Abstract
This research project creates and tests sets of resources that support practitioners to build effective change-focused relationships with young people. It does this using a Community of Practice (CoP) approach that brings together researchers, social sector and tangata whenua (indigenous) practitioners and international experts. The research has three steps: (1) Development of prototype resources; (2) Testing the prototype to confirm usability and efficacy; and (3) The creation of kaitiaki (guardianship) processes which will secure the ongoing availability of the resources beyond the end of the research project. This protocol details the origins of the project in community relationships and the methods used to create the resources and the kaitiaki processes.
Keywords
Introduction
Relational engagement is central to positive outcomes for youth with complex needs - those youth who confront substantial challenges in making a safe transition to prosocial adult lives because of the risk exposure experienced throughout childhood. Often these youth become clients of multiple services across systems. Within service delivery, research shows that positive relational practices have a larger impact on outcomes than any specific intervention/treatment model (Duncan et al., 2007; Munro, 2011; Ruch et al., 2018). Implementing relational practices, however, presents significant challenges (Duncan et al., 2007; Howe, 1998; Munro, 2011; Ross et al., 2011; Ruch, 2005; Turney, 2012). Furthermore, despite the powerful positive impact that relational practices have on outcomes, the primary focus of training and programme development remains upon specific models or technical facets of particular modalities (Duncan et al., 2007; Munro, 2011; Ruch et al., 2018). Consequently, practitioners can be technically skilled but unable to sustain the types of relationships critical to long-term change (Ross et al., 2011; Ruch, 2005; Ruch et al., 2018; Turney, 2012). Evidence suggests that when practitioners fail to sustain effective relationships, interventions risk exacerbating rather than ameliorating risks (Hood, 2014; Horwath & Morrison, 2007; Kapp et al., 2013; Sanders et al., 2017a). This research responds to the lack of relational engagement frameworks available to service providers, building on findings from the Youth Pathways and Transitions Research Projects (https://www.youthsay.co.nz) from which key relational practice elements were integrated into three relational practice frameworks; first PARTH (a general relational framework), then Tōu Ake Mana (a framework that speaks to the needs of Māori practitioners and youth) and more recently Moana (a framework from Pasifika worldviews that supports relationship-based practice). This research aims to establish the frameworks as evidence-supported, sustainable, culturally attuned, relationally informed intervention resources that support improved outcomes for youth facing complex personal and contextual challenges.
Background
As already stated, relational engagement is central to positive outcomes for youth with complex needs and who are often clients of multiple services across systems. Indeed, the Youth Pathways and Transitions Research Projects, upon which this research is based, demonstrated significantly improved outcomes when youth experienced respectful and empowering interventions responsive to culture and context (Sanders et al., 2017a). However, most youth participating in the research did not report experiencing such interventions. More often, inconsistent interventions and poor relational practices across services undermined outcomes (Munford & Sanders, 2014, 2016, 2017a, 2017b, 2019; Sanders et al., 2017b).
Feedback, From End-Users of Tōu Ake Mana/PARTH Resources.
The current research protocol addresses these needs by creating resources that reflect our unique cultural and contextual landscape, reflect what youth say has the greatest impact on thier well-being, are developed with practitioners and youth, promote collaboration, and build capacity and capability, particularly among youth workers, given limited training opportunities.
Relational Resources for Change
This protocol responds to the needs highlighted by service providers. As previously stated, it leverages the Youth Pathways and Transitions Research Projects to create resources that expand capacity to sustain the relationally informed, culturally attuned interventions that evidence indicates creates the best impacts (Duncan et al., 2007; Howe, 1998; Munro, 2011; Ross et al., 2011; Ruch, 2005; Turney, 2012). This research will support three key innovations. First, it will create sets of bespoke, effective, and evidence-based practice resources tested in everyday practice that are firmly grounded in Aotearoa/NZ practice and that reflect Māori world views and other understandings of effective relational practices. These resources will target the areas where practitioners struggle to implement sound, culturally responsive relational practice and enhance work where that practice is strong. These resources will therefore give providers and funders confidence that practice is effective and responds particularly to the needs of Māori youth; the youth who face the greatest challenges of all vulnerable youth (Ministry of Youth Development, 2017; Johnson, 2018; Tanielu et al., 2020).
