Healing Right Way randomised control trial enhancing rehabilitation services for Aboriginal people with brain injury in Western Australia: translation principles and activities

Neil Drew; Meaghan McAllister; Juli Coffin; Melanie Robinson; Judith Katzenellenbogen; Elizabeth Armstrong

doi:10.1071/IB23109

RESEARCH ARTICLE (Open Access)

Healing Right Way randomised control trial enhancing rehabilitation services for Aboriginal people with brain injury in Western Australia: translation principles and activities

Neil Drew ^A , Meaghan McAllister ^B , Juli Coffin ^C , Melanie Robinson ^C , Judith Katzenellenbogen ^D and Elizabeth Armstrong

^E ^*

+ Author Affiliations

- Author Affiliations

^A Kurongkurl Katitjin, Edith Cowan University, Perth, WA, Australia.

^B School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.

^C Ngangk Yira Institute for Change, Murdoch University, Broome, WA, Australia.

^D School of Population and Global Health, University of Western Australia, Perth, WA, Australia.

^E University Department of Rural Health South West, Edith Cowan University, Bunbury, Australia.

^* Correspondence to: b.armstrong@ecu.edu.au

Handling Editor: Dana Wong

Brain Impairment 25, IB23109 https://doi.org/10.1071/IB23109

Submitted: 4 October 2023 Accepted: 21 March 2024 Published: 19 April 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of the Australasian Society for the Study of Brain Impairment. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

This report provides the theory, method and practice of culturally secure translation and knowledge exchange in the Healing Right Way Clinical Trial (2017–2022), outlining activities to date. Healing Right Way was a stepped wedge cluster randomised controlled trial conducted in Western Australia, aimed at enhancing rehabilitation services and quality of life for Aboriginal Australians following acquired brain injury. The trial translation plan was aspirational and action-oriented, with its implementation iterative and ongoing. Translational activities aimed to inform service and research planning for Aboriginal people with brain injury. Situated in the intercultural space, the work guards against undertaking activities that are monocultural, colonial and appropriating in favour of work that is authentically viewed through the dual lens of whiteness and Aboriginal and Torres Strait Islander ways of knowing, being and doing, and is strengths-based.

Methods

Three translational and knowledge exchange components were identified, relating to the role of Aboriginal Brain Injury Coordinators, cultural training of hospital staff and the research process itself. Knowledge plans were developed for key audiences, with potential translation products to be monitored for ongoing impact.

Results

Results demonstrate that translational and knowledge exchange were iteratively embedded throughout the trial life cycle. Data sources included community engagement, partnership meetings and interviews. Activities involved presentations to diverse audiences including bureaucrats, community and participants.

Conclusions

This report provides a snapshot of the first translation knowledge exchange plan and activities constructed in relation to brain injury rehabilitation services for Aboriginal people. Challenges encountered, as well as successes to date, are discussed.

Keywords: Aboriginal, brain injury, implementation science, Indigenous, rehabilitation, stroke, translation and knowledge exchange, traumatic brain injury.

References

Armstrong E, Hersh D, Hayward C, Fraser J (2015) Communication disorders after stroke in Aboriginal Australians. Disability and Rehabilitation 37(16), 1462-1469.
| Crossref | Google Scholar | PubMed |

Armstrong E, Coffin J, Hersh D, Katzenellenbogen JM, Thompson SC, Ciccone N, Flicker L, Woods D, Hayward C, Dowell C, McAllister M (2021a) “You felt like a prisoner in your own self, trapped”: the experiences of Aboriginal people with acquired communication disorders. Disability and Rehabilitation 43(13), 1903-1916.
| Crossref | Google Scholar | PubMed |

Armstrong E, Coffin J, Hersh D, Katzenellenbogen JM, Thompson SC, Flicker L, McAllister M, Cadilhac D, Godecke E, Rai T, Hayward G, Drew N, Lin I, Woods D, Ciccone N (2021b) 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 11(9), e045898.
| Crossref | Google Scholar | PubMed |

Australian Indigenous HealthInfoNet (2023) ‘Overview of Aboriginal and Torres Strait Islander health status 2022.’ (Australian Indigenous HealthInfoNet: Perth, WA)

Balabanski AH, Goldsmith K, Giarola B, Buxton D, Castle S, McBride K, Brady S, Thrift AG, Katzenellenbogen J, Brown A, Burrow J, Donnan GA, Koblar S, Kleinig TJ (2020) Stroke incidence and subtypes in Aboriginal people in remote Australia: a healthcare network population-based study. BMJ Open 10(10), e039533.
| Crossref | Google Scholar | PubMed |

