Family Health Promotion Research Articles

A RE-AIM evaluation of Healthy Together: a family-centred program to support children\u2019s healthy weights

BackgroundHealthy Together (HT) is family-centered program to support healthy eating and physical activity designed for implementation in community organizations serving families who may be experiencing vulnerabilities (e.g., related to low income, isolation, ethnicity, immigrant/refugee status, and/or Indigenous background). The purpose of this study was to conduct an evaluation of HT in a real-world, scale-up phase using the RE-AIM framework.MethodsUsing a cross-sectional, non-comparative design, a community-based program evaluation was conducted in 29 organizations implementing HT as part of their core service programs. Data were collected using questionnaires with program participants and facilitators, and interviews with directors of participating organizations. Quantitative data were analyzed using descriptive statistics and qualitative data were content analyzed.ResultsWith regards to Reach, over 3400 caregivers, children and youth attended community programming that offered HT. Among those attending on the scheduled day for the evaluation, 663 completed the questionnaires. The majority of caregiver respondents (n = 431) were female (92%) and attended with children 0–6 years. Respondents also included children 4–6 years (n = 142) and 7–12 years (n = 65), and youth 13–18 years (n = 25). Effectiveness was demonstrated in reported improvements in physical activity, healthy eating, and strengthened social connections. HT was also widely supported by participants and facilitators. Adoption was influenced by the desire to enrich core service programs for families, HT’s fit within existing programs, organizational commitment, and funding support. Implementation experiences indicated that fidelity to the HT program was generally maintained, with some setting specific adaptations. Maintenance of HT was influenced by financial and non-financial resources within community organizations. Most organizations also introduced new initiatives to extend support for healthy eating and physical activity.ConclusionOur findings indicate improvements in healthy eating and physical activity, and social connections among program participants, as well as efforts by community organizations to create environments to support healthy weights. HT was successfully delivered in “real-world” community settings across multiple contexts and with families with diverse backgrounds. This along with strategies to support program implementation and sustainability indicate that HT provides a model for other public health interventions to promote family health and wellbeing.Trial registrationClincialTrials.gov NCT03550248. Registered May 25, 2018

Pengaruh Promosi Kesehatan Keluarga Terhadap Peran Keluarga Dalam Pengelolaan Anggota Keluarga Dengan Diabetes Mellitus Di Puskesmas Kebakkrmat I

There are 90% diabetes mellitus sufferers in the world. Diabetes mellitus (DM) is a degenerative disease that has increased every year in countries. Diabetes Mellitus if not handled properly will lead to complications. Cooperation between patients and families is expected to prevent chronic complications of DM, by providing information through health promotion. In this study using "pre post test non control group design" where a group before a certain treatment (x) is given a pretest, then given treatment and after the treatment is carried out a post test or a measurement to determine the consequences of the treatment. The independent variable is family health promotion, while the dependent variable is the management of patients with Diabetes Mellitus. This study uses "purposive sampling". In this sampling, families that meet the criteria and can represent the characteristics of the population are selected, namely a family with one of the family members suffering from Diabetes Mellitus. Family health promotion significantly provides a change for the better towards improving the role of the family in the management of family members with DM as shown from the pre-test and post-test data which is then tested with the Kendal tau test on all components of the management of family members with DM. There is a significant influence between family health promotion on improving the role of the family in the management of family members with DM at the Kebakramat 1 Health Center where there is an improvement in the role of the family in the management of family members with DM.

Mental health promotion and prevention interventions in families with parental depression: A randomized controlled trial

BackgroundThe transgenerational transmission of affective disorders calls for integrating promotion of child development in the services offered to families with parental depression. The main objective of the present research was to examine the effectiveness and differences in the impact of two relevant interventions in Greece. MethodsThirty families of depressed patients were randomly assigned to the six-to-eight session Family Talk Intervention group and 32 families were included in the lower intensity parent-only two-to-three session Let's Talk about the Children group. Depressed parents and the eldest of their children were assessed prior to the interventions and 4, 10, and 18 months following baseline assessment. ResultsIn both groups there were significant improvements in parent's depression, anxiety, perceived social support, parenting and family functioning, as well as improvements in child's depression, anxiety, and child emotional/behavioral problems. Child's prosocial behavior, perceived social support, and health-related quality of life were significantly improved in both groups. All positive effects were evident four months following baseline assessment and could be still documented at 1.5-year follow-up. Mixed linear models showed that family functioning and parenting to a lesser extent were associated with the greatest changes in children's psychosocial outcomes in both interventions.. LimitationsThe lack of data regarding parents that refused to receive the interventions may limit generalizability of results. A further limitation is the lack of a no-intervention control group. ConclusionsThe study offers a preliminary evidence base for integrating preventive interventions for child mental health in routine clinical practice with adult depressed patients.

