CRE ABORIGINAL & TORRES STRAIT ISLANDER STREAM

NEWSLETTER – April 2014 We acknowledge and respect the traditional owners of country where we work

across this great land!

Inside this issue Page

Projects updates 1

The NHPA report 2

Feedback – NIIR workshop 4

The Lowitja Congress 2014 5

Data linkage roundtable 8

VPD report 2006 2010 8

HPV campaign 9

Upcoming events 11

Welcome to the electronic newsletter of the

Aboriginal & Torres Strait Islander stream of

the Centre for Research Excellence in

Immunisation.

We are calling for stories so keep them coming

in to Elizabeth at

e.kpozehoven@unsw.edu.au

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Projects updates

7 research project are ongoing within the stream, there is great progress on these

projects. Here are some of the updates:

Project 3: Pen Cat project- Rob Menzies

The CRE is collaborating with the Queensland

Aboriginal and Islander Health Council (QAIHC)

to develop immunisation modules for Pen CAT.

These modules will help services monitor and

improve their immunisation performance, and

provide vaccination coverage data.

Updates:

The project has been piloted in Queensland

will possibly be available to all Pen Cat users by

end of April. Pen CAT software is applicable to

almost all GP software.

Active training programme should be

developed in collaboration with Primary Health

care to be delivered alongside the

implementation of the Pen Cat programme.

Next step will be to initiate a research project

with improvement foundation, health services

providers will be enrolled to participate in the

project.

More research is planned to validate data that

has been collected through the system

Project 1: HPV Vaccine Impact in the Australian

Indigenous Population (VIP-I) (Dina Saulo,

Bette Liu, John Kaldor)

Updates:

Ethics approval has been obtained from all

jurisdictions except Southern Queensland

The groups of researchers in this project have

run presentations, workshops and training

sessions in some of the research sites

Recruitment of study participants has

started in some of the research sites

Project 2: Linkage of the Australian Childhood

Immunisation Register (ACIR) and State-based

registers to evaluate and inform Australia's

Immunisation programs (H Gidding, B Liu, P

McIntyre and WA researchers )

Updates:

Commonwealth Health Department approval

for release of the ACIR data has been received

and data extraction is now underway

A project grant application for 2015 has been

submitted to NHMRC to examine the impact of

timeliness of vaccination on disease burden

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Project 4: Developing an understanding of how

two Aboriginal communities see and experience

immunisation during pregnancy

(A Creighton )

Updates:

Ethics application has been submitted to the

local ethics committee for approval

Ethical approval from ANHMRC will be sought

as well

Consultations with the community are ongoing

Interviews will be begin after obtaining ethics

approval

Project 5: Identification of culturally sensitive

approaches to improve immunisation coverage

and timeliness of Aboriginal and Torres Strait

Islander children and their families( J Royle)

Updates:

Ethics application to be submitted to the

University of New South Wales Ethics

Committee.

Jenny Royle was advised to look at a New

Zealand project which compares characteristics

of practices that have achieved good

immunisation coverage versus practices that

have not, and to learn from any relevant lessons

from the project.

The NHPA report The National Health Performance Authority Immunisation rates for children in 2012–13 report

has been released

Percentages of Aboriginal and Torres Strait Islander children fully

immunised

In 13 of the 58 reported Medicare Local catchments, 95% or more of

Aboriginal and Torres Strait Islander children were fully immunised in at least

one age group, compared with four Medicare Local catchments for all

children.

Many local areas had less than 90% of Aboriginal and Torres Strait Islander

children aged 5 fully immunised:

• Eighteen of 58 reported Medicare Local catchments

• Eight of 34 reported SA3s

The percentages of Aboriginal and Torres Strait Islander children fully

immunised ranged from:

• 1 year of age

Highest at 91.9% – Hunter (NSW)

Lowest at 68.7% – Central Adelaide & Hills

• 2 years of age

Highest at 97.0% – Far North Qld

Lowest at 81.6% – Central Adelaide & Hills

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• 5 years of age

Highest at 97.0% – Gippsland (Vic)

Lowest at 80.6% – Central Adelaide & Hills

In 51 of the 58 reported Medicare Local catchments, less than 90% of Aboriginal and Torres

Strait Islander children were fully immunised in at least one age group. Of these,

13 recorded less than 80%, all in the 1-year-old age group. By comparison, no Medicare

Local catchment returned results below 80% for all children (Figure 4, page 13).

