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Aim: The aim of this paper is to describe the implementation and evaluation of the Growing Strong Brains® (GSB) toolkit in a remote Aboriginal community in Western Australia (WA) over a 2-year period, 2018–2019. Background: Ngala, a community service organisation in WA, developed the GSB toolkit in 2014, a culturally appropriate and interactive resource to build knowledge of early childhood development within Aboriginal communities. This was in response to evidence that a higher percentage of children in Aboriginal communities were developmentally vulnerable compared to the rest of the population. The GSB toolkit promotes awareness and understanding of early brain development pre-birth and in the early years of a child’s life. Methods: The project was underpinned by participatory action research (PAR). Reflective PAR review cycles (n = 5) monitored local community engagement, navigated challenges and utilised community strengths. Fifty-nine local service providers attended a 2-day formal training. Data were collected by using various methods throughout the project, including feedback following training, focus groups, surveys, one-on-one interviews using yarning techniques and reflective feedback from the Project Lead. Findings: Establishing local Aboriginal project staff was pivotal to the success of the project. When delivering services for and with Aboriginal people, it is essential that cultural competence, safety and decision-making is carried through from planning to implementation and evaluation, and involves genuine, respectful and authentic relationships. Sufficient time allocation directed towards building relationships with other service providers and local community members needs to be considered and built into future projects. The Growing Strong Brains® project is embedded within the local community, and anticipated implementation outcomes were achieved. The support of the local people and service providers was beyond expectation, enabling the building of local capacity, and the development of a common understanding of the key messages from the GSB toolkit to allow integration throughout all levels of the community. This project has been important to build on the strategies necessary to introduce, implement and evaluate the GSB toolkit in other remote Aboriginal communities.

ISSUE ADDRESSED Young parents (

People who are homeless or marginalised have poor engagement with mainstream healthcare services. The aim of this study was to explore patient and staff perspectives of a street-based, primary health service, to help identify factors influencing patient access and management. A qualitative study was undertaken from April to September 2016. Interviews (n = 27) explored patients’ experiences of accessing healthcare services. Interviews with allied service staff (n = 5) explored referral pathways and patients’ access to healthcare. Factors influencing patients’ willingness to access primary healthcare through the street health service were identified as doctor–patient empathy, better understanding of patient circumstances, fostering of social capital, facilitating referral pathways and supporting the transition to mainstream general practice as circumstances improve. Hospital discharge planning and follow-up management were identified as gaps in the continuity of service. Ease of access provided by a street-based health service facilitates access to the healthcare system for homeless and marginalised patients.nbsp;div class="hor-line"nbsp;/div.

Background and objectives Street-based clinics provide general practice services to marginalised and homeless persons. The objective of this study was to examine prevalence, patterns and severity of multimorbidity in patients attending one such service. Method A retrospective cohort study (2006–15), comprising medical record review of patients (n = 4285), was undertaken. A Cumulative Illness Rating Scale (CIRS) was used to assess multimorbidity. Results Average age of patients was 38.2 ± 17.9 years. Of 31.5% Aboriginal patients, 50.8% were female (37.6% in non Aboriginal patients). Of all patients, 53% had multimorbidity. Aboriginal patients had higher rates of multimorbidity than non-Aboriginal patients (58.0% vs 50.6%, P

Local communities with good stocks of social capital nurture and support the families residing within. This qualitative study explored through the perspectives of mothers, how families with children aged 0–5 years build social capital in newer residential areas in Perth, Western Australia. Parenthood generally increased the desire to connect to one's local community, which activated and enhanced social capital. Two themes appear to drive this desire: an increased need for social support and an increased vested interest in the local community. However, newer residential areas commonly have a lag of community infrastructure needed to provide opportunities for families with young children to interact with other families. Urban planning and community sectors need to coordinate to provide infrastructure and opportunities for families with young children to connect and build social capital within their local communities.

