Billabong BBQ Evaluation
North Yarra Community Health Internal
Researcher: Caitlin Phillips-Peddlesden
2013
North Yarra Community Health would like to acknowledge and thank the
Elders, Community members and BBQ participants
who generously contributed their insight and time to this report.
We would also like to thank all Service Providers and stakeholders who participated in the
evaluation process.
Photos in this report were contributed by Uncle John Brown.
1
Table of Contents
Billabong BBQ Evaluation and Acknowledgement
1
Executive Summary
3
History
Prior Evaluation
5
6
Methodology
Stakeholders
7
8
Literature Review
9
Analysis Report
12
Recommendations & Limitations
Dissemination
Limitations
18
22
23
References
24
Appendices
Appendix 1: Participation List
Appendix 2: Project Information Sheet
Appendix 3: Consent Form
Appendix 4: Billabong BBQ Aims and Objectives
Appendix 5: Journies with the Parkies
Appendix 6: Billabong BBQ Menu Satisfaction Survey: Nov/Dec 2011
Appendix 7: Current Partner Agencies
Appendix 8: Harmsworth Outreach Project
26
27
28
29
30
34
37
38
2
Executive Summary
This evaluation report is the product of an inhouse monitoring and evaluation project of
the Billabong BBQ program undertaken by
North Yarra Community Health (NYCH).
Background research and context setting,
participant
interviews,
and
individual
discussions with partner agency workers were
utilised to examine the service provision at
the BBQ, and the ongoing vitality of the
program. In light of NYCH’s objective to
expand the BBQ focus from assertive outreach
and food provision to a holistic health and
wellbeing focus, the evaluation aims to
provide an evidence tool to further this
outcome for participants. By utilising
participatory monitoring and evaluation
techniques, the project aimed to avoid
common ‘monitoring as policing’ (Jacobs et al
2010), especially pertinent in the context of
Australian post-colonial treatment of the
Aboriginal and Torres Strait Islander
population. Instead, following guidelines from
the National Health and Medical Research
Council (NHMRC 2003) the evaluation process
sought to promote reciprocity of benefit and
outcomes; aiming for collaboration, reflection
and learning by participants, agencies and
researchers.
to develop a more holistic health and
wellbeing approach for the BBQ, and to
advocate this direction to funding bodies. In
NYCH’s commitment to continuous quality
improvement in health promotion and the
provision of services, and the self-reflection
that this necessitates, the evaluation project
aimed to critically assess the BBQ practices
against the key indicators of culturally
appropriate and dynamic service provision
which guides the Billabong BBQ program’s
original objectives (see Appendix 8).
The formative evaluation style (Patton 1997)
aims to improve the Billabong program:
analysis of the qualitative data gathered
subsequently informed the discussion and
recommendations in this report. Participant
feedback, including quotes and comments,
was used to evaluate impact, and the quality
and applicability of services provided, and to
guide and inform the recommendations for
the future. NYCH recognises that participatory
monitoring and evaluation can:
‘.....place the most marginalised groups at
the centre of systems, focusing on their
views, which are liable to be sidelined in topdown approaches. It is argued that this
strengthens local ownership of activities and
so increases the chance that interventions
are relevant, sustainable and effective.’
(Jacobs et al, 2010, 40).
The monitoring and evaluation project, and in
particular interviews with participants,
focused on three distinct yet interlocking
areas in relation to the program:
o
o
o
A short literature review provided a
theoretical basis for the examination of the
BBQ program as it fits within a health and
wellbeing approach to community healthcare.
Such an approach acknowledges the impact of
the social determinants of health, and is
designed
to
aid
in
developing
recommendations which further a culturally
appropriate model of health service provision.
The series of brief recommendations detailed
at the end of this report have been developed
from the findings gathered through the
evaluation. The recommendations were
developed via collaboration between the
researcher, the Billabong BBQ coordinator,
the AHPACC worker and the Manager of
NYCH’s Access and Diversity teams.
Reflections on the past, and the changes
and progress made since the 2008
evaluation conducted by the Onemda
VicHealth Koori Health Unit at the
University of Melbourne
The current state of the BBQ, and the
views of participants and partner agencies
Identification of future directions, needs
and priorities, as based on participatory
input from participants and service
providers
These three areas will feed into the main
drivers for the monitoring project which are
to evaluate participant’s experiences and
ideas for the future, to provide a
comprehensive evaluation report to be used
3
The evaluation was initiated to address the
lapsed time between the previous evaluation
of the program and today. A follow-up
evaluation was deemed timely in order to
assess the ongoing vitality of the program,
and to inform future directions for NYCH and
other agencies. Both the scope and the
timeframe of the proposed evaluation remain
limited by the availability of the lead
researcher. NYCH acknowledges that the
short timeframe given to the evaluation
process does limit the scope and thus
influence of the evaluation, and that a
succeeding
evaluation
and
follow-up
monitoring could analyse changes and provide
ongoing feedback. The evaluation is thus a
‘snapshot’ of the Billabong BBQ as it currently
exists, aiming to comprehensively capture the
program as it is currently seen by participants,
partner agencies, the City of Yarra funding
body, and by NYCH.
The recommendations developed throughout
the process of the evaluation project and
detailed at the end of the report are based
around main areas:
1. Menu options and planning
2. Increased Health Promotion and
consistency of service provision
3. Recreation activities and significant
events.
4
History
The Billabong BBQ is a unique program run by
a consortium of service providers, based in
the City of Yarra, and run from Harmsworth
Park. Originally a collaboration between
HomeGround Outreach (formerly Outreach
Victoria), North Yarra Community Health
(NYCH) and the Royal District Nursing Service
Homeless Persons Program (RDNS HPP), the
program now attracts over 9 service providers
across the health, justice and government
sectors. The Billabong BBQ program has run
since August 2000, and continues to offer an
innovative health and welfare outreach
approach, based on ‘multidisciplinary
outreach’ which uses food as engagement
with a marginalised population cohort, many
of whom have largely unmet health needs.
The ongoing vitality of the program was
summed up by one stakeholder in his
statement:
o
o
o
o
Identify and address health & welfare
needs in the target group
Impart personal skills and knowledge
to enable the client group to make
choices that lead to better health
Promote ownership of the program by
the target group-ensure that people
have a voice (NYCH 2011), and
Align with the Human Rights and
Equality Opportunity Commission’s
2005 key elements of the right to
health:
availability,
accessibility,
acceptability and quality (53-54).
The BBQ runs once a week, providing a stable
and regular event, something often missing in
participants’ experience of healthcare. The
location, formerly in Harmsworth Park, and
now in Harmsworth Hall across the street,
was chosen as it is a well known meeting
space for Aboriginal community members,
and represents an accessible and ‘culturally
safe’ space for the Parkies.
‘It is a great way for all the service providers
to stay in contact with their clients, and for
the clients to have some social interaction
with their fellow Aboriginal Community
members, along with a healthy feed.’
According to original workers, the initial focus
of the program was client support and service
coordination in the key areas of health and
housing; with service providers conducting
informal case management via a process of
client engagement and follow-up through a
‘warm handover’ based on agency networking
(Doljanin 2013). It should be noted that the
smaller scale of participants in the initial years
facilitated more extensive individual client
discussion and throughput. As the program
evolved in the 2000-2008 period, numerous
changes, including allocation of an Aboriginal
Engagement worker at NYCH, and a decrease
in casework support ensued.
North Yarra Community Health’s identified
aim for the program ‘To improve the health &
wellbeing of highly marginalised people’
prompted development of an innovative
model tailored to suit the environment of
delivery; the Collingwood Housing Estate, and
the target population- the ‘Parkies’ or local
Aboriginal population. The original program
was recognised for its innovative response to
community needs by the Victorian Public
Health Awards, winning the award for
Innovation in Public Health Delivery in 2001.
The program objectives include:
5
Prior Evaluation
Key recommendations from the 2008
evaluation which remain relevant to the
current evaluation project include clarification
of the BBQ’s aims and future development, in
light of the target population; expanded
budget and facilities’ access to increase
capacity; and allocation of an Indigenous
coordinator for the program. As a result of the
recommendations and findings from the 2008
report, a Billabong BBQ Coordinator funded
by the City of Yarra and employed by NYCH
was engaged in late 2009. Since then, the
coordinator has remained vital to the ongoing
success and management of the program’s
aims- as one service provider commented:
ability of the BBQ to pursue a health and
wellbeing model in the future. In order for
NYCH to further this objective for the BBQ,
the evaluation will examine the ability of the
BBQ program to address social determinants
of health, such as housing, education,
livelihoods, as well as health and wellbeing.
Of consideration also is the funding situation
for the BBQ. The City of Yarra has funded the
Billabong BBQ program through its 3 year
Community Grants funding stream. This
funding has since been allocated to an
‘Invitation Only’ grants stream, indicating a
stronger commitment by Council to continue
supporting partnership with the program. This
evaluation report was also designed as a body
of work to support advocacy for the ongoing
funding of the BBQ program, to provide a
comprehensive review of the program,
including its progress over the past 5 years,
the current state of the program, and future
directions/needs. As such, through the
outcomes and recommendations provided in
the report, the City of Yarra can be better
informed to make decisions on its funding
strategy for the Billabong BBQ program.
‘more people have been coming and despite
the same protocols, the success is to do with
the coordinator’.
Key impetus for the current evaluation was
the idea of trying to improve the BBQ based
on participant priorities and how NYCH and
partner agencies could best facilitate this.
Echoing the 2008 evaluation’s approach, this
report will analyse the relevance of processes,
the current capacity of the program, and
6
Methodology
The monitoring and evaluation project was
conducted in-house, by an employee of North
Yarra Community Health. The scope and reach
of this evaluation was therefore much smaller
than the previous evaluation conducted in
2008 by three researchers from the Onemda
VicHealth Koori Health Unit at the University
of Melbourne.
possible within the allocated timeframe in
order to become known to the community
before attempting interviews: ‘If you are
going to design an evaluation it must be
verbal and it must be visual … because our
lives are’ (Elder Geraldine Standup of the
Hodenosaunee 2002, in Johnston 2010, 54).
