First Nations-led projects funded for COVID-19 research
The Paul Ramsay Foundation committed $2million to support APPRISE COVID-19 research with First Nations peoples. Through a unique funding allocation process led by First Nations researchers, we are pleased to announce the following projects have been selected for funding.
Developing a culturally responsive trauma-informed public health emergency response framework for First Nations families and communities during COVID-19
Lead investigator: Associate Professor Catherine Chamberlain – La Trobe University, Vic
This project aims to use our knowledge of trauma to inform best-practice responses to COVID-19.
While the research will draw on data from First Nations people from around Australia, it will also investigate how increased fear and anxiety as a result of the COVID-19 pandemic may compound distress relating to pre-existing trauma in the general population.
Preventing COVID transmission by equipping frail dialysis patients with culturally appropriate COVID-safe practices to avoid unplanned hospitalisations in the Top End
Lead investigators: Associate Professor Jaquelyne Hughes; Ms Onika Paolucci, Menzies School of Health Research, NT
The project will:
- describe how staff and patients work together to achieve COVID-safe practices to use at home and at dialysis, and learn from clients about other ways they live strong and COVID-safe
- improve detection of frailty and assess change in frailty in the first few months after starting dialysis
- count days spent in health care at the Royal Darwin Hospital campus and dialysis units in the first year after starting dialysis.
Using systems thinking to better understand risks and protective factors at play for urban Indigenous peoples during COVID-19
Lead investigator: Professor Bronwyn Fredericks, University of Queensland, Qld
This project aims to improve Indigenous health and well-being using a Systems Perspective. COVID-19 is a risk to any community; however urban Indigenous communities are particularly vulnerable because of the characteristics of the social systems that support their health. The project will use a systems-thinking approach to uncover an operational view of the dynamics of this complex system. It will bring together multidisciplinary stakeholders from relevant disciplines including health and community organisations (including Hospital and Health Services’s and Community Controlled Health Centres), education and communication representatives, housing, and research representatives.
Three professionally facilitated workshops will deliver a holistic picture and systems maps showing both high-level cause-and-effect factors as well as actionable levers and unintended consequences. It is intended that the outputs will provide insights that assist targeted policymaking and will serve as a basis for Indigenous communities around Australia to address socio-cultural vulnerabilities and risk factors in the face of pandemics.
Study aims include:
- to understand urban indigenous social systems and how they expose, mitigate, or protect urban indigenous communities during pandemics
- to formally develop a causal understanding of this system
- to develop a list of policy-oriented action steps
- to translate the outcomes to other indigenous communities
- to promote intersectoral action to tackle the social determinants of health that affect COVID-19 response and prevention.
A culturally specific overcrowding guideline for COVID-19 pandemic planning, response and recovery in remote Kimberley communities
Lead investigator: Mr Ray Christophers – Nirrumbuk, WA
The first wave of the COVID-19 pandemic acknowledged overcrowding as a social determinant exacerbating risk of SARS-CoV-2 transmission. Culturally appropriate ways to think about, manage and address housing occupancy and its health consequences are essential. Nirrumbuk Environmental Health & Services is an Aboriginal community-controlled service with many decades’ experience in serving remote communities of the Kimberley.
This mixed-methods project will ensure Aboriginal experience directly determines the conceptualisation, validation and ongoing use of a culturally specific guideline to address remote housing occupancy, overcrowding and health preventive practices in ongoing COVID-19 preparedness, response and recovery. In three sites in the Kimberley, Nirrumbuk Environmental Health & Services will consult with community to initiate discussions about lived experience and overcrowding. By combining qualitative and quantitative methods, a Guideline with measurement modules will be produced. Kimberley-wide results will be shared and this Guideline disseminated for local use in pandemic planning.
Aboriginal Community Controlled Health Services and Aboriginal and Torres Strait Islander People’s responses to the COVID-19 pandemic
This project involves case studies of four Aboriginal communities in NSW and WA, a survey of Aboriginal Controlled Community Health Organisations and a survey of Aboriginal and Torres Strait Islander peoples.
