Authors:

Abstract

Introduction: Antenatal care and social service is provided according to each family´s need in Denmark. However, care interventions often lack coordination across the primary and secondary sector and across professional specialists.

The randomized controlled trial of the FACAM* project examines if an early and coordinated cross-sectorial intervention during pregnancy and the first year after birth can improve maternal wellbeing and support the development of children in vulnerable families. The intervention consists of 1) assignment a support person during pregnancy and until the child is 6 years old and 2) provide women to participate in an individual- or group mentalization-based attachment intervention.

Aim and Methods: The aim of this qualitative study is to get insight into how care professionals experience the FACAM intervention and the interdisciplinary and cross-disciplinary collaboration.

Eight focus groups were conducted during the period of July 2020-September 2021. Participants were healthcare and social-care professionals working with vulnerable pregnant women and their families in the island of Funen, Denmark; Midwives, health visitors, family therapists, social workers, professionals from the alcohol-and drug treatment center, obstetricians and general practitioners.

The focus groups lasted 60-120 minutes each and were audio-recorded and transcribed verbatim.

Data were analyzed using a thematic analysis.

Results: The preliminary analysis revealed three main themes; Perspectives on vulnerability, Working in the field of care and control, Experience of the Inter- and cross- sectorial collaboration.

Perspectives on vulnerability; a) The concept ‘vulnerability’ as related to a diagnosis or a classified group of people or b) ‘vulnerability’ as a fragile period of life when problems got too big. The care professionals focused on, if and how the parents’ vulnerability influenced the mother/father-child interaction.

Working in the field of care and control; Gaining the families’ trust was important for a successful collaboration and to give the families relevant support. However, the families’ trust could be challenged if more support was needed than first allocated.

Experience of the Inter- and cross- sectorial collaboration; Because of the FACAM project, new working alliances were generated. The analysis showed how poor- and well-functioning inter-or cross-sectorial collaboration made the families respectively more or less vulnerable.

Conclusion: The preliminary findings underline that to provide coherent healthcare and social service for vulnerable families a joint understanding of ‘vulnerability’ is necessary to offer the most relevant support for the families. The inter- and cross-sectorial collaboration has to work well so the system does not increase burden on the families.  

Implication for practice: The practical part of the FACAM project is developed locally in the collaboration of one Municipality and a large hospital in Funen Denmark, but we assess that the overall findings from the study can be used when planning interventions with vulnerable groups in other settings.

*FACAM: FAmilyCenter And Municipality