Chapter 5: Assessment of Healthy Families-Nampa's Early Implementation

5.1 Early Successes of HFN

HFN leaders focused from the outset on building a broad-based coalition with a wide range of participants and potential providers, including groups that had not generally collaborated. One member noted as an example that HFN brought new partners into a collaborative effort for the first time, something that had not occurred before despite the partners’ previous contact through the National Ministerial Association. In less than 2 years, HFN has already engaged a variety of potential providers and partners and has gained community legitimacy for the initiative. This outcome was by no means assured. As noted in Chapter 1, an array of controversial issues, budget issues, and different priorities might have stopped HFN in its tracks and prevented HFN from reaching a significant level of healthy marriage/healthy families activity.

With regard to the delivery of classes and counseling, HFN has pursued a diffusion strategy—providing training in both premarital curricula (Prepare/Enrich) and marriage and relationship curricula (Family Wellness) to other organizations and churches so that their staff and volunteers can offer these programs to community members they work with. This approach appears to be to be taking hold, allowing HFN to spur and facilitate the delivery of marriage and relationship education and other services into many areas of the community, well beyond that which its own staff could provide. “We want to act as a catalyst” for other providers of marriage and family-related services in the community, according to one member. HFN has also acted as a coordinator of existing resources within the community.

HFN’s leadership saw community media and outreach activities as a critical way to get its message out and has therefore developed an extensive outreach effort. As we noted, HFN has successfully engaged the Nampa media—both television and print—and has benefited from significant “free” publicity and public service announcements. The TV station’s investment in HFN, in particular, has given the initiative a profile and reach it could not have purchased.

Despite struggles to raise its local funding match, HFN has moved forward, in part by persuading coalition members and others to contribute significant resources (thus leveraging its own efforts). Overall, HFN seems to be leveraging its efforts successfully and getting a lot of “bang for the buck.” It appears to have been an effective catalyst for coalition members’ and others’ activities which, in turn, appear to have touched a wide range and large number of community members.

HFN made a significant amount of progress logistically and operationally in a relatively short period of time. It has set up a recruitment and referral process through IDHW; developed an MIS; identified, recruited, and established procedures with secular providers; selected core curricula; provided training in Family Wellness; and established a paternity acknowledgement component. In addition, HFN has achieved some success in integrating child support objectives, through linkages with the IV-D system and through its collaboration on in-hospital paternity establishment. These steps have been taken despite the fact that most of HFN’s core coalition members are volunteers with many other responsibilities and demands on their time.

5.2 Key Challenges to HFN’s Success and Approach

Given HFN’s modest level of funding relative to its ambitious goals, HFN had no choice but to pursue a leveraging and diffusion strategy. However, the breadth of services and number of service providers also means that HFN has little direct control over the actual delivery of these services. This approach complicates the potential objectives of achieving high levels of “fidelity” to the model programs and maintaining quality in the delivery of the model. For example, Family Wellness participants who also participated in the focus group suggested that making child care available would be important and improve recruitment. Though HFN realizes this, it is difficult to request of partner organizations who are delivering Family Wellness due to resource limitations.

The HFN coalition has at times added services and activities in ways that appear as piecemeal additions to their main focus. At the time of the January 2005 site visit, some members felt that they needed to step back, declare a moratorium on adding new components, and focus on getting what they had in place operating smoothly before moving on to add other components. One coalition member noted the need to be more “systematic, focused”—“we can’t just implement whatever feels good.”

The data collection and management system HFN is using makes it difficult to gauge exactly what services HFN “is responsible for.” This is partly a reporting problem (getting adequate information from the wide range of providers and partners) and partly a definitional problem (it is not always clear what services HFN is, in fact, sufficiently responsible for to warrant “crediting” the initiative for their delivery). For example, some pastors point out that they were providing counseling before HFN’s Prepare/Enrich classes; although they may counsel more effectively as a result of HFN, the activity itself was not new or induced by HFN.

