Factors that promote success in a maternal-child program serving Indigenous families: a community-based participatory research project in Northern Saskatchewan, Canada.

Introduction: 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.

Methods: 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.

Results: 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.

Conclusion: 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.