Aboriginal Health Research

Western Alliance recognises the importance of demonstrating cultural humility and agility as an organisation, whereby it is responsive to the needs of the Communities it serves and privileges Aboriginal leadership, recognising Community strength and amplifying their voice, ensuring that its processes and language reflect a strengths-based approach.

 

Implementing marra ngarrgoo, marra goorri: The Victorian Aboriginal Health, Medical and Wellbeing Research Accord

The Accord has been launched to give voice to Aboriginal and Torres Strait Islander community within research and help research organisations ensure alignment of research impacting Victorian Aboriginal and Torres Strait Islander communities with the principles of self-determination.

Following the launch of marra ngarrgoo, marra goorri in late 2023, all Western Alliance funded grant applications for 2024 and beyond will be required to demonstrate how proposed projects are informed by and address the specific health needs of western Victoria’s Aboriginal communities and uphold the principles of marra ngarrgoo, marra goorri.

Find out more about marra ngarrgoo, marra goorri here.

 

Completed projects:

Western Alliance has committed to providing funding for Aboriginal led research, and to date has funded two important projects with Budja Budja Aboriginal Cooperative and Dhauwurd-Wurrung Elderly and Community Health Service (DWECHS).

Principal Investigator:  Hannah Beks, Deakin Rural Health, Deakin University

Collaborating organisations:

Budja Budja Aboriginal Cooperative as our research partner

Grampians Health, through the contribution of Associate Professor Anna Wong Shee

Description:

To meet the health care needs of Aboriginal and Torres Strait Islander Peoples residing in Djab Wurrung Country (Ararat Rural City and Northern Grampians region, Victoria, Australia) during the COVID-19 pandemic, Budja Budja Aboriginal Cooperative (BBAC) responded rapidly by modifying the delivery of health care services to telehealth (both videoconferencing and phone) consultations to meet physical distancing requirements.

This research evaluated the implementation of telehealth services for Aboriginal and Torres Strait Islander Peoples accessing primary health care services (GP, pharmacy, allied health etc) through BBAC.

Key outcomes:

Telehealth maintained the delivery of primary health care services during COVID-19 and were generally acceptable to Aboriginal clients and health service personnel. Telephone telehealth consultations by Aboriginal and/or Torres Strait Islander clients were utilised more than videoconferencing telehealth consultations.

However, overwhelming preference for face-to-face consultations remained as this was perceived to be more personal, aligned with cultural ways of doing, enabled a thorough clinical assessment, and provided an opportunity for clients to socialise with other members of the community.

Recommendations included:

  1. Telehealth services, including both telephone consultation and videoconferencing, should continue to be available as a tool for delivering holistic primary health care services to Aboriginal and Torres Strait Islander Peoples.
  2. Support is recommended for Aboriginal and Torres Strait Islander clients to encourage the uptake of videoconferencing as a telehealth platform.
  3. For complex clinical presentations and clinical assessments, including an initial patient assessment, an in-person consultation with a health professional is preferred, with videoconferencing as a second option.
  4. Telephone consults are recommended as an adjunct to clinical care provided in-person and to follow up established goals of care with clients.

Next steps:

The project was part of a broader research program evaluating service delivery models which was informed by a partnership between Deakin Rural Health and Budja Budja Aboriginal Cooperative.  The partnership is now focused on evaluating student placements undertaken at Budja Budja Aboriginal Cooperative.

Impacts on health in the region: 

Evaluation findings were rapidly disseminated through the Western Victoria Primary Health Network to the Minister for Health and Aged Care and Minister for Indigenous Australians in the context of changes to the MBS telehealth item numbers which saw the removal of telephone MBS item numbers that were frequently utilised by Aboriginal and/or Torres Strait Islander clients of BBAC. Telephone MBS item numbers have since been re-instated and made permanent.

Under-utilisation of the nursing workforce was identified in this study. Subsequently, the project also supported upskilling a Nurse Practitioner in research to undertake a scoping review examining evaluated nurse-led models of care implemented in rural, regional, and remote settings of Australia.

Publications:

Beks, H., Versace, V.L., Mitchell, F., Charles, J.A., Hernan, A., Wong Shee, A., Mc Namara, K.P. Evaluation Report – Telehealth services for Aboriginal and Torres Strait Islander Peoples. August 2021 (for Budja Budja Aboriginal Cooperative)

Beks, H., Versace V. L., Zwolak R., Chatfield T. (2022) Opportunities for further changes to the Medicare Benefits Schedule to support Aboriginal Community Controlled Health Organisations. Australian Health Review 46, 170-172.

Beks, H., Mitchell, F., Charles, J.A., Wong Shee, A., Mc Namara, K.P., Versace, V.L. (2023) Implementation of telehealth primary health care services in a rural Aboriginal Community-Controlled Health Organisation during the COVID-19 pandemic: a mixed-methods study. Rural Remote Health 23 (3), 1-14.

