Completed Research Projects
Below are links to the information pages on completed KAMS and RCSWA research projects:
Aboriginal health research in the Kimberley
Social and Emotional Wellbeing
Smoking / Respiratory Disease
Chronic suppurative otitis media (CSOM), a disease of poverty, is very common among Australian Aboriginal children. In Aboriginal children, CSOM usually commences in infancy, causes hearing loss and has adverse effects on child development. This Aboriginal community controlled health services led research showed that twice-daily ear cleaning and topical ciprofloxacin is effective at community-level in achieving cure for CSOM. Healthcare providers to Aboriginal children with CSOM should be given special access to provide ototopical ciprofloxacin as first-line treatment.
Couzos S, Lea T, Murray R, and Culbong M. ‘We are not just participants–we are in charge’: the NACCHO ear trial and the process for Aboriginal community-controlled health research. Ethn Health 2005;10:91-111
Couzos S, Lea T, Mueller R, Murray R, and Culbong M. Effectiveness of ototopical antibiotics for chronic suppurative otitis media in Aboriginal children: a community-based, multicentre, double-blind randomised controlled trial. Med J Aust 2003;179:185-190
The Kimberley eye program has been built up over more than two decades, with a host of factors contributing to its current form. The eye health services in the Kimberley region includes retinal screening performed by Aboriginal health workers (AHWs) and nurses using retinal cameras for diabetic patients, mobile optometry services in remote communities and a visiting ophthalmology team.
The aims of this study are:
- To gather background information about the origins and history of eye health services and programs in the Kimberley region for the past 10 years;
- To describe the current model of eye health services;
- To evaluate outcomes of eye health services by analysing quantitative data from optometry, hospital and primary health care databases;
- To identify the lack of particular services, such as retinal screening, and facilitate appropriate training for health workers in remote health clinics of need.
Progress to date:
- Documented the history of eye health services in the Kimberley region;
- Evaluated eye health services in the Kimberley and analysed diabetic retinal screening activities between 2004-2010;
- Trained AHWs and nurses in how to operate a digital retinal camera and restored retinal screening programs across the Kimberley as part of chronic disease care;
- Further developed eye data record-keeping in a centralised database (MMEx) for Kimberley Aboriginal Community Controlled Health Services;
- Facilitated the forthcoming appointment of a regional eye coordinator and trainer for the region who will support and coordinate eye health services, provide ongoing training in retinal photography and help to report on retinal screening coverage;
- Provided plain language reports of the study findings to all health services included in the study.
- Dr May Sian Oh
- Dr Carmel Nelson
- Assoc Prof Julia Marley
- Prof David Atkinson
- Sue Metcalf
- Philomena Lewis
- Margie O’Neill
- Dr Angus Turner
- Dr Emma Griffiths
- Dr Carole Reeve
- Assoc Prof Richard Murray
Type 2 diabetes mellitus and its complications affect up to 25% of Aboriginal adults. However, access to primary health care is often poor, with primary care providers serving Aboriginal populations often being overwhelmed by acute care needs. Implementing and sustaining culturally safe programs to screen for chronic disease and provide effective continuing care is therefore a significant challenge. This study demonstrated that a devolved program of screening for retinal complications of diabetes in a remote Aboriginal population can be successfully performed by Aboriginal health workers and nurses using non-mydriatic fundus cameras and sustained over time with regional program support. Data sharing across services, client recall lists and point-of-care prompts generated by patient information systems, together with policies that make primary health care providers responsible for care coordination, helped support timely screening while avoiding over-screening.
Murray RB, Metcalf SM, Lewis PM, Mein JK, and McAllister IL. Sustaining remote-area programs: retinal camera use by Aboriginal health workers and nurses in a Kimberley partnership. Med J Aust 2005;182:520-523
This study investigated the extent to which general practitioners in the Kimberley region are available for doctor-provided primary care and relates primary care availability to need and standardised population based on government statistics and interviews with general practitioners, local managers and regional employers and organisations. A shortfall of 20.6 full time general practitioner positions was identified and this was aggravated by a significant number of unfilled positions in the areas of greatest need. Overall the region had only half the primary care general practitioners needed. The Shire of Halls Creek at the time of survey had less than a quarter of the doctors required based on this analysis.
Steps to increase the Australian medical workforce have begun but resources to recruit, support and sustain this workforce are required. Aboriginal health workers and locally trained nurses competently provide much of the primary care but need greater resources to support the available medical care.