Indigenous health: effective and sustainable health services through continuous quality improvement

Bailie, Ross; Si, Damin; O'Donoghue, Lynette R.; Dowden, Michelle

doi:10.5694/j.1326-5377.2007.tb01028.x

Cited by 85 publications

(90 citation statements)

References 13 publications

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“…Furthermore, framing research evaluation as a “wicked” rather than a mere “technical” problem provides the opportunity to tailor more appropriate participatory learning-by-doing approaches based on trust and reciprocity (18–21) to co-create mechanisms to evaluate the impact of research on health and wellbeing. As Rittel and Weber (39) remind us that there are no templates or ready-made answers when dealing with “wicked” problems because, as in the rhizome analogy, as soon as one problem is solved the very solution may trigger two or three other problems (39).…”

Section: Discussionmentioning

confidence: 99%

“…Using participatory snowball techniques, the approach involved “plan–act–learn–plan–act cycles” (18–21), which are wholly consistent with the Lowitja Institute aims and Indigenous decolonized approaches to research (1). The tool development process occurred in three discrete phases, reflecting the plan–act–learn approach, with a fourth phase for the ongoing development and evaluation of a new toolkit.…”

Section: Methodsmentioning

confidence: 99%

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Evaluating Research Impact: The Development of a Research for Impact Tool

Tsey

Lawson

Kinchin

et al. 2016

Front. Public Health

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IntroductionThis paper examines the process of developing a Research for Impact Tool in the contexts of general fiscal constraint, increased competition for funding, perennial concerns about the over-researching of Aboriginal and Torres Strait Islander issues without demonstrable benefits as well as conceptual and methodological difficulties of evaluating research impact. The aim is to highlight the challenges and opportunities involved in evaluating research impact to serve as resource for potential users of the research for impact tool and others interested in assessing the impact of research.Materials and methodsA combination of literature reviews, workshops with researchers, and reflections by project team members and partners using participatory snowball techniques.ResultsAssessing research impact is perceived to be difficult, akin to the so-called “wicked problem,” but not impossible. Heuristic and collaborative approach to research that takes the expectations of research users, research participants and the funders of research offers a pragmatic solution to evaluating research impact. The logic of the proposed Research for Impact Tool is based on the understanding that the value of research is to create evidence and/or products to support smarter decisions so as to improve the human condition. Research is, therefore, of limited value unless the evidence created is used to make smarter decisions for the betterment of society. A practical way of approaching research impact is, therefore, to start with the decisions confronting decision makers whether they are government policymakers, industry, professional practitioners, or households and the extent to which the research supports them to make smarter policy and practice decisions and the knock-on consequences of doing so. Embedded at each step in the impact planning and tracking process is the need for appropriate mix of expertise, capacity enhancement, and collaborative participatory learning-by-doing approaches.DiscussionThe tool was developed in the context of Aboriginal and Torres Strait Islander research but the basic idea that the way to assess research impact is to start upfront with the information needs of decisions makers is equally applicable to research in other settings, both applied (horizontal) and basic (vertical) research. The tool will be further tested and evaluated with researchers over the next 2 years (2016/17). The decision by the Australian Government to include ‘industry engagement’ and ‘impact’ as additions to the Excellence in Research for Australia (ERA) quality measures from 2018 makes the Research for Impact Tool a timely development. The wider challenge is to engage with major Australian research funding agencies to ensure consistent alignment and approaches across research users, communities, and funders in evaluating impact.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Evaluating Research Impact: The Development of a Research for Impact Tool

Tsey

Lawson

Kinchin

et al. 2016

Front. Public Health

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“…To be effective, opportunistic screening must be undertaken in a culturally competent manner as the cultural competence of the health service is associated with the likelihood that Aboriginal people access services 30. Critically important is that opportunistic screening must include pathways for further assessment and treatment, and access must be actively facilitated where necessary 31. Further, opportunistic screening should include improving health literacy so that Aboriginal people are better informed about their health and therefore more likely to identify potential health issues earlier 32…”