Second, development of kaitiaki (guardianship) processes will help ensure the ongoing availability of the resources and provide a framework that facilitates their renewal. The structure and operational details of these processes will be developed during the project in consultation with team partners. These may provide a model that can be applied internationally.
Third, youth with complex needs typically have multiple service systems in their lives (Berzin, 2010; Munford & Sanders, 2014; 2016; Sanders et al., 2013; Stevens et al., 2014; The Treasury, n.d). A common critique is that these systems operate independently of each other, limiting effectiveness, duplicating effort, and risking client fatigue and loss of confidence. Such siloed approaches can harm youth (Hood, 2014; Horwath & Morrison, 2007; Kapp et al., 2013; Sander et al, 2017c). The pan-system focus of the research means resources that support improved relational practices regardless of professional discipline will be created and these should support inter-professional collaboration.
Community of Practice
The project adopts a Community of Practice (CoP) (Ranmuthugala et al., 2011) approach where providers and researchers work in partnership (see Figure 1). Resources are designed and tested collaboratively by researchers and practitioners so that they are grounded in practice realities and supported by sound international and local evidence. Community partners are involved in the research because they recognize a need for the resources in their practice. Many worked together in the Youth Pathways and Transitions Research Projects and have partnered in practice development initiatives emerging from that research. As a result, successful working relationships have been developed with these partners. International collaborators bring expertise in theory, methods and resource design. The networked team of local experts bring key domains of knowledge, including Māori knowledge, service delivery, research and youth work across welfare, education, justice and employment/transitions. International expertise adds to, rather supplants local knowledge. Māori practitioners and researchers ensure that the resources are culturally anchored and responsive to the realities of indigenous practice and realities (Pihama, 2001, 2010; Pohatu, 2005; Smith, 1990, 1997; Smith, 1997). Figure 1 depicts the community of practice. It should be noted that individual partners fit in more than one quadrant. Community of practice.
Project Implementation
Project Phases.
Resources, including cultural resources, training materials, practical implementation and reflective practice resources, theoretical materials that underpin the resources and tools for tracking youth development, will be developed through the partnership. Four key research questions are posed: (1) What resources facilitate ongoing implementation of relational practices in diverse cultural and social contexts (including tools to plan, deliver and track interventions and measure youth progress)? (2) What factors undermine the consistent use of relational practices, and what resources and strategies ameliorate this? (3) What resources and tools support effective practitioner-youth partnerships and practitioner collaboration? (4) What kaitiaki processes facilitate ongoing access to these resources?
Research Methods
Our research responds to calls that research be inclusive of Māori and non-Māori knowledge systems. It adopts a realist epistemology (Booth et al., 2018; Pawson, 2006; Pawson et al., 2004; Pawson & Tilly, 1997; Ranmuthugala et al., 2011; Rycroft-Malone et al., 2012; Wong et al., 2012) guided by kaupapa Māori principles (Pihama, 2001, 2010; Pohatu, 2005; Smith, 1990, 1997; Smith, 1997). This approach ensures that diverse ways of knowing shape the research and are woven meaningfully through the resources developed. This applies particularly to the inclusion of Māori world views and knowledge. Realism also facilitates the inclusion of other cultural frameworks.
Consistent with realism, mixed methods are used to define the mechanisms that underpin interventions (Maxwell & Mittapalli, 2010; Pawson & Tilly, 1997). This facilitates testing of culturally and contextually meaningful factors that enable relational practice in the diverse service contexts encountered by youth with complex needs. This approach responds to the diverse realities of Māori as well as the knowledge systems of youth and practitioners from other cultures and with diverse identities.
