NACCHO Aboriginal Children’s Health :Boosting early learning for Indigenous children

Nov 15

“There’s no doubt there’s a high level of adversity in remote communities,”

There are multiple risk factors for children, including parental wellbeing, alcohol and drug use, mental health issues, poverty and overcrowding.

Cumulatively these all contribute to the poorer social-emotional, health and economic outcomes experienced by far too many Aboriginal people.

There is an opportunity to lay down neural pathways in that critical period under three, when we see the most prolific brain development.

It’s a real opportunity not just to promote optimal development, but also to ameliorate some of the risks disadvantaged children face.”

Early childhood learning is one obvious area for investment but governments need evidence says Dr Anita D’Aprano from the University of Melbourne’s Graduate School of Education.

Originally Published HERE   By Catriona May, University of Melbourne

NACCHO has published over 270 articles Aboriginal Children’s Health in the past 5 years

And yet, despite overwhelming evidence of the benefits of early childhood education and intervention, some Indigenous children have missed out on the developmental tools used routinely with the rest of the population.

Spotting the gap

Dr D’Aprano, a paediatrician who works with children with developmental difficulties, first noticed the disparity while on sabbatical in the Northern Territory.

The ASQ-TRAK tool is empowering for parents, who report feeling proud of their children’s achievements. Picture: NT Department of Education

“The standard screening tool used predominantly by child health nurses to pick up developmental difficulties in young children was not being used for Aboriginal children living in remote settings,” she says.

One of the developmental screening tools commonly used in Australia is the Age and Stage Questionnaire (ASQ-3).

It helps understand how children under five are developing their communication skills, gross motor skills, fine motor skills, ability to interact socially and how they problem solve.

It is designed to detect developmental difficulties before they present at school, so children who need extra support receive it as early as possible.

“The available developmental screening tools were deemed inappropriate for Aboriginal children in remote communities – but nothing was being used in their place. So there was no formal way of identifying children in those communities who needed extra support,” says Dr D’Aprano.

Motivated to change the situation, Dr D’Aprano resigned from her job in Melbourne and signed on for a PhD at the Menzies School of Health Research in Darwin.

The result is the ASQ-TRAK – a culturally adapted version of the mainstream questionnaire, modified for Aboriginal children living in remote communities.

It is already being used in the Northern Territory and Western Australia and currently being trialled in South Australia.

Modifying the questionnaire

Working initially with two communities in central Australia and North East Arnhem Land, Dr D’Aprano consulted early childhood education specialists, child health practitioners, linguists, cultural experts and Aboriginal leaders to adapt each of the 210 items in the questionnaire.

While the intention of every item remains the same, the adapted questionnaire features very simple English, culturally relevant tasks and illustrations.

The ASQ-TRAK is tailored for Aboriginal people living in remote communities. Picture: Supplied

 

At the 12 month check up, for example, the mainstream questionnaire asks parents if their baby walks beside furniture while holding on with only one hand.

“But a lot of homes in remote communities do not have much furniture,” says Dr D’Aprano. “So we modified the question to ask parents whether their child walks beside chairs or beside people sitting on the ground, holding on with just one hand.”

Other simple modifications included asking families if their child uses a stick to draw in the sand (rather than a crayon), and showing that a threading task could be completed using seeds and string, rather than beads.

The adapted tool has been validated, and feedback from practitioners and parents has been overwhelmingly positive.

“The questionnaire is very practical. It’s not a test, it features everyday activities you would expect a lot of children to be able to do at home. It’s an opportunity for everyone to see the child achieving these skills and parents say they really value being able to see what their child can achieve. They feel proud”

An added benefit, says Dr D’Aprano, is the process empowers parents.

“It’s a way of starting a conversation with parents about how they can promote their own child’s development – rather than it being seen as something separate or only a role for so-called experts.”

Dr D’Aprano went on to collaborate with the Central Australian Aboriginal Congress and the Department of Education in the Northern Territory.

One of the programs now using the ASQ-TRAKthe Northern Territory Department of Education’s Families as First Teachers, an early learning and family support program for remote Aboriginal families, with 38 sites.

“They use the questionnaire as a way to understand each child’s developmental needs, and develop individualised learning plans to address those needs.”

Making the case for more investment

“There’s no doubt there’s a high level of adversity in remote communities,” says Dr D’Aprano.

“There are multiple risk factors for children, including parental wellbeing, alcohol and drug use, mental health issues, poverty and overcrowding.

“Cumulatively these all contribute to the poorer social-emotional, health and economic outcomes experienced by far too many Aboriginal people.”

Early childhood learning is one obvious area for investment, says Dr D’Aprano, but governments need evidence.

Her next step is to develop a culturally appropriate standardised tool that measures the effectiveness of early childhood development programs – both for individual children and programs as a whole.

“We haven’t had a culturally appropriate way of looking at outcomes from programs like Families as First Teachers, but we really need to invest in this area.

“When the health dollar has to be spread so thin we have an obligation to make the case for investment in early education, particularly for those children who need it the most.”

Nov 15

NACCHO Aboriginal Health #researchtranslation17 @NHMRC and @KenWyattMP announce $12 Million Investment Aiming to #ClosetheGap in #Indigenous Health

‘We hope it can improve the health of Aboriginal babies,’

Darwin mother Dianne Walker (pictured above )   entered her newborn daughter Rekeesha into the study 29 years ago to track her development, and is happy the project is getting more funding.

