Protocol for the Yapatjarrathati project: a mixed-method implementation trial of a tiered assessment process for identifying fetal alcohol spectrum disorders in a remote Australian community

被引:16
作者
Shanley, Dianne C. [1 ,2 ]
Hawkins, Erinn [1 ,2 ]
Page, Marjad [3 ]
Shelton, Doug [4 ]
Liu, Wei [1 ,2 ]
Webster, Heidi [5 ]
Moritz, Karen M. [6 ,7 ]
Barry, Linda [8 ]
Ziviani, Jenny [9 ]
Morrissey, Shirley [1 ]
O'Callaghan, Frances [1 ]
Wood, Andrew [10 ]
Katsikitis, Mary [10 ]
Reid, Natasha [1 ,6 ,7 ]
机构
[1] Griffith Univ, Sch Appl Psychol, Gold Coast, Australia
[2] Menzies Hlth Inst Queensland, Gold Coast, Australia
[3] North West Hosp & Hlth Serv, Mt Isa, Australia
[4] Gold Coast Univ Hosp, Womens & Childrens Hlth Serv, Gold Coast, Australia
[5] Sunshine Coast Hlth Serv, Child Dev Serv, Sunshine Coast, Australia
[6] Univ Queensland, Child Hlth Res Ctr, Brisbane, Qld, Australia
[7] Univ Queensland, Sch Biomed Sci, Brisbane, Qld, Australia
[8] Ctr Childrens Hlth Res, Queensland Statewide Child & Youth Clin Network, Brisbane, Qld, Australia
[9] Univ Queensland, Sch Hlth & Rehabil, Brisbane, Qld, Australia
[10] Univ Sunshine Coast, Sch Social Sci, Sunshine Coast, Australia
关键词
Fetal alcohol spectrum disorder; Developmental assessment; Rural and remote areas; First nations; Indigenous communities; Implementation strategy; Aboriginal and; or Torres Strait Islander peoples; DIAGNOSIS; CHILDREN; IDENTIFICATION; IMPACT;
D O I
10.1186/s12913-019-4378-5
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background Fetal alcohol spectrum disorder (FASD) is a highly prevalent neurodevelopmental disorder associated with prenatal alcohol exposure. Early identification can improve functioning for individuals and reduce costs to society. Gold standard methods of diagnosing FASD rely on specialists to deliver intensive, multidisciplinary assessments. While comprehensive, prevalence rates highlight that this assessment model cannot meet demand, nor is it feasible in remote areas where specialist services are lacking. This project aims to expand the capabilities of remote practitioners in north Queensland, Australia, where 23-94% of the community identify as First Nations people. Integrating cultural protocols with the implementation science theories of Knowledge-To-Action, Experience-Based Co-Design, and RE-AIM, remote practitioners with varying levels of experience will be trained in a co-designed, culturally appropriate, tiered neurodevelopmental assessment process that considers FASD as a potential outcome. This innovative assessment process can be shared between primary and tertiary health care settings, improving access to services for children and families. This project aims to demonstrate that neurodevelopmental assessments can be integrated seamlessly with established community practices and sustained through evidence-based workforce development strategies. Methods The Yapatjarrathati project (named by the local First Nations community and meaning 'to get well') is a mixed-method implementation trial of a tiered assessment process for identifying FASD within a remote Australian community. In collaboration with the community, we co-designed: (a) a culturally sensitive, tiered, neurodevelopmental assessment process for identifying FASD, and (b) training materials that up-skill remote practitioners with varying levels of expertise. Qualitative interviews for primary, secondary and end users will be undertaken to evaluate the implementation strategies. RE-AIM will be used to evaluate the reach, effectiveness, adoption, implementation and maintenance of the assessment and training process. Discussion Co-designed with the local community, integrated with cultural protocols, and based on implementation science theories, the assessment and training process from this project will have the potential to be scaled-up across other remote locations and trialed in urban settings. The Yapatjarrathati project is an important step towards increasing the availability of neurodevelopmental services across Australia and empowering remote practitioners to contribute to the FASD assessment process.
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