Abstract Presentations
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Strengthening Aboriginal Family Involvement In The Paediatric ESCALATION System- Aboriginal Family Experience
Aboriginal Environmental Health Model of Care
Thinking outside the box: a multidisciplinary approach to General Practice to improve Aboriginal Health outcomes from Birth to Eldership
Eileen Boyle
Curtin University
Kim Gates
Aboriginal Health Council of WA
Sarah Gnanaseharam and Rajeshwary Krishnan
Pramana Medical Centre
Introduction:
The paediatric ESCALATION System, integrating family involvement, promotes recognition and response to early signs of a child's deteriorating health in West Australian (WA) hospitals. Culturally safe environments and effective Aboriginal family and health professional communication are essential for raising concerns and escalating care
Objectives:
To understand Aboriginal families' perspectives about their involvement in detecting clinical deterioration in a hospital setting.
Methods:
Stage one of a pre-post Participatory Action Research project guided by the Practical, Robust and Implementation, and Sustainability Model (PRISM) framework. It used consumer co-designed surveys and interviews/focus groups with Aboriginal families whose children had attended a WA emergency department or a hospital inpatient unit. Survey data were analysed descriptively, and interview data thematically.
Results:
Data were collected from May 2023–August 2024. Eighty-six Aboriginal family members completed surveys. Families reported feeling included and comfortable speaking up, but experienced inconsistent support or receiving timely response to their concerns. Thirty-two Aboriginal families participated in individual interviews/focus groups. Four themes mapped to the (PRISM framework) described the family experiences: i) Family knows best (Recipients-Characteristics/Perceptions)- families recognise illness from experience and want acknowledgement; ii) Feeling comfortable to speak up (Implementation & Sustainability Infrastructure)- family advocacy is supported by health professional expertise and respectful relationships; iii) Speaking up is not easy (Implementation & Sustainability Infrastructure)- challenges included feeling dismissed, language differences, reluctance to question health professionals, and limitations of visual resources; iv) Cultural understanding is a shared responsibility (External Environment), encompassing issues of discrimination, distrust, and the role of Aboriginal health liaison officers.Conclusion:
Aboriginal families identified several issues that impact speaking up when concerned about their child. Supporting hospital-wide care delivery that addresses these factors is essential for improving Aboriginal family engagement. Findings will inform the development of tailored solutions to enhance Aboriginal family engagement in escalating care.
Introduction:
Aboriginal people have a holistic conceptualisation of health. Community, Family, Culture, Spirituality, Language, Country, Emotions and the Physical are all seen as integral in both an individual, and a community for achieving and sustaining health.
In 2023, the Aboriginal Health Council of WA (AHCWA) was funded by the WA Department of Health (DOH) to develop a contemporary Aboriginal Environmental Health (AEH) Model of Care based on the perspectives, experiences and aspirations of the AEH sector in WA. AHCWA worked with the WA DOH, AEH service providers, Aboriginal Community Controlled Organisations, to co-design the scope for the future model.
Methods:
The co-design process included a detailed consideration of the Program focus, future growth of the Program and required resourcing supports. The Model and the co-design process undertaken in its development, are aligned with the National Agreement on Closing the Gap. The importance of this co-designed project has been recognised through its inclusion as a key action in the WA Closing the Gap Implementation Plan 2023-25.
Findings:
The Model is built on effective, creative, evidence-based strategies, respecting and harnessing unique differences in Aboriginal communities in their circumstances, strengths, needs and local knowledge. It encourages more innovation, flexibility and responsiveness to local priorities. It emphasises prevention and AEH promotion and ensures the rights of Aboriginal peoples to healthy environments are realised.
Implications:
The impacts of environmental health conditions for Aboriginal people are significant. This often results in the need for increased tertiary intervention and disproportionately high hospitalisations for preventable diseases.
Under the Model the community outcome is for individuals, families and communities to understand and action the link between their environment, behavioural choices, essential services and health outcomes.
The Model is built on effective, evidence-based strategies, respecting and harnessing unique differences in Aboriginal communities in their circumstances, strengths, needs and local knowledge.