Newly qualified health visitor: Working with families to help reduce obesity

With the government publishing a policy paper on obesity in July 2020, Bethany Boddy looks at the health visitor role in early identification, health promotion and intervention for families

26.E. Workshop: Context and practice of health literacy foundations

Abstract The Shanghai declaration (WHO 2016) stated the role that health literacy (HL) may play in the struggle for more equitable society. Moving from good intentions to social practices of HL reveals that the social context where HL is embedded is a key determinant of the establishment of social practices that may play a critical role in wellbeing and quality of life. Exploring how the translation of HL into a social context is achieved or how the social context may determine strategies to face the challenges that HL production need, is a relevant domain in the public health and health promotion agenda. The aim of this workshop is to share with the audience an opportunity to immerse in five social contexts and explore their HL practices. The first perspective is from Cameroon and the emphasis is on HL role in increasing health knowledge. The authors share the results of an ethnographic analysis of the role of school children in the development of HL in families. The second presentation will unveil one of the topics that is influencing health and well-being of children today when a large struggle to counter act sugar beverages is at the root of obesity. Therefore, a study case from Portugal will focus on HL impact on nutrition status and water intake in children showing the relevance of the social context considered a way forward in the struggle for health promotion. From Germany a third presentation will consider migrants and refugees children's role in promoting the family HL. Recent research on HL stresses the importance of the social context for children's HL, especially among vulnerable groups such as migrants and refugees. However, reaching migrants is difficult, so experts recommend adult second language courses (SLC) as promising settings to promote HL of migrants and their families. Yet, empirical evidence of promoting family health literacy (FHL) in SLC is scarce and therefore addressing such a topic is seminal towards improving the Shanghai HL vision above referred. In Switzerland, adolescent's mental health promotion is the focus of a psychoeducational tool in the pediatric primary care (PPC) that will be considered in the fourth presentation. The aim is to scrutinized this social context, increase mental health literacy of adolescents by implementing proactive mental health strategies and create an opportunity for open discussion with their pediatrician about mental health. Finally, the fifth presentation aims at illuminating (digital) HL practices using applied linguistics. HL is key to making well-informed health decision in analogous and virtual social situations and organizational contexts. Multiple models and instruments of HL exist, but an in-depth understanding of the various HL-related everyday life situations and their digital and linguistic requirements are scarce. Here, the expertise and necessary skills for everyday communication, including health, are the object of an ethnographic research to help fill this gap. Key messages The relevance of the social context and how changes of this context can lead to transformations that influence health literacy of children is a way forward in the struggle for health promotion. share with the audience an opportunity to immerse in five social contexts and explore their HL practices.

Migrants and refugees’ children’s role in promoting the family health literacy in second language courses

Abstract Background Recent research on health literacy (HL) stresses the importance of the social context for children's HL, especially among vulnerable groups such as migrants and refugees. However, reaching migrant is difficult, so experts recommend adult second language courses (SLC) as promising settings to promote HL of migrants and their families. Yet, empirical evidence of promoting family health literacy (FHL) in SLC is scarce. The project SCURA, funded by the German Federal Ministry of Education and Research, therefore aimed at exploring how FHL is addressed in SCL and to develop an FHL promoting intervention. Methods We conducted a mixed-method study, including a scoping study on empirical evidence of HL in SLC (N = 17), analyses of international curricula (N = 22) and of German textbooks (N = 24), participant observation in two SLC (100 hours), expert interviews (N = 15) triangulated the findings and conceptualized an FHL intervention. Results Whereas health is a preferred topic in SLC because it is interesting, and engaging and included in the standard SLC curricula, FHL is rarely targeted and not defined. Qualitative data reveal a vast scope of FHL related occasions offering possibilities to improve parents' health knowledge, communication skills and health literacy. Based on the results, we developed and implemented a multi-modal diversity sensitive FHL program, integrated into SCL, that targets parents' and children's physical, mental and social health topics, promotes FHL, and empowers migrant families to make good health decisions within their new context. Conclusions Currently, standard SLC rarely target FHL in the curriculum, but FHL topics are informally discussed. Hence, training teachers to use the upcoming FHL topics to teach the second language is a win-win-solution for it achieves both aims: increasing HL and language skills.

