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

This submission reflects the views of
Organisation Name: 
Poche Centre for Indigenous Health
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): 
The Poche Centre for Indigenous Health nominates healthy kids in rural/remote and hard to reach communities as a research priority for the next targeted call for research (TCR) in Aboriginal and Torres Strait Islander health. To address poor health status experienced by Aboriginal children in those depressed communities that lack the service infrastructure and face a range of access issues, our efforts in the last three years have highlighted that there exists a significant knowledge and evidence gap about what a localized, collaborative, culturally responsive and sustainable service model looks like. This foundational work support children getting a healthy start to life and to stay healthy that prevents the onset of those preventable chronic illnesses, which accounts for 70-80% mortality and morbidity rates amongst Indigenous Australians. Our work has involved building research into programs, offering clinical training, building service and community capacity, expanding access to allied health services and influencing service delivery by being policy advocates. A TCR in this nominated research priority area about a service model for healthy kids in rural/remote hard to reach communities will add value to the evidence base, contribute towards improved health gains and reduce unwarranted costs to the health system.
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): 
Governments at all levels are committed to closing the health gap particularly in relation to the health of children and potentially preventable hospitalization rates in the following ways a. Council of Australia Government’s (COAG) Closing the Gap health commitments of halving the gap in child mortality by 2018 and closing the life expectancy gap by 2031 b. The Commonwealth’s National Aboriginal and Torres Strait Islander Health and Implementation Plans are laying the foundations for long, healthy lives by investing in children’s growth and development c. Each state/territory have their own health policy commitments and funded initiatives aligned to supporting children’s wellbeing and health. As is the case in NSW, where Poche works, we have the NSW Aboriginal Health Plan and a range of funded initiatives provided by NSW Health such as our oral health program, workforce development and allied health initiatives in support of the closing the gap agenda and our healthy children’s strategy. The above are critical to achieving good health for remote/rural Aboriginal and Torres Strait Islander children in those hard to reach communities. Although vital to such effort is creating the service delivery evidence through research and translation.
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 Poche has witnessed significant gains in the last three years. Our efforts are providing remote/rural children with the best start to life by providing greater support in preventing those chronic diseases that trouble adults in later life. The model, being adopted, provides a way of collectively and collaboratively working with Aboriginal communities and health providers. This service provision model has allowed Poche to build on the strengths and capacity of communities, create educational and economic opportunities and deliver sustainable evidenced based programs locally. For example, our workforce development initiative offers scholars the opportunity to work locally whilst obtaining vocational education training qualifications that, if they choose, articulate into university courses in the areas of allied health, nursing or midwifery and social work professions. We have increased our scholars from 77 in 2015 to 157 in 2016. Inevitably individual, community and service capacity is built locally. The success of our model has proven positive with one specific example being our oral health program that achieved the Dental Weighted Activity Unit (DWAU) target three months earlier than was required under our funding agreement. Certainly, if policy makers and service providers had the evidence of what service configuration would work in depressed and isolated communities than perhaps the health gains would be far greater.
4. How will the TCR reduce the burden of disease on the health system and Australian economy? (200 word maximum): 
If health systems were to provide services in the way that Poche is presenting in this submission, we would argue that there would be significant heath gains amongst Aboriginal children, their families and communities. This is because our experience to date indicates that the model being used, the collaborative and integrated interventions being applied and the evidence we’re creating is influencing the design and delivery of how services are provided and how policy may need to change to address those hard to reach and problematic health issues that have plagued Aboriginal children in those geographically isolated communities. You would anticipate that such sustainable and locally driven efforts would contribute to policy commitments of closing the gap in life expectancy.
5. Are there any reports or findings that support your nomination for the suggested topic? (200 word maximum): 
The needs identified in this submission are outlined in our new five-year strategic plan that we will launch on Wednesday 21 September 2016. The next five years is about strengthening the work we’ve done in the last three years and builds on the strategies of Healthy Kids, Healthy Teeth, Healthy Hearts. This Plan aligns with and supports the work being undertaken in closing the gap undertaken by the COAG and in NSW. Whilst there has been some improvement, Australia cannot be complacent because, as the NHMRC would know, the life expectancy gap between Aboriginal and Torres Strait Islander and non-indigenous peoples is still wide and there remains a long way to go to close that gap. At Poche, we believe that what is missing is having the evidence about local service design that translate into influencing service provision and policy. This is the reasons that at Poche Centre for Indigenous Health we would argue that the next TCR in Aboriginal and Torres Strait Islander Health be about the service model required to provide for healthy kids in rural/remote and hard to reach communities as a research priority for 2016.

Page reviewed: 30 August, 2018