Supporting Families With a Facilitated Playgroup Designed in Discussion With the Community

ABSTRACT

Introduction

This study responds to barriers to access to early intervention for health, welfare and education faced by families who experience sociodemographic disadvantage. Following a needs assessment to inform policy and practice for a community early years hub, a facilitated playgroup was commenced using a model identified by families. The aim was to provide a safe place for families of young children to gather and find support in an environment of relational and professional care and empowerment.

Methods

Evaluation of demographic data and thematic analysis of focus group discussions allows a qualitative exploration of family and provider experience in the supported playgroup.

Results

In its first year, the playgroup was attended by 61 families. Through shared relationships and structured health promotion action, families were empowered with an understanding of child development; six families received assistance with referral to a developmental specialist. Qualitative analysis identified three themes of learning from parents and grandparents, allied health providers, early childhood educators and volunteers, identifying a playgroup model to: ‘reduce experience of social isolation among families’, ‘support families in understanding child development’ and ‘support families through physical space and provision’. Relationality, safety and empowerment were interwoven among themes.

Conclusions

A policy of shared vision is central to empowering families and reducing barriers to access to support for children's developmental health concerns. Through co‐design, families were empowered within the layered influences of learning.

So What?

Evaluation represents a first step to inform policy change and practice for health promotion action towards a co‐designed community hub.

1. Background

This study focused on a playgroup intervention to address social determinants of health. In areas of sociodemographic disadvantage, families face challenges in accessing early years child development services for children aged 0–5 years, limiting potential for early intervention and increasing risk to health and well‐being [1, 2, 3]. Australian data collected between 2009 and 2024 display this risk, showing higher developmental vulnerability of children in their first year of school in a step‐wise pattern as their level of socioeconomic disadvantage increases [4, 5]. This data from the Australian Early Development Census (AEDC) [4] reflects child development in the first 5 years of life, when inequity in outcomes of physical and mental health begins to unfold through patterning into brain pathways [2]. Early intervention helps children to attain their best possible health; however, this is often unavailable or not considered by families who live in areas of socioeconomic disadvantage [1, 6, 7]. For these children and families, disadvantage may be intergenerational, shaped by persistent health and social inequities [3, 8], with subsequent impacts on population health and economic costs for society [2, 9]. These understandings of inequity, child development and lifelong well‐being through social determinants give a framework for health promotion action that is globally acknowledged [2, 10]. Social determinants are shaped by the environments in which people live, learn and play, including available access to support [11]. However, meaningful action tends to remain on the fringe of policy [8, 12].

Playgroups generally focus on play for children [13]. In contrast, we were asked to provide a service that extended the focus primarily to parents and carers through a model identified in a formative study in the community of Armadale, Western Australia [6]. The playgroup was implemented as an initial step in developing a community hub (Figure 1). In the formative study, families spoke of parent loneliness, social isolation and barriers to accessing support for children, including complex referral pathways and long wait times [14]. Consistent with current understanding of social isolation as a powerful predictor of risk to health [15], parents described the harmful effects on their own mental health [14]. Families requested a supported playgroup based on the idea of a coffee morning with space to meet and chat with other parents, volunteers to play with children and informal support for parents by allied health or child development services [6, 14]. This focus aligned with a need for continuing research towards understanding how beneficial outcomes of playgroups are related to the service provided for families [13].

FIGURE 1.

Results of formative evaluation picturing shared vision for a community hub, depicting the initial focus on facilitated playgroups (centre left).

Playgroups are attended together by parents and children to meet with others, with a focus on early childhood education and care [13]. While some playgroups are parent‐led, creating a community space for play, others are supported or therapeutic [16], for example, a therapeutic intervention for children with developmental delays [17]. In this manuscript, we use the term supported playgroup consistent with a finding by Armstrong et al. that it can be difficult to differentiate between supported and therapeutic playgroups [16]. In community playgroups, parents have reported an experience of social exclusion [13]. An important aspect of supported playgroups is therefore skilled facilitation of a relationally safe space [13, 16, 18]. This space provides a soft entry to early intervention for families who are vulnerable through socioeconomic disadvantage and on the fringe of support due to long wait times for access to specialist child development services [16, 18, 19]. Because of combined aims to reduce social isolation, support parent knowledge and child development and build community, Armstrong et al. [16] described supported playgroups as a ‘complex intervention’ (p. 145). McLean et al. [13] asked what ‘features of the playgroup may lead to beneficial outcomes’ for carers and children attending together (p. 3), including processes of relationship building; learning environments and strategies; and staff qualifications.

