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

ID: 
44
This submission reflects the views of
Organisation Name: 
Early Start Research Institute
Personal Details
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): 
Poor levels of attendance at primary school among Aboriginal children is a major reason for lower levels of academic achievement among Aboriginal students1. Around 20% were rated “well below age level” in literacy and numeracy achievement1. Moreover, one-quarter of Aboriginal children experience significant social, emotional, behavioural and health issues that negatively impact on their ability to learn at and engage with school1. The antecedents of these problems can be traced back to Indigenous children arriving at primary school with very low levels of school readiness – defined as possession of the skills, knowledge, and attitudes necessary for success in school and for later learning and life. Inclusive, relevant and culturally competent school-readiness programs are greatly needed in Early Childhood Education and Care settings where Indigenous children attend and in their homes. A TCR in this area would ensure the testing of such programmes could occur, building an evidence base for rapid dissemination into communities where they are most needed, potentially leading to breakthrough outcomes for these children and positively impacting the trajectory of their development and health. 1Zubrick et al. The Western Australian Aboriginal Child Health Survey: Improving the Educational Experiences of Aboriginal Children and Young People. 2006
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): 
The Indigenous Advancement Strategy has five broad-based programmes, one of which is children and schooling. In addition, one of the three overarching priorities of the Indigenous Advancement Strategy relates to school attendance and academic performance. It focuses on the positive impact that education has on the future success of children and their families (and more broadly their communities) and recognises that children who go to school have better life outcomes. See http://www.indigenous.gov.au/indigenous-advancement-strategy The 2016 Closing the Gap Report has a target of 95% of all indigenous 4-year-olds enrolled in early childhood education by 2025; to halve the gap in reading, writing and numeracy achievements for children by 2018; and to close the gap in school attendance by the end of 20181. A key point of this report is that all governments are prioritising early childhood education programmes for all children in the year before full-time primary school2 1 http://closingthegap.dpmc.gov.au/chapter-02/index.html 2 http://closingthegap.dpmc.gov.au/chapter-01/index.html
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): 
Recent policy reports1,2 and research reviews3 highlight the importance of attending to settings where children spend their time. Furthermore, research indicates that health-related behaviours and psychosocial wellbeing are largely established in the preschool period. Early childhood education and care (ECEC) settings are thus ideal contexts for improving children’s health-related behaviours (diet, physical activity, sedentary behavior) and wellbeing (psychological well-being and stress-response regulation). ECECs can also be highly effective in connecting with Aboriginal families. Hence working with Aboriginal ECEC service providers and families to develop supportive environments and initiatives in the preschool period is likely to have direct health and wellbeing benefits, as well as longer term (indirect) health benefits.4 A TCR in this area would focus on addressing risk factors and antecedents for negative physiological and psychological impacts; break intergenerational cycles of disparity through identification of at risk & vulnerable, early intervention services; and grow an evidence base connecting positive cultural practices and stronger connections to improved health and social justice outcomes, resilience, reduced antisocial behaviour/incarceration. 1 WHO. The final report of the commission on ending childhood obesity. 2 Marmot M. Fair society, healthy lives: a strategic review of health inequalities in England post-2010. 3 Ball K. Health Prom Int. 2015;30:S2. 4 Larson N. J Am Diet Assoc. 2011;111:1343-62.
4. How will the TCR reduce the burden of disease on the health system and Australian economy? (200 word maximum): 
This TCR will provide a flagship model of working with indigenous communities and families to facilitate and enhance the quality of child care education for Aboriginal children at a crucial time in their lives when they are more receptive to learning and when the education and health inequality gaps are smallest, with benefits not only for the children, but for their parents and the economy. It is estimated that every $1 invested returns $1.50-$3 with a benefit ratio for disadvantaged children of about $17. If Aboriginal children enter primary school with greater skills or learning in our proposed areas of focus they are less likely to repeat grades or drop out of school, and more likely to enrol in post-secondary education. There is also the cost-benefit of facilitated and supported pathways in education, and into employment and economic independence and the likely reduction in short- and long-term reliance on welfare which ahs the potential to break the intergenerational welfare dependence cycle. We know from the work of Marmot and others that the longer-term health of individuals is closely tied to their level of educational attainment. Therefore we should view the development of health related behaviours and learning abilities and dispositions as critically intertwined. We cannot achieve higher levels of health amongst communities without parallel improvements in education.
5. Are there any reports or findings that support your nomination for the suggested topic? (200 word maximum): 
National surveys have found that Indigenous children are more than twice as likely to be developmentally vulnerable than non-Indigenous children at the beginning of formal schooling1. Our Early Start Baseline data (n≈800 children, mean age 4.4 [0.4] years, 35% Aboriginal) collected from 35 Centres across NSW and ACT, as well as a other studies conducted on the health and development of young Indigenous children showed the following in relation to domains of school readiness: i. Perceptual, motor and physical development: low levels of fine motor skills and a high prevalence of overweight and obesity (20%)2. ii. Social and emotional development: low levels of pro-social behaviour and high levels of hyperactivity, conduct problems, peer problems, and emotional problems3. iii. Language and communication: low levels of productive vocabulary skills1,4 iv. Cognition: low levels of cognitive self-regulation1,4. v. Approaches to learning: low levels of behavioural self-regulation. 1Snapshot of Early Childhood Development in Australia 2009. 2 Thurber K. Overweight and obesity among Indigenous children: individual and social determinants. Deeble Institute Issues, Brief 3. ANU 2014. 3Baxter J. LSAC Annual Statistical Report, Ch 10, The family circumstances and wellbeing of Indigenous and non-Indigenous children, 2012. 4Brinkman S. Pub Health Bullet. 2010; 7: 4-7

Page reviewed: 30 August, 2018