CRCAH Intranews

ABCD Nominated for Excellence Award

One of the CRCAH's longest-running and most successful research projects, the Audit and Best Practice in Chronic Diseases project has been nominated for the CRC Associations' 2006 Awards for Excellence in Innovation.

ABCD's nomination is for innovation in the application and use of research and focuses on the project's success in the utilisation and uptake of research results by users and the significant benefits which accrued as a consequence of this success.

The ABCD project initially involved 12 health services across the Top End of the NT, introducing them to a simple and effective model of quality improvement. The NT Department of Health and Community Services is now implementing the ABCD model for use in all its remote health clinics.

Indigenous health services in NSW , WA and Central Australia have joined the ABCDE(xtension) project, with Queensland soon to join. ABCD principles and audit tools are being used in OATSIH's Healthy for Life program, a national continuous quality improvement program being conducted over the next 4 years.

Winners will be announced at the CRC Association's Annual Conference in May. We will keep you posted.

Workshop at the ABCD planning meeting in
Alice Springs June 05

Lyn O’Donoghue and Michelle Dowden traveling to ABCD site for project training.

Intellectual Property and Indigenous Knowledge

Aboriginal health sector involvement growing rapidly

One of the challenges facing people working in areas of Aboriginal research is the recognition and protection of Indigenous Knowledge (IK). This is certainly a significant issue for the CRCAH and was further identified in our Commercialisation and Utilisation Plan, approved by the Board in November 2005.

The Plan identified a need to revise policies and procedures about the CRCAH's management of Intellectual Property and Indigenous Knowledge and Practices.

The CRCAH's Centre Agreement (the agreement between the Core Partners that establishes the CRCAH as a collaborative body) includes a number of sections which deal with either Intellectual Property or Indigenous Knowledge and Practices.

CRCAH partners and project leaders have expressed a strong interest in clarifying CRCAH policies and procedures around both of these areas, and the Commercialisation and Utilisation Plan recommended a number of steps required to do this.

A particular area of interest is to make sure that Intellectual Property requirements do not discourage partners from submitting in-kind projects. CRCAH staff are working with Intellectual Property lawyers to develop policies and procedures that are simple and streamlined, and that meet the needs of the organisation and the partners.

In relation to Indigenous Knowledges, a key issue is ensuring the recognition and protection of Indigenous Knowledge. The Centre Agreement contains sections which refer to this, and the current process of review will consider options for the types of consultations and further work required to operationalise and/or alter these sections.

The CRCAH's interaction with Aboriginal medical services, peak bodies, governments and other health-related organisations has been increasing rapidly over recent months, as the five CRCAH programs begin to gain momentum.

In the CRCAH context, the term ‘industry' is often used to refer to both the Aboriginal community sector and governments who are involved in work that is either directly related to or has an impact on Aboriginal health.

Since the last Board meeting in November 2005, we have seen:

• Growing participation by both industry and research Program Leaders in the development and direction of programs;

• Enthusiastic and committed involvement by both industry and research people in the process of developing and reviewing projects for the Comprehensive Primary Health Care, Health Systems and Workforce Program;

• Twenty-four representatives at an Industry Roundtable to advise on priorities for the Chronic Conditions Program;

• Strong attendance (more than 30 organisations) from Government and the Aboriginal health sector at the Canberra and Adelaide CRCAH Showcases;

• CRCAH support to Aboriginal medical services to bring research perspectives into the development of new service models and funding arrangements;

• Involvement of 47 industry participants in the Ear Health and Hearing Network; and

• The CRCAH Communications Unit assisting in the launch of the new edition of Binan Goonj - Bridging Cultures in Aboriginal Health.

To view the Industry Table please click here

Ear Health Research Transfer

The CRCAH is supporting the development of a website to support the recently formed National Indigenous Ear Health and Hearing Network and to expedite research transfer to ear health and hearing workers across Australia .

The network, with 48 members from various fields (including audiologists and audiometrists, teachers, medical officers, nurses, Aboriginal Health Workers), was formed in early 2005 to link people working in the field so that they could share information, experiences and ideas, and other resources.

The National Indigenous Ear Health and Hearing Website, a ‘one stop shop' for people working with Indigenous children and their families affected by otitis media (middle ear disease) will aid in information-sharing and collaboration in ear health and hearing. Development of the Website has started, in consultation with Aboriginal ear health workers and other people working in this important area.