The project will:
- investigate factors that promoted community resilience and the rapid and effective community responses to COVID-19 in Aboriginal communities
- examine how these responses were activated and the processes for sustaining individual and community wellbeing over the pandemic and beyond
- study the governance arrangements and engagement with Aboriginal organisations, other NGOs and government agencies and the barriers and facilitating factors in community mobilisation.
The impacts of the project include:
- learning which processes have and have not worked for Aboriginal peoples and supporting the resilience of Aboriginal communities to respond to the pandemic and its aftermath, including the social and economic impacts on the communities
- using this understanding to support other communities to better respond to adverse ‘shocks’ including natural disasters, and economic adversity
- raising the profile of Indigenous self determination through a demonstration of how Indigenous governance and Aboriginal-led service provision can provide solutions to challenging social problems.
TeleHealth use in Cape York Communities – in response to COVID-19 travel restrictions
This project aims to develop a framework for an effective, efficient and cost-effective Telehealth Service in Cape York Communities, not only for future pandemics but for usual day to day patient care.
This is an Indigenous-led project in collaboration with communities in Cape York. Qualitative data will be gained from community members and Apunipima staff regarding their experience with Telehealth. Questions will focus on community member and staff member confidence in using Telehealth, type of consultations, privacy and confidentiality, cultural considerations, facilities and equipment, connectivity and staff training. A cost analysis will be conducted to identify total costs of infrastructure and training for an effective working system in Cape York Communities. Once the framework is developed, Apunipima will collaborate with communities regarding the outcome and recommendations.
First Nations COVID-19 Pandemic Response: Harnessing the evidence from an urban First Nations health ecosystem to inform ongoing response, recovery and health system adaptation
Lead investigator: Professor James Ward, Institute for Urban Indigenous Health (IUIH), Qld
Focussed on First Nations-led responses in an urban context, the project aims to:
- identify how an Indigenous-led approach compares and contrasts with mainstream and international First Nation responses and outcomes, primarily through comprehensive literature review
- prepare a strategy for, and undertake if circumstances determine, the documentation of the First Few Cases should an outbreak occur in South East Queensland among urban Indigenous peoples
- investigate, through detailed case studies, key aspects of service planning, response, and reorientation; and community activation achieved during the current pandemic
- identify strengths and gaps of the overall pandemic response within a large, urban regional Community Controlled Health Service network, using systems thinking methods
- support the development and advancement of Aboriginal and Torres Strait Islander researchers is an integral component of all research conducted through the Urban Indigenous Health / Poche collaboration, with training, mentoring and technical assistance structured to support transfer of knowledge and skills, along with career development for early First Nations researchers in particular.
This project will deliver:
- an in-depth understanding of the critical success factors, any exigent challenges and key learnings from a large urban Indigenous health ecosystem pandemic response, with relevance for this and future pandemics as well as more broadly, for health system (both Indigenous-specific and mainstream) understanding, development and improvement
- practical tools and resources for dissemination, adaptation and adoption
- advancement of individual and collective First Nations research knowledge, skills and career development.
Pandemic health messaging for Indigenous peoples during COVID-19
Lead investigator: Mr Shea Spierings, University of Queensland, Qld
The aim of this project is to gain an understanding of how COVID-19 health messaging has been shared and understood among Aboriginal and Torres Strait Islander communities across Australia and determine best practice in the longer term during the COVID-19 pandemic. Information gathered throughout this study will also be used to inform future pandemic health messaging for Aboriginal and Torres Strait Islander communities.
Project objectives are to investigate:
- how COVID-19 pandemic health messaging has communicated risks associated with COVID-19 to Aboriginal and Torres Strait Islander communities
- where community members access health messaging regarding COVID-19
- community members’ perspectives on the effectiveness of long-term health messaging during COVID-19 pandemic
- strategies for future long-term responses to COVID-19 is an effective tool
- vaccine hesitancy and vaccine uptake amongst Aboriginal and Torres Strait Islander communities.
