INTRODUCTION:This study responds to barriers to access to early intervention for health, welfare and education faced by families who experience sociodemographic disadvantage. Following a needs assessment to inform policy and practice for a community early years hub, a facilitated playgroup was commenced using a model identified by families. The aim was to provide a safe place for families of young children to gather and find support in an environment of relational and professional care and empowerment. METHODS:Evaluation of demographic data and thematic analysis of focus group discussions allows a qualitative exploration of family and provider experience in the supported playgroup. RESULTS:In its first year, the playgroup was attended by 61 families. Through shared relationships and structured health promotion action, families were empowered with an understanding of child development; six families received assistance with referral to a developmental specialist. Qualitative analysis identified three themes of learning from parents and grandparents, allied health providers, early childhood educators and volunteers, identifying a playgroup model to: 'reduce experience of social isolation among families', 'support families in understanding child development' and 'support families through physical space and provision'. Relationality, safety and empowerment were interwoven among themes. CONCLUSIONS:A policy of shared vision is central to empowering families and reducing barriers to access to support for children's developmental health concerns. Through co-design, families were empowered within the layered influences of learning. SO WHAT?: Evaluation represents a first step to inform policy change and practice for health promotion action towards a co-designed community hub.

Background: Children’s development is dependent on a range of factors influencing their life course outcomes. Protective and challenging social and cultural determinants impact how Indigenous families support their children’s developmental foundations. However, there is a lack of international evidence investigating Indigenous child development interventions. To gain a perspective across nations with comparable settler-colonial histories, this scoping review summarised studies on family and community-centred approaches among Indigenous populations in Australia, Canada, New Zealand, and the United States, focusing on outcomes and evidence gaps. Methods: A scoping review followed PRISMA-ScR guidelines. Medline, CINAHL, and PsycINFO (Ovid) were searched from their inception to October 2025, including grey literature sources from Aboriginal HealthInfoNet, the Lowitja Institute and the Secretariat of National Aboriginal and Islander Child Care. Empirical studies, including quantitative, mixed-methods, evaluation studies, and descriptive or case-study designs, were included provided they reported empirical data on intervention outcomes. Due to study heterogeneity, data were synthesised narratively. Results: Following screening of 2355 records, eight from 2013 to 2020 met the inclusion criteria. These were mostly small-scale, non-randomising designs evaluating different interventions, with the behavioural and emotional domain being the most frequently assessed outcome, alongside developmental vulnerability and academic/educational areas. There was limited consideration of protective cultural determinants of health in the study design and implementation. Six studies reported positive associations between interventions or programmes and early childhood development outcomes. Conclusions: While the number and rigour of identified interventions were limited, several demonstrated potential benefits for Indigenous children’s early childhood development. However, strengthening the evidence base requires culturally grounded, adequately powered evaluations using rigorous study designs that include culturally co-designed adaptations conducted with Indigenous families and communities. Support is recommended for capacity building and funding.

INTRODUCTION:Foundations for health are set in the first years of life, however many children in Australia do not attain optimal development due to inequitable access to specialist care through impacting social determinants of health. There is a research gap in evidence for sustaining early years services that address these barriers. This study aimed to understand experiences and priorities of parents/carers and service providers around access to specialist early years health services in low socioeconomic areas of Armadale, Western Australia. METHODS:Thematic analysis was used to interpret meanings across focus group discussion data and find priorities for access to care and service delivery using a multilevel socio-ecologic model. Facilitators and barriers to access were identified related to each theme. RESULTS:Two major themes were identified. Within theme 'Finding Help', facilitators to access included extended family, community, and childcare. Barriers included social isolation, and overwhelm. In theme 'Structural Factors', facilitators included safe places and practices, political action and universal care. Barriers included social determinants of health, institutional bias, and fiscal policy. CONCLUSION/DISCUSSION:Findings will inform policy, service delivery, and research priorities toward facilitating timely access to integrated care for vulnerable families with young children. Health equity will focus on co-design to remove structural barriers using a "one-stop-shop" model with soft entry, triage capacity, and a key worker to coordinate care for at risk families. To promote structural equity, a focus on access will include continuing engagement with families, facilitated by relational models of care to scaffold and support families toward autonomy.

