Applying what works: a systematic search of the transfer and implementation of promising Indigenous Australian health services and programs

BMC Public Health

Roxanne Bainbridge¹  Anthony Shakeshaft²  Wendy Earles³  Anton Clifford⁴  Komla Tsey¹  Janya McCalman⁵ 

[1] The Cairns Institute and School of Education, James Cook University, McGregor Rd, Smithfield, 4878, Australia;University of NSW, King St, Sydney, 2031, Australia;The Cairns Institute and School of Arts and Social Sciences, James Cook University, McGregor Rd, Smithfield, 4878, Australia;Institute for Urban Indigenous Health, Edgar St, Bowen Hills, 4006, Australia;The Cairns Institute and School of Education, James Cook University, McGregor Rd, Smithfield 4878, Australia

关键词: Uptake.;    Adoption;    Implementation;    Dissemination;    Spread;    Transfer;    Indigenous;   

Others  :  1163375
DOI  :  10.1186/1471-2458-12-600

 received in 2012-03-29, accepted in 2012-07-26,  发布年份 2012

【 摘 要 】

Background

The transfer and implementation of acceptable and effective health services, programs and innovations across settings provides an important and potentially cost-effective strategy for reducing Indigenous Australians' high burden of disease. This study reports a systematic review of Indigenous health services, programs and innovations to examine the extent to which studies considered processes of transfer and implementation within and across Indigenous communities and healthcare settings.

Methods

Medline, Informit, Infotrac, Blackwells Publishing, Proquest, Taylor and Francis, JStor, and the Indigenous HealthInfoNet were searched using terms: Aborigin* OR Indigen* OR Torres AND health AND service OR program* OR intervention AND Australia to locate publications from 1992–2011. The reference lists of 19 reviews were also checked. Data from peer reviewed journals, reports, and websites were included. The 95% confidence intervals (95% CI) for proportions that referred to and focussed on transfer were calculated as exact binomial confidence intervals. Test comparisons between proportions were calculated using Fisher's exact test with an alpha level of 5%.

Results

Of 1311 publications identified, 119 (9.1%; 95% CI: 7.6% - 10.8%) referred to the transfer and implementation of Indigenous Australian health services or programs, but only 21 studies (1.6%; 95% CI: 1.0% - 2.4%) actually focused on transfer and implementation. Of the 119 transfer studies, 37 (31.1%; 95% CI: 22.9 - 40.2%) evaluated the impact of a service or program, 28 (23.5%; 95% CI: 16.2% - 32.2%) reported only process measures and 54 were descriptive. Of the 37 impact evaluation studies, 28 (75.7%; 95% CI: 58.8% - 88.2%) appeared in peer reviewed journals but none included experimental designs.

Conclusion

While services and programs are being transferred and implemented, few studies focus on the process by which this occurred or the effectiveness of the service or program in the new setting. Findings highlight a need for partnerships between researchers and health services to evaluate the transfer and implementation of Indigenous health services and programs using rigorous designs, and publish such efforts in peer-reviewed journals as a quality assurance mechanism.