Building the Pediatric Practice of the Future: Care Innovation for Families Facing Adversity

Background Pediatric primary care plays a central role in promoting the health and well-being of young children. Although significant advances have been made in pediatrics, such as behavioral health integration, additional innovations are required to reduce disparities and promote family health. Systemically addressing the unmet needs of families facing adversity requires health systems to bring together child serving sectors with the voices of families to put every child on a path to a healthy, resilient life. Approach The Center for the Urban Child and Healthy Family was established by the …

Parent Stress as a Consideration in Childhood Obesity Prevention: Results from the Guelph Family Health Study, a Pilot Randomized Controlled Trial.

Parents’ stress is independently associated with increased child adiposity, but parents’ stress may also interfere with childhood obesity prevention programs. The disruptions to the family dynamic caused by participating in a behaviour change intervention may exacerbate parent stress and undermine overall intervention efficacy. This study explored how family stress levels were impacted by participation in a home-based obesity prevention intervention. Data were collected from 77 families (56 fathers, 77 mothers) participating in the Guelph Family Health Study (GFHS), a pilot randomized control trial of a home-based obesity prevention intervention. Four measures of stress were investigated: general life stress, parenting distress, depressive symptoms, and household chaos. Multiple linear regression was used to compare the level of stress between the intervention and control groups at post-intervention and 1-year follow-up, adjusted for baseline stress. Analyses for mothers and fathers were stratified, except for household chaos which was measured at the family level. Results indicate no significant differences between intervention and control groups for any stress measure at any time point, indicating a neutral effect of the GFHS intervention on family stress. Future work should investigate the components of family-based intervention protocols that make participation minimally burdensome and consider embedding specific stress-reduction messaging to promote family health and wellbeing.

Model-Based Family Health Promotion To Improve The Quality Of Life Of Children Aged 2-4 Years

Children aged 2-4 years are a golden period as a basis for the next development. Because the primary care role of children under five is by families, it is necessary to do family-based health promotion. Model health promotion information-motivation-behavioral skills s implemented in the form of family assistance activities. Namely the family assistance model by providing information, motivation, and examples of behavioral skills in parenting children under five.
 The purpose of this research is knowing the effectiveness family-based model of health promotion models in formation-motivation-behavioral (IMB) skill s to the quality of life for toddlers 2-5 years. Pure design experiment using Randomized Controlled Trial with pre-post test with a single-blind control group. The research subjects are toddlers aged 2-4 years many 60, who meet the criteria have significant congenital abnormalities and not multiple. The instrument of this study is a Guide to family-based health promotion models, with the research instrument being the Pediatric Quality of Life Inventory (PedsQL ™) Questionnaire.
 The health promotion model of information-motivation-behavioral skills (IMB) is carried out in the form of family mentoring activities to improve the quality of life of children aged 2-4 years ( p-value0,000). The average enhancement child's quality of life score, more large ( mean difference 16.90, p-value 0,000 ) in the group experiment ( IMB Model ) compared the control group. External variables that affect the quality of life of children aged 2-4 years are income and parenting parents.

Health and Life Satisfaction Among Parents of Children with Physical Disabilities

The current study examined patterns of self-reported health and life satisfaction among parents of children with and without physical disabilities. Although research has shown that parents of children with disabilities face numerous challenges, no studies to date have exclusively focused on samples comprised entirely of families at risk for poverty and dissolution. The present study examines potential impacts of child disability on parent well-being above and beyond economic and social factors. The current study used data from the Fragile Families and Child Wellbeing Study. Statistical analyses compared self-reported physical health and life satisfaction between parents of children with and without disabilities, controlling for numerous demographic and financial factors. The resulting sample was families of 4324 children, including 115 children with physical disabilities. Although parents of children with disabilities reported lower levels of health and life satisfaction over time, these differences did not exist for mothers when controlling for demographic and financial factors. However, child disability still significantly predicted fathers’ health beyond measures of poverty, education, and race. Even among at-risk populations, the presence of a child disability can have an impact on parents’ health and well-being. Parents of children with disabilities at risk for poverty and dissolution likely need additional, specialized supports and services to promote family health.