ISSUE ADDRESSED:Outcomes of health and wellbeing are shaped in the first 5 years as childrens' brains and bodies develop in response to their environment. Families at sociodemographic disadvantage face barriers to early intervention that may be reduced through access to integrated care across health, early education, and welfare services. There is, however, internationally documented evidence of difficulty in sustaining and translating such services. This needs assessment sought to understand existing knowledge on creating safe, accessible integrated service hubs for families with young children, providing a foundation for longitudinal evidence-based translation of early intervention into practise. METHODS:Building on a formative evaluation, this needs assessment analysed data to identify strengths and gaps in support for children pre-birth to age 5 and their families in the low socioeconomic area of Armadale, Western Australia, including mapping, definition of family, and review of evidence for outcome measures. RESULTS:Combined evidence identified priorities to support access in a location of unmet need in the local government area. The focus on one-place that is culturally safe with trained professionals empowering people using a relational model of care to build trust for families who have experienced disadvantage through poverty and social barriers. CONCLUSIONS:We identified a priority to empower families through consumer engagement and co-design, with a need for evidence-based measures to evaluate intervention effectiveness. This provides a focus for ongoing intervention development and research and evaluation. RELEVANCE TO HEALTH PROMOTION:This needs assessment provides an example of health promotion action towards evidence-based early years support.

BackgroundDuring pregnancy, childbirth and postnatally, women are at their most vulnerable, requiring health and social care systems able to meet their needs. In the context of perinatal care, assessing Aboriginal women’s mental health requires consideration of their whole-of-life to establish their overall social and emotional wellbeing. This requires mechanisms which respect women’s cultural positioning and needs. In the Australian health care system, Aboriginal women’s mental health is routinely viewed through mainstream screening and assessment tools, such as the Edinburgh Postnatal Depression Scale which does not address cultural strengths or the protective nature of being connected to culture. In the face of significant structural inequities, including in perinatal care, Aboriginal women are frequently marginalized which contributes to their disengagement from services. Despite this, women’s resilience remains evident and understanding why may hold the key to better perinatal care planning. As such, the aim of this study was to explore Aboriginal women’s resilience, self-efficacy and empowerment during their perinatal experiences, assessing factors contributing to their cultural strengths when addressing perinatal mental health concerns.Methodssituated in a larger pilot implementation project, this qualitative study used an Aboriginal Participatory Action Research method and was undertaken on Whadjuk Country, Boorloo (Perth Western Australia). Aboriginal women (n = 8) were invited to participate in yarns with the study’s lead Aboriginal researcher. Data was inductively and deductively analyzed, with findings interpreted through a decolonizing framework which prioritized strengths and cultural ways of being.ResultsSix themes were identified from analysis of the qualitative data: (1) strengthening identity-reconnecting to Culture; (2) connection to kinship/family sub-theme, strong partner support; (3) connection to country; (4) connection to culture; (5) resilience and self-efficacy; and (6) women’s experiences using the Baby Coming You Ready program’s digital platform. Themes 1–5 clearly demonstrated women’s strengths and resilience which were reported as a direct result of their culture and cultural connections; while theme 6 reported their positive experiences of using a strengths-based and culturally developed perinatal assessment platform.ConclusionThe results of this study confirm the positive benefits and value of co-designing tools for use in clinical settings which incorporate the cultural determinants of health and holistic perspectives of social and emotional wellbeing when screening Aboriginal women’s perinatal mental health.