It encourages more innovation, flexibility and responsiveness to local priorities. It emphasises prevention and AEH promotion and ensures the rights of Aboriginal peoples to healthy environments are realised.
Since 2008, there has been little improvement in perinatal, infant and child mortality, diabetes, suicide, assault, out of home care, and incarcerations rates for Aboriginal people. This is in part because the biological and environmental characteristics of the first 1000 days of life that impact and shape the life span of an individual are often overlooked by health services.
For Aboriginal communities’ health is not just physical; it encompasses connection to land, spirituality, ancestry, kingship, and the social, emotional and cultural wellbeing of the whole community. The key to closing the gap involves taking a bio-psycho-social approach to health care, partnering with the community, and focusing on meeting the needs of the youngest member of the family to the eldest.
This widened approach to health is impossible for one single General Practitioner to manage and it cannot happen without thinking outside the box. Pramana Medical Centre (PMC) has been trialing a multidisciplinary and community-based approach to address some of the common barriers to accessing care that First Nations families face.
Through the implementation of weekly home visits led by a General Practitioner and specialist Paediatric Nurse Practitioner we have been successfully delivering health across the lifespan that is holistic, preventative, and encompasses culturally connected care. With a total of 428 children less than 5 years of age and 3355 adults greater than 50 years of age, PMC has begun this trial, with targets to improve health outcomes for every family member known to our practice.
Our collaborative approach to health has resulted in rebuilding trust, empowerment, cultural connectedness and overall better patient health outcomes from birth to eldership.
In this presentation we will present our unique model of care and Patient Reported Outcome Measures (PROMs) from this trial to date, as well as our future direction.
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Knowledge + Innovation = Power
Remembering the COVID-19 pandemic: the vital role of the WA Aboriginal Community Controlled Health Services Sector
Trauma Informed Care in Practice
Emma Haynes and Jessika Purnomo University of Western Australia
Deanne Rodney and Danie Zappa
South West Aboriginal Medical Service
Marianne Wood and Amanda Collins-Clinch
Aboriginal Health Council of Western Australia
Tanya Hallett
TIPT
A new initiative led by the South West Aboriginal Medical Service (SWAMS), Knowledge + Innovation = Power, centre's Aboriginal data sovereignty as a foundational principle in research and evaluation. The project affirms the right of Aboriginal communities to govern how their data is collected, interpreted, and shared. We aim to ensure that what is measured, how it is interpreted, and how it is used and the stories told from the data reflect community-defined truths, strengths, and priorities. Through the establishment of a Research Advisory Group and a Community Panel, the project embeds community leadership and lived experience at its core. The Community Panel, comprised of local Aboriginal people, will identify community hopes, aspirations, strengths, and areas of success, which will serve as the foundation for informing program and service design, delivery, and evaluation. This strengths-based, culturally grounded approach supports not only more responsive service systems but also contributes to building enduring community capability and capacity in research. In doing so, Knowledge + Innovation = Power advances a model of research practice that is aligned with Aboriginal ways of knowing, being, and doing, and upholds principles of self-determination, empowerment, and collective impact.
Our presentation will share early learnings from co-designing and implementing these governance structures. We will describe the process of developing the Research Advisory Group systems and structures; and the initial stages of r Community panel formation. We will reflect on the importance of trust, cultural authority, and relational accountability in building enduring research partnerships.
Introduction:
This presentation examines the critical role played by Aboriginal Community Controlled Health Services (ACCHS) in Western Australia's (WA) response to the COVID-19 pandemic. Despite operating largely outside formal emergency planning structures, the ACCHS Sector demonstrated remarkable agility and effectiveness in supporting Aboriginal communities throughout the pandemic, highlighting the ACCHS’ unique, holistic and comprehensive Model of Care.