The evaluation report used the insight behind
the Most Significant Change (MSC) approach,
adapting it to incorporate interview questions
and responses, rather than stories. This was in
recognition that the evaluation project retains
more of a monitoring impetus, where it aims
to evaluate past changes, identify future
transformations and importantly, facilitate
improvements
(Patton
1997).
Here,
participants are effectively identifying and
deciding on their own domains for change, in
an approach which enables rather than
directs the evaluation focus. Through the
chosen interview questions, participants were
encouraged to contribute their own analysis
of the BBQ, in order to support their story of
change and/or their claim for future change.
Furthermore, developing interview questions
allowed the researcher to limit the scope of
the
project,
due
to
distinct
timeframe/resource limitations. In basing the
evaluation technique around the MSC model,
the aim therefore was that responses from
participants would ‘identify or imply follow-up
actions that need to be taken in order to
make a change’ (2005).
The methodology chosen for the evaluation
process was designed in order to adequately
capture participant’s views, feedback and
voices. In following a participatory model of
monitoring and evaluation, the research was
based around primary stories and views as
provided by a small group of BBQ participants,
in order to ensure that the BBQ is providing
culturally appropriate services. A quantitative
evaluation, based on data collection and
analysis, was inappropriate in this case, given
the tight timeframes and limited data
collection facilities of the researcher. A
qualitative and evidence-based research
approach was thus chosen, in order to best
capture the community’s viewpoint around
outcomes and priorities for the future of the
program. Furthermore, NYCH recognises the
often
‘fraught
relationship
between
Indigenous peoples and research’ based in the
over-analysis and theorisation of their lives
and culture (Walter 2005, 27-8)1. As such, the
qualitative participatory data collection tool of
community surveys and oral testimonies
(Jacobs et al 2010, 40) was used for this
evaluation in order to invite honest ‘thick
description’ (Geertz 1973) from participants,
where their accounts are placed in local
context. Finally, the researcher acknowledged
the importance of relationships and face-toface communication for the target
community, attending the BBQ as often as
1
Walter discusses the failure of ‘science based positivist
research models’ in speaking in the interests of
Aboriginal people, creating a strong suspicion within the
population of research and researchers, as linked with
ongoing colonialist policies and impacts. The researcher
was very aware of this history, and so approached all
potentials interviewees with tact, emphasising the
voluntary nature of participation in the evaluation.
7
Stakeholders:
the course of several BBQ’s (6 weeks in total)
encouraging participant-centred ‘thickdescription’ (Geertz 1973) to provide detailed
accounts in context. The report was based on
interviews with 7 Parkies, representing a
subjective and situated snapshot of the
program; it therefore does not claim to
provide a fully representative picture.
The participatory approach to the evaluation
ensured the inclusion of a broad sphere of
stakeholders at the Billabong BBQ (Jacobs et
al 2010, 39) who were engaged in various
ways in order to develop a comprehensive
overview of the program in terms of resources
and input, social impact, individual and group
outcomes, and needs or priorities. The below
stakeholders were engaged during the
research period:
The Partner Agencies – a broad consortium of
healthcare service providers support and
attend the Billabong BBQ program. 2 The
researcher undertook individual discussions
with representatives from the regular
attending partners, including the Victoria
Aboriginal Health Service, HomeGround,
Turning Point, Harm Reduction Victoria,
Victoria Police and Royal District Nursing
Service HPP (RDNS). The purpose of this was
to delineate general agency views on the
program, and gather input from each agency
regarding the administration and future of the
program. The researcher also consulted with
past and present NYCH staff involved with the
BBQ, including Jo Southwell (Manager Access
and Diversity), Katrina Doljanin (dietician),
Luke Sultan (AHPACC worker), Bo Barney
(Aboriginal Engagement Worker) and Ngarra
Murray (current Billabong coordinator). In
addition, the researcher liaised with Aldo
Malavisi (Coordinator Community Advocacy)
from
the
City
of
Yarra.
The Participants – the Parkies/Aboriginal
population who attend the BBQ on a weekly
basis. This group is described as being a
‘floating population’ in that it is not a stable
group which attends each week. Participants
may turn up regularly to the BBQ, or perhaps
only once. Such use correlates with the nature
of the target community, the mobile culture
and history of ‘walkabout’ of the Australian
Aboriginal population. It also reflects the
target group’s position of marginalisation- a
large proportion of the BBQ attendees are
either homeless or do not have access to
stable housing, thus reducing the likelihood
of steady attendance. On the other hand, the
BBQ does represent a rare constant in many
lives, and as such may be attended regularly
as it represents a stable and safe
environment- or even just ‘a good feed’.
Participant Interviews were conducted across
2
See Appendix 7 for a full list of current partner
agencies.
8
Literature Review
The Billabong BBQ program represents a
unique model, combining Assertive Outreach
by multiple agencies from different sectors
with provision of a healthy meal in a culturally
safe and appropriate environment. Such
outreach ensures point of contact service
provision leading to early intervention, and
allows for participants to be referred into
services and appropriate follow-up from the
safety of the Aboriginal community space. The
program model fits with Johnston’s assertion
that most Aboriginal programs combine
grounding in both traditional Aboriginal and
western knowledge and practices (2010, 52),
as it emulates an informal gathering space for
community, where participants can access
formal pathways into services. The
participatory feedback model of the
evaluation report has generated input from
men, women and service providers to inform
a critical analysis of how the program is
addressing local priorities (see Jacobs et all
2010), with the aim of allowing them to have
more influence over its implementation and
coordination. This literature review also
delineates the social determinants approach
to
community
healthcare,
including
examinations of social capital, Indigenous
culture and the intersection with health in the
Australian context.
discrimination may be the result of long term,
perhaps even historical, treatment and cannot
be overcome in the short term’ (HREOC 2005,
60) addressing these statistical disparities in
health requires awareness of Aboriginal
Australia’s
complex
socio-historical
background, and subsequent development of
suitable and accepted service provision.
According
to
Wallerstein,
successful
empowerment strategies can crucially
‘increase people’s abilities to manage disease,
adopt healthier lifestyles and use health
services more effectively’, yet they need to
take into account the lived experiences and
histories of particular populations (2006, in
Tsey & Every 2000, 170); according to selfassessment the Aboriginal and Torres Strait
Islander population continues to experience
ill-health, being twice as likely as the broader
populace to report their health as poor
(NHATSIS 2004-5). Targeting the systemic
barriers to health facing Aboriginal people
acknowledges the social determinants of
health, and recognises that:
‘health to Aboriginal peoples is a matter of
determining all aspects of their life, including
control over their physical environment, of
dignity, of community self-esteem, and of
justice’ (National Aboriginal Health Strategy).
In light of the WHO Commission on Social
Determinants of Health Final Report’s (2008)
finding that ‘unequal distribution of wealth
and power within and across nation-states
primarily explains why some people are
healthier than others’ (Tsey & Every 2000,
177), the Billabong program explicitly aims to
address the marginality of the Parkies. The
negative impacts of colonisation on Australia’s
Aboriginal and Torres Straight Islanders
peoples is enduringly seen in the health gap
which still sees an Aboriginal and Torres Strait
Islander person subject to a respective live
expectancy gap of 17 years (AIHW 2008). In a
human rights based approach which
‘acknowledges
that
inequality
and
Whilst the three agencies on the original
Billabong partnership were funded to target
homeless people, they had identified that
many Aboriginal people were not accessing
Aboriginal agencies, for a variety of reasons.
Following the moral that their agencies have a
responsibility
to
provide
culturally
appropriate services to those individuals who
choose to use them (NYCH 2011), the team
decided to target the Parkie population
through developing a unique social model
emphasising health and welfare (Doljanin
2000, 7) to specifically address the disparity in
health dollars (AIHW 2001).
9
Whilst the Billabong BBQ’s innovative
approach was an inter-agency development,
NYCH follows the view that Indigenous
communities themselves are sources of
innovation (Anderson 2008, 2), and so has
sought participant feedback throughout the
evaluation process to try and determine
whether ‘culturally-safe’ and appropriate
services are being provided. By collecting
participant responses to questions, following
MSC theory, the evaluation was able to
capture the effects of the program on
people’s lives in their own words. Thus
focusing ‘on learning rather than
accountability’ (MSC 2005) in the program’s
outcomes, participant responses can also aid
staff to improve analysis of their work and
impact. Government in Australia has made
several commitments over the years to
comprehensively address the issue of
Indigenous health inequality, with
administration and policy changes remaining a
challenge.3 Very little gains have been made.
Recent government approaches to
Reconciliation have thus been based in
partnership (COAG 2000), focusing on
strengthening community capacity and
addressing social determinants of health by:
‘fostering an environment that enables
communities, families and individuals to
engage more actively in sharing
responsibility for their own health’ (HREOC
2005, 86)
The take-up of social services by Aboriginal
and Torres Strait Islander populations varies
according to geographic location and ‘such
factors as community control of the service,
the gender of health service staff, and the
degree of proficiency in spoken and written
English’ (Ivers et al 1997, in AIHW 2012).
Aboriginal specific services present at the
BBQ, including the Victorian Aboriginal Health
Service and Ngwala aim to address issues of
acceptability and quality through culturally
appropriate health provision. This attempt to
tailor the healthcare response to the
participant group’s needs links to strategies of
individual empowerment around choice and
access. Some issues remain however; some
participants spoke of the communities’
distrust of the Aboriginal agencies present at
the BBQ, and a preference for instead
attending the BBQ, but the Fitzroy site of
NYCH due to the ‘friendly’ welcome they
receive there. The importance of increasing
Aboriginal workers on Aboriginal health
programs is acknowledged, however this
invokes specific issues of culture and politics,
as has been revealed in discourses around age
and respect in relation to program
coordinators.
3
As an example, see the COAG endorsed ‘National
Commitment to Improved Outcomes in the Delivery of
Programs and Services for Aboriginal peoples and Torres
Strait Islanders’ which recognised the need to address
underlying causes to disadvantage and inequalities
(COAG 1992).