The gap between the percentages of Aboriginal and Torres Strait Islander children fully

immunised and all children was greatest among the 1-year-old age group in most Medicare

Local catchments. The gap in percentages between Aboriginal and Torres Strait Islander

children and all children narrowed in many Medicare Local catchments when the rates for

the 2-year-old age group were compared

Numbers of Aboriginal and Torres Strait Islander children not fully immunised

The five Medicare Local catchments with the greatest number of Aboriginal and Torres Strait

Islander children not fully immunised aged 1, 2 and 5 years combined were Northern

Territory (272), Far North Qld (263), Townsville-Mackay (Qld) (235), North Coast NSW (198)

and Western NSW (192).

Changes in child immunisation rates from 2011–12 to 2012–13

The Authority‟s previous report on child immunisation identified 23 Medicare Local

catchments where less than 90% of children aged 5 years were fully immunised. In 2012–

13, this had dropped to 13 Medicare Local catchments.

Across Medicare Local catchments changes in the percentages of children fully immunised

from 2011–12 to 2012–13 were greatest among 5-yearold children. Across almost all

Medicare Local catchments, there were improvements in the percentages of 5-year-old

Aboriginal and Torres Strait Islander children between 2011–12 and 2012–13. Of the 55

Medicare Local catchments reported for both years, the number with more than 90% of

children fully immunised increased from 17 to 38 Medicare Local catchments across the two

years.

Source: The National Health Performance Authority Immunisation rates

for children in 2012–13

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A common theme of the workshop was the untapped potential of the Australian Childhood Immunisation

Register (ACIR) to inform Indigenous immunisation strategies. The three presentations in this session

showed how the full potential of ACIR could be realised using population-based data linkage. Hannah

Moore explained how the linkage of individual-level data across multiple population-based datasets can

bring together a wealth of information about each person, such as their vaccine preventable disease

history and associated morbidity, vaccination status, detailed demographic information, and co morbid

conditions, whilst at the same time maintaining privacy. Heather Gidding described progress with the first

study to link ACIR data (to state-based data sets in Western Australia and New South Wales) for the

purposes of measuring the effectiveness of Australia‟s immunisation program. The key outcomes will

include the following, all of which were considered priorities by the workshop participants:

1) Accurate measures of Indigenous status (Indigenous status on the ACIR has never been compared

with other data sources); 2) Population-based estimates of vaccine coverage and effectiveness (VE) by

Indigenous status; and 3) predictors of these measures. In particular, factors associated with timeliness of

vaccine receipt (significantly lower in Indigenous children).

A specific question is whether the rotavirus vaccine is less effective in Indigenous populations. In the final

presentation, Sarah Sheridan described how she will use linked state datasets in the Northern Territory

and Queensland to examine this question, using ACIR data to estimate coverage for „control‟ groups. It

will be interesting to compare Sarah and Heather‟s results once their studies are completed.

Feedback from the National indigenous immunisation research

workshop

Author: Heather Gidding

The Lowitja Congress 2014

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Summary of the Lowitja Congress 2014 - Author Jenny Royle-

CQI Conference 17-18 March 2014, Etihad Stadium, Melbourne Docklands

Congress Lowitja was preceded by the Lowitja Institute 2nd National Conference on Continuous Quality

Improvement (CQI) in Aboriginal and Torres Strait Islander Primary Health Care. Information about the

CQI Conference is available on the Lowitja Institute website- www.lowitja.org.au/cqi-2014.

Congress Lowitja 19-20 March 2014, Etihad Stadium, Melbourne Docklands

Welcome to country: Aunty Di Kerr

Performances celebrating Aboriginal Culture:

Ms Deborah Cheetham, Koori Youth Will Shake Spears, Skin Choir.

Opening:

Dr Lowitja O‟Donoghue AC CBE DSG, Patron, The Lowitja Institute

Lowitja O‟Donoghue was the inaugural Chair of the Cooperative Research Centre (CRC) for Aboriginal

and Tropical Health (1997-2003), which led to the CRC for Aboriginal Health (2003-2009) and current

CRC for Aboriginal and Torres Strait Islander Health, which is incorporated in the Lowitja Institute.

This presentation by Lowitja O‟Donoghue covered many aspects of the development of the Lowitja

Institute. She touched on themes which recurred throughout the Congress- carrying out research that

does not just sit on the shelf and striving for equality in health outcomes for Aboriginal and Torres Strait

Islander Peoples.

