Evidence map›Paper›PMID 41680749›Full record

ArticleBMC health services research2026

Advancing equity in neurodevelopmental care with the Tracking Cube: protocol for an effectiveness-implementation hybrid (type 1) stepped-wedge cluster randomised controlled trial.

Dianne C Shanley, Marjad Page, Doug Shelton, Emma L Harbeck, Robert S Ware, Joshua Byrnes, Melanie J Zimmer-Gembeck, Kurt Towers, Ngiare Brown, Joan Marshall and 8 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Dianne C ShanleySchool of Applied Psychology, Griffith University, Brisbane, Australia. d.shanley@griffith.edu.au.
Marjad PageKambu Aboriginal and Torres Strait Islander Corporation for Health, Ipswich, Australia.
Doug SheltonWomen's & Children's Health Services, Gold Coast Hospital and Health Service, Gold Coast, Australia.
Emma L HarbeckSchool of Applied Psychology, Griffith University, Brisbane, Australia.
Robert S WareGriffith University, Brisbane, Australia.
Joshua ByrnesSchool of Medicine and Dentistry, Griffith University, Brisbane, Australia.
Melanie J Zimmer-Gembeck *School of Applied Psychology, Griffith University, Brisbane, Australia.
Kurt TowersDepartment of Health and Wellbeing, Adelaide, South Australia.
Ngiare BrownNgaoara Indigenous Child and Adolescent Wellbeing, Wollongong, Australia.
Joan MarshallGriffith University, Brisbane, Australia.
Louise BarnsbeeSchool of Applied Psychology, Griffith University, Brisbane, Australia.
Natasha ReidChild Health Research Centre, The University of Queensland, Brisbane, Australia.
Sheena ReillyGriffith University, Brisbane, Australia.
Ned Chandler-MatherSchool of Applied Psychology, Griffith University, Brisbane, Australia.
Wei LiuSchool of Applied Psychology, Griffith University, Brisbane, Australia.
Naila KhanBangladesh Protibondhi Foundation, Dhaka, Bangladesh.
Sheri MadiganDepartment of Psychology, University of Calgary, Calgary, Canada.
Erinn HawkinsSchool of Applied Psychology, Griffith University, Brisbane, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Tracking Cube is a co-designed, digitally-embedded solution that supports neurodevelopmental care for children and adolescents in primary healthcare. It aims to enable culturally-responsive, community-based care by providing clinical decision-support tools for ongoing screening, assessment, triage, and support. Current practice in Australia lacks consistent, system-wide management of developmental risk, particularly in services for First Nations children, leading to inequities in identification, support and referral. Pilot findings have indicated that the Tracking Cube can accelerate adoption of best practice, improve triage accuracy, provide timely, culturally-responsive support within primary care, and reduce unnecessary referrals to specialists. This trial will assess its effectiveness and implementation across seven diverse primary healthcare sites serving First Nations children.

methodsThis type 1 hybrid effectiveness-implementation trial combines a stepped-wedge cluster randomised trial to assess effectiveness, with a mixed-methods implementation evaluation guided by the EPIS framework. Seven sites (defined as geographic regions that encompass one or more service delivery locations) not currently using standardised neurodevelopmental screening and triage for individuals under 18 years will be randomised to implement the Tracking Cube. Sites will commence in 2-month intervals; data will be collected over a 6-month baseline, 24-month intervention, and 6-month sustainability phase. Effectiveness outcomes (increased identification of neurodevelopmental concerns and disorders, improved follow-up in primary healthcare, and more appropriate specialist referrals) will be evaluated via longitudinal chart audits. Implementation strategies will be documented, and outcomes (barriers, enablers, accessibility, acceptability, appropriateness, feasibility, and readiness) will be evaluated through a place-based learning database, journey tracking database, and healthcare provider and family surveys and interviews. DISCUSSION: This trial addresses healthcare system gaps by embedding neurodevelopmental care into routine practice through a culturally grounded, co-designed model. Sharing knowledge across community, industry, and academia resulted in a strengths-based, holistic approach that supports children whose developmental needs are often overlooked due to systemic failures. By conducting a rigorous stepped-wedge cluster randomised trial and documenting implementation strategies, outcomes from this trial could showcase how the uptake of a complex intervention can be accelerated across diverse contexts. If effective, the Tracking Cube could inform an equity-focused, scalable solution for neurodevelopmental support within primary healthcare that maintains site-specific relevance.

trial registrationThis trial is registered: ACTRN 12624001116516; Date of registration 17-09-24, https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12624001116516

Indexed as

Neurodevelopmental DisordersPrimary Health CareAdolescentAustraliaChildChild, PreschoolDecision Support Systems, ClinicalHumansRandomized Controlled Trials as TopicTriageChild neurodevelopmentClinical-decision supportCo-designConsumer-ledDigital healthImplementationIndigenousPrimary healthcareStepped-wedgeTracking Cube

Identifiers

PMID41680749
PMCPMC12997990

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.