10
Macdonald notes that it is the ‘maintenance
of environments which foster health’ which
are just as important as technology or medical
interventions when it comes to improving
outcomes (2010, 34) - the question here is
whether the Billabong program continues to
promote use of the services that are present
at the BBQ, and furthermore, whether takeup is reflective of improved health and
wellbeing for the Parkies. Inter-sectorial
collaboration, i.e. the presence of Aboriginal
legal services, amongst others, contributes to
addressing the complex needs of the target
group.
Improving both individual and group/family
capacity to deal with daily life, including
healthcare needs, relies on a holistic outlook
(Tsey & Every 2000, p.170). As the City of
Yarra worker noted, a key strength of the BBQ
is the ritual element, NAIDOC, Memorial Day
and Christmas celebrations all enhance social
capital and build trust between the Parkies
and service providers. However, the disjointed
and transient nature of the target community
ultimately reduces the opportunity for
community consultation and partnership, and
consequently ownership. Identified as one of
the objectives of the Billabong program (NYCH
2011), this element remains key to ensuring
that service delivery is culturally appropriate
and actually utilised. Ideally the increased
representation of the current Billabong
coordinator on local Aboriginal networks such
as the Smith Street Working Group, the Yarra
Aboriginal Support Network and the Yarra
Aboriginal Advisory Group can upscale twoway feedback and advocacy from the Parkie
community into local issues and decisionmaking.
‘Research suggests that at least a partial
explanation for the remaining differences lies
in other determinants of health such as
aspects of the social environment. These
include the neighbourhood in which one lives,
one's position in the workplace relative to
others, the quality of one's social connections
with friends, family and the community, and
the degree to which one feels included or
excluded by society’ (Wilkinson, 1999, Shaw et
al 1999, in AIHW 2001).
11
Analysis Report
‘Without them, these guys would have nothing.’
Discussion of the Billabong BBQ program
should begin with a confirmation of the
positive impact, outcomes and reception of
the program, within the target group, the
local Aboriginal community, and the broader
service sector. Both service providers and
participants re-iterated that without the BBQ,
some would not get a proper feed. Service
providers themselves also enjoy the social
* Health *
element of the BBQ, with one Aboriginal
service provider confirming that he ‘loves
coming here for the friendly atmosphere’,
where he knows the clients and they don’t
worry him.
Promoting health and wellbeing for
participants at the BBQ seems to be
predicated on three main areas:
* Food *
To this end, strong and ongoing coordination
is vital to the continuing strong functioning of
the program, ensuring all partner agencies
attend regularly, food is varied and healthy,
and that further social programs are offered.
Engagement of an Aboriginal NYCH worker as
coordinator, initiated after the 2008
evaluation, continues to be imperative, as this
official Indigenous leadership legitimates
mainstream agency use of so-called ‘black
funding’ for Aboriginal-specific programs. The
ongoing presence of the coordinator creates a
stabilising effect on the program, facilitating
engagement with a community presenting
with complex needs. One stakeholder also
noted the young age of current NYCH workers
(Billabong coordinator and AHPACC worker)
as a plus bringing energy and passion to the
BBQ, however it should also be noted that
another comment was recorded regarding the
inappropriateness of a young female as
coordinator.
* Recreation *
capacity or policy direction are explicitly felt
by participants, with many remaining
unaware of these new means of accessing
services- producing a perceivable feeling of
abandonment or intentional reduction of
service access and provision. The City of Yarra
expressed a concern, repeated by workers
and Parkies, that Aboriginal agencies need
prioritise a regular presence at the BBQ, and
furthermore that all agencies attend the Yarra
Aboriginal Support Network (YASN) ‘to stay
informed on what the issues are within the
local Aboriginal Community.’
A more objective perspective provided to the
evaluation project, by a relatively new service
provider, is that concrete service provision to
Parkies at the BBQ seems to be subsumed by
the practical activities of cooking. This worker
expressed disillusionment about service
provision, and the willingness of workers to
actually carry out service provision whilst
there, citing a lack of referrals from other
workers. Whilst positive feedback has been
received regarding the BBQ’s viability in
offering a feed, meeting place, and a sense of
community for the Parkie community, the
main objective of service provision in some
sense seems to be lacking in focus. A key
advantage of the program as the ability of
participants to access services and health
information away from the main health
centres –‘I go to see the workers, a lot of
people don’t like going to the centres’, is
therefore undermined by dwindling focus on
the assertive nature of the outreach. A return
to the original model’s opportunistic point of
In the past five years, the impacts of the
politics of both the community and partner
agencies has been seen in fluctuations in
service provision. For example, the internal
changes at Centrelink have impacted on their
ability to provide services at the BBQ.
Reduced staff capacity has resulted in less of
an ‘individual customer focus’ and a shift to
the use of a Community Engagement Team,
rather than having the original Centrelink
worker attend each week. Parkies can now
only access services via self-service or through
a staff member calling Centrelink directly.
Changes such as this in partner agency
12
contact service provision and follow-through
around active referral and advocacy is
advised. Such informal case management,
whilst creating time pressures on workers,
remains responsive to the nature of the
Parkies as a ‘floating population.’
Another possibility is to create a roster, and
increase the number of community volunteers
helping out in preparing the food, freeing up
workers to implement service provision via
actively approaching and offering their
services to individuals. It is noted that at least
one participant has completed the Food
Safety Training course undertaken by workers,
this course and the opportunity to help out
could be recommended to all Parkies
attending.
supporting the ad hoc attendance of both
workers and participants is a challenge for the
future.
Health promotion at the BBQ seems limited in
its individual participant/worker focus. One
service provider spoke of her attempt to run
group education sessions following the feed
at the BBQ: despite the difficulties she
experienced, this suggestion remains salient.
Conducting ad hoc group sessions around a
particular health issue 4 could include
discussion, questions, dissemination of
information, and benefit from the attendance
of Peer Educators5 and Elders. Challenges will
remain with the nature of the Parkies as a
‘floating population’, as attendance will
always fluctuate. Community and family
events, dynamics and politics also interact
here with changes to the program, for
example prompted by coordinator changeovers. From the original 10-20 participants, up
to around 50 several years ago, and now
around 25-30, the mob will always ‘do their
own thing’. Individual contact will also remain
important, as Hatvani’s observation attests:
Related to this is the issue of service provider
presence, information dissemination, and
consistency. A main finding is that agency
attendance remains inconsistent, on a weekly
but also broader timeframe; some
participants accordingly spoke of the
reduction in services offered over the years,
citing how optometrists, dentists, access to
the gym in the flats, legal aid, housing and
Centrelink used to be regularly offered at the
BBQ. Linked to this is a certain disjunction
between the form of services available, and
knowledge of this by Parkies and other
workers. As an example, one-off services are
sometimes not well advertised prior to the
day. Improving information dissemination at
the BBQ could address these issues, and is
based around two areas:
o
o
‘[t]he itinerant and shifting nature of the
Parkies community was the first challenge in
targeting and guiding projects. We learnt
quickly the importance of one on one
communication over group discussions. As is
often the case when working in large groups,
the diversity of opinion amongst this
community was not exposed in a larger
setting’ (2000).
Workers information: current attending
agencies and their cohort of workers who
attend
Weekly updates: informing of who is
attending each week, and also whether
there are any additional sessions/services
or recreation programs planned.
Shame and denial around personal issues such
as drug use, may also make personal
interventions more effective.
Disseminating knowledge regarding the BBQ
currently operates under a word of mouth
system that, whilst remaining flexible to the
nature of the Parkie population and their
needs, does not adequately reach participants
and ensure worker awareness of their
colleagues. The logistics of a system which can
provide
adequate
information
whilst
4
Group sessions could be around
health/diet/exercise/other social activities/history and
culture, with an extended timeframe for the relevant
BBQ to accommodate.
5
In this context other Aboriginal workers known to the
group with their own skill set and personal stories.
13
A key theme to emerge from everybody that
the researcher spoke to is relationships
building. Workers in particular spoke of the
importance of developing rapport and trust
with the community, and how this may take
months to develop. Relationships built on
trust must exist between not only the Parkies
and the workers, but between the workers
themselves, for truly responsive and
comprehensive
service
provision
and
advocacy to occur. Earlier on in the history of
the program, HomeGround recognised the
role of Recreational activities in building such
social relations, as they ‘allow for workers to
engage with the Parkies as they together learn
new skills. This serves to strengthen
relationships in a way that would otherwise
take much longer to achieve’ (Hatvani 2000).
Some workers showed recognition of the
importance of fostering stronger agency and
worker relationships around the BBQ, for
example the Turning Point worker invited
inaugural attendance from the Headspace
Aboriginal and Torres Strait Islander worker,
to further youth mental health services
available to the Parkies from the Billabong
space. Developing this ‘linking in’ function of
the BBQ seems important to the future
viability of the BBQ, furthering the flexible
approach to ensuring that the complex needs
of the community are met.
Evident across participant’s narratives was the
feeling of enhanced social capital felt from
attendance at the BBQ, described variously as
‘mateship’ or ‘having a natter’. The program’s
current strength in acting as a ‘connecting
point’ for those social isolated revolves
around its ability to allow participants to find
out what’s going on in relation to family and
community- for example ‘sorry business’. The
positive implications of social connectedness
should not be overlooked here, with
narratives like:
‘Cause I like to volunteer, gets me out of the
house’ and ‘I like coming down, I get to meet
people, have a yarn’
This highlights the feeling of wellbeing
participants get from attendance. However,
whilst the recent move inside the Harmsworth
Hall has provided much needed shelter, a split
has been perceived amongst the Parkie
population. Several participants and service
providers expressed regret that there is a
distinct population who stay inside the hall
and those who stay outside, as this was seen
to create a ‘disconnect’ in the community.
Furthermore, this has potentially reintroduced the incidences of grog being
consumed due to less agency presence at the
gazebo site itself.6
6
It is noted that this is an unsubstantiated claim by an
individual worker, and is not necessarily indicative of the
actual incidences of alcohol consumed at the BBQ.
14
The introduction of the Billabong Coordinator
role, following recommendation from the
2008 nemda evaluation, has improved the
structure and management of the program.
Coordinators have in the past approved new
service providers and one-off attendees,
developed protocols for client and worker
safety and conduct, and ensured overall
administration of the program is carried out.
