Factors that promote success in a maternal-child program serving Indigenous families: a community-based participatory...

Despite investment in maternal-child health programs, there has been little impact on the health outcomes of Indigenous mothers and their children, creating a need to understand how programs can be successfully implemented. Community input is essential for successful programs; however, there is little research exploring the perspectives of frontline workers providing these programs. To gain a better understanding of how to support maternal-child health program success a research partnership was formed with the KidsFirst North program in Northern Saskatchewan, Canada. Using a community-based participatory research approach, this study was codeveloped to (1) explore families', frontline workers', and administrators' perceptions of factors that contribute to the success and barriers of a program for Indigenous families; and (2) describe the current role of frontline workers within health program planning, implementation, and evaluation.

From September 2019 to January 2020, data were collected through in-person meetings, focus groups, and semi-structured interviews with KidsFirst North families (n=9), frontline workers (n=18), and administrators (n=7) from 11 sites in Northern Saskatchewan. Data were analyzed using the Collective Consensual Data Analytic Procedure.

The identified factors of program success included the importance of staff, where staff demonstrated certain positive characteristics and created a welcoming atmosphere for families; community events that were open to the entire community; and the integration of Indigenous culture in the program. Program barriers included jurisdictional policy that negatively impacted frontline workers, a lack of father inclusion in program activities, and community challenges such as a lack of access to other services within the community. All frontline workers had a role in program delivery, most reported involvement in program development and planning, and approximately half were included in program evaluation.

Factors of success and barriers from the KidsFirst North project have illustrated elements to build on and areas to address in public health program planning, implementation, and evaluation of maternal-child health programs that serve Indigenous families. KidsFirst North has demonstrated ways a contemporary maternal-child health program can utilize frontline workers outside of program delivery to influence all aspects of health program planning, implementation, and evaluation. Contributing to the evidence base of maternal-child health programs for Indigenous families may help foster the success of public health programs; inform the role of frontline workers in health program planning, implementation, and evaluation; and positively impact the health of Indigenous children and families.