Introduction Many children and their families, especially those from priority populations, experience barriers to accessing high-quality early childhood health, education, social and legal services. Further, these families are often under-represented in service planning and research; hence innovations are not designed to meet their needs. Our aim is to codesign with families and the wider community, a Strength-based, Tiered, Accessible Resources and Supports for Kids (STARS for Kids) programme to optimise child development, parental mental well-being, and family psychosocial needs in the first 2000 days from pregnancy to start of school.Methods and analysis This study will employ a mixed methods design at three sites: (1) Fairfield, urban multicultural site in South-Western Sydney New South Wales; (2) Taree, a regional town with a large Indigenous community; and (3) The City of Wanneroo, a low socioeconomic area of Western Australia. The codesign process will involve five phases of the design thinking methodology informed by culturally safe, strengths-based, and trauma-informed practices. Codesign will involve families, service providers, and community leaders from priority groups such as multicultural stakeholders from South-Western Sydney and an Aboriginal Community Consultation Group with Biripi Elders and other local Indigenous representatives at Taree. Data collection will include semi-structured interviews, workshops, or focus groups as well as ‘yarning’ for the Aboriginal community. Qualitative data will be thematically analysed using Braun and Clarke’s six-phase method of thematic approach.Trial registration number Australian New Zealand Clinical Trials Registry - ACTRN12624000806561 (This protocol pertains only to the initial codesign phase, during which the STARS for Kids tiered care model will be finalised for subsequent implementation and evaluation in the next trial phase which is outlined in the trial registry).

The Circle of Security-Parenting program (COS-P) is a widely disseminated attachment and mentalization-informed parenting intervention. Outcome studies, however, have yielded mixed results and its effectiveness for parents from different demographic groups is largely unknown. This study examined the outcomes of COS-P and explored parent demographics (mother/father status and education). Participants were 117 parents who attended COS-P at an Australian Early Parenting Center. The Composite Caregiving Questionnaire (CCQ) assessed caregiving representations (self-efficacy regarding emotion/affection and empathy/understanding, hostility, caregiving helplessness, and parental reflective functioning). Outcomes were analyzed using a mixed model repeated measures design. Results revealed significant post-intervention improvement on all CCQ domains, with some demographic differences. Fathers reported a greater rate of improvement in parental self-efficacy regarding empathy and understanding compared to mothers, after starting from a lower level. There were no differences in any outcomes between parents who were university-educated and those who were not. Findings provide further evidence that COS-P improves caregiving representations, but there may be some differences for mothers and fathers.

Recent decades have seen emergence of numerous evidence-based early parenting interventions. To make an impact at a population level, they need to be delivered at scale. This study aimed to identify factors that enable successful scaling of early parenting interventions for sustainable implementation and impact. Participants were 22 individuals from the United States of America, Australia, Korea and the Netherlands, all who had experience in the development, implementation dissemination and/or scaling of early parenting interventions. Participants completed in-depth interviews about their experiences or observations of scaling early parenting intervention, and enablers and barriers to successful scaling. Transcripts were analysed using thematic analysis. Results revealed six key themes: (1) adopting a business mindset, including sustainable funding and governance models; (2) securing multi-level stakeholder buy-in, from clinicians to policymakers; (3) implementing flexible, context-sensitive models that support fidelity and adaptation; (4) ensuring intervention quality, including evidence-based design and cultural relevance; (5) assembling multidisciplinary teams with the necessary expertise and leadership; and (6) time and planning. Results suggest that scaling early parenting interventions is a dynamic, non-linear process that can take considerable time and planning. Scaled interventions need to be evidence-based and culturally relevant, but there also needs be a sound business model, widespread stakeholder involvement, and strong leadership. Sensitivity and flexibility to meet the needs of local contexts are also vital. Taken together, this study offers actionable insights for policymakers, funders, and practitioners seeking to expand the reach and impact of early parenting interventions within diverse service systems.

Migrant women and children can face significant barriers when accessing child and family health services. Child and family health hubs (hubs) represent a potential solution to simplify pathways between maternity, child, and social care services for migrant populations. However, how these hubs operate specifically for migrants remains underexplored. Our study addresses this gap by exploring what helps and hinders the establishment and delivery of hubs across three different contexts in New South Wales, Australia for migrant populations using a case study approach. While all sites found the hub model appropriate and acceptable, its feasibility varied. Challenges included limited resources, particularly the absence of a dedicated hub coordinator, governance issues, and personnel turnover. Success depended on clear leadership, dedicated coordination, systematic referral pathways, cultural sensitivity, and community engagement. The evidence from this study can be used within other contexts to plan and deliver hubs for migrant and potentially other priority population families with young children.