Central to realist analyses is the context-mechanism-outcome configuration (CMOC) (Astbury & Leeuw, 2010; Lacouture et al., 2015; Mayntz, 2004; Steele, 2004; Tilly, 2001). This configuration explains how contextual factors trigger particular mechanisms that underpin different outcomes (Gilmore et al., 2019; Pawson, 2006; Wong et al., 2012). Mechanisms can include psychological, societal and system processes. For this project, they include factors such as relationships and the ways in which individuals (i.e., youth, practitioners) understand their interactions as well as the systemic processes that facilitate practitioner uptake and use of relational resources. Multiple mechanisms can be at play in any situation. They are not necessarily linear, complementary, or straightforward. Given this complexity, realism provides a methodology for specifying how multiple and varied mechanisms operate in diverse real-world settings and explaining why certain approaches work for particular people in particular contexts but not in others (Gilmore et al., 2019; Rycroft-Malone et al., 2012; Wong et al., 2012). For instance, internationally, the benefits of relational practices are well recognized, and locally Youth Pathways and Transitions Research Project clearly demonstrated that relational approaches led to significantly better outcomes for youth (Munford & Sanders, 2014, 2016, 2017a, 2017b, 2019, Sanders et al., 2017b, 2017a). However, these practices do not consistently underpin service delivery, meaning that many youth do not benefit from service engagement. The range of resources produced by this research will support relational practice in a wide variety of settings thereby increasing the capacity for widespread uptake.
Figure 2 End-user involvement is key to the approach adopted here. The partnership structure and iterative development prioritizes end-user experiences. Mixed methods (i.e., surveys, interviews, focus groups) allow diverse ways of knowing to shape the development and testing of the resources. Quantitative techniques (e.g., surveys) capture the impact of the resources on interventions, test the validity of tools and measure youth engagement and outcomes. Qualitative approaches (e.g., interviews, e-journals) build understandings of relational practice uptake as well as why and how particular outcomes are achieved. This allows the role the resources play in youth outcomes to be identified. Provides an overview of the key research steps.
Phase 1: Design Prototype Resources and Identify Options for Kaitiaki Processes
Figure 3 Prototype resources will be developed using an iterative process. These will be critically reviewed by practice experts within the CoP and draw on expertise within their organizations and wider networks. Figure 3 illustrates one iterative cycle. This process ensures sector knowledge and expertise drives the resource creation process. It ensures that content, format and delivery have a strong fit with the diverse practitioners and contexts in which the resources will be used. Iterative design process.
The iterative approach secures inclusion of existing knowledge and previously unexplored insights that may not have been rigorously assessed, but which are nonetheless critical to effective service delivery (Astbury & Leeuw, 2010; Lacouture et al., 2015; Mayntz, 2004; Steele, 2004; Tilly, 2001). From this process, underlying theories and mechanisms of relational approaches can be extracted and elements to be included in the prototype resources will be defined (Gilmore et al., 2019; Rycroft-Malone et al., 2012; Wong et al., 2012). This is an efficient method for reaching a shared agreement regarding theoretical and empirical underpinnings of relational practices and determining the best ways of incorporating these into the prototype resources.
Three sets of data will be collected in this phase. First, practitioners who participated in early PARTH trainings will be interviewed to identify facilitators and barriers to adopting relational practices and resources that support these practices. Second, a realist Knowledge Synthesis (KS) (Booth et al., 2018; Gilmore et al., 2019; Greenhalgh et al., 2011; Ruggiero, 2018; Rycroft-Malone et al., 2012; Wong et al., 2012, 2013) of diverse literature will be conducted, to understand how relational engagement practice works, under what circumstances and in what contexts. The KS will highlight framework elements that are consistent with international and local best practice; elements that need to be added or revised; and resources that support relational practices including tools for planning, interventions, supervision, reflective processes, as well as measuring impacts.
Finally, a Scoping Review (SR) will be conducted to identify specific measurement tools relevant to the study (i.e., delivery and outcome/impact data), open-source IT platforms and applications that are relevant to supporting this work over the long-term, and options for the kaitiaki processes that will house the resources.
Phase 2: Testing the Prototype and Finalising the Kaitiaki (Guardian) Processes
Phase 2 involves the implementation, assessment and modification of the prototype resources developed in Phase 1. CoP partners play a key role in facilitating these processes. The focus of Phase 2 is on assessing: (1) The efficacy and practicality of the resources in enabling relational practice, (2) Implementation issues, including underlying mechanisms that facilitate and impede the use of the resources, (3) The impact of the resources on youth outcomes and engagement, and (4) Methods service providers can use for tracking youth growth and development.