Background: Models of care for community health nursing need to address social determinants of health for families, requiring community health nurse leaders to encourage all nurses to facilitate culturally safe models of care, particularly for vulnerable and underserved populations. Many challenges impact on pro-vision of support for a range of population groups, with increasing attention focusing on how community health nurses lead equitable health activities for Aboriginal Australian families. Aim: The aims of this study were to investigate the suitability, feasibility and acceptability of parent support, informing a culturally safe model for a peer-led support program for Aboriginal families.Methods: Participatory action research enabled Aboriginal peer support workers and parents, community agencies and a child health researcher to collaboratively review cultural safety, suitability, and progress of the program. Qualitative data were analysed through thematic analysis.Findings: The Australian Health Practitioner Regulatory Agency's cultural safety framework guided four themes: Acknowledgement of colonisation, racism, and social determinants of health; recognition of in-fluences of personal racism and power differentials; recognising importance of partnership approaches to care and collaboration with individuals and families to ensure appropriate and acceptable care; and promotion of safe working environments. Discussion: Community-based initiatives informed by Aboriginal perspectives are needed to support Abo-riginal families. Participatory action research enables community health nurse leaders to engage with Aboriginal participants, facilitating co-design of culturally safe models of care. Conclusion: Reflections on culturally safe strategies enabled development of peer-led support for Aborigi-nal families, focusing on self-determination, empowerment, and equity. Acceptability of the strategies has contributed to an emerging culturally safe model of care. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal.(c) 2022 Australian College of Nursing Ltd. Published by Elsevier Ltd.

ObjectiveThis scoping review identifies evidence for design, models and evaluation of integrated care service provision for families and children in the first 2000 days, in the context of community-based specialised health, education and welfare services.DesignScoping review following the Joanna Briggs scoping review method.Data sourcesMedline, CINAHL, Cochrane and PsycINFO. Grey literature used a manual search of original articles, and snowball technique to identify government and policy documents relevant to Australia.Eligibility criteria for selecting studiesInclusion criteria were 'population' of prebirth to age 5; 'concept' of design, models and delivery of integrated specialist care for children and families; and 'context' of community-based specialised health, education and welfare services. Medical Subject Heading (MeSH) and free text searches were conducted in electronic database sources. Limits January 2010 to October 2022, full text, English language, human.Data extraction and synthesisData were extracted independently by two authors using a piloted data extraction table and presented in table and narrative form.ResultsFull text of 11 articles were reviewed, domains were coded using four domains of a framework identified in one reviewed article to maintain consistency of reporting; 'governance,' 'leadership,' 'organisational culture and ethos,' and 'front-line interdisciplinary practice.' A fifth domain was identified, 'access.'ConclusionsServices providing integrated care for families in the early years will ideally be based on values generated through codesign with families and the community. Considerations include sound governance and leadership, shared vision, and commitment to providing accessible and culturally safe family-centred care.

Introduction The first 2000 days of a child’s life (during pregnancy up to age 5 years) represent a critical period, in which early interventions reduce risk associated with developmental delay, disability and intergenerational disadvantage. The risk is exacerbated by barriers to specialised early intervention for children and families. This scoping review seeks to contribute to the evidence for sustaining integrated community-based specialist care in these earliest years of a child’s life. Methods and analysis The Joanna Briggs Institute scoping review framework will be followed. Inclusion and exclusion criteria for screening of literature is predefined, guided by the criteria of population, concept and context. The review will identify models of care delivery, and will identify quality of care outcomes that have been measured, including evidence of reliability and validity. Sources of evidence will include CINAHL, Cochrane databases, Medline, PsycINFO and Scopus. Ethics and dissemination In a three-part study, evidence synthesis from the scoping review of the literature; mapping of existing specialist early years services in one community and a consumer consultation (Curtin University Human Research Ethics approval HRE2021-0546) in the same community will inform a model of integrated care that accounts for the context of the community it seeks to serve. Results will be disseminated by peer-reviewed publications and conference presentations, contributing to the evidence base for delivering sustainable community-based integrated care in the context of the first 2000 days. This protocol is specific to the scoping review.

