YOUNG MUMS ROCK! NARRATIVE EVALUATION

Introduction

This narrative evaluation explores the first phase of the Young Mum's Rock Project, the process we used and what we learned about conducting health promotion in empowering ways. Narrative evaluation explores the role of using stories to supplement evaluation of health promotion initiatives. The Victorian Government, Department of Human Services, has played an active role in promoting the value of narrative evaluation in health promotion planning. Our experience in using this approach identified a range of issues including:

The need to be explicit about feminist principles underlying actions
Having women's voices as central to the narrative
The need to reflect on the strengths, challenges and learnings of our work

Evaluation

"We're not just a bunch of tarts you know"
"If you can push one of these things out, you can do anything!"

Peals of laughter fill the room.

"But they think that you can't do anything, the doctor said to me; 'how can you manage a baby, you don't even have a job. I did have a job but he just assumed I didn't."
"You feel so alone, there could be 20 people in the hospital delivery room and you feel alone."

Young mothers share their experiences and feelings amidst chaos. Babies gurgle on the floor or are passed from mother to mother. The conversation tends to break up into small groups until someone says something outrageous which unites the group once again in laughter. Discrimination, social isolation, tears, fear and always an overwhelming sense of joy.

This was one of six workshops with a young mothers support group as part of an action research project to promote the mental health of young mothers living in Melton, an outer western suburb of Melbourne.

The young mothers group was established and thriving. Service providers were curious and intrigued. "We've been trying everything to engage young mothers, they're just not interested, how did you do it?", they asked the group facilitator. "It's been a long and hard journey, the facilitator replied, "It's taken eight months. I think the main thing was that we did what they wanted."

Doing what people want. Not rocket science. A cornerstone of health promotion and the Ottawa Charter. People as experts of their own health. Not so simple in practice.

To me this project felt like riding the New York subway. Every train line has a complicated identification of a letter, numbers and colour like 'A119 red line'. You may have an idea of which direction you are going in but you're never quite sure where you will get out. Not that it really matters, because you know that the journey and destination will always be a valuable and interesting. You're bound to learn something along the way!

Initially, we wanted to hire one young mother to be a co-researcher on this project. But then we realised that this could create problems within the support group by creating a sense of inequity. We then adopted an action research approach which enabled the young mothers as a group to identify what action they would like to undertake to promote the mental health of young mothers. We went in with a very open ended task. The project had a timeframe of 12 months and a budget of $10,000. They could decide what actions they wanted to undertake.

At the same time, we were working very closely with workers attached to the support group including the facilitator and two community health nurses, one a male nurse to provide the women with a positive male model and support partners who were also invited to participate in the support group. We also liaised with a wide range of service providers via existing service provider networks.

Our initial aim was to observe and learn about the context within which these young mothers live and their experiences and feelings. What is it like to be a young mother living in Melton? How does it feel? What are the good things? What are the not so good things? What might help to make it better or easier?

Young mothers told us about feeling very isolated and scared.

They felt there weren't enough services to support young mothers and that they didn't have enough information about the support services that existed or the confidence to access services each step of the way. They told us about the shocking discrimination they face walking down the street and by service providers. What did they want? To be valued, respected and appreciated by their community, to know what help was available and how they could access this help. More chances for young mothers to meet and share their experiences. To have more child and mother friendly community activities for themselves and their children. To have better transport services. More doctors. Free dental services. Opportunities for education and work training.

We were also very interested in the context and experiences of service providers. How did they work with young mothers? What things worked? What didn't work? What are the service gaps? What might help service providers to deliver quality services to young mothers living in Melton?

Interest in young mothers by service providers was high. Young mothers were felt to slip between the gaps of youth and adulthood services.