Beks, H., Mc Namara, K.P., Mitchell, F., Charles, J.A., Versace, V.L. (2023) Responsiveness of a rural Aboriginal Community Controlled Health Organisation: A qualitative study. Australian Journal of Rural Health 31 (6), 1214-1228.

Beks, H., Clayden, S., Wong Shee, A., Binder, M.J., O’Keefe, S., Versace, V.L. (2023) Evaluated nurse-led models of care implemented in regional, rural, and remote Australia: A scoping review. Collegian 30 (6), 769-778.

Principal Investigators: 

Hannah Beks, Deakin Rural Health, Deakin University

Vincent Versace, Deakin Rural Health, Deakin University

Collaborating organisations:

Dhauwurd-Wurrung Elderly and Community Health Service (DWECHS): an Aboriginal Community Controlled Health Organisation located on Gunditjmara Country (Portland, VIC)  co-designed the project and all activities

Flinders University supported the scoping review

Warrnambool Clinical School provided support for the project

National Indigenous Knowledges Education Research Innovation (NIKERI) Institute co-designed project and provided cultural guidance

Global Obesity Centre, Institute for Health Transformation co-designed project and led data collection and analysis of yarning luncheons

Description:

The project involved:

  1. A scoping review to determine where chronic disease prevention and management programs for Aboriginal and Torres Strait Islander Peoples in Australia have been implemented and evaluated within primary health care, and to identify geographical gaps of implementation and evaluation using the Remoteness Structure.
  2. A retrospective clinical audit to quantify chronic disease and risk factor prevalence within a cohort of Aboriginal Peoples in Gunditjmara country.
  3. Yarning luncheons using Group Model Building (GMB) to identify the barriers and enablers of chronic disease management forAboriginal Peoples residing in Gunditjmara country to develop community-driven strategies to improve disease prevention and management.
  4. A clinical upskilling workshop to Aboriginal Health Workers (AHWs) within the region as a professional development opportunity.

Key outcomes:

  1. The scoping review was published in 2019 and identified a need for greater focus on the evaluation of chronic disease programs for Aboriginal people residing in Inner and Outer Regional areas, and Remote areas of Australia.
  2. The clinical audit was conducted with ongoing pre-meetings, attendance and talks at DWECHS monthly Community Luncheons incorporating Deakin staff and DWECHS community members.
  3. DWECHS community members gathered for ongoing feedback, mapping of data and development of action ideas via the GMB method.
  4. A clinical and leadership upskilling workshop was delivered by DWECHS for Aboriginal Health Workers to bring in line with new RACGP and Aged Care standards.

Next steps:

This project demonstrated a process for productive and successful collaboration between Deakin University, Dhauwurd-Wurrung Elderly and Community Health, and the Gunditjmara community in Portland, Victoria.

The project achieved important steps toward community-informed, health service-supported improvements in local chronic disease management and built significant trust and fostered relationships between the parties above. This trust may lead into deeper investigation of implementation within the health service setting, or further engagement of the local community to discuss other health issues.

The processes used here may equally be applied to Indigenous health issues at other levels, such as exploring perceptions of Indigenous health policies among stakeholders.

Impacts on health in the region: 

The upskilling of all relevant staff in the new RACGP and Aged Care standards, Chronic Disease Management plans and team care arrangements have helped ensure that services are delivered within scope of practice and via an interdisciplinary approach.

Strategies developed through the GMB yarning sessions informed DWECHS organisational statement of intent – a requirement of Safer Care Victoria’s Partnering in Healthcare Framework.

Publications:

Beks H, Binder M, Kourbelis C, May N, Clark R, Hudson K, et al. Geographical analysis of evaluated chronic disease programs for Aboriginal and Torres Strait Islander people in the primary healthcare setting: a scoping review protocol. JBI Database of Systematic Reviews and Implementation Reports 2018; 16(12): 2268-2278. 

Beks H, Binder MJ, Kourbelis C, Ewing G, Charles J, Paradies Y, et al. Geographical analysis of evaluated chronic disease programs for Aboriginal and Torres Strait Islander people in the Australian primary health care setting: a systematic scoping review. BMC Public Health 2019; 19(1): 1115. 

Beks H, Amos T, Bell J, Ryan J, Hayward J, Brown A, Mckenzie C, Allen B, Ewing G, Hudson K, Clark R, Morphett B, Allender S, Creighton D, Johnstone M, Versace VL.  Participatory research with a rural Aboriginal Community Controlled Health Organisation: lessons learned using the CONSIDER statement. Rural and Remote Health 2022; 22: 6740. https://doi.org/10.22605/RRH6740