This phase begins with the delivery of the prototype resources to 60 practitioners followed by an assessment of their implementation and outcomes. Participating practitioners will be asked to complete a series of guided reflective e-logs capturing the use of the resources. Practitioners can respond to prompts that explore strategies used from the resources, other strategies, effectiveness, adaptations, issues, usability and relevance, enablers and barriers. They will also be asked to complete a semi-structured interview one month after completing the delivery which will examine usability, relevance, impact, organizational and policy implications, facilitators and barriers, and changes needed.
Service managers, supervisors, cultural and practice leaders and front-line staff will explore the role(s) played by the resources in engagement with youth, in interventions and in contribution to youth outcomes. The approach taken here will be adapted to suit the participating organisations, for example, it might be through a focus group, an online meeting, or individual reflections with practitioners, managers and supervisors. Between 10 and 20 such reflections will be completed. This process fine-tunes understanding of how the elements of the resources fit within the CMOC (Astbury & Leeuw, 2010; Lacouture et al., 2015; Mayntz, 2004; Steele, 2004; Tilly, 2001), to impact outcomes and generates details of changes needed to improve efficacy.
Service managers, practice leaders, supervisors, and practitioners will also be invited to participate in a critical review process. Using individual interviews or focus groups with up to 20 staff, we will examine the effectiveness of the resources. These reviews will focus on implications for management and delivery, policy, facilitators and barriers, changes to ensure improved practice, and organizational issues that need to be accounted for (e.g., cultural and supervision practices and organizational changes required to facilitate uptake).
Revisions made during this process may raise the need for further training to be provided to either practitioners who are already part of the research or to new practitioners. This will occur as the assessment indicates is required and similar processes to those described above will be used to assess the efficacy of new or revised components.
To assess the impact of the resources on worker practice 200 youth receiving services from staff participating in the trial will be invited to complete a survey focused on the quality of service experiences and the individual, relational and contextual resources that assist in change and facilitate well-being. Decisions regarding which tools to use will occur in Phase 1. They are likely to be similar to those validated on Aotearoa/NZ youth in Youth Pathways and Transitions Research Project assessing the quality of service engagement (YSS-13) (Liebenberg et al., 2016), resilience resources (CYRM-28) (Sanders, Munford, Thimasarn-Anwar, & Liebenberg, 2017) and outcomes (Mental Health Continuum Short form) (Keyes, 2007). The sample size is based on anticipated service provider caseloads. This sample size will support both within-sample t-tests and other analyses to assess the impact of the resources on outcomes. Youth will be invited to complete the surveys on three occasions to enable us to gather data on the process of relationship development and its connection to overall youth wellbeing. The timing of these administrations will be determined by the nature of each programme. For example, some will be school-based group programmes that run within a school term, others will be short programmes of around 6–12 weeks duration, still others deliver long-term support to youth over several years. There will thus be an internal logic to the timing of surveys based on the nature of each programme, but the goal is to obtain meaningful feedback from youth about the process of relationship development given practitioner exposure to the resources, and its impact on overall youth well-being. The first administration will generally take place immediately prior to or shortly after staff participation in the training, the second during the delivery of the programme and the final administration at the end or after completion of the programme.
A subsample of 30 youth (15% of the quantitative sample) will complete semi-structured interviews after completion of the third survey. These interviews will identify whether elements of the resources can be detected in youth narratives and linked to positive outcomes. It is estimated that 30 interviews will achieve saturation (Sanders et al., 2018), allowing for robust findings. Additional interviews will be undertaken if needed.
Because the resources have an organization-wide impact, random allocation of youth to treatment and non-treatment groups during the trial is not feasible due to risks of cross-contamination. Therefore, youth who exit services prior to the trial will complete the same survey tools as youth who participate in the testing process. This will provide baseline comparison data. It is estimated that a minimum of 120 youth will have completed interventions in the two months prior to staff participating in the delivery of the prototype. Completion of 100 surveys will thus give a sample of approximately 80% of the youth in the services in the two months prior to prototype delivery.
