From Voice to Outcomes: Consumer Engagement in the Healthy Homes and Neighbourhoods Initiative

Background: The Healthy Homes and Neighbourhoods (HHAN) initiative was established by Sydney Local Health District in 2015 to provide long term integrated care coordination for priority families with complex health and social care needs. From the feasibility phase, 269 families were enrolled in HHAN as of 30 June 2019, with approximately 40% Aboriginal families there were positive outcomes in decreased hospitalisations, and improved client experience. Based on these promising findings, HHAN is one of the chosen integrated care initiatives to be funded and scaled to other Local Health Districts. HHAN is currently being evaluated, informed by the WHO integrated people centred health services framework (IPCHS).

 

Our research is embedded within this work and centres the voices of families and communities to strengthen equitable, culturally safe health systems. Amplifying consumer voices is critical in understanding barriers like historical mistrust, financial stress and fragmented service navigation. The aim of the research undertaken is to examine patient and carer engagement with HHAN and their impact on care outcomes and empowerment.

 

Approach: A research-at-the-interface approach integrated Western and Indigenous research methods through yarns and semi structured interviewing. Indigenous research methodology is a collaborative, community driven approach grounded in culture, spirituality, storytelling, and respect for Country and relationships. Reflective practice, iterative interpretation and shared sense making with Aboriginal and Torres Strait Islander team members were embedded. Data from families and service providers who directly worked with HHAN families were thematically analysed using the WHO IPCHS Strategy 1, Engaging and Empowering People and Communities.

 

Results: From 8 families and 12 service providers, seven themes were identified: emotional experience of engagement, impact on care experience, communication and accessibility, relationships and trust, advocacy and contextual factors. HHAN was described as a safe and trusted space that supported confidence, reduced anxiety, enabled advocacy, and improved access to services including the National Disability Insurance Scheme, housing, and paediatrician diagnosis. Cultural representation and relationship-based care particularly with3 social workers enabled engagement, while administrative delays and systemic barriers risked disengagement.

 

Implications: Findings show that embedding consumer voice, culturally representative workforce models and streamlined service navigation strengthens engagement. Policy and practice should prioritise the inclusion of lived experience in shaping service delivery and cross sector collaboration. HHAN demonstrates that centering community voices, trust, cultural safety and advocacy enables meaningful engagement of Aboriginal and multicultural families, driving empowerment and improved health outcomes. Embedding participatory approaches with strong and governance, accountability and culturally responsive research methods has been central to advancing community centered initiatives like HHAN.

 

This includes HHAN’s partnership research model which brings clinicians, academics and health services managers across SLHD, Primary Health Networks and academic institutes alongside community involved groups like the Aboriginal and Torres Strait Islander Advisory Group formed in 2023 to provide cultural guidance and stewardship. Other person-centred initiatives can draw on HHANs model of care to enhance community-based approaches to reduce health inequities and strengthen outcomes for families.