The Communicate Study Partnership

NCT05629416 | Recruiting Phase 2

• 1 other identifier: 2008644
• Study Type: interventional
• Target: 340
• Locations: 1 country
• Sites: 4

Brief Summary

The vision of the Communicate Study Partnership is to ensure more Aboriginal patients receive culturally safe healthcare in their first language. The Communicate Study Partnership will implement and evaluate creative ways to embed cultural safety training and increase use of Aboriginal Interpreters and Aboriginal Health Practitioners at Northern Territory Top End hospitals. Quantitative outcomes (interpreter uptake, outcomes including leave against medical advice, costs) will be measured using time-series analysis. Qualitative outcomes derived from interviews with patient, healthcare provider and interpreter participants, will be informed by decolonising theory and participatory approaches. Successful project implementation will improve experience of care and health outcomes for Aboriginal people, build Aboriginal workforce, and improve healthcare provider satisfaction.

Conditions

Aboriginal Health; Cultural Safety; Access to Interpreters; Healthcare Provider Training

Outcome Measures

Primary Outcomes (2)

• Self discharge among Aboriginal inpatients at Royal Darwin Hospital, Palmerston Hospital, Katherine Hospital and Gove District Hospital

  Self discharge (also referred to as 'Discharge against medical advice,', 'take own leave' or 'incomplete care') will be assessed among all admitted Aboriginal patients every quarter as a measure of the effeciveness of hospital-level study activities * Measured as proportion of all admissions of Aboriginal people that end in self-discharge * Data source: hospital Admitted Patient Care dataset (routinely collected by health services) The study has a two-year baseline phase July 1 2020 - June 30 2022, and four-year intervention (activity) period July 1 2022 - June 30 2026. There are no individually enrolled participants followed up at given time points; instead, activities are implemented continually at the level of the health systems, and outcomes are assessed using continuous hospital data and qualitative data, summarised quarterly.

  Up to 4 years. (Health system level data are collected and summarised quarterly during July 1 2022 - June 30 2026, and compared with the baseline phase July 1 2020 - June 30 2022)

• Patient experience (qualitative evaluation)

  Patient experience pre- and post-implementation of the interventions will be assessed through in-depth 30-60 minute one-on-one, face-to-face interviews of inpatients and patients who have recently (within 14 days) been discharged, by a member of the research team. The research team member will speak the patient's first language, or will work with an Aboriginal interpreter to conduct the interview. Some individuals with repeated contact with healthservices (such as renal dialysis patients) will be invited to participate in serial interviews over time

  Up to 4 years. Interview data will be collected at regular intervals throughout the study (2022-2026) to track any change in patient experience during the course of the intervention period

Secondary Outcomes (5)

• Documentation of language in hospital medical records

  Up to 4 years. (Documentation of language will be tracked throughout the 4-year intervention period.)

• Access to an interpreter during admission

  Up to 4 years. (Documentation of interpreter access will be tracked throughout the 4-year intervention period.)

• Healthcare provider experience

  Up to 4 years. Interview data will be collected at regular intervals throughout the study (2022-2026) to track any change in healthcare provider experience during the course of the intervention period

• Cost

  Up to 4 years. Continuous data (daily data, summarised monthly) will be assessed during - the two-year baseline phase July 1 2020 - June 30 2022 - the four-year intervention (activity) period July 1 2022 - June 30 2026

• Unplanned readmission within 28 days

  Up to 4 years. Continuous data (daily data, summarised monthly) will be assessed during - the two-year baseline phase July 1 2020 - June 30 2022 - the four-year intervention (activity) period July 1 2022 - June 30 2026

Study Arms (1)

Cultural safety training and behaviour change intervention

EXPERIMENTAL

\- Interventions to transform the culture of healthcare systems to achieve excellence in providing culturally safe care for First Nations peoples

Behavioral: Interventions to transform the culture of healthcare systems to achieve excellence in providing culturally safe care for First Nations peoples

Interventions

Interventions to transform the culture of healthcare systems to achieve excellence in providing culturally safe care for First Nations peoples BEHAVIORAL

1. Implement 'Ask the Specialist Plus', a structured program to promote anti-racism within Northern Territory (NT) hospitals by giving healthcare providers training in cultural safety. 2. Implement strategies to foster 'Clinical champions of cultural safety' through a social media chat platform and face to face meetings to discuss anti-racism practice, cultural safety and practical ways to deliver culturally safe care including interpreter use. 3. Support simplified and improved strategies for booking an interpreter to increase uptake. 4. Implement retention strategies to ensure interpreters receive workplace support. 5. Provide training in health terminology for interpreters. 6. Integrate interpreter supply and demand through efficiency and effectiveness strategies tailored to participating sites. 7. Implement continuous quality improvement cycles with senior managers, using findings from qualitative and quantitative data collection and evaluation.