Our supported playgroup intervention aimed to provide a safe place for families of young children to gather and find support in an environment of relational and professional care and empowerment. To contribute to the evidence for the delivery of supported playgroups, we asked an overarching research question: Is the aim of the playgroup to provide a safe place for families of young children to gather and find support in an environment of relational and professional care and empowerment achieved?

Research Questions

1. What can we learn about the delivery of this type of supported playgroup?

2. What can we learn about relationality, empowerment and safety in the context of the supported playgroup?

2. Theoretical Framework

The focus on relationality, empowerment and safety was situated within a framework of ‘family‐centred practice’ [20], incorporating a ‘trauma‐informed approach’ [21]. Family‐centred practice recognises that families are empowered to make informed decisions, solve problems and identify resources to meaningfully support child and family well‐being through relationships of respect and dignity [20, 22]. Within this model, a sense of safety is implied but not routinely named [22, 23]. However, a community‐based study on family‐centred practice in Australia identified the importance of creating a respectful environment ‘where parents felt safe and able to discuss and participate in decision‐making’ [20] (p. 283). In recognition of the population of high disadvantage and potential for toxic stress and unsafe environments to disrupt development pathways in children's brains and biology [24], the aim of a trauma‐informed approach was to provide a safe environment of relational trust and empowerment [21]. Thus, the trauma‐informed and family‐centred approaches overlapped, with the overall aim of providing a safe base, a scaffold to support families in building foundations for health and learning for carers and children [24].

3. Methods

The Review of this supported playgroup includes an evaluation of demographic data, including an overview of staff experiences [13], and thematic analysis of focus group discussions (FGDs) to explore family and provider experience in the supported playgroup.

3.1. Study Context

The facilitated playgroup was held once a week in the Local Government Area of Armadale South, represented by the 2021 Index of Relative Socioeconomic Disadvantage (IRSD) percentile score of 3, as an area within the highest 3% of socioeconomic disadvantage in Australia [25] and recognised by the Australian government as a priority area for early childhood care [26]. The location was a short walking distance from a central train and bus terminal and adjacent to a food pantry providing bread, fruit and vegetables at no cost and groceries at a low set price. The playgroup began in October 2024, facilitated by a consultant with expertise in early childhood; early childhood educators and volunteers were present. From February 2024, a team of four allied health providers (speech therapist, physiotherapist, occupational therapist and psychologist) rotated in 2‐weekly cycles during school terms. Each week, a topic was presented informally as families engaged individually with facilitators, and a handout was given to interested families to take home. Allied health providers were available to support families, answering questions and providing information on referral pathways.

3.2. Study Design

Formal evaluation of the supported playgroup included deidentified, routinely collected demographic data provided by the overseeing organisation and qualitative evaluation at two time points, at 6 months (Time 1) and 12 months (Time 2), with FGDs and thematic analysis [27].

3.3. Participant Recruitment

All families who attended the playgroup were invited to participate in an FGD at Time 1 and Time 2 in the weeks preceding via an information sheet and consent form. Families were informed that the FGD would be held straight after the playgroup, with childcare provided by early childhood educators and volunteers, and a light meal for participants and children. All volunteers and service providers were invited by email to participate in an FGD at Time 1, held at their place of employment. Participants gave informed consent (HRE2021‐0546), and parent/carer and volunteer participants received an AUD$30 gift card in acknowledgement of their time.

3.4. Data Collection

Parent/carer FGDs were facilitated by an experienced qualitative researcher (H.J.N., PhD) and a community co‐researcher, a volunteer who built strong relationships of trust with families attending the playgroup (K.S., MA). We anticipated that inclusion of a trusted co‐researcher at the parent/carer FGDs would promote rich discussion [27].

