Do Australian policies enable a primary health care system to identify family adversity and subsequently support these families—A scoping study

Abstract

Issue Addressed: To determine if Australian policies support a primary health care system to identify family adversity and subsequently support these families.Methods: Two methodological approaches were used: (i) a scoping review of Australian federal and two states (Victoria and New South Wales) policies related to family adversity (e.g., childhood maltreatment or household dysfunction, such as parental mental illness); (ii) thirteen semi-structured interviews with Victorian Community Health Service (CHS) staff and government policy makers, recruited via snowball sampling to understand the context of policy making and service implementation.Data collected were subsequently discussed in relation to the Stages Model of policy analysis.Results: One hundred and eighty-eight policies referenced family adversity. Of these, 37 policies met all eligibility criteria including a focus on early intervention within primary care and were included in the review. Most policies were developed within health departments (78%) and included a wide range of adversities, with the majority based within maternal and child health and CHS platforms. Most policy development included consultation with stakeholders. Although most policies received some level of funding, few included funding details and only a third included evaluation.Conclusions: There are many policies related to family adversity in Australia, with most focused within existing primary care platforms. Given these policies, Australia should be well positioned to identify and respond to family adversity.

Feasibility of linking universal child and family healthcare and financial counselling: findings from the Australian Healthier Wealthier Families (HWF) mixed-methods study

“…Australian policies are increasingly recognising the role of healthcare in addressing early adversities 20 ; however, there is a dearth of research in Australia and internationally on the implementation and benefits of asking about early adversity in healthcare. 9 10 In the three pilot sites delivering universal CFH services, the 20%-41% of caregivers disclosing financial hardship was comparable with Australian population level data (also collected in 2020-2021) showing that one in three families could not afford essential items.…”

The potential of intervening on childhood adversity to reduce socioeconomic inequities in body mass index and inflammation among Australian and UK children: A causal mediation analysis

“…[19,20] In the present study, we focused on four childhood adversities (family violence, household member mental illness, household member substance abuse, and harsh parenting), given they occur in the family environment and are more often targeted than other adversities (e.g., parent legal problems, parental divorce, household member death). [21] Currently, considerable policy and practice opportunities in Australia and the UK now focus on reducing family adversity through schools, health services, and communities. [19,21] If childhood adversity substantially mediates socioeconomic inequities in childhood obesity and chronic inflammation, this would present even more compelling evidence for childhood adversity as a priority intervention target for reducing NCD risk factors.…”

“…[21] Currently, considerable policy and practice opportunities in Australia and the UK now focus on reducing family adversity through schools, health services, and communities. [19,21] If childhood adversity substantially mediates socioeconomic inequities in childhood obesity and chronic inflammation, this would present even more compelling evidence for childhood adversity as a priority intervention target for reducing NCD risk factors.…”