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Providing the know-how for Closing the Gap:
The new research agenda
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• New CRC for Aboriginal and Torres Strait Islander Health (CRCATSIH) sits within the Lowitja Institute
• CRC funded till June 2014• Lowitja Institute will establish an ongoing funding
mechanism (such as an endowment fund) to sustain Indigenous health research in the long-term
• Lowitja Institute will continue on after the CRC has ended.
The new CRC and the Lowitja Institute
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The CRCAH Advisory Board
DIISR
The Congress
The By Laws
The Centre Agreement
The CW Funding
AgreementThe CRC Partners
The Company
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• Burden of disease, mortality trends• End-user feedback, 2008 review of policy
priorities• Life course framework• 2008 audit of research capacity in Indigenous
health• Synthesis of 5 program outcomes• Ongoing input through FDA processes
Research program priority setting
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1. Healthy Start, Healthy Life
2. Healthy Communities and Settings
3. Enabling Policies and Systems
• Programs target 80% of the Indigenous health gap.
• They integrate a research focus on clinical processes, the determinants of health and upstream systems
Three new research programs:
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CRCAH legacy: successful interventions in chronic illness care (e.g. ABCD, AIMhi) (chronic conditions program, SEWB, primary care program)
New research:• Guide the implementation interventions
• Extend the breadth of CQI initiatives
• Maternal and child health interventions
• Support early intervention
• Risk factor interventions (tobacco)
Program 1: Healthy Start Healthy Life
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CRCAH legacy: targeted interventions in local communities (e.g. Healthy Skin), social determinants program, SEWB program
New Research: Multi-faceted health promotion interventions Shepparton project: 8-year collaboration with community organisations
in the Goulburn Valley
Development of measurement systems for health and social development
New intervention models that are community rather than organisation focussed
Program 2: Healthy Communities and Settings
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CRCAH legacy: Health services research (primary care program, chronic conditions), work on the social determinants of Indigenous health
New research:
Addressing up-stream barriers to health gain
Oriented to systems reform in regulation, funding, performance measurement, workforce development, contract management.
Program 3: Enabling Policy and Systems
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Unintended Complexity
Services of a medium-sized ACCHS
ClinicsYouth Service
Schools Chronic Disease
Medicare & PBS$$$
Commonwealth $$$$
States/Territories$$$
Health Authority and other depts $$$$ $ $ $
$$$$State Programs
Commonwealth Programs
Commonwealth Departments $$$$
Others $$
Men’shealth
DentalMothers& Babies
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Program Framework – Connections and Innovation- adapted from WHO Innovative Care for Chronic Conditions Framework
Healthy Communities and Settings
Healthy Life, Healthy Start
Patients and Families
Links
Community
Partners
Health Care Team
Enabling Policy and Systems
Outcomes
Health care organisation- Best practice care- Information systems
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CRCAH legacy:
• Effective interventions• Expertise in research transfer and communications
New build:• Diffusion strategy• Workforce development• Tools and resources
Emphasis on implementation
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• Partnerships with existing web-based knowledge portals
• Knowledge brokerage positions in policy and service sector
• Strategic communication of evidence, inc. setting up media exchange
Diffusion Strategy
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• Supporting the transition of research findings into formal and informal education and training
• National Centre for Quality Improvement in Indigenous Primary Health Care
• Formalised links with key workforce training providers
Workforce development
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Example:• Healthy Community and Settings Program aims
to resource people and organisations to implement multifaceted local interventions
• Supported by: • audit tools, network development resources,
evaluation frameworks, social and health indicator frameworks
Tools and resources
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Developing the connect between research projects and mechanisms for usage
National Centre for Quality Improvement in Indigenous Primary Health Care
APPRAISAL
INTEGRATED HEALTH INFO SYSTEMS
LONGITUDINAL STUDY
Research program
management
Implementation project
management
Diffusion strategies
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Access Economics prospective economic evaluation• Used methods adapted from a study of impact
of NHMRC research• Only 25% of the economic benefit attributed to
the proposed CRCAH program• Estimates based on impact in single health
condition per project – to avoid double countingOverall return of $526 million in economic benefit,
return of $7 for each $1 spent
Economic benefit
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• Australian Indigenous arm of International Tobacco Control project
• Anti-racism intervention in local government
• Stewardship for Indigenous health
• others
Early start projects