Defining the Kaitiaki Processes
In the Phase 1 Scoping Review, a range of options for the kaitiaki processes will be explored. In Phase 2 sector organisations will be surveyed to identify options most relevant to the Aotearoa/New Zealand context. This will begin with the organizational database created in Youth Pathways and Transitions Research Project and the networks of the practice experts within the CoP. It will expand as required. By the end of Phase 2 this work will be complete.
The focus of this work is on identifying sustainable and efficient processes that secure availability of the resources in the long-term, strategies for refresh of resources and ensuring broadest possible access to the resources.
Phase 3: Finalisation and Dissemination
During the third phase of the project, the content of the resources will be finalized based on results from Phase 2. Analysis of the final round of youth surveys will also be completed in this phase and the kaitiaki processes will be finalised. Any foundation documents, such as trust deeds, charities registration; an intellectual property plan if required; operational policies; definition of relationships between involved parties; accountability processes, and systems for managing and refreshing resources if required will be completed here. Dissemination of findings will also occur during this phase. These activities will focus on translating findings into audience-specific feedback to maximize use of the resources. Information from this programme will be made available through meetings, workshops, seminars, reports, case studies, peer-reviewed scientific publications, websites and/or presentations at conferences.
Data Management and Analysis
A secure, password-protected web-based server based at Massey University will house data. Interviews will be audio-recorded and transcribed and group discussions will be summarised. Youth will be able to complete surveys directly using MS Forms. Paper and pen versions will also be made available.
Qualitative data will be analyzed in QSRNvivo (QSR International Pty Ltd, 2020) using thematic analysis (Guest et al., 2012). SPSS (version 28; IBM Corp, 2021) will be used for quantitative analysis including descriptive statistics (for cross-sectional analysis and population descriptions) and within-sample t-tests. If the data supports it, AMOS (version 28; Arbuckle, 2021) will be used to conduct structural equation modelling (path analysis) to measure the impact on youth outcomes longitudinally. Analysis of all data will be driven by the CMOC (Astbury & Leeuw, 2010; Lacouture et al., 2015; Mayntz, 2004; Steele, 2004; Tilly, 2001). Combined, this will yield a comprehensive, theoretically grounded and empirically validated set of resources that have been tested in a range of real-world practice settings.
Critical Resources
End-user expertise is the most important specialist resource for this project. End-user experts include front-line staff, supervisors, cultural and practice leaders and service managers in the organizations that provide support to youth across the country. End-user experts are also the youth clients of services. The involvement of all these specialists is central to the partnership approach adopted here. These end-user partners have made an ongoing commitment to the research and to implementing its outcomes beyond the end of the research.
Cultural expertise is a key specialist resource for this project. Engaging practitioners and researchers with this specialized knowledge is critical to the capacity of the project to deliver its goals of producing resources that are culturally and contextually anchored. Of importance is access to the rich diversity of Māori knowledge. Cultural understandings of practitioners from the varied Pacific peoples in Aotearoa are also important. Researchers and partner organizations within the CoP provide access to tangata whenua and Pacific practitioners and youth. Because there is not a ‘one size fits all’ set of resources, the combination of these diverse knowledge bases help ensure that the resources created are responsive and relevant to practitioners working in a wide range of settings.
Youth, as clients of services, are important sources of specialist knowledge as service users. There are both traditional research roles for youth as survey and interview participants as well as roles providing expert input into the resources. Where partner organisations have youth advisory processes these will be used to draw youth into the project as experts.
The project asks a lot of partner organisations in terms of sharing their expertise and testing resources. A division of labour between researchers and organisational staff has been established where researchers are responsible for undertaking the fieldwork, literature work and developing the first drafts of resources. Organizational partners and youth provide critique, guidance and ideas through the development and testing process. The project has budgeted for release of staff, and recognition of contributions from youth so that these key parties are able to contribute to the development of the resources. Further, the design allows for pacing of levels of involvement of partners to reduce the risk of overload.