Hear ABC interview HERE

http://www.abc.net.au/radio/sydney/programs/pm/aboriginal-health-research/9139838

Menzies will also continue the nation’s longest cohort study of Aboriginal health which examines almost 700 children to identify disease risk factors.

“These nine important projects aim to improve and save lives and will provide more opportunities for health breakthroughs,

From diet improvement to vitamin supplements and antibiotics, this broad range of critical work will continue to increase our clinical knowledge.

I congratulate the Menzies School of Research for its work over more than 30 years, with health services and community partners, on people-focused projects to make a real difference on the ground.”

Indigenous Health Minister Ken Wyatt AM said medical research was critical to closing the gap on Indigenous life expectancy.

Indigenous Affairs Minister Nigel Scullion and Indigenous Health Minister Ken Wyatt AM last Friday  announced the National Health and Medical Research Council (NHMRC) funding for researchers at Darwin’s Menzies School of Medical Research, covering Indigenous-specific and broader health projects

The Turnbull Government will fund nine landmark Northern Territory medical research projects worth over $12 million, aiming to save children’s lives and help close the gap in Indigenous health.

“This research’s focus on child health and chronic disease will help address significant challenges in Aboriginal and Torres Strait communities,” Minister Scullion said.

“This demonstrates how the Coalition Government works closely with important Territory institutions like Menzies School of Medical Research to deliver better outcomes for Territorians.

“The funding includes major support for Menzies to undertake a trial of maternal immunisation to prevent pneumonia in infants and to continue a 30-year ground-breaking cohort study of 689 Aboriginal children born to mothers at the Royal Darwin Hospital.”

The grants continue the Turnbull Government’s commitment to world-leading medical research, with the NHMRC tasked with expending at least 5 per cent of its funding to Aboriginal and Torres Strait Islander Health research.

“Through NHMRC, the government is also developing Road Map 3 A Strategic Framework for Improving Aboriginal and Torres Strait Islander Health through Research,” Minister Wyatt said.

“This guide will communicate our objectives and investment in Aboriginal and Torres Strait Islander health research for the next decade.”

Menzies School of Health Research funding:

CIA NAME TITLE
BUDGET
Prof Anne Chang Preventing early-onset pneumonia in Indigenous infants through maternal immunisation: a multi-centre randomised controlled trial

 

$3,210,617.60
Dr Michael Binks Vitamin D supplementation to prevent respiratory infections among Indigenous children in the Northern Territory: a randomised controlled trial.

 

$3,164,378.55
A/Pr Gurmeet Singh Early life and contemporary influences on body composition, mental health, and chronic disease risk markers in the Aboriginal Birth Cohort

 

$3,117,044.30
Prof Anne Chang Prophylactic antibiotics to prevent recurrent lower respiratory tract infections in children with neurological impairment (PARROT) study

 

$1,193,515.70
A/Pr Julie Brimblecombe Healthy Stores 2020: Reducing retail merchandising of discretionary food and beverages in remote Indigenous community stores

 

$903,135.10
Dr Anna Wood Diabetes and cardiovascular risk among Indigenous women after pregnancy complicated by hyperglycaemia.

 

$126,437.00
Dr Simon Smith A prospective study of the aetiology, associations, clinical features and outcomes of community-acquired pneumonia in children and adults in tropical Australia

 

$126,437.00
Ms Jemima Beissbarth Vaccine and antibiotic selective pressures on the microbiology of otitis media in Aboriginal and Torres Strait Islander children in northern Australia

 

$87,302.00
Ms Christina Spargo 2017 Equipment Grant
$84,491.50

NACCHO Aboriginal Health @KidneyHealth : Download @MenziesResearch Indigenous Australians travelling 1000 kilometres for kidney dialysis: report

 

 

” Remote Aboriginal Australians with kidney disease have demanded equitable access to life-saving treatment closer to home to prevent the removal of people from their traditional homelands.

In a new Menzies School of Health Research report, patients and carers from across northern and central Australia called on state, territory and federal government health ministers to overhaul the system to provide more holistic care.”

Download Report Here

Menzies IPV_REPORT_FINAL_09112017

Report lead author Dr Jaquelyne Hughes says the current model meets medical needs, but missed the mark in helping indigenous people feel connected to their country, families and culture.

“We heard, overwhelmingly, of how people felt lonely, distressed and isolated following relocation to access treatment,” Dr Hughes said.

Some patients reported homelessness and desperation because of this disconnect, describing having to stay in the long grass when Darwin hostels are booked out.

A Torres Strait Islander said many sick people are forced to travel up to 1000 kilometres to Cairns and Townsville to receive dialysis.

“And they cry, their tears are running, because they want to go back home, they miss their families, they miss the lifestyle of the islands, because they are islanders,” the patient said.

Many noted the disease can fracture communities as elders become ill and are relocated together with their relatives, who miss out on cultural obligations and suffer disruptions to education and employment.

“We want them (the elders) to stay in communities. They are the old people; they have to hold country and family together for us,” one patient said.

“Families living in Darwin (for dialysis) are missing out on ceremonies, funerals and other important stuff,” another person said.

Dr Hughes said the only type of care available to most indigenous renal failure sufferers was designed by and for people in cities at the expense of those in the bush.