Bammer G, Michaux A, Sanson A (Eds) (2010) ‘Bridging the ‘Know-Do’ Gap: Knowledge Brokering to Improve Child Wellbeing.’ (ANU Press: Canberra, ACT, Australia)

Beidas RS, Dorsey S, Lewis CC, Lyon AR, Powell BJ, Purtle J, Saldana L, Shelton RC, Stirman SW, Lane-Fall MB (2022) Promises and pitfalls in implementation science from the perspective of US-based researchers: learning from a pre-mortem. Implementation Science 17, 55.
| Crossref | Google Scholar | PubMed |

Bohanna I, Fitts MS, Bird K, Fleming J, Gilroy J, Esterman A, Maruff P, Clough AR (2018) The Transition from Hospital to Home: Protocol for a Longitudinal Study of Australian Aboriginal and Torres Strait Islander Traumatic Brain Injury (TBI). Brain Impairment 19(3), 246-257.
| Crossref | Google Scholar |

Ciofalo N, Dudgeon P, Nikora LW (2021) Indigenous community psychologies, decolonization, and radical imagination within ecologies of knowledges. American Journal of Community Psychology 69, 2883-2293.
| Crossref | Google Scholar | PubMed |

Damschroder LJ, Aron DC, Keith RE, et al. (2009) Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science 4, 50.
| Crossref | Google Scholar | PubMed |

Damschroder L, Reardon C, Widerquist O, Lowery J (2022a) Conceptualizing outcomes for use with the Consolidated Framework for Implementation Research (CFIR): the CFIR Outcomes Addendum. Implementation Science 17, 2-10 7.
| Crossref | Google Scholar |

Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J (2022b) The updated Consolidated Framework for Implementation Research based on user feedback. Implementation Science 17(1), 75.
| Crossref | Google Scholar | PubMed |

Drew N (2006) The Seagull Imperative. The Australian Community Psychologist 18(1), 40-41.
| Google Scholar |

Drew N (2015) Social and emotional wellbeing, natural helpers, critical health literacy and translational research: connecting the dots for positive health outcomes. Australasian Psychiatry 23(6), 620-622.
| Crossref | Google Scholar | PubMed |

Drew N, Adams Y, Walker R (2010) Issues in mental health assessment with Indigenous Australians. In ‘Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practices’. (Eds N Purdie, P Dudgeon, R Walker) pp. 91–104. (Commonwealth of Australia: Canberra, ACT)

Dudgeon P, Fielder J (2006) Third spaces within tertiary places: indigenous Australian studies. Journal of Community & Applied Social Psychology 16, 396-409.
| Crossref | Google Scholar |

Dudgeon P, Walker R (2015) Decolonising Australian Psychology: discourses, strategies, and practice. Journal of Social and Political Psychology 3, 276-297.
| Crossref | Google Scholar |

Ellison C (2014) ‘Indigenous knowledge and knowledge synthesis, translation and exchange (KSTE).’ (National Collaborating Centre for Aboriginal Health: Prince George, BC, Canada)

Esterman A, Thompson F, Fitts M, Gilroy J, Fleming J, Maruff P, Clough A, Bohanna I (2018) Incidence of emergency department presentations for traumatic brain injury in Indigenous and non-Indigenous residents aged 15–64 over the 9-year period 2007–2015 in North Queensland, Australia. Injury Epidemiology 5, 40.
| Crossref | Google Scholar | PubMed |

Fredericks B (2008) Making an impact researching with Australian Aboriginal and Torres Strait Islander peoples. Studies in Learning, Evaluation, Innovation and Development 5(1), 24-33.
| Google Scholar |

Graham ID, Logan J, Harrison MB, Straus SE, Tetroe J, Caswell W, Robinson N (2006) Lost in Knowledge Translation: Time for a Map? The Journal of Continuing Education in the Health Professions 26, 13-24.
| Crossref | Google Scholar | PubMed |

Gray MA, Oprescu FI (2016) Role of non-Indigenous researchers in Indigenous health research in Australia: a review of the literature. Australian Health Review 40(4), 459-465.
| Crossref | Google Scholar | PubMed |