This project developed out of an urgent need to transfer research findings into practice. Despite there being a large body of knowledge about how best to prevent, diagnose, treat and manage middle ear disease and the associated communication problems people working in the area of Aboriginal ear health, hearing and education are often working in isolation in remote areas of Australia and do not have ready access to good quality information and resources. Health and education workers need quality information and resources about how to prevent and manage ear health and address hearing problems. The website has been designed to cater to an audience of mixed cultural and educational backgrounds.

The website will include; reviews, guidelines and protocols, resources, lessons learned (including case studies and evaluations), policies and strategies, publications and links. It will also include information about research activity, funding opportunities, organisations, agencies and individuals working in the field, news and events and training programs.

The website is still being developed, and members of the network will help identify and collect resources to be included on the site.

The website and network are for policy makers and project/program managers, medical officers (including GPs), nurses, Aboriginal Health Workers; early childhood workers; teachers and teacher aides; audiologists and audiometrists; speech pathologists; researchers; and families and communities of Indigenous children affected by otitis media (particularly those living in remote communities where ear disease is a serious health issue).

Thanks to the team at Australian Indigenous HealthInfoNet.

www.healthinfonet.ecu.edu.au/ears

Irlpe Apmere – Congress Takes on Ear health

In early 2002 the Central Australian Aboriginal Congress developed the concept for a best-practice ear health and hearing model to address the major prevalence of otitis media and associated hearing impairment amongst Aboriginal children in most Central Australian Aboriginal populations.

The Irlpe Apmere - Centre of Excellence in Ear, Language Enhancement and Hearing Services model will be an early intervention language enhancement and hearing services facility, as well as a regional service centre for Aboriginal ear and hearing health interventions. It will also offer training, support and resources for community ear and hearing program development and implementation.

In 2005 Congress was granted the opportunity by the Office of Aboriginal and Torres Strait Islander Health (OATSIH) to develop a comprehensive business case for the establishment, ongoing operation and viability of the Irlpe Apmere model. In collaboration with the key reference group stakeholders (AMSANT, OATSIH, Commonwealth DFACS, NTDEET, NTDHCS, Australian Hearing and the consultants Healthcare Management Advisors), the business case is currently in its final stages. The presentation of the final business case will take place at the end of February 2006.

For more information:
Donna Ah Chee,
Deputy Director,
Central Australian Aboriginal Congress,
Ph: 08 8951 4401

Asia/Pacific Evaluation Conference

The importance of evaluating Aboriginal health programs and research is constantly emphasized by the CRCAH and so it is opportune that the Australasian Evaluation Society (AES) is holding its 2006 International Evaluation Conference in Darwin .

The conference, from 4-7 September 2006, will bring together people involved in evaluation from Australia , New Zealand , Asia and the Pacific. The AES has an increasingly active Indigenous forum and in the past few years the conference has included growing numbers of Indigenous people and those involved in evaluation with Indigenous communities, particularly in New Zealand and the Pacific region.

The 2006 International Evaluation Conference in Darwin aims to build on the international relationships and support and highlight evaluation activity in Indigenous and international development contexts.

The conference provides opportunities for people to share ideas and knowledge in evaluation in a range of emerging areas. A range of papers, posters, roundtables and panel discussions will be presented in the following streams:

Indigenous contexts
International development contexts
Innovative approaches to working in changing contexts
New theoretical models and frameworks

Pre conference workshops and World Bank training

The AES Conference provides valuable professional development in evaluation by running pre conference workshops in a variety of evaluation techniques and practices.

The World Bank is also planning to conduct an introductory version of its highly regarded International Program for Development Evaluation Training in Darwin prior to the AES conference.

Submission of proposals

Proposals for conference presentations or pre conference workshops must be submitted by 17 March 2006.

For more information and to submit proposals:
www.aes.asn.au

Advocating for Renal Health in Tennant Creek

IMPAKT ( Improving Access to Kidney Transplant ) is a 3 year, NHMRC-funded and endorsed CRCAH ‘in-kind' study investigating the disparity in access to kidney transplants between Aboriginal and Torres Strait Islander Australians compared with other Australians.

Over the last 12 months the IMPAKT team has been concentrating on the qualitative component of this study, traveling widely – from Cairns to Perth, from Broome to Dubbo - seeking the views of patients (non-Indigenous as well as Indigenous) and renal staff on aspects of treatments, on the effectiveness of patient education and on transplant as a treatment option.

Our recent visit to Tennant Creek is especially significant. The previous CRC for Aboriginal and Tropical Health worked closely with the Barkley community during 1999-2001 to document the case for a dialysis treatment facility in Tennant Creek. The Tennant Creek community had been advocating for this service for many years, as they saw more and more individuals and their families disappearing to live permanently in Alice Springs so they could receive dialysis treatments.