Communicating with migrants: children’s health literacy, digital technology, health promotion tools

Abstract Background Being a migrant can enact road blocks in the process of integration, if language barriers persist in the communication between health professionals and migrants. Moreover, health literacy levels (HL) can differ, based on different cultural contexts or conceptions of health and illness. This research aims at exploring migrants (digital) HL and the mediating role of migrant’s children in primary health care setting. Health professionals’ resort to migrants’ children as interpreters and mediators has been highlighted with the younger generations’ digital literacy, as critical tools to overcome such barriers. Assessing and promoting migrant’s HL is a public health mandate in the promotion of individual and family health to establish a common ground base for communication. Methods A qualitative and ethnographic study based on narratives, participant observation, focus group and ethno biographic interviews with nurses, migrants, medical doctors and intercultural mediators, involved 52 participants in a primary health care setting in Santarém district, Portugal. Partnership with the Observatory for Migration, the High Commission for Migration (ACM) and with migrant associations, enabled the completion by migrants of an online questionnaire focusing on digital HL. Results Migrants’ children were identified as facilitators in the clinical setting at three levels: the communication, HL promotion and adherence to continuity of care. Conclusions Improve migrant’s HL and health decisions is feasible when considering several strategies to overcome cultural barriers. Migrants’ children are potential mediators in the process of communication between health professionals and adults. Awareness of their potential allows adjustments in the primary health care sector. The need to further investigate migrants’ HL and digital HL (e.g. telephone translation services, Internet-based tools for scheduling health appointments) are some tasks that need further research.

Health promotion around the birth

Abstract Background With the “Child Protection Act” in 2012, the Prevention Law in 2015 and the new health goal ’Health around Birth’ in 2017, the framework conditions for health promotion and prevention in pregnancy have improved. This takes into account the fact that health behavior is essentially determined by embryonic and early childhood experiences in families. Methods First: Analyzing the family-related legal regulations by Early Helps and the Prevention Act as well as the health goal “Healthy Birth”; Second: Analyzing data from 153 interviews with socially disadvantaged mothers; Third: Collecting mothers’ impressions (in citations) about physiological, psychological and social coping factors; Fourth: Analyzing conceptually and within different phases of pregnancy (orientation-, self-conception-, subject conception-, anticipation- and birth phase) and postnatal phases (postpartum, family becoming, stabilization and socialization to society) phase-specific prevention needs and potentials identified as well as examples of health promotion. Results Pregnancy and becoming a family are associated with different coping requirements, which should be treated specifically according to phases and social conditions. A tailored analysis provides a variety of methods and approaches for health promotion, which can be offered via setting-approaches or in individual counseling and support. They can be described as parts of family health promotion, which should be designed as a joint task of the health service and child and youth welfare as well as other local actors. Discussion Family health promotion is a complex challenge for the actors in the care, in the social area and in the control levels. It requires an independent, scientifically justified intervention approach with method programs and institutional assignments. Key messages Pregnancy and becoming a family are associated with different coping requirements. It requires an independent, scientifically justified intervention approach with method programs and institutional assignments.

학령기 아동의 알레르기 질환 유병률과 관련요인: 국민건강영양조사 자료[2013~2016] 활용

Purpose: The purpose of this study was to examine factors affecting the prevalence of allergic diseases among school-aged children in order to establish a theoretical basis for a family-centered nursing intervention. Methods: A secondary data analysis study design was adopted. This study used raw data from the sixth (2013~2015) and seventh (2016) Korea National Health and Nutrition Examination Surveys, and 1,750 school-aged children (7~12 years) participated in the survey. The allergic diseases included allergic rhinitis, atopic dermatitis, and asthma. Data were analyzed using descriptive statistics, chi-squared tests, and multiple logistic regression. Results: Of the participants, 53.2% and 46.8% were boys and girls, respectively. The prevalence of allergic diseases was 38.6%. In the multiple logistic regression, girls had a 0.76 times lower risk of developing allergic diseases than boys (95% confidence interval [CI] = 0.62~0.93), and senior elementary school students (10~12 years) had a 1.24 times higher prevalence of allergic diseases (95% CI = 1.02~1.52) than junior elementary school students (7~<10 years). Families with three or more generations had a 0.60 times lower risk of allergic diseases than one-or two-generation families (95% CI = 0.60~0.93). Parents with allergic diseases showed a development of allergic diseases 2.27 times (95% CI = 1.84~2.80) higher than parents without allergic diseases. Allergic diseases were 0.58 times (95% CI = 0.37~0.90) less common in parents in average health and 0.61 times (95% CI = 0.39~0.96) less common in parents in good health than in parents in poor health. Conclusion: The findings of this study suggest that senior male school age children from one or two-generation families, having parents with allergic diseases or poor health status need special attention to prevent and manage allergic diseases. Future research in health promotion for families at high risk of allergic disease is warranted to prevent and manage potential allergic disease in school age children.

