NACCHO #closethegap Aboriginal Health : Deadly Step program promotes screening, early detection and follow up of chronic disease in Aboriginal communities


The 1 Deadly Step program promotes screening, early detection and follow up of chronic disease in Aboriginal communities in NSW.

The unique component of 1 Deadly Step is the involvement of sport and its ability to engage Aboriginal people that would not normally be screened for chronic disease. Piloting the program across selected communities in NSW will enable NSW to refine the delivery model before a statewide implementation is developed.

Picture above : Staff from Orange Aboriginal Medical Service modelling the 1 Deadly Step replica jersey. These are free for everyone who completes the 1 Deadly Step health screening.

More info website


The 1 Deadly Step project is an initiative of the Chronic Care for Aboriginal People Program (CCAP). This project demonstrates how the CCAP Model of Care can be used as a framework for designing chronic disease programs targeting Aboriginal people and communities.

1 Deadly Step provides an ideal platform on which to establish committed partnerships between local major health service providers such as the Local Health District, Aboriginal Medical Service and Medicare Locals, to improve health outcomes for Aboriginal people and to adopt a coordinated service to follow up after the event.

1 Deadly Step has high level of acceptability within Aboriginal communities and has demonstrated great success in being able to engage Aboriginal people. High rates of Aboriginal men have participated in 1 Deadly Step.


  • 1 Deadly Step works best when it’s part of a bigger community event where the focus is on getting together and having fun.
  • The event consists of screening stages for albumin creatinine ratio, HbA1c, cholesterol, blood pressure, blood glucose, body mass, waist circumference, drinking and smoking.
  • A local organising committee is formed between staff from the local ACCHS, Local Health District and Primary Health Networks which will plan an event for their community to be screened for chronic disease.
  • Any participant with concerning results will be identified for follow up with their GP or another health professional.
  • 1 Deadly Step has a partnership with NSW Country Rugby League who are able to support events with current and past NRL players and providing games and activities for kids.
  • Data is collected using an iPad app which produces a summary of participant’s chronic disease risk status. GP’s are able to download reports for their patients via the 1 Deadly Step web portal to support efficient and targeted follow up.



Local Health Districts; Aboriginal Community Controlled Health Services; Primary Health Networks; and NSW Country Rugby League.


Key Dates

Pilot Sites

1 Deadly Step is currently in the second round of its pilot phase. In 2015, pilot programs were delivered in Campbelltown, Newcastle, Orange and Tamworth. Planning is underway for further sites in 2016. Pilot sites are selected based on consultation with community stakeholders.

Implementation Sites

Implementation will be determined after the evaluation of the second phase pilot period.


An independent evaluation of the pilot program indicated a number of factors that supported the 1 Deadly Step model as a successful engagement strategy targeting Aboriginal people. The evaluation also provided an analysis of the data collected from the 5 sites to support components of the program that have potential in further development.

The 2012 pilot identified opportunities to enhance two components of the 1 Deadly Step model for the next phase of the pilot, namely increasing education around risk factors and link to chronic disease prevention and management; and having a more structured approach to follow up of screening results from 1 Deadly step events.

A second independent evaluation will finish in early 2016; this will inform the final model for 1 Deadly Step.

Related Initiatives

Further Details

1 Deadly Step provides medical equipment and consumables required for testing; incentives for community participation; and support to plan and deliver a screening event. Host sites are required to establish a working party who will have ultimate responsibility for delivery of the community event; provide staff for 1 Deadly Step stages; and commit to a plan for following-up participants from the day. Check out


Kiel Hennessey
Manager, Chronic Care for Aboriginal People
02 9464 468602 9464 4686

Chris Shipway
Director, Primary Care and Chronic Services
02 9464 460302 9464 4603


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