Improving health outcomes for Aboriginal and Torres Strait Islander Australians with chronic disease through strategies to reduce systems barriers to necessary care.
Read more about the Kanyini Vascular Collaboration at the Collaboration website
Aims
To improve health outcomes in Aboriginal and Torres Strait Islander people with chronic vascular and chronic kidney disease, through strategies of care that address health systems or service barriers.
Methods
This 5-year research program includes the following component studies:
- an audit of chronic disease prevention and management practices in the Indigenous-specific primary care sector with a particular focus on how well vascular risk is identified and managed
- a qualitative evaluation of knowledge, attitudes, practices and perceived needs of patients, communities, health care providers and policy makers with respect to prevention and management of chronic disease
- a randomised controlled trial of a polypill based strategy compared to usual care for Indigenous and Non Indigenous people at high risk of cardiovascular disease
- an electronic decision support (EDS) tool is a cardiovascular risk assessment tool designed to provide point-of-care access to national guideline recommendations for patients identified with high cardiovascular risk.. The project aims to develop a valid EDS system for vascular disease management and prevention and to implement this system for widespread use in Aboriginal Community Controlled Health Services (ACCHS) and general practices across Australia.
- a Communication project which comprises of a documentary and communication study to look at the real-life journeys made by Aboriginal and Torres Strait Islander people with chronic illness as they negotiate their health care needs. The Communication study has the goal of presenting real research findings to different audiences, especially Aboriginal & Torres Strait Islander communities, in an innovative, relevant and engaging manner
Status/Results
The audit of chronic disease prevention and management was undertaken in 2007 and early 2008. Clinical audits were undertaken in health service partners in NSW, Qld and Central Australia. The Clinical Vascular Audit primary results paper has been published by the Medical Journal of Australia in September2009- ‘Cardiovascular disease risk management for Aboriginal and Torres Strait Islander peoples in primary health care settings: findings from the Kanyini Audit.’
Data collection for the Kanyini Qualitative Study at our participating partner health services was completed in Dec 2009. 200 interviews were conducted with community, clinical and non-clinical health service staff, and hospitals across all Kanyini partner sites. The research team met in December 2009 for a data analysis and coding workshop. During this workshop we organised the themes coming from the interviews to provide a framework for interpreting the stories about participants’ experiences and attitudes around seeking care. It was a productive and engaging time of discussion about the codes developed from our site specific analysis and combining these codes to form a coding dictionary. This allowed us to enhance our qualitative analysis skills, NVivo skills and to learn from each other’s experiences.
The Kanyini Guidelines Adherence with the Polypill study started recruitment in December 2009 across a few of our partner Aboriginal Community Controlled Health Services (ACCHS) and mainstream general practices. We are currently in the process of initiating all other sites and recruiting more mainstream General Practices.
The Communication Project’s short film excerpt of an indigenous patient’s journey with Chronic Kidney Disease was expanded by ABC and the inspiring story of Mandawuy Yunupingu was told on Australian Story to help build awareness of chronic disease prevention and management amongst Aboriginal Australians.
The Electronic Decision Support Tool has been piloted in NSW among 21 health professionals and 200 patients in three partner health services and several mainstream general practices. The pilot evaluation found the system was highly acceptable to GPs and important design features were recommended to make it ready for widespread implementation. The George Institute is now working with Pen Computer Systems, one of Australia’s largest primary care software developers, to integrate PULSE with two of the most commonly used medical software platforms. This is expected to be ready in late 2010 for a large scale roll out and evaluation.
Institute Investigators
- Alan Cass
- Anushka Patel
- Stephen Jan
Program Chief Investigators
- Alan Cass (executive committee), The George Institute
- Alex Brown (executive committee), Baker IDI Heart and Diabetes Institute
- Anushka Patel (executive committee), The George Institute
- Sandra Eades, Baker IDI Heart and Diabetes Institute
- Noel Hayman, Inala Indigenous Health Service
- Nicole Isbel, Princess Alexandra Hospital
- Stephen Jan, The George Institute
- Ian Ring, University of Wollongong
- Greg Stewart, Sydney South West Area Health Service
- Andrew Tonkin, Monash University
- Tarun Weeramanthri, WA Health
- Vicki Wade, Sydney South West Area Health Service
Program Staff
- Dr David Peiris, Senior Research Fellow, The George Institute
- Ms Suzanne Ingram, Research Fellow, The George Institute
- Dr Hueiming Liu, Program Manager, The George Institute
- Ms Maria Tchan, Research Fellow, The George Institute
- Ms Bernadette Rickards, Research Officer, Baker IDI Heart and Diabetes Institute, Alice Springs
- Mr Ricky Mentha, Indigenous Research Fellow , Baker IDI Heart and Diabetes Institute, Alice Springs
- Mr John Brady, Indigenous Research Fellow, Inala Indigenous Health Service, Brisbane
- Ms Joanne De Vries, Indigenous Research Fellow, Wuchopperen Health Service, Cairns
- Mr Barry Fewquandie, Indigenous Research Fellow, Wuchopperen Health Service, Cairns
- Ms Sonya Cameron, Indigenous Research Fellow, Aboriginal Medical Service Western Sydney, NSW
- Ms Anita Curtis, Indigenous Research Fellow, Baker IDI Heart and Diabetes Institute, Alice Springs
- Ms Maria Tattersall, Indigenous Research Fellow, Maari Ma Aboriginal Corporation, NSW
- Ms Pamela Simon, Indigenous Research Fellow, Tharawal Aboriginal Cooperation, NSW
Health Service Partners
Collaborators
- Clinical Trials Research Unit, School of Population Health, University of Auckland
- Baker IDI Heart and Diabetes Institute
Funding Agencies
- National Health and Medical Research Council (NHMRC)
- AMGEN
- Faculty of Health Sciences, University of Sydney