Cultural safety training and behaviour change intervention

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Different patient and provider participants (e.g. Aboriginal patients, Aboriginal interpreters, healthcare providers of any ethnicity) will be invited to participate in interviews, observations and surveys to assess effectiveness of study activities

You may not qualify if:

• None

Sponsors & Collaborators

• Menzies School of Health Research: lead
• Northern Territory of Australia as represented by the Department of Health: collaborator
• Djalkiri Foundation Aboriginal Corporation: collaborator
• Charles Darwin University: collaborator
• National Accreditation Authority for Translators and Interpreters: collaborator
• Northern Territory Government as represented by the Department of The Chief Minister and Cabinet: collaborator

Study Sites (4)

Royal Darwin Hospital

Darwin, Northern Territory, 0810, Australia

RECRUITING

Palmerston Hospital

Darwin, Northern Territory, 0830, Australia

NOT YET RECRUITING

Katherine Hospital

Katherine, Northern Territory, 0850, Australia

NOT YET RECRUITING

Gove District Hospital

Nhulunbuy, Northern Territory, 0880, Australia

NOT YET RECRUITING

Related Publications (8)

• Kerrigan V, McGrath SY, Herdman RM, Puruntatameri P, Lee B, Cass A, Ralph AP, Hefler M. Evaluation of 'Ask the Specialist': a cultural education podcast to inspire improved healthcare for Aboriginal peoples in Northern Australia. Health Sociol Rev. 2022 Jul;31(2):139-157. doi: 10.1080/14461242.2022.2055484. Epub 2022 Apr 3.

  PMID: 35373706 BACKGROUND

• O'Connor E, Kerrigan V, Aitken R, Castillon C, Mithen V, Madrill G, Roman C, Ralph AP. Does improved interpreter uptake reduce self-discharge rates in hospitalised patients? A successful hospital intervention explained. PLoS One. 2021 Oct 12;16(10):e0257825. doi: 10.1371/journal.pone.0257825. eCollection 2021.

  PMID: 34637434 BACKGROUND

• Kerrigan V, McGrath SY, Majoni SW, Walker M, Ahmat M, Lee B, Cass A, Hefler M, Ralph AP. "The talking bit of medicine, that's the most important bit": doctors and Aboriginal interpreters collaborate to transform culturally competent hospital care. Int J Equity Health. 2021 Jul 23;20(1):170. doi: 10.1186/s12939-021-01507-1.

  PMID: 34301261 BACKGROUND

• Kerrigan V, McGrath SY, Majoni SW, Walker M, Ahmat M, Lee B, Cass A, Hefler M, Ralph AP. From "stuck" to satisfied: Aboriginal people's experience of culturally safe care with interpreters in a Northern Territory hospital. BMC Health Serv Res. 2021 Jun 4;21(1):548. doi: 10.1186/s12913-021-06564-4.

  PMID: 34088326 BACKGROUND

• Mithen V, Kerrigan V, Dhurrkay G, Morgan T, Keilor N, Castillon C, Hefler M, Ralph AP. Aboriginal patient and interpreter perspectives on the delivery of culturally safe hospital-based care. Health Promot J Austr. 2021 Feb;32 Suppl 1:155-165. doi: 10.1002/hpja.415. Epub 2020 Dec 4.

  PMID: 32888378 BACKGROUND

• Communicate Study group*. Improving communication with Aboriginal hospital inpatients: a quasi-experimental interventional study. Med J Aust. 2020 Aug;213(4):180-181. doi: 10.5694/mja2.50700. Epub 2020 Jul 25. No abstract available.

  PMID: 32710454 BACKGROUND

• Kerrigan V, Lewis N, Cass A, Hefler M, Ralph AP. "How can I do more?" Cultural awareness training for hospital-based healthcare providers working with high Aboriginal caseload. BMC Med Educ. 2020 May 29;20(1):173. doi: 10.1186/s12909-020-02086-5.

  PMID: 32471490 BACKGROUND

• Ralph AP, Lowell A, Murphy J, Dias T, Butler D, Spain B, Hughes JT, Campbell L, Bauert B, Salter C, Tune K, Cass A. Low uptake of Aboriginal interpreters in healthcare: exploration of current use in Australia's Northern Territory. BMC Health Serv Res. 2017 Nov 15;17(1):733. doi: 10.1186/s12913-017-2689-y.

  PMID: 29141623 BACKGROUND

Related Links

• Project team's web page

Study Officials

• Anna Ralph, PhD

  Menzies School of Health Research

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Anna Ralph, PhD

CONTACT

+618 89468647; anna.ralph@menzies.edu.au

Victoria Kerrigan, PhD

CONTACT

+61889468600; vicki.kerrigan@menzies.edu.au

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Interventions to transform the culture of healthcare systems to achieve excellence in providing culturally safe care for First Nations peoples

Study Record Dates

• First Submitted: November 7, 2022
• First Posted: November 29, 2022
• Study Start: May 23, 2022
• Primary Completion (Estimated): May 11, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: February 16, 2023

Record last verified: 2023-02

Data Sharing

• IPD Sharing: Will not share

Locations

AU (4)