Practitioner reported barriers to parental engagement with Child Health Hubs in North West London disadvantaged neighbourhoods: a COM-B framework analysis
4 affiliations
- 1Northwick Park Hospital, London, UK
- 2Division of Psychiatry, Imperial College London, London, UK
- 3Imperial College London Department of Primary Care and Public Health, London, UK
- 43 Lanzhou University Library, Lanzhou University, Lanzhou, Gansu, China
Abstract
Background Families from underserved communities face disproportionate barriers to accessing early years support. In response, Early Years GP Child Health Hub Pilots were set up in three North West London boroughs (Brent, Ealing, Harrow) between 2023 and 2025 to improve access to integrated services, reflecting the NHS 10-Year Plan’s ambition for neighbourhood-based care. The hubs have been funded to continue supporting local communities. However, there is limited understanding of how parents from underserved communities experience these services and the challenges they encounter in engaging with them. This study explored practitioner-reported barriers parents face in accessing and engaging with integrated child health services.Methods We used qualitative multiple practitioner-generated case study data specifically for families with children aged 0–5 years from the three pilot sites. We applied the Capability, Opportunity, Motivation-Behaviour (COM-B) framework to analyse the data thematically, guided deductively by the framework and inductively allowing for emergent themes.Results Twenty-one case studies, collected between September 2024 and January 2025, were generated by practitioners using information they recorded from contact with each family. Barriers were identified across all COM-B domains and multiple barriers overlapping domains. Capability barriers were reported to be the most common (eg, poor parental mental health, low parenting confidence and limited health literacy). Opportunity barriers included financial hardship, competing priorities, social isolation and family interference. Motivational barriers included fear of judgement, emotional stress and previous negative experiences with services. The case studies also identified several enablers including trusted practitioner relationships, culturally sensitive care, proactive follow-up and multidisciplinary collaboration.Conclusion Families living in disadvantaged areas face multiple, intersecting barriers to engaging with integrated services. Child Health Hubs should adopt co-produced, community-informed approaches with parents that integrate health and social support to improve equitable access and sustained engagement for families experiencing adversity.
Related
- Proof-of-implementation of the SMART2D intervention: findings from a cluster randomised feasibility trial for prevention and control of type 2 diabetes in socio-economically disadvantaged neighbourhoods in Stockholm, Sweden
- Looking through different lenses at meeting places in disadvantaged Dutch neighbourhoods: A qualitative participatory study assessing needs, barriers and success elements for women with non-Western migration backgrounds and teenage girls
- Reach and engagement in the ECAIL trial targeting socially disadvantaged families across the COVID-19 pandemic and cost-of-living crisis: A mixed-methods implementation study
- Improving engagement with preconsult patient-reported outcome measures: A mixed-methods pilot study
- Short-Term Changes in Nutrition Literacy, Dietary Engagement, and Reported Food Habits Among Adolescents After One Session with a Gamified Digital Nutrition-Education Platform: A Single-Arm Pre–Post Study
BibTeX
@article{blair2026practitioner,
title = {{Practitioner reported barriers to parental engagement with Child Health Hubs in North West London disadvantaged neighbourhoods: a COM-B framework analysis}},
author = {Mitch Blair and Bina Ram and Dougal Hargreaves and Jin Qin},
journal = {BMJ Paediatrics Open},
year = {2026},
month = oct,
doi = {10.1136/bmjpo-2026-005272},
url = {https://doi.org/10.1136/bmjpo-2026-005272},
note = {CC BY},
}
RIS
TY - JOUR
TI - Practitioner reported barriers to parental engagement with Child Health Hubs in North West London disadvantaged neighbourhoods: a COM-B framework analysis
AU - Mitch Blair
AU - Bina Ram
AU - Dougal Hargreaves
AU - Jin Qin
PY - 2026
DA - 2026/10/23
JO - BMJ Paediatrics Open
DO - 10.1136/bmjpo-2026-005272
UR - https://doi.org/10.1136/bmjpo-2026-005272
AB - Background Families from underserved communities face disproportionate barriers to accessing early years support. In response, Early Years GP Child Health Hub Pilots were set up in three North West London boroughs (Brent, Ealing, Harrow) between 2023 and 2025 to improve access to integrated services, reflecting the NHS 10-Year Plan’s ambition for neighbourhood-based care. The hubs have been funded to continue supporting local communities. However, there is limited understanding of how parents from underserved communities experience these services and the challenges they encounter in engaging with them. This study explored practitioner-reported barriers parents face in accessing and engaging with integrated child health services.Methods We used qualitative multiple practitioner-generated case study data specifically for families with children aged 0–5 years from the three pilot sites. We applied the Capability, Opportunity, Motivation-Behaviour (COM-B) framework to analyse the data thematically, guided deductively by the framework and inductively allowing for emergent themes.Results Twenty-one case studies, collected between September 2024 and January 2025, were generated by practitioners using information they recorded from contact with each family. Barriers were identified across all COM-B domains and multiple barriers overlapping domains. Capability barriers were reported to be the most common (eg, poor parental mental health, low parenting confidence and limited health literacy). Opportunity barriers included financial hardship, competing priorities, social isolation and family interference. Motivational barriers included fear of judgement, emotional stress and previous negative experiences with services. The case studies also identified several enablers including trusted practitioner relationships, culturally sensitive care, proactive follow-up and multidisciplinary collaboration.Conclusion Families living in disadvantaged areas face multiple, intersecting barriers to engaging with integrated services. Child Health Hubs should adopt co-produced, community-informed approaches with parents that integrate health and social support to improve equitable access and sustained engagement for families experiencing adversity.
SN - 2399-9772
ER -