Methods:
Aboriginal Health Council of WA (AHCWA), and its Members, undertook a review to document ACCHS’ experience of COVID-19 between 2020 and 2022. Information regarding preparedness, public health responses, maintenance of essential primary care services, vaccination efforts, and the response to COVID-19 after the WA border opened in 2022 was synthesised across the Sector, through the analysis of key documents, relevant literature, and interviews with ACCHS staff and leaders. Findings: The Sector filled critical gaps in government planning and response, particularly in culturally appropriate communication, building community trust, and delivering essential services. ACCHS proactively implemented innovative solutions, including quickly pivoting to telehealth models, and pioneering flexible vaccination programs for communities. Challenges included a lack of formal integration into pandemic planning, inadequate data sharing, and a government reliance on mainstream systems that created access barriers for many Aboriginal people.
Implications:
The COVID-19 pandemic highlighted ACCHS indispensable role in promoting and protecting the health of Aboriginal people and communities during health emergencies, which is driven by a steadfast commitment that comes from Aboriginal Community Control and Aboriginal leadership. Key learnings emphasise the urgent need for formal and meaningful integration of ACCHS into all levels of pandemic planning and response, fostering genuine partnerships that respect local knowledge and expertise, ensuring equitable resource allocation, and establishing robust data sharing mechanisms; underscoring the importance of the four priority reform areas of the National Agreement on Closing the Gap in preparing and responding to health emergencies.
This presentation explores the trauma informed pillars of safety, trust, choice, collaboration and empowerment and why this is crucial when developing relationships and trust with Aboriginal communities. And better yet, how do you build practically provide these pillars? And how do you become culturally responsive with gamify, storify and make it social?
Trauma Informed Practice paired with culturally responsive strategies promotes psychological safety, which means people will feel safe enough to share concerns or challenges they may have. If there is not trust, there is no psychological safety and people won't share.
This presentation gives practical strategies on how to have trauma informed conversations and by following a simple strategy:
- Listen
- Validate
- Safety
- Medical/Mental Heath Support
- Check back in
This presentation talks about the impact of trauma and stress on brain and cognitive function. It will unpack the importance of reflective listening when speaking to people of CALD backgrounds, and how those with a history of trauma are more sensitive to physical and verbal cues. The presentation will also discuss the importance storytelling, of validation when building safety and trust and talk about the effects of traumatic invalidation.
One of the most crucial and practical steps to trauma informed care is choice and empowerment, but how does this look in practice? How do you provide choice when it is limited, maintain transparency and empower Aboriginal communities to have control and power in situations where it seems like there is none? Learn how the simple things we might regard as being meaningless can have a huge impact on overall community well being and relationships.
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Community-led Outcomes in Stroke Prevention
Sole Stories: Yarning About Diabetic Foot Pressure Mapping with Aboriginal People
Let's Yarn About Sepsis
Liam Guy
Aboriginal Health Council of WA
Mariam Alkhamisi and Yaxin Liang
University of Western Australia
Anita Campbell
Child and Adolescent Health Service and Perth CHildren's Hospital
Background:
The purpose of the project is to develop a culturally appropriate and effective Aboriginal FAST stroke awareness campaign in order to empower Aboriginal people to recognise the signs and symptoms of stroke quickly, and access appropriate treatment promptly. Co-design with Aboriginal community members was integral in ensuring that the resources created were culturally safe, effective and relevant.
Approach:
With Aboriginal consumer feedback at the forefront of this project, the initial survey was used to determine the public’s knowledge, opinions and ideas about stroke and stroke resources. This was anonymous, online and distributed to internal and external stakeholders. Once the efficacy and awareness of previous health promotion messaging was ascertained, an initial Aboriginal reference group meeting updated the members on the survey’s findings. Face-to-face focus group testing across several WA regional and metropolitan sites was conducted, which provided important feedback and recommendations on the early draft resources. A second reference group meeting and resource amendments followed, before online presentations to the sites for additional feedback. A third reference group meeting was held before release of the resources, including physical and digital assets for public dissemination.
Significance:
This campaign aligns with the national Agreement on Closing the Gap Priority Reform 3 – Improving mainstream services for Aboriginal and Torres Strait Islander people. It focuses on themes such as ‘building trust and collaborating with community’ and ‘chronic disease: prevention, management and community-led solutions’. This campaign was innovative in that at every stage, community-led expertise, collaboration and co-design was pivotal in all decision making. The facilitator travelled to each site to ensure that participants could provide recommendations in situ. This enabled greater understanding of the unique regional differences, leading to a suite of diverse and wide-reaching resources.
