Abstract
BackgroundPrimary healthcare services in Australia, Canada, New Zealand and the United States have embraced the concept of family-centred care as a promising approach to supporting and caring for the health of young Indigenous children and their families. This scoping review assesses the quality of the evidence base and identifies the published literature on family- centred interventions for Indigenous early childhood wellbeing.MethodsFourteen electronic databases, grey literature sources and the reference lists of Indigenous maternal and child health reviews were searched to identify relevant publications from 2000 to 2015. Studies were included if the intervention was: 1) focussed on Indigenous children aged from conception to 5 years from the abovementioned countries; 2) led by a primary healthcare service; 3) described or evaluated; and 4) scored greater than 50% against a validated scale for family-centredness. The study characteristics were extracted and quality rated. Reported aims, strategies, enablers and outcomes of family-centredcare were identified using grounded theory methods.ResultsEighteen studies (reported in 25 publications) were included. Three were randomised controlled studies; most were qualitative and exploratory in design. More than half of the publications were published from 2012 to 2015. The overarching aim of interventions was to promote healthy families. Six key strategies were to: support family behaviours and self- care, increase maternal knowledge, strengthen links with the clinic, build the Indigenous workforce, promote cultural/ community connectedness and advocate for social determinants of health. Four enablers were: competent and compassionate program deliverers, flexibility of access, continuity and integration of healthcare, and culturally supportive care. Health outcomes were reported for Indigenous children (nutritional status; emotional/behavioural; and prevention of injury and illness); parents/caregivers (depression and substance abuse; and parenting knowledge, confidence and skills); health services (satisfaction; access, utilization and cost) and community/cultural revitalisation.Discussion and conclusionThe evidence for family-centred interventions is in the early stages of development, but suggests promise for generating diverse healthcare outcomes for Indigenous children and their parents/caregivers, as well as satisfaction with and utilisation of healthcare, and community/cultural revitalisation. Further research pertaining to the role of fathers in family-centred care, and the effects and costs of interventions is needed.
Highlights
Primary healthcare services in Australia, Canada, New Zealand and the United States have embraced the concept of family-centred care as a promising approach to supporting and caring for the health of young Indigenous children and their families
Primary healthcare services have embraced the concept of family-centred models of care as one approach to improve health and preventive services for Indigenous children [1,2,3]
The research question was: What is thecurrent evidence base for the impact of family-centred interventions on Indigenous earlychildhood health? Both the Cochrane and this scoping review were contracted by a Queensland regional Indigenous community controlled health service, Apunipima Cape York Health Council, to inform the implementation of their family-centred Baby One Program (Bainbridge R, McCalman J, Campbell C, Redman-MacLaren M, Vine K, Canuto K, Sewter J, MacDonald M: Growing a relational and responsive family health promotion program: A grounded theory evaluation of the Baby One Program, inpreparation)
Summary
Primary healthcare services in Australia, Canada, New Zealand and the United States have embraced the concept of family-centred care as a promising approach to supporting and caring for the health of young Indigenous children and their families. This scoping review assesses the quality of the evidence base and identifies the published literature on family- centred interventions for Indigenous early childhood wellbeing. Family-centred care approaches provide support and care for the whole family, their lives and wellbeing concerns, often at the family’s home This scoping review was conducted to inform the development for a Cochrane review protocol [3] by systematically searching, selecting and synthesizing existing knowledge to map key concepts, types of evidence, and gaps in research about family-centred healthcare [4]. The research question was: What is thecurrent evidence base for the impact of family-centred interventions on Indigenous earlychildhood health? Both the Cochrane and this scoping review were contracted by a Queensland regional Indigenous community controlled health service, Apunipima Cape York Health Council, to inform the implementation of their family-centred Baby One Program (Bainbridge R, McCalman J, Campbell C, Redman-MacLaren M, Vine K, Canuto K, Sewter J, MacDonald M: Growing a relational and responsive family health promotion program: A grounded theory evaluation of the Baby One Program, inpreparation)
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