Children's views have often been supplementary to those of adults in research on children's lives. With growing awareness of the Rights of the Child, children are being engaged as experts in their ...own lives, that is, young people who have valid perspectives on the things that matter and are important to them. In this study, a draw-write-tell activity was used to capture children's understandings of transition to school. A Vygotskian view of drawing was adopted, with drawing used as a mediating tool for children to make meaning of experiences and thoughts and express these to others. Children's drawings and explanatory narratives were thematically analysed in a social constructivist paradigm. Children shared their friendships and feelings about aspects of school and home, and their growing awareness of school life. Drawings were supported as a useful tool for understanding children's views of transition to school and capturing changes in their feelings, knowledge and independence at this important time. Author abstract
This research explores the implementation of a child-centred, co-designed, community-embedded program called 'Young Doctors for Life' (YDFL). YDFL is designed to improve health and wellbeing outcomes ...for Aboriginal children in the middle childhood years. Focus is given in this paper to the processes of program adaptation of the YDFL to ensure local cultural relevance, drawing on the experiences and perspectives of children, parents, schoolteachers, and the implementation team.
Two focus groups with program stakeholders were convened. The first group consisted of three members from the local Aboriginal implementation team, and the second group comprised two members of the program design team. Children (
= 22) and schoolteachers (
= 2) participated in semi-structured interviews. Parent survey data (
= 16) were also collected and included. The data was analysed, guided by the five elements of implementation as outlined in the Hexagon Implementation framework (Capacity; Fit; Need; Usability; Support; and Evidence), which served as
themes.
YDFL provides a promising example of how programs can be adapted with and for Aboriginal communities to support child health. Successful adaptation and implementation of this program required a co-design approach engaging program designers and the local implementation team. Community collaboration was also essential to identifying and addressing local community goals and aligning new programs with local service and cultural contexts.
Health programs to support positive child outcomes are more likely to be successful when they share their focus between the risks and challenges within a community, and the positive, protective factors that can be leveraged to support children to flourish. Stakeholder engagement and community leadership are necessary to achieve meaningful program adaptation and implementation in Aboriginal communities.
The aim of this study was to explore the experiences of healthcare interpreters working with child and family health nurses (CFHNs) in providing child and family health nursing (CFHN) services and ...sustained nurse home visiting (SNHV) programs to culturally and linguistically diverse (CALD) families with limited English proficiency.
A mixed methods longitudinal research design was conducted to develop, implement and evaluate a training and practice support model for healthcare interpreters working with nurses and CALD families in providing CFHN services and SNHV programs in three major local health services in Sydney, Australia. One pre-training survey with 24 healthcare interpreters was conducted; field notes were recorded during training and implementation; and a post-implementation focus group with six healthcare interpreters was conducted. Quantitative survey data were analysed descriptively using Alchemer. The focus group was audio-recorded for transcription purposes, and this and the field notes were thematically analysed applying a socioecological framework.
Three themes were identified from the initial, pre-training survey: facilitate communication and delivery accurately; a bridge linking the clients and the healthcare practitioners; and make everybody feel comfortable. Practice support implementation was negatively impact by system and COVID-19 related barriers. Four themes were developed from evaluative phase of the study including: system-related issues; interpreters' challenges; working with nurses; and client session related issues.
Quality interpreting was favourably influenced by adequate time for interpreting the session including a pre- and post-briefing session with CFHNs, an appropriate mode of interpretation, allocation of female interpreters and the same interpreters with CALD mothers and clarity about interpreter role and cultural comfort. These strategies support the quality of communication and relationships in delivery of CFHN services and SNHV programs to CALD mothers with limited English proficiency.
Children from refugee backgrounds are less likely to access appropriate health and social care than non-refugee children. Our aim was to identify refugee children's health/wellbeing strengths and ...needs, and the barriers and enablers to accessing services while preparing for primary and secondary school, in a low socio-economic multicultural community in Australia.
Ten focus groups were facilitated with Arabic-speaking refugee parents of children aged 2-5 years (n = 11) or in first year secondary school (n = 22); refugee adolescents starting high school (n = 16); and key service providers to refugee families (n = 27). Vignettes about a healthy child and a child with difficulties guided the discussions. Data was thematically analysed and feedback sought from the community via the World Café method.
Personal resilience and strong family systems were identified as strengths. Mental health was identified as a complex primary need; and whilst refugees were aware of available services, there were issues in knowing how to access them. Opportunities for play/socialisation were recognised as unmet adolescent needs. Adults spoke of a need to support integration of "old" and "new" cultural values. Parents identified community as facilitating health knowledge transfer for new arrivals; whilst stakeholders saw this as a barrier when systems change. Most parents had not heard of early childhood services, and reported difficulty accessing child healthcare. Preschooler parents identified the family "GP" as the main source of health support; whilst parents of adolescents valued their child's school. Health communication in written (not spoken) English was a significant roadblock. Differences in refugee family and service provider perceptions were also evident.
Refugee families face challenges to accessing services, but also have strengths that enable them to optimise their children's wellbeing. Culturally-tailored models of care embedded within GP services and school systems may assist improved healthcare for refugee families.