Yet, ‘Billabong has always been a political
animal’ and the coordinator’s style and
manner has been seen to impact upon the
atmosphere at the BBQ. In addition to this,
workers have noted that the passing of a
strong community leader who ‘wore the
pants’ and critically brought the group
together has reduced attendee numbers.
Based on participant and worker feedback,
the coordinator role should continue to
prioritise relationship building between and
amongst the Parkies and service provider
communities, particularly ensuring a balance
of Indigenous and mainstream agency
representation. It is noted that the current
coordinator and AHPACC worker have
generated a generally positive reaction at the
BBQ, with their ‘inclusive and open approach’
reducing previous tensions.
Objective 3: Impart personal skills and
knowledge to enable the client group to
make choices that lead to better health. See
Appendix 8.
The program model remains an effective way
of engaging with the target community.
Whilst offering flexibility and the ability of
participants to access services at their
personal discretion, the challenge now
remains to improve the impact of the
program toward holistic positive health and
wellbeing outcomes, and even selfdetermination in healthcare for the Parkies.
Review of the coordinator’s role and
objectives could perhaps closely align this
position with not only the practicalities of
managementsuch
as
protocols/responsibilities/incidents
and
safety, but also to advancement of the
broader health promotion aims of the
program.
It is important to acknowledge the differences
in Aboriginal and non-Indigenous worldviews
which may impact upon the appraisal and
evaluation of the Billabong program. Western
evaluation techniques which emphasise
process and outcome can fail to recognise the
significance of interdependence and respect
in the Parkie community, and thus overlook
‘holistic thinking [which] may see the
establishment of a program as an
accumulation of qualitative relationships’
(Johnston 2010, 53). Here process and
outcome can become blurred, as the
establishment
and
maintenance
of
relationships of trust through attendance at
the BBQ can be seen to constitute improved
health outcomes in and of themselves. As one
participant identified, the BBQ is not just
about healthy food, but a chance to see
friends, family and staff- many of whom
participants have a strong emotional
connection with.
Unique to the Billabong BBQ program is the
opportunity to offer a program that provides
a targeted health and wellbeing model
providing culturally responsive and safe
service provision, toward enhanced health
and wellbeing of the Parkie community.
Program coordination and management must
remain aware of the position of Aboriginal
and Torres Strait Islander people in Australian
society, and the impact of this on social
determinants of health including income,
education and functional communities
(HREOC 2005, p.12) in transforming the
program for the future. As an evident
application of Objectives developed from the
early days of the Billabong (then Harmsworth
Outreach Project) like:
‘A time to communicate, with lots of laughs.’
15
The link between recreation activities and
lowered substance abuse is one that has been
applied in many Aboriginal programs across
Australia (NATSIHC 2004-5; HREOC 2005). As
one partner agency worker noted, less alcohol
is being seen at the BBQ in recent years, with
the offering of more social programs
particularly for the men, being significant. Reinvigorating the social element of the
Billabong program, with the explicit inclusion
of women and perhaps through extending the
time of the BBQ, could also foster increased
engagement between Parkies and workers,
building relationships and trust.
The program provides a key space for
information dissemination also. Participants
can gain health knowledge not just via feeding
into services outside of the BBQ space, but
through ongoing attendance- ‘If you wanna
learn stuff, come down.’ The evaluation has
shown that the program can assist individual
participants to increase their health
awareness and ability to address their own
health problems, allowing them to improve
their sense of wellbeing. The program seems
to have also supported traditional communal
concerns for wellbeing, with one worker
noting ‘it’s the community that comes and
grabs me’ as Parkies themselves refer on
other members to service providers. Whilst
individual knowledge is the first step toward
an active approach to self-determination in
healthcare it does not necessarily lead to
behaviour change; as Tsey & Every identify, ‘in
the context of postcolonial societies such as
Indigenous Australia where people experience
trans-generational grief and loss resulting
from racism and other discriminatory
government policies’, change is also
influenced by complex individual, familial and
broader social interactions (2010, 178). Work
focusing on individuals and their immediate
health needs at the BBQ may therefore be
overlooking increasing positive health
outcomes in a broader community sense.
Increased understanding of the relational
aspect of the Aboriginal community, for
example intergenerational respect and
age/gender
responsibilities,
and
its
relationship to improved health outcomes
could help the program and staff work toward
communal empowerment in a structural
sense.7
The outreach element of the program
continues to be significant, many participants
expressed that they would not be attending
the agencies’ main sites, preferring to access
service provision directly at the BBQ even if
this meant waiting until the next week’s BBQ
to attend to health needs. Follow-up is also
made easier for workers, as they can ‘hookup’ with Parkie clients they find difficult to
locate at other times. By providing holistic
health and justice services in the one location,
the BBQ is contributing to empowerment
building for the participants – allowing them
the opportunity to tailor their access, and
have control over the services they do, and
often
do
not,
choose
to
utilise.
7
Formal training for all agencies and workers could be
organised around this educational goal.
16
Tsey & Every cite the importance of the
‘control factor’, or ability to problem solve
daily challenges, as being particular important
for Indigenous Australians and health, due to
‘the high levels of psychological distress
experienced’ (2010, 177), linked to colonial
control and disadvantage. A core principle of
the program as identified in the 2008
evaluation is to ‘respect the right of
individuals to live according to personal
choice’, and it is clear here that the ability of
participants to influence program factors, i.e.
food provided, request additional outings and
projects, is influential in their satisfaction with
the BBQ. Several participants expressed
concern that in recent times they have had
less involvement, citing for example noninvitations to meetings with agencies to be
able to discuss issues and be consulted.
Foucault’s adage that ‘knowledge is power’ is
again proven accurate, as exclusion from
decision-making and information on the
BBQ’s direction is explicitly experienced as
disempowerment for this group.
It seems that the program could benefit from
a strategic re-focus on the original advocacy
function of the program, highlighted as ‘an
integral role of all service providers’ by the
previous evaluation (Onemda 2008), and with
the historically increased visibility of the BBQ
within the health and broader service
community serving as leverage. The ability of
BBQ workers to connect with Aboriginal issues
and committees in the region, for example
concerns raised around the Parkies occupying
space on Smith Street in the 2000s, has
permitted a certain liaison role where they
can communicate Aboriginal issues and needs
toward policy makers such as the Office of
Housing (Doljanin 2013). In addition, both
participants and service providers cited the
importance of the BBQ in providing a voice for
the Parkies, as exemplified by increased
consultation with them as a community, and
increased visibility through organised events
such as NAIDOC week, the Family Day, Parkie
Memorial Day and Billabong Christmas
Celebrations. By giving the Parkies increased
say in the type and form of services offered
them, they are informing on acceptability of
services (HREOC 2005), with positive
implications for both individual and
community empowerment.
17
Recommendations and Limitations
‘We’re fighting for our people’
The primary goal of the Billabong BBQ
program in supporting improved health
outcomes for the traditionally marginalised
Parkies population needs be the starting point
of any evaluation review. Toward this
objective, is the BBQ fulfilling the
availability/accessibility/quality/acceptability
functions in service provision as identified by
the Human Rights Equal Opportunity
Commission 2005? Embeddedness in the
community health sector means that all
service providers attending the BBQ have an
organisational
culture
which
remains
responsive to the social determinants of
health model, however understanding of how
‘this population and their cultural,
philosophical approaches to health are unique
features of the total Australian cultural
landscape’ (Macdonald 2010, 35) could be
broadly beneficial.
The following three main recommendations fit
within the three broad areas of health, food
and recreation, as identified in the Evaluation
Analysis Report.
1. Menu Options: targeted menu planning
for the BBQ, facilitated by the NYCH dietician
could address any dissatisfaction with the
‘same-old’ nature of the food provided.
Incorporation of participant feedback regarding
the food could be invited via a regular
consultation meeting with participants and
follow-up feedback surveys regarding the
menu, as per those conducted in 2007 and
2011 (see Appendix 6). Importantly, this will
require a balance between overly labour
intensive options, and provision of nutritious
food. Suggestions for food gathered through
the evaluation process include:
o a greater variety of meats, especially fish
and kangaroo
o continue to provide fruit and vegetables,
fruit in salad form so all can eat, and
ensure weekly fruit and vegetables are
available for people to take away
o tailor the food options to the seasons- e.g.
stews in winter, salad in summer
o improve the nutritional content of options
currently available- i.e. homemade, rather
than bottled juices, low-fat yoghurts
o food provided should be more mindful of
the disproportionately high rate of
chronic diseases, particularly diabetes,
experienced by the Australian Aboriginal
population (at 2.5 times that of the
broader Australian population according
to QAIHC 2011) as was noted by one
participant.
NYCH has already developed resources
around nutrition and menu planning, such
as the ‘Billabong BBQ Healthy Catering
Guidelines July 2012’, to inform future
catering options.8
Resources and maintenance emerged as key
areas of concern, particularly for service
providers involved in the weekly provision of
the food. Funds reserved to buy the food have
not increased in conjunction with rising food
prices over the years, impacting negatively on
the program’s ability to provide nutritious and
diverse breakfast options. As both
participants and service providers alike have
noted, $98.00 per week remains inadequate
to be able to effectively provide a wholly
nutritious menu option. Furthermore, the
unmaintained state of the BBQ used for
cooking continues to be a major issue noted
by all involved with the program. One option
here is to follow one suggestion for NYCH to
invest in a new BBQ, which could potentially
be stored within the Harmsworth Hall, and
used only for BBQ purposes. A coordinated
inter-agency application to the Department
contact advocating for increased maintenance
and prioritisation of this issue is
recommended. Increased funding for the
program could both substantially improve
participant satisfaction with the feed, and
reduce current tensions around inadequate
cooking facilities.
8
See the resources, including guidelines, menu cycles,
recipes, food safety checklist, and surveys and results,
developed by the NYCH AHOT Team across 2007-2012.