Section: Introductionmentioning

confidence: 99%

Opportunistic screening to detect atrial fibrillation in Aboriginal adults in Australia

et al. 2016

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IntroductionThere is a 10-year gap in life expectancy between Aboriginal and non-Aboriginal Australians. The leading cause of death for Aboriginal Australians is cardiovascular disease, including myocardial infarction and stroke. Although atrial fibrillation (AF) is a known precursor to stroke there are no published studies about the prevalence of AF for Aboriginal people and limited evidence about AF in indigenous populations globally.Methods and analysisThis mixed methods study will recruit and train Aboriginal health workers to use an iECG device attached to a smartphone to consecutively screen 1500 Aboriginal people aged 45 years and older. The study will quantify the proportion of people who presented for follow-up assessment and/or treatment following a non-normal screening and then estimate the prevalence and age distribution of AF of the Australian Aboriginal population. The study includes semistructured interviews with the Aboriginal health workers about the effectiveness of the iECG device in their practice as well as their perceptions of the acceptability of the device for their patients. Thematic analysis will be undertaken on the qualitative data collected in the study. If the device and approach are acceptable to the Aboriginal people and widely adopted, it may help prevent the effects of untreated AF including ischaemic stroke and early deaths or impairment in Aboriginal people.Ethics and disseminationThis mixed methods study received ethics approval from the Aboriginal Health and Medical Research Council (1135/15) and the Australian Health Council of Western Australia (HREC706). Ethics approval is being sought in the Northern Territory. The findings of this study will be shared with Aboriginal communities, in peer reviewed publications and at conferences. There are Aboriginal investigators in each state/territory where the study is being conducted who have been actively involved in the study. They will also be involved in data analysis, dissemination and research translation.Trial registration numberACTRN12616000459426.

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“…This approach is endorsed for Aboriginal and Torres Strait Islander research given that it emphasises participation by the people being studied, cultural respect, capacity building and collaboration 32. The key features of the action research approach to be used in this study are ‘cyclical activities involving examination of existing processes, change monitoring the apparent effects of the change, and further change’ 33.…”

Section: Methodsmentioning

confidence: 99%

A service-level action research intervention to improve identification and treatment of cannabis and related mental health issues in young Indigenous Australians: a study protocol

et al. 2014

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IntroductionRegular cannabis use is associated with negative mental health impacts including psychosis, depression and anxiety. Rates of cannabis use have increased in Aboriginal and Torres Strait Islander communities in northern Australia within the last two decades, presenting a significant increased risk to young people's mental health in these regions. Improved screening, early detection and treatment for cannabis-related mental health issues are urgently required. This paper describes a service-level action research intervention and evaluation protocol for use in the few services where it is possible to engage young Aboriginal and Torres Strait Islander Australians.Methods/DesignThe protocol is being developed in two services where youth mental health is core business: a primary healthcare centre and a youth service in the Cairns and hinterland region, far north Queensland. The protocol calls first for baseline data to be collected using staff and client surveys; network mapping; and analysis of screening, treatment and referral rates. The protocol's intervention phase is driven by service needs identified from baseline data. Intervention strategies focus on implementing/enhancing cannabis screening instruments and processes in line with current best practice; enhancing networks with external drug and mental health services; developing culturally acceptable training and resources; developing activities aiming to reduce cannabis use in young Aboriginal and Torres Strait Islander clients using the services. The protocol requires implementation of the multilevel intervention within each service for 1 year, with follow-up data then collected and compared to baseline. Process evaluation identifies the more effective intervention strategies and documents the challenges to be overcome for full implementation.Ethics and disseminationEthics approval was provided by The James Cook University, Human Research Ethics Committee. Ethics Approval Number H5322. Peer-reviewed publications will also be used to disseminate the finding. Results will also be discussed with stakeholder organisations.

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Indigenous health: effective and sustainable health services through continuous quality improvement

Cited by 85 publications

References 13 publications

Evaluating Research Impact: The Development of a Research for Impact Tool

Evaluating Research Impact: The Development of a Research for Impact Tool

Opportunistic screening to detect atrial fibrillation in Aboriginal adults in Australia

A service-level action research intervention to improve identification and treatment of cannabis and related mental health issues in young Indigenous Australians: a study protocol

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