Process evaluation of a co-designed best practice model of dementia care for First Nations peoples
Tracks
Ballroom 3
Aboriginal and/or Torres Strait Islander
Best practice
Dementia
First Nation People
Models of Care
| Thursday, November 14, 2024 |
| 3:15 PM - 3:30 PM |
Speaker
Dr Jo-anne Hughson
Research Fellow
The University Of Melbourne
Process evaluation of a co-designed best practice model of dementia care for First Nations peoples
Abstract
Introduction: This process evaluation aimed to understand the factors influencing uptake of a co-designed best practice model of dementia care implemented in Aboriginal Community Controlled Health Service (ACCHS) settings, to address high prevalence and low detection of cognitive impairment and dementia in First Nations Communities.
Method: The Integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) Framework guided the evaluation, ultimately in a reframed form to reflect First Nations’ epistemologies. Data collection included: individual/focus group interviews with ACCHS staff (n=35) and research staff (n=13), researcher journal entries (n=102), workshop evaluations (n=69) and ACCHS implementation activity checklists (n=12). Thematic analysis identified contextual factors. Descriptive summary statistics were calculated to measure fidelity, reach, dose delivered and dose received.
Results: Three major themes related to: 1. Aboriginal health and diverse environmental eco-systems (with sub-theme: complexities and competing challenges in Indigenous communities); 2. Reciprocal relationships built on collaboration and cultural responsiveness; 3. Community knowledges and understandings of memory and thinking problems. Fidelity to the planned intervention was low to medium, and dose delivered varied markedly. The project’s reach was high and ACCHS staff demonstrated high engagement.
Conclusions: While challenges were encountered, several components were successfully implemented with relatively high uptake and acceptability among ACCHSs staff. These successes are linked to an increase in clinical activities relating to the diagnostic pathway. Further, essential key components for successful implementation were highlighted. These findings will inform future initiatives to improve dementia care in primary care contexts.
Method: The Integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) Framework guided the evaluation, ultimately in a reframed form to reflect First Nations’ epistemologies. Data collection included: individual/focus group interviews with ACCHS staff (n=35) and research staff (n=13), researcher journal entries (n=102), workshop evaluations (n=69) and ACCHS implementation activity checklists (n=12). Thematic analysis identified contextual factors. Descriptive summary statistics were calculated to measure fidelity, reach, dose delivered and dose received.
Results: Three major themes related to: 1. Aboriginal health and diverse environmental eco-systems (with sub-theme: complexities and competing challenges in Indigenous communities); 2. Reciprocal relationships built on collaboration and cultural responsiveness; 3. Community knowledges and understandings of memory and thinking problems. Fidelity to the planned intervention was low to medium, and dose delivered varied markedly. The project’s reach was high and ACCHS staff demonstrated high engagement.
Conclusions: While challenges were encountered, several components were successfully implemented with relatively high uptake and acceptability among ACCHSs staff. These successes are linked to an increase in clinical activities relating to the diagnostic pathway. Further, essential key components for successful implementation were highlighted. These findings will inform future initiatives to improve dementia care in primary care contexts.
Biography
Jo-anne Hughson (PhD) is a Research Fellow at the University of Melbourne whose research focuses on improving health outcomes for First Nations and culturally and linguistically diverse communities using co-design and community participatory research approaches. She has been Project Manager of the national NHMRC-funded Let's CHAT (Community Health Approaches To) Dementia in Aboriginal and Torres Strait Islander Communities research project since 2018. This study aims to optimise detection and care for older Aboriginal and Torres Strait Islander people living with or at risk of developing cognitive impairment and dementia, and their carers, families and communities through the development and implementation of a co-designed, best-practice model of care for primary health care services.
Lauren Poulos is a Biripi woman from NSW, who is a project coordinator in the Aboriginal Health and Ageing Program at NeuRA. Lauren managed the Caring for Spirit Project which translates research into culturally relevant and accessible dementia information, education and training for Aboriginal and Torres Strait Islander communities. Over the past two years, Lauren has been collaborating with the team on the Let's CHAT dementia project, where she has been actively engaging with ACCHS staff and various stakeholders in NSW within the Indigenous health and aged care sector. Together, they're working to improve the overall health outcomes and quality of life for older individuals dealing with cognitive impairment or dementia, along with their families and communities.
Session Chair
Aislinn Lalor
Senior Research Fellow & Senior Lecturer
Monash University
