A Structured Systems Approach For Improving Health Promotion Practice For Chronic Diseases In Indigenous Communities
Funder
National Health and Medical Research Council
Funding Amount
$666,592.00
Summary
This project will trial a model for continuous improvement, with the aim of assisting health services and community based organisations to improve the services they deliver to promote health and prevent chronic disease in Indigenous communities.
Pandemic Influenza Containment Strategies In Aboriginal Communities: What Is Acceptable And Feasible?
Funder
National Health and Medical Research Council
Funding Amount
$1,056,688.00
Summary
Influenza is a serious disease with a much greater impact in Indigenous communities. This project will work with Aboriginal communities in NSW, north Qld and WA on modifying the national pandemic influenza plan to develop control strategies that are acceptable to the culture and circumstances of those communities. A template and acceptable process will then be offered to other Indigenous communities, finally leading to negotiation to modify implementation of pandemic influenza plans.
An Education Intervention For Childhood Asthma By Local Aboriginal And Torres Strait Islander Health Workers
Funder
National Health and Medical Research Council
Funding Amount
$97,500.00
Summary
There are only a few studies on asthma in Aboriginal and Torres Strait Islander children, and those are restricted to prevalence and hospitalisation data. We have previously shown that the prevalence of childhood asthma in the Torres is similar to that of mainstream Australia and that children of this region generally have more severe asthma than children seen in urban areas. Using a model of care appropriate for Aboriginal and Torres Strait Islander people, with the involvement of local Indigen ....There are only a few studies on asthma in Aboriginal and Torres Strait Islander children, and those are restricted to prevalence and hospitalisation data. We have previously shown that the prevalence of childhood asthma in the Torres is similar to that of mainstream Australia and that children of this region generally have more severe asthma than children seen in urban areas. Using a model of care appropriate for Aboriginal and Torres Strait Islander people, with the involvement of local Indigenous health care workers, we have adapted an asthma information package. With Study 1, we will examine the effect of local health care workers using this education package to educate children about their asthma. Our hypotheses is that children who receive additional asthma education by health worker have better asthma control. So we propose a randomized controlled trial of a culturally appropriate education intervention with children diagnosed with asthma. Enrolled children will be allocated by chance to one of the two regimes: (1) additional asthma education intervention: children will receive a personalised booklet (containing individual data eg. growth, photo of the child, health worker visits etc) that will be used during the medical consultation. They will also have 3 visits from the health worker for their asthma. (2) no additional intervention (they will receive usual information about asthma at the consultation and no health worker visit). With Study 2 we will examine the natural history of children with asthma and asthma-like symptoms and with symptoms suggestive of sleep breathing problems. Two groups of children previously seen by this team (5 years ago) will be clinically reassessed. Our hypothesis is that short to medium term history of asthma in Indigenous children in the Torres Strait is similar to non-Indigenous Australian children where there is a general improvement with age.Read moreRead less
Safe Koori Kids: Community Based Approaches To Indigenous Injury Prevention
Funder
National Health and Medical Research Council
Funding Amount
$671,905.00
Summary
The study will involve the development of an intervention targeting Indigenous children, schools and families and schools in urban environments. Specifically, over a three year period, the proposed research aims to: explore the incidence and impact of intentional and unintentional injury in selected urban Indigenous communities in NSW and identify factors contributing to positive and negative consequences relating to injury; develop and evaluate initiatives in Indigenous communities aimed at inc ....The study will involve the development of an intervention targeting Indigenous children, schools and families and schools in urban environments. Specifically, over a three year period, the proposed research aims to: explore the incidence and impact of intentional and unintentional injury in selected urban Indigenous communities in NSW and identify factors contributing to positive and negative consequences relating to injury; develop and evaluate initiatives in Indigenous communities aimed at increasing resiliency in at-risk children, youth and families; and make recommendations for changes to policy and practice across a range of government portfolios and non-government organisations. Injury, which has received almost no research attention among Indigenous populations, is the leading cause of death, illness and disability for young Australians with the burden of injury for Indigenous Australians significantly higher than for the non-Indigenous population. Indigenous children and youth are over-represented in both intentional (eg. suicide, domestic violence and abuse, assaults and self-harm) and unintentional (eg. burns, road injury, falls and drowning) injury statistics. The complexity of injury to Indigenous people and its 'downstream' impact on families and communities has been documented in recent studies and reports. Although Indigenous children and youth are particularly vulnerable to the impact of injury, there have been few studies that have documented the incidence and impact of injury on Indigenous children or which have offered sustainable and culturally acceptable solutions to the problem of injury. The proposed research focuses on the development of effective, sustainable and culturally acceptable interventions for Indigenous children and youth based on an Indigenous perspective.Read moreRead less
ESTIMATION OF INDIGENOUS MORTALITY WHERE DESIGNATION OF INDIGENOUS STATUS ON DEATH CERTIFICATES IS UNRELIABLE
Funder
National Health and Medical Research Council
Funding Amount
$158,840.00
Summary
