“Watch Me Grow- Electronic (WMG-E)” surveillance approach to identify and address child development, parental mental health, and psychosocial needs: study protocol

Abstract

Background The COVID-19 pandemic and the associated economic recession has increased parental psychosocial stress and mental health challenges. This has adversely impacted child development and wellbeing, particularly for children from priority populations (culturally and linguistically diverse (CALD) and rural/regional communities) who are at an already increased risk of health inequality. The increased mental health and psychosocial needs were compounded by the closure of in-person preventive and health promotion programs resulting in health organisations embracing technology and online services. Watch Me Grow- Electronic (WMG-E) – developmental surveillance platform- exemplifies one such service. WMG-E was developed to monitor child development and guide parents towards more detailed assessments when risk is identified. This Randomised Controlled Trial (RCT) aims to expand WMG-E as a digital navigation tool by also incorporating parents’ mental health and psychosocial needs. Children and families needing additional assessments and supports will be electronically directed to relevant resources in the ‘care-as-usual’ group. In contrast, the intervention group will receive continuity of care, with additional in-person assessment and ‘warm hand over’ by a ‘service navigator’ to ensure their needs are met. Methods Using an RCT we will determine: (1) parental engagement with developmental surveillance; (2) access to services for those with mental health and social care needs; and (3) uptake of service recommendations. Three hundred parents/carers of children aged 6 months to 3 years (recruited from a culturally diverse, or rural/regional site) will be randomly allocated to the ‘care-as-usual’ or ‘intervention’ group. A mixed methods implementation evaluation will be completed, with semi-structured interviews to ascertain the acceptability, feasibility and impact of the WMG-E platform and service navigator. Conclusions Using WMG-E is expected to: normalise and de-stigmatise mental health and psychosocial screening; increase parental engagement and service use; and result in the early identification and management of child developmental needs, parental mental health, and family psychosocial needs. If effective, digital solutions such as WMG-E to engage and empower parents alongside a service navigator for vulnerable families needing additional support, will have significant practice and policy implications in the pandemic/post pandemic period. Trial registration The trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.

Parental experience of an early developmental surveillance programme for autism within Australian general practice: a qualitative study

“…In NSW, a similar project, the WMG-E, has been implemented to engage parents/caregivers using opportunistic contacts to complete developmental checks digitally and thereafter sends automated reminders for parents to retake the developmental checks at the next recommended ages and stages (6, 12, 18, 24, 36, 48 and 60 months), thereby providing opportunity for ongoing developmental monitoring. 16 17 The Victorian Maternal and Child Health service provides universal access to all Victorian children for 10 ‘key age and stage’ assessments (after-birth home visit; visits of 2, 4 and 8 weeks; visits of 4, 8, 12 and 18 months; and visits of 2 and 3.5 years). 35 These assessments include ongoing monitoring of child development (including the online SACS assessment), 36 as well as child and parental/caregiver health and well-being.…”

“…14 15 In this context, a userfriendly digital developmental surveillance programme, the Watch Me Grow-Electronic (WMG-E), was trialled using opportunistic general practitioner (GP) visits with automated reminders for ongoing monitoring and was found to be feasible and acceptable. [16][17][18] There is also a discordance between early identification of developmental and behavioural conditions and the engagement of families to participate in early intervention pathways. 13 19 This means parents/caregivers may not always receive the relevant support about their child's early intervention needs/care plan even though early diagnosis has been detected, due to several factors such as a lack of services availability and referrals, high costs, unwillingness to participate due to cultural/language barriers and/or other factors.…”

“… 14 15 In this context, a user-friendly digital developmental surveillance programme, the Watch Me Grow-Electronic (WMG-E), was trialled using opportunistic general practitioner (GP) visits with automated reminders for ongoing monitoring and was found to be feasible and acceptable. 16–18 …”

Watch me grow integrated (WMG-I): protocol for a cluster randomised controlled trial of a web-based surveillance approach for developmental screening in primary care settings

“…[13][14][15][16][17] Developmental surveillance is a continuous and cumulative process whereby knowledgeable healthcare professionals identify children who may have developmental problems. 18 19 There is, however, a significant gap between policy recommendations regarding developmental surveillance and clinical practice with the uptake being only 20% for the current Australian state-based surveillance programmes in community health centres between 1 and 4 years of age. 20 Variation in care of these children is also an issue, with evidence indicating that children from higher socioeconomic groups with developmental difficulties are more likely to be identified and to receive an appropriate referral, in contrast to those children from lower socioeconomic groups.…”

“…Given the benefits of early identification, universal developmental surveillance is recommended best practice 13–17. Developmental surveillance is a continuous and cumulative process whereby knowledgeable healthcare professionals identify children who may have developmental problems 18 19. There is, however, a significant gap between policy recommendations regarding developmental surveillance and clinical practice with the uptake being only 20% for the current Australian state-based surveillance programmes in community health centres between 1 and 4 years of age 20.…”