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Targeted Call for Research - public call for research priorities in Aboriginal and Torres Strait Islander health

ID: 
12
Personal Details
First Name: 
Helen
Last Name: 
Kehoe
Specific Questions
1. What is the research priority (a significant research knowledge gap or unmet need) you are nominating? How would a TCR in this area greatly advance our understanding of this issue? (200 word maximum): 
To investigate and optimise benefits of the Indigenous-specific health check (MBS item 715). This check: • Is a high profile and key part of the Australian Government's plan for Closing the Gap (KPMG 2014) • Aims to combat chronic disease, the biggest cause of excess Indigenous deaths • Comprises a suite of evidence-informed requirements (NACCHO and the Chronic Disease Alliance of NGOs 2008; NACCHO and RACGP 2012) • Provides access to other gap-closing initiatives, including the PBS co-payment measure and MBS-rebated follow ups (items 10987 and 81300 to 81360 range). (Department of Health 2013) • Has increasing coverage and consequent expenditure: from about 10% of Indigenous people in 2010/11 to nearly 24% in 2014/15 (AIHW 2016). Despite this, research about health checks’ impact is scant (Spurling, Hayman et al. 2009; Dutton, Stevens et al. 2015). Although of uncertain application to Australian Indigenous people, international evidence of health benefit is not encouraging (Krogsbøll, Jørgensen et al. 2012), and within Australia some concerns have been raised (Bookallil and Thomas 2006). A comprehensive analysis of impact is overdue. This would: • Guide revisions to the check’s requirements if needed • Address concerns about its effectiveness • Support a renewed, coordinated effort to address known barriers to uptake (Kehoe 2007; Kehoe 2007; Kehoe and Lovett 2008; Kehoe 2013; Jennings, Spurling et al. 2014; Heike Schütze, Lisa Jackson Pulver et al. 2016).
2. What are the relevant Australian Government Priorities, and/or Ministerially-agreed State and Territory health research priorities linked to your nominated priority? (200 word maximum): 
Relevant Australian Government Priorities are: • The Indigenous Chronic Disease Package, implemented 2009-2013, aimed to increase health check uptake from about 10% (then the baseline) to 45% of adults over 4 years to 2012-13. • The Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 sets new goals for increasing Indigenous-specific health check uptake. By 2023: o for children aged 0–4, the goal is 69% (23% in 2015) o for children aged 5–14, the goal is 46% (18% in 2015) o for young people aged 15–24, the goal is 42% (17% in 2015) o for adults aged 25–54, the goal is 63% (23% in 2015) o for adults aged 55 and older, the goal is 74% (33% in 2015).
3. How would a TCR in this area contribute to Aboriginal and Torres Strait Islander health and improve health outcomes for the individual and/or community? (200 word maximum): 
The health check aims to reduce death and disability from treatable conditions, but little evidence on its impact has been captured (Spurling, Hayman et al. 2009; Jennings, Spurling et al. 2014; Dutton, Stevens et al. 2015). A TCR in this area would help realise the health benefits of the check. Once the impact is better understood, policy and programs can be reviewed to: • Better promote the check, including identify the best ways to overcome barriers to follow up of health issues found through Indigenous health checks (Jodie Bailie 2014) • Refine the check so its health benefits are strengthened.
4. How will the TCR reduce the burden of disease on the health system and Australian economy? (200 word maximum): 
It will optimise health checks resulting in better health outcomes for Indigenous people, by giving the check a solid evidence base.
5. Are there any reports or findings that support your nomination for the suggested topic? (200 word maximum): 
Bookallil, M. and D. Thomas (2006). "Little evidence of effectiveness for screening in new Aboriginal and Torres Strait Islanders Health Check." Australian and New Zealand Journal of Public Health 30(2): 187. Department of Health (2013). Follow-up Health Services Provided by a Practice Nurse or Aboriginal and Torres Strait Islander health practitioner – MBS item 10987. Dutton, T., W. Stevens, et al. (2015). "Health assessments for Indigenous Australians at Orange Aboriginal Medical Service: health problems identified and subsequent follow up." Australian Journal of Primary Health 22((3) ): 233-238 Heike Schütze, Lisa Jackson Pulver, et al. (2016). "The uptake of Aboriginal and Torres Strait Islander health assessments fails to improve in some areas." Australian Family Physician 45(6): 415-420. Jennings, W., G. K. Spurling, et al. (2014). "Yarning about health checks: barriers and enablers in an urban Aboriginal medical service." Australian Journal of Primary Health 20(2): 151-157 Jodie Bailie, G. H. S., Margaret A Kelaher, Alison F Laycock, Nikki A Percival, Lynette R O’Donoghue, Tracy L McNeair, Amal Chakraborty, Barbara D Beacham, Ross S Bailie, (2014). "Follow-up of Indigenous-specific health assessments — a socioecological analysis." Medical Journal of Australia 200(11): 653-657. Kehoe, H. (2007). A call for action: Better Aboriginal and Torres Strait Islander health through better GP identification, ACT Division of General Practice Kehoe, H. (2007). Final Project Report Aboriginal and Torres Strait Islander Health Awareness Project, , ACT Division of General Practice Kehoe, H. (2013). So close, yet so far: how a lack of accountability undermined COAG’s Aboriginal and Torres Strait Islander health goals. Menzies School of Health Research. Darwin, Charles Darwin University. Master of Public Health. Kehoe, H. and R. Lovett (2008). "Aboriginal and Torres Strait Islander health assessments: barriers to improving uptake." Australian Family Physician 37(12): 1033-1038. KPMG (2014). National Monitoring and Evaluation of the Indigenous Chronic Disease Package: Final Report. Canberra, Australian Government Department of Health. Krogsbøll, L. T., K. J. Jørgensen, et al. (2012). "General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis." British Medical Journal. NACCHO and RACGP (2012). National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people. South Melbourne, The RACGP. NACCHO and the Chronic Disease Alliance of NGOs (2008). The Well Person's Health Check. Aboriginal Primary Helath Care. S. Couzos and R. Murray. Melbourne, Oxford. Spurling, G. K. P., N. E. Hayman, et al. (2009). "Adult health checks for Indigenous Australians: the first year’s experience from the Inala Indigenous Health Service." Medical Journal of Australia 190(10): 562-564.

Page reviewed: 30 August, 2018