Keynote Address:

„Future of Aboriginal and Torres Strait Islander Health‟

Mr. Warren Mundine, Chairman, Prime Minister‟s Indigenous Advisory Council.

Mr. Mundine outlined some of the roles of the Advisory Council:

To focus on practical changes to improve the lives of Indigenous people

Improve school attendance

Increase employment opportunities

Empowering communities, increasing capacity of communities

Shared responsibility to achieve constitutional recognition

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Plenary Session

„Future Thinking in Aboriginal and Torres Strait Islander Health‟

Ms Pat Anderson, Chairperson, the Lowitja Institute Board

Ms Pat Anderson presented an inspiring long-term approach and powerful view of the future. She

described how we now live in a world unimaginable a few decades ago- many Aboriginal and Torres Strait

Islander peoples attending Universities, becoming sophisticated advocates. She outlined the history of the

development of the Aboriginal Community Controlled Organisations starting in 1971 in Redfern.

Ms Pat Anderson said despite the success stories of our ACCHOs there will be increasing pressure to

focus on a narrow medical model of care, limited individual approach and non-holistic. She strongly

believes the health services in our ACCHOs could be under increasing pressure to change to providing a

narrower service contrary to the current successful established holistic care.

Young Orator’

Ms Shannon Dodson, Digital Campaign Manager, Recognise

Shannon Dodson presented a memorable, inspiring, personal oration from the perspective of a blond, fair

skinned young Aboriginal adult. She shared the assumptions that have been made about her because of

her surname, her father‟s connection with and role on the national stage, and as an individual who doesn‟t

fit the stereotype of what she, as an Aboriginal, should look like.

“I will not accept other people deciding who I am”. “I will decide who I identify as”. “I am a proud Aboriginal

woman. I will not accept criticism of this.”

Day 2, Opening

Dr Tim Soutphommasane, Race Discrimination Commissioner, Australian Human Rights Commission.

Dr Soutphommasane spoke with conviction, determination and knowledge regarding the goal of health

equality and the cost of racism. He acknowledged racism is a fundamental driver of poor health. His

description of the cost of racism focused around diminished social cohesion and harmony that racism

brings. He presented data on percentages of Australians as a whole who suffer from different forms of

racism. The impact of racial vilification is on the health of individuals and communities. It is not appropriate

for people to say others should develop a „thicker skin‟. Racism inflicts injury on each and every occasion.

Keynote Address

Dr Alessandro Demaio, Global Health Fellow, Harvard Medical School and CoFounder, NCDFree.

Dr Demaio presented global health tasks and optimism in youth to address these tasks by their will and

drive and global connectedness. We strive for a healthy global community with equity of health and equity

of access. He believes the two greatest global health challenges are climate change and non-

communicable diseases (NCDs).

Workshop: ‘Cultural Competency of Health Services’

Facilitator: Dr Michael Tynan, Associate Director, Knowledge Exchange and Research, Lowitja Institute

This workshop commenced with detailed examples of cultural competency work in the hospital setting.

The St Vincent‟s Hospital in Melbourne outlined their Cultural Competency training program, which is up

and running well. They highlighted the need for the involvement of Aboriginal people in the planning of

such programs and tailoring the program to be locally specific.

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The Future of the Lowitja Institute

Ms Lynn Brodie, CEO Lowitja Institute

Ms Brodie provided a snapshot of key Lowitja Institute concepts

Embracing the many partnerships and looking at increasing partnerships

Shared understanding of knowledge exchange

Implementation and translation focus

Don‟t do research that will sit on the shelf

Need to be nimble and responsive

Integrated health research centre

Sophisticated system of social and emotional well being- holistic

Dr Michael Tynan, Associate Director, Knowledge Exchange and Research, Lowitja Institute

Dr Tynan highlighted the need for research leadership across program areas, project review, rapid policy

synthesis, public comment on key emerging issues and mentoring emerging researchers. He outlined the

Lowitja Institute faculty concept and 3 programs.

Program 1: Community capability and the social determinants of health

Program 2: ATSI health workforce

Program 3: Health policy systems

Closing Speaker

Prof Marcia Langton AM, Foundation Chair in Australian Indigenous Studies, University of Melbourne

Prof Langton complemented the organizers of the Congress on the range and quality of presentations and

summarized the key points of each.

Prof Langton said the need for Constitutional change is vital. So many people do not know Aboriginal and

Torres Strait Islander people are not mentioned in the constitution. She described the constitutional

change as the vital next step- the Redfern Speech, the Apology and now constitutional recognition. This

vital next step is a further platform to lift us up. “We deserve parity in all walks of life”.

