Click the project titles below to expand information.
Researchers: Dr Rhonda Marriott (Murdoch University), Professor Anne McMurray (Murdoch University), Assoc Prof Keryln Carville (Silver Chain and Curtin University), Jenny Prentiss (Nurses Board of WA), Veronica Strachan (Wounds West)
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Funding: State Health Research Advisory Council
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Project summary: This project aims to improve wound healing rates and access to best practice management of complex wounds in Indigenous communities across Western Australia through a culturally inclusive approach. This will include: the incorporation of Indigenous beliefs and perspectives into patient management and treatment protocols; the implementation of education and health promotion programs; and interventions aimed at prevention, early detection and effective management of wounds. Expected outcomes of the project include increased awareness of wound assessment, wound complications and management; increased skill levels of health practitioners (particularly of the Indigenous health workforce); improved appropriateness of referrals to acute WA health centres; improved healing rates of wounds; a decrease in amputations (and other complications); and increased access to culturally appropriate best practice wound management by Indigenous patients. It is anticipated, based on a previous pilot conducted in the Kimberley region that significant cost savings will be realised within the duration of this project and will be sustained beyond the life of the project. The project will be led by Aboriginal researchers supported by highly qualified senior clinicians and scientists. Funding was received in August 2007 and the project will end in July 2008. Provision will be made for a follow up evaluation to be conducted 12 months after the project has concluded to measure sustainability of the outcomes of this project.
Reference: 2007-006 Project Title: Official name: The Longitudinal Study of Indigenous Children (LSIC) / Common name: Footprints in Time or Footprints Researchers: Pam Hunter (Derby Research Administration Officer, Department of Families, Community Services and Indigenous Affairs (FaCSIA)), Dr Melisah Feeney (Project director, FaCSIA), Graham Brice (Ethics and Research, FaCSIA)
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Funding: Australian Government through FaCSIA
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Project summary: Footprints intends to work with Aboriginal and Torres Strait Islander families in 11 regions across Australia, including Derby, Fitzroy Crossing and the surrounding communities to help better understand what impacts on children’s lives over time and explore how they can be better supported to grow up strong and resilient regardless of location. The study will concentrate on babies (6-18 months) and 3½-4½ year olds. It is overseen by a Steering Committee chaired by Professor Mick Dodson (ANU), and includes Adele Cox of the Kimberley region. The Committee has mandated that Footprints in Time must be designed and conducted so that it has the acceptance and support of Aboriginal and Torres Strait Islander communities and of participating families. The key research questions have been developed following consultation with Aboriginal and Torres Strait Islander communities around Australia, as well as Government departments and service providers, to identify areas where longitudinal research would provide useful information. The key questions are:
What do Indigenous children need to have the best start in life to grow up strong?
What helps Indigenous children to continue to grow healthy, positive and strong?
What is the importance of family, extended family and community in the early years of life and when growing up.
What differences are there between how Indigenous children are raised compared to non-Indigenous children.
Communities also have the opportunity to request additional questions be included at the local level. All requests for additional questions go to the LSIC steering committee. This is the first longitudinal study of Aboriginal and Torres Strait Islander children across Australia. This means that parents/carers will be asked for permission to be re-interviewed at least every year for four years or longer.
Project Title: Alcohol and Pregnancy: Aboriginal Women’s knowledge, attitude and practice
Researchers: Heather D’Antoine (Telethon Institute for Child Health Research), Nadine Henley (Edith Cowan University), Jan Payne (Telethon Institute for Child Health Research), Elizabeth Elliott (University of Sydney), Carol Bower (Telethon Institute for Child Health Research), Anne Bartu, (Drug and Alcohol Department)
Funding: Healthway Starter Grant
Contact: Heather D’Antoine
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Project summary: The aim of this project is to collect qualitative data from Aboriginal women in the Kimberley (Fitzroy Crossing), Goldfields and the Metropolitan area on their knowledge, attitudes and practice regarding alcohol use in pregnancy. The data will be collected through focus groups. Data from non-Aboriginal women on this topic has already been collected through a computerised telephone survey. As anticipated, Aboriginal women were under-represented in this survey and it was planned that we would collect qualitative data from Aboriginal women on this topic. This information will be used to inform the development of an intervention aimed at informing women and the broader community about the effects of alcohol use in pregnancy. The data collection in the Kimberley and Goldfields is funded by a Healthways Starter Grant. The data collection for the Metropolitan area, which has commenced, is funded through the current NHMRC Program Grant.
