Evaluating Patient Experience at a Novel Health Service for Aboriginal and Torres Strait Islander Prisoners: A Pilot Study

BackgroundThe Winnunga Alexander Maconochie Centre Health and Wellbeing Service (AMCHWS) is the first prison health service operated by an Aboriginal Community Controlled Health Organisation in Australia. This pilot study developed and implemented a patient experience survey to evaluate the novel model of healthcare delivered by the Winnunga AMCHWS to Aboriginal and Torres Strait Islander prisoners. MethodsPatients accessing the Winnunga AMCHWS between February and May 2020 were invited to participate in the study. Descriptive data were analysed and compiled for demographics, patient satisfaction, patient perception of care quality, cultural safety, and patient thoughts on the Winnunga AMCHWS. FindingsSixteen of 26 eligible patients participated in the survey (62% response rate). At least 75% of patients were satisfied with the waiting time to see staff at the Winnunga AMCHWS most or all of the time. All 16 patients reported that Winnunga AMCHWS staff always treated them with dignity and respect. Of 14 patients who identified as Aboriginal, nine felt that they were treated better by staff because of their Aboriginal identity while the other five felt their Aboriginal identity made no difference to their treatment by the staff. InterpretationThis patient experience survey of the Winnunga AMCHWS found that it has provided highly satisfactory, timely, respectful, and culturally safe care to patients. Due to the limitations of this study, continual evaluation of the Winnunga AMCHWS and future studies to evaluate the continuity of care, health, and re-offending rates of released patients are needed to fully evaluate the Winnunga AMCHWS model

"I want to be heard" : an analysis of needs of Aboriginal and Torres Strait Islander illegal drug users in the ACT and region for treatment and other services.

This is the report of a study, conducted over a three year period, 2001 to 2004, of the needs of Aboriginal and Torres Strait Islander illegal drug users in the Australian Capital Territory (ACT) and its surrounding region for treatment and other services.The study was funded by the NHMRC under a special National Illicit Drugs Strategy funding roun

"I want to be heard" : an analysis of needs of Aboriginal and Torres Strait Islander illegal drug users in the ACT and region for treatment and other services. Community Report

This Community Report shows the findings of a study which took place from 2001 to 2004 of the needs of Aboriginal and Torres Strait Islander illegal drug users in the Australian Capital Territory (ACT) and surrounding region for treatment and other services.This Community Report is based was funded by a National Health and Medical Research Council, National Illicit Drug Strategy Program GrantThis report was produced in 2005 with support from the ACT Office for Aboriginal and Torres Strait Islander Health, Department of Health and Agein

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues

Walan Girri: developing a culturally mediated case management model for problematic alcohol use among urban Indigenous people

OBJECTIVE. To describe the design and implementation of a culturally mediated case management model at Winnunga Nimmityjah Aboriginal Health Service (Winnunga) for Indigenous clients who consume alcohol at problematic levels. METHODS. Our research took place from March 2008 to March 2010 in the Australian Capital Territory and built on previous research partnerships between Winnunga and The Australian National University’s National Centre for Epidemiology and Population Health. We conducted a review of existing models to determine elements for consideration in the community controlled setting, and conducted staff surveys to assess current levels of skill and confidence around alcohol screening, brief intervention and care planning. Using the information from the review and staff surveys, we then undertook staff capacity building to build confidence and skills in conducting alcohol screening, brief intervention and care planning. This process was driven by Winnunga’s social health team. To meet Medicare benefits schedule requirements, and frame the study within the Aboriginal and Torres Strait Islander Chronic Disease Package framework, we included team care arrangements, care planning and health checks. RESULTS. Elements of case management were suggested by staff and incorporated into the final model. Forty staff in the health service participated in identifying training needs for the development of the case management model and undertook a range of training before the model was implemented. Staff working within the social health team decided that the focus of the case management was to build a stronger future for their clients, hence the name of the case management model ‘Walan Girri’ (Wiradjuri language for strong future). The model included a package of screening instruments and brief intervention, related polices and discussion of ‘mob’ and ‘country.’ Changes in Winnunga management and staff, the composition of the research team and the way Walan Girri evolved led to protracted development and implementation. CONCLUSIONS. This project highlights considerations for implementing a case management model in a dynamic health service environment. Capacity building for Winnunga staff and for an Indigenous PhD scholar were part of the process and were integral in maintaining momentum in the project.The original research was funded by the DoHA. The first author’s PhD research was initially made possible by an NHMRC scholarship and then by an Indigenous Visiting Research Fellowship at the Australian Institute of Aboriginal and Torres Strait Islander Studies. NCEPH provided additional funding for salary and for community outreach activities