This article explores the practices of 'Acknowledgement to Country' in Australian early childhood education contexts. Acknowledgement is a process of seeking out and honouring local Aboriginal ...Country and knowledge and investing in local resources of language, art, stories, nature and songs. Twenty educators across six early learning centres participated in semistructured interviews to explore the experience, processes and resources that supported the implementation of Acknowledgement practices. Acknowledgement practices were not limited to a daily protocol but embedded in each centre's physical place and programming. Wanting to be respectful yet fearing offending Aboriginal people, most educators expressed feelings of uncertainty and under-confidence about what to do. Developing relationships with local Aboriginal people and identifying resources were also concerns. Acting from the heart with good intentions was regarded as a way forward together, with commitment, resources and a strong distributed pedagogical leadership culture, where educators felt supported to take small yet foundational steps.
This paper explores children's understandings of Acknowledgement to Country practices and Aboriginal knowledges. Guided by the relational lenses of respect, responsibility and reciprocity, we ...conducted focus groups with children across five Australian early education centres. We found that Acknowledgement practices were evident through recitation of their Acknowledgement to Country, engaging with artefacts, and/or discussion of artworks. Secondly, children demonstrated emerging understandings about place names, the symbolic use of flags for places and people, and Australian plants and animals. Thirdly, Aboriginal cultures as living cultures were evident in temporal discussions about people and culture. Finally, imaginative play implied efforts to make sense of Aboriginal concepts and language. Across the study, children were active in experimenting with ideas in their own meaning making. Acknowledgement to Country was not a moment in the day; rather, it was embedded throughout the day through routines, storytelling, play and creative activities, all designed to foster learning.
Background
Hospitals are insufficiently resourced to appropriately support young people who present with suicidal crises. Digital mental health innovations have the potential to provide ...cost-effective models of care to address this service gap and improve care experiences for young people. However, little is currently known about whether digital innovations are feasible to integrate into complex hospital settings or how they should be introduced for sustainability.
Objective
This qualitative study explored the potential benefits, barriers, and collective action required for integrating digital therapeutics for the management of suicidal distress in youth into routine hospital practice. Addressing these knowledge gaps is a critical first step in designing digital innovations and implementation strategies that enable uptake and integration.
Methods
We conducted a series of semistructured interviews with young people who had presented to an Australian hospital for a suicide crisis in the previous 12 months and hospital staff who interacted with these young people. Participants were recruited from the community nationally via social media advertisements on the web. Interviews were conducted individually, and participants were reimbursed for their time. Using the Normalization Process Theory framework, we developed an interview guide to clarify the processes and conditions that influence whether and how an innovation becomes part of routine practice in complex health systems.
Results
Analysis of 29 interviews (n=17, 59% young people and n=12, 41% hospital staff) yielded 4 themes that were mapped onto 3 Normalization Process Theory constructs related to coherence building, cognitive participation, and collective action. Overall, digital innovations were seen as a beneficial complement to but not a substitute for in-person clinical services. The timing of delivery was important, with the agreement that digital therapeutics could be provided to patients while they were waiting to be assessed or shortly before discharge. Staff training to increase digital literacy was considered key to implementation, but there were mixed views on the level of staff assistance needed to support young people in engaging with digital innovations. Improving access to technological devices and internet connectivity, increasing staff motivation to facilitate the use of the digital therapeutic, and allowing patients autonomy over the use of the digital therapeutic were identified as other factors critical to integration.
Conclusions
Integrating digital innovations into current models of patient care for young people presenting to hospital in acute suicide crises is challenging because of several existing resource, logistical, and technical barriers. Scoping the appropriateness of new innovations with relevant key stakeholders as early as possible in the development process should be prioritized as the best opportunity to preemptively identify and address barriers to implementation.
Children's views have often been supplementary to those of adults in research on children's lives. With growing awareness of the Rights of the Child, children are being engaged as experts in their ...own lives, that is, young people who have valid perspectives on the things that matter and are important to them. In this study, a draw-write-tell activity was used to capture children's understandings of transition to school. A Vygotskian view of drawing was adopted, with drawing used as a mediating tool for children to make meaning of experiences and thoughts and express these to others. Children's drawings and explanatory narratives were thematically analysed in a social constructivist paradigm. Children shared their friendships and feelings about aspects of school and home, and their growing awareness of school life. Drawings were supported as a useful tool for understanding children's views of transition to school and capturing changes in their feelings, knowledge and independence at this important time.
Children's views have often been supplementary to those of adults in research on children's lives. With growing awareness of the Rights of the Child, children are being engaged as experts in their ...own lives, that is, young people who have valid perspectives on the things that matter and are important to them. In this study, a drawwritetell activity was used to capture children's understandings of transition to school. A Vygotskian view of drawing was adopted, with drawing used as a mediating tool for children to make meaning of experiences and thoughts and express these to others. Children's drawings and explanatory narratives were thematically analysed in a social constructivist paradigm. Children shared their friendships and feelings about aspects of school and home, and their growing awareness of school life. Drawings were supported as a useful tool for understanding children's views of transition to school and capturing changes in their feelings, knowledge and independence at this important time. Author abstract
Children's views have often been supplementary to those of adults in research on children's lives. With growing awareness of the Rights of the Child, children are being engaged as experts in their ...own lives, that is, young people who have valid perspectives on the things that matter and are important to them. In this study, a draw-write-tell activity was used to capture children's understandings of transition to school. A Vygotskian view of drawing was adopted, with drawing used as a mediating tool for children to make meaning of experiences and thoughts and express these to others. Children's drawings and explanatory narratives were thematically analysed in a social constructivist paradigm. Children shared their friendships and feelings about aspects of school and home, and their growing awareness of school life. Drawings were supported as a useful tool for understanding children's views of transition to school and capturing changes in their feelings, knowledge and independence at this important time.
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