Centre for Research Excellence in Urban Aboriginal Child Health

The Centre is led by Professor Emily Banks (Australian National University), Professor Jonathan Craig (University of Sydney/Sydney Children’s Hospital Network), Ms Sandra Bailey (Aboriginal Health and Medical Research Council, NSW) and Professor Sally Redman (Sax Institute) as well as other leading researchers from partner institutions.

Key partners of this Centre include the NSW Ministry of Health, the Sydney Children’s Hospital Network and beyondblue.

Professor Emily Banks: Professor of Epidemiology and Public Health, National Centre for Epidemiology and Population Health (NCEPH), Australian National University; Scientific Director, 45 and Up Study, Sax Institute

Professor Jonathan Craig: Paediatric Nephrologist and Head, Clinical Research, Centre for Kidney Research, Sydney Children’s Hospitals Network; Professor, Clinical Epidemiology, University of Sydney

Ms Sandra Bailey: Chief Executive Officer, Aboriginal Health and Medical Research Council, NSW

Professor Sally Redman: Chief Executive Officer, Sax Institute

Professor Cate D’Este: Chair in Biostatistics, National Centre for Epidemiology and Population Health (NCEPH), Australian National University

Dr Anna Williamson: Director, CIPHER, Sax Institute

Dr Hasantha Gunasekera: Staff Specialist, Sydney Children’s Hospitals Network; Senior Lecturer in Paediatrics and Child Health, University of Sydney

Dr Alison Purcell: Senior Lecturer in Speech Pathology, University of Sydney

Dr Sue Woolfenden: Community Paediatrician, Sydney Children’s Hospitals Network; Conjoint Senior Lecturer, University of NSW

Mr Darryl Wright: Chief Executive Officer, Tharawal Aboriginal Corporation

Dr Jennifer Bell: Medical Director, Riverina Medical and Dental Aboriginal Corporation

Professor Beverly Raphael: Director of Population Mental Health and Disasters, University of Western Sydney

Raylene Gordon: Chief Executive Officer, Awabakal Ltd

Dr Tim Senior: General Practitioner, Tharawal Aboriginal Corporation

Professor Kirsten Howard: Professor of Health Economics, School of Public Health, University of Sydney

Hearing, EAr health & Language Services (HEALS)

The gap between Aboriginal and non-Aboriginal Australian health outcomes is well documented. Aboriginal families also experience greater barriers than most other Australians when accessing health services due to factors such as socio-economic problems and limited access to culturally appropriate healthcare.

One health gap identified as a priority for Indigenous people is ear health. Preliminary data from SEARCH found 42% of participating children suffered from middle ear disease, and 58% of children aged 1-8 years had delayed speech skills.

The intervention

Based on the evidence presented in the preliminary SEARCH data, additional funds of $950,000 were provided through the Federal Government and the NSW Ministry of Health in 2013, for specialist services  – speech therapy, audiology and Ear, nose and throat (ENT) services – for Aboriginal children across five participating ACCHSs linked to SEARCH.

Coordinated service delivery

The HEALS project, was first implemented from March to June in 2013, as a partnership between NSW Health, the Sax Institute and SEARCH and was managed through the Sydney Children’s Hospitals Network.

• A total of 353 Aboriginal children were provided speech therapy and ENT surgical procedures through HEALS
• HEALS facilitated 3008 speech therapy sessions for 271 children (124% of the target set by NSW Health). Children received between one and 28 half-hour sessions.
• HEALS provided 119 ENT surgical procedures for 94 children (102% of the target set by NSW Health)

Specialist services provided through HEALS eliminated waiting lists for speech and language therapy  at all participating ACCHSs; waiting lists for ENT surgery eliminated at three services and substantially reduced at a fourth site.

The NSW Ministry of Health refunded HEALS in 2014 for Aboriginal children across five participating ACCHSs and a State clinic providing services to Aboriginal community at La Perouse. More than 2100 speech therapy sessions and 90 operations were delivered.

Consultations have been held with the NSW Ministry of Health to consider scaling up HEALS to a state-wide program.

Evaluation

The Centre is now investigating the experiences of families and the perspectives of healthcare providers on specialist healthcare in the urban Aboriginal setting to qualitatively assess the level of service use before and after the HEALS project, the factors affecting access to services and how the funding has impacted the health of Aboriginal children in the short term.

Data Enhancement Program

One of the key aims of the Centre is to use SEARCH data to drive change, to ensure that the information collected is accessed by the ACCHSs in a way that is useful and meaningful.

The ACCHSs and community members have also expressed a need for easy access to data that is local to them to help them to quantify their health needs, to identify priorities for healthcare and to advocate for new programs. Use of their data will also enable the ACCHSs to see how they are performing in terms of targets set by them or in comparison with other populations.

The program includes:

• Obtaining qualitative information on the perspectives of the ACCHS staff on current data access, use, barriers to access and use, and data requirements in order to inform the development of strategies for disseminating SEARCH data, and supporting its use at all ACCHSs.
• Designing and implementing simple tools, such as data cubes, that allow complex data to be modelled and visualised in multiple dimensions. These tools will provide sustainable access to SEARCH data by the ACCHSs.
• The services of a knowledge broker and a data analyst through an expert ‘hub’ that will provide analytic, methodological, capacity building and material resources to assist the ACCHSs in their program planning and advocacy activities.

SEARCH is making a strong contribution to Aboriginal research capacity building. The direct involvement of ACCHS staff in SEARCH is building capacity in the use of research findings to inform the provision of relevant and effective healthcare services.

More than 10 Aboriginal people are employed in the Centre and SEARCH study programs, and they undertake regular skills development sessions in addition to their work on the program, including training in research methods, public speaking, individual interviewing and presentation design.

ACCHS staff members are actively involved as authors on papers and presentations from SEARCH data.

The following Aboriginal staff members are currently being supported by the CRE to undertake formal programs to further their skills:

• Dr Raymond Lovett, Post-Doctoral Researcher, Australian National University: Investigating tobacco use in Aboriginal people and developing skills in large-scale data analysis.
• Simone Sherriff, Sax Institute: Simone completed her Graduate Diploma in Aboriginal Health Promotion in 2013 and continued into the Master of Public Health Program in 2014 through the University of Sydney
• Jasmin Speedy, Sax Institute: Jasmin completed the Graduate Diploma in Indigenous Health Promotion through the University of Sydney
• Peter Fernando, Sax Institute: Peter completed a Diploma in Management through the Aboriginal Health College
• Research capacity building in the ACCHSs: A key element of the Data Enhancement Project is building research capacity within the ACCHSs. Qualitative work is currently underway to establish the needs and priorities of the ACCHSs in this area.

Post-Doctoral Research

Dr Anna Williamson, Post-Doctoral Award, Sax Institute: Urban Aboriginal child health: social and emotional well-being

Current PhD and Masters projects

These projects are designed to increase the research output about the health of Aboriginal children and their carers in urban settings.

• Katherine Thurber, PhD Candidate, Australian National University: Health trajectories of Aboriginal children
• Bronwen Taylor, PhD Candidate, Sax Institute and the University of Sydney: Green Space and Aboriginal Child Health, University of Sydney
• Katrina Gott, Masters Student, University of Sydney: Parent-Child Comparative Analysis of Speech Production
• Christian Young, University of Sydney: Enhancing resilience in Urban Aboriginal Children