UNSW, Sydney, New South Wales, Australia
UNSW, Sydney, New South Wales, Australia.
BMJ Open. 2022 Aug 30;12(8):e061002. doi: 10.1136/bmjopen-2022-061002.
Continuity of child and family healthcare is vital for optimal child health and development for developmentally vulnerable children. Migrant and refugee communities are often at-risk of poor health outcomes, facing barriers to health service attendance including cultural, language, limited health literacy, discrimination and unmet psychosocial needs. 'Integrated health-social care hubs' are physical hubs where health and social services are co-located, with shared referral pathways and care navigation.
Our study will evaluate the impact, implementation and cost-benefit of the First 2000 Days Care Connect (FDCC) integrated hub model for pregnant migrant and refugee women and their infants.
This study has three components. Component 1 is a non-randomised controlled trial to compare the FDCC model of care with usual care. This trial will allocate eligible women to intervention and control groups based on their proximity to the Hub sites. Outcome measures include: the proportion of children attending child and family health (CFH) nurse services and completing their CFH checks to 12 months of age; improved surveillance of growth and development in children up to 12 months, post partum; improved breastfeeding rates; reduced emergency department presentations; and improved maternal well-being. These will be measured using linked medical record data and surveys. Component 2 will involve a mixed-method implementation evaluation to clarify how and why FDCC was implemented within the sites to inform future roll-out. Component 3 is a within-trial economic evaluation from a healthcare perspective to assess the cost-effectiveness of the Hubs relative to usual care and the implementation costs if Hubs were scaled and replicated.
Ethical approval was granted by the South Eastern Sydney Local Health District Human Research Ethics Committee in July 2021 (Project ID: 020/ETH03295). Results will be submitted for publication in peer-reviewed journals and presented at relevant conferences.
ACTRN12621001088831.
儿童和家庭医疗保健的连续性对于发育脆弱儿童的最佳儿童健康和发育至关重要。移民和难民社区往往面临健康状况不佳的风险，他们在参加医疗服务方面面临着各种障碍，包括文化、语言、有限的健康素养、歧视和未满足的心理社会需求。“综合健康社会护理中心”是医疗和社会服务集中的实体中心，具有共享的转诊途径和护理导航。
我们的研究将评估针对孕妇和移民难民及其婴儿的“头 2000 天关怀连接”（FDCC）综合中心模式的影响、实施情况和成本效益。
本研究有三个组成部分。第一部分是一项非随机对照试验，旨在比较 FDCC 护理模式与常规护理。该试验将根据妇女与中心地点的接近程度，将符合条件的妇女分配到干预组和对照组。结果测量包括：接受儿童和家庭健康（CFH）护士服务并完成 CFH 检查至 12 个月大的儿童比例；12 个月大时儿童生长发育监测的改善；提高母乳喂养率；减少急诊就诊；改善产妇福祉。这些将通过链接的医疗记录数据和调查进行测量。第二部分将涉及混合方法实施评估，以阐明 FDCC 如何以及为何在各站点实施，为未来的推广提供信息。第三部分是一项基于试验的经济评价，从医疗保健的角度评估中心相对于常规护理的成本效益，以及如果中心扩大和复制的实施成本。
2021 年 7 月，东南悉尼地方卫生区人体研究伦理委员会批准了该研究的伦理批准（项目 ID：020/ETH03295）。结果将提交给同行评议期刊发表，并在相关会议上展示。
ACTRN12621001088831。