PurposePriority settings are important to plan and direct future research. The aim of this study was to identify the top ten pediatric and child health nursing research priorities from the perspectives of consumers, community, and healthcare professionals in Western Australia.Design and methodsThis study used an adapted James Lind Alliance Priority Setting Partnership design with three phases. 1) A planning workshop to inform a survey. 2) A survey using five open-ended-questions distributed between October 2020 and January 2021 through social media and healthcare professionals' emails. Responders' statements were analyzed with content analysis. 3) A consensus workshop to finalize and rank the themes.ResultsThe planning workshop participants (n = 25) identified gaps such as community child healthcare and confirmed lack of consumer engagement in previous studies. The survey responses (n = 232) generated 911 statements analyzed into 19 themes. The consensus workshop participants (n = 19) merged and added themes, resulting in 16 final themes. The top three ranked themes were: ‘access to service’, ‘mental health and psychological wellbeing’, and ‘communication’.ConclusionsThe research themes are necessarily broad to capture the wide range of issues raised, reflecting the scope of pediatric and child health nursing.Practice implicationsThe priorities will inform future research to be directed to areas of priority for stakeholders who have often not had a say in setting the research agenda.

The aim of this development paper is to inform the ongoing implementation of the partnership approach with Aboriginal families in Australia. As almost all Community Health Nurses employed by the Health Department of Western Australia, Country Health Service are non-Aboriginal, there are a number of factors that may, potentially, limit their capacity to work effectively with the primary caregivers of Aboriginal children. Historically, much that has been written about the health and development of Aboriginal people in Australia has been negative and derogatory with wide criticism for their non-participation with health services and healthy lifestyle activities. Not only has this “deficit discourse” approach proved to be unhelpful in terms of improving the health and well-being of Aboriginal people but also there is mounting evidence that it has been detrimental to mental and physical health and capacity to achieve autonomy in all aspects of life. In response to the voices of Aboriginal people, the partnership approach to care has been promoted for use by Community Health Nurses in Western Australia. However, the implementation of the approach is not always genuinely strength based, and it does not always focus on mutual goal setting within authentic partnership relationships. The partnership approach has the potential to improve the lives of Aboriginal people if it is implemented with appropriate cultural sensitivity, shared responsibility, dignity and respect.

Patient experience surveys have a user focus and measure the quality of person-centered health care for hospital inpatients and consumers of community health services, providing a governance process to evaluate the quality of care and to action improvement. Experience of care has been described as effective communication, respect and dignity, and emotional support. Measurement criteria for these domains are not standardized, leading to inconsistent reporting of patient experience. The objective of this scoping review was to synthesize evidence for measuring experience of care in children’s community health services using the Joanna Briggs Institute framework for scoping review method. Three parent-reported surveys met the inclusion criteria, and 50 survey items were assessed by expert reviewers for fit to domains of healthcare experience. Conceptual domains of parent experience in children’s community health services included respect and dignity, effective communication, and emotional support. A gap was identified, in that few items in identified surveys measured emotional support. This contribution will promote consistent reporting of healthcare experience, informing policy and practice for person-centered health care.

Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers’ perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.

Ngala is an evidence-informed community-based parenting and early childhood organisation in Western Australia. During 2007, a strategic decision was made to forge formal links with universities where researchers could actively participate in the establishment of a research agenda that supported identified priority areas for Ngala. This decision provided strategies for embracing the challenges of evidence-informed practice (EIP) for the organisation alongside competing financial demands which, for many not-for-profit organisations, is an ongoing dilemma. This paper will discuss the identified trends, changes and examples which informed the foundational components to sustain a research and evaluation culture within an evidence informed community service organisation (CSO). A case study design was used to describe activity and experiences over a decade. Participants included academics from a range of disciplines, and Ngala managers and practitioners. Multiple data sources were analysed – current literature, an audit of organisational documents, and a leadership survey to establish key components necessary to sustain a research culture. Challenges are described as well as examples of success that enabled growth and change. The sustainability of a culture results in the strength of an organisation to continue building on successes of the past and to focus on the long term. In today’s environment of funders requiring organisations to demonstrate the difference they are making for families with children, it is even more crucial for services to build in resources for research and evaluation, despite growing costs. Senior level leadership and commitment enhances the drive for EIP which takes a whole of organisation approach for sustainability.

