A case study of enhanced clinical care enabled by Aboriginal health research: the Hearing, EAr health and Language Services (HEALS) project.

OBJECTIVE: To describe and evaluate Hearing EAr health and Language Services (HEALS), a New South Wales (NSW) health initiative implemented in 2013 and 2014 as a model for enhanced clinical services arising from Aboriginal health research. METHODS: A case-study involving a mixed-methods evaluation of the origins and outcomes of HEALS, a collaboration among five NSW Aboriginal Community Controlled Health Services (ACCHS), the Sydney Children's Hospitals Network, NSW Health, the Aboriginal Health and Medical Research Council, and local service providers. Service delivery data was collected fortnightly; semi-structured interviews were conducted with healthcare providers and caregivers of children who participated in HEALS. RESULTS: To circumvent health service barriers, HEALS used relationships established through the Study of Environment on Aboriginal Resilience and Child Health (SEARCH) to form a specialist healthcare network. HEALS employed dedicated staff and provided a Memorandum of Understanding (detailing mutual goals and responsibilities) for each ACCHS. Despite very tight timeframes, HEALS provided services for 653 Aboriginal children, including 5,822 speech-language pathology sessions and 219 Ear, Nose and Throat procedures. Four themes reflecting the perceived impact of HEALS were identified: valued clinical outcomes, raising community awareness, developing relationships/networks and augmented service delivery. CONCLUSIONS: HEALS delivered rapid and effective specialist healthcare services through an existing research collaboration with five ACCHS, cooperation from local health service providers, and effective community engagement. Implications for Public Health: HEALS serves as a framework for targeted, enhanced healthcare that benefits Aboriginal communities by encapsulating the 'no research without service' philosophy.

The Study of Environment on Aboriginal Resilience and Child Health (SEARCH): a long-term platform for closing the gap.

The full potential for research to improve Aboriginal health has not yet been realised. This paper describes an established long-term action partnership between Aboriginal Community Controlled Health Services (ACCHSs), the Aboriginal Health and Medical Research Council of New South Wales (AH&MRC), researchers and the Sax Institute, which is committed to using high-quality data to bring about health improvements through better services, policies and programs. The ACCHSs, in particular, have ensured that the driving purpose of the research conducted is to stimulate action to improve health for urban Aboriginal children and their families. This partnership established a cohort study of 1600 urban Aboriginal children and their caregivers, known as SEARCH (the Study of Environment on Aboriginal Resilience and Child Health), which is now having significant impacts on health, services and programs for urban Aboriginal children and their families. This paper describes some examples of the impacts of SEARCH, and reflects on the ways of working that have enabled these changes to occur, such as strong governance, a focus on improved health, AH&MRC and ACCHS leadership, and strategies to support the ACCHS use of data and to build Aboriginal capacity.

The Chronic Care for Aboriginal People program in NSW.

Aboriginal people living in NSW continue to experience greater health risks, poorer health and shorter life expectancies than non-Aboriginal Australians. The NSW Health-funded program, Chronic Care for Aboriginal People, was established from existing initiatives to rethink the way chronic care services were delivered to Aboriginal people in NSW. Refocusing and building on existing projects led to NSW Health providing an evidence base of what was working in Aboriginal communities. A model of care for Aboriginal people with chronic disease has been developed. Recommendations from two evaluations have allowed further improvement for the delivery of chronic care services for Aboriginal people. The Local Health District Service Agreements include relevant indicators and strategic priorities relating to the chronic care program.