Service providers told us that many young mothers didn't feel they fitted with older mothers. Their experience was that a lot of young mothers weren't interested in support groups, that trying to get support groups established and sustainable was too hard. That many young mothers didn't like the traditional style of health education. Some service providers were looking for new ways to engage with young mothers. To build relationships and share information. Some felt like introductory agencies where they would introduce like minded young mothers to each other. Others had tried to get groups of young mothers together but these had collapsed without worker support.

Initial reactions to the project were reserved. What is it all about? What does it hope to achieve? There was a sense of scepticism. Is it worth the effort? The young mothers were generally more enthusiastic. "If we can help to make it better for other young mothers that would be great." Their sense of how their experiences could help others in the community strengthened throughout the project.

It seemed like a juggling process to keep up the motivation of the project with service providers while at the same time giving the young mothers control over what action would be done. People kept asking, but what are you actually going to do? I didn't know. It was up to the young mothers. And that took three months to work out. We understood that whatever the action, it needed to be realistic and achievable to build and maintain the trust of both young mothers and service providers.

The first couple of workshops focused on their experiences as young mothers. We sat and mainly observed; watching women share and learn from each other amid the noise and seeming chaos. The third and fourth workshops included some brainstorming tasks to further explore wellbeing within the community. The project task did not prescribe that the action directly impact on young mothers (on the assumption that actions could occur in the broader community and impact positively on young mothers indirectly). But these young mothers wanted to focus on young mothers specifically, and so we ran with it.

It was a delicate balance between keeping the project moving towards identifying an action and respecting the wants and needs of women in the support group to share their experiences. At times the young mothers resented the time taken up on the project, every second week of their support group time. We considered having the project outside of group time but everyone was sceptical that the women would turn up. This was the established time and place they were used to attending. Many of the women had very complex lives and this group had become a routine.

The women were generally enthusiastic; some were even excited to be involved in the project. Their main motivation was to make it easier or better for other young mothers. But their motivation did wax and wane according to other things happening in their lives, and if they missed a session. We tried to make the sessions fun. One of the things we did was to bring little gifts each week. We would put them on the table: strawberries, essential oils, stress balls, chocolates, flowers. Something new each week to look forward to. Little gifts to pamper and nurture. That's what they identified as important to their wellbeing - having a sense that they were appreciated.

It was very challenging to identify a common goal for all the women. Why did we feel so pressured to have a common goal? We had to achieve something and it seemed if we could find something that all the young mothers wanted to do then we could pool their motivation. But this was a diverse group in terms of age, life experience and personality. Some mothers resented being identified as young mothers. Others appreciated recognition that young women who have babies may have specific needs. It was important but tricky not to let the leaders of the group overwhelm the quieter women. Even service providers differed according to the value of separating motherhood according to age. How old is a young mother today? Under 20? A generation ago most women had babies under 20. Under 25? What about older mothers? There were no clear cut answers and no one answer suited everyone.

As the project progressed one thing became very clear. We needed an action that was realistic and achievable for the young mums. And we needed to ensure the action was implemented. These women were used to being let down. We had made a commitment and we needed to follow it through.

I became quite anxious. I talked with the young mums. I talked with key workers and the project reference group. I talked with other workers with expertise in working with young mums. Ideas for what we could do, what would be realistic and achievable? What would really help young mothers? We talked about poor public transport and child facilities in the local shopping centre. Was there something we could do about this? I didn't want to be tokenistic. It seemed like trying to fix the titanic with a life boy. But we had limited resources.

Two issues kept coming up in the young mother's experiences: feeling socially isolated and not knowing about what services were available. One idea from the young mothers group was to have an event for young mums at an indoor playground called Mumbo Jumbo which was a well known treading ground for young mothers in the region. Women had noticed a lot of young mums went here but they didn't seem to interact with each other. Here was a chance for young mums to meet other young mums in a fun and informal atmosphere. The young mums seemed excited about having an event.