AIMS:The Parent Support Team (PST) is an intensive early intervention home visiting programme delivered by child and family health nurses to families with infants aged 0-6 months experiencing psychosocial and health vulnerabilities. In contrast, mainstream services provide universal clinic-based care and scheduled developmental checks. This mixed-methods study aimed to: (1) describe demographic and psychosocial characteristics, service activity and well-baby check attendance among PST clients compared with mainstream service clients; (2) evaluate changes in maternal depressive symptoms following PST engagement; and (3) explore client experiences, including perceived outcomes and facilitators and barriers to change. DESIGN:Convergent parallel mixed-methods study. METHODS:Retrospective data were extracted from electronic medical records for PST clients (909 mothers; 1038 children) and mainstream service clients (17,707 mothers; 21,764 children) between August 2019 and December 2022. Quantitative analyses described demographics, psychosocial characteristics, service use and maternal depressive symptoms. PST client experience surveys (166 mothers) were analysed using descriptive statistics and thematic analysis. RESULTS:PST clients demonstrated greater psychosocial complexity and higher maternal depressive symptoms at entry than mainstream clients. PST mothers had more frequent service contacts and maintained stronger engagement with services after discharge. The proportion of mothers with clinically significant depressive symptoms decreased following programme participation. Survey findings indicated improved parenting confidence and practical skills. Positive outcomes were attributed to nurse qualities, opportunities to discuss concerns, a holistic care approach and the service model. Reported barriers included accessibility, scope of education topics and communication challenges. CONCLUSION:The PST programme effectively engages vulnerable families, supports maternal mental health and promotes sustained connection with child and family health services. IMPACT:Intensive early intervention home visiting programmes may improve outcomes for families with complex needs and warrant broader implementation. REPORTING METHOD:SRQR guidelines were followed. PATIENT OR PUBLIC CONTRIBUTION:None.

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.

BACKGROUND:Digital screening and navigation interventions are increasingly integrated into health systems to identify and support families' unmet social care needs, yet their effectiveness in improving outcomes remains unclear among priority population communities. We hypothesise that responses to such digital interventions might vary based on sociodemographic and psychosocial characteristics. METHODS:Data were analysed from 288 participants in a randomised controlled trial evaluating Watch Me Grow-Electronic - a digital screening and service navigation model to identify psychosocial needs, parental wellbeing, and child developmental needs in South Western Sydney (urban site) and Murrumbidgee (regional/rural site), New South Wales, Australia. Latent class analysis was used to identify subgroups of families based on parental and child clinical and sociodemographic factors. A zero-inflated negative binomial regression was conducted to assess changes in unmet needs, stratified by class and intervention group. RESULTS:Three distinct classes were identified. Class 1 (n = 134) included people who were entirely non-culturally and linguistically diverse (CALD) background, in good mental health, with higher education and socioeconomic status (SES), and from the regional/rural site. Class 2 (n = 94) included people who were predominantly non-CALD, of low education and SES, had poor mental health, and from the regional/rural site. Class 3 (n = 56) included people of CALD, high SES and education, and good mental health, who were from the urban site. Compared to the Class 3, participants in Class 2 showed significantly higher needs, indicating that the intervention was not effective in this vulnerable group. DISCUSSION:Digital navigation tools might support families that experience lower psychosocial adversity but are insufficient for families that experience higher levels of adversity, highlighting the need for tiered approaches to ensure equity.

Evidence-based early parenting programs delivered in early childhood can improve children’s social-emotional and mental health outcomes, yet achieving population-level impact requires effective delivery at scale. Despite growing interest in scaling such interventions, no comprehensive review has synthesized lessons from past efforts. This systematic review aimed to synthesize available peer-reviewed literature on scaled ‘early’ parenting programs (defined as programs delivered during pregnancy and up to child age 5 years). Specifically, the review examined (1) which programs have been scaled, (2) frameworks guiding scaling efforts, (3) reported outcomes, and (4) barriers and enablers to successful scaling. Guided by PRISMA-SR, four databases (PsychInfo, EMBASE, SCOPUS, PubMed) were searched for studies published between 2004 and March 2026. Eligible studies reported data on scaling early parenting programs beyond a single site. Data were synthesized narratively, and qualitative thematic analysis was applied to barriers and enablers. Sixty-two papers describing 39 distinct scaling efforts were included, spanning 15 unique programs. Scaled programs included attachment-based interventions and behavioral programs. While some initiatives employed implementation frameworks, most did not. Data suggested positive impacts for families in some relevant areas, however most evidence came from descriptive or non-randomized study designs, and there was significant variation in how outcomes were measured. Reported outcomes relating to scaling reach, fidelity, and sustainability were limited. Six key enablers/barriers were identified: implementation approach; local contexts; collaboration; institutionalizing within systems; leadership; and funding and resources. In the last two decades, efforts have been made to scale early parenting programs to support child social-emotional and mental health outcomes. To support future scaling, ongoing research is required.

