Even though the Smith Family's Wendy Field manages a successful program monitoring team, she is still searching for the "sweet spot" between implementing evidence-based programs and adapting them to the complex needs of disadvantaged families.

"The challenge is the context - the ability to drill down to the core elements of an evidence-based program and then working through what are the bits we can tweak," she says. "There is a constant push and pull around how programs get delivered. It's important to stay open to what our teams are telling us are lessons happening on the ground."

As Head of Policy and Programs at the Smith Family (based in its Sydney headquarters), Field oversees the organisation's policy development and program design and implementation. To Field, good evidence is central to providing quality programs and ensuring clarity.

"Evidence underpins the process you use to develop, implement and continuously improve programs. When we are considering how to address an issue, we will look to what the literature says, then develop a theory of change based on literature, our own practice and input from on the ground staff. Then we trial that approach."

The Smith Family has a small dedicated Research and Advocacy team, led by Anne Hampshire, as well as program design and implementation support teams. One feature of their work is that a policy analyst works with each program to assist with implementation and evaluation.

"Each analyst works with local teams and provides program guidelines, planning support and tools. They support teams on the ground, but are also a driver of quality assurance in implementation."

Despite this, there is tension in keeping "faithful" to evidence-based programs, both in delivering and evaluating them. Field highlights the challenge of maintaining an effective "feedback loop" between practitioners and researchers.

"It requires being really clear with on the ground staff about why particular components of the program are important and getting their buy in. Communication is vital and it's a constant challenge in busy environments. What can happen is all the data that workers collect goes into a black hole and by the time it comes out workers are already onto the next tranche of the program. We are trying to speed up the feedback to staff and to give more targeted information about the impact of programs in their communities."

The Smith Family is currently working on the development of an organisation-wide 'Enterprise Information Program', which will enable more real-time data feedback to practitioners.

While she believes evidence-based programs need to be balanced with on the ground needs, Field is adamant about the value of proven programs. One way the Smith Family retains 'fidelity' to evidence-based programs is through a 'program quality framework' that stipulates what program elements are sacrosanct and what elements can be adapted by practitioners to local circumstances.

"We are duty bound to ensure that interventions with vulnerable families are based on what we know can make a difference for them. However, there are different understandings of what makes a difference in practice. In that sense, I don't think that we can say that the evidence base is complete - it's a work in progress, and we need to stay open to different ways of working that update the existing evidence."

Field uses the example of the Smith Family adapting the evidence based Let's Count numeracy program to suit local needs. Run by the Smith Family since 2010, the program is traditionally conducted by specifically trained educators in early childcare centres with disadvantaged communities. But based on recent feedback from practitioners on the ground, new implementation models will be trialled by the Smith Family in other locations (such as libraries).

Field also warns the policy preference for evidence-based programs needs to be weighed against the need to have flexible and localised responses to clients with multiple issues.

"There is a strong tension between place-based and evidence-based approaches. The risk is evidence-based programs can be siloed, and developing a whole community approach is really key. The issues facing families aren't nicely cut - they are so complex and interconnected."

Despite these challenges, Field remains focused on clients.

"We need to get the balance right across localised responsiveness and the integration of programs," she says. But ultimately we keep our work focused on the families and the kids we are trying to support - that is the central guiding thing around everything that we do."

This article is part of series of practitioner profiles originally published in Family Matters No.99: Research to Results.

Read the first article of the series: Practitioners on evidence: Karen Field

The feature image is by Unsplash, CC0 1.0.