MENZIES Press Release

Indigenous people with kidney disease living in remote and rural Australia as well as their support networks have made a resounding call for equitable health care closer to home in a report released today by Menzies School of Health Research (Menzies).

In the ‘Indigenous Patient Voices: Gathering Perspectives, Finding Solutions for Chronic and End-Stage Kidney Disease’ 2017 symposium report, renal patients and carers from across northern and central Australia highlighted the need for more holistic care and services to be made available closer to home.

Report lead author Dr Jaquelyne Hughes said current health care systems met medical care needs, but missed the mark in helping Indigenous people feel connected to their country, communities and culture while they received treatment.

“We heard, overwhelmingly, of how people felt lonely, distressed and isolated following relocation to access treatment,” Dr Hughes said.

“Some patients reported homelessness and desperation because of this disconnect. They are not rejecting the desire to live well; they are rejecting the only model of care available to them.

“The care available to kidney patients was designed by and for people who live close to cities. This automatically excludes people who live further away and in the bush.”

The report follows the Indigenous Patient Voices Symposium held during September in Darwin in conjunction with the 53rd Annual Scientific Meeting of the Australia and New Zealand Society of Nephrology (ANZSN).

Dr Hughes is one of many health practitioners urging the Australian state, territory and federal government health ministers to respond to this call to action.

“Consumer engagement is a national priority of Australian health services, and the symposium showed many Aboriginal and Torres Strait Islander people are willing to provide feedback to support the necessary health care transformation,” she said.

“We’ve highlighted the patient-reported barriers to accessing quality services for chronic and end-stage kidney disease, how and where services are delivered, how information is communicated and developing pathways and career opportunities for Indigenous Australians within the renal health care workforce.”

The report is available via the Menzies website at http://bit.ly/2znSx7d.

The Indigenous Patients’ Voices Symposium was supported by Kidney Health Australia, Astellas Pharma Australia and Novartis Pharmaceuticals Australia.

 

 

 

NACCHO Aboriginal Health #Data : Dr Ray Lovett #Indigenous health data and the path to healing

 ” The health disadvantages of Indigenous peoples around the world have their roots in colonisation and discrimination and are related to a loss of autonomy over lands and culture.

This history has profoundly affected social determinants of health, such as poverty and marginalisation, and contributed to higher rates of communicable and non-communicable diseases in Indigenous people, and life expectancies that are typically 5 years or more lower than in non-Indigenous populations. 

Despite persistent health inequities, Indigenous peoples are determining the path to healing their communities.”

Download the research HERE  Ray Lovett ANU

” There has been major progress in the reduction of smoking rates, cardiovascular deaths and vaccine coverage among Indigenous people, but these achievements get overshadowed by the bad news stories.”

Dr Ray Lovett from the ANU Research School of Population Health said studies and media reports often portrayed Indigenous health as only a problem and overemphasised negative findings, rather than highlighting progress (Pictured above at the recent #NACCHOagm2017

View NACCHO TV Interview with Dr Lovett at #NACCHOagm2017

 

There has been major progress in the reduction of smoking rates, cardiovascular deaths and vaccine coverage among Indigenous people, but these achievements get overshadowed by the bad news stories.

Major gaps in data are impeding the ability of Indigenous communities to gain a clear picture of their health and access to services, an Indigenous health expert from The Australian National University (ANU) has found.

Dr Lovett is part of an international research collaboration from Australia, New Zealand and Canada that has proposed a new way to ensure Indigenous people maintain control of their health data.

The research and proposed governance processes for use of routinely collected Indigenous health data are published in The Lancet .

“The landscape of health data is changing with increasing access to diverse sources, including health system encounters, health payment claims and disease registries,” Dr Lovett said.

“The value of these routinely collected data is enhanced if they can be linked securely and anonymously at the level of the individual to create reliable health records.”

In Australia, the Federal Government has responsibility for primary health care through Medicare and Indigenous identity can be registered when enrolling for coverage.

“The problem is that enrolment in Medicare is incomplete, as is Indigenous self-identification,” Dr Lovett said.

He said Medicare data was not linked with other administrative and registry data at the national level to investigate the health and care of Indigenous people.

No national agreements on the governance of Indigenous health data exist in Australia, New Zealand or Canada.

ANU conducted the research with the Laurentian University and Institute for Clinical Evaluation Sciences and The Chiefs of Ontario in Canada, The University of Waikato in New Zealand and Bond University in Queensland.

NACCHO Aboriginal Health News Alert : Download the $33.4 Billion 2017 Indigenous Expenditure Report :

 ” Australia’s failure to meet Closing the Gap targets or to design policies that help improve the lives of Indigenous Australians means that governments need to pick up the slack.

 We are spending more than we would like on reacting to disadvantage (for example, A$4.1 billion on “public order and safety”) compared to activities that reduce disadvantage (for example, only A$1.3 billion on tertiary education or A$411 million on early childhood education).

What we still don’t know (and can’t extrapolate from this report) is whether the money we are spending on Indigenous Australians is having any positive impact whatsoever. This report certainly doesn’t provide the data or the level of policy rigour to answer that much more important question.

More targeted information and higher-quality evaluations are urgently needed. Crucially, Indigenous peoples need to be involved at all stages to provide more meaningful answers.”

