Patricia Elarde, a Torres Strait Islander woman, has been involved in Aboriginal and Torres Strait Islander health for about 19 years. Her working experiences expand across a range of areas that include health, child protection and financial management. Patricia is currently the Manager of the Indigenous Health Unit within Diabetes Qld. The team has a strong working relationship with a variety of key stakeholders that include Queensland Health, the Primary Health Networks and more specifically with the state peak body, QAIHC and their Aboriginal and Torres Strait Islander Health Services. The education and training programs for Aboriginal and Torres Strait Islander health workers and members of the communities are highly regarded. Patricia is also an NDSS priority leader for Aboriginal and Torres Strait Islander people. This national role involves providing national coordination and leadership assistance to Diabetes Australia for various aspects of diabetes education and support programs for Aboriginal and Torres Strait Islander peoples. Other responsibilities are establishing and fostering relationships to assist in the promotion of the NDSS (National Diabetes Service Scheme) resources and training for the Indigenous diabetes workforce. While Patricia has travelled all over Australia with the many health focused projects, she has been involved in the sport of basketball as a player and elite coach at local, state, national and international levels, in states of Qld, NT, ACT and NSW.
The rate of diabetes within Australia’s Aboriginal and Torres Strait Islander people aged 25-54 years is up to eight times higher than it is for other Australians. While there are a number of existing diabetes resources targeting Aboriginal and Torres Strait Islander populations, most are print based. The future of diabetes care will increasingly lie in self-management systems and education and motivation are the key to improving self-management of diabetes.
Improving health outcomes for Aboriginal and Torres Strait Islander people is a key priority for Australia. Drawing upon digital technology is an innovative way to enhance and distribute educational diabetes resources to Aboriginal and Torres Strait Islander people now and in the future. For most of us, being connected on a daily basis is something that is often taken for granted. Yet there is a gap between those of us who are connected and those who are not. This is particularly so in many of our Aboriginal and Torres Strait Islander communities in Australia where factors such as distance, language, infrastructure, education and other factors only add to the complexity of the digital “divide”. However from these challenges can rise great opportunities to advance digital inclusion for Aboriginal and Torres Strait Islander people, specifically those living in rural and remote areas of Australia.
Building on the success of existing resources, the not-for-profit, government, and Aboriginal Community Controlled Sector formed a partnership to use interactive technology to develop digital animations and deliver diabetes education for Aboriginal and Torres Strait Islander people. The resultant diabetes module, The Diabetes Story, sits on over 70 touchscreen kiosks throughout Australia, delivering culturally appropriate health and wellbeing diabetes information to Aboriginal and Torres Strait Islander people. ‘The Diabetes Story’ uses digital technology to explain a complex issue in a direct, interesting way that encourages people ‘to take charge of their diabetes’.
The initiative aims to assess the effectiveness and cultural appropriateness of using digital, interactive diabetes self-management resources for Aboriginal and Torres Strait Islander people. Usage Reports from the kiosks provide tailored trace data from the network highlighting what information people are using. This includes the number of users, type of information viewed, and the time spent using the module.
The next step in this digital environment is to tailor this initiative to the smartphones and tablet devices.
Velvet Eldred has a Bachelor of Arts (Theatre QUT), Grad Dip of Counselling, Grad Cert in Expressive Art Therapies (Sophia College) and is a Facilitator for Drumbeat program (relationship training using drumming). Velvet is an actor, director, producer, devising/collaborating, workshop facilitator, counsellor and drummer. She has been running and designing innovative creative workshops for 25 years. Velvet works across cultures, industries, communities, age groups and abilities to give voice to participants who wish to express their stories. Velvet has worked for Access Arts, Queensland Performing Arts Centre, Graft N Arts, QUT, Cairns Distance Education, New York Theatre Company, Tropical Arts, Jute Theatre Company, Migrant Resource Services, ARC Disability Services, St John’s and Lush cabaret. Velvet also worked at Family Planning Queensland setting up the children’s sexual assault counselling services then as a councillor to children. Velvet was awarded the Cairns 2012 Woman of the Year Award and the Cairns Post Best Theatre Performance 2013. Velvet has been awarded State and Local council recognition with awards in education and the arts for her work at ARC Disability Services. She is a passionate, focused and determined advocate who uses the arts as a vehicle to build community capacity, resilience, engagement and inclusion. Velvet is currently employed by ARC Disability Service as Arts Facilitator of its performing arts program, and with Queensland Performing Arts Trust (QPAT) in the We All Dance community collaboration with The Royal Ballet.
