Background: Community-based child and family health (CFH) services work collaboratively with parents in the early years of a child’s life to support optimal child development and positive parent-child relationships so children can thrive. Inequity, however, in health and social outcomes is pervasive, with poorer outcomes identified in rural communities. An international call to action to address the health outcomes gap for those living in disadvantaged regions has been emphasised by the World Health Organization, highlighting the need to adapt interventions and develop contextualised service models.

Aim: To explore the extent to which an Australian metropolitan service model for specialist (level 2) child and family health services can be implemented in rural and regional areas.

Method: An integrative review informed three research phases: (a) Participatory action research (PAR) in a rural setting in New South Wales (NSW), Australia to review the fit of an established metropolitan CFH service model for local context; (b) a Modified eDelphi Study to identify elements to be considered when adapting CFH service models for rural community contexts; and (c) a second PAR study in a different rural community setting to test a draft framework to guide the adaptation of CFH service models.

Results: This research identified that established CFH service models can be implemented in diverse contexts; however, scope for adaptation must be built into such service models. Flexibility and time are required to effectively engage, consult with, and co-produce innovative and culturally safe service adaptations, drawing on community strengths while addressing local needs.

Conclusions: The research findings informed the development of the framework for Collaborative Adaptation of Service Models for Child and Family Health in Diverse Settings (CASCADES) to support iterative community co-design. The benefits of community participatory co-design extend beyond the immediate service implementation to service sustainability, integration, and community capacity building. 

Implications for children and families: This research demonstrated the importance of hearing your voice and insights when adapting a service that will meet the needs of your community.

Implications for practitioners: This research has resulted in the development of a framework and toolkit of resources to support you and your colleagues when adapting an established service model for your unique community context.

Funding: Australian Government Research Training Program

Key words: families’ voices, professionals’ voices, innovations, child and family health, policy, vulnerable communities, regional/rural communities, quantitative methods

This presentation relates to the following United Nations Sustainable Development Goals:

• SDG 3: Good Health and Well-being
• SDG 10: Reduced Inequality