Researchers: Deborah Lehmann, Anke Bergmann (Telethon Institute for Child Health Research), Paul van Buynder & Carolien Giele (Communicable Diseases Directorate, Western Australian Department of Health), David Smith & Jacinta Bowman (Division of Microbiology and Infectious Diseases, PathWest Laboratory Medicine), Amanda Leach & Kim Hare (Menzies School of Health Research, Darwin)
Funding: Department of Health WA
Contact: Deborah Lehmann
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Project summary: The bacterium Streptococcus pneumoniae (pneumococcus) can cause middle ear infection and invasive pneumococcal disease (IPD) resulting in meningitis, pneumonia and blood poisoning. The Australian Aboriginal population has among the highest reported IPD rates worldwide. The existence of 90 different types (serotypes) of pneumococci increases the challenge of prevention, particularly vaccine development.
A vaccine covering the 7 most common serotypes (Prevenar) and a booster with a vaccine covering 23 serotypes (Pneumovax) is offered to Aboriginal children. Pneumovax is also offered to Aboriginal adults.
Following the introduction of Prevenar in 2001 incidence of IPD has fallen in children, though the serotypes causing disease are not entirely those not included in Prevenar. Further cause for concern is a marked increase of IPD in Aboriginal adults, also predominantly due to serotypes not included in the Prevenar vaccine. The likelihood of replacement diseases due to non-vaccine serotypes needs further investigation.
Surveillance of IPD is hampered because antibiotics are often given before there is an opportunity for collecting blood cultures, particularly in remote parts of WA. However pneumococci are carried in the back of the nose of healthy individuals (up to 50% of Aboriginal children and more than 25% of Aboriginal adults). Carriers can transmit pneumococci to other members of the community. Surveillance of pneumococcal carriage can assist in predicting emerging serotypes causing IPD and susceptibility of pneumococci to antibiotics. Furthermore, carriage studies can assist in developing appropriate policies with regard to the next generation of pneumococcal vaccines, two of which are likely to be licensed in Australia soon.
Project Title: Establishing Breastfeeding Trends in Kununurra
Researchers: Reference: 2008-006
Project Title: Establishing Breastfeeding Trends in Kununurra
Researchers: Trish Graham (Kimberley Public Health Unit (KPHU), Tracy Leon (Kimberley Division of General Practice, Hanneke Schoe (KPHU), Noelene Bending (KPHU), Margaret Williams (Ord Valley Aboriginal Health Service), Brenda Walters (Kununurra District Hospital)
Project Title: Good Medicine Better Health Project Evaluation
Researchers: Linda Klein (National Prescribing Service), Meg Stuart (National Prescribing Service), Michele Robinson (Aboriginal Health Council of South Australia)
Contact: Linda Klein
Funding: National Prescribing Service
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Project summary: There is a need for Aboriginal people to be better informed about how to use their medicines wisely and safely. Aboriginal Health Workers (AHWs) who work in Aboriginal Health Services are well placed to help their clients with medicine issues. The Good Medicines Better Health project provides training for AHWs about quality use of medicines (QUM), focusing on 3 chronic conditions where medicines use is common – hypertension, diabetes and asthma. The project uses a train-the-trainer strategy. Senior AHWs have become trainers and have begun to train local AHWs at KAMSC. This evaluation will focus on how QUM training has helped local AHWs function more effectively with clients in promoting QUM. A qualitative methodology is proposed with questions focusing on how AHWs respond to QUM training and use the information in their work with clients. A week of evaluation activities is planned at KAMSC, using observational methods to assess the practices of AHWs within the context of their daily work. Observation will be conducted by the AHW trainers or a local worker (to be identified) with which AHWs are comfortable. Only de-identified summary data will be collected for clients who have provided verbal permission for observation. An NPS evaluation staff member will be at KAMSC to discuss the observations, assist with record keeping, conduct discussion groups with AHWs, analyse findings and prepare a report for KAMSC and program stakeholders.
