as community can become a connecting and strengthening thread. It can help to build a collective understanding of the history of a place and what must be addressed or acknowledged in any change process, as well as where communities want to head together.

In reflecting on their experience of exploring story of place in work with a community with a particularly complex history, one team shared: “people want to tell their stories, communities remember them, and retell them their own way. Enabling local artists and storytellers to visualize their experiences of place changes the wairua and the perception of place and thus community participation in events and activations”.

Localisation of policy in place

As noted a challenge with working at national and population levels is that tracked outcomes can be disconnected from what matters or what leads to differences on the ground. As discussed in blog post Evidence for Innovation, we know that in order to be more meaningful evidence needs to be localised to, as well as developed in, context. For example, how do measures of stress or executive functioning – critical to both adult and child wellbeing and development – translate into the everyday lives of parents in different communities and cultures? How do actions that we believe are important to children’s language development translate from one cultural context to the next? What can we learn from traditional knowledge or indigenous cultures about language development that may not be understood in ‘western’ science?

Working in place provides an opportunity to connect local practices, context and culture to broader policy goals, measures, models and outcomes – localising evidence in ways that help us build a more sophisticated understanding of what matters for families, and how this translates into supporting conditions for wellbeing.

A version of this was trialled in the Wellbeing in Waitematā initiative which sought to co-design and prototype community-led primary prevention of family violence [13]

Stakeholders from central and local government collaborated with regional family violence networks who worked within their specific local communities. A key aspect of this initiative was to understand how a generic and draft Primary Prevention framework developed at central government level could be operationalised at a local community level and to test and improve the framework as a result. Practitioners from the local networks worked with people from their community including schools, young people, parents groups and community groups to identify what protective factors (identified in the model) looked like in context, how they already showed up in that particular community, as well as how they might be amplified (e.g., visiting a neighbour, being there for a friend, creating a safe space to connect).

The core concept, learning and support for the initiative was provided through central and local government, with local providers holding the relationship with their communities to localise, activate and feedback on the model. The prototype showed how different protective factors manifest in different communities, as well as ways in which change could potentially be measured. The framework was developed into a set of tools and protective factors that were more accessible for use within the community. A localised evidence base began to develop to support the generic model including a local interpretation of what would be required to support and enable the community-led model to work in practice and in place.

Challenges and potential in practice

Above we have explored three opportunities for supporting and catalysing wellbeing that are made possible by working in place. The examples have shown promise in their ability to build connection and capacity in community and organisations to work differently and to utilise and bring together resources that already exist in ways that better serve community wellbeing needs and aspirations. They also suggest opportunities for better connections between high-level policy and how it is connected to action in different communities.

However, such approaches require skills in working collectively. They ask us to re-organise current work practices and rethink our perspectives and strategies for accountability and outcomes. A direct implication is that a relational approach is required. This means getting to know and working responsively and reciprocally with specific people, families, places, networks and institutions rather than generalised groups populations or geographies. They ask for a learning dialogue between different parts of the system. Below we explore some of these challenges and how co-design and developmental evaluation can contribute to place-based work.

Expertise, capability and the power to configure

Recognising the strength and expertise of communities as equal to that of government and other experts means a shift in power around who leads and where and how decisions are made. Done well, co-design processes can help create the space for this to happen, offering a framework and practice for bringing together different organisations and entities to work in a culturally situated place-based way with and for the benefit of a particular community. Such processes recognise and can help to bring forward the expertise and role of young people, families, community members and frontline workers in identifying and responding to the challenges they experience. They facilitate the surfacing of community strengths and aspirations and provide room for organisations to recognise the support they can offer a community and test out ways they can configure their assets in more collective ways towards a shared goal. This might mean new services, but more likely it will mean the reconfiguration of existing assets, services, practices, resources and funding flows in ways that better address the needs and unlock the potential in place. This might include developing alternative models such as peer-to-peer or informal, community-led models. While it does not mean shifting the responsibility (solely) to the community, it does require working together in partnership with young people, community members and frontline practitioners and finding ways to better support aspirations and provide and grow the capability of community over time.

While this sounds like common sense in many ways, it necessarily involves challenging traditional power structures and relationships, how resources are governed and decisions made. Government’s role is to work in enabling ways to support communities to achieve their aspirations and amplify or grow the potential that already exists there – working alongside, with and in, communities providing support for them to lead or play a key part in their own change and innovation. This more relational and responsive approach challenges the conventional mode and role of government as service deliverer, power holder and decision-maker. It requires us to adopt a learning stance – so that we can learn with communities about what is needed for better outcomes and participation in the learning process.

