Improving health and education outcomes for children in remote communities: A cross-sector and developmental evaluation approach

Abstract

Early childhood is one of the most influential developmental life stages. Attainments at this stage will have implications for the quality of life children experience as they transition to adulthood. Children residing in remote Australia are exposed to socioeconomic disadvantage that can contribute to developmental delays and resultant poorer education and health outcomes. Complex contributing factors in far west New South Wales have resulted in children with speech and fine motor skill delays experiencing no to limited access to allied health services for a number of decades. More recently, growing awareness that no single policy, government agency, or program could effectively respond to these complexities or ensure appropriate allied health service access for children in these communities has led to the development of the Allied Health in Outback Schools Program, which has been operational since 2009. The program is underpinned by cross-sector partnerships and a shared aspirational aim to improve the developmental outcomes of children to enhance their later life opportunities. It was identified early that the initiative had the potential to deliver mutually beneficial outcomes for communities and participating partner organisations.Over the last five years the program has been the catalyst for partnership consolidation, expansion and diversification. The developmental evaluation approach to continuous program adaptation and refinement has provided valuable insights that have informed health and education policy and enabled the program to be responsive to changing community needs, emerging policy and funding reforms.This article explores the evolution of the program partnerships, their contribution to program success and longevity, and their capacity to respond to an emergent and dynamic environment. The authors propose that a community-centred and developmental approach to program innovation and implementation in remote locations is required. This is based on the premise that contemporary linear, logic-based policy development and funding allocations, with predetermined program deliverables and outcomes, are no longer capable of responding appropriately to the complexities experienced by remote communities.Keywords: allied health, remote communities, cross-sectoral partnerships, service learning

Design and delivery of an innovative speech pathology service-learning program for primary school children in Far West NSW, Australia

“…The factors that come into play in the transferability and scalability of this service-learning model include: 1) the higher cost of clinical placements per speech pathology student; 2) the source of funding for the service-learning model; 3) the need to negotiate agreements with universities providing students; 4) the schools in which servicelearning programs are delivered; and 5) the local health services to which children may be referred. 20,28 Use of service-learning placements in which undergraduate students provide services under supervision, as an innovative approach to addressing student learning and health workforce shortages, has attracted interest in Australia. 29 There is a large body of evidence about its positive impact on student learning, including evaluation data from the Broken Hill allied health student-led clinics.…”

“…The schools obtained parental consent, and participation rates were reported to be very high. 20 The severity of each child's communication difficulty was graded as either mild, moderate or severe based on the screening tools (Erin Wilkins Screen of Articulation and the Screen of Communication Skills), additional clinical information, and parental and/or teacher feedback (Table 1). Therapy included one or more treatment modalities: class-based, small groups, individual sessions outside the classroom and home programs.…”

“…The program is considered innovative because the service-learning model, although embraced in the US 21,22 , is relatively rare in Australia. 20 Barriers to rural clinical placements include a shortage of allied health placements, adequacy of supervision, isolation from other university students and learning resources, and lack of placement coordination. 23 Study findings reported by Jones et al 20 indicate that student learning outcomes in this service-learning classroom-based model may be equal to, if not greater than, those in metropolitan and traditional hospital settings.…”

“…11,17,18 In 2009, the Broken Hill University Department of Rural Health (BHUDRH) established a student-led speech pathology clinic in local primary schools in partnership with school education, the local health service and a metropolitan-based faculty of health sciences. The service was developed in response to concerns expressed by primary school principals about the high proportion of children entering school with communication impairments 6,10,19,20 and the lack of access to allied health services, in this case qualified speech pathologists. 9 The service-learning program aimed to: 1) support early identification and treatment of speech, language and communication delays in young children; 2) improve the educational, social and health outcomes of children experiencing these delays; 3) facilitate communityengaged learning experiences and work-readiness for speech pathology students; and 4) promote rural and remote practice and primary health care approaches to service provision.…”

Interprofessional Academic Service-Learning in Rural Australia: Exploring the impact on allied health student knowledge, skills, and practice. A Qualitative Study

“…More recently interprofessional service-learning (IPSL) (Clark et al 2015, Leander et al 2014 is emerging within the rural Australian context, directly aligning student learning to IPP experiences to address community identified areas of health need (Frakes et al 2014, Jones et al 2015.…”