Two FGDs were held for providers, one with allied health specialists and one with early childhood educators and community volunteers, facilitated by two experienced qualitative researchers (H.J.N. and A.M., PhD). FGDs were audio recorded, FGD guides were followed, reflective notes were taken, and data were transcribed verbatim, deidentified and managed using NVivo 11 data analysis software [28].

3.5. Data Analysis

Thematic analysis used a six‐stage process, first becoming familiar with the dataset. Second, inductive coding to show relevance to research questions by a single coder is recommended as best practice by Braun and Clarke [27]. Third, shared patterns of meaning were identified to generate initial themes as patterns of meaning, either visible or latent. Fourth, themes were developed and reviewed by co‐researchers. Fifth, a brief synopsis was written for each theme. Sixth, a narrative report to interpret results included data extracts. Consistent with a codebook method of thematic analysis, we accepted a priori themes, but also that themes might develop beyond this [27]. A reflective record was kept, tracking changes and recording the reasoning process. Consistent with Braun and Clarke [27], rather than data saturation, we sought ‘information power’, defined as richness of data to meet the aims of the study. The guiding theoretical assumption was to identify knowledge that is meaningful to informing an understanding of what a safe and welcoming physical space looks like in supported playgroups.

3.6. Ethical Considerations

Human research ethics approval was received (HRE2021‐0546), including the collection of service metrics. Demographic data and FGD transcripts were deidentified. Research data, including ethics documents, data analyses and results, were stored on a secure drive only accessible by project investigators.

4. Findings

4.1. Demographic Data

Attending the playgroup from 4 October 2023 to 16 October 2024 were a total of 61 families and 98 children; 78 adult carers attended, reflecting shared care of children by parents and extended family members (Table 1). Of the 61 families, 21 attended only in 2023. This is consistent with an annual change in playgroup attendance in Australia as children begin formal schooling. Three families (5%) identified as Aboriginal, and 16 families (26%) spoke a language other than English at home, representing 10 languages (Afrikaans, Creole, Finnish, French, Japanese, Malay, Mandarin, Tagalog, Tamil and Thai). Six families (10%) received assistance with a referral to a developmental specialist.

TABLE 1.

Demographic data for attendance over 1 year.

Families attending playgroup	Total number
Families attending playgroup	61 families (98 children)
Adult carers attending playgroup with children	78 adults (parents, grandparents and extended family)
Families who identified as Aboriginal	3 (5%)
Families who spoke a language other than English at home	16 (26%)
Families who received assistance with referral to a developmental specialist	6 (10%)
Other playgroup data
Number of playgroup sessions	48
Stakeholder organisations engaged	6
Volunteers participating	17
Training events for volunteers and early childhood educators	6 h (understanding trauma and positive behaviour support strategies)

Three FGDs were held between 10 April 2024 and 23 April 2024 (Time 1), one each for parents/carers, allied health providers, early childhood educators and volunteers. FGDs lasted between 26 and 32 min (total 85 min). No FGD participants identified as Aboriginal; two parents and two early childhood educators spoke a language other than English at home. Parents attended with children aged 7 months–3 years 9 months (median age 2 years 5 months). Allied health participants had from 4 to 10 years of experience. Early educator experience ranged from 7 to 27 years (median 19 years), with data for years of experience missing for one educator. One FGD was held in October 2024 (Time 2) for parents/carers, lasting 31 min (Table 2). Five parents attended both Time 1 and Time 2.

TABLE 2.

Demographic data for focus group participants.

Parent/carers (T1 n = 7; T2 n = 6)	T1 number (%)	T2 number (%)
Born in a country other than Australia	2 (28.6%)	1 (16.7%)
Speaks a language other than English at home	2 (28.6%)	1 (16.7%)
Lone parenting	0	0
Allied health specialist (n = 4)
Born in a country other than Australia	0
Speaks a language other than English at home	0
Highest level of education
Degree	2 (50%)
Postgraduate	2 (50%)
Early childhood educator (n = 9)
Born in a country other than Australia	2 (22.2%)
Speaks a language other than English at home	2 (22.2%)
Highest level of education
Diploma	3 (33.3%)
Degree	3 (33.3%)
Postgraduate	3 (33.3%)
Volunteer (n = 3)
Born in a country other than Australia	0
Speaks a language other than English at home	0
Highest level of education
Diploma	1 (33.3%)
Degree	1 (33.3%)
Postgraduate	1 (33.3%)