Intellectual Property Considerations
Existing Intellectual Property
Ownership of all IP brought to the development of the Project proposal by CoP members will remain vested in them. Partners grant a non-exclusive, royalty-free, non-transferable licence of relevant background IP to each other, to the extent that they are able, unless there are reasonable grounds not to grant such a licence. These licences are solely for the purpose of creating the resources during the Project and for vesting these resources in the kaitiaki.
IP Identification
Any new IP developed in the course of the research will be vested in the kaitiaki for the benefit of organizations in the youth sector that work with youth with complex needs. Kaitiaki processes will ensure that resources produced are available at limited cost to these youth sector organizations and no profit is made from this.
Intellectual Property Protection
The commercialization of the resources is not an intended outcome of this Project. Any IP produced is to be used for the benefit of youth sector organizations to build the capacity and capability of their workforce for the benefit of youth with complex needs in Aotearoa/New Zealand through the mechanisms of the kaitiaki processes. Should significant IP be identified during the course of the research, the focus will be on the protection of IP material to ensure its availability for use by youth sector organisations.
Ethics
Organizations invited to participate in this research will freely choose to participate. Additionally, individual organisational information and resources will not be shared without permission. The focus of this research is on the efficacy of the resources developed from this research, not their organizational performance and so evaluation or assessment of any programme is not part of this project. Finally, as organizations will be recruited individually, arrangements can be adapted to ensure the protection of all parties.
Once organizations have agreed to participate, their staff will receive free training and support in the use of the resources. Individual practitioners will provide their own consent to participate in the research. Declining to participate will have no impact on employment. All responses will be anonymised and captured on a secure research server ensuring confidentiality. Case examples will only be shared with worker permission, and workers will be advised to seek guidance from their supervisors or managers should a research task raise practice concerns. Again, it will be made clear to practitioners that the focus of this work is on the efficacy of the resources, not worker performance.
As with practitioners, youth invited to the study will freely consent to their participation. It will be made clear to them that declining will have no impact on their access to services. Youth data will be stored on a secure research server. Information sheets provide guidance on where to go for support should participation raise issues for youth. All data will be anonymised.
Rigour
Rigour will be ensured in this study by integrating Patterson, Ball, Corkish, and Whittick’s (2023) framework. This framework emphasizes the importance of ethical co-construction, methodological alignment and multi-perspective interpretation. These three facets are intended to enhance rigour in qualitative studies. Ethical co-construction is achieved via the CoP that underpins the implementation structure of this project. In this way, power differentials are accounted for, establishing a collaborative and respectful partnership. Additionally, the research design is informed by previous collaborative experiences and therefore includes enough flexibility to ensure it remains collaborative. Finally, the design ensures careful management of risk exposure, empowers practitioner participants in terms of their relational practice skills, and returns bespoke sets of resources back to the service community.
Second, the research ensures methodological alignment by establishing a clear guiding epistemology (critical realism and Kaupapa Māori principles) and integrating the methods used from there. Importantly, the methods align with both the epistemology selected (i.e., mixed methods) as well as the focus of the research questions (i.e., the specific measurement tools selected, and the focus of the various qualitative methods chosen). Importantly, these mixed methods serve to highlight the CMOC factors related to the efficacy of the resources. Their use ensures that we understand if and when use of the resources are impactful as well as why and how it is or is not impactful. This understanding is developed through the use of multiple methods, and also through the integration of diverse perspectives (i.e., practitioners and service users). The range of voices included in the data will add diversity to findings and this is enhanced by the CoP which also brings multiple perspectives in the interpretation of the data and emerging findings.
Concluding Comments
This protocol outlines a CoP approach to testing relational practice resources for youth practitioners in Aotearoa. The protocol draws together methodologies, methods, participants, resources and practical considerations that are contextually relevant and sufficiently flexible to ensure successful application in diverse settings. The inclusion of a kaitiaki process supports longevity of the resources and enhances the project’s ability to shape practice over time. This protocol may be replicable by other researcher/practitioner partnerships aiming to facilitate sector-wide, long-term improvements in diverse settings.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Ministry of Business, Innovation and Employment.