Aim The aim of this study was to explore the ways that mothers' groups and playgroups support families with children aged 0–5 years and foster community connectedness in newer residential communities in Perth, Western Australia. Background The transition to parenthood is a time of increased support need. Changing community demography has resulted in a loss of traditional support structures and an increased need for local community initiatives to support families with young children. Design A qualitative descriptive design was used for this initial phase of a mixed methods sequential exploratory study. Method Data were collected between December 2011–August 2012. Interviews and focus groups conducted with 39 mothers provided insights from 16 mothers' groups and 13 playgroups. In addition, interviews were undertaken with three child health nurses and four local government early childhood staff. Findings For the participants in this study, mothers' groups and playgroups provided opportunities to learn about parenting, to build a supportive network, to forge friendships and a connectedness to the local community. The families who relocated often experienced isolation until new groups and social networks were found. In general, where participation in mothers' groups and playgroups facilitated relationships with others from the local community, connectedness to that community was reported by participants to be enhanced. Conclusion Mothers' groups and playgroups provide important community development opportunities and appear to help reduce potential isolation for mothers with young children. The findings are of interest to nurses and other health professionals working with families with young children.

Issue addressed The study aim was to investigate the relationships between social capital measures and playgroup participation in a local residential area for parents with children of playgroup age (1–4 years) compared with non-participation and participation in a playgroup outside the local residential area. Research indicates playgroup participation has benefits for families, however, less is known about the potential local community social capital for parents who participate in playgroups. Methods Data were collected through a cross-sectional survey from March 2013 to January 2014 in Perth, Western Australia. The data from a group of parents (n = 405) who had at least one child aged between 1 and 4 years were analysed using multivariable regression. Reported playgroup participation (local, outside the area or non-participation) in the previous 12 months was investigated for associations with three measures (Neighbourhood Cohesion Index, Social Capital and Citizenship Survey and local reciprocity) that capture attributes of social capital. Results Participation in playgroup locally was generally associated with higher levels of social capital than both participation in playgroup outside the local area and non-participation. Mothers with two or more children fared better for social capital measures than mothers with one child. Conclusions Participation in a locally placed playgroup may provide an important opportunity for families with children of playgroup age (1–4 years) to build social capital in their local community. So what? Playgroups in a family’s local area have the potential to foster locally placed social capital through community interaction, social networks and cohesion, which are important for mental health promotion in communities.

Aim To investigate the relationships between participation in mothers’ groups and social capital, social support and mental well-being measures for mothers whose oldest child was 0-5 years. Background Evaluations of facilitated mothers’ groups have found positive benefits for information sharing and support. Mothers’ groups often continue as parent-led groups; however, little is known about the potential benefits of ongoing participation compared with non-participation. Design Cross-sectional survey. Methods Data were collected through a survey from March 2013–January 2014 in Perth, Western Australia. The data from a subgroup of mothers (N = 313) whose oldest child was 0-5 years of age were analysed using multivariable regression. Participation in mothers’ groups in the previous 12 months was investigated for associations with social capital {Neighbourhood Cohesion Index (NCI); Families, Social Capital and Citizenship Survey (FSCCS) and Reciprocity}; social support {Medical Outcomes Study-Social Support Survey (MOS-SSS) and Parent Support Outside Home Scale (PSOHS)}; and mental well-being {Warwick Edinburgh Mental Well-Being Scale (WEMWBS)}. Participation was measured as three groups – locally, outside area of residence and non-participation. Results Mothers who participated in mothers’ groups locally scored significantly higher than those who had not participated in mothers’ group for ‘social capital’ (NCI, FSCCS, Reciprocity), ‘social support’ (MOS-SSS, PSOHS) and ‘mental well-being’ (WEMWBS). Mothers who participated in mothers’ group outside the area scored significantly higher than those who had not participated in mothers’ groups for one measure of ‘social support’ (PSOHS). Conclusions Participation in mothers’ group locally may provide support and social capital benefits for mothers of children aged 0-5 years, which may influence mental well-being.