4.2. Qualitative Analysis

Iterative rounds of data analysis identified three themes of learning from parents and grandparents (parent), allied health providers (provider), early childhood educators (educator) and volunteers. The three themes were a playgroup model to (1) ‘reduce experience of social isolation among families’, (2) ‘support families in understanding child development’ and (3) ‘support families through physical space and provision’. Relationality, safety and empowerment were interwoven among these themes (Figure 2). Each subtheme reports findings from parents, followed by findings of providers and volunteers (providers).

FIGURE 2.

Thematic map.

4.2.1. Theme 1: A Playgroup Model to Reduce Experience of Social Isolation Among Families

4.2.1.1. Subtheme 1.1: Relationality Among Families—Forming a Support Network

4.2.1.1.1. Parents

Through a model of care proposed in the formative evaluation, parents and grandparents (parents) valued the opportunity for ‘socialisation’ (Parent 1, Time 2). Supported by volunteers, the playgroup was experienced as ‘friendly and welcoming … a nice environment to come to’ (Parent 5, Time 1), ‘stimulating for the kids and also for the adults’ (Parent 3, Time 1) and ‘inviting’ (Parent 4, Time 2). A request made in the formative study for opportunities to sit with a coffee and chat with other parents became foundational to the welcome in this playgroup: ‘I actually like having a coffee’ (Parent 4, Time 1).

I feel welcomed and, you know do you want a coffee? You just get a sense of being looked after (Parent 3, Time 1).

All valued time to ‘sit and talk’, supported by the presence of volunteers to play with or watch over children, ‘it's really good here how the mothers can just sit and talk and you've got volunteers here’ (Parent 6, Time 2). ‘You know your kid is safe … it's easy for me to come here—I feel comfortable’ (Parent 4, Time 2).

Most places I go with two kids I spend my whole time chasing them around … the (volunteers) keep an eye on my kids, so if I need to attend to one that's helpful, but also I can sit and talk to another mum, that kind of we share whatever's happening in our lives and we feel less isolated. Which is something that I really don't get much else during the week (Parent 1, Time 2).

This time of socialisation was empowering as parents learned through shared experience: ‘we can actually talk to each other and learn from each other's experiences … can have that adult conversation’ (Parent 2, Time 1). One mother of multicultural background described a different experience of feeling empowered, ‘and coffee … yeah, to meet people and speak English, very good’ (Parent 8, Time 1).

4.2.1.1.2. Providers

Allied health providers and early childhood educators reflected that families were forming a ‘support network around each other’ (Provider 1), ‘I also like how families develop a friendship with each other through the (playgroup)’ (Educator 7). Another description was of families building a ‘network’,

Creating a sense of community and from that everything else grows, such as building trust and relationships. … families building relationships with each other. But also, the children building relationships with each other. (Educator 6)

Relationality was supported through the deliberate welcome, including the offer of a coffee, ‘Straight away when they walk in the door there's people there, “would you like a coffee?”’ (Educator 4).

I think the food bank and coffee is a way to include parents as well because a lot of these spaces are totally aimed at the children and the parents are like a bit superficial. So it's a way of making sure that you are welcoming the whole family unit in. And we have had a few dads as well, and they are people that are excluded in that environment. They don't seem to feel that way (Volunteer 2).

4.2.1.2. Subtheme 1.2: Relationality and Safety Are Empowering for Children

4.2.1.2.1. Parents

Parents reflected on the routine that was embedded within the playgroup, a safe and relationally engaging environment for children week after week through routine with play, morning tea at a long table followed by story, music and dance—supported by volunteers. Described as ‘stimulating and welcoming, just the way that everything's set out … Like sitting at the food table for the kids. But also the different types of toys, sensory play’ (Parent 3, Time 1). ‘And you've got the messy play … Yeah, I like the bubbles with the classical music’ (Parent 3, Time 2).