18
Investment in additional resources, including
a juicer, slow cooker, pressure cooker etc.
may facilitate greater variety and nutrition in
the food. Also recommended is a transition
back to washable cutlery and crockery, as
opposed to currently used disposables, alongthe
with ensuring that takeaway containers arethe
available for those who regularly take their
food from the site. Noted here is the need for
formalised support for the coordinator in
ensuring adequate cleanup, both at the Hall
site, and back at NYCH Fitzroy. In addition,
based on consultation with the coordinator
and manager of the Billabong program, the
current process for ordering/purchasing the
food each week and ensuring all supplies are
delivered
requires
improvement.
Recommended is a focus group with all NYCH
workers involved, to develop trial options,
and ensure a best-fit process is adopted.
2. Health Promotion: prioritising a broader
health and wellbeing approach relies on
enhancing the ability of the BBQ to increase
health
knowledge
and
disseminate
information.
19
‘empowerment interventions to improve
health conditions, particularly among socially
disadvantaged groups’, (Tsey & Every 2000,
513)
program must reach a critical mass of the
target group. There needs be a reprioritisation by workers on service provision
rather than food preparation, effectively
increasing the utilisation of service providers
(Onemda
2008).
This
necessitates
implementing
alternative
procedures,
including organising community volunteers to
take on these roles. The program would need
to develop a system to ensure this takes
place, and follow-up with health and safety
regulations, including Food Safety Handling
courses for Parkies. This approach could also
promote shared responsibility, and increase
the sense of ownership the Parkies have over
the program and their own health needs. As
one worker suggested, the coordinator could
more actively plan service provision and
feedback procedures, incorporating worker
and participant consultation and inviting
support from the Yarra Aboriginal Support
Network. Increasing connections with
targeted outreach services, such as those for
vaccinations, optometry, housing, legal and
more, could address holistic health and
wellbeing needs and priorities of the Parkies.
Regular health information session could be
organised, perhaps on a fortnightly or
monthly basis, including with different themes
and speakers. Advertising sessions in advance,
particularly through community leaders will
ensure that participants will attend.
To address worker and Parkie dissatisfaction
with the ad hoc nature of agency attendance
and the lack of knowledge of workers and the
services they represent, the program should
prioritise improving consistency of service
provision attendance and agency awareness.
Regular attendance of key agencies, including
worker continuity, is necessary for organising
initial
assessments
on-site
and
advocacy/follow-up, and importantly to help
‘spread the load’. Some suggested service
providers who could attend regularly who
currently
do
not
are
Koori
Connect/Centrelink/the Aboriginal Family
Violence Prevention and Legal Service (FVPLS
Victoria)/Dental Services through either North
Richmond or the Dental Van run by VAHS.
Dissemination by the coordinator of a weekly
post-BBQ Email to service providers summing
that week’s BBQ, advising of events, updates
and opportunities, could formalise the current
practice of an informal meeting immediately
following the BBQ.9
Health Promotion information resources
could be available to take, for example:
o
o
o
o
Information sheets
Recipe books, nutrition information
Health information flyers
Referral information
Formal Training Sessions could also be
targeted
toward
Service
Providers,
particularly in the areas of:
o
o
o
o
o
Advocacy
Cultural communications and awareness
Community history and context
Thematic:
drug & alcohol/mental
health/domestic violence etc.
Food Safety
Weekly Roster and Updates: use of a
whiteboard within the Hall, which each week
would display the agency and worker in
attendance. In addition, cards from each
agency could be available in the space, so that
participants can contact at their own
discretion. Furthermore, instillation of a glass
case outside the Hall within which notices
could be weekly posted could aid in informing
community.
Finally, awareness needs to be raised for all
service providers and stakeholders of the
importance of relationships and trustbuilding, including formal processes such as
worker Orientation at the BBQ, and the
informal time which needs to be dedicated to
developing this with the Parkie population.
Acceptable and effective service provision at
Billabong relies on both Parkies and workers
knowing who is in attendance and being
aware of service availability.
‘even the simple act of having Parkies and
service providers cooking together can
represent health promotion and therefore
service provision in and of itself’
9
It is noted that this process is currently being
implemented by the new Billabong Coordinator.
20
Another recommendation is to develop the
idea of creating an information booklet of
Service Providers attending, the workers
including a brief biography of each, and the
services they offer. This could address worker
knowledge and wellbeing, and also contribute
toward a formalisation of service provision at
the BBQ, whereby workers are better able to
network and ultimately link participants in
with the services they need. This
recommendation recognises that worker
satisfaction and rapport, particularly from the
Aboriginal agencies, is also vital to continuing
harmony and effectiveness of the program.
These recommendations are in light of the
observation that increased recreation with
Billabong has resulted in less alcohol
consumption, increased community cohesion
and social capital linkages, and broadlyimproved wellbeing across the Parkie
community. Cultural programs and activities
can also be developed to include ‘a subtle
therapeutic
component’
through
a
reconnection with culture, community and
country (Hatvani 2000), and contribute to
growth in community leadership. The current
development of a ‘Calendar of Events’ to
increase significant cultural events at the BBQ
is a welcome move toward the above
recommendations.
Agency Booklet: which contains information
on each attending agency and the service they
offer, and also a short biography of each
worker engaged on the BBQ.
Any such recreational program would have to
involve increased funding, planning, and a
comprehensive risk management strategy.
Recommended is to both coordinate/lead on
activities, and also link-in with existing
recreation programs offered by other
services. For example VACCHO could provide
support for recreation activities and
workshops, and local community organisation
offer a lot of good recreation options. The
Billabong program has potential to better link
in with Recreation activities for women run by
HomeGround10 Following procedure used on
previous Recreational programs run by
HomeGround, a RM strategy would
acknowledge NYCH’s duty of care, and could
also be modelled on that of Out Doors
Incorporated, including the creation of a
number of protocols, tools, and a training
manual for workers (Hatvani 2000)11.
Service
Provider
Protocols:
review,
formalisation, and public dissemination of
these,
particularly
around
safety,
responsibility and attendance.
3. Recreation program: ‘There are no
holidays from chronic poverty’ (Hatvani). The
third recommendation is to offer a broader
recreational
program,
involving
day
trips/outings to local sites and out of the city
attractions, as some participants were keen to
‘get out of this concrete jungle.’ This is of
particular relevant for females, as feedback
highlighted the fact that there are fewer
projects/activities offered for women in the
Aboriginal community. Outings could be on
Tuesdays after the BBQ, or organised for an
alternative time.
Some suggestions include:
o
o
o
o
o
o
o
o
o
The zoo
Bowling
The movies
Football Match
Museum visit
Picnic/Walks down the river
Aquarium visit
Culturally relevant sites and sights, and
cultural skills- e.g. didge/clapping sticks
making
Arts and Crafts sessions
10
See Laviena Pasikala, HomeGround worker who
coordinates this Recreation program;
lavienapasikala@homeground.org.au
11
Hatvani’s ‘Journies with the Parkies’ provides ideas
and protocols for conducting a variety of safe and
managed recreational activities.
21
‘They’re not just our clients, they’re our people’ Billabong Service Provider
The final recommendation is that the program
continue to reflect the above point, and strive
to build and improve on what is enduringly a
unique form of assertive outreach, which for
over 10 years has offered an alternative mode
of service provision in awareness of the target
population’s history of dispossession,
paternalism and subsequent distrust of
mainstream health agencies. Building and
promoting reconciliation in Australia is
predicated on just such important work.
Copies be made available to all
participants
Copies be sent to all current Billabong
workers and partner agencies
Dissemination to the NYCH CEO and
Board; Yarra Aboriginal Service Network;
Office of Housing
Copies made available for general NYCH
internal staff and stakeholders, including
accessible via the website, featured in the
weekly staff Bulletin, and in the NYCH
Quality of Care Annual Report
Opportunities be sought to present the
evaluation report and its findings at
conferences and forums, and in journal
articles
Presentation to the Aboriginal Health
Practitioners
Regulation
Agency’s
Managers Network
Dissemination:
Following consultation with the Billabong BBQ
coordinator and the Manager of Access and
Diversity at NYCH, is it proposed that the
evaluation report be disseminated to the
following stakeholders:
22
Limitations:
The research would like to first acknowledge
that analysing qualitative data is always a
subjective process. Drawing conclusions and
recommendations from a participatory
evaluation is difficult as the process is ‘liable
to political manipulation, as respondents may
give feedback that they believe will be most
advantageous to them’ (Jacobs et al 2010, 42).
In following the Most Significant Change
approach, the evaluation report has
attempted to analyse participant and worker
stories to delineate potential options for
positive transformations- a difference that
makes a difference’ (MSC ch5).
The logical next step in this process is an
analysis of outcomes- i.e. is the health and
wellbeing status of participants improved by
attendance at the BBQ? As the above report
remained too limited in its scope, resources
and timeframe, to be able to adequately
analyse individual and community health
outcomes, further evaluation in this area is
also suggested. A greater understanding of
current theoretical debates in the provision of
services to Aboriginal and Torres Strait
Islander Australians could inform the future
direction of the program. Remaining abreast
of innovations and changes within both the
health and Indigenous affairs sectors can
inform future interventions. Regular
participatory monitoring and evaluations of
both an informal and formal nature can best
contribute to the above critical analysis.
The researcher recommends that further
monitoring work is done around process in
terms of health provision and utilisation.
Following on from the issue of access, greater
examination needs to be made of utilisationi.e. the above report has shown that the
Parkies are able to access a wide range of
services at the BBQ space, but do they do so?
Here quantitative research and evaluation
could help to delineate the take-up of services
available, and the factors informing this takeup by the participants. For example, could
service providers improve the way that they
engage with the participants on a weekly
basis? Could there be a more effective (both
in terms of cost, time and human resources)
way of engaging and delivery healthcare?
A further recommendation is that NYCH
and/or other agencies complete further
reports and publications highlighting the good
work conducted at the BBQ, so as to
disseminate the key learnings from the
program. This innovative model of health
service delivery could be utilised in other
contexts in relation to Aboriginal, and indeed
other marginalised populations.
23
References
Anderson, I. 2008. The Knowledge Economy and Aboriginal Health Development. Dean’s Lecture,
Faculty of Medicine, Dentistry & Health Sciences. Onemda VicHealth Koori Health Unit, The
University of Melbourne.
Australian Human Rights and Equal Opportunity Commission (HREOC). 2005. Social Justice Report.