Additional Lowitja Congress presentations and workshops

This summary does not include information on the Constitutional Recognition Panel session (March 19th)

or 5 additional parallel workshops held across the 18-19th March.

The congress website can be accessed to read the detailed program- www.lowitja.org.au/congress-2014.

Prof Marcia Langton AM, Foundation Chair of Australian Indigenous Studies, University of Melbourne

Find more information

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The Lowitja Institute and Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS)

roundtable on Aboriginal and Torres Strait Islander Health Data Linkage was held in Melbourne, on 31

October 2013. The roundtable was attended by approximately 30 people from diverse range of

organisations across the country with an interest in data and data linkage, including the Aboriginal

Community Controlled sector, government agencies, health service providers/clinics, research institutes

and non-government organisations.

The purpose of the roundtable was to:

bring together researchers, community controlled services and government agencies involved in data

collection, analysis and usage, data management and data integration and linkage

provide an overview of data gaps and barriers to good health data and linkage concerning Aboriginal and

Torres Strait people

identify opportunities for closing data gaps through data linkage strategies, including the linking of

registry and administrative databases across jurisdictions

improve data linkages at the regional level

establish better communication/collaboration across the different health systems to improve data linkage

capacity

identify potential interventions based on the sharing of ideas on data and data linkages

share information about current data linkage initiatives in different States around Aboriginal and Torres

Strait Islander health data

discuss ownership and use of data and their linkages.

Visit the Lowitja website for report, presentations and related materials

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Roundtable on Aboriginal and Torres Strait Islander Health Data

Linkage

Vaccine preventable diseases and vaccination coverage in

Aboriginal and Torres Strait Islander people, Australia 2006–2010

„Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people

2007 to 2010‟ is the third in a series of reports published in Communicable Diseases Intelligence. It

provides data on disease notifications, hospitalisations, deaths and childhood vaccinations, comparing

rates in Aboriginal and Torres Strait Islander and non-Indigenous people. It identifies areas of success

and improvement, and areas that need further attention.

This report was prepared at the National Centre for Immunisation Research and Surveillance of

Vaccine Preventable Diseases (NCIRS)

Vaccine preventable diseases and vaccination coverage in Aboriginal and Torres Strait Islander people,

Australia 2006–2010 - Printable version (PDF 1894 KB)

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The national HPV vaccination program - New resources for

Aboriginal and Torres Strait Islander communities

An HPV vaccination comic book for Aboriginal and Torres Strait Islander Males and

females is now available

Comic book for girls

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The national HPV vaccination program - New resources for

Aboriginal and Torres Strait Islander communities

Comic book for boys

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14th National Immunisation Conference: Maintaining excellence in immunisation: Consolidating

gains, identifying gaps

17 – 19 June 2014, Pullman Melbourne

Click here to register

Workshop: Equity in disease prevention_ Vaccine for the elderly

Date: Friday, 20th June 2014 (9am – 4:30 pm)

Workshop venue: Lakeside 3, Bayview On the Park Hotel, (Map), 52 Queens Road, Melbourne, VIC 3004,

Australia

We live in an ageing society, where positive ageing and prevention are key to a healthy future. Vaccines

can prevent disease, suffering and death. The elderly are at increased risks of vaccine preventable

diseases such as influenza, pneumococcal disease, herpes zoster and pertussis. Immunisation is an

effective and available strategy for reducing disease burden in the elderly, yet vaccines for the elderly are

under-utilised and under-valued compared to children. “Pneumonia is the old man‟s friend” is a common

misperception, laden with value judgement about the elderly and does not take into account the suffering

associated with acute infections, nor the transmissibility to others. The “older” elderly and people with

dementia are less likely to be vaccinated than younger, more health elderly. For many reasons, there are

missed opportunities for preventing vaccine preventable-diseases and suffering in the elderly.

Find more information WORKSHOP FLYER and PROGRAM

For enquiries, contact Elizabeth Kpozehouen e.kpozehoven@unsw.edu.au

REGISTER , places are filling up

Upcoming events

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CONTACT US

CRE Office | Room 323 | Level 3 Samuels Building | The School of Public Health and Community Medicine | Gate 11 Botany Street, Randwick | The University of New South Wales, Sydney NSW 2052, Australia. Website: www.creimmunisation.com.au