Children were invited into each activity, but alternative safe places were kept for those who wanted to watch: ‘the activities are good, but nothing is like too structured … not like your kid has to do it … it's whenever they are ready to participate’ (Parent 1, Time 1). Children's empowerment was demonstrated through growing confidence, appreciated by a mother of a CaLD background, ‘Helping that my daughter, she's able for school next year’ (Parent 8, Time 2). Many spoke of growth in their child's confidence: ‘I couldn't walk away, four weeks later she's a new girl and that's amazing. The first time I brought her she sat on my knee the whole time (Parent 6, Time 2)’.

When (child's name) first started she wouldn't go and play. Like mummy, you have to follow me … (Today) she was dancing, and it's really good, I just feel that social, emotional, and the other things (Parent 2, Time 2).

As children become comfortable, they begin to explore and learn in play, which is discussed as ‘an opportunity for the kids to learn from each other as well. They see something he can't, but when you see someone doing, he can copy’ (Parent 7, Time 1).

4.2.1.2.2. Providers

Early childhood educators and volunteers confirmed the intent to support and empower child engagement through familiar activities and people, providing an environment in which children felt safe and empowered to join in, ‘a program so that they will have different sensory play or craft activities but there's consistent areas as well, so that it's a safe space for the kids’ (Educator 1). Through a predictable and safe space, children were invited, but not required, to participate in activities.

When we gather for the singing and the songs works really well, and without the pressure of it as well. You know, so (we are) very much about inviting, not forcing. And I think that's worked really well, … it draws the children in naturally as well. Even the ones that might just stand back and watch from a distance (Educator 5).

4.2.2. Theme 2: A Playgroup Model to Support Families in Understanding Child Development

4.2.2.1. Subtheme 2.1: Model of Informal Support Was Enhanced Through Relational Continuity With Care Providers

4.2.2.1.1. Parents

Parents spoke with confidence of their relationship with allied health providers, supported by relational continuity of four providers over the year, ‘If we have a little question or query or something it's really easy to oh remember they will be coming to playgroup. Like, you can just ask them’ (Parent 4, Time 2). Over time, families developed a rapport and felt safe in the continuing care and interest shown by providers, ‘And they still come up to me, how are you going, have you got questions? So they've got that rapport’ (Parent 2, Time 2).

Yes, so she was like I would definitely go see a child health nurse and get a referral … Like that I wasn't making a big deal out of nothing. And it kind of felt like she was celebrating with me when he did start rolling and did start crawling. Like she cared about his development as well (Parent 1, Time 2).

4.2.2.1.2. Providers

Allied health providers spoke of using a deliberate model of integrated care. Each provider attended 2 weeks in a row, cycling over an 8‐week rotation, resulting in families' confidence to ask deeper questions over time.

I went back the second time they were like oh yeah, we spoke last week. And it's nice to kind of see that rapport developing. Yeh, definitely people were more like kind of smiley. I've been really enjoying it (Provider 2).

I hadn't been there for two months by the time we cycled through everyone and the questions I got today were a lot more open and personal and deeper than I initially had. And I think they feel a lot more, quite safe to ask us now they get to know us (Provider 1).

Interruptions to this model were reflected in family confidence to engage: ‘I think that's important because the first time that I went I was off sick the following week so I didn't get that two a row and I felt like I was almost starting again when I went back last week’ (Provider 3). A volunteer commented on the value of consistent engagement by team members, ‘That sense of consistency, building familiarity, which is all part of the welcome, seeing familiar faces’ (Volunteer 2).

4.2.2.2. Subtheme 2.2: Supporting Education and Empowerment of Families

4.2.2.2.1. Parents

Families valued conversations in the ‘informal setting’ of the playgroup (Parent 3, Time 2). ‘Just asking a few questions and getting a bit of a rough idea, because (allied health care) can be really hard to access’ (Parent 4, Time 1). ‘Just being told that what you are thinking is valid, and you should go and see a specialist’ (Parent 1, Time 2).