HFN’s MIS is not well-suited to gauging the extent of services for a highly diffuse initiative that includes a large number of unpaid partners. The MIS appears designed to measure service delivery in a more traditional program in which it is clear who is and who is not a participant and where most participants spend a considerable time receiving services. In the future, it may be possible to design a system that captures services in layers, from direct provision to the facilitating of services.

The key role of loosely affiliated church partners adds a level of complexity to the initiative and to articulating and implementing a consistent vision about marriage/relationships and marriage/relationship education. To some extent, different faiths appear to have different ideas of what appropriate marriage education and counseling services should be (and of what marriage should be). These different visions are likely to be seen by some as coming under the umbrella of HFN even if they are not entirely consistent with the vision and goals of the initiative’s creators. As an example, at the time of the site visit one coalition member suggested that some faith-based organizations do not take domestic violence issues as seriously as they should.17 Related to the large number of coalition partners, HFN recently has had some concerns around maintaining its focus, as demands for collaboration from other community organizations looking to partner with faith-based organizations to promote other initiatives have multiplied.

Although HFN appears to be moving forward energetically, the difficulty raising the local funding match presents an ongoing challenge. The site seems to have addressed funding needs for the time being, in part by establishing solid relationships with a wide range of other organizations and actors and by relying on many organizations for resources. However, this may be an area of future vulnerability. Funding to pay for secular services will be among their biggest challenges, although contracted services have been noted to be a more consistent source of services than volunteers with other full-time obligations. The problem of sustainability may well arise after the 5-year term of the Federal waiver ends and with it Federal funding. It remains an open question whether a model so reliant on leveraging will be too difficult to maintain.

HFN’s ability to leverage resources and draw on others to deliver services is impressive, but the potential for replicating this approach is unclear. Such a coalition of the kind developed through HFN may work best in a relatively small and close-knit community and may not be possible in large communities.

5.3 Lessons Learned

The early experience of HFN offers a number of lessons for other community initiatives that require leveraging to succeed. It is apparently important to invest early on in developing close initial relations among coalition members and potential coalition members. This effort can be difficult, given that people and groups often have preexisting relationships, good or bad, especially in the context of an initiative that is complicated substantively and politically. In Nampa, the payoff has apparently been large. One coalition member noted that it is important to leverage existing relationships and to “look for groups that already have good relationships” and that are the “most high functioning in the community.” Building on prior community collaborations was worthwhile, even when they were not directly about marriage or relationship education. These prior collaborations helped establish relationships and ways of doing business that set the stage for HFN.

In the marriage and family arena, it makes sense to draw in organizations already providing similar services and encourage them to expand their reach and to upgrade their quality. Methods for accomplishing these tasks include sponsoring training, engaging leaders as partners in a communitywide enterprise, involving the faith-based community, and attracting help from the media. Success in these endeavors is likely to require that people recognize the centrality of healthy families for the future of their communities.

Like nearly all other social programs, participation in sponsored activities can be surprisingly low, even among those clearly eligible for benefits. The evidence strongly indicates that referrals especially from IV-D and also from IV-A agencies generally do not translate into participation. Follow-up is required to determine why people who would benefit from a healthy families and/or marriage skills program choose not to participate and whether incentives or making attendance more convenient can yield increases in participation.

Still, given the early investment in coalition-building and targeting groups that can expand services at low costs, it looks feasible to cover a large number of individuals and couples at a modest unit cost. However, documenting success in this area requires improved data collection and an MIS that captures services to community partners.

Finally, it will be important to follow the unfolding of the HFN demonstration, both from its role as a community initiative and its ability to reach a large share of the target populations. As noted above, the financial sustainability of the initiative is an open question. Also, as the initiative begins to cover increasing numbers of people in Nampa, information about the services is likely to spread. Whether, as is likely, people recommend friends and family to take advantage of classes remains to be seen. Another development worth watching is the ability of HFN to retain its focus while extending the coalition to schools and to other institutions. Strengthening relationships within the coalition and community to build further visibility and funding is the focus of HFN for the coming year. Will HFN be able to embed the healthy family/healthy marriage agenda into the institutions of Nampa or will the initiative fail to sustain its early energy?