Social Care Providers Research Articles

A Community of Practice to increase education and collaboration in dementia and ageing research and care: The Liverpool Dementia & Ageing Research Forum.

Too often, dementia research is conducted in research silos without thorough integration and the involvement of people with lived experiences, care professionals and the Third Sector. Research can also get lost in academic publications, without reaching those benefiting most from the evidence. The aim of this methods and evaluation paper was to outline the aims, components and evaluation of the public-facing and -engaging Liverpool Dementia & Ageing Research Forum, to provide a blueprint for setting up similar communities of practice. The Forum was set up in 2019 with the aim to (a) connect different stakeholders in dementia and ageing and co-produce research and to (b) inform and educate. This paper provides an account of the Forum model and evaluates the following key elements: (1) engagement; (2) experiences of the Forum and its impact (via an online evaluation survey and three reflections). All Forum members and attendees were asked to complete a brief evaluation survey about their experiences from October to November 2022. Three regular Forum attendees provided a case study about their involvement and its impact. The Forum has reached out to diverse stakeholders and the general public, generating growing interest and engagement since its initiation. Forty-four members and attendees completed the survey. Most attendees completing the evaluation survey have so far engaged in between 5 and 20 activities (47.8%), and 91% felt the aims of the Forum have been met. Engaging in the Forum has produced various benefits for attendees, including increased research capacity and knowledge, as well as improved connectivity with other stakeholders. Eleven percent of respondents, 39% of lived experts, stated they experienced improved access to postdiagnostic care. This is the first reported multistakeholder Community of Practice (CoP) on dementia and ageing. We make key recommendations for setting up and running similar dementia CoP, as they provide a noninterventional format for raising awareness, capacity and access to dementia care. This paper reports on the involvement and engagement of people with dementia, unpaid carers, health and social care providers and Third Sector organisations in a CoP.

Changing the paradigm in health and care services: modern value chains using open innovation for the creation of new digital health solutions.

Digital Health is a subject of extensive discourse when considering its current and future significance. This significance arises from a convergence of various factors, including the escalating capabilities and cost-effectiveness of computing and communication technology, coupled with the mounting demands and challenges faced by healthcare systems. The integration of health and technology, when studied collectively with the purpose of addressing tangible real-world issues, holds the potential to generate substantial outcomes that greatly influence the provision of clinical and social care, thereby enhancing the overall well-being of both individuals and populations. In this sense, in this paper we propose a collaborative approach, using Open Innovation, where the most relevant stakeholders-health and care professionals, citizens and companies-work together to develop and validate innovative digital solutions for health and care. We have called this approach of value co-creation the Collaborative Ecosystem, and we focus specifically on the potential development of the Regional Ecosystem for Collaborative Innovation in Digital Health and Care, and the envisioned implications of its implementation in economic and social dimensions.

Boko Haram Insurgency and Socio-Economic Crisis in Borno State Nigeria

<p>So much has been written about the formation and activities of the Boko Haram insurgency since its advent in 2002 as religious fundamentalism. The Islamic sect is a group of "People Committed to the propagation of the Prophet's Teachings and Jihad" opposing western education. Their operations have degenerated into armed conflict, insurgency and terrorism, causing untold devastation and economic loss to some states of the federation. However, their significance in the socio-economic crisis of Borno State has not been adequately reported. This is the lacuna filled by this paper. The study adopted both primary and secondary sources of research instruments. The study discovered that Boko Haram insurgency has crippled markets, business activities and blocked the trade routes in Borno State. About 10,000 Eastern and South western business people fled the state; international business entrepreneurs from Chad, Cameroon and Niger returned to their countries; these affected the State's economic revenue in an unimaginable way, with negative implications on the sustainable development agenda of the United Nations. The Study recommends, among other things, adequate security measures, provision of social support system and care, provision of jobs and social amenities, development of infrastructures, reconciliation among local communities, reduction of poverty, a proactive step by the Federal government on supply of adequate funding, weapons and well-equipped military personnel to put an end to the insurgency in North Eastern Nigeria.</p>

“Coming out of the closet about sexual assault”: Intersectional sexual assault stigma and (non) disclosure to formal support providers among survivors using Reddit