4.2.2.2.2. Providers

Allied health providers confirmed this, that when families are ‘bringing up issues (we are) reassuring them yes that's typical, or who they can talk to about that and that sort of thing’ (Provider 3), relaying a discussion with a parent;

About as soon as I sat down and told her who I was she said oh I've been wanting to talk … that turned into a very big conversation about what she'd been told and sort of wanting reassurance and wanting to know what to do. … So, who else would she have spoken too? Like she didn't seem that she had anyone else that she could talk to, so I felt that was really valuable (Provider 3).

This model of care developed from an initial plan for allied health providers to give a short presentation to families on a selected topic each week. However, it quickly became evident that a ‘more personal’ model of talking individually to parents and providing a prepared handout was preferable in the playgroup setting (Provider 1). The handout was ‘a little bit of an icebreaker when we did approach parents. But also I know that when they did receive the handouts they were very welcomed and they did really appreciate having something physical to be able to take’ (Provider 4). One allied health provider described a goal of ‘removing stigma and creating awareness’ of how therapists can help, stating that as rapport developed, families were empowered to ‘ask questions’ (Provider 2). All confirmed that ‘every week there are so many different questions’ (Provider 1). A multi‐disciplinary approach empowered families. This was evident in a conversation between the providers, relaying a story of feedback given by a parent recounting how each had contributed to the conversation with the family over the preceding months. ‘We are really glad that they went (to an external allied health provider) because they are now more confident to help their child’ (Provider 1).

We are not assessing but just being able to give general advice … Feedback from families that they are implementing it, that they are feeling more confident and they can actually have reassurance that their child is on the right track, and they're not worried anymore (Provider 1).

Early childhood educators followed the same model to empower families, ‘we like walking around the group because then you can just grab the information that's relevant to that family. So yeah, tailoring that has worked’ (Educator 1).

4.2.2.3. Subtheme 2.3: Addressing Challenges to Access for Parents Who Are Concerned About Child Development

4.2.2.3.1. Parents

A strength of the supported playgroup model was that parents felt free to attend infrequently with the purpose of speaking with an allied health provider to ask about their child's development or confirm a need to access specialist support. ‘Because waiting lists for things to actually go and see someone are like just crazy. So if it's just some little enquiry it's been really helpful’ (Parent 4, Time 2). This service empowered families, providing reassurance and allaying financial and time pressures.

(Some of my friends) have really, really liked that having the extra allied health people … Because they can be really hard to access … knowing that without a formal assessment still be able to have a chat with somebody and get an idea of whether they need to go that (referral) route or not. Especially with health care being so expensive as well, you kind of avoid these things because you don't want to pay money (Parent 4, Time 2).

And you don't spend weeks going is my kid delayed, is there something wrong with my kid because this other kid can do 200 words. But you just get that instant answer that helps take that worry and stress away (Parent 1, Time 1).

4.2.2.3.2. Providers

A volunteer reflected the value of this service, including the support provided in negotiating referral processes.

The number of parents that I talk to who have insane wait times to get access to that sort of information as well. So cutting across huge waitlists and being able to interact with people that can speak to them about their concerns about their child development, it's great. And how you access those services, that's often a mystery to parents (Volunteer 2).

As the playgroup progressed, families asked to know in advance which day each allied health speciality would be represented. This became a consideration in providing information for parents who were unable to attend on a weekly basis, for example, empowering families who worked to plan time off to speak with an allied health provider. ‘We put out a timetable of which of the (allied health) professionals were coming on which week, because we found that people were saying when's the speech therapist coming? When is the occupational therapist coming?’ (Volunteer 3). An intentional decision was made to provide a walk‐in service, meeting the needs of families who might struggle to access support. ‘A parent said to me that a lot of play groups you've actually go to book online… that can be a barrier to some people’ (Educator 3).

4.2.3. Theme 3. A Playgroup Model to Support Families Through Physical Space and Provision

4.2.3.1. Subtheme 3.1: A Central Location, With Food Pantry and Enclosed Space

4.2.3.1.1. Parents

The location near a central public transport terminal, with a food pantry to reduce barriers associated with food insecurity, and an enclosed space for children to play were experienced as safe and empowering for families. ‘And the place as well, like not too far from my house’ (Parent 7, Time 1). In consideration of food insecurity, morning teas for children were provided: ‘Your food is really good for kids, like less sweet and very good. Yeah, the morning tea’ (Parent 7, Time 1). The adjacent food pantry was accessed by many families.