In April 2005 their efforts were successful and the Tennant Creek dialysis unit was opened. There are currently 24 patients (all local Aboriginal people), out of a possible 32 now able to dialyse in, or near their homes.

IMPAKT spent a week working with patients and staff at the new unit. The region continues its strong history of coordinated community advocacy. A Management Committee of key stakeholders – the NT Health Department renal unit, Anyinginyi Congress, Julalikarri Council and the local NT housing agency will meet regularly and collaboratively address the complex health and social issues affecting patients in these regions. A similar community-wide, cross-organisational planning and advocacy strategy was highly effective in convincing the NT Government to provide this service in the region.

The previous CRCATH provided additional research capacity to the earlier Management Committee. The CRCATH compiled the evidence and documented the case for establishing a local dialysis facility, and funded a community study tour to inspect existing remote region renal treatment facilities in places such as Nguiu, Broome, Bidyadanga & Katherine.

The recent IMPAKT visit re-establishes a CRC relationship with the Barkly region and its kidney health issues with patients and staff providing valuable input to the larger IMPAKT project. Patients stressed the difference it has made to be treated close to home, while staff highlighted the regularity of patient attendances and the value that patients place on maintaining their place in this local renal treatment program. Several patients also emphasised how important it is to try to prevent others from ending up with damaged kidneys and needing dialysis in the first place.

For further information: acass@thegeorgeinstitute.org

The IMPAKT team will travel to Canberra in late March to address the annual conference of the Transplant Surgeons of Australia and New Zealand .

CRCAH Turns Project Development on its Head

Tennant Creek Renal Unit

The CRCAH's new way of developing research projects has been used in preparing project proposals within the Comprehensive Primary Health Care, Health Systems and Workforce (CPHC,HS&W) Program.

This new approach, which we're calling the ‘facilitated development approach', turns the traditional process of on its head.

Instead of researchers putting forward their ideas, the process began last year with the identification of research priorities by the Aboriginal health sector. These are then further prioritised by the CRCAH Board in August 2005 to focus on questions where the CRCAH may be able to make most impact.

At this stage, the research priorities were little more than topics which Research Director, Ian Anderson, and the three CPHC,HS&W Program Leaders (in this case, Ross Bailie, Ben Bartlett, and Justin Mohamed), began to turn them into research questions. The result was four potential research projects.

Meanwhile the CRCAH call for Expressions of Interest from those interested in being involved in the process of developing, conducting or reviewing the research saw more than 40 people nominate.

From that group, the Research Director and Program Leaders then identified four drafting teams, each with Aboriginal community organisation, research and government expertise and experience, which were then asked to prepare a research proposal.

With a very tight timeline, each team then began the complicated job of trying to work collaboratively, usually across distance, to flesh out a research proposal which was consistent with the identified priorities set out by the Program Leaders. In doing this, they were supported by the Program Manager, Barbara Beacham.

The four leaders of the drafting teams - Judith Dwyer, David Scrimgeour, Michael Bentley and Russell Renhard - performed an extraordinary job to manage to produce substantial drafts within the timeline.

The drafts were then circulated to reviewers. Again, the reviewers included government and Aboriginal community sector representatives, as well as researchers.

In another major departure from traditional research development, the reviewers and drafting teams were then brought face to face in February 2006 to talk through the strengths and weaknesses of the proposal, and improve it. This interactive process continued beyond the face to face workshop, through teleconferences and email exchanges, and in some cases, further face to face meetings.

The face to face review workshop also provided highly constructive feedback to the CRCAH on the conduct of this ‘facilitated development process'. While there was strong support for the general principles, and particularly the face to face review workshop, some revision of processes was required, particularly around timelines and the identification of project leaders and project teams. This feedback will be incorporated into a more extensive evaluation of the process, and has already informed planning for the next phase of project development.

Positive feedback included that the process ‘provides a great way to be able to do research that you know that the Aboriginal health sector has identified as a priority.' Another participant added: ‘And I don't think the importance of that can be underestimated.'

Wendy Edmondson, former CEO of the Aboriginal Health Council of SA, said she was initially uncertain about taking part in the review process. ‘I wasn't sure what I could offer,' she said. ‘I came here expecting to be on the periphery of the research process and it's been a wonderful day, and I've found myself able to be right in the centre of the process of developing this project. And I want to keep being involved.'