Mortality of indigenous Australians is regarded as unacceptably high compared to other Australians and compared to indigenous minorities in other similar countries. Indigenous mortality is based on data from WA, SA and NT, although some of the data are unreliable. There are few reliable data available in Qld, NSW, Vic or Tas because Indigenous status is significantly under-recorded on the death certificate. The objective of the research is to devise and validate indirect methods for estimating i ....Mortality of indigenous Australians is regarded as unacceptably high compared to other Australians and compared to indigenous minorities in other similar countries. Indigenous mortality is based on data from WA, SA and NT, although some of the data are unreliable. There are few reliable data available in Qld, NSW, Vic or Tas because Indigenous status is significantly under-recorded on the death certificate. The objective of the research is to devise and validate indirect methods for estimating indigenous mortality in sub-populations where there are significant proportions of indigenous people, and where designation of indigenous status on death certificate is unreliable. This would permit assessment of mortality differentials and trends in a significant number of Aboriginal and Torres Strait Islander communities in Qld, NSW, Vic and possibly Tas and provide new perspectives in the study of determinants of mortality in indigenous populations through comparisons of communities with relatively high and relatively low mortality, and allow population-based evaluation of the effectiveness of services and programs through surveillence of mortality trends and differentials. The methods rely on the basic premise that the total mortality of a population is contributed to by the mortality of its components in relation to their proportion of the total population. The units of analyses will be mainly municipalities. Mortality and proportion indigenous will be used in the comparison of municipalities with similar socio-economic and geographic characteristics, and mortality by municipality will be statistically modelled using various characteristics of these populations, including proportion indigenous (using ABS data). Methods will be validated by employing them on selected WA, SA and NT mortality data where designation of indigenous staus is considered reliable. Mortality estimates will then be made for indigenous communities in NSW, Qld, and other states.Read moreRead less
A Case-control Study Of Rotavirus Vaccine Effectiveness Against Gastroenteritis Hospitalisation Of Children In The NT
Funder
National Health and Medical Research Council
Funding Amount
$465,859.00
Summary
Almost 1 out of 5 children in remote Aboriginal communities are hospitalised with diarrhoea caused by rotavirus. This study will evaluate the impact of rotavirus vaccination in preventing these hospitalisations. In addition to making sure that vaccination works and that those at highest risk are receiving the benefits, it will assess the indirect impact against other causes of diarrhoea providing, critical information relevant to the vaccine's broader introduction in developing country settings.
To Improve The Accuracy And Precision Of Estimated GRF (eGFR) Measurements In Indigenous Australians
Funder
National Health and Medical Research Council
Funding Amount
$959,349.00
Summary
There is an overwhelming burden of chronic disease in Indigenous Australians. In order to attempt to improve kidney disease in this high-risk population, it is vital that we are able to accurately measure kidney function. This study will provide evidence to accurately assess kidney function in Indigenous Australians. This will then enable development of appropriate clinical guidelines and more effective monitoring of future interventions to slow progression of kidney disease.
An Examination Of The Causes Of Mortality Following Imprisonment In New South Wales Using Data-linkage.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine ....Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine the causes of mortality among prisoners following release from detention. Most interest has focused on overdoses in the period immediately following release; the aim of this study will examine all causes of death among individuals exposed to the correctional environment and compare these to death rates for NSW. Correctional centres house a largely male (94% in NSW) population with backgrounds of disadvantage in all areas, including Indigenous Australians, people of lower socio-economic status, those with a mental illness, and the intellectually disabled. There are currently over 21,000 (June 2001) prisoners detained in Australian correctional centres with approximately 39% housed in NSW. Fifteen percent of the NSW prisoners are Indigenous but comprise only 2% of the general population. The aims of this project will be to: (1) Identify all causes of death among ex-prisoners in NSW for the period 1985 to 2001; (2). Compare death rates in the study group with those in the NSW community; (3) Correlate pre-release health information contained in medical records with specific causes of death; (4) Compare causes of mortality among various sub-groups eg. injecting drug users, the mentally ill, violent offenders, and the intellectually disabled; (5) Examine causes of mortality between Indigenous and non-Indigenous inmates; and (6) use this information to develop pre-release programmes aimed at reducing excess mortality among this group.Read moreRead less
Indigenous Community Action To Reduce Harms Associated With Heavy Cannabis Use In Cape York
Funder
National Health and Medical Research Council
Funding Amount
$814,163.00
Summary
Cape York Indigenous communities together with Queensland Police, are working to reduce cannabis availability. Community leaders report that cannabis use is widespread in their communities with associated problems such as violence, mental illness and economic hardship. This project will deliver tailored strategies to reduce the demand for cannabis whilst providing support and education about the effects of cannabis and reasons to avoid using it over a three year period.
Randomised Controlled Trial Of Azithromycin To Reduce The Morbidity Of Severe Bronchiolitis In Indigenous Infants
Funder
National Health and Medical Research Council
Funding Amount
$1,456,802.00
Summary
Acute lower respiratory infections are the commonest cause of hospitalisations and retrievals from remote communities. Early severe respiratory infections likely impair lung growth. We will examine whether azithromycin (antibiotic with anti-inflammatory properties) should be used to treat infants hospitalised with bronchiolitis to reduce the severity of bronchiolitis and prevent rehospitalisation. The study potentially improves acute clinical care as well as prevents future respiratory illness.