Protocol for the Yapatjarrathati project: a mixed-method implementation trial of a tiered assessment process for identifying fetal alcohol spectrum disorders in a remote Australian community

BMC Health Services Research

  ^{1    2    3    3    4    4    5    6    6    6    7    8    9    1,10} 

[1] 0000 0000 9320 7537, grid.1003.2, Child Health Research Centre and School of Biomedical Sciences, The University of Queensland, Brisbane, Australia;0000 0000 9320 7537, grid.1003.2, School of Health and Rehabilitation, The University of Queensland, Brisbane, Australia;0000 0001 1555 3415, grid.1034.6, School of Social Sciences, University of the Sunshine Coast, Sunshine Coast, Australia;0000 0004 0437 5432, grid.1022.1, School of Applied Psychology, Griffith University, Gold Coast, Australia;0000 0004 0437 5432, grid.1022.1, School of Applied Psychology, Griffith University, Gold Coast, Australia;0000 0000 9320 7537, grid.1003.2, Child Health Research Centre and School of Biomedical Sciences, The University of Queensland, Brisbane, Australia;0000 0004 0437 5432, grid.1022.1, School of Applied Psychology, Griffith University, Gold Coast, Australia;Menzies Health Institute of Queensland, Gold Coast, Australia;0000 0004 0625 9072, grid.413154.6, Women’s and Children’s Health Services, Gold Coast University Hospital, Gold Coast, Australia;Child Development Services, Sunshine Coast Health Services, Sunshine Coast, Australia;North West Hospital and Health Service, Mt Isa, Australia;Queensland Statewide Child and Youth Clinical Network, Centre for Children’s Health Research, Brisbane, Australia;

关键词: Fetal alcohol spectrum disorder;    Developmental assessment;    Rural and remote areas;    First nations;    Indigenous communities;    Implementation strategy;    Aboriginal and/or Torres Strait Islander peoples;   

DOI  :  10.1186/s12913-019-4378-5

来源: publisher

【 摘 要 】

BackgroundFetal alcohol spectrum disorder (FASD) is a highly prevalent neurodevelopmental disorder associated with prenatal alcohol exposure. Early identification can improve functioning for individuals and reduce costs to society. Gold standard methods of diagnosing FASD rely on specialists to deliver intensive, multidisciplinary assessments. While comprehensive, prevalence rates highlight that this assessment model cannot meet demand, nor is it feasible in remote areas where specialist services are lacking. This project aims to expand the capabilities of remote practitioners in north Queensland, Australia, where 23–94% of the community identify as First Nations people. Integrating cultural protocols with the implementation science theories of Knowledge-To-Action, Experience-Based Co-Design, and RE-AIM, remote practitioners with varying levels of experience will be trained in a co-designed, culturally appropriate, tiered neurodevelopmental assessment process that considers FASD as a potential outcome. This innovative assessment process can be shared between primary and tertiary health care settings, improving access to services for children and families. This project aims to demonstrate that neurodevelopmental assessments can be integrated seamlessly with established community practices and sustained through evidence-based workforce development strategies.MethodsThe Yapatjarrathati project (named by the local First Nations community and meaning ‘to get well’) is a mixed-method implementation trial of a tiered assessment process for identifying FASD within a remote Australian community. In collaboration with the community, we co-designed: (a) a culturally sensitive, tiered, neurodevelopmental assessment process for identifying FASD, and (b) training materials that up-skill remote practitioners with varying levels of expertise. Qualitative interviews for primary, secondary and end users will be undertaken to evaluate the implementation strategies. RE-AIM will be used to evaluate the reach, effectiveness, adoption, implementation and maintenance of the assessment and training process.DiscussionCo-designed with the local community, integrated with cultural protocols, and based on implementation science theories, the assessment and training process from this project will have the potential to be scaled-up across other remote locations and trialed in urban settings. The Yapatjarrathati project is an important step towards increasing the availability of neurodevelopmental services across Australia and empowering remote practitioners to contribute to the FASD assessment process.

【 授权许可】

CC BY