Kanyini Vascular Collaboration

Improving health outcomes for Aboriginal and Torres Strait Islander Australians with chronic disease through strategies to reduce systems barriers to necessary care.

Aims

To improve health outcomes in Aboriginal and Torres Strait Islander people with chronic vascular and chronic kidney disease, through strategies of care that address health systems or service barriers.

Methods

This five year research program includes the following component studies:

  • An audit of chronic disease prevention and management practices in the Indigenous-specific primary care sector with a particular focus on how well vascular risk is identified and managed
  • A qualitative evaluation of knowledge, attitudes, practices and perceived needs of patients, communities, health care providers and policy makers with respect to prevention and management of chronic disease
  • A randomised controlled trial of a polypill based strategy compared to usual care for Indigenous and Non Indigenous people at high risk of cardiovascular disease
  • An electronic decision support (EDS) tool is a cardiovascular risk assessment tool designed to provide point-of-care access to national guideline recommendations for patients identified with high cardiovascular risk. The project aims to develop a valid EDS system for vascular disease management and prevention and to implement this system for widespread use in Aboriginal Community Controlled Health Services (ACCHS) and general practices across Australia
  • A Communication project which comprises of a documentary and communication study to look at the real-life journeys made by Aboriginal and Torres Strait Islander people with chronic illness as they negotiate their health care needs. The Communication study has the goal of presenting real research findings to different audiences, especially Aboriginal and Torres Strait Islander communities, in an innovative, relevant and engaging manner

Status

The audit of chronic disease prevention and management was undertaken in 2007 and early 2008. Clinical audits were undertaken in health service partners in NSW, Qld and Central Australia. The Clinical Vascular Audit primary results paper has been published by the Medical Journal of Australia in September 2009 - 'Cardiovascular disease risk management for Aboriginal and Torres Strait Islander peoples in primary health care settings: findings from the Kanyini Audit.'

Data collection for the Kanyini Qualitative Study at our participating partner health services was completed in December 2009. 200 interviews were conducted with community, clinical and non-clinical health service staff, and hospitals across all Kanyini partner sites. The research team met in December 2009 for a data analysis and coding workshop. During this workshop we organised the themes coming from the interviews to provide a framework for interpreting the stories about participants' experiences and attitudes around seeking care. It was a productive and engaging time of discussion about the codes developed from our site specific analysis and combining these codes to form a coding dictionary. This allowed us to enhance our qualitative analysis skills, NVivo skills and to learn from each other's experiences.

The Kanyini Guidelines Adherence with the Polypill study started recruitment in December 2009 across a few of our partner Aboriginal Community Controlled Health Services (ACCHS) and mainstream general practices. We are currently in the process of initiating all other sites and recruiting more mainstream General Practices.

 

The Communication Project's short film excerpt of Aboriginal patients’ journey with Chronic Kidney Disease was adapted by the Australian Broadcasting Commission and the inspiring story of the late Mr Yunupingu was told on Australian Story to help build awareness of chronic disease prevention and management amongst Aboriginal Australians.

The Electronic Decision Support Tool has been piloted in NSW among 21 health professionals and 200 patients in three partner health services and several mainstream general practices. The pilot evaluation found the system was highly acceptable to GPs and important design features were recommended to make it ready for widespread implementation. The George Institute is now working with Pen Computer Systems, one of Australia's largest primary care software developers, to integrate PULSE with two of the most commonly used medical software platforms. This is expected to be ready in late 2010 for a large scale roll out and evaluation.

Program staff

Bernadette Rickards
Research Officer, Baker IDI Heart and Diabetes Institute, Alice Springs

Ricky Mentha
Indigenous Research Fellow , Baker IDI Heart and Diabetes Institute, Alice Springs

John Brady
Indigenous Research Fellow, Inala Indigenous Health Service, Brisbane

Joanne De Vries
Indigenous Research Fellow, Wuchopperen Health Service, Cairns

Barry Fewquandie
Indigenous Research Fellow, Wuchopperen Health Service, Cairns

Sonya Cameron
Indigenous Research Fellow, Aboriginal Medical Service Western Sydney, NSW

Anita Curtis
Indigenous Research Fellow, Baker IDI Heart and Diabetes Institute, Alice Springs

Maria Tattersall
Indigenous Research Fellow, Maari Ma Aboriginal Corporation, NSW

Pamela Simon
Indigenous Research Fellow, Tharawal Aboriginal Cooperation, NSW

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Further reading