【 授权许可】

   
2012 McCalman et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Wejnert B: A conceptual threshold model of adoption of innovations as a function of innovation's value and actor's characteristics. Journal of Asia-Pacific Business 2010, 11(3):197-217.
• [2]Ovretveit J: Widespread focused improvement: lessons from international health for spreading specific improvements to health services in high-income countries. International Journal for Quality in Health Care 2011, 23(3):239-246.
• [3]National Health and Medical Research Council: Criteria for health and medical research of Indigenous Australians n.d. Commonwealth of Australia, Canberra; 2003:1.
• [4]Clifford A, et al.: Disseminating best-evidence health care to Indigenous health-care settings and programs in Australia: identifying the gaps. Heal Promot Int 2009, 24(4):404-414.
• [5]Jackson N: Handbook for systematic reviews for health promotion and public health interventions. Deakin University and Australian Department of Health and Aging, Melbourne; 2005.
• [6]Derrick G, et al.: A bibliometric analysis of research on Indigenous health in Australia, 1972–2008. Australian and New Zealand Journal of Public Health 2011. online.
• [7]Clapham K, O'Dea K, Chenhall R: Interventions and sustainable programs, in. In Social determinants of Indigenous health. Edited by Bronwyn Carson TD, Richard C, Ross B. Crows Nest, Allen and Unwin; 2007.
• [8]National Aboriginal Health Strategy Working Party (NAHS: A National Aboriginal Health Strategy. AGPS, Canberra; 1989.
• [9]Sanson-Fisher RW, et al.: Indigenous health research: a critical review of outputs over time. Australasian Medical Publishing Company 2006, 184(10):502-505.
• [10]Hawe P, Degeling D, Hall J: Evaluating health promotion: A health worker's guide. MacLennan Petty, Sydney; 1990.
• [11]Brady M, et al.: The feasibility and acceptability of introducing brief intervention for alcohol misuse in an urban Aboriginal medical service. Drug and Alcohol Review 2002, 21:375-380.
• [12]Gardner K, et al.: Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best practice for Chronic Disease project. Implement Sci 2010, 5(21):14.
• [13]Gardner K, et al.: Reorienting primary health care for addressing chronic conditions in remote Australia and the South pacific: review of evidence and lessons from an innovatibe quality improvement process. Aust J Rural Heal 2011, 19:111-117.
• [14]Kitchener B, Jorm A: Early intervention in the real world. Mental Health First Aid: An international programme for early intervention. Early Intervention in Psychiatry 2008, 2:55-61.
• [15]Mitchell J: A matter of urgency! Remote Aboriginal women's health: Examining the transfer, adaptation and implementation of an established holistic Aboriginal Well Women's health program from one remote community to another with similar needs and characteristics, in School of Nursing and Midwifery, Faculty of Health Sciences. Flinders University, Adelaide; 2006.
• [16]NSW Department of Health, Cancer Institute, and University of Sydney, Final report. The NSW Aboriginal SmokeCheck tobacco prevention project 2007–08: NSW Department of Health, Cancer Institute. University of Sydney, Sydney; 2010:117.
• [17]Parker E, et al.: Our games our health: a cultural asset for promoting health in indigenous communities. Health Promotion Journal of Australia 2006, 17(2):103.
• [18]Sheehan M, Ridge D, Marshall B: 'This was a great project': reflections on a 'successful' mental health promotion project in a remote Indigenous school. Health Promotion Journal of Australia 2002, 13(3):201-204.
• [19]Bailie R, et al.: Study protocol: Audit and best practice for chronic disease extension (ABCDE) project. BMC Heal Serv Res 2008, 8(184):7.
• [20]Bailie R, et al.: Study protocol: national research partnership to improve health care performance and outcomes for Indigenous people. NBMC Health Service Research 2010, 10(129):11.
• [21]Field P, McLay A, Grundy J: Laramba family wellness model: Integration, sustainability and transferability. 6th edition. National Rural Health Conference, Canberra; 2001:7.
• [22]Wright H, Keeffe J, Taylor H: Barriers to the implementation of the SAFE strategy to combat hyperendemic trachoma in Australia. Opthalmic Epidemiology 2010, 17(6):349-359.
• [23]McCalman J, et al.: Bringing back respect: the role of participatory action research in transferring knowledge from an Aboriginal men's group to youth programs. Australasian Psychiatry 2009, 17:S59-S63.
• [24]McKay K, et al.: Building bridges: Learning from the experts. Australian Institute for Suicide Research and Prevention, Griffith University, Brisbane; 2009:27.
• [25]Rowley K, et al.: Effectiveness of a community-directed 'healthy lifestyle' program in a remote Australian Aboriginal community. Australian & New Zealand Journal of Public Health 2000, 24(2):136-144.
• [26]Tsey K, et al.: Adapting the 'Family Wellbeing' empowerment program to the needs of remote Indigenous school children. Australian and New Zealand Journal of Public Health 2004, 29(2):112-116.
• [27]Midford R, Daly A, Holmes M: The care of public drunks in Halls Creek. Health Promotion Journal of Australia 1994, 4(1):5-8.
• [28]Hunter E, Brown J, McCulloch B: Encouraging practitioners to use resources: Evaluation of the national implementation of a resource to improve the clinical management of alcohol-related problems in Indigenous primary care settings. Drug and Alcohol Review 2004, 23:89-100.
• [29]Department of Families Community Services and Indigenous Affairs: Army Aboriginal Community Assistance Program. Australian National Audit Office, Commonwealth of Australia, Canberra; 2010.
• [30]Barnett L, Kendall E: Culturally appropriate methods for enhancing the participation of Aboriginal Australians in health-promoting programs. Health Promotion Journal of Australia 2011, 22(1):27-32.
• [31]Redman S: Towards a research strategy to support public health programs for behaviour change. Australia and New Zealand Journal of Public Health 1996, 20(4):352-8.
• [32]Paul C, et al.: Being sorry is not enough. The sorry state of the evidence base for improving the health of Indigenous populations. American Journal of Preventive Medicine 2010, 38(5):566-68.
• [33]Cochrane Effective Practice and Organisation of Care Group: The data collection checklist. Cochrane Effective Practice and Organisation of Care Group, Ottawa; 2003.