Purpose:
This study aims to explore the experiences of Aboriginal people in Australia with diabetic foot disease (DFD) and their families in receiving podiatry foot care. It also seeks to identify the medical jargon encountered by Aboriginal individuals with DFD and their families during podiatry foot care. Additionally, the study aims to investigate Aboriginal peoples' perspectives on the value of foot pressure maps in DFD education. Finally, the study aims to co-design strategies for effectively communicating foot pressure maps, potentially using metaphors or narratives.
Study design:
Co-designed strategies are developed under the guidance of an Aboriginal Chief Investigator and through collaboration with Aboriginal Advisory Group. Qualitative methods will involve one-on-one research yarns to discuss DFD education and plantar pressure maps to gather data from Aboriginal individuals with DFD and their families. The data collected is analysed to identify common experiences, encounters with medical jargon, and perspectives on foot pressure maps.
Originality:
This study addresses the gap in research regarding the use of foot pressure maps in DFD education within the Aboriginal community. By combining the cultural practice of yarning with the visual representation of foot pressure maps, the study aims to improve DFD education for Aboriginal individuals. The research contributes to the development of culturally appropriate educational tools that respect Aboriginal culture and improve DFD prevention and treatment outcomes. The co-design strategies developed in this study have the potential to enhance communication and engagement between Aboriginal individuals and healthcare providers.
The partnership approach to care has been adopted in Australia and internationally as a strength-based approach that promotes engagement and participation of families in health care. In the WA Aboriginal Health & Wellbeing Framework 2015-2030, partnership is one of the guiding principles to improve the health and wellbeing of Aboriginal people. Australian Aboriginal people often face social and health disparities that persist from the prenatal period, through to adulthood.
The aim of a current research project is to highlight the views of primary caregivers of Aboriginal pre-school aged children, Aboriginal community leaders, Aboriginal Health Workers, Community Health Nurses and Medical and Allied Health staff regarding the implementation of the partnership approach to care adopted by Community Health Nurses in the WACHS Goldfields region of Western Australia.
Research questions were developed in collaboration with an Aboriginal Reference Group. Data were collected through focus group yarning and one-on-one in-depth interviews. Inductive thematic analysis was applied.
Four themes which influence the implementation of an authentic strengths-based partnership approach emerged from the data. These were Understanding Culture and Aboriginality; Health Organisational Structure; Professional Practice; and Communications.
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Culturally Safe Partnerships to Support Optimal Health and Wellbeing of Aboriginal Children
Naomi Sprigg Dos Santos
Curtin University
Aboriginal and Torres Strait Islander children have more than three times increased risk of sepsis compared with non-Aboriginal children and are twice as likely to die if admitted to intensive care. Despite this, little is known about the lived experience of sepsis from the perspectives of Aboriginal families, which is vital to promote sepsis awareness as well as develop co-designed culturally-secure tools for sepsis prevention and care.
Aim:
We aim to identify areas for improvement in sepsis recognition, awareness, prevention, and care for Aboriginal children and families through a mixed-methods study design.
Methodology:
Aboriginal children (≤ 18 years) admitted to Perth Children’s Hospital with sepsis between October 2022 - July 2024 were included. Part one will involve a qualitative analysis through yarning interviews with families. Part two will examine retrospective observational data from the hospital sepsis registry in a matched case-control study design, reviewing patient healthcare benchmarked against national sepsis care standards for Aboriginal children compared with non-Aboriginal children with sepsis.
Results:
Preliminary findings will be summarised for Aboriginal children admitted with sepsis including epidemiologic, medical and microbiologic differences impacting sepsis care between these children and matched controls.
Conclusion:
This study aims to evaluate the experience of Aboriginal families impacted by sepsis as well as identifying gaps in care. This will provide direction for future community co-designed culturally informed educational tools and sepsis care models for those families most affected by sepsis.