From the Conversation

 ” An estimated $33.4 billion of Australian, State and Territory government expenditure was spent on services provided to Aboriginal and Torres Strait Islander Australians in 2015-16, according to the 2017 Indigenous Expenditure Report.

Around 18 per cent of this expenditure was on targeted programs for Aboriginal and Torres Strait Islander Australians, and the remainder was through non-targeted, or mainstream, services.”

Download the Report HERE and read Commission press release PART 2 below

2017 Indigenous Expenditure Report $33 Billion

Share of funding to Indigenous-run groups falls over past nine years

Australian funding to other organisations earmarked as Indigenous spending has increased by one third

Reports The Guardian

The proportion of funding that goes directly to Indigenous-run organisations has fallen over the past nine years, while funding to other organisations that is earmarked as Indigenous spending has increased by one third.

The social researcher Eva Cox said the decreased portion of targeted Indigenous funding was concerning. “We do know that Indigenous-specific services do tend to deliver on outcomes,” she told Guardian Australia.

Cox said the focus should not be on how much money was spent but on where and how it was spent, and which organisations received the funding.

Indigenous expenditure accounts for 6% of total expenditure, while Indigenous Australians make up 3.2% of the population. That was an understandable and necessary concentration of funding, Cox said, because it addressed an area of higher need.

“It’s obvious if we are going to deal with a population that is isolated and has entrenched levels of disadvantage then it’s going to cost us more,” she said. “And it should cost us more money but it should be well spent.”

She said the implication from successive government reports, including a damning Australian National Audit Office report on the federal government’s flagship Indigenous advancement strategy, was that money had not been well

“Continuing to spend the money does not necessarily mean that the services are well thought out, well-placed, or well-delivered,” she said.

Melbourne University researcher Elise Klein said targeted funding was necessary to address structural disadvantages faced by vulnerable groups.

“Just to direct funds towards Indigenous programs isn’t enough,” Klein said. “It again matters the kinds of programs that are being funded – just because they say they are doing good doesn’t mean they are. It also matters about who is delivering the programs as there has been a dramatic decrease (and in some cases cessation) of funding to Indigenous community organisations.

“For example only 46% of organisations funded under the Indigenous advancement strategy are Indigenous – receiving only 55% of the total funding.”

The Northern Territory had the highest rate of targeted Indigenous funding nationally, with $20,348 of the $65,929 spent per person directed toward Indigenous-specific services. The Territory also had the highest per person spending, because of higher levels of chronic need and the greater cost of delivering services to remote areas.

Of the bigger states, New South Wales and Queensland directed the lowest proportion of funding toward Indigenous-specific services, with 12% and 15% respectively.

However, both states had the highest overall Indigenous expenditure, with NSW spending $9bn, or $38,452 per person, while Queensland spent $8.5bn or $40,350 per person.

Part 2 Productivity Commission Press Release

Since 2008-09 (and after adjusting for inflation), targeted expenditure has remained relatively constant at around $6.0 billion, while expenditure on mainstream services has increased by almost one-third (from $20.9 billion to $27.4 billion).

Per head of total population, expenditure (targeted and mainstream) equated to $44 886 per Aboriginal and Torres Strait Islander Australian, around twice the rate for non- Indigenous Australians ($22 356) and similar to ratios previously reported back to 2008 -09.

 

Around two-thirds of the higher per person expenditure for Aboriginal and Torres Strait Islander Australians is accounted for by greater intensity of service use (reflecting greater need and younger age profile), with the remaining one-third accounted for by the higher cost of providing services (such as in remote locations).

Peter Harris, Chairman of the Productivity Commission and Chair of the Steering Committee for the Review of Government Service Provision emphasised the importance of robust, public evaluations to understand the adequacy, effectiveness and efficiency of government spending, something which is outside the scope of this report.

‘Understanding which policies and programs deliver outcomes effectively is vital for Aboriginal and Torres Strait Islander

Australians, and all Australians. Without understanding what works and why, we cannot say if money is being well spent’ he said.

The full suite of information on this report, including the report, data tables and a ‘how to’ video for accessing the 2017 report data can be found at:

http://www.pc.gov.au/ier2017

The report is produced by the Productivity Commission for the Steering Committee

Background Related Productivity report

Overcoming Indigenous Disadvantage: Key Indicators 2016

The Overcoming Indigenous Disadvantage report measures the wellbeing of Aboriginal and Torres Strait Islander Australians.

This comprehensive report card measures where things have improved (or not) against 52 indicators across a range of areas including governance, leadership and culture, early childhood, education, health, home and safe and supportive communities, and includes case studies on things that work to improve outcomes.

The report is produced in consultation with all Australian governments and Aboriginal and Torres Strait Islander Australians.

The 2016 report was released on 17 November 2016

This report measures the wellbeing of Aboriginal and Torres Strait Islander Australians, and was produced in consultation with governments and Aboriginal and Torres Strait Islander Australians. Around 3 per cent of the Australian population are estimated as being of Aboriginal or Torres Strait Islander origin (based on 2011 Census data).