Sexual assault is a pervasive, violent and often gendered crime that can result in significant negative consequences. Many sexual assault survivors consider disclosing to health and social care providers, therapists, and others who collectively fall under the banner of formal support, in order to access information, referrals, treatment and/or emotional support, however barriers to disclosure remain. This qualitative study is unique in its application of an intersectional sexual assault stigmatization framework to understand (non)disclosure to formal support providers among diverse sexual assault survivors. Through anonymous online narratives posted to the platform Reddit, survivors documented experiences of intersectional sexual assault stigma (perceived, internalized, anticipated, experienced) showing that they were not only stigmatized through negative gender stereotyping, but they were also marginalized through other structural inequities. The experience of multiple marginalization that arose from intersectional sexual assault stigma often impeded survivors in accessing and/or utilizing the formal support they wished for. The findings suggest that formal support providers could benefit from stigma reduction training related specifically to sexual assault survivors and that current models of stigma and discrimination training need to be expanded to include intersectional stigma. Further, the findings suggest that beyond training at an organizational level, a broader intervention aimed at reducing structural stigma and discrimination toward sexual assault survivors at a societal level appears warranted. Implications for future research related to the unique disclosure, health, and social care needs of diverse sexual assault survivors and support-seeking online alongside or in lieu of formal support are discussed.

Identifying facilitators and barriers to integrated and equitable care for community-dwelling older adults with high emergency department use from historically marginalized groups

BackgroundHigh rates of emergency department (ED) use by older adults persist despite attempts to improve accessibility of appropriate and comprehensive care. Understanding the drivers of ED visits from the perspective of older adults from historically marginalized groups could help reduce ED use by patients with needs that are preventable or could have been treated in a more appropriate setting. This interpretivist, feminist study aims to explore the unmet care needs of older adults (age 65 +) with high ED use and belonging to historically marginalized groups to better understand how social and structural inequities reinforced by neoliberalism; federal and provincial governance structures and policy frameworks; and regional processes and local institutional practices, shape the experiences of these older adults, particularly those at risk of poor health outcomes based on the social determinants of health (SDH).Methods/designThis mixed methods study will employ an integrated knowledge translation (iKT) approach, starting with a quantitative phase followed by a qualitative phase. Older adults self-identifying as belonging to a historically marginalized group, having visited an ED three or more times in the past 12 months, and living in a private dwelling, will be recruited using flyers posted at two emergency care sites and by an on-site research assistant. Data obtained through surveys, short answer questions, and chart review will be used to compile case profiles of patients from historically marginalized groups with potentially avoidable ED visits. Descriptive and inferential statistical analyses and inductive thematic analysis will be conducted. Findings will be interpreted using the Intersectionality-Based Policy Analysis Framework to identify the interconnections between unmet care needs, potentially avoidable ED admissions, structural inequalities, and the SDH. Semi-structured interviews will be conducted with a subset of older adults at risk of poor health outcomes based on SDH, family care partners, and health care professionals to validate preliminary findings and collect additional data on perceived facilitators and barriers to integrated and accessible care.DiscussionExploring the linkages between potentially avoidable ED visits by older adults from marginalized groups and how their care experiences have been shaped by inequities in the systems, policies, and institutions that structure health and social care provision will enable researchers to offer recommendations for equity-focused policy and clinical practice reforms to improve patient outcomes and system integration.

Measures of Shared Decision Making for People With Mental Disorders and Limited Decisional Capacity: A Systematic Review.

Shared decision making (SDM) is a health communication model to improve treatment decision making and is underused for people with mental health conditions and limited, impaired, or fluctuating decisional capacity. SDM measures are essential to enhancing the adoption and implementation of SDM practices, yet no tools or research findings exist that explicitly focus on measuring SDM with such patients. The aim of this review was to identify instruments that measure SDM involving individuals with mental health conditions and limited decisional capacity, their family members, and their health and social care providers. A systematic review was performed by searching the PubMed, Embase, Web of Science, and PsycInfo databases. The authors included peer-reviewed, quantitative articles published in English during 2009-2022 that focused on adults (≥18 years old). All authors performed the screening independently. A total of 7,956 records were identified, six of which met the inclusion criteria for full-text review and five of which were analyzed (one full-text article was not available). No instruments were identified that measured forms of SDM involving patients with mental health conditions and limited, impaired, or fluctuating decisional capacity. Measurement instruments to address and assess SDM in health care-related communication processes involving individuals with a mental health condition and limited decisional capacity are needed.

