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CREATE Funding

This research was supported by the National Health and Medical Research Council (NHMRC Number 1061242). The contents of the published material are solely the responsibility of the Administering Institution and the authors and do not reflect the views of the National Health and Medical Research Council.

CREATE Collaborating Institutions

CREATE was a collaborative enterprise between the Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, the Joanna Briggs Institute, University of Adelaide, the School of Public Health, University of Adelaide and the National Aboriginal Community Controlled Health Organisation.

CREATE Investigators

CREATE Chief InvestigatorsProfessor Alex Brown, South Australian Health and Medical Research Institute

Professor Ngiare Brown, South Australian Health and Medical Research Institute

Professor Annette Braunack-Mayer, University of Wollongong

Associate Professor Edoardo Aromataris, Joanna Briggs Institute, The University of Adelaide

Professor Emeritus Alan Pearson (retired)

CREATE Associate InvestigatorsDr Drew Carter

Professor Zoe Jordan

Ms Elaine Kite

Associate Professor Craig Lockwood

Ms Alexa McArthur

Dr Sandeep Moola

Ms Kim Morey

Associate Professor Zac Munn

Dr Odette Pearson (nee Gibson)

Dr Matthew Stephenson

Ms Renee Williams

CREATE Research Team

The CREATE research team changed over the life of the project. The team members listed below (in alphabetical order) contributed to systematic literature reviews and/or case studies. Those marked with * also contributed to the development of this resource.

Dr Karla Canuto*

Dr Carol Davy

Dr Anna Dawson*

Ms Summer May Finlay*

Mrs Pamela Fletcher

Dr Odette Pearson (nee Gibson)*

Mrs Karen Glover

Dr Judith Gomersall

Dr Christina Hagger

Mr Stephen Harfield*

Dr Janet Kelly*

Ms Elaine Kite

Mrs Karen Laverty*

Ms Kim Morey*

Dr Brita Pekarsky

Ms Leda Sivak

Ms Janet Stajic

Ms Kimberly Taylor*

Mrs Gemma Walker

Mr Heath White

CREATE Affiliate ResearchersProfessor Judith Dwyer

Dr Teresa Burgess

Dr Dylan Coleman

Dr Kootsy Canuto

About the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange

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CREATE Leadership Group and other

contributors

We acknowledge and thank the CREATE Leadership Group for their invaluable time, enormous contribution, thoughtful guidance and ongoing support. We also acknowledge and thank the many contributors who were involved in the project in other ways such as reviewing chapters of this resource or participating in case studies as an Aboriginal Research Fellow.

The CREATE Leadership Group (past and present) and other contributors are listed below. Those marked with an * were also involved in the development of this resource. The list includes only those people who provided permission to be acknowledged in this document. We would also like to extend our appreciation to those not able to be listed below who contributed to the project in meaningful ways.

We would like to especially remember and acknowledge the support and contribution of Mrs Mary Buckskin, who at the beginning of the project was the CEO of the Aboriginal Health Council of South Australia. Mary’s wisdom, guidance and experience was greatly valued, and she will be remembered for her significant contribution to Aboriginal health both in South Australia and nationally.

Adrian Carson

Anna Baker

Ben Thomson*

Beverley Scott-Visser

Carol Davy

Chris Halacas*

Christina Hagger

Damian Rigney*

Dawn Casey*

Deborah Woods*

Eddie Mulholland*

Erin Lew-Fatt

Fay Adamson*

Gokhan Ayturk*

Isaac Hill*

Jenny Hunt

Jill Gallagher

Josée Lavoie*

Julie Tongs

June Sculthorpe*

Karen Hawke*

Karrina DeMasi*

Louise Lyons*

Maida Stewart*

Marianne Wood*

Mary Buckskin

Maureen Davey*

Nicole Clinch

Patricia Lewis*

Paul Stephenson

Paula Myott

Polly Paerata*

Raylene Foster

Sarah Fraser*

Shane Mohor

Tracey Brand

Yvette Roe

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The research was conducted in alignment with the principles within the South Australian Aboriginal Health Research Accord1 and in accordance with National Health and Medical Research Council’s guidelines for ethical conduct: the National Statement on Ethical Conduct in Human Research (2007, revised 2018) and the Australian code for the responsible conduct of research, 2018). The CREATE Leadership Group guided the research process including recruitment, question development and analysis of the findings to ensure that cultural safety and respect was a priority.