Outcomes have improved in a number of areas, including some COAG targets. For indicators with new data for this report:

  • Mortality rates for children improved significantly between 1998 and 2014, particular for 0<1 year olds, whose mortality rates more than halved (from 14 to 6 deaths per 1000 live births).
  • Education improvements included increases in the proportion of 20–24 year olds completing year 12 or above (from 2008 to 2014-15) and the proportion of 20–64 year olds with or working towards post-school qualifications (from 2002 to 2014-15).
  • The proportion of adults whose main income was from employment increased from 32 per cent in 2002 to 43 per cent in 2014-15, with household income increasing over this period.
  • The proportion of adults that recognised traditional lands increased from 70 per cent in 2002 to 74 per cent in 2014-15.

However, there has been little or no change for some indicators.

  • Rates of family and community violence were unchanged between 2002 and 2014-15 (around 22 per cent), and risky long-term alcohol use in 2014-15 was similar to 2002 (though lower than 2008).
  • The proportions of people learning and speaking Indigenous languages remains unchanged from 2008 to 2014-15.

Outcomes have worsened in some areas.

  • The proportion of adults reporting high levels of psychological distress increased from 27 per cent in 2004-05 to 33 per cent in 2014-15, and hospitalisations for self-harm increased by 56 per cent over this period.
  • The proportion of adults reporting substance misuse in the previous 12 months increased from 23 per cent in 2002 to 31 per cent in 2014-15.
  • The adult imprisonment rate increased 77 per cent between 2000 and 2015, and whilst the juvenile detention rate has decreased it is still 24 times the rate for non-Indigenous youth.

Change over time cannot be assessed for all the indicators — some indicators have no trend data; some indicators report on service use and change over time might be due to changing access rather than changes in the underlying outcome; and some indicators have related measures that moved in different directions.

Finally, data alone cannot tell the complete story about the wellbeing of Aboriginal and Torres Strait Islander Australians, nor can it fully tell us why outcomes improve (or not) in different areas. To support the indicator reporting, case studies of ‘things that work’ are included in this report. However, the relatively small number of case studies included reflects a lack of rigorously evaluated programs in the Indigenous policy area.

 

 

Aboriginal Health Research @NHMRC Road Map 3: A Strategic Framework for Improving Aboriginal Health through Research for public consultation.

The National Health and Medical Research Council (NHMRC) has released the draft Road Map 3: A Strategic Framework for Improving Aboriginal and Torres Strait Islander Health through Research (Road Map 3) for public consultation.

The aims of the public consultation are to:

  1. Seek feedback on the draft Road Map 3, including comments on the objective and priority areas
  2. Identify any gaps in Road Map 3, and
  3. Seek feedback on the inclusion of an Action Plan.

NHMRC has committed to develop Road Map 3 to guide and communicate its objectives and investment in Aboriginal and Torres Strait Islander health research for the next decade. Road Map 3 builds on the previous documents, Road Map I (2002) and Road Map II (2010).

From March to July 2017, the NHMRC and its Principal Committee Indigenous Caucus (PCIC) worked with Nous Group (Nous) to conduct a national consultation process for the development of Road Map 3.

The consultation process for Road Map 3 began with a series of interviews with nine leaders from Aboriginal and Torres Strait Islander health and research peak bodies.  This was followed by seven workshops across Australia attended by researchers, health workers, government officials and community leaders. An online survey was also made available for those who could not attend the workshops.

Scope of this public consultation

NHMRC is seeking responses to a series of questions related to the development of Road Map 3.

Consultation Questions:

  1. Is the proposed objective of Road Map 3 relevant?  Why/why not?
  2. Are the three priority areas of Road Map 3 accurate?  Why/why not?
  3. Are there any further priority areas to add?
  4. Is there anything missing from Road Map 3?  Please provide further details.
  5. Are there any other comments you would like to make regarding Road Map 3?

Consultation dates:

Opening date – Friday, 13 October 2017 – 12:00pm, AEST

Closing date – Sunday, 10 December 2017 – 11:59pm, AEST

Extensions will not be provided.

Consultation document:

Supporting documents:

Please note: These documents are for information only and are not open for public consultation.

Please note: If you are having problems downloading a document, please right-click on the link and select “Save Target/Link as…” and choose a location to save the file to.

Personal information

Please provide your contact details: Name, Organisation (if relevant), Email, and Phone number.  This information will not be used or disclosed for any other purpose.

How NHMRC will consider submissions

Due consideration will be given to submissions that address the public consultation questions and provide additional evidence that meets the inclusion criteria.  NHMRC’s Principal Committee Indigenous Caucus (PCIC) will provide advice to NHMRC on responses received.

Privacy and confidentiality

After the final document Road Map 3 is released, submissions may be made publicly available via the NHMRC online public consultation portal, unless they have been requested NOT to be published.

How to make your submission

Provide a submission by response to the above questions using the submission form provided below, and email through to NHMRCroadmap3@nousgroup.com.au. (link sends e-mail)

Contact for further information:

Samantha Faulkner, Aboriginal and Torres Strait Islander Adviser

Email: Samantha.faulkner@nhmrc.gov.au (link sends e-mail

WEBSITE

Aboriginal Maternity Health Program : #CATSINaM17 @IUIH_ Million-dollar boost for groundbreaking #Indigenous maternity program

“It is informed by Indigenous knowledge and community control with a redesigned health service to provide 24/7 continuity of midwifery care and birthing in an Indigenous birth centre,

“With Indigenous leadership and a team with expertise in Indigenous health and research we can translate what we know works in other settings, and other countries, into practice here in Australia.”