중년기의 가족저녁식사와 가족건강성 간 가족차생활의 매개효과

The purpose of this study was to analyze the mediating effect of middle-aged family tea life on the relationship between family dinner and family health. For this purpose, a survey was conducted from April 20, 2018 to April 30, 2018. Data of 339 married men and women aged 40-64 years were used for analysis. The main results of this study can be summarized as follows. First, the family dinner activities of middle-aged married men and women were average 3.83 points out of 5 points. Family tea life activities showed an average of 3.46 points out of 5 points. Second, the family health of the subjects showed an average of 3.98 points out of 5 points. It was found that finding the related variables that can enhance the family health of middle-aged people is a temporal issue. Third, family health was statistically correlated with family dinner and family tea life. Fourth, as a result of the three-step regression analysis, the partial mediating effect of family tea life between family dinner and family health was verified. In conclusion, middle-aged family tea life is a factor influencing family health with family dinner, and it is a meaningful mediating variable between family dinner activity and family health promotion. In the future, it will be necessary to activate the tea life of the middle-aged family so that the health of the family can be improved complementarily with the family dinner.

Provimento e fixação de médicos na atenção primária à saúde no estado da Bahia

Resumo Este artigo analisa as estratégias de gestão do trabalho da Fundação Estatal Saúde da Família (FESF-SUS), criada para suprir a necessidade de médicos no Estado da Bahia. Objetiva contribuir com o debate acerca das dificuldades de provimento e fixação de médicos na Estratégia Saúde da Família (ESF). A pesquisa consistiu em um estudo de caso, por meio de diversas estratégias metodológicas, destacando-se a análise documental. Os achados apontam como solução a criação de uma carreira intermunicipal. A proposta de gestão do trabalho da Fundação Estatal Saúde da Família (FESF-SUS, n.d.) incluiu os seguintes aspectos: remuneração variável, mobilidade do trabalhador entre os municípios e fatores associados ao suprimento de médicos. A complexidade dessa proposta se depara com a ausência de experiência na gestão desse modelo e também com as questões estruturais e institucionais que marcaram historicamente a gestão do trabalho nos municípios.

A Program Model Describing a Community-Based Mother and Infant Health Program.

The objective of this study was to formulate a MOMS Orange County program model to describe the components and function of a successful community-based maternal and infant health program. A logic framework was used to guide the development of the MOMS program model. Twenty-five MOMS staff members were interviewed; MOMS documents and existing research literature were reviewed. Content analyses were used to identify themes of interviews and the review guide was used to summarize the documents. The key components of the MOMS program were identified to formulate a narrative and graphic model. The main elements of this model included: target population (underserved women who have low socioeconomic status and have limited access to healthcare in Orange County); theoretical assumptions (social determinants of health, human ecology, self-efficacy); goals (empower women, enhance health of infants, strengthen families); inputs (funded by public and private sources; 50 staff members); activities (care-coordination home visitation community-center group health education); outputs (the number of home visitations, referrals to medical and/or psychological services, and group health education classes); and outcomes (short-term: healthy pregnancy, birth outcomes, family support; medium-term: postpartum well-being, infant development, family functioning; long-term: women's well-being, children's development, family relationships. Future research should test how this model functions to empirically improve maternal, newborn, child, and family health. The MOMS program provides a new approach to community-based maternal and infant health interventions focusing on health promotion and disease prevention for underserved families in socioeconomically disadvantaged communities.

Evidence-based Health Promotion for Youth, Farmers and Families of the Gore Community: A Focus on Mental Health and Family Violence

Evidence-based Health Promotion for Youth, Farmers and Families of the Gore Community: A Focus on Mental Health and Family Violence

Structural and Contextual Patterns in Family Health History Knowledge among African American Adults: A Mixed-Methods Social Network Analysis Study*