Disability policies, transnationalism and policy diffusion: ‘Asocial’ models of inclusion for children and youth in low and middle-income countries (LMICs)

This paper examines the advances made by low- and middle-income countries (LMICs) in the inclusion of children with disabilities and youth within mainstream policies on education, employment, health, and social care provisions and the implications on their outcomes. Theoretically, this paper advances critical disability studies and addresses stigma and discrimination as barriers to progressive social policies. It also critically examines the diffusion of the social model of disability, which finds expression in the Convention on the Rights of Persons with Disabilities (CRPD). Methodologically, this paper uses latent class analysis (LCA) to analyse clusters of LMICs, regarding the adoption of social-legal provisions as stipulated by the CRPD. Finally, the paper concludes with a paradigm shift within the sociology of disability towards a sociology of enablement within the fold of emancipatory politics that addresses stigma and discrimination.

Innovative management of the social sphere in the context of digitalization

The paper investigates the implementation of digital solutions and technologies in the social services for senior citizens in terms of the national project “Demography”. Current changes, according to the author’s position, form a new and problematic area for the management of social processes at the stages of planning, forecasting, control, and exchange of information. The development of information systems and electronic services is only one aspect of the multifactorial nature of the current situation. The main task is to solve the problem of interdepartmental fragmentation of participants in the system of long-term care for senior citizens and regulatory legal acts. Therefore, modern tendencies of studying and introduction of the positive experience of regions, search and systematization of information on effective methods of working with the population were analyzed, and examples of successful practices of innovative management were given. In addition, information products for different types of organizations were analyzed, and the modern system of interdepartmental interaction between healthcare and social service organizations in the provision of social services and medical care for senior citizens was assessed. Moreover, major problematic issues of interdepartmental interaction between healthcare and social service organizations in the provision of social services and medical care for senior citizens and the prospects for the effective development of resources of social service providers in the implementation of strategic sectoral development were identified. Consequently, recommendations on improving the efficiency of interdepartmental interaction in the system of social services and ways of exchanging information were offered. Particular attention was focused on the factors that inhibit innovation processes in the implementation of digital solutions and technologies in the activities of social services. In conclusion, the guidelines for the formation and development of innovative potential in the system of social services were specified.

A Conceptual Model to Share Resources and Align Goals: Building Blockchain Application to Support Care Continuity Outside a Hospital

The increased use of advanced technologies by consumers and hospitals is moving care closer to patients, and the challenge is one of how patient data can be shared with external care providers and patients. To support care continuity, patient data include both clinical data used by external care providers and non-clinical data used by social care providers. Care coordination of a patient outside a hospital requires peer-to-peer connectivity among a number of these clinical and social care providers, using a digital platform that aligns their goals and assigns their resource sharing responsibilities. With no single entity supporting such care coordination, most hospitals currently distribute this responsibility to several of its provider partners and patients. Such a division of responsibility with no real time feedback leads to discontinuous resource sharing, localized data analysis, and challenges in tailoring care to improve health outcomes. The goal of this paper is to propose a blockchain architecture model that uses a number of constructs for creating and assigning ownership to patient data so it can support peer-to-peer resource sharing and uses smart contracts to support goal alignment. Using two blockchain applications implemented in Hyperledger and illustrating their potential representation using the constructs in multi-chain, we develop a conceptual model for developing blockchain applications in general to support continuity of care. The generalizability of this model is illustrated by applying these constructs to four additional healthcare applications. Finally, we conclude the paper with a discussion of the limitations and directions for future research.

Providers’ perspectives of the neonatal intensive care unit context and care provision for adolescent parents: an interpretive description