Institute for Urban Indigenous Health CEO Adrian Carson said a key component of the project was the Indigenous control and governance of services.

A maternity program designed to achieve better health outcomes for Aboriginal and Torres Strait Islander women and their babies has received a $1.1 million grant from the National Health and Medical Research Council (NHMRC).

The project, led by The University of Queensland’s Professor Sue Kildea and researchers from the University of Sydney and the Institute for Urban Indigenous Health, will implement Birthing on Country on a number of sites with a view to an Australia-wide roll out.

The NHMRC grant will help determine the sustainability of a Birthing on Country service model in each community, along with the impact on Aboriginal and Torres Strait Islander women, their communities and health services.

“The Birthing On Country program has a strong emphasis on culturally and clinically safe care, strengthened support for families, growing a culturally capable workforce and the Indigenous maternal and infant workforce,” Professor Kildea said.

“This program focuses on the year before and the year after birth, as the most important time in life.

“It also allows us to review the effect on three of the most costly health outcomes across the lifespan for Aboriginal and Torres Strait Islander peoples: preterm birth, low birth weight and hospital admissions in the first year of life.”

Professor Kildea said the project team was calling on all Australian governments and health organisations to work with them to implement Birthing On Country programs.

“After two decades of research, including consultation with Indigenous elders and communities, we can now enact State and Federal health policy and put into practice national and international evidence of the safety, benefits and cost-effectiveness of culturally safe care,” she said.

“With Indigenous leadership and a team with a wealth of cross-disciplinary expertise in Indigenous and health services, we can translate what we know works in other settings and other countries into practice here in Australia.”

The project, entitled ‘Building on Our Strengths (BOOSt): Developing and Evaluating Birthing On Country Primary Maternity Units’, also includes the Aboriginal and Torres Strait Islander Community Health Service (ATSICHS) Brisbane, the Waminda South Coast Women’s Health and Welfare Aboriginal Corporation, the Australian College of Midwives, the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives, and the Rhodanthe Lipsett Indigenous Midwifery Charitable Fund.

The NHMRC grant builds on previous funding from the Ian Potter Foundation in Melbourne, the Institute for Urban Indigenous Health, ATSICHS Brisbane, the Mater Health Service, Queensland Health and an earlier NHMRC grant.

 

NACCHO Aboriginal Health #RUOKDay : Download @RACGP Report underlines crucial role of GPs in #mentalhealthcare

“With a shortage of psychologists and other mental health professionals in rural and remote areas, the role of rural doctors in providing mental healthcare is already absolutely critical, and is becoming more so.

“Feedback from many rural and remote doctors backs up the findings in today’s RACGP report — namely, that there is a significant mental healthcare load in general practice.

“And this area of general practice care is growing.

“Many rural doctors already undertake additional upskilling in advanced mental healthcare.”

President of the Rural Doctors Association of Australia (RDAA), Dr Ewen McPhee

Download a PDF Copy of report

Health-of-the-Nation-2017-report

Read over 150 Aboriginal Mental Health Articles published over the past 5 years by NACCHO

A major report released today on general practice care in Australia shows that the most frequent visits to GPs are for psychological care, demonstrating that the sector plays a critical role in helping patients with their mental health as well as physical health.

The report, General Practice: Health of the Nation, is the first of what will be an annual insight into the state of general practice in Australia, published by the Royal Australian College of General Practitioners (RACGP).

Dr Ewen McPhee continued

“And under the National Rural Generalist Pathway that the Federal Government is progressing, medical graduates training as Rural Generalist doctors will be able to undertake advanced mental healthcare as a key element of their training, alongside other advanced skills.

“Earlier this year, we also welcomed an announcement by the Federal Government that, from November, it will increase access for rural and remote Australians to Medicare-rebated psychological care delivered by video consultations.

“Under the change, psychologists will be able to deliver up to 7 of the currently available 10 face-to-face sessions accessed through a General Practitioner. The rebates for these sessions have previously only been available if provided by a GP.

“This change will help to significantly improve access to tele-psychology services for many rural and remote Australians and the Government deserves full credit for implementing it.”

RDAA has supported concerns raised by the RACGP, however, that despite the fact that over 85% of the Australian population visits their GP each year, the general practice sector receives only 5% of the total annual health budget.

“This should be sending significant warning bells to governments” Dr McPhee said.

“Given the reliance that Australians have on general practice for their primary care — and the ability of investment in general practice to generate significant budget savings by reducing hospital admissions — it is clear that additional investment in general practice needs to be made, sooner rather than later.”

Consumers Health Forum MEDIA RELEASE :

The finding that psychological issues are a leading reason patients see GPs highlights the importance of the GPs’ role as the first base for health concerns in the community.

The Health of the Nation report released by the Royal Australian College of GPs today reveals mental health issues like depression and anxiety are among the most common ailments reported by 61 per cent of GPs.

“That is a disturbingly high figure.  It is also the issue causing GPs most concern for the future,” the CEO of the Consumers Health Forum, Leanne Wells, said.

The next most commonly mentioned as emerging issues by GPs are obesity and diabetes.  The prevalence of these conditions, all of which raise complex challenges for the most skilled GP, underlines the need for a well-coordinated and integrated health system in the community.

“The Consumers Health Forum recognises the GP as the pivotal figure in primary health care who needs more support through such measures as the Government’s Health Care Homes, initiating more integrated care of those with chronic and complex conditions.