Office of the Aboriginal and Torres Strait Islander Social Justice Commissioner, Sydney, NSW.
Australian Institute of Health and Welfare (AIHW). 2001. Expenditures on health services for
Aboriginal and Torres Strait Islander people 1998-99. Cat. no. IHW 7. AIHW & Australian Government
Department of Health and Aged Care, Canberra.
Australian Institute of Health and Welfare. 2012. Australia’s Health 2012. Australia's health no. 13.
Cat. no. AUS 156. Canberra. < http://www.aihw.gov.au/publication-detail/?id=10737422172 >
Council of Australian Governments (COAG). Communiqué #3, 1992; and Communiqué #7, 2000.
<www.coag.gov.au/meetings/>
Ellis, P. 2004. Ten Points for Better Monitoring and Evaluation. Development Bulletin, No. 65, pp. 6871.
Geertz, C. 1973. Thick Description: Toward an Interpretive Theory of Culture. In The Interpretation of
Cultures: Selected Essays. New York, Basic Books, pp. 3-30.
Hatvani, G. Journies With the Parkies, HomeGround Services. Parity.
International Initiative for Impact Evaluation. 2013. Various Working Papers,
<http://www.3ieimpact.org/en/evaluation/working-papers/>
Jacobs, A., Barnett, C., & Ponsford, R. 2010. Three Approaches to Monitoring: Feedback Systems,
Participatory Monitoring and Evaluation and Logical Frameworks. IDS Bulletin, Vol. 41, No. 6,
Institute of Development Studies, pp. 36-42.
Johnston, A. 2010. Using Technology to Enhance Aboriginal Evaluations. The Canadian Journal of
Program Evaluation, Vol. 23, No. 2, pp. 51–72.
Olaris, K. 2001. The Harmsworth Street Outreach Project. North Yarra Community Health.
Macdonald, J. 2010. Health Equity and the Social Determinants of Health in Australia. Social
Alternatives, Second Quarter, No. 29, Vol. 2, pp. 34-40.
2005. The ‘Most Significant Change’ (MSC) Technique: A Guide to Its Use.
<www.mande.co.uk/docs.MSCGuide.html>
National Aboriginal and Torres Strait Islander Health Council (NATSIHC), 2004-5. National Strategic
Framework for Aboriginal and Torres Strait Islander Health. Framework for action by governments.
Canberra.
24
National Aboriginal and Torres Strait Islander Health Survey (NATSIHS). 2004-5.
<http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4715.0Main+Features1200405?OpenDocument>
Patton, M. 1997. Utilization Focused Evaluation, 3rd Edition.
Queensland Aboriginal and Islander Health Council (QAIHC). 2011. Catering Guidelines:
Recommendations for Implementing Healthier Catering Practices. Queensland University of
Technology.
Tsey, K., and Everly, A. 2000. Evaluating Aboriginal empowerment programs: the case of Family
WellBeing. Australian and New Zealand Journal of Public Health, Vol. 24, No. 5, pp. 509-514.
Walter, M. 2005. Using the 'power of the data' within Indigenous research practice. Australian
Aboriginal Studies, Vol. 2, pp. 27-34.
World Health Organisation (WHO). 2008. WHO Commission on Social Determinants of Health Final
Report.
25
Appendices
Appendix 1:
Parkie and Service Provider Participation List
Parkies:
Rodney Hall
Nancy Peart
Victor Lovett
Tracey Brigs
Roseanna Gillman
Lorina Lovett
Eugene Lovett
Service Providers:
- NYCH: Katrina Doljanin; Bo Barney; Luke Sultan; Ngarra Murray; Jo Southwell
- Victoria Police: John Brown
- Royal District Nursing Homeless Persons Program: Ann Hatchett
- City of Yarra: Colin Hunter; Aldo Malavisi
- Centrelink: Olly Phillips
- Harm Reduction Victoria: Jane Dicka
- Victorian Aboriginal Health Service: Danny Glasby
- HomeGround: Andrew Robinson
- Turning Point: Michael Honeysett
- Headspace: Tony Lee
26
Appendix 2:
Project Information Sheet
Billabong BBQ Evaluation
Information Sheet
Project Title: NYCH Billabong BBQ Monitoring and Evaluation 2013
Researchers: Caitlin Phillips-Peddlesden, Ngarra Murray, Jo Southwell, all from North Yarra Community Health
This evaluation is being undertaken in order to have a better understanding of the Billabong BBQ program, to
assess its overall impact on the health and wellbeing of the participants. The evaluation will be examining the
Billabong BBQ’s progress since the previous evaluation in 2008, its current situation, and future directions. The
research will look at the health services offered at the BBQ, how these are being used, and any improvements
the participants would like to see. The research project is an in-house evaluation being conducted by North
Yarra Community Health, in consultation with partner agencies.
The researcher will be primarily speaking with around 8 community members who are current participants of
the BBQ, conducting interviews based on three questions. The questions relate to what participants feels about
the past, present and future of the BBQ, and individual interviews should take around 10 minutes each. The
researcher will take notes as each interviewee speaks. These notes can be reviewed with the participant before
they are used in the report. Feedback from interviews will be used in the report which will include
recommendations for the future.
The researcher will also be conducting a Focus Group with all of the partner agencies of the BBQ program.
Feedback from this Focus Group will be used in the report and recommendations developed.
No names will be recorded. The notes taken will be typed up and kept in a password-protected computer and a
locked file at North Yarra Community Health Collingwood site that only the researchers will have access to.
Data recorded will be kept for five years, after which it will be destroyed. Approved information included in the
evaluation report may be used in other reports or presented at conferences.
If you would like to stop the interview at any point, please let the researcher know. You can withdraw at any
time. Your participation in this project is entirely voluntary, and you do not have to take part in this project if
you do not want to.
If you have any questions or concerns, please contact Caitlin Phillips-Peddlesden at North Yarra Community
Health on (03) 9411 4348, Caitlin.phillips-peddlesden@nych.org.au.
27
Appendix 3:
Consent Form
The below Consent form was signed by both Participant Interviewees and the Researcher, with copies made
available to Participants if requested.
Billabong BBQ Evaluation
Consent Form
A signed and witnessed copy must be given to all participants.
I........................................................................................agree to participate in a project entitled:
‘Billabong BBQ Monitoring and Evaluation’
Conducted by
Caitlin Phillips-Peddlesden, Ngarra Murray, and Jo Southwell from North Yarra Community Health.
The Researcher, Caitlin Phillips-Peddlesden, has discussed this research with me. I have had the opportunity to
ask questions about this research and have my questions answered. I have read and kept a copy of the
Information Sheet, and understand the general purpose, risks and methods of this research project.
I agree to take part because:
- I know what I am expected to do, and what the interview involves
- The risks and inconvenience of participating in the research have been explained to me
- My questions have been answered to my satisfaction
- I understand that the project may not be of direct benefit to me
- I can withdraw my responses from the study at any time
- I am satisfied with the explanation given in relation to the project and my consent is freely given
- I can obtain a summary of the results of the research when it is completed
- I understand that my personal information (including identity) will be kept private
- I agree to the publication of results from this research provided details that might identify me are removed
Signed by the participant:................................................................... Date:.....................................
Name and Address:............................................................................................................................
Signed by an independent witness:............................................. Date:......................................
Signed by the researcher:................................................................... Date:.....................................
Any queries or concerns should be raised initially with Caitlin Phillips-Peddlesden, Executive Assistant at North
Yarra Community Health on (03) 9411 4348 or via email: Caitlin.phillips-peddlesden@nych.org.au
28
Appendix 4:
Billabong BBQ Aims and Objectives
Revised June 2011
Aim
To improve the health & wellbeing of highly marginalised people.
Objectives
Identify and address health & welfare needs in the target group
Increase utilisation of health & welfare services by the target group
Impart personal skills and knowledge to enable the client group to make choices that lead to
better health
Promote ownership of the program by the target group-ensure that people have a voice
Improve coordination of care of individuals with complex needs within the group
Increase participation by the client group in activities – support and provide opportunities to
celebrate cultural and other events
Increase access to and consumption of safe and nutritious food
supporting social connections within the group and community
29
Appendix 5:
Journies With the Parkies
By George Hatvani, HomeGround Services
From the early days of our recreation work with the Parkies, the benefits were obvious. We aimed to engage with highly
marginalised individuals with chronic drug and alcohol issues, isolated from most mainstream recreation options precisely
because of their addiction, and sought to provide them with the recreation experiences they craved. In terms of improving
their lives, and in fostering engagement between HomeGround and the Parkies, recreation projects have proved
invaluable. Recreation projects allow for workers to engage with the Parkies as they together learn new skills. This serves
to strengthen relationships in a way that would otherwise take much longer to achieve.
In 2000, recognising the effectiveness of the work of the Billabong BBQ, Bedford Street Outreach (now HomeGround), with
the support of Out Doors Incorporated (a specialist recreation service for people with a psychiatric disability), secured
funding from VicHealth to employ a part-time recreation worker to extend the work of the Billabong Barbeque (see earlier
article also in this edition of Parity).
It was one thing, however, to establish the benefits of recreation programs and quite another to ensure their smooth
running and compliance with the range of rules and regulations which apply to such programs. This article is therefore an
exploration of some of the problems and pitfalls we’ve surmounted along the way.
The itinerant and shifting nature of the Parkies community was the first challenge in targeting and guiding projects. We
learnt quickly the importance of one on one communication over group discussions. As is often the case when working in
large groups, the diversity of opinion amongst this community was not exposed in a larger setting.
Small groups allowed individuals to voice their preferences and concerns more freely, and have their thoughts considered
and taken on board. This in turn grew confidence in the program. It helped create allies among members and identify the
leaders who would be instrumental in paving the way for recreational activities. Through this process it also became clear
that women were a substantial proportion of the Parkies community, facing similar issues and clearly articulating a desire
for recreation.
Over the years, numerous successful activities have taken place, based on the needs and desires expressed in these early
conversations.
