Overview
This qualitative study explored practitioners’ experiences of reaching underserved populations—particularly culturally and linguistically diverse and socioeconomically disadvantaged families—when scaling up early childhood health interventions like INFANT (INfant Feeding, Active play and NuTrition) in Victoria, Australia. Interviews were held with 15 experienced early-years practitioners, such as maternal and child health nurses, dietitians, coordinators and program officers.
Key Findings
1. Families experience barriers to accessing programs and services
- Practitioners perceived that some families don’t feel welcome or understood
- Challenges like transport, work, financial stress and language barriers made it hard for families to join health programs.
2. Practitioners’ strategies and challenges when engaging families in programs and services
- Trust and familiarity matter for families, and this could be built through personal connections, using bicultural workers, and partnering with community organisations.
- Programs and services should fit with families’ needs, for example, tailoring content to different cultures and literacy levels and modifying delivery formats.
- Practitioners wanted to improve inequities but felt uncertain and often didn’t have enough time, staff, or resourcing – even when organisational support was present.
Implications
- Despite being universally available, many health programs were poorly aligned with the realities and needs of priority populations.
- Effective implementation at scale requires local adaptation informed by community needs and experiences.
- Equity-focused implementation cannot rely solely on local practitioners. Structural support—funding, workforce training, and inclusive policies—are essential.
Recommendations for Practice
Outlined in the paper’s “Box 2”, the study emphasises:
- Co-designing programs with target populations.
- Partnering with trusted community groups.
- Culturally adapting content and delivery methods.
- Prioritising empathy, respect, and inclusion.
- Advocating for adequate funding and leadership support.
- Training staff in equity-focused implementation strategies.
Conclusion
Equitable reach in scaled-up health programs is complex and context-dependent. Practitioners are navigating this with creativity and compassion but face significant limitations. Embedding health equity into the foundation of scale-up efforts is critical—not just through theory but with actionable resources and policies.
Read the full article here: https://onlinelibrary.wiley.com/doi/epdf/10.1111/mcn.70046