“At a recent Consumers Roundtable meeting with Health Minister, Greg Hunt, we set out priorities for a National Health Plan to strengthen Australia’s primary health system, making it more consumer-centred, prevention-oriented and integrated with hospital and social care.

“We also called for more investment in health systems research, shaped by consumer and community priorities, to stimulate services that reflect advances in health sciences and knowledge.

Too often Australians, particularly those with chronic illness, are confounded by our fragmented health system.

We have world class health practitioners and hospitals. But these are disconnected so that patients don’t get the comprehensive top-quality care that should be routine.

“Investing in primary health care led by GPs is the way to a better performing and more consumer-responsive health system,” Ms Wells said.

 

 

NACCHO #Aboriginal Health and #Diabetes @theMJA the @NHMRC #Indigenous guidelines need update

Early onset of type 2 diabetes is very common in Aboriginal communities following Westernisation, so I agree with the recommendations of NACCHO and the RACGP, which recommended early screening.

Whether you do it annually or every 3 years is a less important question to me, and very patient-dependent.

Only 18% of Indigenous adults were tested for diabetes annually, as per the more intensive guidelines by the National Aboriginal Community Controlled Health Organisation (NACCHO), leading the authors to claim that the RACGP/DA guidelines were more practicable “

Professor Kerin O’Dea, Professor Emeritus at the University of South Australia and Honorary Professor at the University of Melbourne, said that the NHMRC recommendations “really need to be updated”.

Originally published MJA

Read over 120 diabetes related posts by NACCHO over past 5 years

MORE can be done to increase diabetes screening rates among Indigenous Australians and enable earlier intervention, say experts who are calling for a greater focus on young adults.

A study published in the MJA found enormous variation in diabetes screening rates between different Aboriginal Community Controlled Health Services (ACCHSs).

The proportion of Indigenous adults screened for diabetes at least once in 3 years – as per the Royal Australian College of General Practitioners and Diabetes Australia (RACGP/DA) guidelines – ranged from 16% to 90% between different services.

Overall, 74% of Indigenous adults received a screening test for diabetes at least once between 2010 and 2013, the study found, based on de-identified data on 20 978 patients from 18 ACCHSs.

Only 18% of Indigenous adults were tested for diabetes annually, as per the more intensive guidelines by the National Aboriginal Community Controlled Health Organisation (NACCHO), leading the authors to claim that the RACGP/DA guidelines were more practicable.

Extract Overview provided by NACCHO

Download a full copy of 2 nd edition

http://www.racgp.org.au/download/documents/AHU/2ndednationalguide.pdf

Type 2 diabetes is most commonly found in obese adults who develop increasing insulin resistance over months or years. For these patients there is a substantial ‘prediabetic’ window period of opportunity to offer preventive interventions. Screening for diabetes is safe, accurate and cost effective, and detects a substantial proportion of people who may not otherwise have received early intervention.1 This chapter discusses type 2 diabetes in adults who are not pregnant.

The prevalence of type 2 diabetes in Aboriginal and Torres Strait Islander populations is 3–4 times higher at any age than the general population, with an earlier age of onset.2 The precise prevalence is hard to pinpoint; a 2011 systematic review of 24 studies showed prevalence estimates ranged from 3.5–31%, with most lying between 10% and 20%. Diabetes prevalence in remote populations is approximately twice that of urban populations and is higher among Aboriginal and Torres Strait Islander people.3

Aboriginal and Torres Strait Islander men and women die from diabetes at 23 and 37 times the rate of non-Indigenous Australian men and women respectively, in the 35–54 years age group.4 Large scale clinical trials have demonstrated that appropriate management of diabetes can prevent the development or delay the progression of complications such as myocardial infarction, eye disease and renal failure.5

Obesity is a very strong predictor for diabetes; a body mass index (BMI) ≥30 kg/m2 increases the absolute risk of type 2 diabetes by 1.8–19-fold, depending on the population studied. A cohort study of non-diabetic Aboriginal adults aged 15–77 years in central Australia found that those with a BMI of ≥25 kg/m2 had 3.3 times the risk of developing diabetes over 8 years of follow up compared to those with a BMI <25 kg/m2.1 The AusDiab study found that three measures of obesity: BMI, waist circumference and waist-to-hip ratio, all had similar correlations with diabetes and CVD risk.6 Waist circumference performed slightly better than BMI at predicting diabetes in a remote Aboriginal community

The study defined screening tests to include glycated haemoglobin (HbA1c) testing as well as the oral glucose tolerance test and venous glucose level testing.

Barriers to screening included being aged under 50 years, being transient rather than a current patient and attending the service less frequently, the study found. The authors concluded that particular attention should be given to increasing the screening rate in these groups.

The finding that young people were less likely to be tested was “intuitively reasonable”, the authors said, given that the risk of developing diabetes rises with age. However, they suggested that it was still best practice to test Indigenous adults from the age of 18 years, as it provided a “substantial opportunity for limiting the impact of type 2 diabetes”.

Indigenous Australians aged 25–34 years are five times more likely to have diabetes or high blood sugar levels than non-Indigenous Australians of the same age, they noted.

Despite this difference between Indigenous and non-Indigenous people, the National Health and Medical Research Council (NHMRC) only recommends screening Indigenous people for diabetes once they are aged over 35 years, and doing it every 3 years.

