Providing the know-how for Closing the Gap:

The new research agenda

• 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

The CRCAH Advisory Board

DIISR

The Congress

The By Laws

The Centre Agreement

The CW Funding

AgreementThe CRC Partners

The Company

• 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

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:

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

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

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

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

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

CRCAH legacy:

• Effective interventions• Expertise in research transfer and communications

New build:• Diffusion strategy• Workforce development• Tools and resources

Emphasis on implementation

• 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

• 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

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

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

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

• Australian Indigenous arm of International Tobacco Control project

• Anti-racism intervention in local government

• Stewardship for Indigenous health

• others

Early start projects