Effectiveness of a Digital Screening and Navigation Model in Addressing Unmet Social Needs among Parents and Caregivers in Priority Population Groups: A Randomised Controlled Trial.

内容摘要

Children and families from priority populations (e.g. culturally and linguistically diverse and regional/rural communities) often experience significant psychosocial challenges and barriers to accessing health and social care. These inequities were further exacerbated during the COVID-19 pandemic. Integrating social care with health services has been proposed as an approach to improve service access and address unmet needs. A two-site parallel randomised controlled trial was conducted in Australia between August 2021 and 2023. Parents/carers of children from priority populations were recruited through Child and Family Health services (n = 288) and randomised to the Watch Me Grow-Electronic (WMG-E) intervention (n = 145) or care as usual (n = 143). The WMG-E program comprised digital developmental screening and community navigation to relevant health and social services via a service navigator. The primary outcome was change in unmet social needs measured using the WE CARE instrument. Intention-to-treat generalised linear mixed-effects models adjusted for child developmental concerns, parental mental health, and sociodemographic factors. Unmet social needs decreased over time across both groups (β = -0.23, SE = 0.11, p = 0.036). At 12 months, the intervention group showed greater reductions in unmet needs than the control group (β = -0.35, SE = 0.17, p = 0.046), although the time × group interaction was not significant. The WMG-E platform demonstrated feasibility as a digital developmental screening and navigation tool supporting families from priority populations. WMG-E shows promise in improving access to health and social care and reducing unmet social needs; however, further research is needed to assess sustained impacts across diverse settings. The study (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st 2021, and the trial results are being reported according to recommendations in the CONSORT Statement. What is already known on this topic Significant inequities exist in the access to healthcare for priority population families with preschool children and this results in children missing opportunities for early identification and intervention for health and developmental problems.While addressing heath care inequities is critical for providing children a healthy start to life, there are no effective and systematic ways to reach such families as they do not engage with services early, and often experience significant barriers due to social care needs.Addressing health inequities by tackling social determinants of health alongside healthcare is critical to supporting families in priority population groups, aligning with the Sustainable Development Goals (SDGs) of the World Health Organization (WHO). What this study adds This study is one of the first Australian randomised controlled trials evaluating the effectiveness of a digital developmental screening program coupled with service navigation for improving unmet social care needs in multicultural and rural/regional communities.Significant reductions in unmet need scores were observed over time in both intervention and control groups, with a greater reduction in the intervention group, though no significant interaction between time and group was found.The Watch Me Grow Electronic (WMG-E) platform was shown to be a feasible and effective tool for developmental screening and navigation to address unmet social needs in diverse, priority population families.