Multi-level efforts that are focused on outcomes at a local level with local communities and stakeholders must also strive to work with and seek to influence and broker new kinds of power-sharing with municipal, state, regional or national policy systems and structures that set the conditions for communities on the ground. This requires collaboration, shared learning and sharing of decision-making between citizens, service providers, governments, philanthropy and the private sector. Current structures that have governments and funders holding power and control around assets. How these assets are configured and how value is attributed are deeply ingrained through structural mechanisms and behaviours. Facilitating genuine power-sharing beyond design and discovery and into policy and implementation faces many challenges and raises interesting questions and challenges for the role of government. How might the holistic view offered by working in place inform a more holistic way of working across government? What does it look like to have an enabling government that supports where needed, that shares power with communities and builds capacity through each engagement? How can we support and be responsive to learning in and with our communities?

One way is building capacity in government around participatory and evaluative practices and mindsets that are responsive and developmental. Working together through a well facilitated design and discovery process helps build capacity and capability as well as readiness. Developmental evaluation also has a strong emphasis on capacity building and built into the approach is an intentional process of learning and embedding knowledge in place that can increase the stickiness and longevity of learning by communities.

Building localised evaluative capacity also plays a role in nudging the accountability tensions that exist in place-based work towards the community holding more of the decision making and learning cards in their hands – holding a mirror up to teams and the system about what patterns and behaviours are in play. It can also help to highlight gaps between stated intentions to “co-design” and share power, and how actual behaviours and decision-making plays out on the ground that may reflect something different.

Transfer of learning – wider systems influence and change

The transfer of learning from local prototypes and initiatives to broader policy and systems change is one of the biggest challenges for this work. Inherent in place-based work are cycles of learning – building know-how (practice-based evidence) about what works, and what skills and structures are needed to sustain new ways of working – those on the ground are working to grow the capacity to achieve this at the same time (connections, skills etc). Such local learning is critical; however, we need the skills and mechanisms to ensure that such learning is connected back into central policy and funding cycles.

For any meaningful impact the relationships between local and higher-level systems must also be fostered. Currently the relationships between learning on the ground and the policy systems landscape are still relatively ad hoc. Exchanges between and local learning about change and outcomes and policy are loose and opportunistic. Creating a two-way line of sight between high-level policy and practices and experience on the ground requires that place-based initiatives find ways to first understand what the structural and relational enablers and barriers across system boundaries are. Approaches that can leverage system influence in relational and organisational terms, as well as structural and technical ways, need to be intentionally built in. Different layers of the system, including government, need to be engaged in a two-way dialogue. This includes the various policy jurisdictions that govern assets, resources and laws from local, state, regional and national levels mobilising their knowledge about what is working and why. This is no simple task and the challenges of influencing change further up the system have been noted in international studies, such as the Aspen Institute review. Yet place-based work can only have a truly transformative effect if it connects into broader systems change and addresses the conditions set beyond the community – else its stays localised and forever constrained by the system.

As practitioners, supporting innovation and place-based work we can see opportunities to use developmental evaluation as a part of the learning system. There is no right way to do evaluation in place-based work, and it’s contribution to supporting breakthrough change is imperfect and variable. However, developmental evaluation is one approach that has developed to support innovation and respond to the challenges of working in complexity in participative and relational ways. It can be tailored to the context and place and designed to accompany people on the messy, long term journey of place-based change, adapting the methods, approaches and reporting to suit particular circumstances and audiences.

‘Strategic learning’ approaches emphasise the value of embedding developmental evaluation as a key part of the design process. Rapid feedback cycles of relevant data and evidence can help people to learn quickly and adapt their strategies accordingly. At the same time, systematic and targeted use of evaluative approaches to learning synthesis and communication can strengthen the robustness of judgements and broaden the reach of this learning to other system actors.

Principles-focused developmental evaluation can also help to cohere collective efforts around shared values and principles guiding the change process. These principles can also provide a high-level framework for learning, tracking change and evaluating the overall value of initiatives in the short and longer-term.

Reframing accountability and outcomes

Most systems of accountability are designed top-down, with measurement, indicators and targets designed and set to account upwards. There are usually only nominal formal feedback loops back to communities built into the system, and iteration of the design, collection and analysis of data and measures is almost never possible.

