The Salvation Army

Background:Informal caregivers are essential in supporting community-dwelling older adults, especially as global populations age. However, caregiving responsibilities often result in high stress, depressive symptoms, and diminished quality of life. Traditional support services are fragmented, and many programs overlook caregivers' emotional and informational needs. Telecare-the remote delivery of health and social care via digital technologies-offers a promising approach to provide accessible, personalized, and timely support. Objective:This study evaluated the effectiveness of a telecare-based intervention program, developed by a health-social partnership team, in improving psychological well-being and caregiving outcomes among informal caregivers of community-dwelling older adults. We hypothesized that caregivers in the intervention group would show greater improvements in stress, self-efficacy, depression, quality of life, and caregiving burden compared to those receiving usual care. Methods:A single-blind randomized controlled trial was conducted from January to December 2023, with 75 informal caregivers providing care to older adults (aged ≥60 y) for at least 4 hours per week. Participants were randomized to an intervention group (n=38, 51%) or a control group (n=37, 49%). The 3-month intervention included (1) biweekly online nurse case management supported by a multidisciplinary health-social team, (2) personalized WhatsApp videos on caregiving skills, and (3) a password-protected caregiver website offering resources and peer discussion. The control group attended 6 in-person educational sessions at a community center. Outcomes such as stress, self-efficacy, depression, quality of life, and caregiving burden were measured at baseline and postintervention. Results:Participants had a mean age of 65.5 (SD 9.617) years, and 81.3% (61/74) were female. Baseline characteristics were similar between groups. Compared to controls, the intervention group showed significantly higher self-efficacy (t=1.98; P=.04) and lower depression (t=-2.24; P=.03) at follow-up. Within-group improvements in the intervention group were also observed for stress, depression, self-efficacy, mental quality of life, and caregiving burden. No significant between-group differences were found for stress, quality of life, or caregiving burden. No significant within-group improvements were observed in the control group. Conclusions:This study provides novel evidence that a digitally delivered, nurse-led telecare program-integrating health and social services-can improve psychological outcomes among informal caregivers. These findings have practical implications for health systems seeking scalable, low-barrier solutions to support caregivers. Telecare models may be a valuable complement to traditional services, enhancing caregiver resilience and promoting aging in place while alleviating long-term strain on institutional care systems.

Introduction:Children and families from priority populations (e.g. culturally and linguistically diverse and regional/rural communities) often experience significant psychosocial challenges and barriers to accessing health and social care. These inequities were further exacerbated during the COVID-19 pandemic. Integrating social care with health services has been proposed as an approach to improve service access and address unmet needs. Methods:A two-site parallel randomised controlled trial was conducted in Australia between August 2021 and 2023. Parents/carers of children from priority populations were recruited through Child and Family Health services (n = 288) and randomised to the Watch Me Grow-Electronic (WMG-E) intervention (n = 145) or care as usual (n = 143). The WMG-E program comprised digital developmental screening and community navigation to relevant health and social services via a service navigator. The primary outcome was change in unmet social needs measured using the WE CARE instrument. Intention-to-treat generalised linear mixed-effects models adjusted for child developmental concerns, parental mental health, and sociodemographic factors. Results:Unmet social needs decreased over time across both groups (β = -0.23, SE = 0.11, p = 0.036). At 12 months, the intervention group showed greater reductions in unmet needs than the control group (β = -0.35, SE = 0.17, p = 0.046), although the time × group interaction was not significant. Discussion:The WMG-E platform demonstrated feasibility as a digital developmental screening and navigation tool supporting families from priority populations. Conclusion:WMG-E shows promise in improving access to health and social care and reducing unmet social needs; however, further research is needed to assess sustained impacts across diverse settings. Trial registration:The study (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st 2021, and the trial results are being reported according to recommendations in the CONSORT Statement. Summary Box:What is already known on this topic Significant inequities exist in the access to healthcare for priority population families with preschool children and this results in children missing opportunities for early identification and intervention for health and developmental problems.While addressing heath care inequities is critical for providing children a healthy start to life, there are no effective and systematic ways to reach such families as they do not engage with services early, and often experience significant barriers due to social care needs.Addressing health inequities by tackling social determinants of health alongside healthcare is critical to supporting families in priority population groups, aligning with the Sustainable Development Goals (SDGs) of the World Health Organization (WHO). What this study adds This study is one of the first Australian randomised controlled trials evaluating the effectiveness of a digital developmental screening program coupled with service navigation for improving unmet social care needs in multicultural and rural/regional communities.Significant reductions in unmet need scores were observed over time in both intervention and control groups, with a greater reduction in the intervention group, though no significant interaction between time and group was found.The Watch Me Grow Electronic (WMG-E) platform was shown to be a feasible and effective tool for developmental screening and navigation to address unmet social needs in diverse, priority population families.

