Primary outcomes | Baseline assessment | 6 and 12 months post Hub implementation begins | |||
Caregiver survey | Practitioner survey | Caregiver survey | Practitioner survey | ||
Caregiver | |||||
Identification of adversity | Increase in the proportion of caregivers who report being asked by a service provider about adversity in the past 6 months. | X | X | ||
Intervention for adversity | Increase in the proportion of caregivers who report spending extra time with or receiving an intervention from a Hub service provider for adversity in the past 6 months. | X | X | ||
Referrals for adversity | Increase in the proportion of caregivers who report receiving a referral to an intersectoral service for adversity in the past 6 months. | X | X | ||
Secondary outcomes | |||||
Child | |||||
Infant temperament | Increase in the proportion of caregivers who report their infant is easier/much easier than average; assessed through single caregiver-reported item on infant temperament; has a moderate correlation (r=0.51) with the Easy-Difficult Scale (EDS) of Australian version short form of Revised Infant Temperament Questionnaire78; completed for one child* aged 0–8 in each family 0 to <2 years. | X | X | ||
Child mental health | Decrease in the mean scores for caregiver-reported internalising or externalising symptoms for their child. Completed for one child* in each family. For children aged 0 to <2 years: Ages & Stages Questionnaire Social-Emotional Second Edition (ASQ-SE2).79† For children aged ≥2 to 8 years: Strengths & Difficulties Questionnaire.80 | X | X | ||
Global health | Increase in the mean scores of caregiver-reported general child health; assessed through single item (GHQ-S1) from Child Health Questionnaire81; completed for one child* aged 0–8 in each family. | X | X | ||
Caregiver | |||||
Uptake of referrals | Increase in the proportion of caregivers who report uptake of referrals to other services in the past 6 months. | X | X | ||
Mental health | Decrease in the mean scores of caregiver-reported psychological distress as assessed by Kessler Psychological Distress Scale 6 (K6); 6-item.82 | X | X | ||
Global health | Increase in means scores of caregiver-reported general health; assessed through single item of the Short Form Health Survey (SF-12).83 | X | X | ||
Parental warmth, parenting hostility and efficacy | Increase in mean scores of parental warmth and efficacy; decrease in mean scores on parenting hostility. Three self-report subscales drawn from the Longitudinal Study of Australian Children (LSAC), Australia’s first nationally representative longitudinal study of child development which will allow for national comparisons of the study data84; assessing parental warmth, parenting hostility and efficacy. Parental warmth (6-items), parenting hostility (5-items) and parenting efficacy (4-items). | X | X | ||
Quality of life | Increase in mean caregiver quality of life scores calculated from the EuroQol Health and Well-being Instrument Short Form (EQ-HWB-S).72 | X | X | ||
Caregiver experience | Caregiver reported acceptability and feasibility of the Hub; Increase in the proportion of caregivers who report their satisfaction with Hub care as measured by three items from the Australia Bureau of Statistics Patient Experiences in Australia Survey.85 | X | X | ||
Personal well-being | Increase in mean scores of caregiver-reported personal well-being outcomes measured by the Personal Well-being Index; 7 items.86 | X | X | ||
Practitioner | |||||
Identification of adversity | Increase in the proportion of practitioners who report asking about adversity in the past 6 months. | X | X | ||
Intervention for adversity | Increase in the proportion of practitioners who report spending extra time or providing an intervention for adversity in the past 6 months. | X | X | ||
Referrals for adversity | Increase in the proportion of practitioners who report referring caregivers to an intersectoral service for adversity in the past 6 months. | X | X | ||
Practitioner experience | Practitioner reported acceptability and feasibility of the Hub; Increase in the proportion of practitioners who report feeling confident and competent to detect and support families experiencing adversity. | X | X | ||
System level | |||||
Strength and structure of intersectoral service linkages | Increase in the number and strength of service linkages between Hub practitioners as assessed through social network analysis (SNA) indicators for network density, degree, centrality and betweenness, and map of linkages between Hub practitioners based on i) contact, (ii) referrals to, (iii) referrals from, and (iv) quality of the relationship.68–71 | X | X | ||
Health economics outcomes | Costs of implementation of the Hub models, caregiver-reported intersectoral service usage and value of unmet need. | X | X |
*Caregivers with more than one child will respond to questions pertaining to one child in their family based on the child they are most concerned about.
†The ASQ-SE is limited by its design as a screening tool that may not be a sensitive outcome measure. The measure is used in this study because it more directly measures mental health and well-being than the ASQ.