The Building Blocks for Successful Hub Implementation for Migrant and Refugee Families and Their Children in the First 2000 Days of Life

Michael Hodgins; Katarina Ostojic; Tania Rimes; Karen Edwards; Kenny Lawson; Mevni Fonseka; Carmen Crespo; Kim Lyle; Ann Dadich; Valsamma Eapen; Rebekah Grace; Melissa Green; Amanda Henry; Nick Hopwood; Catherine Kaplun; Jane Kohlhoff; Shanti Raman; Tracey Szanto; Sue Woolfenden

doi:10.1111/hex.70082

The Building Blocks for Successful Hub Implementation for Migrant and Refugee Families and Their Children in the First 2000 Days of Life

Health Expect. 2025 Feb;28(1):e70082. doi: 10.1111/hex.70082.

Authors

Michael Hodgins¹, Katarina Ostojic², Tania Rimes³, Karen Edwards⁴, Kenny Lawson^{5

6}, Mevni Fonseka⁷, Carmen Crespo¹, Kim Lyle⁸, Ann Dadich⁹, Valsamma Eapen^{10

11}, Rebekah Grace¹², Melissa Green^{13

14}, Amanda Henry¹⁵, Nick Hopwood^{16

17}, Catherine Kaplun¹⁸, Jane Kohlhoff^{19

20}, Shanti Raman²¹, Tracey Szanto²², Sue Woolfenden^{2

23

24}

Affiliations

¹ Population Child Health Research Group, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia.
² Community Paediatrics Research Group, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
³ Child, Youth and Family Services, Population and Community Health, South Eastern Sydney Local Health District, Sydney, Australia.
⁴ Counterpoint Consulting Pty Ltd, Sydney, Australia.
⁵ Health Economics, Psychiatry and Mental Health, University of New South Wales, Sydney, Australia.
⁶ Translational Health Research Institute, Western Sydney University, Sydney, Australia.
⁷ UNSW Medicine and Health, University of New South Wales, Sydney, Australia.
⁸ Child, Youth and Family Primary and Community Health, North Sydney Local Health District, Sydney, Australia.
⁹ School of Business, Western Sydney University, Sydney, Australia.
¹⁰ Discipline of Psychiatry and Mental Health/School of Clinical Medicine, UNSW Medicine & Health, University of New South Wales, Sydney, Australia.
¹¹ Academic Unit of Infant Child and Adolescent Psychiatry Services, South Western Sydney Local Health District, Sydney, Australia.
¹² Transforming early Education and Child Health (TeEACH), Western Sydney University, Sydney, Australia.
¹³ School of Clinical Medicine, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia.
¹⁴ Neuroscience Research Australia, Sydney, Australia.
¹⁵ Discipline of Women's Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia.
¹⁶ University of Technology Sydney, Sydney, Australia.
¹⁷ University of Stellenbosch, Stellenbosch, South Africa.
¹⁸ Ingham Institute for Applied Medical Research, Western Sydney University, Sydney, Australia.
¹⁹ Discipline of Psychiatry and Mental Health, School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, Australia.
²⁰ Karitane, Sydney, Australia.
²¹ Community Paediatrics, South Western Sydney Local Health District, Sydney, Australia.
²² NSW Agency for Clinical Innovation, Sydney, Australia.
²³ Sydney Institute Women, Children and their Families, Sydney, Australia.
²⁴ Community Paediatrics, Sydney Local Health District, Sydney, Australia.

Abstract

Background and objective: Migrant and refugee women, families, and their children can experience significant language, cultural, and psychosocial barriers to engage with child and family services. Integrated child and family health Hubs are increasingly promoted as a potential solution to address access barriers; however, there is scant literature on how to best implement them with migrant and refugee populations. Our aim was to explore with service providers and consumers the barriers, enablers, and experiences with Hubs and the resulting building blocks required for acceptable Hub implementation for migrant and refugee families.

Design, setting and participants: This project was undertaken in Sydney, New South Wales, in communities characterised by cultural diversity. In this qualitative study, we used semi-structured interviews guided by the consolidated framework for implementation research, with service providers from health and social services (32 participants) and migrant and refugee parents (14 parents) of children who had accessed Hubs.

Research and discussion: Our initial qualitative data themes were developed into step-by-step building blocks, representing a way to address contextual determinants to establish and sustain a Hub that can support migrant and refugee families. These include the setting-up phase activities of buy-in and partnership development, which outlines mechanisms to foster collective action and collaboration between health and social services. Following this, our orientation model articulates the need to establish Hub coordination and navigation, activities that enhance a Hub's relevance for migrant and refugee families and ongoing integration mechanisms, such as engagement of same-language general practitioners. This is the first study to explore the building blocks required for acceptable Hub implementation to meet the needs of migrant and refugee families in the first 2000 days of a child's life-a critical time to optimise child development and health.

Patient or public contribution: The research questions were developed based on qualitative research undertaken with Hub participants, community members, and service providers. The original investigator team had a consumer representative who has since relocated and consultation was undertaken with local Hub partner services. The researchers also consulted multicultural health services, including cultural support workers, to ensure research materials were culturally nuanced. Patients or participants have not directly been involved in the current study design.

Clinical trial registration: This trial was registered with the Australian New Zealand Clinical Trials (ACTRN12621001088831).

Keywords: child and family health; child development; continuity of care; culturally and linguistically diverse; health services; infant health; migrants; resources for child health.

MeSH terms

Child
Child Health Services / organization & administration
Child, Preschool
Female
Health Services Accessibility*
Humans
Infant
Infant, Newborn
Interviews as Topic
Male
New South Wales
Qualitative Research*
Refugees* / psychology
Transients and Migrants* / psychology

Grants and funding

This project was funded by the NSW Health Translational Research Grants Scheme. In kind support was also provided by the Early Life Determinants of Health Group, Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE).