ABSTRACT
Background: Children and families from disadvantaged backgrounds are experiencing significant psychosocial and mental health (MH) issues due to the COVID-19 pandemic with inequity in service access particularly for culturally and linguistically diverse (CALD) and regional/rural families. The Watch Me Grow-Electronic (WMG-E) platform is an innovative technology that reaches vulnerable families at their homes and communities. Objectives: To evaluate WMG-E as a digital support and navigation tool to identify and address parental MH, psychosocial well-being and child developmental needs. Methods: A two-group (intervention and control) by three time-points (baseline, 6 months, 12 months) randomised controlled trial for families with 6-month-old to 3-year-old children from multicultural Fairfield Local Government Area and regional/rural Murrumbidgee Local Health District. Both groups are to complete the WMG-E containing screening measures while the intervention group has access to a service navigator offering 'warm hand-over' and continuity of care. Findings: As of October 2021, a full sample of 300 families have been recruited. Preliminary data suggest that about 33% have no risk;27%, low;38%, moderate;and 3%, high risk. In addition to developmental concerns for their children, the top social needs included unemployment, smoking and food insecurity and one-third reported parental MH concerns. Families reported satisfaction following referral/linkage to relevant services. Conclusion: WMG-E was found to be feasible and acceptable as a digital engagement, monitoring and navigation tool. Families in the intervention group who receive wrap-around health and social care commensurate with needs are expected to show significantly improved engagement and health outcomes at 6-month and 12-month follow-up.
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.