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Published (Version of Record)CC BY-NC V4.0, Open Access
Journal article
Healing Right Way: study protocol for a stepped wedge cluster randomised controlled trial to enhance rehabilitation services and improve quality of life in Aboriginal Australians after brain injury
BMJ open, Vol.11(9), e045898
2021
PMID: 34588230
Abstract
Introduction
Despite higher incidence of brain injury among Aboriginal compared with non-Aboriginal Australians, suboptimal engagement exists between rehabilitation services and Aboriginal brain injury survivors. Aboriginal patients often feel culturally insecure in hospital and navigation of services post discharge is complex. Health professionals report feeling ill-equipped working with Aboriginal patients. This study will test the impact of a research-informed culturally secure intervention model for Aboriginal people with brain injury.
Methods and analysis
Design: Stepped wedge cluster randomised control trial design; intervention sequentially introduced at four pairs of healthcare sites across Western Australia at 26-week intervals.
Recruitment: Aboriginal participants aged ≥18 years within 4 weeks of an acute stroke or traumatic brain injury.
Intervention: (1) Cultural security training for hospital staff and (2) local, trial-specific, Aboriginal Brain Injury Coordinators supporting participants.
Primary outcome: Quality-of-life using EuroQOL-5D-3L (European Quality of Life scale, five dimensions, three severity levels) Visual Analogue Scale score at 26 weeks post injury. Recruitment of 312 participants is estimated to detect a difference of 15 points with 80% power at the 5% significance level. A linear mixed model will be used to assess the between-condition difference.
Secondary outcome measures: Modified Rankin Scale, Functional Independence Measure, Modified Caregiver Strain Index, Hospital Anxiety and Depression Scale at 12 and 26 weeks post injury, rehabilitation occasions of service received, hospital compliance with minimum care processes by 26 weeks post injury, acceptability of Intervention Package, feasibility of Aboriginal Brain Injury Coordinator role.
Evaluations: An economic evaluation will determine the potential cost-effectiveness of the intervention. Process evaluation will document fidelity to study processes and capture changing contexts including barriers to intervention implementation and acceptability/feasibility of the intervention through participant questionnaires at 12 and 26 weeks.
Ethics and dissemination
The study has approvals from Aboriginal, university and health services human research ethics committees. Findings will be disseminated through stakeholder reports, participant workshops, peer-reviewed journal articles and conference papers.
Trial registration number ACTRN12618000139279.
Details
- Title
- Healing Right Way: study protocol for a stepped wedge cluster randomised controlled trial to enhance rehabilitation services and improve quality of life in Aboriginal Australians after brain injury
- Authors/Creators
- Elizabeth Armstrong - Edith Cowan UniversityJuli Coffin - The Kids Research Institute AustraliaDeborah Hersh - Edith Cowan UniversityJudith M. Katzenellenbogen - The University of Western AustraliaSandra Thompson - The University of Western AustraliaLeon Flicker - The University of Western AustraliaMeaghan McAllister - Edith Cowan UniversityDominique A. Cadilhac - Monash UniversityTapan Rai - University of Technology SydneyErin Godecke - Edith Cowan UniversityColleen Hayward - Edith Cowan UniversityGraeme J. Hankey - The University of Western AustraliaNeil Drew - Edith Cowan UniversityIvan Lin - Univ Western Australia, Western Australian Ctr Rural Hlth, Geraldton Campus, Geraldton, WA, AustraliaDeborah Woods - College Station Medical CenterNatalie Ciccone - Edith Cowan University
- Publication Details
- BMJ open, Vol.11(9), e045898
- Publisher
- Bmj Publishing Group
- Number of pages
- 9
- Grant note
- Geraldton Regional Aboriginal Medical Service Kimberley Aboriginal Medical Services Council Western Australian Department of Health Royal Perth Hospital Medical Research Foundation Bega Garnbirringu Health Services Stroke Foundation 1132468 / NHMRC; National Health and Medical Research Council (NHMRC) of Australia Neurological Council of Western Australia
- Identifiers
- 991005560344207891
- Copyright
- © Author(s) (or their employer(s)) 2021
- Murdoch Affiliation
- Ngangk Yira Institute for Change
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.134 Trauma & Emergency Surgery
- 1.134.286 Traumatic Brain Injury
- Web Of Science research areas
- Clinical Neurology
- ESI research areas
- Clinical Medicine