The women were motivated to help other young mothers going through what they had been through: they wanted to tell them that you didn't have to go through the hard parts of being a young mum - that there are other women who are going through it too and you can get help and support. I introduced the idea of producing a brochure which would be designed by young mums for young mums and could be given out at hospitals, maternal and child health centres and community health centres targeting isolated young mothers. We could launch this on the Young Mum's Rock Event day. The women were excited. Together the young women, service providers and researchers decided on two achievable actions: to hold an event day and to produce a brochure. And we two months to do it.

Workshops with the young mums identified the brochure would talk about the good and bad stuff of being a young mum, that reaching out for help can be hard to do, tips on getting the support you deserve, 'you've got rights' and where to start. The young mothers were interested in using cartoons and we were able to use the great talent of a worker to design the cartoons based on what the young mums wanted the pictures to portray - real looking young mums not Barbie dolls; cultural diversity using a women wearing a hijab with a baby approaching; mum and two kids crying their hearts out; mum and child in loving cuddle and a group of young mums talking at the table. The brochure would be launched on the Young Mum's Rock Day. The young mums worked really hard on the brochure. They were able to recognise and use their experience and wisdom to help other young mothers. They were very excited to see the final design of the brochure with their words printed and the bright and colourful cartoons.

It wasn't perfect. It wasn't going to change the world. But it was something we could really achieve. We talked about a title for the project. Young Mum's Rock was most popular. It promoted a strong, resilient and positive image of young mothers. It challenged the discrimination of young mothers in the community. We had some stickers and balloons made up. These could be used at other council events to help promote more positive images of young mothers.

We thought about how we could make the most of the Young Mum's Rock Day. We decided to make the day a fabulous celebration of young mothers. To let them know that they were special and appreciated. We had a range of activities to pamper the body and soul including make-up, nails, massage, jewellery making, music and dance - where possible run by other mothers from the region. We invited workers from the Council including family services, youth services, housing, community development workers, Centrelink, maternal and child health nurses, family violence workers. They local workers could bring information and chat informally with women and be involved in the pampering activities. Information was available on tables away from the crowd. Young mothers could choose if and when they wanted to get information and could do so privately especially information which they may want to access privately like sexual health and family violence. This was young mother's turf. This was a way to help make services more friendly and accessible. We provided childcare and transport.

The young mothers worked hard to promote the Young Mum's Rock Day. We had over 100 enquires. All of a sudden the Event Day at Mumbo Jumbo Indoor Playground was happening and it was a fantastic success! Over 90 mothers and 60 children attend. Women loved the friendly and fun atmosphere. They were able to meet with each other and get information on local services. They want more events like this.

"One woman told me that she hadn't been out since the birth of her baby six months ago. A day like this gets you out of the house."

Over 15 local service providers came to the event. They told us it was a great way to engage with young mothers. They told us they would be willing to support more events like this. We are now looking to see if we could have regular Young Mum's Rock Days at Mumbo Jumbo Indoor Playground.

Both the mothers and service providers felt the brochure was fun and informative and shared the real life experiences of young mothers. We are exploring other ways of giving information to women about local services, particularly family violence, in a second phase of the project.

Thinking back over the project we know that it hasn't been perfect and there are many things to be learnt. Questions beg to be asked: How can we better work with young mothers to hear their stories and service needs? How can we include a diversity of young mothers in our work, especially very young mothers? How can we identify and implement actions which can have a real and long lasting effect on the community? How can we better involve service providers? Learnings will feed into the second phase of the project. And so the story and the learnings go on…

Young Mums Rock! continues to be a wonderful, challenging and in many ways inspirational adventure. The strength and resilience of these young mothers is a privilege to witness. To see their real life experience and wisdom shared amongst each other and with workers has been the most valuable outcome to date. To see their pride and sense of achievement:

"I'd like to help people in similar situations"
"I contributed something to the community."

Young Mums Rock - you bet they do!

Narrative written by Joy Free, researcher, Women's Health West.

The Victorian Government has produced information and resources on narrative evaluation in health promotion.