BackgroundThe neonatal intensive care unit (NICU) is a complex care environment, with the NICU patient population among the most vulnerable in a hospital setting. Adolescent parents are a unique group within the broader NICU parent population and admission of their infant to the NICU contributes to an already complex situation as adolescent pregnancy and parenting is often associated with a range of psychosocial challenges. How the NICU care context influences care provision for adolescent parents is a significant gap in the NICU parenting and support discourse. Therefore, this study aimed to explore health and social care providers’ perspectives of the NICU care context and how providers perceive the context as influencing the experiences of adolescent parents in the NICU.MethodsThis was a qualitative, interpretive description study design. In-depth interviews were conducted with providers, including nurses and social workers, caring for adolescent parents in the NICU. Data was collected between December 2019 and November 2020. Data were analyzed concurrently with data collection. Constant comparison, analytic memos, and iterative diagramming techniques were used to challenge developing analytic patterns.ResultsProviders (n = 23) described how the unit context influenced care provision as well as experiences for adolescent parents. We learned that having a baby in the NICU was perceived by providers as a traumatic experience for parents – impacting attachment, parenting confidence and competence, and mental health. Environmental factors – such as privacy and time – and perceptions that adolescent parents are treated differently in the NICU were also seen as influencing this overall experience.ConclusionsProviders involved in the care of adolescent parents in the neonatal intensive care unit described the distinctiveness of this group within the broader parent population and how quality of care may be impacted by contextual factors as well as experiences of age-related stigma. Further understanding of NICU experiences from the parents’ perspectives are warranted. Findings highlight opportunities for strengthened interprofessional collaboration and trauma- and violence-informed care strategies within the neonatal intensive care environment to mitigate the potential negative influence of this experience and improve care for adolescent parents.

Challenges and perspectives of palliative medicine: Awebinar by the Paediatric Virology Study Group.

Palliative medicine focuses on the quality of life of patients with incurable conditions, who require the adequate relief of physical symptoms, adequate information to make decisions and spiritual wellbeing. Generalist palliative care is provided by family members, general practitioners, care home workers, community nurses and social care providers, as well as non-specialist hospital doctors and nurses. Patients with more complex, physical or psycho-social problems require the shared work of specialized doctors in palliative medicine, nurses, social workers and allied professionals. It is estimated that ~40 million patients require palliative care annually, worldwide; of these, 8 out of 10 patients reside in low- or middle-income countries, and only ~14% are able to access this type of care. Palliative medicine was recognised as a distinct medical specialty in the UK in 1987, with its own specialist curriculum and training pathway, which was recently revised in 2022. The main obstacles that palliative medicine had to overcome in order to be accepted as a separate specialization were the following: i) Defining a unique body of knowledge; ii) standardisation of training; and iii) proving that it warranted being a specialty in its own right. Over the past decade, it has been accepted as more than end-of-life care, supporting patients with an incurable illness at much earlier stages. Given the current absence of specialized palliative care in low- or middle-income countries, as well as the aging population across most European countries and the USA, it is estimated that there may be an increasing need and demand for specialists in palliative medicine in the ensuing years. This article is based on a webinar on palliative medicine, which was performed on October 20, 2022 in the context of the '8th Workshop of Paediatric Virology' organized by the Institute of Paediatric Virology based on the island of Euboea (Greece).

456 Urinary catheterisation in the nursing home setting: challenges and opportunities in catheter use and design: a questionnaire study