With the initial VicHealth funding a number of activities took place; a large-scale fishing trip to Port Phillip Bay for men and
women, day trips to a NAIDOC week concert in St Kilda and to the Collingwood Children’s farm, and two overnight fishing
trips to the Cottadidda state forest on the Murray River near Cobram. When this money ran out, funding from the
Community Strengthening Initiative allowed for many more activities – well over 50 – in the next 3 years, as the program
split into a men’s program focusing on day fishing trips around Melbourne, and a women’s program based on art and
leisure.
Women-specific activities included trips to Ricketts Sanctuary, the Rhododendron Garden at Mount Dandenong,
Melbourne Aquarium, and fishing at Torquay. A weekly arts program was also developed. Initially focusing on painting,
collage making and knitting, its members eventually began discussing the idea of creating a video of their experiences. This
has now come to fruition.
In 2003, in what was a real coup for both workers and the women involved, HomeGround secured funding from the
Department of Human Services to produce this video. A professional director and editor were employed to document the
life experiences of some of the women. Over nine months the director sought, with the help of female outreach staff, to
assist the women to tell their stories of life on the street and as ‘Parkies’. The ‘Walkabout’ video was launched at the Koori
Heritage Trust in 2004. As a final product, it does us all proud, telling the powerful stories of some real survivors.
At the time of writing, HomeGround’s recreation work with the Parkies continues, with a new realm of activity currently
underway, made possible by the learnings of recent years. This would not have been achieved without serious
commitment on the part of both the Parkies and ourselves, in overcoming the many obstacles in our way. Sticking with it
has wrought some wonderful results, for both the Parkies and HomeGround.
Harm Minimisation versus Unrealistic Restrictions
While recreational activities have undoubtedly resulted in some exceptional outcomes, they have also highlighted a range
of risk management issues.
These issues relate to the provision of remote area recreation to individuals who suffer from chronic health issues,
including potentially life-threatening diseases such as asthma, diabetes and epilepsy, exacerbated by drug and alcohol
abuse. Lack of resources to purchase camping equipment, fishing rods, access to buses and other necessary equipment has
been an additional difficulty, partially resolved with the Community Strengthening Initiative funding.
30
Following the principles of harm minimisation, a certain amount of alcohol use was tolerated and even required due to the
risks of seizure for chronic alcoholics. Alcohol withdrawal can be life-threatening, so managing this addiction is a serious
concern. Nicotine addiction also had to be addressed in the early trips. Individuals without cigarettes could become
agitated, occasionally aggressive, and completely preoccupied. This of course served to negate the intended benefits of the
recreation program. It also often meant that other participants with cigarettes had to ‘share’ whatever it was they had,
even if it meant they were left with none themselves.
The program adopted a long-term, non-punitive approach based on consistent limits, a measure of flexibility, and a focus
on the positive outcomes of moderation. It was decided to tolerate (though not pay for) a measure of alcohol use and
promote a harm minimisation approach. This meant, for example, that if an individual habitually drank port, the
consumption of a smaller amount of a lower alcohol drink (such as beer) was recommended and encouraged. In addition,
communal cigarettes were provided.
Intoxication poses its own safety risks to the individual, other participants and workers, and much effort was put into
discussing and eventually adopting the principle of non-attendance when intoxicated. This frequently meant that workers
had to judge the ‘safe’ or ‘acceptable’ level of inebriation, an unsatisfactory situation at times.
To help address the distraction provided by abstinence or modification of habitual drug and alcohol use, a large and varied
food menu was provided for each activity. This included fresh rolls and bread, cut meats, cheeses, salads, fruits, cakes,
biscuits and plenty of fruit juice and cordials. Tea and coffee was also provided as a matter of course and it was not
uncommon for 75% of the budget for each activity to be taken up by the cost of food. At the end of each activity,
participants shared the remaining food and took it home with them.
Documentation and Disclosure
Various concerns around client safety and the long-term security of the program prompted the development of a
comprehensive risk management strategy. This decision acknowledged HomeGround’s duty of care, and the particular
frailties of the client group. Developed in 2001, the strategy was based on a model successfully utilised by Out Doors
Incorporated and involved the creation of a number of protocols, tools, and a training manual for workers.
As part of this process, we debated the nature of the activities within the service and amongst as many members of the
community as possible. This led to some significant decisions.
First, the programs would be split by gender, with the men focusing on fishing and the women combining a series of leisure
and art activities with outdoor-based recreation. Second, it was decided that there was at this time, insufficient skill and
resources within HomeGround to continue the overnight trips and so the focus would be on day activities. Activities lasting
only 4-5 hours were also much more satisfying for individuals withdrawing from alcohol or moderating their intake.
New protocols also included the completion of detailed medical forms for all participants, and the development of
comprehensive “trip intentions” forms. The latter includes all activity related information such as venue details, itinerary,
emergency contacts and the details of local hospitals and medical centres. In addition, critical incident protocols for trip
leaders and office-based on-call staff were created. All information gathered is contained in two identical folders, one
taken on the activity and the other kept by the on-call person.
There was much conflict within the Parkies community about these decisions. The issue of forms with detailed medical
histories was problematic and took much persuasion. The life experiences of most Parkies means a distrust of disclosing
personal information, understandable when this trust has been abused in the past by systems of authority. The gender
split was also accepted by some but fiercely rejected by others. The decision to discontinue the overnight camps was met
with dismay.
The men initially resisted the new formalised procedures, and thus the program floundered. Formalisation ran counter to
the ‘casual’ attendance approach favoured by the Parkies. At first, individuals frequently arrived for activities unknown to
workers, without completed medical forms, sometimes intoxicated, and confident of their inclusion due to the assurances
of other participants.
This led to conflict and confusion. Individuals felt excluded when told they could not attend due to intoxication and/or noncompletion of forms. Workers found activities taking two to three hours longer then expected with time spent completing
and photocopying forms, or taking individuals to appointments such as signing on at police stations or dropping-off
Centrelink forms. While the casual approach is understandable in the Parkies community, it was impossible to manage.
Further discussion within the service and with regular participants led to the targeting of key individuals, and much smaller
groups for each activity. As a result the male program focused on 15-20 individuals, in regular groups of 3-4 (rather than 710). The groups were people they knew and wanted to be with, and the activity chosen was fishing around Melbourne.
With this modified approach, the men’s program ran more than 30 day fishing trips, over 18 months. More than 25
individuals attended, the majority of Indigenous background.
31
The women’s program encountered its own series of difficulties outside the risk management issues. The weekly arts
program initially focused upon painting, collage-making and knitting but lost focus when one of the key community Elders
broke her shoulder and was no longer able assist in bringing the other women together. Domestic violence was also an
issue and led to one woman withdrawing completely for her own safety. Another key female Elder was forced to take on
greater community responsibilities, giving her less time for the program.
Continuity Concerns
In the beginning of the program, after several successful activities had taken place, and all involved were enthusiastic and
engaged, the issue of worker continuity came to the fore. The program was dealt a significant blow with the resignation of
the original recreation worker. This individual had formed strong relationships with the Parkies, and also had considerable
bushcraft and recreation skills and qualifications. This setback highlighted a recurring issue about the impact of worker
continuity in building successful programs.
Fortunately, since the resignation of the original recreation worker, the same outreach worker has been involved in almost
all of the men’s program activities. As a result, the engagement process has been relatively uninterrupted and the worker
transition smooth. Recently, HomeGround has also been able to integrate another worker into the process. And with
additional funding, the original recreation worker has been re-employed on a casual basis to assist in the delivery of a
series of larger-scale activities, as part of the ‘Going Further’ program (see below).
Women’s only activities have also suffered problems due to lack of staff continuity, with four female outreach workers
involved at various times. The program was put on hold for these reasons, though it is shortly to recommence with new
funding from the City of Yarra.
Where to From Here?
With so much valuable relationship building and learning having now taken place, HomeGround looks forward to many
more recreation projects with the Parkies. The feedback from participants clearly elucidates the positive change the
programs have brought to their lives. HomeGround workers attest to much strengthened relationships and new
opportunities to support this group.
The aim of the ‘Going Further’ program is therefore to consolidate the engagement process and build upon the skills
already developed by the men. The popular overnight program recommenced in early 2005. These overnight trips may lead
to interstate and even international trips in 2005/2006. The trips now include a subtle therapeutic component based upon
a reconnection with land and country. They are proving effective in supporting the development of community leaders.
With the re-instatement of the original recreation worker comes outdoor adventure and bushcraft skills, along with his
background in family therapy and history of successfully implementing drug and alcohol programs with Koori inmates of
Victorian jails. This worker identified the site for the overnight trips, and made connections with Indigenous landowners
who welcome our trips and their purpose.
So far, two large-scale day trips to the Goulburn River near Shepparton have occurred and the first overnight trip to the
Indigenous owned land of the Wemba Wemba people near Swan Hill. An Aboriginal Elder from this area, himself a long
time member of the Parkies and identified as an important leader, accompanied this trip as guide and cultural custodian.
He is integral to the program and helped to develop a code of conduct for the trip as well as supporting crucial parts of the
‘healing’ component.
CODE OF CONDUCT
We are guests on Wemba Wemba land and need to behave as guests.
This is a cultural journey – not a piss-up. We will not be going into town and there will be no grog-runs.
We are all bound by culture on these trips.
This trip is not a social occasion and we are representing our tribes and communities.
Reg is our guide; he is the cultural custodian of the land.
We are here as a self-contained group, there are not other people invited except the owner of the land.
There are many jobs that need doing – lets pull together.
HEALING COMPONENT
What is the essence of the question of ‘going further’?
Healing. What does this mean?
We need to get the conversation started.
We need to go further into our responsibilities as men:
Where are we headed as men?
Where are our communities headed?
What are the social ramifications of our behaviour?
What are our responsibilities and where is our respect for each other?
32
The overnight trip was a resounding success, with seven men participating. Our guide welcomed us to country and was
highly influential in the success of the trip, particularly during a medical emergency. One of the participants had to be
hospitalised in Swan Hill due to a flare-up of a previously unknown medical condition. Without the influence of the Elder,
this man may not have attended the hospital. His medical condition deteriorated so rapidly he may have died if he had
stayed with us in our remote location, twenty kilometres outside Swan Hill, beyond mobile phone reception. The incident
promoted discussions amongst the men around alcohol abuse, the damage it can do, and of listening to our bodies when it
is in a compromised state. It also highlighted factors that have contributed to the success of the program.