Background: Early parenting services (EPS) in Australia provide a range of expanding and rapidly changing services, including innovative digital technologies to improve service access for metropol...

Pediatric healthcare providers understand that the early years of children's lives are critical to their health and learning. Babies are born wired for social interaction and through parental nurturing and responsive caregiving, secure attachment is established.1 Through this attachment, parents’ problem-solving skills and parenting styles, infants and young children can learn to regulate their emotions and enable the development of meaningful relationships.1 Indeed, emotional regulation through attachment is considered to be the cornerstone for ongoing positive mental health.2 For families, parenting can bring a range of physical, emotional and social changes where mothers often need considerable support, especially from people they are close to.3 How parents and families manage depends on a range of factors. Some parents acquire knowledge and skills that support health behaviors through education, a supportive workplace or prior exposure to caring for young children.4 Some families are well supported by extended family and a network of friends and neighbors, which encourages community connection and engagement in early learning and developmental activities.4 However, other parents are not well supported, feel physically or culturally isolated and have limited access to health services or community resources.5 A child's needs may be compromised if a mother's responsiveness is affected by anxiety or depression.6 Further, the stress, anxiety and fatigue experienced by parents can impact their caregiving and undermine their parenting confidence, potentially influencing their child's emotional, attentional and cognitive regulation.2 In addition, such experiences of stress may result in maladaptive responses between parents, such as taking out their frustrations on each other, further impacting the psychosocial environment.7 A need for improved approaches in health care to support family functioning has been identified,8 especially for families managing their child's major health problem7 and for those living with socio-economic disadvantage.2 Such evidence highlights the need to support the psychosocial environments of young children and families to enable them to build confidence, connect with others and engage with appropriate community resources.4 In practice, talking about psychological and social issues with families can be challenging for healthcare providers, especially when children are ill.9 Parents attending a healthcare facility with their child will put their child's needs first and feel that talking about their worries may detract from the care required for their child.10 Some parents have reported feeling judged about being unable to cope or believing they are inadequate as parents, which can reduce their likelihood of engaging in conversations with healthcare providers.9 For healthcare providers, there is reluctance about discussing family issues with parents for fear of opening up a “can of worms” that leads to the potential unfolding of a range of complex problems.11 However, talking with families is integral to healthcare providers, especially pediatric nurses who provide care for the child in the context of the family.12 Once psychosocial issues are identified, interventions that promote engagement and community participation include complex social processes.4 Linking with others and engaging in community activities results in reported benefits to parents’ psychological health and confidence-building,3 improved family access to local services,4 and enhanced effectiveness of interventions that are based on partnership-building.13 Whether family-centered or community-centered, each intervention depends on building a partnership that is based on mutual respect and collegiality, and guided by genuine enquiry and reflective listening.14 This research evidence illustrates a need to implement interventions based on partnership-building and communication about psychosocial issues with young children and families. By focusing research on the issues that matter most to families and ensuring that parents are engaged as equal partners in their children's health, interventions are more likely to be feasible and sustainable. More importantly, such focused enquiry acknowledges family functioning and the caregiving environment as key determinants for the long-term health and developmental outcomes of young children and their families. In this issue of the JBI Database of Systematic Reviews and Implementation Reports, enquiry focuses on the health of children and the influence of family. In all cases, a psychosocial assessment can enhance parental engagement and present healthcare providers with information that enables them to offer the most appropriate support to parents, leading to the best health outcomes for children. Declaration Sally Wilson is a Senior Associate Editor of the JBISRIR.

AIMS AND OBJECTIVES:This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants' perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. BACKGROUND:The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. DESIGN:This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. METHODS:Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. RESULTS:Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. CONCLUSIONS:Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. RELEVANCE TO CLINICAL PRACTICE:Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal.