Moving from idea to reality: The barriers and enablers to implementing Child and Family Hubs policy into practice in NSW, Australia.


Journal

Health research policy and systems
ISSN: 1478-4505
Titre abrégé: Health Res Policy Syst
Pays: England
ID NLM: 101170481

Informations de publication

Date de publication:
15 Jul 2024
Historique:
received: 23 04 2024
accepted: 23 06 2024
medline: 16 7 2024
pubmed: 16 7 2024
entrez: 15 7 2024
Statut: epublish

Résumé

Adverse childhood experiences can impact physical and mental health throughout the lifespan. To support families experiencing adversity and improve child health and developmental equity, an integrated, multi-sector response is required. Child and Family Hubs (Hubs) are a feasible and acceptable approach to providing such a response. In the Australian context, a number of federal and New South Wales (NSW) state policies support an integrated, multi-sector response using Hubs to support families experiencing adversity. This study examined NSW policy stakeholder and health service manager perspectives on the barriers and enablers to translating policy into practice in the implementation of Child and Family Hubs. Semi-structured interviews were conducted with 11 NSW government policy stakeholders and 13 community health service managers working in child and family policy and planning or child and family community-based services. Interviews were of 30-60 min duration and explored stakeholder knowledge, perspectives and experiences around childhood adversity, and barriers and enablers to operationalizing policies supporting Hubs. Analysis of barriers and facilitators to implementation of Hub models of care was undertaken using the Consolidated Framework for Implementation Research (CFIR). Key barriers that emerged included short-term and inconsistent funding, lack of resourcing for a Hub co-ordinator, limited support for evaluation and insufficient time to plan for Hub implementation. Key enablers included flexibility and adaptability of Hub models to meet local needs, formal change management processes, strong governance structures and engagement among Hub practitioners. Key insights included the importance of targeted strategies to support sustained individual practice change and the need for organization-wide commitment to enable the successful adoption and maintenance of the Hub model of care. This study provides valuable insights and contributes evidence around what is needed to strengthen and support the operationalization and scalability of the Hub model of care. Key recommendations for Hub practitioners include the importance of formal change management processes and establishment of strong governance structures, while key recommendations for policymakers include the need for sustainable Hub funding and a standardized, evidence-based framework to support Hub implementation and evaluation.

Sections du résumé

BACKGROUND BACKGROUND
Adverse childhood experiences can impact physical and mental health throughout the lifespan. To support families experiencing adversity and improve child health and developmental equity, an integrated, multi-sector response is required. Child and Family Hubs (Hubs) are a feasible and acceptable approach to providing such a response. In the Australian context, a number of federal and New South Wales (NSW) state policies support an integrated, multi-sector response using Hubs to support families experiencing adversity. This study examined NSW policy stakeholder and health service manager perspectives on the barriers and enablers to translating policy into practice in the implementation of Child and Family Hubs.
METHODS METHODS
Semi-structured interviews were conducted with 11 NSW government policy stakeholders and 13 community health service managers working in child and family policy and planning or child and family community-based services. Interviews were of 30-60 min duration and explored stakeholder knowledge, perspectives and experiences around childhood adversity, and barriers and enablers to operationalizing policies supporting Hubs. Analysis of barriers and facilitators to implementation of Hub models of care was undertaken using the Consolidated Framework for Implementation Research (CFIR).
RESULTS RESULTS
Key barriers that emerged included short-term and inconsistent funding, lack of resourcing for a Hub co-ordinator, limited support for evaluation and insufficient time to plan for Hub implementation. Key enablers included flexibility and adaptability of Hub models to meet local needs, formal change management processes, strong governance structures and engagement among Hub practitioners. Key insights included the importance of targeted strategies to support sustained individual practice change and the need for organization-wide commitment to enable the successful adoption and maintenance of the Hub model of care.
CONCLUSIONS CONCLUSIONS
This study provides valuable insights and contributes evidence around what is needed to strengthen and support the operationalization and scalability of the Hub model of care. Key recommendations for Hub practitioners include the importance of formal change management processes and establishment of strong governance structures, while key recommendations for policymakers include the need for sustainable Hub funding and a standardized, evidence-based framework to support Hub implementation and evaluation.

Identifiants

pubmed: 39010121
doi: 10.1186/s12961-024-01164-0
pii: 10.1186/s12961-024-01164-0
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

83

Subventions

Organisme : National Health and Medical Research Council Practitioner Fellowship
ID : 1155290
Organisme : National Health and Medical Research Council Practitioner Fellowship
ID : 1136222

Informations de copyright

© 2024. Crown.

Références

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Auteurs

Anna Calik (A)

Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia. anna.calik@health.nsw.gov.au.
Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia. anna.calik@health.nsw.gov.au.

Huei Ming Liu (HM)

Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia.
Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia.
The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.
Sydney Medical School, The Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.

Alicia Montgomery (A)

Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia.
Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia.

Suzy Honisett (S)

Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria, Australia.

Kerri-Anne Van Munster (KA)

Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia.

Tamara Morris (T)

Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia.
Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia.
Discipline of Paediatrics and Child Health, University of New South Wales, Sydney, NSW, Australia.

Valsamma Eapen (V)

Discipline of Psychiatry and Mental Health/Faculty of Medicine and Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia.

Sharon Goldfeld (S)

Department of Paediatrics, University of Melbourne, Victoria, Australia.
The Royal Children's Hospital, Victoria, Australia.
Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria, Australia.

Harriet Hiscock (H)

Department of Paediatrics, University of Melbourne, Victoria, Australia.
The Royal Children's Hospital, Victoria, Australia.
Health Services and Economics, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria, Australia.
Centre of Research Excellence in Childhood Adversity and Mental Health, Centre for Community Child Health, Murdoch Children's Research Institute, Victoria, Australia.

John Eastwood (J)

Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia.
Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia.

Susan Woolfenden (S)

Department of Community Paediatrics, Sydney Local Health District (SLHD), Sydney, NSW, Australia. susan.woolfenden@health.nsw.gov.au.
Sydney Institute for Women, Children and Their Families, SLHD, Sydney, NSW, Australia. susan.woolfenden@health.nsw.gov.au.
Sydney Medical School, The Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia. susan.woolfenden@health.nsw.gov.au.

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