Hodgetts D, Rua M, Groot S, Hopner V, Drew N, King P, Blake D (2022) Relational ethics meets principled practice in community research engagements to understand and address homelessness. Journal of Community Psychology 50(4), 1980-1992.
| Crossref | Google Scholar | PubMed |

Indigenous Peoples’ Health Research Centre (2005) ‘Knowledge translation and Indigenous knowledge symposium and consultation sessions’. pp. 1–37. (Indigenous Peoples’ Health Research Centre: Saskatchewan, Canada)

Jancey J, Binns C, Smith J, Barnett L, Howat P (2017) Health Promotion leads the way in ‘knowledge translation’: but just a new coat? Health Promotion Journal of Australia 28, 89-90.
| Crossref | Google Scholar | PubMed |

Katzenellenbogen JM, Atkins E, Thompson SC, Hersh D, Coffin J, Flicker L, Hayward C, Ciccone N, Woods D, Greenland ME, McAllister M, Armstrong EM (2018) Missing voices: profile, extent, and 12-month outcomes of nonfatal traumatic brain injury in Aboriginal and non-Aboriginal adults in Western Australia using linked administrative records. Journal of Head Trauma Rehabilitation 33(6), 412-423.
| Crossref | Google Scholar | PubMed |

Kennedy A, Sehgal A, Szabo J, McGowan K, Lindstrom G, Roach P, Crowshoe L, Barnabe C (2022) Indigenous strengths-based approaches to healthcare and health professions education – Recognising the value of Elders’ teachings. Health Education Journal 81(4), 423-438.
| Crossref | Google Scholar | PubMed |

Kok MO, Schuit AJ (2012) Contribution mapping: a method for mapping the contribution of research to enhance its impact. Health Research Policy and Systems 10, 21.
| Crossref | Google Scholar | PubMed |

Kok MO, Gyapong JO, Wolffers I, Ofori-Adjei D, Ruitenberg J (2016) Which health research gets used and why? An empirical analysis of 30 cases. Health Research Policy and Systems 14, 36.
| Crossref | Google Scholar |

Lengnick-Hall R, Gerke D, Proctor E, Bunger A, Phillips R, Martin J, Swanson J (2022) Six practical recommendations for improved implementation outcomes reporting. Implementation Science 17, 16.
| Crossref | Google Scholar | PubMed |

McGrath P (2012) The important role of knowledge translation. Australian Asian Journal of Cancer 11(3), 163-165.
| Google Scholar |

Nakata M (2007) The Cultural Interface. The Australian Journal of Indigenous Education 36, 7-14.
| Crossref | Google Scholar |

Ninomiya ME, Atkinson D, Brascoupé S, Firestone M, Robinson N, Reading J, Smylie JK (2017) Effective knowledge translation approaches and practices in Indigenous health research: a systematic review protocol. Systematic Reviews 6, 34.
| Crossref | Google Scholar | PubMed |

Skoss R, White J, Stanley MJ, Robinson M, Thompson S, Armstrong E, Katzenellenbogen JM (2021) Trial protocol for a prospective process evaluation of a culturally secure rehabilitation program for Aboriginal Australians after brain injury: the Healing Right Way trial. BMJ Open 11, e046042.
| Crossref | Google Scholar | PubMed |

Smith L (1999) ‘Decolonizing methodologies: Research and indigenous peoples.’ (Zed Books: London, UK)

Stensland KD, Sales AE, Damschroder LJ, Skolarus TA (2022) Applying implementation frameworks to the clinical trial context. Implementation Science Communications 3, 109.
| Crossref | Google Scholar | PubMed |

Thackway S, Campbell D, Loppacher T (2017) A long-term, strategic approach to evidence generation and knowledge translation in NSW, Australia. Public Health Research & Practice 27(1), e2711702.
| Crossref | Google Scholar |

Thomson N (2012) ‘Translational research and the Australian Indigenous HealthInfoNet.’ (Australian Indigenous HealthInfoNet: Perth, WA)

World Health Organization (2016) ‘A guide to implementation research in the prevention and control of communicable disease.’ (World Health Organization: Geneva)

Zarcadoolas C, Pleasant A, Greer DS (2005) Understanding health literacy: an expanded model. Health Promotion International 20(2), 195-203.
| Crossref | Google Scholar | PubMed |

Zhang J, Fedder B, Wang D, Jennerjahn TC (2022) A knowledge exchange framework to connect research, policy, and practice, developed through the example of the Chinese island of Hainan. Environmental Science & Policy 136, 530-541.
| Crossref | Google Scholar |