When we go to the food pantry as well the kids get like an apple nearly every week, and they love getting that apple (Parent 4, Time 1).

Parents discussed safety through the enclosed space for play, giving peace of mind, rest, and space to interact with others, and as space for their own well‐being ‘I get a bit of space’ (Parent 4, Time 2).

I think the enclosed thing for many knowing that you can be dealing with one kid and the other kid can't get out of the area is very helpful (Parent 1, Time 1).

4.2.3.2. Subtheme 3.2: A Challenge of No Outdoor Area

4.2.3.2.1. Parents

However, a lack of outdoor space for children to play did provide a challenge for some families as numbers grew and as some children neared school age. This was described as,

There's no outdoor space, and sometimes (older preschool age children) need to be outside creating havoc out there. Last week, there was a lot more people here and the older kids played a bit of havoc because they want to run around (Parent 6, Time 2).

Other parents valued the large indoor space, ‘We don't have that outdoor space, but also, I'd hate to compromise this for a smaller indoor space’ (Parent 1, Time 2), stating that in the current space, there were separate areas for toddlers and older preschool‐aged children.

4.2.3.2.2. Providers

Allied health providers and early childhood educators also addressed the challenge of no outdoor area, ‘It would be nice if we had a little outdoor area. You know like grass where they can play. That would be really nice’ (Educator 2). Or a space for active physical play for children:

(To) can climb up and down, like a small little obstacle course type thing or something. They're moving around from activity to activity, they get to work on their gross motor skills practicing their sitting and stuff like that but maybe a little bit more where they can practice like safe climbing … space that they can practice those other activities they might not get access to elsewhere (Provider 4).

5. Discussion

Whereas the focus of playgroups has primarily been on children [13], our study adds to the literature through a request by the community to include a focus on parents and carers. We asked if the aim of the playgroup to deliver a safe place for families of young children to find support in an environment of relational and professional care and empowerment had been achieved. Consistent with McLean et al. [13], our study found the benefit of the playgroup to families through specialist facilitators, a welcoming environment and clear routines and structure. In addition, our study added to learnings on processes that support parents and children through relational consistency; empowering families through a model of education and support; and support in a safe physical environment.

5.1. Relational Consistency

In our study, parents and carers spoke of the supported playgroup as a relationally safe community, removing barriers to seeking help through a warm welcome and consistent relationships. Relationships developed on two levels: between families and through continuity of allied health providers, early childhood educators and volunteers. Previous research has shown the value of service networks as a secondary feature of some playgroups, providing referral options and information sharing [13]. Our study added early findings of value through a primary function of support for parents through a model of relationship building, reflected in parent trust and confidence to seek and accept support. Similarly, Krahe et al. assessed belonging, safety and awareness of children's development needs in a supported playgroup intervention for young mothers of socioeconomic disadvantage [18]. Consistent with our findings, parents were empowered through increasing knowledge of child development and support with complex referral processes [18]. In contrast, Drummond et al. reported on a community intervention that was not playgroup‐focused. In areas of social disadvantage in Canada, community providers made 23 contacts to facilitate one episode of support for a child—contacts to break down stigma, search out available services and subsidise payment [29]. A supported playgroup model can provide a structure to scaffold families within an environment of relational continuity and trust [13, 18, 30].

Despite international awareness of the social and economic impact of inequity, many policies still place responsibility for health and well‐being on individual behaviour and decisions [8], with an internationally recognised gap in sustaining a relational approach to care for children and families in communities of socioeconomic disadvantage [31]. In the context of our study, parents living in an area of socioeconomic disadvantage, including parents of culturally and linguistically diverse backgrounds, asked to be taken care of within a supported playgroup [6]. The requested support was for an empowering environment, a scaffold from which to learn and build relationships and understanding. A supported playgroup model to meet this request required a funded resource of time for specialist staff with expertise in child development [32] and to equipping volunteers with training and support. For example, early childhood educators and volunteers received formal training in trauma‐informed care. Families were empowered through health‐promoting actions of capacity building within relationships of mutual trust and respect and participatory help‐giving using a strengths‐based approach [22].

