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Table 1 Translation; dissemination and training associated with sub-studies conducted

From: Improving Aboriginal maternal and infant health services in the ‘Top End’ of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change

Sample, data used Translation Training/capacity development
Baseline data study: Hospital and health centre data of 412 mothers and their 413 infants (2004–6) were audited from the two remote study sites and RC hospital; 120 hours of observation of maternal and infant health services in 3 settings and 60 semi-structured interviews with key stakeholders; This work was instrumental in: developing the MGP and improvements to infant health care; informing the choice of indicators; well disseminated through publications. PhD student A; thesis accepted December 2013; 5 publications.
Epidemiological studies: 7,560 mothers with singleton pregnancies from NT perinatal data using uni- and multivariate analyses for groupings by Aboriginal status; region (Top End/Central Australia); Remote/Urban residence; and the two field sites; 2,421 Aboriginal mothers aged 13–34 years and 254 non-Aboriginal teenagers with singleton pregnancies; Comparison of community records, birth registrations and perinatal counts in standardised data sets and;42 indicators sets with more than 1,000 individual indicators reviewed to develop core indicators for remote. Iterative Input from 30 experts as the list was developed. Confirmed that quality of care and remoteness, rather than Aboriginality, influence the worse outcomes of remote living Aboriginal women and infants. We also demonstrated that Aboriginality, rather than age, is the important variable related to outcomes for young women. The comparison work showed errors in birth counts. that have significant influence on managers who should try to staff by volume and acuity of work but do not. The final study has potential to provide targeted indicators for remote living Aboriginal women and infants in the TE. PhD student B graduated with 4 + 1 under review publications.
We were able to differentiate subgroups of Aboriginal women and infants to identify those with poorer outcomes so health services and clinicians could target service delivery and improvement interventions at the regional and local levels.
Study of out of hospital births: audit of 32 records of women who birthed locally, detailed field notes, stories collected and unstructured interviews with 7 locally birthing women and 5 of their family. Influenced system improvement and the establishment of the MGP. Honours student graduated and now doing a related PhD in remote Aboriginal Australia; 1 publication.
Parenting study: Longitudinal interviews and observations with 15 women from each field site from pregnancy until their babies were 12 months. Discussions were held with women and family members and narratives collected. Repeated requests for conference presentations (including 2 keynotes at national conferences) and staff seminars to access and discuss this work and the implications it has on the delivery of health and human services. Development of research skills in Aboriginal co-researchers; 1 publication.
Impact of colonisation of health care in the NT; An Aboriginal PhD candidate with Aboriginal co-researchers in a candidate led study of the quality and nature of health care with a case study on intergenerational learning about birthing. Evaluation of cultural security across general health services conducted as an industry sponsored piece of research that fed into policy and services with a case study analysis in train sponsored by the candidate. PhD in train; 1 publication, one book chapter and one eBook chapter on basis of method used; Industry Case Study Report on Cultural Security.
Post intervention evaluation: 66 participants were interviewed, record audit repeated, field notes kept and observations undertaken in remote sites as well as RDH replicating baseline data collection. Published in a commissioned report for the NT Government with papers nearly completed for publications. Contributing to PhD student C- well advanced in thesis. Reports (n = 2) to Industry. Publications in preparation.
Participatory Action Research Study; Baseline data on problems with transfer of information between the RC and remote clinics led to study between senior manager and 2 researchers on improving the system. Work between a CI, PhD student and senior manager on starting to improve the system made progress towards improvement, particularly in discharge planning. Contributed to PhD student C’s doctorate; I publication.
Costing study: 315 mothers and singleton infants who were clients of the MGP compared with 408 mothers with singleton pregnancies from the baseline study post MGP intervention. Direct costs from the Department’s perspective from first antenatal visit till 6 weeks post-partum and infant data from birth to 28 days. Has strengthened the sustainability of the MGP model with a costing paper that demonstrates the new system actually saves money as well as producing better results. Post-Doctoral researcher trained by the project in health economics led the analysis and publication of this data; 1 publication.
Benchmarking of neonatal nursery admissions; Records of all neonates (n:463) born in 2010 and admitted to nursery. Demonstrated admissions are within national benchmarks for admissions and justified. Study done with paediatrician responsible for nursery care in NT. Confirms baseline and evaluation data. Paper ready for submission and contributing to PhD candidate D’s thesis.