Ethical approval for this research was granted by the:

• Aboriginal Health Research Ethics Committee (Protocol number 04-16-651)

• Aboriginal Health & Medical Research Council Ethics Committee of New South Wales (Protocol number 1123/15)

• Menzies School of Health Research Human Research Ethics Committee (Protocol number HREC 2015-2481)

• Central Australian Human Research Ethics Committee (Protocol number HREC-15-352)

• Western Australian Aboriginal Human Research Ethics Committee (Protocol number 680)

• University of Adelaide Human Research Ethics Committee (Protocol number H-2015-221)

• St Vincent Hospital Melbourne (HREC-A 110/16 and HREC/16/SVHM/136)

• University of Queensland Human Research Ethics Committee A (Approval number: 2017000181)

1Morey K. (2017). On behalf of the Wardliparingga Aboriginal Research Unit, South Australian Aboriginal Health Research Accord: Companion Document. SAHMRI, Adelaide, South Australia.

Ethics Research Process

Research GovernanceSenior Aboriginal and Torres Strait Islander representatives from the ACCHO sector nationwide were invited to form the CREATE Leadership Group. The CREATE Leadership Group met twice yearly to oversee the work of the research team and guide the research process. They identified ten domains of interest: health service delivery, governance, funding, workforce, accreditation, continuous quality improvement, social determinants of health, health promotion, aged care and key performance indicators.

Research QuestionsTwo research questions guided the work of CREATE.

1. What principles underpin best practices in Aboriginal Community Controlled Health Organisations?

2. How do Aboriginal Community Controlled Health Organisations develop and sustain best practice?

Research MethodThe research team undertook several scoping and systematic reviews of the literature to synthesise existing research evidence in relation to the ten domains identified by the CREATE Leadership Group. The CREATE Leadership Group then guided the research team to conduct case studies with ACCHOs to explore ways of working not yet described in published literature. The research team conducted case studies on workforce, accreditation, continuous quality improvement, social determinants of health, funding, health promotion and aged care. These case studies informed a meta-analysis of ACCHO ways of working in relation to ACCHO governance and ACCHO health service delivery. A funded PhD student also undertook a series of case studies on ACCHO experiences of the national key performance indicators.

The objective of the case studies was to capture practical examples of best practice service delivery within ACCHOs and articulate the principles that underpin the delivery of these services. Once ethics approval was obtained across all states and territories of Australia, the CREATE Leadership Group assisted with identifying and

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inviting potential case study sites to participate. All work undertaken by the CREATE Research team was guided by a Case Study Handbook that was provided to potential sites and outlined the process to be undertaken including a draft case study report.

The key steps in undertaking case studies:

• Identify and invite potential case study sites: this included negotiating terms and conditions such as the focus of the case study, ethical approvals, timelines, provision of the Case Study Handbook, the potential appointment of an Aboriginal staff member to take up the role of an Aboriginal Research Fellow, and contractual arrangements such as completion of a Memorandum of Understanding or Scope of Works.

• Initial engagement with the case study site: this included an initial telephone conversation or site visit to introduce the Research team, identify potential participants for the interviews and begin to complete the Case Study Tool.

• Collect the Best Practice data: this included training the Aboriginal Research Fellow (where applicable), completing the Case Study Tool, providing potential interviewees with the Information Sheet and Consent Form and seeking informed consent to participate, and conducting interviews based upon the semi-structured interview guide.

• Analyse the Best Practice data: this included arranging for transcription of interviews, de-identification of transcripts and analysis of transcripts in NVivo software based upon a framework that described ways of working, benefits and outcomes, enablers, challenges and recommendations.

• Draft Case Study Report: the findings were presented in a draft Case Study report and sent to the participating ACCHO for their review.

• Finalise and present the Case Study Report: the draft Case Study report was updated based on feedback from the participating ACCHO with a finalised Case Study Report presented back to ACCHO staff and/or Board at a convenient time negotiated with the site.

Research Translation The Case Study reports were de-identified and the content was used to inform the development of chapters for this resource that described ACCHO ways of working across key domains of interest. The content within the chapters was refined to consider the experiences of the ACCHO sector nationwide through collective feedback from the CREATE Leadership Group. This collective feedback and refinement occurred over a two-year period through three face-to-face meetings (total days = 5) and five teleconferences.

Other CREATE Outputs

For more information on other CREATE outputs and achievements, including published literature see the CREATE website: create.sahmri.org

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