First, a high level of first aid skill is needed for remote locations. Second, the risk management procedures are critical and
worked very well. For this trip we also carried additional CDMA and satellite phones that proved invaluable. Critical
linkages made through the Billabong BBQ meant that the participant’s medical care could be coordinated from Melbourne
by the Royal District Nursing Service nurse. This allowed the trip to continue with limited interruption. The individual
concerned was eventually airlifted to St Vincent’s hospital and linked back into Indigenous support services from which he
had become estranged.
The second trip is planned to occur at the end of April and already we have 10 participants intending to come. The Parkies
now have a Code of Conduct. The Elder has planned to augment the cultural aspect of the program by bringing along his
son, a dancer and musician, to deepen the connection with the land.
Left Overs
People like the Parkies, who face disadvantage and discrimination at every turn, don’t often get a chance to be involved in
recreational activities. There are no holidays from chronic poverty. Indeed, despite white Australians’ glib assumption that
Aboriginal people are always at home in the bush, some of the Parkies hadn’t left their inner urban patch for twenty years
or more.
33
Appendix 6:
BILLABONG BBQ
MENU SATISFACTION SURVEY: Nov/Dec 2011
Goal of Survey: To update menu provided at Billabong BBQ so it meets the health and
cultural food preferences needs of those who come to the BBQ.
Methods:
Surveys were filled out by the Dietitian, who directly interviewed 11 participants at the Billabong BBQ
on Tuesday 8th November, Tuesday 22nd November and Tuesday the 6th December 2011. This was 9
participants less than we surveyed during the previous survey in 2007.
Surveys were collated and results recorded. Survey questions were similar to the 2007 survey in order
to allow for comparisons to be made.
Survey responses:
1. What is the main reason you come to the Billabong BBQ?
REASON
To have some breakfast (only)
To catch up with friends (only)
To catch up with one of the workers (only)
To have some breakfast & catch up with friends
To have some breakfast & catch up with a worker
To catch up with friends and a worker
For breakfast, friends and worker
Other
Number who answered yes
2
2
0
0
0
1
4
2 - volunteer, walk dog
2. How important is the menu in helping you decide if you will come to the
Billabong BBQ or not?
Answer
Very – I will come or not come depending on whether I like the food
Important – I might decide not to come if it is something really horrible
Doesn’t matter – I just like to come along for other reasons
3
3
5
3. How important are these qualities of the food provided to you?
Quality
Really tasty food I like
Good for diabetes/health
Food is low in fat & sugar
There is fruit & vegetables
There is meat every week
Should be breakfast food
Should be lunch food
Different food each week
2 choices on the day
No. not important
1
4
3
1
0
3
2
1
2
34
No. matters a bit
4
2
3
1
5
3
5
1
5
No. very important
6
5
5
8
6
4
3
9
4
4. What else is important to you about the food provided?
Includes vegetables, Healthy, Cooked food
5. On the day of the BBQ, is the food provided your breakfast or lunch?
Breakfast
Lunch
Breakfast and Lunch
Other
2
1
7
1
6. How many additional meals do you eat on the day of the BBQ?
3 meals/day plus snacks
2-3 meals/day
1 meal/day
0
3
8
7. Do you take additional food home with you from the BBQ (describe)?
Bread loaf (6 respondents), Plate of food (2 respondents), Milk
8. In general, how often do you eat?
Frequency of eating
3 meals/day plus snacks
2-3 meals/day
1 meal/day
a few meals per week
lots of snacks but not meals
Number who answered yes
3
4
4
0
0
% of respondents
27%
36%
36%
0%
0%
9. Do you have any special diet needs?
Health Issue/diet needs
Diabetes
High cholesterol/heart problems
Liver problems
Need to lose weight
Need to put on weight
High blood pressure
Problems with bowels
Problems with teeth
Other
Number who answered yes
2
2
0
1
2
1
1
5
1
Would you like any of the following items as a regular part of the breakfast
menu?
Menu item
Sausages
Steak, kangaroo
Hamburgers + cheese + salad in roll
Fish
Lamb mince kebabs in pita bread
Chicken and vegetables kebabs
Vegetables kebabs
Salad
Bacon and eggs
Baked beans
Yes
9
10
9
7
9
8
3
9
11
8
35
No
1
0
1
4
0
1
6
1
0
2
% Yes
90%
100%
90%
64%
100%
89%
33%
90%
100%
80%
Eggs, mushrooms, spinach and tomato
Scrambled eggs and BBQ silver beet
Omelette with cheese and tomato
Grilled tomatoes
Corn fritters
Corn cob
Sweet potato chips
Rice
Soup
Toasted cheese sandwich
Raisin bread French toast
Raisin bread
Toast with different spreads
A range of cereals
Porridge and fruit
Pancakes with strawberries or banana
Fruit salad and yoghurt
Grilled bananas
Milk
Milo
Fruit Juice
Water
9
10
10
9
3
5
8
6
8
9
8
8
10
6
7
9
10
9
7
6
10
9
1
0
1
1
7
4
1
4
3
1
2
2
0
3
3
1
1
1
4
4
0
1
Do you have any other ideas for the menu (that can be cooked on a BBQ)?
Pineapple, Beetroot, Cheese, More fruit
10. Would you like to help with the cooking or cleaning?
Yes
No
5
6
11. Would you like some nutrition information at the BBQ?
Yes – about the food provided
Yes – about healthy eating
Yes – from the dietitian
No
0
3
2
5
36
90%
100%
91%
90%
30%
55%
89%
60%
73%
90%
80%
80%
100%
67%
70%
90%
91%
90%
64%
60%
100%
90%
Appendix 7:
Current Service Provider Agencies attending the Billabong BBQ Program
North Yarra Community Health
Royal District Nursing Homeless Persons Program
Home Ground
Neighbourhood Justice Centre
Centrelink
Fitzroy Legal Service
Victorian Aboriginal Health Service
Turning Point
Ngwala
City Of Yarra
Harm Reduction Victoria
Victoria Police
Headspace
37
Appendix 8:
HARMSWORTH OUTREACH PROGRAM
Aim: To improve the health and wellbeing of a highly marginalised group of people.
Target group: The program targets homeless people or people at risk of homeless with complex needs. In
particular, the service aims to work with people who are socially isolated and those not receiving services from
the mainstream service system.
The program targets people who meet in the shelter barbecue “gazebo” area in Collingwood. This is building
on long-term relationships developed by RDNS Homelessness Persons Program and Outreach Victoria with
clients who have unmet health needs who frequent the park area. At any one time between 10 and 40 people
congregate in this area.
1. Philosophy:
Harmsworth Street Outreach provides services in the belief that society should provide for the
fundamental needs of all communities.
The program operates in the belief that good health is a fundamental right and therefore the obligation of
society to provide services that promote good health and well being.
The program respects the right of individuals to live according to personal choice.
The program respects people’s right to confidentiality.
The program views poor health as a systemic failure of society and therefore works to change people’s
circumstances, leading to better health choices.
Objectives
Identify health & welfare needs
in the target group
Increase utilisation of health &
welfare services by the target
group
Strategies
Evaluation
Conduct focus group interviews with the target group
(or representative of the group, chosen by the group)
Service providers initially involved in the program to
record needs that were initially identified
Collect ongoing data of needs as identified
throughout the program
Utilise established health data on homelessness &
Aboriginal health
Develop trust between the client group and local
services by having service providers engage with
them in the environment in which they live and
frequent
Provide a weekly outreach clinic providing health &
welfare services at the gazebo in Harmsworth St
Utilise the adjacent community center to provide
health and welfare services as required
Provide relevant health & welfare services in a
wholistic, culturally appropriate and flexible manner
that responds to the needs of the client
Facilitate referral of individuals to mainstream health
& welfare services as required
Advocate for clients upon entry into mainstream
services
38
Focus group occurred
Data collected
Baseline data collected
Weekly data collection to
include demographics and
numbers of new and ongoing
clients accessing outreach health
& welfare services, food and
recreation programs. It shall also
document any referrals made to
other programs or services, and
any new health needs identified
by clients or workers. Evaluation
shall include collation and
analysis of data collected and
comparison of this data with
that collected initially.
Second focus group of
participants after program has
been running for 12 mths
Impart personal skills and
knowledge to enable the client
group to make choices that lead
to better health
Incorporate health promotion advice in client
contacts
Provide information in a culturally appropriate
manner
Focus group of participants after
program has been running for 12
mths
Promote ownership of the
program by the target group
Involve the target group in the planning,
implementation & evaluation of the program
Respond to self identified needs
Improve coordination of care of
individuals with complex needs
within the group
Convene monthly meetings of service providers to
coordinate service provision to individuals
Nominate case managers for individuals as
appropriate
Participation of target group in
the planning, implementation
and evaluation of the program
Focus group of participants after
program has been running for 12
mths
Meetings occurred regularly
Increase participation by the
client group in sustainable
healthy recreational activities
Provide regular access to culturally appropriate
healthy recreational opportunities
Increase access to and
consumption of safe and
nutritious food
Provide a once weekly culturally appropriate lunch
program utilising the barbecue at the Gazebo in
Harmsworth St
Provide food which complies with HACC National
Guidelines and the Australian Dietary Guidelines
Promote safe food handling and preparation
practices
Develop guidelines on safe food handling for the
program
Impart skills and knowledge to enable and encourage
the target group to prepare and cook health meals on
a barbecue
Contain costs of food provision to $50 - $100 per
week
Promote awareness of the
social justice needs of the client
group
The program to operate within the philosophy
outlined in this document
Workers to advocate for the client group on social
justice issues as relevant
39
Data on number of people
participating in the recreation
program collected and collated
Focus group of participants after
program has been running for 12
mths
Collect and collate data on
number of people accessing the
meals program
Analyse nutritional contribution
of food provided
Have food handling
requirements been met?
Involvement of participants in
food preparation, cooking and
cleaning to be recorded
Analyse costs of the food
program
Focus group of participants after
program has been running for 12
mths
Advocacy occurred