Where's your country?' New approaches for working with problematic alcohol use among Indigenous Australians in an urban setting

Conversations between Indigenous Australians meeting each other for the first time often include the question, ‘Where’s your country?’. ‘Country’ is used by Indigenous Australians to refer to land which for them has historical and cultural significance. The association between Indigenous Australians and country and emerging literature on the importance to wellbeing of maintaining that association suggests that dislocation from country may have significance for treatment and rehabilitation of problematic alcohol drinking. Our paper has two parts: it describes a project conducted between 2008 and 2009 that evolved into a PhD commencing late 2009 (RL undertaking, PD and JG supervisory panel members); it then describes the PhD, which hypothesises that some people may be living on country from which they may not derive Indigenous cultural identity and that problematic alcohol use is associated with that dislocation

Working in partnership: skills transfer in developing a cross-cultural research team

As part of a broader study on Indigenous illegal drug use, the authors undertook skills training to increase cross-cultural mutual understanding of the often different approaches and methodologies between research and practice, as well as Aboriginal and non-Aboriginal understandings of these approaches. The study and the skills transfer training were part of a longerterm partnership between Winnunga Nimmityjah Aboriginal Health Service and the National Centre for Epidemiology and Population Health at The Australian National University, Canberra, Australia. The authors describe the skills transfer process involving specific training in the ethical issues relating to research generally and this particular study, research funding processes, basic epidemiological and biostatistical concepts, and aspects of interviewing and questionnaire design. They use five vignettes to illustrate how the skills transfer process fulfilled their broader aim related to the ethical conduct of research with Aboriginal and Torres Strait Islander communities

Positive impact of a long-running urban Aboriginal medical service midwifery program

Background: The Winnunga Nimmityjah Aboriginal Health Service Aboriginal Midwifery Access Program (AMAP) was established in 2001 to provide antenatal care, birth support and postnatal care to clients in the Australian Capital Territory (ACT). Aim: To describe the uptake and impact of AMAP services on access to antenatal care, behavioural risk factors and pregnancy outcomes and to compare the characteristics of AMAP clients with other women giving birth in the ACT. Methods: A descriptive study of medical records for AMAP clients who gave birth in 2004-2008. Outcome measures: maternal and baby characteristics, antenatal visits, behavioural risk factors and complications. Characteristics of AMAP clients were compared with the ACT Maternal and Perinatal Collection. Results: Of 187 women, 11.2% were aged <20 years, 50.3% presented in the first trimester and 94.7% attended five or more antenatal visits. Of 193 babies, 17.1% were born preterm and 18.1% had low birthweight. Compared with the ACT Maternal and Perinatal Collection, Aboriginal and Torres Strait Islander AMAP clients had a higher smoking rate (63.8 vs 49.0%), a lower caesarean delivery rate (20.0 vs 27.6%), a slightly lower proportion of preterm babies (18.8 vs 21.6%) and a slightly lower proportion of low-birthweight babies (18.8 vs 21.0%). Conclusions: Aboriginal Midwifery Access Program provides high-quality antenatal care in a trusted environment. The high rate of smoking in pregnancy needs to be addressed