Service Provider Perspectives on Implementing the 'F-Words for Child Development': An Innovative Approach to Children's Health and Developmental Services

Background: The 'F-words for Child Development'-Functioning, Family, Fun, Friends, Fitness and Future-provide a framework that brings to life key World Health Organization ideas about child health and development in an innovative and family-friendly way. Given international uptake of the F-words, understanding service providers' (SPs') experiences and perceived impact of F-words on pediatric disability and developmental services is important. Objectives: This study explored SPs' (i) knowledge of the F-words and confidence in using the framework; (ii) perceptions and experiences using F-words; and (iii) barriers/facilitators to implementing the F-words. Methods: This descriptive study was part of a larger project implementing the F-words across five sites in Canada and New Zealand from 2021 to 2024. SPs who provide services for children and youth with disabilities or developmental concerns (e.g., neurodevelopmental disabilities) were surveyed and interviewed after F-words implementation to explore their experiences implementing the F-words. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed via team-based conventional content analysis. Results: Fifty-seven SPs completed the survey and 10 participated in interviews. SPs rated F-words familiarity (X̄ = 3.41/4) and knowledge (X̄ = 3.05/4) high, with moderate confidence using the F-words (X̄ = 2.93/4). Content analysis revealed that SPs perceived the F-words to enhance their service-delivery experiences, indicating that they provide a structured yet flexible approach to deliver strengths-based, holistic, family-centered care, while fostering relationship-building and empowerment with/among families. Examples of implementation facilitators included organizational buy-in, access to F-words resources/tools, and F-words alignment with service-delivery models. Reported implementation barriers included time constraints, the need for ongoing F-words training, and uncertainties regarding the cultural/social safety and responsiveness of the F-words for families. Conclusion: Within this study, SPs had positive perceptions and experiences using the F-words to promote strengths-based, family-centered care for children and youth with disabilities or developmental concerns and their families. Future efforts should address implementation challenges, leverage facilitators, and continue to explore F-words implementation experiences across diverse settings.