5.2. Empowering Families Through Education and Support

Supported playgroups provide a soft entry to early intervention for vulnerable families [16, 18]. Consistent with Edwards et al., early intervention was supported in our study through the walk‐in community‐based service, with information about child health, health promotion activities and long‐term relationships with specialist providers [32]. Similar to McLean et al., families in our study were empowered through the scaffolding of structured routines [13] within a model of trauma‐informed care. Routines included a term planner of weekly activities, allied health provider attendance, a topic of discussion and routines to facilitate social opportunities for parents and structured play for children. An original plan for a short talk to be given to families each week was adapted to a model of informal support through a handout and personal discussion. Similar to the concept of ‘stacked’ interventions [11], within the supported playgroup were opportunities to address complex needs experienced by families, including family adversity, food insecurity, social isolation and child development concerns. Our qualitative findings gave many examples of empowerment through increased parent self‐efficacy, described as protective for child and parent well‐being [33]. The aligned protection of these stacked interventions demonstrates the concept of a supported playgroup as a complex intervention [16].

Reviews of policy have identified that access to healthcare in Australia is mostly associated with acute care services [11, 34]. For example, Littleton and Reader [34] found a siloed and acute care approach to health policy, with a lack of action for the most vulnerable families. They proposed policy development to understand ‘current windows of opportunity’ for promoting health within an understanding of social determinants of health [34]. Social support for families of young children is ‘an essential determinant of health’ [30] (p. 1), including physical and mental health [15]. A policy focused on such support within community interventions is critical to the promotion of child mental health competence, equated to well‐being and thriving [11], to empower families and reduce health inequity [35].

5.3. Support in a Safe Physical Environment

Consistent with Heaperman et al. [30], our study found that access through the no‐cost walk‐in community‐based service eased barriers to access for vulnerable families. In addition, families valued the immediate access to informal allied health support, without a requirement to attend the playgroup each week, allaying financial and time pressures. This reflects a safe model of support that is relevant to postmodern society, where many are physically distanced from extended family, with parents needing to work to meet financial commitments [30]. The physical location with a co‐located food pantry and provision of morning tea reduced food insecurity. However, without an outdoor area for play, the venue did present challenges to some families through increased noise and activity in the enclosed space. These findings reinforce recommendations of a need to establish infrastructure for families of young children in areas of socioeconomic disadvantage [36], for example, co‐located services in proximity to the neighbourhood [30], including schools [13]. A safe and welcoming environment will provide for a sense of calm, social inclusion, physical provision and cultural safety [13, 30].

A limitation of the predominantly qualitative study is the lack of a validated measure to understand families' experiences of cultural safety and the provision of culturally relevant materials. McLean et al. [13] identified a research gap in the use of validated measures to support evaluation. Our study was a small study with a predominantly qualitative focus; we recognise a continuing need to expand on research design to use longitudinal studies with validated measures to identify outcomes for children and families.

6. Conclusion

Our findings add to reported evidence on the mediating role of relational trust in reducing inequity through a supported playgroup programme, with a focus on empowering parents and carers. Families were empowered within the layered influences of learning through opportunities to discuss shared experiences with other families and opportunities to access support within facilitator‐led interventions. The shared vision for ongoing delivery of the playgroup reflected a structural challenge of access to a venue providing for outdoor play, indicating a priority when considering the location of a planned hub. Our findings represent a first step to inform policy change and practice for health promotion action towards a co‐designed community hub for children and families to tackle both the human and economic cost of inequity.

Funding

This work was funded by Carey Community Resources.

Ethics Statement

Ethics approval was obtained (Curtin University Human Research Ethics approval HRE2021‐0546).

Conflicts of Interest

This work was conducted as part of a longitudinal evaluation for Carey Hope Ltd., a non‐government organisation.

Nelson H. J., Munns A., Siggins K., and Burns S. K., “Supporting Families With a Facilitated Playgroup Designed in Discussion With the Community,” Health Promotion Journal of Australia 37, no. 3 (2026): e70210, 10.1002/hpja.70210.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.