Velvet Eldred in this presentation offers her personal story and work practices. Velvet will demonstrate why the arts worker is vital to a healthy community.
In any community there are people, who believe - believe in community spirit, believe that everyone needs to be valued and cared for, believe that people are worth listening to and have the right to self-determination and personal sovereignty. In seeking out these people, Velvet has kept true to a journey to meet people, to create a relationship, to ask questions, to share visions and to create opportunities/pathways for people to explore. Velvet begins with a vision of the “WE” then creates and brings it to fruition. Along the way the vision gathers excitement and possibility to completion.
People are the dynamic of the story they embody. This narrative is told by family, culture and structure. One is given a belief in a story. The stories can change though—go off on different subplots, meet heroic or shadow characters, rise to the challenge or fall. There is an infinite number of ways to tell a good story.
Art and community development is story making—music, theatre, books and films engage the ability to offer other ways of seeing the self. Of putting the self into a narrative and to be offered the qualities that create change. I speak to the people I work with as collaborator’s in a narrative. I am a director and I am working with an actor. I am not a therapist fixing someone or a support worker to a client. That is the difference.
The awareness of story is vital. The embodiment of a story underpins our individual truths and the truth’s communities understand about themselves. As health care workers you work also with an individual’s story, interrupting narratives that have led to a lack of self-care, perpetration of violence, alcohol abuse, drug abuse, sexual assault, dropping out of school. These are stories of lack of self-esteem and self-determination. All these stories tell us about the health and wellbeing of an individual or of a community and the capacity to be agents of change. That’s why I work as an arts worker and not a therapist, even though I am both.
This presentation presents a detailed story of how to build engaged and inclusive communities.
Elizabeth Elliott AM is a Distinguished Professor in Paediatrics and Child Health in the Sydney University Medical School; a Consultant Paediatrician at the Sydney Children’s Hospitals Network at Westmead; a National Health and Medical Council of Australia (NHMRC) Practitioner Fellow; and Chair of the National Fetal Alcohol Spectrum Disorders Technical Network, convened by the Australian Government Department of Health. She has been involved in clinical services, research, advocacy and policy development regarding fetal alcohol spectrum disorders (FASD) in children, and alcohol use in pregnancy, for over 20 years, is Head of the NSW FASD clinic and Co-Director of a Centre for Research Excellence on harms from alcohol in pregnancy (REAACH). She was a Deputy Chair of the Intergovernmental Committee on Drugs Working Party on FASD; a Member of the NHMRC committee to develop Australian Alcohol guidelines (2009); Member of the group to develop World Health Organization guidelines for identification and management of alcohol misuse during pregnancy (2014); and Member of the group to develop an International Charter for the Prevention of FASD.
In 2009, Aboriginal leaders in the very remote Fitzroy Valley in Western Australia invited University of Sydney researchers to assist them to progress a strategy to address alcohol use in pregnancy and foetal alcohol spectrum disorders (FASD). Following extensive community consultation, the Lililwan Project was initiated. In a suite of research studies we examined the pattern of alcohol use in pregnancy; prevalence of FASD; speech, motor, cognitive and behavioural problems associated with FASD; and child health service use and needs.
Of children born in 2002-3, 55% were exposed prenatally to alcohol (90% high risk). FASD was diagnosed in 1/5 (19%) amongst the highest rate worldwide. Children with FASD had birth defects, learning, behavioural and academic difficulties, ADHD, speech and motor disorders. Health needs and service use, including hospitalisation rates are high. These children have chronic complex disabilities requiring multi-disciplinary care but services are fragmented and health professionals scarce. They are vulnerable and many will face unemployment, contact with the justice system, and substance abuse.
