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Adapting community child and family health service models for rural and other diverse settings: A modified Delphi study to identify key elements
Author(s) -
Stockton Deborah A.,
Fowler Cathrine,
Debono Deborah,
Travaglia Joanne
Publication year - 2022
Publication title -
health and social care in the community
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.984
H-Index - 68
eISSN - 1365-2524
pISSN - 0966-0410
DOI - 10.1111/hsc.14052
Subject(s) - delphi method , participatory action research , context (archaeology) , service delivery framework , service (business) , knowledge management , citizen journalism , adaptation (eye) , process management , community based participatory research , public relations , medicine , nursing , psychology , business , computer science , political science , sociology , marketing , geography , world wide web , archaeology , artificial intelligence , neuroscience , anthropology
Inequity in health outcomes is pervasive, with poorer health outcomes identified in rural, regional and remote communities. An international call to action emphasises the need for service models adapted for less well‐resourced settings. The aim of this study was to identify key elements of a framework for the adaptation of specialist community‐based child and family health (CFH) service models for rural and other under‐resourced settings. A modified Delphi study was undertaken with a 12‐person expert panel in CFH including Australian and international professionals and parents from rural and remote communities. The study was informed by the WHO Framework for Strengthening Health Service Systems building blocks, the outcomes of an integrative review of literature and a Participatory Action Research study. Experts assessed 107 potential elements for service model development and rated them for importance when adapting service models for different contexts. Round 1 of the Delphi generated considerable consensus with 80 of the 107 potential elements identified as necessary for the service model adaptation framework. A further 17 elements for CFH service models were added in round 2. While multiple varied elements are important for adapting CFH service models for diverse settings, some elements had common themes. Experts highlighted the importance of community engagement and participation; utilising both data and local knowledge to develop a robust understanding of the community context; and the need for a flexible approach to funding and modes of service delivery to address barriers to implementation and access.