Strengths-based, tiered, accessible, resources and supports (STARS for Kids) program

The intervention group will receive the co-designed STARS for Kids tiered care model. This model was co-designed with parents/carers as well as service providers in all three sites (South Western Sydney, Taree, and Wannerroo). Participants were presented with example case scenarios about tier models and invited to provide feedback using interviews (30-40 minutes), workshops, and focus groups up to 3 hours. Additionally, other elements such as the barriers to access (digital literacy level, role of service navigators, etc) were also considered in the co-design activities. The co-design process will be ongoing to ensure that the research considers the specific needs of each population throughout the phase of the project. This comprises universal and tiered care services as detailed below. Universal service: The universal service comprises the Watch Me Grow – Electronic (WMG-E) as a universal digital screening tool that has been found to be effective and acceptable to families (including translations and supported by multicultural, out-of-home care, refugee, or other support workers, as needed) for the early identification of child developmental, parental mental health, and family psychosocial needs (Findings from clinical trial - ACTRN12621000766819). The innovative web-based screening and monitoring program provides unique opportunities to reach vulnerable families at their homes and communities. WMG-E uses opportunistic contacts that the family has with trusted service providers, such as immunisation visits or routine service contact with General Practitioners (GPs), playgroups, social care agencies, government, and non-governmental organizations (NGOs) in order to empower parents to engage with child developmental checks. The program aims to identify child development needs while also ascertaining and de-stigmatising mental health and psychosocial screening, and provide urgent targeted interventions, particularly using digital technology. WMG-E contains in-built logic to identify children at developmental risk at the point of care to aid shared decision-making using several primary and secondary assessments (see primary and secondary outcomes). This can be accessed via QR code via poster/flyers or weblink via email. It will take approximately 30-40 minutes for parents/carers to self-complete the assessments. Based on the WMG-E screening results, resources and supports are provided as per the level of risk. Further, the results are automatically transmitted to parent/carer and the service provider who will conduct further clinical review as needed. Once engaged, the platform issues automated reminders to the family, prompting them to take the developmental checks again at the next recommended ages and stages (e.g., 6, 12, 18, 24, 36, 48, and 60 months of age) derived from guidelines as per Personal Health Record Blue Book program in NSW or Purple Book in WA. Tiered service approach: Based on complexity and needs. Additional resources (Tier 1): Parent/carers with mild concerns will be provided with anticipatory guidance, such as mental health literacy, sign posting for resources, awareness, etc will be administered via email and text messages to parents/carers by the digital navigator. Given the nature of risk in Tier 1, no further consultations will be provided in this tier. However, the digital service navigator and the research team will follow up parents/carers at 6-monthly timeperiod to reassess based on their next 6-monthly completion of assessments. Targeted services (Tier 2): Parent/carers with child developmental concerns or a mild to moderate mental health issue will be connected via digital navigation with online/in-person services (e.g., Triple P online, STEPs program, etc). The digital navigator will either contact the parents/carers via text, email or telephone to connect them to appropriate services. The number of sessions in the in-person/online services and any further review will depend on the specific needs of the family. For example, this tier will include, but not limited, to group based parenting supports of up to 2 hours, free triple P resources, etc. Similar to tier 1, the digital service navigator and the research team will follow up parents/carers in this tier 2 at 6-monthly time period to reassess based on their next 6-monthly completion of assessments. Service Navigation (Tier 3): Parents/carers with complex health and family psychosocial needs will be linked with an In-person Service Navigator who will connect them with relevant health (e.g. developmental assessments and intervention) and social care providers (e.g., place-based hubs, intensive parenting interventions, strengths-based approaches to increase family and community connectedness etc.) so that the families receive wraparound care with ‘warm handover’ to referred services and ‘continuity of care’ to ensure the referral needs are met. The number of sessions in the tier 3 services and any further review will depend on the specific needs of the family. Data collection will be monitored via REDCap, a secure web application for building and managing online surveys and databases. Where needed, a research staff will send reminders to those participants who have not completed all the baseline assessments and may help those with issues of digital literacy to guide them through completion.