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文化安全康复方案对澳大利亚原住民颅脑损伤后前瞻性过程评估的研究方案:“正确康复之路”项目。

Study protocol for a prospective process evaluation of a culturally secure rehabilitation programme for Aboriginal Australians after brain injury: the Healing Right Way project.

机构信息

Institute for Health Research, The University of Notre Dame Australia, Fremantle, Western Australia, Australia

Telethon Kids Institute, Perth, Western Australia, Australia.

出版信息

BMJ Open. 2021 Sep 28;11(9):e046042. doi: 10.1136/bmjopen-2020-046042.

Abstract

INTRODUCTION

Aboriginal and Torres Strait Islander (hereafter respectfully referred to as Aboriginal) people are Australia's First Peoples, having the longest continuous culture in the world and deep spiritual connections with ancestral land. Improvements in their health and well-being is a major policy goal of Australian governments, as the legacy of colonisation and disruption of cultural practices contribute to major health challenges. Lack of culturally secure services impacts participation of Aboriginal people in health services. Aboriginal people with a brain injury typically experience poor access to rehabilitation and support following hospital discharge. 'Healing Right Way' (HRW) is a randomised control trial aiming to improve access to interdisciplinary and culturally secure rehabilitation services for Aboriginal people after brain injury in Western Australia, improve health outcomes and provide the first best practice model. This protocol is for the process evaluation of the HRW trial.

METHODS AND ANALYSIS

A prospective mixed methods process evaluation will use the Consolidated Framework for Implementation Research to evaluate implementation and intervention processes involved in HRW. Data collection includes qualitative and quantitative data from all sites during control and intervention phases, relating to three categories: (1) implementation of trial processes; (2) cultural security training; and (3) Aboriginal Brain Injury Coordinator role. Additional data elements collected from HRW will support the process evaluation regarding fidelity and intervention integrity. Iterative cross-sectional and longitudinal data synthesis will support the implementation of HRW, interpretation of findings and inform future development and implementation of culturally secure interventions for Aboriginal people.

ETHICS AND DISSEMINATION

This process evaluation was reviewed by The University of Western Australia Human Research Ethics Committee (RA/4/20/4952). Evaluation findings will be disseminated via academic mechanisms, seminars at trial sites, regional Aboriginal health forums, peak bodies for Aboriginal health organisations and the Australian Indigenous HealthInfoNet (https://healthinfonet.ecu.edu.au/).

TRIAL REGISTRATION NUMBER

ACTRN12618000139279.

摘要

简介

原住民和托雷斯海峡岛民(以下简称原住民)是澳大利亚的原住民族,拥有世界上最古老的连续文化,与祖传土地有着深厚的精神联系。改善他们的健康和福祉是澳大利亚政府的主要政策目标,因为殖民化和文化习俗的破坏导致了重大的健康挑战。缺乏文化安全服务影响了原住民参与卫生服务的程度。脑损伤的原住民在出院后通常很难获得康复和支持。“正确康复方式”(HRW)是一项随机对照试验,旨在改善西澳大利亚脑损伤后原住民获得跨学科和文化安全康复服务的机会,改善健康结果,并提供第一个最佳实践模式。本方案是 HRW 试验的过程评估。

方法和分析

前瞻性混合方法过程评估将使用实施研究综合框架来评估 HRW 中涉及的实施和干预过程。数据收集包括控制和干预阶段所有地点的定性和定量数据,涉及三个类别:(1)试验过程的实施;(2)文化安全培训;(3)原住民脑损伤协调员角色。从 HRW 收集的其他数据元素将支持关于保真度和干预完整性的过程评估。迭代的横断面和纵向数据综合将支持 HRW 的实施、结果的解释,并为未来开发和实施针对原住民的文化安全干预措施提供信息。

伦理和传播

该过程评估已由西澳大利亚大学人类研究伦理委员会(RA/4/20/4952)审查。评估结果将通过学术机制、试验现场研讨会、区域原住民健康论坛、原住民健康组织的主要机构和澳大利亚原住民健康信息网(https://healthinfonet.ecu.edu.au/)进行传播。

试验注册号

ACTRN12618000139279。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5311/8479980/888c284e842a/bmjopen-2020-046042f01.jpg

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