Transcript Document 7391371

Providing the know-how for
Closing the Gap:
The new research agenda
The new CRC and the Lowitja Institute
• 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 longterm
• Lowitja Institute will continue on after the CRC has
ended.
The Company
The CW
Funding
Agreement
The Centre
Agreement
DIISR
The Directors (The Board)
The CRC
Partners
The CEO (Staff)
The By
Laws
The Congress
The CRCAH
Advisory
Board
Research program priority setting
• 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
Three new research programs:
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
Program 1: Healthy Start Healthy Life
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 2: Healthy Communities and
Settings
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 3: Enabling Policy and Systems
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.
Unintended Complexity
Commonwealth
$$$$
Medicare & PBS
$$$
States/Territories
$$$
Commonwealth
Departments $$$$
$
$
$
$
Health Authority
and other depts $$$
Commonwealth
Programs
Others $$
State Programs
Mothers
& Babies
Men’s
health
Clinics
Youth
Service
Schools
Services of a medium-sized ACCHS
Chronic
Disease
$
Dental
$
$
$
Program Framework – Connections and Innovation
- adapted from WHO Innovative Care for Chronic Conditions Framework
Enabling Policy and Systems
Links
Healthy Life,
Healthy Start
Healthy
Communities and
Settings
Health care organisation
- Best practice care
- Information systems
Patients and Families
Outcomes
Emphasis on implementation
CRCAH legacy:
• Effective interventions
• Expertise in research transfer and communications
New build:
• Diffusion strategy
• Workforce development
• Tools and resources
Diffusion Strategy
• Partnerships with existing web-based
knowledge portals
• Knowledge brokerage positions in policy and
service sector
• Strategic communication of evidence, inc.
setting up media exchange
Workforce development
• 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
Tools and resources
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
Developing the connect between research projects and
mechanisms for usage
EVALUATED WORKFORCE INTERVENTIONS
Research
program
management
APPRAISAL
INTEGRATED HEALTH INFO SYSTEMS
LONGITUDINAL STUDY
National Centre for Quality Improvement in
Indigenous Primary Health Care
Diffusion strategies
Implementation
project
management
Economic benefit
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 counting
Overall return of $526 million in economic benefit,
return of $7 for each $1 spent
Early start projects
• Australian Indigenous arm of International Tobacco
Control project
• Anti-racism intervention in local government
• Stewardship for Indigenous health
• others