Abstract Introduction Urinary catheter use is associated with a range of complications including infection, encrustation, blockage, leakage, pain and discomfort (1). There is a limited evidence-base regarding prevalence of catheterisation, and issues experienced in using urinary catheters in the nursing home (NH) population. Aim To explore the prevalence of urinary catheterisation and the types of catheters used by NH residents in a region of the United Kingdom (UK), to investigate the most common issues associated with catheter use, and to explore urinary catheter services in NHs. Methods Three different versions of a questionnaire for self-completion were designed (for NH managers, nurses and non-registered healthcare assistants), piloted and distributed to NH staff in a region of the UK, via post or online. NH managers were recruited through postal distribution to all registered NHs in the region (n=243) and via email distribution facilitated by a non-profit membership organisation representing health and social care providers. Nurses and healthcare assistants in 83 nursing homes across the region were recruited through a gatekeeper (GM: an academic care home nurse specialist and link-link lecturer from the School of Nursing and Midwifery, QUB. Questionnaires contained 47 items (managers), 48 (nurses), and 18 items (healthcare assistants), with a mixture of Likert scale questions, yes/no questions and a small number of open questions. Data were anonymised and entered into SPSS (V27) for statistical analysis. Descriptive analysis was conducted for closed-ended questions, and thematic analysis was used for open-ended questions. Results Questionnaires were completed between March and June 2022 by 162 participants. Eighty-eight responses were received from NH managers (response rate = 36.2%; 88/243). Seventy-four responses were received from nurses and healthcare assistants (31 and 43, respectively). Prevalence of catheterisation among NH residents was 6.4% (206/3226) and numbers of catheter users ranged between zero and eight per NH. Most residents (78.6%; 162/206) used indwelling urethral catheters. Almost one third of NH managers (29.5%; 26/88) and nurses (32.3%; 10/31) reported that catheters cause UTIs often and almost one in ten (8.0%; 7/88 and 9.7%; 3/33, respectively) reported a UTI occurring every time a catheter is used. Two-thirds (67.0%; 59/88) of NH managers and 58.1% (18/31) of nurses reported that catheter care training is not mandatory for all staff. Most managers and nurses agreed or strongly agreed that they had adequate catheter training in the past (80.7%; 71/88 and 74.2% 23/31, respectively), but less than half of managers and nurses reported good availability of catheter care retraining (45.5%; 40/88 and 48.4%; 15/31, respectively). Around 64.8% (57/88) of managers and 71.0% (22/31) of nurses wanted catheters to be reviewed more often than they currently are. NH managers and nurses reported difficulty in contacting specialists regarding catheter-associated problems in complex cases; only one third of managers and nurses indicated this was easy or very easy (34.1%; 30/88 and 38.7%; 12/31, respectively). Improvements to catheter design were not considered feasible by many respondents; approximately one third of managers, nurses and healthcare assistants thought improvements could be made (35.2%; 31/88, 32.3%; 10/31 and 30.2%; 13/43, respectively). Conclusion These findings highlight issues in catheter care training and management of catheter-related complications in the NH setting. Providing all NH staff, including healthcare assistants, with adequate urinary catheter training in managing catheter-associated complications has the potential to improve patient quality of life and reduce unplanned hospital visits and represents a priority for research and clinical practice. This study is the first to examine catheter prevalence and issues with use in NHs in this region of the UK. However, findings may not be generalisable to other parts of the UK or internationally.

Interprofessional care in a retirement and assisted living community: the complexity of teamwork

ABSTRACT Teamwork is an aspiration in the delivery of interprofessional care to older adults, but how does it play out in residential settings that combine independent living, assisted living, and skilled nursing care? This study investigated teamwork as an organic part of a retirement and assisted living community immersed in mission-driven care. Drawing on 44 in-depth interviews, 62 meeting observations, and five years of immersion in the setting by the first author, we explored the complex dynamics of teamwork. Our overarching findings showed that co-location aided by physical design and a mission-driven investment in care may not be sufficient to effect teamwork in a complex care environment, and that the organizational context was potentially damaging to teamwork. Our study highlights opportunities to improve teamwork and interprofessional collaboration in organizational settings that combine the provision of health and social care. Increasing expectations for teamwork outcomes may prove essential as retirement and assisted living care settings offer supportive and therapeutic environments for older adults who move between different levels of care.

“A multitude of things”: A qualitative analysis of practitioner perceived barriers to identifying and responding to childhood adversity

BackgroundChildhood adversity contributes to poor physical and mental illness across the lifespan. Given its multifaceted nature, responding to childhood adversity requires action across health and social care; but such action is complex. This study aimed to explore the barriers for practitioners across health and social services in identifying and responding to adversity. MethodsIndividual and group semi-structured interviews with 26 practitioners working across health and social care providers in Melbourne, Victoria. Interviews explored challenges practitioners experienced identifying and responding to childhood adversity. Interviews were audio recorded, transcribed verbatim and analysed using reflexive thematic analysis. ResultsFour main themes were identified. (1) “Get clues as you go along”. Practitioners relied on gut instinct or caregiver disclosure to identify adversity. (2) Out of my control. Practitioners identified systems barriers that were out of their control including lack of service availability and funding. (3) Navigating complex systems. Practitioners acknowledged challenges in knowing about available services and how to access these services. (4) “Opportunity to engage”. While practitioners identified trust as important for relationships with families, they could not describe how to improve trust. ConclusionsPractitioners encounter a “multitude of barriers” across health and social care that impede identification of, and response to, childhood adversity. Improving practitioner confidence and capability to work relationally with families, including directly asking about adversity, is critical for overcoming these barriers to systematically identify adversity in practice. Improving practitioner knowledge about community services and service navigation will be a crucial starting point.

Older adults’ experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) for diabetes self-management in Canada: a qualitative descriptive study

ObjectivesTo assess the experiences and perceived impacts of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP) from the perspectives of older adults with diabetes and other chronic conditions....

