Family member and service provider experiences and perspectives of a digital surveillance and service navigation approach in multicultural context: a qualitative study in identifying the barriers and enablers to Watch Me Grow-Electronic (WMG-E) program with a culturally diverse community
Authors: Barr Karlen R. , Hawker Patrick , Winata Teresa , Wang Si , Smead Melissa , Ignatius Hilda , Kohlhoff Jane , Schmied Virginia , Jalaludin Bin , Lawson Kenny , Liaw Siaw-Teng , Lingam Raghu , Page Andrew , Lam-Cassettari Christa , Boydell Katherine , Lin Ping-I , Katz Ilan , Dadich Ann , Raman Shanti , Grace Rebekah , Doyle Aunty Kerrie , McClean Tom , Di Mento Blaise , Preddy John , Woolfenden Susan , Eapen Valsamma ,   the Watch Me Grow-Electronic (WMG-E) study group, Liaw S. T. , Lin Daniel P. , Grace Rebecca , Cibralic Sara , Diaz Anthony Mendoza , Bruce Jodie , Myers Nicole , Descallar Joseph , Kaplun Cathy , Arora Amit , Blight Victoria , Wood Angela 
Published: August 2024

Abstract
Background
Children and families from priority populations experienced significant psychosocial and mental health issues to the COVID-19 pandemic. Yet they also faced significant barriers to service access, particularly families from culturally and linguistically diverse (CALD) backgrounds. With most child and family health nurse clinics ceasing in-person consultations due to the pandemic, many children missed out on health and developmental checks. The aim of this study was to investigate the perspectives and experiences of family members and service providers from an urban, CALD community regarding the implementation of a digital, developmental surveillance, Watch Me Grow-Electronic (WMG-E) program.

Methods
Semi-structured interviews were conducted with 17 family members, service navigators, and service providers in a multicultural community in South Western Sydney, Australia. This qualitative study is an implementation evaluation which formed as part of a larger, two-site, randomised controlled trial of the WMG-E program. A reflexive thematic analysis approach, using inductive coding, was adopted to analyse the data.

Results
Participants highlighted the comprehensive and personalised support offered by existing child and family health services. The WMG-E was deemed beneficial because the weblink was easy and quick to use and it enabled access to a service navigator who support family access to relevant services. However, the WMG-E was problematic because of technology or language barriers, and it did not facilitate immediate clinician involvement when families completed the weblink.

Conclusions
Families and service providers in this qualitative study found that using WMG-E empowered parents and caregivers to access developmental screening and learn more about their child’s development and engage with relevant services. This beds down a new and innovative solution to the current service delivery gap and create mechanisms that can engage families currently not accessing services, and increases knowledge around navigating the health and social care services. Notwithstanding the issues that were raised by families and service providers, which include accessibility challenges for CALD communities, absence of clinical oversight during screening, and narrow scope of engagement with available services being offered, it is worth noting that improvements regarding these implementation factors must be considered and addressed in order to have longevity and sustainability of the program.
Trial registration.
The study is part of a large randomised controlled trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.