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).

BackgroundChildren with severe conduct problems often experience disruptions in parent-child relationships, yet validated observational tools suitable for early and middle childhood remain limited. This study investigated associations between mother-child emotional availability (EA) and conduct problem severity in a clinic-referred sample.MethodParticipants were 92 mother-child dyads with children aged 3 to 9 years diagnosed with Oppositional Defiant Disorder (ODD) or Conduct Disorder. Mothers completed standardised questionnaires and a diagnostic interview. Dyads participated in a 30-min semi-structured interaction coded with the EA Scales (4th edition), from which maternal and child EA composite scores and EA Zone classifications were derived.ResultsLower maternal EA was associated with higher clinician-rated ODD severity, although effects were modest. Child EA demonstrated only a marginal association with ODD severity, and neither maternal nor child EA predicted mother-reported conduct problems. Most dyads were classified within the "complicated" EA Zone, reflecting insecure-ambivalent relational patterns characterised by inconsistent emotional responsiveness and engagement. This finding is notable as conduct problems are more commonly linked with insecure-avoidant or disorganised attachment.ConclusionsFindings highlight the clinical relevance of maternal emotional availability and suggest that inconsistent emotional responsiveness may be an important intervention target for children with conduct problems.

BACKGROUND AND OBJECTIVES:Migrant families have reduced access to universal child and family health (CFH) services, including CFH nursing visits, wherein infant and maternal surveillance offers a key opportunity to identify maternal health and child developmental concerns. Evidence is emerging on the effectiveness of integrated health and social care hubs (Hubs) to improve access to CFH services. Our aim was to evaluate the impact of Hubs at 2 sites in Sydney, Australia for migrant women and their infants on attendance to CFH nursing visits until 12 months postpartum for infant and maternal surveillance. METHODS:We conducted a nonrandomized trial to compare Hubs (intervention) with routine CFH nursing services (control). Pregnant and/or recently birthed migrant women were allocated to Hubs (n = 119) or routine care (n = 120), with allocation based on residential proximity to the Hubs. Mothers and their infants were followed until the child was aged 12 months. RESULTS:Compared with routine care, the Hub group demonstrated a more than 4-fold higher rate of attendance at CFH nursing visits (12-month visit: adjusted relative risk, 4.68; 95% CI, 2.48-8.84) and a 2-fold increase in completion of maternal postnatal depression and psychosocial surveillance at visits. There was no difference in completion of infant surveillance between Hubs and routine care at visits. CONCLUSIONS:There was a significant improvement in attendance of CFH nursing visits for migrant women and their infants attending Hubs compared with routine CFH nursing services. Completion of maternal surveillance was higher in Hubs. Hubs are important service models to be considered when addressing disparities in access to CFH nursing services for migrant communities.

Child abuse is a pervasive problem impacting millions of children. Researchers largely rely on parent-report questionnaires to examine risk for child abuse, leaving a gap in research concerning the link between observed parent and child behaviors and child abuse potential. The current study pursued a multi-method approach to explore relations between parent and child factors and child abuse potential (via the Brief Child Abuse Potential Inventory; BCAP) in a sample of 84 referred for behavioral problems in Australia. About half of the sample engaged in socially desirable responding which resulted in an invalid profile on the BCAP. Therefore, analyses were conducted twice to assess risk factors for child abuse within the standard valid BCAP profile sample (n = 41) and the full sample including valid and invalid profiles (n = 84). Within the valid-only sample, parent emotion dysregulation contributed significantly to the model predicting child abuse potential. However, within the full sample, parent emotion dysregulation, romantic attachment avoidance, stress, and negative touch were significantly associated with child abuse potential. Findings highlight the importance of including parents with invalid BCAP profiles when assessing child abuse potential as these high-risk parents may go unnoticed and miss connections to critical interventions.