Professor Kerin O’Dea, Professor Emeritus at the University of South Australia and Honorary Professor at the University of Melbourne, said that the NHMRC recommendations “really need to be updated”.

“Early onset of type 2 diabetes is very common in Aboriginal communities following Westernisation, so I agree with the recommendations of NACCHO and the RACGP, which recommended early screening,” she told MJA InSight.

“Whether you do it annually or every 3 years is a less important question to me, and very patient-dependent,” she said.

Professor O’Dea said that more widespread use of HbA1c testing could increase the screening rate in Aboriginal communities, particularly among younger people and those who were more transient.

“If screening for diabetes was just a simple opportunistic HbA1c test, you wouldn’t have so many problems getting people to have it done,” she said. “HbA1c testing will give you a good idea of the mean glucose level, and unlike the glucose tolerance test, you don’t have to ask the patient to return in the fasting state.

“If it does turn out that the patient has borderline diabetes, then you can ask if they are prepared to do a glucose tolerance test,” she added.

Study co-author, Associate Professor Christine Paul, said that there was significant variation in the use of HBA1c testing across sites and across time in the study.

“I think it is possible that increasing the use of HbA1c as a screening test may help [to increase screening rates]; however, I don’t think it’s the main answer,” she said. “Clearly some health services need support to get systems in place, regardless of which test they use.”

 

NACCHO Aboriginal Health and Smoking : Survey #Nosmokes How #socialmedia supports positive health behaviour

How does accessing the NoSmokes health campaign support anti-smoking behaviour in Aboriginal and Torres Strait Islander youth?

What is this project about?

The aim of this project is to explore how the NoSmokes health campaign supports Aboriginal and Torres Strait Islander youth to deal with smoking situations. We will also explore whether accessing NoSmokes supports young people to stay quit or resist starting smoking.

What are the benefits of the project?
This project will help us to understand more about how online technology and social media can be used to support positive health behaviour, particularly in relation to smoking. You may also learn more about your own confidence in dealing with a number of different smoking situations.

What will I have to do?

To participate you must use /view

1.NoSmokes Facebook page.

VIEW HERE

2. NoSmokes website.

VIEW HERE

3. NoSmokes YouTube channel.

VIEW HERE

4. NoSmokes  Instagram page

VIEW HERE

5.and be 16 years of age or older.

Your participation is voluntary, so you don’t need to take part if you don’t want to. If you choose to take part, you will complete an online questionnaire answering questions about: your experience with smoking; your experience of NoSmokes, your confidence in dealing with different smoking situations. This will take around 20-25 minutes.

If there are any questions in the survey you don’t like, or that you do not feel comfortable answering, then leave that question and move onto the next one. You can complete the survey on your mobile phone or computer. If you change your mind about participating, or are feeling uncomfortable, you can choose to stop the survey at any time by closing the web page or by not pressing the ‘submit’ button. Any data collected before you withdraw will be deleted at the end of the data collection period.

What will happen to my information?

Only the researcher will have access to the individual information provided by participants. Privacy and confidentiality will be assured at all times. The project findings will be used as part of the researcher’s Honours Thesis project, and will be published on the NoSmokes and Ninti One websites. The research may also be presented at conferences and written up for publication.

Only anonymous information will be gathered – you will not be required to provide any identifiable personal information, such as your name or date of birth. No one will know you have taken part in this research from reading the thesis, reports or other publications.

If you are interested in viewing the results of this research, a summary report will be available on the NoSmokes website http://nosmokes.com.au/ in December 2017. You can also request a copy of the final thesis by emailing Neeti Rangnath on u3105740@uni.canberra.edu.au.

Researcher
Neeti Rangnath
Honours Student
Discipline of Psychology, Faculty of Health
University of Canberra, ACT 2601
Email: u3105740@uni.canberra.edu.au
Supervisor
Dr Penney Upton
Associate Professor in Health
Centre for Research and Action in Public Health
University of Canberra, ACT 2601
Ph: 02 6201 2638
Email: penney.upton@canberra.edu.au
Data storage
During the project, the anonymous data will be stored securely on a password protected computer, and then stored securely on the University of Canberra network server. The information will be kept for 5 years, after which it will be destroyed according to University of Canberra protocols.

Ethics Committee Clearance
The project has been approved by the Human Research Ethics Committee of the University of Canberra (HREC 17-83).

Queries and Concerns
If you have any questions or concerns about this project you can contact the researchers, whose details are provided at the top of this form. If you are concerned about the conduct of this project please contact

Mr Hendryk Flaegel, Ethics and Compliance Officer at the University of Canberra (p) 02 6201 5220 (e) humanethicscommittee@canberra.edu.au

There are no anticipated risks associated with participating in this research. However, if completing this questionnaire makes you feel uncomfortable, sad, or angry about your own smoking or the smoking behaviour of someone you know, you are encouraged to visit the following website to find support with smoking-related issues in your state or territory:

http://www.quitnow.gov.au/internet/quitnow/publishing.nsf 

Consent Statement 
I have read and understood the information about the research. I am not aware of any reason that I should not be participating in this research, and I agree to participate in this project. I have had the opportunity to ask questions about my participation in the research. All questions I have asked have been answered to my satisfaction.

Complete consent and start survey here