INTRODUCTION:Families from disadvantaged communities often experience social care needs that adversely impact access to social and healthcare services. This study aimed to explore the determinants of social care needs and the associated clinical characteristics such as parental mental health among families from multicultural and regional/rural communities of Australia. METHODS:This study is a secondary analysis of a randomised controlled trial conducted among parents/carers of children from culturally and linguistically diverse (CALD) communities of South Western Sydney and rural/regional communities of Murrumbidgee. The primary outcome of unmet social care needs was measured using the WE CARE survey. As the data were overdispersed (variance-to-mean ratio = 2.06), multivariable and generalised estimating equations (GEE) negative binomial regression models were applied to examine factors associated with unmet needs, with unmet needs treated as count outcomes. RESULTS:Of the sample of 288 participants, 61% (n = 176) reported one or more unmet needs. Findings of the multivariable negative binomial regression analyses showed that clinical indicators such as parental mental distress (AIRR 1.05, 95% CI 1.04, 1.07) and child developmental concerns (AIRR 1.28, 95% CI 1.12, 1.45) alongside other sociodemographic factors such as CALD status (AIRR 1.63, 95% CI 1.13, 2.35), lower levels parental education (AIRR 2.25, 95% CI 1.62, 3.15), and marital status - De facto/single/divorced (AIRR 1.42, 95% CI 1.06, 1.89) were associated with higher rate of unmet needs at baseline. Additionally, findings of the GEE negative binomial model were largely consistent with the multivariable analyses and further demonstrated that families in the intervention group had a significantly lower rate of unmet needs over time compared with the control group (AIRR 0.75, 95% CI 0.60, 0.95). CONCLUSION:The study highlights the significant burden of unmet social needs among families from multicultural and rural/regional communities, emphasising the role of parental mental health and education levels as key contributing factors amongst other sociodemographic factors. Findings suggest the need for integrated, family-centred interventions that address both social and healthcare needs, particularly for vulnerable populations. TRIAL REGISTRATION:This trial was registered with the Australian New Zealand Clinical Trials Registry (registration number: ACTRN12621000766819).

Background Encouraging healthy childhood development and aiding the early identification of developmental difficulties are crucial to providing the best possible outcomes. Young children in rural areas are at a higher risk of missing timely developmental screening than their non-rural counterparts. This study examined the feasibility and acceptability of a digital developmental surveillance program with a service navigator, Watch Me Grow-Electronic (WMG-E), trialled in rural Australia via a randomised controlled trial (RCT). Methods Qualitative data were collected from semi-structured interviews with ten parents who participated in the RCT (six intervention, four control) and six service providers. Transcripts were analysed via reflexive thematic analysis. Results The study revealed barriers and enablers of both the existing Child and Family Health Services (CFHS) and the WMG-E program comprising of a weblink and service navigation. Enablers of the CFHS included the flexible service options and comprehensive support model, while also acknowledging the resource barriers and service capacity limitations during the COVID-19 pandemic. Enablers of WMG-E weblink included its valuable feedback on child development, digital accessibility benefits, and user-friendly interface. Barriers of the WMG-E weblink included limited clinician oversight during survey completion, and technological barriers related to the digital format. Enablers of the WMG-E service navigation included the ability to address service gaps by connecting families to local services, provide support during waitlist periods, and alleviate the strain on understaffed remote healthcare facilities. Conclusions Access to digital support was perceived as particularly valuable during the COVID-19 pandemic when services were closed. The WMG-E program offers a promising avenue to improve the accessibility and uptake of developmental screening services in rural Australia when functioning in harmony with existing care providers. Trial registration: The study is part of a randomised controlled trial (Protocol No. 1.0, Version 3.1) registered with ANZCTR (registration number: ACTRN12621000766819, July 21st, 2021) and reporting of the trial results will be according to recommendations in the CONSORT Statement.

The place of work can sometimes be hazardous to health, even fatal occupational hazards is one of the most important health problems in the world, especially in developing countries. Fishing is a well-known industry and there are certain risks of work-related diseases and accidents, occupational hazards and safety issues. In response to this issue, interventions such as video-assisted teaching programs are being developed to enhance fishers' knowledge and attitudes toward occupational hazards. Video Assisted Teaching will improve the knowledge and attitude regarding occupational hazards and its prevention. The research design chosen for this study was quasi-experimental non- randomized control group design. Purposive sampling technique was used. The sample size comprised of 60 fishers out of which 30 was in the experimental group and 30 was in the control group. Demographic data, occupational data and Structured Knowledge Questionnaire for pre-test and post-test were administered in face to face method, after getting informed consent. Video assisted teaching programme regarding occupational hazards and its prevention was administered to the experimental group. The data were analyzed based on objective and hypotheses of the study The Video Assisted Teaching Programme was effective in increasing the knowledge score and change attitude. There was significant positive relationship between post-test knowledge score and post-test attitude score regarding occupational hazards and its prevention among fishers. There was significant association between pre-test level of knowledge and educational status, source of information and place of fishing. There was significant association between pre-test level of attitude and educational status, source of information and place of fishing. The study concluded that Video Assisted Teaching Programme is an effective intervention in increasing knowledge and changing attitude among fishers.