Creating, disseminating and mobilising evidence on outreach services for marginalised groups – development of a decision making tool.

Background: Outreach is commonly utilised for engaging marginalised groups. However, little guidance exists for those designing and commissioning outreach programmes on how to maximise effectiveness potential. Aim: This presentation reports on the development of a decision aid to enhance programme specificity when designing and commissioning outreach interventions. Methods: This work builds on a realist evidence synthesis, funded by the National Institute for Public Health Research and associated with FUSE (the Centre for Translational Research in Public Health), that examined how and in what circumstances outreach interventions are successful in engaging and improving the health of one socially excluded group, Traveller Communities. Subsequent work was undertaken to disseminate these findings and explore their potential impact for practice among key stakeholders. This led to partner organisations expressing an interest in the development of a decision aid to facilitate the commissioning and design of outreach programmes most likely to be effective. Results: Three key components of outreach work in tangent to influence the success of interventions and form the basis of the decision aid: the degree to which the outreach worker is trusted; the extent of intervention flexibility; and desired outcomes. Where outreach workers are highly trusted, outreach programmes can achieve a range of health outcomes and there is less need for intervention flexibility. However, outreach workers with no pre-established links need to exercise flexibility to respond to needs as they arise. This can be used as a strategy to build trust, may improve access to statutory services, but is less likely to lead to long term engagement. Conclusions: The process of distilling learning from a substantial review into a decision making tool, integrating the views of key practice partners will be detailed in this presentation.