A mixed-race sample of 38 Australian mother-child dyads was assessed at 2 time-points (child ages of 3 months and 3.5 years) to examine the continuity of relationship qualities focusing on maternal sensitivity, attachment, and children's behaviour problems. Maternal sensitivity was assessed in 2 episodes (free play and reunion) of the Still Face Procedure (SFP). Children's representations of attachment were assessed with a Narrative Story Stem Task, coded with 4 scales. Narrative enactments of attachment behaviour were significantly associated with maternal sensitivity assessed in the SFP, and a mediated pathway was found from maternal sensitivity, through narrative attachment, to children's behaviour problems. This study marks the first time that a longitudinal linkage of maternal sensitivity assessed in infancy was established with children's narrative representations of attachment at preschool age, and the first time that the SFP has been used in conjunction with a Narrative Story Stem Task.

This study explored the demographic and psychosocial characteristics, and presenting concerns of new or expectant fathers seeking perinatal mental health (PMH) support through the Australia-based ForWhen service, compared to a sample of mothers. The retrospective observational analysis examined routinely collected data from 105 male and 203 female clients who were supported by ForWhen between February 2022 to June 2024. Fathers and mothers did not differ in terms of demographic characteristics, and both presented with similarly high levels of distress during intake. However, fathers were more likely to report current self-harm and/or suicidal ideation, as well as current relationship issues and financial stress. Conversely, mothers were more likely to report parenting concerns such as infant sleep and settling challenges. Overall, far fewer men than women access support through ForWhen, despite the known prevalence of PMH concerns among fathers. There were also differences in how clients accessed the service, with fathers more often referred by their intimate partner, suggesting that partners may be an important avenue to encourage help-seeking for paternal PMH concerns. These findings highlight the need to adapt PMH services-traditionally designed for women-to be more inclusive of and better engage men.

Dysregulation in early childhood is associated with increased vulnerability to psychopathology and poor psychosocial outcomes. While there is evidence that both child language ability and parental mentalization are associated with dysregulation in early childhood, there is little understanding of the relationships between these variables, and minimal research has been conducted in clinical samples. This study tested the association between child language ability (using the Mullens Scale of Early Learning) and child dysregulation (using the Child Behavior Checklist Dysregulation Profile), and examined whether parental mentalization (operationalized as Parental Reflective Functioning and Mind‐Mindedness, assessed using Diamond Maternal Reflective Functioning Scale and interactional 20‐min play sessions, respectively) mediated this relationship, in a clinical sample of 90 mother–child dyads (child M age = 19.48 months, SD = 3.15) referred to a specialized community‐based child behavior treatment clinic located in Sydney, Australia. Results showed that greater child receptive language and better parental reflective functioning were associated with lower rates of child dysregulation. Contrary to expectation, however, parental mentalization did not mediate the relationship between child language and dysregulation.These findings suggest that clinically, children with dysregulation may benefit from interventions targeting receptive language and parental reflective functioning; however, further research in this area is required.

Parent-Child Interaction Therapy-Toddler (PCIT-T) and Circle of Security-Parenting (COS-P) are two attachment-based early parenting programs with emerging evidence bases. Most of the research has, however, been quantitative in nature. Understanding caregiver perspectives and acceptability of the programs is therefore needed. This study aimed to address this gap in research by examining perspectives of parents who participated in PCIT-T or COS-P at an Australian community-based child behavior clinic for treatment of toddler behavior problems. Twenty-nine mothers were purposively recruited to participate in a semi-structured post-program interview (COS-P: n = 10; PCIT-T: n = 19). Data were analyzed using an inductive thematic analysis approach. Results of thematic analysis showed that parents in both groups experienced a range of positive gains (for the toddler, themselves as a parent, and for relationships). Participants in both groups identified the clinician as a key facilitator of positive program outcomes, and time commitment as a barrier. For the COS-P group, the group process and treatment journey were identified as facilitators, and inconsistent attendance from group attendees was a barrier. The PCIT-T group viewed the live coaching and the manualized protocol as facilitators. Results suggest that both COS-P and PCIT-T are viewed positively by parents and identify several parent-identified facilitators/barriers.

