Co-design of a model of child and family health nursing support for culturally and linguistically diverse families

Abstract

In Australia, despite having a large culturally and linguistically diverse (CALD) population that does not speak English, there is a lack of research on the experiences of CALD families engaging with child and family health nursing services and, in particular, sustained nurse home visiting (SNHV) programs. The aim of this study was to co-design a model of child and family health nursing support for CALD families—particularly those with limited English proficiency (LEP)—to support better access to and engagement with child and family health nursing services and, in particular, SNHV programs. This study employed descriptive qualitative methods to conduct 14 semi-structured, in-depth interviews with CALD mothers with young children, as well as two focus groups with 13 child and family health nurses (CFHNs) and one focus group with six healthcare interpreters. A child and family health nursing model of support was co-designed with three CFHNs and five healthcare interpreters. The study took place in the South Eastern Sydney Local Health District, Sydney Local Health District and South Western Sydney Local Health District. An interpretative phenomenological analysis and socioecological framework guided the study. Data were analysed using inductive thematic analysis. The research explored the facilitators and barriers that influence CALD families’ access to and engagement with child and family health nursing services, and particularly SNHV programs. Factors that affect the quality of the family–nurse–interpreter relationship were identified. The CALD families’ experiences suggested that they do not have effective access to and engagement with child and family health nursing services, and particularly SNHV programs, as a result of multifaceted challenges. These challenges are likely to exist across their ecology. A combination of factors experienced by CALD mothers, including language barriers, cultural incompatibility, lack of knowledge about the healthcare system, nurse–mother relationship issues, issues around working with interpreters, and a lack of access to female interpreters, showed that existing program and service issues pushed the mothers to take responsibility and make attempts to manage the culture, service system and their relationship with healthcare professionals. This study offers valuable information about this under-researched area in Australia. It provides evidence of the significant role that CFHNs can play in collaboration with professional healthcare interpreters to improve CALD families’ access to and better engagement with child and family health nursing services and SNHV programs. Furthermore, co-designing a model of support for CALD families with LEP has the potential to improve families’ engagement and lead to better health outcomes for their children. The co-designed model provides a greater understanding of CALD families’ health beliefs, cultural values and practices that influence their access to and engagement with responsive health service provision, and it highlights the important role played by ‘bilingual educators’ in the child and family health service system. This study also identified best practice implications and necessary adaptations to child and family health nursing services, and particularly SNHV programs, to better support access to and engagement with CALD families.

Date of Award	2023
Original language	English
Awarding Institution	Western Sydney University
Supervisor	Lynn Kemp (Supervisor)