When working in place, accountability is more complex than the one-way system orthodoxy of current accountability systems and structures. Learning outcomes need to be considered as critical to the process as much as changes in the system and outcomes for families and whānau. We need to have our eye on all the outcomes across the systems as well as on the barriers and challenges that surface as the initiatives progress. Lifehack’s outcome model, for example, accounted for outcomes for young people as well as change at sector and system levels [14].

Outcomes are also emergent as we collectively probe to understand and untangle relationships of place, history and system that give the context for the current state, and then collectively move to respond. Community must lead in defining what is of value and have the capacity to help identify what outcomes matter. The Wellbeing in Waitematā initiative showed the potential of communities being involved in identifying what outcomes work for them and how they can be enacted in context. Accountability back to the community takes priority, especially for those teams working within their own communities. And the evidence for any outcomes achieved will be multifaceted – it will be empirical, practical and experiential.

This approach challenges traditional notions of measurement – as we have discussed in our earlier blog. We are conditioned to thinking about measurement as providing us with answers and assurance. In place-based work, the answers are not in the data, the data doesn’t speak for itself. Rather we – all of us engaged in place-based work – have to use the range of evidence we have, and make sense of it, in place. If evidence is to be meaningful it needs to be interpreted in context.

One of the new accountabilities for the higher levels of the system in place-based work should be to support those on the ground to build streams of useful data and evidence that can be layered over time, with each source balancing out the limitations of other sources. Then collectively, with participants from across the system, collaborative sense-making and deliberation can become a key strategic learning capability. This collective expertise must be developed in place. It takes time and must be underpinned by trusted relationships.

Because the system is always adapting, and our evidence base is continually changing, it’s far more important to be accountable for ongoing adaptation and learning than being locked into a pre-set list of indicators that can easily become redundant over time.

In closing

As practitioners working in these spaces, we are confronted by a range of challenges when the intent is to support transformative change, yet the structures and behaviours remain the same. The blog that follows this is the final in the series and will look at innovation as ethical practice. This addresses the responsibilities of supporting rigorous innovation alongside communities and the kinds of skills, practices and structures needed to support learning in complex and sensitive contexts. This includes the challenges and opportunities of working in place, and in new ways with communities where we prototype both to address immediate needs and challenges as well as to build learning with the intent to contribute to longer-term shifts in the system.

The Innovate for Impact blog series is co-authored by Jamie Gamble (Imprint Consulting), Penny Hagen (Auckland Co-design Lab) and Kate McKegg (The Kinnect Group) in collaboration with Sue West from the Centre for Community Child Health.

Innovate for Impact blog series

This blog post is part of a series identifying shifts the co-authors believe are emerging and important to community service and systems change. Links to the other posts (as they published) are below.

More Innovate for Impact resources

Contact Sue West for Innovate for Impact blog series enquiries.

References

[1] Community Leader, in Hancock, F. (2018). A relational approach to community and social innovation: Practices that make a difference. Auckland, New Zealand: Auckland Council.

[2] Place-based Initiatives Transforming Communities, 2012, Centre for Community and Child Health

[3] The evidence: what we know about place-based approaches to support children’s wellbeing, 2014, Murdoch Children’s Research Institute

[4] Place-based collective impact: an Australian response to childhood Vulnerability, 2018, Policy Brief, Centre for Community Child Health

[5] Further details can be found in the Lifehack Report. For full transparency the report was co-authored by Penny Hagen who was involved in the initiative. Excerpts of the report have been used here in the description of the initiatives.

[6] https://lifehackhq.co/lifehack-resources/2013-2017-final-impact-report/

[7] See also https://lifehackhq.co/?s=oro and Mike Ryan from the local council sharing his perspective on the Oro collaboration at the Co-design for YouthWellbeing event https://www.youtube.com/watch?v=ziQQNojGeoA in 2017

[9] Definition: Wairua – spirit. Access a fuller exploration of the definition of Wairua

[10] https://healthyfamiliessouthauckland.nz/strengthen-your-wellbeing-let-nature-in/

[11] https://regenesisgroup.com/

[12] The term is borrowed from Rengensis

[13] https://library.nzfvc.org.nz/cgi-bin/koha/opac-detail.pl?biblionumber=5246

[14] https://lifehackhq.co/lifehack-resources/2013-2017-final-impact-report/