The projects under development will be presented to the Board at its March meeting for endorsement, and it is hoped that they will be able to commence in April. The four projects are:

• Frameworks for best practice in the organisation and resourcing of Primary Health Care Services for Aboriginal and Torres Strait Islander People

This project is looking at mapping models of funding arrangements, service provision and workforce arrangements that are in place in different states/territories to support delivery of primary health care services to Aboriginal people, and how a comparative analysis can lead to more effective PHC services across Australia .

• Support systems for Aboriginal Primary Health Care services

This project aims to describe the models currently used to support Aboriginal specific primary health care services at a regional level, and what might be the best models for use in different contexts. It also aims to identify the best method of improving local quality assurance and continuing evaluation processes in Aboriginal primary health care services, whilst utilising regional resources and contributing to central data collections.

• Health services utilisation and ‘dropping through the holes'

This project looks at patterns of health service use, particularly in urban areas, by Aboriginal people. What services do or don't people use, and why? What degree of coordination exists between different services, and how can these be coordinated better? How can systems support continuity of care for Aboriginal people?

• Improving the culture of hospitals

This project is looking at the tools currently available for use in hospital settings to ensure quality assurance/improvement, and how can these be developed to improve services and settings relevant to the needs of Aboriginal patients and staff.

Chronic Conditions Industry Roundtable

An industry roundtable was held in Melbourne last month to further develop activities within the CRCAH Chronic Conditions program. The meeting involved 24 participants from a variety of health sector organisations across the country including peak representative bodies, health services and non-government organisations as well as representatives from the research sector and government departments.

CEO Mick Gooda introduced the group to the CRCAH and to the facilitated development approach the CRCAH is using to ensure Aboriginal involvement in every stage of the research process. This generated a discussion about why the extensive body of knowledge we already have around chronic illness in Aboriginal and Torres Strait Islander peoples has not translated to better health outcomes, and it was agreed that more Indigenous involvement in research and the application of research is vital.

Further discussion produced clear and consistent messages about what further research activities are needed around chronic illness in Aboriginal and Torres Strait Islander peoples.


Catriona Elek(Central Australian Aboriginal Congress), Danielle Aquino (Katherine West Health Board), Andrew Bell (Katherine West Health Board), Leisa McCarthy (Menzies School of Health Research) and Janelle Stirling (Queensland Institute of Medical Research)

Gwenda Gless (Wurli Wurlinjang Aboriginal Health Service) and Brendan Gibson ( Office for Aboriginal and Torres Strait Islander Health )

Discussion also focused on:

the need to revisit the definition of Aboriginal health (including the social, emotional and cultural well-being of the whole community) and the need for performance indicators that reflect this definition;
the need for more effective prevention and self-management strategies that place an individual within their family and community context and which incorporate Aboriginal value structures;
the burden of disease in our communities and the real cost of running services to address chronic illness;
the need for improved integrated and coordinated care across the health sector and the responsibility of mainstream and government services; and
the collection and utilisation of health services data and how to use the available evidence to lobby governments for policy change.

Men's health services, cardiovascular rehabilitation, tobacco use and nutrition, particularly in urban communities, were also identified by the group as specific issues requiring attention and it is envisaged that the CRCAH will develop collaborative partnerships with many of the organisations represented at the meeting to address these issues.

The meeting provided a great opportunity to develop meaningful links with other organisations working towards improved outcomes around chronic illness and proved invaluable to guiding future research activities as identified by the Aboriginal health sector. The Chronic Conditions Program Team would like to thank all those that attended for their time and participation in the day and looks forward to further engagement to ensure the research and other activities are of value and benefit to Aboriginal and Torres Strait Islander communities.


CRCAH Canadian Visitors Pat Anderson Adelaide Conference Targets Health Inequalities CRCAH Calendar of Events	ABCD Nominated for Excellence Award Intellectual Property and Indigenous Knowledge Aboriginal Health Sector involvement growing rapidly Ear Health Research Transfer Irlpe Apmere - Congress Takes on Ear Health Asia/Pacific Evaluation Conference Advocating for Renal Health in Tennant Creek CRCAH Turns Project Development on its Head Chronic Conditions Industry Roundtable

Roque Lee, Artist Health, Hoops and "The Man" New Edition of Binan Goonj Launched Showcase Update	Where are they now? Scholarship Round Indigenous International Program Summer School


Leah Ahmat	Joe Fitz	Erin Lew Fatt	Loyla Leysley Ex-CRCAH Trainee graduates at Bachelor