Description of impactThe type of impact includes Welsh Government policy, health visitor professional practice, the families of all children aged under 5 years of age living in Wales and increasing research capacity und understanding in health visitor practice.
o The FRAIT is named in the Healthy Child Wales Programme https://gov.wales/topics/health/publications/health/reports/healthy-child/?lang=en (Welsh Government Policy) and is compulsory for all health visitors in Wales to use at 7 occasions (5x home setting and 2x clinic setting) with every family on their caseload from pre-birth to 5 years of age. There are 1063 health visitors in Wales. Each health visitor has a minimum of 250 families on their caseload. Therefore (250 x7)1063=1,860,250 contacts in 5 years in Wales. The FRAIT data collected by every health visitor and centrally collated by NWIS (NHS Wales Information Service) as part of the Healthy Child Wales programme data. This data collection started from January 2018. FRAIT informs the Health Visitors decision making about the type and frequency of intervention required to support a family’s resilience.
o The FRAIT website www.frait.wales and twitter account @HVFRAIT to promote user dialogue and discussion became available to practitioners in Wales in June 2017. The website currently has 422 users, of which 336 are registered from known Welsh email addresses. The website includes access to the FRAIT itself, training materials, COP, and guidance documentation.
How did your research contribute?The external need/issue was the validation of a single assessment for HV in Wales to assess Family Resilience. Prior to this activity Health Visitors in Wales (and wider UK) did not have a validated assessment tool and instrument to measure family resilience. There is no other equivalent assessment tool and measurement scale known in the literature to measure family resilience for public health nurses and health visitors in the UK and internationally. We have developed and tested the FRAIT (Family Resilience Assessment Instrument and Tool) for practice in Wales.
Who is affected?Health Visitors, NHS Wales, Welsh Government are affected.
The FRAIT has underpinned health visitor practice by assessing family resilience for the first time. What has changed is that in some parts of Wales health Visitors did not use an assessment as part of their toolkit. In three of the UHBs they used a family assessment but they were not validated and were different in their construction and detail. This research has standardised the assessment of family resilience across the whole of Wales in both practice and higher education. HV now have a validated assessment tool which underpins their assessment and the decisions they make when translating those decisions into prescribed interventions.
It has raised questions about health visitor assessment for example, some health visitors have found it challenging because it has forced them to ask questions for example about a family’s ability to manage finances and their educational attainment and also their assessment skills e.g. using an aide memoire or the actual document in the home. The FRAIT training has been cascaded through a train the trainer model and so from October 2017 all health visitors in Wales were trained (1063). All higher education establishments teaching student health visitors deliver the same standardised training provided by the FRAIT team.
FRAIT has been included in Welsh Policy and provides opportunity for government and NHS to consider an alternative to deprivation scores when planning resources.
|Impact date||2014 → 2018|
|Impact level||In progress|