_{Learn about the work of Tyrown Waigana}

Welcome to our page describing our CVD implementation work. Our ANU team is based in Canberra; we acknowledge the Ngunnawal and Ngambri people as traditional owners of the land we work on and pay respects to all Elders past, present and emerging.

Navigation

1. About
2. Our Approach
3. Objective 1
4. Objective 2
5. Objective 3
6. Outputs and Resources
7. Contact

About

Despite recent reductions in deaths from cardiovascular disease (CVD), Aboriginal and Torres Strait Islander peoples continue to experience a high burden of chronic diseases such as diabetes, CVD and chronic kidney disease (CKD) from a young age.

Our program of work aims to improve prevention of chronic disease for Aboriginal and Torres Strait Islander Peoples at the population, health service and individual levels, through three objectives:

• Objective 1 - Ensuring better and appropriate CVD risk prediction through national guidelines
• Objective 2 - Identifying sustainable approaches to support high quality risk assessment and follow-up through enhancing service delivery
• Objective 3 - Developing shared-decision making resources to support patient-centred care for Aboriginal and Torres Strait Islander peoples

Our approach is guided by evidence, shared knowledge and systems strengthening.

Our Approach

Our CVD implementation team works with organisations and governments across Australia using a community-focused and strengths-based approach that emphasises First Nation’s leadership and expertise. Our efforts to achieve long term sustainable improvement are underpinned by a collaborative approach.

We are funded by the Australian Government Department of Health, Indigenous Health Division.

Our approach is led by First Nation’s knowledge, expertise and leadership. Our way of working is based upon a continuous cycle of sharing, discussion, feedback and refinement.

Our team involves Aboriginal and Torres Strait Islander leadership and voices at all stages of our research, from design through to output development and dissemination:

• Our CI team and collaborators include Aboriginal and Torres Strait Islander researchers
• We meet regularly with Thiitu Tharrmay, our Aboriginal and Torres Strait Islander Health Program Reference Group
• We are guided by principles of Indigenous Data Sovereignty and Indigenous Data Governance put forth by the Maiam nayri Wingara Indigenous Data Sovereignty Collective

Objective 1 – Ensuring updated CVD risk guidelines are appropriate for Aboriginal and Torres Strait Islander peoples

We are working with guideline developers to ensure better CVD risk prediction that is appropriate for Aboriginal and Torres Strait Islander peoples.

Absolute CVD risk guidelines are being updated for release in 2022. Our team is engaged with the Management of Absolute Cardiovascular Disease Risk Guideline Update led by the Heart Foundation.

When working towards ensuring the appropriateness of the next CVD risk equation and guidelines for Aboriginal and Torres Strait Islander peoples, we considered this within two contexts:

1. Data: The data and statistical methods needed to ensure an accurate CVD risk algorithm;
2. Discourse: Shared knowledge; consideration of the impact of racism, unmeasured inequities and non-traditional biomarkers relevant to Aboriginal and Torres Strait Islander CVD risk

These two components address the main considerations in updating CVD risk guidelines to achieve better prevention of CVD in primary care and to ensure the next guidelines are more inclusive and representative for Aboriginal and Torres Strait Islander peoples (Figure 1).

Objective 2 – Strategies to support high population coverage of chronic disease risk assessment and follow-up

Learning from leaders.  - Sharing what works to improve chronic disease care for Aboriginal and Torres Strait Islander clients

We will be conducting several qualitative case studies with lighthouse services across Australia. We want to learn from the strengths of individual services that provide high quality chronic disease care and help amplify these lessons so that other services across the country can establish their own systems and processes to make sure their chronic disease care is the best possible.

After information gathering at each site, we will bring staff and patients from across all sites together to co-design practice and policy options that will help enhance chronic disease screening and management for Aboriginal and Torres Strait Islander peoples.

ANU HREC approval 2020/618 and 2021/424

AIATSIS approval reference number EO234-20210223

Learn more about experience based co-design methods

• What is experience-based co-design? The King’s Fund
• Co-design with Aboriginal communities Agency for Clinical Innovation

Objective 3 – Co-designed shared-decision making resources to support patient-centred care for Aboriginal and Torres Strait Islander peoples

Building on previous work of decision aids and CVD risk calculators, resources will be developed through co-design to support shared decision making around health for Aboriginal and Torres Strait Islander peoples.

This objective is led by Dr Carissa Bonner and her team at The University of Sydney.

Working group

Carissa Bonner: CVD risk communication, decision aids, Heart Foundation roles

Judith Parnham (Ankamuthi/Erub): Health Worker, NAATSIHWP role, MPhil candidate

Natasha Freeman: GP, AMS roles in NT/NSW, qualitative research

Carys Batcup: behaviour change, qualitative research, administrative support

Shannon McKinn: community health literacy, qualitative research

Advisory group

Michelle Dickson (Darkinjung/Ngarigo): Indigenous Public Health, yarning research methodology

Lyndal Trevena: GP, shared decision making, ACI roles

Marguerite Tracey: GP, health literacy, RACGP & AMS roles

Kirsten McCaffery: health literacy, shared decision making

AIATSIS approval reference number EO294-20210826

Outputs and Resources

• Brochure summarising our approach and objectives 
• Visit here for resources on CVD risk communication with Aboriginal and Torres Strait Islander Peoples: toolkit for health professionals.

Contact

For more information about this project, please contact Dr Jason Agostino (Lead Investigator) jason.agostino@anu.edu.au or Dr Deborah Wong (Project Manager) deborah.wong@anu.edu.au