Impact of the COVID-19 pandemic on access to health services in an urban Aboriginal and Torres Strait Islander primary health care service
Lead investigator: Professor Noel Hayman, University of Queensland, QLD
To understand the impact of COVID-19-related changes in primary health service delivery at the Inala COE, this project will:
- document the COVID-19-related changes implemented at the Inala Centre of Excellence (COE)
- compare the number of occasions of service and the services provided from March 2020 to Feb 2021, to the previous, pre-pandemic 12 months
- determine if (and how) the Inala COE practice population changed during the 12 months from March 2020, compared to the previous 12 months
- identify the impact of COVID-19 related changes on staff and people attending the Inala COE, including the uptake and impact of telehealth.
Short-term benefits of this research will be the identification of sub-groups of Inala COE regular attendees who have not accessed care during the pandemic to ensure that appropriate catch-up care is provided.
The longer-term, and nationally oriented benefit of this research will be increased understanding about the feasibility and acceptability of telehealth, with the associated potential to improve access to a range of hitherto “difficult to access services” for Aboriginal and Torres Strait Islander people in urban, regional, and remote settings, such as specialist outpatient appointments at a culturally unsafe hospital or clinic space, and also primary health care services when transport is problematic.
Revisiting the ‘Gambling Bug’ during COVID isolation: Developing and evaluating a holistic Aboriginal public health awareness strategy to improve service access and wellbeing in a rural and urban Australian setting
The project aims to develop a public health strategy to increase awareness around problem gambling and its dissociation with Indigenous culture. The project will look to develop and evaluate a community-driven public health intervention based on the narratives of those with problem gambling behaviours within Indigenous communities during the COVID-19 pandemic. It is planned to operate in one regional and one urban setting within New South Wales, providing an insight into the impacts of COVID-19 on problem gambling for Indigenous communities in a range of environments. The research will employ an Indigenist approach, considering the complex socio-cultural factors contributing to the overrepresentation of Indigenous people in problem gambling statistics.
The experiences of using telehealth in rural and regional Victorian ACCOs during COVID-19: perspectives from health service managers, clinic staff and patients
Lead investigator: Mr Dallas Widdicombe, Bendigo & District Aboriginal Co-operative (VIC)
The aim of the project is to explore Aboriginal Community Controlled Organisation (ACCO) medical staff and patient perceptions of primary care health appointments via telehealth during COVID-19.
This is an Aboriginal-led project involving collaboration between Bendigo and District Aboriginal Co-operative (BDAC), Njernda Aboriginal Corporation (Echuca), Mallee District Aboriginal Services (Mildura, Swan Hill, Kerang), and Murray Valley Aboriginal Co-operative (Robinvale). The first stage of the research will involve interviewing ACCO medical staff, including general practitioners, health service managers, nurses, and Aboriginal health workers. In the second stage Aboriginal community members that access ACCO services will be interviewed.
Key research questions:
- How does primary health care via telehealth during COVID-19 compare to pre-COVID-19 experiences of primary health care?
- What have been the barriers and challenges to using telehealth during COVID-19?
- What have been the benefits of using telehealth during COVID-19?
- What healthcare is better-delivered in person?
- What are the financial impacts of telehealth during COVID-19?
- How has telehealth fitted within wider COVID-19 experiences?
- What aspects of telehealth should be available on an ongoing basis, post COVID-19?
The findings from this project will guide the development of ongoing service provision within Bendigo and District Aboriginal Co-operative, Mallee District Aboriginal Services, Murray Valley Aboriginal Co-operative and Njernda Aboriginal co-operative during and post COVID-19. Findings will also inform advocacy for ACCO and Aboriginal community needs in a fast-changing telehealth policy and service provision environment.