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STARFISH

Stopping Acute Rheumatic Fever Infections to Strengthen Health

Rheumatic heart disease (RHD) stems from the abnormal immune response of acute rheumatic fever (ARF) triggered by preventable group A streptococcal (Strep A) infections.

The environment and context in which people live is the major determinant of the inequitable burden of Strep A, ARF and RHD for Australian Indigenous people. 

The RHD Endgame Strategy identified healthy environments as one of the Five Priority Action Areas for Implementation to eliminate RHD in Australia by 2031.

STARFISH is an Indigenous-led program of work, taking an interdisciplinary approach to answer the question: What are the most effective environmental health initiatives to reduce Strep A infections and prevent ARF among communities at greatest risk?

Our principles and ways of working

  1. Indigenous governance, cultural security and data sovereignty in all research initiatives to ensure both-ways learning
  2. Service-Research to ensure ‘no research occurs without service’
  3. Sustainability, both financial and programmatic, of all environmental health initiatives
  4. Holistic health following an Indigenous understanding of health and wellbeing
  5. Voice of participants and community leaders will be listened to, empowered and supported to drive change
  6. We will seek to align with the four Priority Reforms of the National Agreement on Closing the Gap in all aspects of STARFISH. 

We will seek to align with the four Priority Reforms of the National Agreement on Closing the Gap in all aspects of STARFISH.

Our research questions

The questions asked by communities and collaborators underpinning the STARFISH grant are practical enquiries about Strep A infections and what can be done. The pragmatic, stepwise, approach to tackling Strep A can be distilled into five key questions: 

  1. How is Strep A transmitted?
  2. How can Strep A transmission be disrupted by environmental health initiatives?
  3. What environmental health initiatives to disrupt Strep A transmission are most acceptable to communities?
  4. How can the effect of environmental health initiatives be meaningfully and objectively evaluated?
  5. How can environmental health initiatives be funded and embedded into action?

Funding

STARFISH is funded a National Health and Medical Research Council (NHMRC) Synergy Grant (GNT2010716).