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

ID: 
48
Personal Details
First Name: 
Sally
Last Name: 
Chan
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): 
Research priority: How can the recruitment and retention of Aboriginal and Torres Strait Islander students to healthcare degrees be improved? Why it is important? There is inequality in health, education and employment between Aboriginal and Torres Strait Islander and non-Indigenous Australians (AIHW, 2014). There is also disproportionately low number of Aboriginal and Torres Strait Islander healthcare professionals, especially in rural and remote areas (Alford, 2015). Within nursing, Aboriginal and Torres Strait Islander people represent 1.7% of all commencing students and only 1% of completions (Alford, 2015), meaning nearly half do not complete the degree. Aboriginal and Torres Strait Islander students are less likely to enter into university, less likely to participate in healthcare degrees, and more likely to drop out in their first year (Bandias et al., 2013) than non-Indigenous students. Barriers to entering higher education include academic unpreparedness, conflicting family obligations, and institutional poor understanding of cultural needs (Usher et al, 2005; Oliver et al., 2013). Lack of information and encouragement as being a barrier to undergraduate enrolment (Drysdale et al., 2006). The objectives of the research would include: • To understand the multiple factors that contribute to low Aboriginal and Torres Strait Islander enrolment and completion; • to establish the barriers and facilitators for Aboriginal and Torres Strait Islander student enrollment; • to determine strategies for recruitment and retention; • to investigate the practicalities of implementing and maintaining interventions; • to evaluate the effectiveness of interventions. A number of strategies have been implemented at various universities such as pre-entry requirements, quotas, and scholarships (Drysdale et al., 2006). There is limited evidence of the success of such programs. A targeted research priority to increase the number of Aboriginal and Torres Strait Islander nursing and midwifery students will in the long term increase the number of graduate practitioners from Indigenous backgrounds; and lead to graduates returning to their communities to practice. This will increase health care workforce capacity and improve health outcomes for the disproportionately disadvantaged Indigenous population.
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): 
There is a well-known health and wellness shortfall for people who identify as Aboriginal and Torres Strait Islander. Life expectancy is significantly shorter and morbidity is significantly higher than for non-Indigenous people (AIHW, 2015). Closing this health gap is a national priority. One strategy to help resolve the health disparity is to increase the number of Aboriginal and Torres Strait Islander healthcare workers.
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): 
Aboriginal and Torres Strait Islander are the first people of Australia. They have their own culture and beliefs, and that culture is dynamic and continues develop. The best way to provide healthcare services is to have a healthcare workforce that reflects the population it serves. Closing the gap requires a well-trained and culturally safe health workforce. The proposed research priority will increase the number and proportion of Aboriginal and Torres Strait Islander healthcare workers serving in communities across Australia.
4. How will the TCR reduce the burden of disease on the health system and Australian economy? (200 word maximum): 
The burden of disease due to the gap is immense. For example, the rate of fatal burden experienced by Aboriginal and Torres Strait Islander Australians is 2.6 times the rate experienced by non-Indigenous Australians (AIHW, 2015). Most of the burden of disease is due to non-communicable diseases such as kidney disease, cardiovascular disease, and diabetes (ABS, 2008). The impact of such diseases can be greatly reduced by culturally safe and appropriate health service intervention. The gap in first people health and wellness is not unique to Australia. Indigenous populations all over the world have poorer health and wellness outcomes than their non-Indigenous counterparts (e.g. Bramley et al., 2005). There is tremendous amount of heterogeneity among first people groups across the world. One solution will not fit all. Closing the gap requires strategies developed and implemented by the first people in each region. By increasing the number of first people healthcare workers, we will increase the capacity of health services to provide culturally safe and relevant interventions to improve first people health and wellness.
5. Are there any reports or findings that support your nomination for the suggested topic? (200 word maximum): 
There are numerous reports detailing the health and wellness disparities between Aboriginal and Torres Strait Islander people and non-Indigenous people. Most recently, the “Closing the Gap: Prime Minister’s Report” (2016) detailed the continuing decreased life expectancy and increased morbidity of Aboriginal and Torres Strait Islander people. Reports dating back to 1979 (House of Representatives Standing Committee on Aboriginal Affairs, 1979) call for more Aboriginal and Torres Strait Islander healthcare professionals, yet there is still a significant disparity and no strategies to increase improve the situation.

Page reviewed: 30 August, 2018