Health activities driven by remote Indigenous communities may be key to the sustainable and successful treatment and prevention of a potentially fatal disease, a study has found.
In a study led by Menzies School of Health Research (Menzies) and The Kids Research Institute Australia, researchers learned a health system strengthening approach to support the prevention of rheumatic heart disease (RHD) was successful to a certain extent.
However, the results of the study, published today in two papers in the Journal of the American Heart Association, found activities in the study had only small measurable benefits due to the challenges in genuine community engagement, and limiting factors such as high staff turnover in remote clinics.
“The challenges identified here make a clear case for investment in community-led models of care, and better preventive strategies for RHD,” said study lead author at Menzies, Associate Professor Anna Ralph.
“The qualitative evaluation method we used, embedded in a randomised trial, provided in-depth understanding of outcomes, including whether findings could be attributed to project design factors, how implementation occurred, or the study context.”
Monthly penicillin injections over the course of a decade for people in at-risk groups are recommended to prevent acute RHD. However, adherence is very challenging.
“It was pleasing to see the adherence to penicillin to prevent RHD had doubled overall in the Northern Territory (NT) between studies conducted over the last 10 years; this is a major achievement for primary care providers and the NT RHD Control Program,” said senior research leader Professor Jonathan Carapetis from The Kids Research Institute Australia in Perth.
“This study paves the way for community co-designed approaches which bring the health sector together with environmental, housing and education sectors to tackle the issues underpinning high RHD rates.”
The study results were published as companion papers on the outcomes and qualitative evaluation of this large community trial in the NT that aimed to improve the delivery of penicillin injections to prevent RHD in at-risk people.
Using evidence-based approaches, activities were supported at primary care centres to help staff deliver more penicillin injections and to track their progress is reaching adherence targets.
The research papers are available here:
- Qualitative Evaluation of a Complex Intervention to Improve Rheumatic Heart Disease Secondary Prophylaxis
- Improving Delivery of Secondary Prophylaxis for Rheumatic Heart Disease in a High‐Burden Setting: Outcome of a Stepped‐Wedge, Community, Randomized Trial
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Menzies School of Health Research
Menzies School of Health Research is one of Australia’s leading medical research institutes dedicated to improving Indigenous, global and tropical health. Menzies has a history of over 30 years of scientific discovery and public health achievement. Menzies works at the frontline, joining with partners across the Asia-Pacific as well as Indigenous communities across northern and central Australia. Menzies collaborates to create new knowledge, grow local skills and find enduring solutions to problems that matter.