The project has been highly influential and the ATSI Social Justice Commissioner, hailed it as an exemplar for conducting research with Aboriginal communities. Assessment tools developed for the project are used in elsewhere and have informed a new national diagnostic tool. Diagnosis of children with FASD has enabled initiation of and referral for treatment, and identification of women at risk of drinking in a future pregnancy. Our data identify the urgent need for trauma-informed drug and alcohol services, psychological services and Aboriginal health workers. They have attracted funding for training and employing multi-disciplinary health and education teams and led to better co-ordination of health services. Films made during the project have been used for education in Aboriginal communities, nationally and internationally. Our work also influenced formation of the Parliamentarians for the Prevention of FASD, and the initiation of a Federal Inquiry into FASD. They were included in the Inquiry report, which resulted in substantive ($20 mill) investment in a national strategy for FASD and funding of a National FASD Technical Network. They were included in reports of Inquiries into alcohol use in ATSI peoples and FASD in Northern Territory and influenced provision of NHMRC funding for FASD research. Results have been widely reported in the media, presented to scientific and lay audiences nationally to raise awareness of potential harms of alcohol in pregnancy and have informed new prevention, treatment and parent support programs.
Anthony Elliott is the Chief Operating Officer for North Queensland Primary Health Network. In this role he is a change champion for primary health care. Anthony has experience delivering high-performing primary health care programs in general practice, Aboriginal and Torres Strait Islander health, remote health, health promotion and prevention. Anthony has a commitment to working to make health services and systems integrated and patient centered, locally and nationally. Anthony’s clinical background is nutrition and dietetics. He has devoted his career to primary health care, having worked in both Medicare Locals and Divisions of General Practice, in senior executive roles and as a clinician in multidisciplinary allied health teams.
People living in rural and remote areas have reduced access to health services, greater distances to travel for medical attention, and generally have higher rates of ill health and mortality compared to those living in larger cities.
So when a rural and remote Primary Health Network was selected as one of only two regions in Australia to conduct the opt-out trial of the national My Health Record digital record system, it gave them the opportunity to improve the connectedness of care for their community, especially in improving health outcomes for Aboriginal and Torres Strait Islander peoples.
Their region, the fourth largest in geographical size in Australia, covers an twice the size of the UK. It is home to over 700,000 people, which includes more than 80,000 Indigenous Australians.
It was important to trial this initiative in this region due to a high burden of chronic conditions and complex needs, alongside the tyranny of distance between various communities, including remote Indigenous communities. The challenges in delivering connected healthcare in urban, regional and very remote areas are significant throughout this PHN’s footprint, and an electronic health record is a key enabler for sharing information in this environment.
This presentation will share the strategies and methods by which the PHN implemented the opt-out trial of the My Health Record on behalf of the Commonwealth Government, including:
Mary Emeleus is a GP and psychotherapist part-time at headspace Cairns. She has a role with Generalist Medical Training, James Cook University as a medical educator in their GP training program (Northwest Queensland area). She has pursued a special interest in primary care mental health throughout her career as a GP in rural and regional Queensland. She has become involved in Mental Health/Counselling Skills Training for GPs and registrars over the last few years and enjoys distilling the “best bits” from psychotherapy research and practice to make them practical and relevant for GPs. Mary has recently been given the opportunity to commence training in psychiatry, and she hopes that as she progresses in that direction she can hold strongly onto her grounding as a generalist! Professional interests include lifestyle medicine, adolescent mental health, early psychosis intervention, psychological and social approaches to psychosis, “low-intensity” CBT for GPs, psychodynamic, Jungian and existential theory and practice.
Aim: This pilot study will test the effectiveness of a modular online training format for rural GPs by identifying barriers and enablers to mental health training and specifically the value of a modular format and online case based discussion groups for consolidating new learnings in cognitive behavioural therapy (CBT).
Methods: A cohort of 38 participants have undertaken the pilot training program for a six month period. A series of four surveys are being conducted throughout the pilot, one at the completion of each of the four training modules. The online surveys collected a mix of qualitative and quantitative data in determining research objectives.
Relevance: Despite high demand, mental health training in its current form is not meeting the upskilling needs of GPs working in rural and remote communities. The rigid structure and workshop training formats make this training inaccessible to many. This pilot training program aims to enable rural GPs to acquire these skills whilst remaining in their communities. This model aims to facilitate access and quality peer interaction lifting both time and access constraints and reducing pressures on an already stretched GP workforce.
Results: A number of themes are explored in the surveys including barriers and enablers to accessing mental health training for rural general practitioners, the quality of modular training undertaken and self-assessed confidence in utilising CBT skills in clinical practice upon completion of training.
Final results will be available for analysis in October 2016. Results will assist in determining the effectiveness of modular training and online case based discussion groups for rural GPs.
Conclusions: Conclusions will be drawn at the completion of the pilot study in October 2016.