Helping family members affected by a relative’s substance use or gambling: an evaluation study of the 5-Step Method delivered in the Netherlands

Aims Research over many years indicates that individuals with problematic alcohol or drug use or gambling disorders can cause considerable burden on family members. And yet, affected family members (AFMs) are largely neglected in research, health and social care policy and provision. To address the needs of AFMs of people struggling with a substance use or gambling disorder, the 5-Step Method was developed. Methods The goal of this study is to evaluate the routinely delivered 5-Step Method in the Netherlands using measures at baseline (N = 145), and end-of-treatment (N = 102). In addition, a subsample at three-month post intervention (N = 70) was included. The intervention was delivered via video-conferencing to half (47.6%) of the participants. Findings Participants reported significantly lower rates of Total Family Burden after completing the 5-Step Method, when comparing measurements at baseline and end-of-treatment (d = 0.56), and measurements at baseline and three-month post intervention (d = 0.85). In addition, participants following the intervention via video-conferencing (N = 69) performed equally well or better compared to participants following the intervention face-to-face (N = 76). Conclusions Following the 5-Step Method for AFMs results in lower Total Family Burden. In accordance with the Stress-Strain-Information-Coping-Support (SSICS) model, the effectiveness of the intervention could be improved by finding new ways of increasing support for AFMs.

The future integrated care workforce.

The future integrated care workforce.

Філософія та паліативна медицина: питання природи людини, смерті та вмирання

The philosophical issues of palliative and hospice care, death and dying of a person - the provision of medical and social care at the terminal stages - are closely related to the development of philosophical anthropology, axiology, bioethics, ideas and concepts of humanities, philosophical, sociological, psychological doctrines of human nature. In the context of philosophical problems of death and dying, the ideas of perception of time, human fragility, the meaning of life, trauma, dignity of the individual, which form the modern understanding of the phenomena of death and dying in medical discourse, are analyzed. It is concluded that under the influence of the key ideas of philosophy, psychology, psychotherapy, palliative and hospice care should be transformed into a multidimensional activity that includes not only medical care, but also spiritual and psycho-corporeal, psychotherapeutic support, understanding of the uniqueness and spiritual dimensions of human life. No conflict of interests was declared by the author.

Intergenerational Esthetic Co-Creation Program for Promotion of Community Creative Aging

The world is facing rapid global aging. Global countries are concerned about the development of aging societies and related topics ranging from successful, healthy, and active aging in the past to the current creative aging (CA) perspective. However, in-depth research on applying esthetics to promote community CA in Taiwan is lacking. To address this deficiency, the Hushan community in Douliu City, Yunlin County was selected as the research area, and the CA perspective was adopted to promote community CA through multi-stage intergenerational esthetic co-creation (IEC) workshops. A model for applying IEC workshops to promote CA was constructed. Using the action research approach, community CA enabled the elderly to identify with their inherent values, opening new possibilities for the provision of elderly social care. This study explored the psychological impacts of implementing IEC workshops on the elderly, analyzed their interactions with peers and youth, helped the elderly review their lives, analyzed relevant data to construct a practical model for applying IEC workshops to promote CA, and provided the data collected during the multi-stage applications of CA and an IEC model for promoting CA as a reference for future researchers, thereby opening new possibilities for sustainable care in aging societies.

Critical success factors for school-based integrated health care models: Learnings from an Australian example.

Integrated school-based health services have the potential to address the unmet health needs of children experiencing disadvantage, yet these models remain poorly evaluated. The current article examines an integrated social and health care hub located on the grounds of a regional Australian public primary school, the Our Mia Mia Wellbeing Hub, to identify critical success factors for this service and others like it. Semi-structured qualitative interviews were conducted with N= 55 multi-sector stakeholders comprising parents, students, school staff, social and health care providers, and local Aboriginal community members. Interview transcripts were analysed according to a grounded theory approach. Six themes emerged from the analysis, reflecting important success factors for the model: service accessibility; service coordination; integration of education and health systems; trust; community partnerships; and perceptions of health. Findings highlighted Our Mia Mia as a promising model of care, yet also revealed important challenges for the service as it responds to the varied priorities of the stakeholders it serves. SO WHAT?: Through capturing the perspectives of a large number of stakeholders, the current study provides valuable insight into key challenges and success factors for Our Mia Mia; these learnings can guide the development of other emerging school-based health services and integrated care hubs.