Integrated Child and Family Hub models for detecting and responding to family adversity: protocol for a mixed-methods evaluation in two sites.

Journal: BMJ open

Volume: 12

Issue: 5

Year of Publication: 2022

Affiliated Institutions:  Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia. Centre of Health Systems Science, The George Institute for Global Health, Camperdown, New South Wales, Australia. Centre for Research in Education and Sustainability, Torrens University Australia - Fitzroy Campus, Melbourne, Victoria, Australia. Health Economics Unit, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia. Department of Education, Monash University, Melbourne, Victoria, Australia. Monash University, Clayton, Victoria, Australia. ICAMHS, South Western Sydney Local Health District, Liverpool, New South Wales, Australia. Mental Health, The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia. Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia. Jean Hailes Research Unit, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia. Paediatrics and Child Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia. School of Public Health, University of the Western Cape, Cape Town, Western Cape, South Africa. Health Justice Australia, Melbourne, Victoria, Australia. Sydney Institute for Women, Children, and their Families, Sydney Local Health District, Sydney, New South Wales, Australia. IPC Health, Wyndham Vale, Victoria, Australia. School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia. Centre for Community Child Health, Murdoch Childrens Research Institute, Parkville, Victoria, Australia harriet.hiscock@rch.org.au.

Abstract summary 

Integrated community healthcare Hubs may offer a 'one stop shop' for service users with complex health and social needs, and more efficiently use service resources. Various policy imperatives exist to implement Hub models of care, however, there is a dearth of research specifically evaluating Hubs targeted at families experiencing adversity. To contribute to building this evidence, we propose to co-design, test and evaluate integrated Hub models of care in two Australian community health services in low socioeconomic areas that serve families experiencing adversity: Wyndham Vale in Victoria and Marrickville in New South Wales.This multisite convergent mixed-methods study will run over three phases to (1) develop the initial Hub programme theory through formative research; (2) test and, then, (3) refine the Hub theory using empirical data. Phase 1 involves co-design of each Hub with caregivers, community members and practitioners. Phase 2 uses caregiver and Hub practitioner surveys at baseline, and 6 and 12 months after Hub implementation, and in-depth interviews at 12 months. Two stakeholder groups will be recruited: caregivers (n=100-200 per site) and Hub practitioners (n=20-30 per site). The intervention is a co-located Hub providing health, social, legal and community services with no comparator. The primary outcomes are caregiver-reported: (i) identification of, (ii) interventions received and/or (iii) referrals received for adversity from Hub practitioners. The study also assesses child, caregiver, practitioner and system outcomes including mental health, parenting, quality of life, care experience and service linkages. Primary and secondary outcomes will be assessed by examining change in proportions/means from baseline to 6 months, from 6 to 12 months and from baseline to 12 months. Service linkages will be analysed using social network analysis. Costs of Hub implementation and a health economics analysis of unmet need will be conducted. Thematic analysis will be employed to analyse qualitative data.Royal Children's Hospital and Sydney Local Health District ethics committees have approved the study (HREC/62866/RCHM-2020). Participants and stakeholders will receive results through meetings, presentations and publications.ISRCTN55495932.

Authors & Co-authors:  Hall Teresa T Goldfeld Sharon S Loftus Hayley H Honisett Suzy S Liu Hueiming H De Souza Denise D Bailey Cate C Reupert Andrea A Yap Marie B H MBH Eapen Valsamma V Haslam Ric R Sanci Lena L Fisher Jane J Eastwood John J Mukumbang Ferdinand C FC Loveday Sarah S Jones Renee R Constable Leanne L Forell Suzie S Morris Zoe Z Montgomery Alicia A Pringle Glenn G Dalziel Kim K Hiscock Harriet H

Study Outcome 

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Statistics
Citations :  Moore T, Arefadib N, Deery A. The first thousand days: An evidence paper - summary. Parkville, Victoria: Centre for Community Child health, Murdoch Children’s Research Institute, 2017.
Authors :  24
Identifiers
Doi : e055431
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Australia
Other Terms
Child & adolescent psychiatry;Community child health;MENTAL HEALTH;PRIMARY CARE;PUBLIC HEALTH;Protocols & guidelines
Study Design
Cross Sectional Study
Study Approach
Qualitative
Country of Study
Publication Country
England