What was the impact of a participatory research project in Australian Indigenous primary healthcare services? Applying a comprehensive framework for assessing translational health research to Lessons for the Best

• Published in: BMJ open 2021-02, Vol.11 (2), p.e040749
• Main Authors: Ramanathan, Shanthi Ann, Larkins, Sarah, Carlisle, Karen, Turner, Nalita, Bailie, Ross Stewart, Thompson, Sandra, Bainbridge, Roxanne, Deeming, Simon, Searles, Andrew
• Format: Article
• Language: English
• Subjects: Accountability; Australian Aboriginal and Torres Strait Islander Peoples; capacity strengthening; Chronic illnesses; Community; Community-Based Participatory Research; continuous quality improvement; Costs; Health Economics; Health services; Health Services, Indigenous; Humans; impact assessment; indigenous primary healthcare; Medical libraries; Medical research; Native peoples; Northern Territory; Participatory research; Primary Health Care; Prospective Studies; Quality improvement; Retrospective Studies; Success; Total quality
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-040749

ObjectivesTo (1) apply the Framework to Assess the Impact from Translational health research (FAIT) to Lessons from the Best to Better the Rest (LFTB), (2) report on impacts from LFTB and (3) assess the feasibility and outcomes from a retrospective application of FAIT.SettingThree Indigenous primary healthcare (PHC) centres in the Northern Territory, Australia; project coordinating centre distributed between Townsville, Darwin and Cairns and the broader LFTB learning community across Australia.ParticipantsLFTB research team and one representative from each PHC centre.Primary and secondary outcome measuresImpact reported as (1) quantitative metrics within domains of benefit using a modified Payback Framework, (2) a cost-consequence analysis given a return on investment was not appropriate and (3) a narrative incorporating qualitative evidence of impact. Data were gathered through in-depth stakeholder interviews and a review of project documentation, outputs and relevant websites.ResultsLFTB contributed to knowledge advancement in Indigenous PHC service delivery; enhanced existing capacity of health centre staff, researchers and health service users; enhanced supportive networks for quality improvement; and used a strengths-based approach highly valued by health centres. LFTB also leveraged between $A1.4 and $A1.6 million for the subsequent Leveraging Effective Ambulatory Practice (LEAP) Project to apply LFTB learnings to resource development and creation of a learning community to empower striving PHC centres.ConclusionRetrospective application of FAIT to LFTB, although not ideal, was feasible. Prospective application would have allowed Indigenous community perspectives to be included. Greater appreciation of the full benefit of LFTB including a measure of return on investment will be possible when LEAP is complete. Future assessments of impact need to account for the limitations of fully capturing impact when intermediate/final impacts have not yet been realised and captured.