Families First Edmonton (FFE) (FFE)

Families First Edmonton: The Comparative Effects and Expense of Four Models of Augmenting Services for Low-income Families

This study is designed to provide clear evidence for health and social policymakers about the influence of alternate service-delivery models and practices on enhancing and sustaining low-income family linkages to available services. A challenge faced by Canadian health and social service providers is to promote health for low-income families in a proactive and cost-effective manner. Families with low incomes experience an array of health and social barriers that compromise their resilience, lead to negative family outcomes, and act as barriers to available services. Family barriers are compounded by service delivery barriers and result in reduced opportunities for effective, primary-level services and in increased use of secondary-level services (e.g., emergency room visits, emergency intervention, police involvement), with the obvious increase in costs. Randomized-controlled trials are rare in community-based intervention research.

This Families First Edmonton randomized-controlled trial (RCT) will enable testing of innovative service-delivery models and provide an opportunity for evidence-based decision making for Canadian policy makers. Critical information will be provided about

1. optimizing cost effectiveness for public systems
2. the long-term effects on the health of low-income family members
3. mechanisms that intervene between the interventions and their effect on the health of low-income family members
4. building on previous research and on community-based initiatives
5. promoting knowledge transfer

Study Overview

• Status: Completed
• Conditions: Low-Income Population
• Intervention / Treatment: Behavioral: Primary Health Care Model (PRMHLTH); Behavioral: Recreation Coordination Model (REC); Behavioral: Comprehensive Model (COMP)

• Study Type: Interventional
• Enrollment (Actual): 2400
• Phase: Phase 2

Contacts and Locations

Study Locations

• Canada
  • Alberta
    • Edmonton, Alberta, Canada, T5A 1C6
      • Alberta Human Resources and Employment

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Participant families will

  1. have received low-income assistance either in the form of

     1. Alberta Works Income Support
     2. Alberta Child Health Benefits,
     3. Alberta Works Adult Health Benefits
     4. participating in City of Edmonton Leisure Access Program
     5. living in Capital Region Housing
  2. have a child or children between 0 and 12 years of age
  3. reside in city of Edmonton
  4. be able to provide signed consent

Exclusion Criteria:

• Potential study participants will be excluded if they refuse to give informed consent to be interviewed
• are unable to read and write English and an appropriate translator is not available
• have plans to move outside the region
• are unwilling to participate for the entire follow-up period

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Factorial Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: 1	Behavioral: Primary Health Care Model (PRMHLTH); Primary health care service delivery
Experimental: 2	Behavioral: Recreation Coordination Model (REC); Recreation coordination service delivery
Experimental: 3	Behavioral: Comprehensive Model (COMP); a comprehensive service delivery model consisting of PRMHLTH plus REC.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Increased linkages between low income families and established services in their communities	Baseline, 12-month, 24-month, 36-month follow-up

Collaborators and Investigators

• Sponsor: University of Alberta
• Investigators: Principal Investigator: Jane Drummond, PhD, University of Alberta

Publications and helpful links

General Publications

• Browne G, Byrne C, Roberts J, Gafni A, Whittaker S. When the bough breaks: provider-initiated comprehensive care is more effective and less expensive for sole-support parents on social assistance. Soc Sci Med. 2001 Dec;53(12):1697-710. doi: 10.1016/s0277-9536(00)00455-x.
• Drummond J, Wiebe N, So S, Schnirner L, Bisanz J, Williamson DL, Mayan M, Templeton L, Fassbender K; Community-University Partnership for the Study of Children, Youth, and Families. Service-integration approaches for families with low income: a Families First Edmonton, community-based, randomized, controlled trial. Trials. 2016 Jul 22;17:343. doi: 10.1186/s13063-016-1444-8.
• Drummond J, Schnirer L, So S, Mayan M, Williamson DL, Bisanz J, Fassbender K, Wiebe N. The protocol for the Families First Edmonton trial (FFE): a randomized community-based trial to compare four service integration approaches for families with low-income. BMC Health Serv Res. 2014 May 19;14:223. doi: 10.1186/1472-6963-14-223.

Helpful Links

• Families First Edmonton Homepage

Study record dates

Study Major Dates

• Study Start: December 1, 2005
• Primary Completion (Actual): June 1, 2011
• Study Completion (Actual): June 1, 2011

Study Registration Dates

• First Submitted: June 24, 2008
• First Submitted That Met QC Criteria: June 25, 2008
• First Posted (Estimate): June 26, 2008

Study Record Updates

• Last Update Posted (Estimate): April 21, 2016
• Last Update Submitted That Met QC Criteria: April 20, 2016
• Last Verified: April 1, 2016

More Information

Terms related to this study

• Keywords: children; recreation; low-income families; family healthy lifestyle; linkages to community resources; Families with low incomes; working poor; welfare recipients
• Other Study ID Numbers: 137444