Project Title: Improved communication and informed decision making by Aboriginal and Torres Strait Islander families: Antenatal diagnosis, neonatal care, and end of life decisions
Researchers: Dr Roz Walker (Telethon Institute of Child Health Research)
Contact: Dr Roz Walker
Funding: Department of Health Office of Aboriginal Health
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Project summary: This research is being conducted by the Telethon Institute for Child Health Research (the Institute) in collaboration with the WA Department of Health’s Women’s and Newborns Health Network (WNHN) and the Office of Aboriginal Health. This project explores the communication and decision-making processes surrounding prenatal, neonatal and end of life decisions between Aboriginal families, their communities and health care providers. It aims to develop more effective and culturally appropriate practices and procedures, to improve communication between health care professionals and Aboriginal women and their families in relation to prenatal diagnosis, neonatal intensive care, and end of life decisions. It also aims to develop resources for health care professionals and allied staff to increase their understanding of the cultural issues and complexities faced by Aboriginal families when prenatal, neonatal and end of life decisions are required; as well as identifying culturally appropriate resources to support Aboriginal families to make health care decisions when experiencing the death or dying of an infant/child.
Project Title: Broome Diocese Child Protection Response Project
Researchers: Vickie Hovane (Principle Researcher, Contracted to Notre Dame University Australia Broome), Joe Edgar (Research/ Community Facilitator, Nulungu Centre for Indigenous Studies, Notre Dame University Australia Broome), Steve Kinnane (Acting Assoc. Dean Arts and Sciences, Nulungu Centre for Indigenous Studies, Notre Dame University Australia Broome)
Contact: Steve Kinnane
Funding: Caritas Australia
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Project summary: The aim of the research project is to consult with Catholic Religious Congregations, Church personnel and school staffs in the Kimberley which have been associated with the Broome Diocese over a period of time on the issue of Child Protection. The project will seek feedback from these groups on the preventative, educative or healing responses, or lack thereof, currently in operation through the Diocese as a means of ensuring child protection for children engaged by these institutions. The research will be overseen by a reference group of Indigenous and non-Indigenous workers associated with the Broome Diocese. The results of the research will be utilised to guide the Broome Diocese in ensuring adequate and effective responses are actioned to prevent child abuse in any institutions or communities within the Diocese through educative, healing and program support.
Project Title: National Indigenous Eye Health Survey
Researchers: Prof Hugh Taylor (University of Melbourne), Prof Jill Keeffe, Sarah Fox & Anna-Lena Arnold (Centre for Eye Research Australia)
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Funding: RANZCO Eye Foundation, Vision CRC
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Project summary: The National Indigenous Eye Health Survey is designed to provide essential baseline evidence for future use in planning and prioritising the effective delivery of eye care to Indigenous Australians. The Survey is designed to assess the prevalence and main causes of vision impairment, the utilisation of eye care services, barriers to health and the impact of vision impairment on people. The survey utilises and relies upon a broad spectrum of expertise within the Indigenous health and eye health sectors. The structure of the project, with its state and national participating organisations, will produce meaningful information about the true extent of Indigenous eye health. This survey will provide definitive and quantitative data from which organisations around the country can advocate and plan service delivery to enhance existing services and develop new referral services. The implementation of effective eye health services will improve the health status of Indigenous people. The final report will provide the necessary information for the Government’s National Eye Health Framework. The ultimate goal is to provide the evidence base for the provision of eye care services so they will be available, accessible and appropriate for all Australians.