Abstract Background: Family health history is a strong risk factor for many chronic diseases. Ethnic minorities have been found to have a low awareness of their family health history (FHH), which may pose a contributing factor to health disparities. Purpose: The purpose of this mixed-methods social network analysis study was to identify structural and contextual patterns in African American adults’ FHH knowledge based on interpersonal communication exchanges with their family members. Methods: African American adults completed individually administered family network interviews. Participants’ 3-generation family pedigree served as a visual aid to guide their interview. Our primary outcome of interest for this analysis was whether a family member was reported as someone who talks to the participant about their own (i.e., the family member’s) health, which we refer to as a “personal health informant.” To contextualize quantitative findings, participants were asked to describe how they learned about the health history of the relatives they identified during their interview. Results: Participants (n=37) reported an average family network size of 29.4 relatives (SD = 15.5; Range = 10-67). Each participant, on average, named 17% of their familial network as personal health informants. Multivariate regression results showed that participants were more likely to name an alter as a personal health informant if the alter was female (OR = 2.14, p = 0.0519), from the maternal side of the participant’s family (OR = 1.12, p = 0.0006), had one or more chronic health conditions (OR = 2.41, p = 0.0041), was someone who has discussions with the participant about the participant’s health (OR = 16.28, p &lt; 0.0001), was a source of family health information (OR = 3.46, p = 0.0072), and was someone whose health the participant helps to monitor or track (OR = 5.93, p = 0.0002). Complementary qualitative findings indicate that FHH knowledge is facilitated by open, direct communication among relatives. Personal health informants were described as disclosing information for the purposes of informing others for preventive purposes and for gaining social support. Participants also learned about FHH via other methods, including direct observation, during caretaking, and following a relative’s death. Conclusions: Communication and disclosure practices is an important determinant of African Americans’ FHH knowledge. More culturally and contextually meaningful public health efforts are needed to promote family health history sharing, especially regarding paternal family health history, siblings, and extended relatives.

Testing the Family Health Promotion Model for Family Having Children with Duchenne Muscular Dystrophy/Spinal Muscular Atrophy

The global role of action of family health promotion in all aspects of family health behavior, family health capacity, and family health status has received inadequate empirical examination relative to its potential significance, notably within a causal model pathway. The purposes of the study were to determine whether family health capacity and family health status maintain internal and external dimensions that influence family health behavior/family health status and analyze the predictive factor influence on major variables in the theoretical model of family health promotion. Analyses were conducted on data derived from 86 families that were affected by Duchenne muscular dystrophy (DMD) or spinal muscular atrophy (SMA). The participants (113; mean age, 42.68 years) including parents, siblings, patients, and caregivers completed self-reported questionnaires. Family support and family hardiness were the mediators on family general health, family general function, and family health behavior. Family support produced a mediator effect on general family function through the power to propose ideas/plans. However, general family health produced a mediator effect on general family function through geography, family support, and family hardiness, as well as a mediator effect on family health behavior through family support and family hardiness, and represented by family monthly income. Families were important sources of interpersonal influence that could increase or decrease commitment, challenge, or control to health promotion behavior.

Implementing the Baby One Program: a qualitative evaluation of family-centred child health promotion in remote Australian Aboriginal communities

BackgroundA healthy start predicts better health in later life. Many remote-living Aboriginal and Torres Strait Islander Australian families lack access to consistent, culturally-safe health services. This paper presents a study of implementation of the Baby One Program (BOP). The BOP was designed as a family-centred, Indigenous Healthworker-led, home-visiting model of care focused on promoting family health to give children the best start to life. It was developed by Aboriginal community-controlled Apunipima Cape York Health Council and delivered in Queensland Cape York remote communities. We aimed to determine how the BOP was implemented, enablers, strategies used and formative implementation outcomes.MethodsThe qualitative approach utilised theoretical and purposive sampling to explore people’s experiences of a program implementation process. Data were generated from semi-structured interviews with four family members enrolled in the BOP and 24 Apunipima staff members. In addition, twenty community members, including two program users, participated in a men’s community focus group. The findings are presented according to themes arising from the data.ResultsThe BOP was rolled out in nine remote Cape York communities between July 2014 and December 2015 and there was high uptake. Indigenous Healthworkers were supported by midwives and maternal and child health nurses to deliver health education to 161 eligible families. The key to effective implementation of family-centred care appeared to be the relationships formed between health practitioners, especially Indigenous Healthworkers, and families. The data revealed the following themes: challenging environments for new families and valuing cultural ways, resourcing program delivery, working towards a team approach, negotiating the cultural interface, engaging families, exchanging knowledge through ‘yarning’, strengthening the workforce, and seeing health changes in families. Healthworker education and training, and knowledge exchange between Healthworkers, midwives and nurses was critical to program effectiveness. The program continues to grow despite substantial logistic, financial and practical challenges.ConclusionsThis study describes an evolving process and explores how health providers connect with families and how the program responds to family and cultural issues. Program development is ongoing; strengthened by more community-level involvement, embedded strategies for ongoing self-evaluation and continuous quality improvements that are responsive to family needs.