This study explored whether caregiving helplessness and parenting stress were associated with callous-unemotional (CU) traits in a clinic-referred sample of 92 children (3–9 years). Mothers (N = 92) and fathers (N = 35) of children with diagnosed conduct disorders (72

Child abuse is a significant public health concern that impacts children worldwide. Efforts to connect at-risk parents with prevention and intervention programs require the use of high-quality measures that evaluate child abuse potential. The widely-used Brief Child Abuse Potential Inventory (BCAP) contains response bias indices. Little is known about factors that relate to invalid responses and whether these validity scales aid in identifying high-risk parents. Using a sample of 84 mother-toddler dyads referred for child behavior problems to an Australian outpatient clinic, the current study investigated factors that determined the likelihood of having an invalid profile on the BCAP. Logistic regressions evaluated relations between parent, child, and parent-child relational factors associated with the odds of having an invalid BCAP profile. Results indicated that greater parental dysregulation (OR = 1.047, p < 0.001), stress (OR = 1.043, p = 0.001), depressive symptoms (OR = 1.133, p = 0.021), and negative parenting (OR = 57.629, p = 0.049)) were related to increased odds of an invalid BCAP profile. Invalid BCAP profiles frequently occur. Parents with invalid BCAP profiles are a high-risk subset of parents that should be thoughtfully evaluated for child abuse. As parents with invalid BCAP profiles have historically been overlooked within clinical/research settings, the current research may inform best practices and enhance accuracy in parenting evaluations.

ABSTRACTBackground and ObjectiveMigrant and refugee women, families, and their children can experience significant language, cultural, and psychosocial barriers to engage with child and family services. Integrated child and family health Hubs are increasingly promoted as a potential solution to address access barriers; however, there is scant literature on how to best implement them with migrant and refugee populations. Our aim was to explore with service providers and consumers the barriers, enablers, and experiences with Hubs and the resulting building blocks required for acceptable Hub implementation for migrant and refugee families.Design, Setting and ParticipantsThis project was undertaken in Sydney, New South Wales, in communities characterised by cultural diversity. In this qualitative study, we used semi‐structured interviews guided by the consolidated framework for implementation research, with service providers from health and social services (32 participants) and migrant and refugee parents (14 parents) of children who had accessed Hubs.Research and DiscussionOur initial qualitative data themes were developed into step‐by‐step building blocks, representing a way to address contextual determinants to establish and sustain a Hub that can support migrant and refugee families. These include the setting‐up phase activities of buy‐in and partnership development, which outlines mechanisms to foster collective action and collaboration between health and social services. Following this, our orientation model articulates the need to establish Hub coordination and navigation, activities that enhance a Hub's relevance for migrant and refugee families and ongoing integration mechanisms, such as engagement of same‐language general practitioners. This is the first study to explore the building blocks required for acceptable Hub implementation to meet the needs of migrant and refugee families in the first 2000 days of a child's life—a critical time to optimise child development and health.Patient or Public ContributionThe research questions were developed based on qualitative research undertaken with Hub participants, community members, and service providers. The original investigator team had a consumer representative who has since relocated and consultation was undertaken with local Hub partner services. The researchers also consulted multicultural health services, including cultural support workers, to ensure research materials were culturally nuanced. Patients or participants have not directly been involved in the current study design.Clinical Trial RegistrationThis trial was registered with the Australian New Zealand Clinical Trials (ACTRN12621001088831).

Numerous systematic reviews have shown home visiting interventions to be effective at improving a variety of parent and child outcomes. No review has, however, examined the impact of home visiting programs targeting child (aged 0–5 years) mental health, socioemotional and/or developmental outcomes in the context of families with high vulnerability and complex needs. A systematic review and meta-analysis were undertaken to examine and synthesize the literature on home visiting programs administered by professionals/paraprofessionals for families with young children, high vulnerability, and complex needs. PsychInfo, Scopus, Embase, PubMed, and CINAHL were searched through August 2023. A manual review was also undertaken of the reference lists of the articles selected for the review and the Home Visiting Evidence of Effectiveness 2023 review/database. English language studies were included if they were evaluated with a group of participants (case studies were excluded), reported results of home visiting intervention targeted at improving mental health and psychosocial outcomes of caregivers and/or developmental outcomes for children (aged 0–4 years 11 months) of families with high vulnerability and complex needs. Two independent reviewers extracted data and assessed for risk of bias. Qualitative results were consolidated narratively while a meta-analysis was used to synthesize quantitative results. Initial searches identified 623 articles, of which 22 were included in the final review. Findings showed that 18 different home visiting interventions have been implemented with families with high vulnerability and complex needs, and that these interventions are effective at improving a variety of child outcomes. The meta-analysis showed that the weighted mean standardised effect sizes ranged from -0.31 to 0.20, with only one of the four outcomes (i.e., socioemotional and/or behavioural outcomes) being significantly different from 0 (standardised mean difference -0.31; 95