Psychosocial vulnerabilities present complex barriers to meaningful engagement with healthcare and family support services, placing infants and young children at significant risk. To address this risk, Sunshine Coast Hospital and Health Service’s Children’s Plus, together with stakeholders, implemented a novel continuity of care model; the P1000 Health Advisor Role. P1000 provides intensive midwifery and child health support for families with vulnerabilities during the critical first years of their child’s development. The P1000 Program’s key focus is to encourage health service engagement, improve health literacy, and optimise health and wellbeing outcomes for children and families at risk of child protection involvement. An evaluation of the program's effectiveness from the perspective of service users was undertaken to determine 1) The acceptability and maternal satisfaction with the P1000 Program, 2) The feasibility of integrating the program into existing services, and 3) The clinical outcomes of families who engaged with P1000.
In-depth interviews were conducted with 10 service users who had engaged with the service. Interview data were transcribed, coded and thematically analysed to establish key themes. Two themes of 1) Meeting Families Where They Are At and 2) Suggestions to Strengthen the Service were found.
Service users found the P1000 Program to be a critical support and suggested that their engagement with health services was improved as a result. Engagement strategies valued by families with vulnerabilities include approaches that are flexible, trauma-informed, family-centred, non-judgmental, and holistic. Findings suggest that effective and meaningful engagement with health services can be achieved when services responsively adapt to meet the unique needs of families with complexity. For the families in this study, meaningful engagement with services was reliant on a trusting, sustained relationship with the practitioner, who could facilitate and encourage meaningful connections with health systems, mental health and domestic violence supports and other family-focused support providers.

Three Key Learnings:
1. Trust-based, continuity health delivery models within the first 1000 days can enhance engagement and outcomes for infants and families facing complex vulnerabilities.

2. Effective and meaningful engagement with health services can be achieved when services responsively adapt to meet the unique needs of families with complexity.

3. Engagement strategies valued by families with vulnerabilities include approaches that are flexible, trauma-informed, family-centred, non-judgmental, and holistic.