Project Title: The Rio Tinto Aboriginal Health Partnership: Building a strong foundation and sustainable future
Researchers: Prof Fiona Stanley (Telethon Institute for Child Health Research), Prof Colleen Hayward, Dr Clair Scrine & Heather Monteiro (Kulunga Research Network, Telethon Institute for Child Health Research)
Contact: Heather Monteiro
Funding: Rio Tinto Ltd
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Project summary: This Project responds to a call from Aboriginal Health Workers for more training, development and support. It aims to build the capacity of Aboriginal Health Workers, Aboriginal community controlled health organisations and government agencies, and the Aboriginal community through the development and provision of practical tools and programs to bring about improvements in the area of Aboriginal child and maternal health. This will be achieved through the development of a toolkit which will provide ongoing assistance to individuals and organisations. Content of the toolkit will include the topics addressed through community consultation, as well as a range of other information and resources relevant to Aboriginal maternal and child health. The toolkit will also provide resources which aim to build the capacity of Aboriginal Health Workers by providing them with the skills and knowledge to conduct their own research.
Project Title: Vitamin D deficiency in Aboriginal children and adolescents in metropolitan and rural Western Australia
Researchers: Dr Jason K Tan, (Paediatric registrar), Dr Andrew Martin (Supervisor, Gen. Paediatrician/Metabolic consultant), Dr Aris Siafarikas (Endocrinology consultant), Princess Margaret Hospital
Contact: Dr Jason Tan
Funding: Internal
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Project summary: Vitamin D plays a key role in strengthening bones to help prevent fractures. Less well recognised, but possibly even more important are the roles vitamin D plays in supporting the immune system to help fight infections and in protecting against certain forms of cancer and diabetes. Humans produce vitamin D in their skin under the influence of sunlight. Lack of sun exposure and dark skin increase the risk of vitamin D deficiency.
At Princess Margaret Hospital, up to 80% of children seen at the Refugee Clinic (predominantly of African origin) are vitamin D deficient. These children require vitamin D supplementation, which can be given either in small doses each day or in a high dose at six-weekly intervals (“depot therapy”). Although there are no published studies examining the prevalence of vitamin D deficiency in Australian Aboriginal children, it seems highly likely that those children with darker skin who do not get regular sunlight exposure will also be at very high risk of vitamin D deficiency.
The aims of this study are to determine the prevalence of vitamin D deficiency in Aboriginal children from metropolitan and rural settings in Western Australia (WA); to examine the relationship between vitamin D levels and childhood infections; and to determine if depot and daily vitamin D therapy have the same therapeutic outcomes.
Project Title: Evaluation of the Halls Creek Mother’s Support Initiative –‘Yanan Ngurra– ngu Ngamayiu’
Researchers: Dr Roz Walker (Telethon Institute of Child Health Research), Valma Banks (Aboriginal Program Manager, HCMSI), Aboriginal community care workers (Halls Creek Mother’s Support Initiative)
Contact: Dr Roz Walker
Funding: Department of Health Western Australia
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Project summary: The Halls Creek Mother’s Initiative –‘Yanan Ngurrangu Ngamayiu’ is a community-based maternal and child health prevention and education program for pregnant women and parents of young children in Halls Creek Halls Creek and the immediate surrounding communities which commenced in April 2008.
This program aims to draw together the combined skills, knowledge and experience of local Aboriginal women and health professionals and other service providers to improve birth and developmental outcomes and mother’s wellbeing and capacity. This study is important to find out about the experiences of program participants and staff and whether the program is helping to change things positively for the women, children 0-3 years and the community.
Researchers: Dr Louise Maple-Brown (Menzies School of Health Research, Darwin), Dr Paul Lawton (Director, NT Renal Services), Prof Kerin O’Dea (Director, Sansom Institute, Uni SA), Prof Wendy Hoy (University of Queensland), Dr Alan Cass (The George Institute), Prof George Jerums (Austin Health, Melbourne), Dr Mark Thomas (Royal Perth Hospital), Dr Kevin Warr (Royal Perth Hospital), Dr Jaqui Hughes (Menzies School of Health Research), Dr Graham Jones (SydPath, St Vincents Hospital, Sydney)
Contact: Dr Louise Maple-Brown
Funding: NHMRC project grant 545202, 2009-2011
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Project summary: There is an overwhelming burden of chronic kidney disease and end-stage renal failure in Indigenous Australians. It is vital that we are able to accurately measure kidney function in this high risk population. Glomerular filtration rate (GFR) is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that estimates of GFR derived for European populations may not be appropriate for Indigenous Australians.
