Bruk av linkarbeidere i barnevernet: en systematisk kartleggingsoversikt

Background\nThe relationship between families from ethnic minority backgrounds and the child welfare services is sometimes described as challenging by those delivering the services, not for profit organisations working with the families, and the families themselves. One possible solution for better communication and cooperation between child welfare services and ethnic minority families is the use of link workers, also known as cultural mediators. Link workers function as bridge builders and mediators between two parties. They give support in cases where cultural sensitivity and contextual understanding are beneficial for successful communication, cooperation, and conflict resolution.\nObjective\nThe purpose of this systematic mapping review is to map and describe research conducted between 2000 and 2020 about link workers in child welfare services and related services in cases involving children and families from ethnic minority backgrounds.\nMethod\nWe conducted a systematic mapping review. A mapping review gives descriptive information about and classification of research on a specific topic. To identify relevant studies a search specialist searched in ten international databases – including MEDLINE, EMBASE and PsycINFO – in April 2020. We also searched in Google and examined the reference lists of relevant and included studies.\nWe included empirical primary studies and literature reviews published between 2000 and 2020 on the use of link workers in child welfare or related services in cases involving families from ethnic minorities. Two researchers independently screened and selected studies. First, they screened titles and abstracts and thereafter full texts in accordance with the inclusion criteria. Two researchers independently evaluated the methodological quality of the included studies using the Critical Appraisal Skills Programme checklist for qualitative studies.\nOne researcher extracted data and results from the included studies and a second researcher double checked the data extraction. We then sorted and summarized the results from the included studies narratively, in line with the research questions. Tables were created where relevant.\nResults\nWe identified six studies that met our inclusion criteria. The six studies were published between 2002 and 2019 and included a total of 199 participants. Two studies were conducted in Europe (England, Italy) and four in North America (Canada, USA). All of the studies included link workers as participants and three included also other workers/professions. Only one study included ethnic minority families as participants. Link workers were active in different settings. In three studies, link workers were used within child- or welfare services, whereas the link workers in the three remaining studies were involved with local organisations or public programs.\nWe critically assessed the methodological quality of the included studies. We assessed the methodological quality of two of the studies as high, one as moderate and three as low due to poor reporting of methods and researcher reflexivity.\nAll of the included studies used qualitative research methods to explore experiences with or viewpoints related to different aspects of being a link worker. One study used a mixed-methods design, using both qualitative research methods and a survey to gather data. Our mapping review set out to answer several research questions and our classification of the included studies showed that the results could best be presented in reference to four research questions. In brief, the results were:\nThe impact of using link workers\nAll the included studies, to some extent, explored the impact of using link workers in child welfare or related services. Link workers often took on the role of advocate for families when they were interacting with public services. In two studies, link workers supported public services in choosing interventions that would ensure cultural sensitivity and adjust to meet the families’ needs. In all six studies, link workers contributed to an increase in cultural understanding within the social services and supported these services by providing important information about the families. Central to the link workers’ role was relationship building with families and offering emotional support in difficult situations.\nExperiences in relation to selecting and training link workers\nAll six of the included studies, to some extent, explored the selection of which families link workers would work with and their training. In five of the studies, link workers were selected because they shared the same background as the families they were going to work with (same culture, ethnicity or language). Only three studies reported that link workers received specific training. The studies gave no details about this training. None of the studies reported on quality control of the work conducted by link workers.\nWhat is needed to make the role of link worker function well\nFour of the six included studies said something about what should or must be taken into consideration for the role of link worker to function well. Many of the studies uncovered a need for clearer understanding of the link worker role along with a more specific/clear role description. One study found there were organisational challenges in relation to the use of link workers in the public service. None of the studies compared the use of link workers between different types or groups of ethnic minority families.\nLink workers’ roles and areas of responsibility\nNone of the included studies explored this research question. While many of the studies described which roles the link workers in the studies actually had, they did not discuss which areas of responsibility link workers should have in relation to child welfare services and ethnic minority families. \nDiscussion and conclusion\nIn this mapping review we have summarized primary studies that investigated the work of link workers in cases involving ethnic minority families involved with child welfare services or related services. We found that there is limited research in this area – almost all research that exists is qualitative – and that the research that does exist has variable methodological quality. We found no quantitative studies investigating the effect, impact or prevalence of the use of link workers in child welfare and related services. We found no studies from Norway or other Scandinavian countries that met our inclusion criteria. All of the studies included in this mapping review used qualitative methods and had relatively few participants, who were mostly link workers. The views expressed by these participants may not be generalizable to other link workers or those in similar positions.\nThe findings from across the studies, for the most part, show that link workers can serve as advocates and bring forward the viewpoints of families from ethnic minority backgrounds to the services they are interacting with. Link workers can provide emotional support and build trusting relationships with clients. Furthermore, this allows link workers to provide detailed information about the families, which enables them to support child and welfare services in decisions around referrals and the choice of supportive interventions. However, the studies also found that in most cases there was a lack of standardization of training and education of link workers as well as a lack of clarity around their roles and responsibilities.\nAlthough the included studies had a broad scope, there is a need for more, methodologically well-conducted studies on this topic. These future studies should focus on what is needed for link workers to function and fulfil their intended purpose and explore ways to ensure the quality of eventual training and education of link workers within child and family services. This research should also look at topics such as quality appraisal of the services (evaluation and or implementation research), what is required to qualify as a link worker and the breadth of the roles and responsibilities that the role of link worker could have.\nIn this mapping review we have not systematically synthesized the results of the included studies or evaluated our confidence in the findings of the studies. Therefore, the interpretation of our summary of the results of the included studies should be interpreted with caution.

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