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

Abstract

IntroductionIntegrated 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.Methods and analysisThis 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.Ethics and disseminationRoyal 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.Trial registration numberISRCTN55495932.

Family member and service provider experiences and perspectives of a digital surveillance and service navigation approach: A qualitative study with a culturally diverse community

“…However, it is to be noted that this may have been a unique issue during COVID-19 when services were closed. Also, the availability of Child and Family Hubs as a place-based 'one-stop-shop' service that families can access and service navigators can refer to would be helpful in this regard (41).…”

Identifying and responding to family adversity in Australian community and primary health settings: a multi-site cross sectional study

“…As part of the broader project, the two community health services in this study are now implementing Hubs including integrative professional support and collaborative practice opportunities through co-location and clinical integration of interdisciplinary staff ( 13 , 25 ). The Hubs are also providing clearer service linkages and referral pathways for both families and practitioners.…”

“…This study analyzed baseline survey data collected as part of a mixed methods process and outcomes evaluation of two integrated Child and Family Hubs ( 13 ). Caregivers were recruited from November 2021 to June 2022 by researchers in the waiting rooms of each service or via a mail out to the services' client databases.…”

“…This study investigated current practice in identifying and responding to adversity in families attending two Australian community health services. Both health services are part of a larger project that aims to co-design, test, evaluate, and scale integrated Child and Family Hubs, with an upstream focus on identifying and responding to family adversity ( 13 ). The services are in low socioeconomic, metropolitan areas that serve families who may experience various adversities, namely, Wyndham Vale in Victoria and Marrickville in New South Wales (NSW).…”

Co-designing an Integrated Health and Social Care Hub With and for Families Experiencing Adversity

“…This study was conducted as part of a broader research project aiming to co-design, test and evaluate two integrated Child and Family Hub models to detect and respond to children aged 0–8 years and their families experiencing adversity in Victoria, and New South Wales in Australia [ 30 ]. This paper describes the co-design process of the Hub in Wyndham Vale, Victoria.…”