The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, with significant heterogeneity amongst these groups, thus differences in body build and body composition likely also affect the accuracy of GFR between different Indigenous groups.
By assessing kidney function in these high-risk Indigenous Australian populations from Northern Queensland, Northern Territory, and Western Australia, we aim to determine a validated and practical measure of GFR suitable for use in all Indigenous Australians. We will compare the accuracy of the following techniques to measure GFR to the reference GFR measured by the plasma disappearance rate of iohexol: Modification of Diet in Renal Disease 4 variable formula (MDRD-4), Cockcroft-Gault formula and cystatin C. Detailed assessment of body build and body composition will be performed using anthropometric measurements, skinfold thickneses and bioelectrical impedance and a sub-study in larger centres will use dual-energy absorptiometry (DXA). It is possible that these measures may enable a modification (derived from a simple measure of fat free mass in each participant) to be incorporated into the MDRD formula for estimating GFR. Alternatively, a biochemical measure of kidney function other than serum creatinine may be found to be the most reliable measure of kidney function in all Indigenous Australians.
We do not believe that a single correction factor (similar to that for African Americans) is appropriate or practical for Indigenous Australians. Once eGFR methods are validated by this study it would lay the foundations for future interventional studies that aim to ameliorate the progression of kidney function to ESRF in Indigenous Australians.
Researchers: Anke van der Sterren, Viki Briggs, Terry James, Dallas Young, Nicole McMillan (Centre for Excellence in Indigenous Tobacco Control (CEITC), University of Melbourne)
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Funding: Department of Health & Ageing
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Project summary: Smoking is a major contributing factor to Indigenous poor life expectancy and remains comparatively high (Indigenous 51%, other Australians 19%). Indigenous Healthcare workers (IHWs) are key to improving Indigenous health through their multifaceted role as community members and trusted knowledgeable professionals. Their workload is high while their capacity to meet the demand is low, and they face particular challenges in providing tobacco control programs in their communities. The Department of Health & Ageing (DoHA) have funded the CEITC to undertake a national review and consultation across the country to assess the capacities and needs of the workforces in Indigenous health services to effectively deliver tobacco prevention and cessation activities and programs. The findings of the review and consultation process will result in recommendations to DoHA on the strategic directions for its Indigenous Tobacco Control Initiative.
Researchers: Victoria Hovane (nee Martin), Professor Alfred Allan, Dr M Allan (Edith Cowan University, Joondalup)
Contact: Victoria Hovane
Funding: Internal
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Project summary: The sexual abuse of children in Aboriginal communities continues to be a critical social problem in Western Australia. This research will investigate local Aboriginal understandings about child sexual abuse, what it looks like, how it is experienced, what are the barriers to addressing the issue and how those barriers can be overcome.
A qualitative methodology utilizing a grounded theory approach and involving semi-structured interviews will be used. The interviews will be conducted with a minimum of 12 adult Aboriginal men and 12 Aboriginal women or until saturation is reached. Each interview will be audio-taped and transcribed. Thematic content analyses will be conducted on the transcribed data and the results used to develop a theoretical framework about child sexual abuse in the local Aboriginal community. This framework will be verified through two forums; one with a community group, and the other with a group of workers and professionals.
The resultant framework may then be used to inform policy development and strategies for addressing the issue.
Project Title: Research Project to Engage Children and Young People About Views of Their Wellbeing
Researchers: Jan Saggers, Marie Finlay, Maxinne Sclanders, Jan Stuart, Caroline Adupa, Issihaka Toure, (Nexus Strategic Solutions), Mary Sankey (Sankey Associates), Dr Janet Fletcher (UWA Child Study Centre), Yarmintali (Rhonda) Murphy, (Yarmintali Consultancy)
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Funding: Commissioner for Children and Young People
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Project summary: The purpose is to conduct research with children and young people about their views on wellbeing. The specific objectives are to ensure research conducted obtains the views and perspectives of children and young people across Western Australia on what is important to their wellbeing and engages directly with a mix of children and young people across Western Australia, including Aboriginal and Torres Strait Islander and vulnerable or disadvantaged children and young people.
