JMIR Publications

ABSTRACT

Background:

Families experiencing adversity are disproportionately affected by mental health challenges among both children and caregivers and encounter systemic barriers to accessing, navigating, and benefiting from information, services, and supports. To address these challenges, we developed a digital Child and Family eHub (eHub) through user‑centered design with families experiencing adversity and local service providers. The eHub aimed to improve access and navigation to reliable evidence‑based information and relevant primary health, mental health, and social services.

Objective:

To assess implementation outcomes - acceptability, adoption and appropriateness, of the eHub among caregivers experiencing adversity, and to examine impacts on access to and use of information and services, help‑seeking behavior, and child and caregiver mental health.

Methods:

A mixed‑methods implementation–impact evaluation was conducted with a prospective cohort of caregivers from three Australian communities who accessed the eHub. Caregivers completed surveys at baseline and 6-month follow-up and participated in semi‑structured interviews. eHub analytics captured engagement and satisfaction. Qualitative data were analysed using framework analysis, and quantitative outcomes were examined using logistic and linear regression. Findings were triangulated across data sources.

Results:

Of 252 caregivers completing the baseline survey, 210 completed the 6 month follow up and 15 participated in interviews. Implementation outcomes indicated high acceptability, adoption, and appropriateness of the eHub. At follow up survey, 80.5% of caregivers reported the information and 71.0% reported the services were useful in meeting their child’s needs; among those reporting usefulness, 81.0% were satisfied with the eHub. Qualitatively, caregivers expressed confidence in the evidence based information. Impact outcomes between baseline and 6 months included reduced use of primary health services and increased use of psychosocial services. The proportion of children receiving services for emotional or behavioural problems declined (32.5% to 26.7%), while the proportion of caregivers reporting that children’s needs were met increased (42.7% to 51.8%). Caregivers reported fewer help seeking barriers, no significant change in psychological distress, and reduced risk of mental health symptoms among children aged 0–2 years (57.1% to 38.9%; OR = 0.48, 95% CI: 0.27–0.84).

Conclusions:

The eHub was acceptable and appropriate for caregivers experiencing adversity and was associated with meaningful shifts in help seeking, with reduced reliance on primary health care and increased use of psychosocial supports. Caregivers reported better alignment between services received and their child’s needs, alongside reduced service use for emotional and behavioural concerns. Early findings suggest reduced mental health risk among infants and toddlers; however, results should be interpreted cautiously given the modest sample size and follow up duration. Clinical Trial: ISRCTN Registry ISRCTN49839991