Relational Care and Wellbeing: Applied Epidemiology in Aboriginal Community Controlled Health settings

Abstract

This thesis presents the projects and the experience I acquired to fulfil the competencies of the Master of Applied Epidemiology (MAE), Australian National University. From March 2023 to December 2024, I undertook an MAE field placement with the Institute for Urban Indigenous Health (IUIH), Brisbane, Queensland. In 2009, IUIH was established to create a unified network of Aboriginal and Torres Strait Islander Community Health Services (ATSICHS) in Southeast Queensland. The network works collaboratively to provide culturally tailored and appropriate healthcare services that are accessible, affordable and place based. This was IUIH's first experience at offering a field placement for an MAE Scholar and the majority of the MAE projects were completed at this placement. To fulfil the requirement of an investigation of an acute public health problem or threat, I undertook a short-term field placement with the Public Health Intelligence Branch (PHI), Queensland Health, for an outbreak investigation and response. Presented in this bound volume are the major competencies of an evaluation of a public health surveillance system, investigation of an acute public health problem or threat, analysis of a public health dataset and an epidemiological study. Included within are the minor competencies of a literature review, lay summary, conference presentation, peer-review publication and the teaching of field epidemiology.

The first chapter outlines the activities undertaken during the MAE field placement to meet my MAE core competencies. The second chapter is an evaluation of the ATLAS Indigenous Primary Care Surveillance and Research Network for sexually transmissible infections (STIs), blood-borne viruses (BBVs) and vaccine preventable diseases (VPDs). The second chapter describes the system nationally and from the perspective of one of its clinical hubs, IUIH. Stakeholder yarns, a survey, continuous quality improvement (CQI) focus groups, and the ATLAS national workshop were used to examine the attributes of acceptability, simplicity, flexibility, timeliness and stability. In addition, a data quality assessment of a subset of hepatitis C data were examined for the clinical hub. The third chapter describes the first outbreak of locally acquired mpox in Southeast Queensland which included the establishment of a Incident Management Team (IMT) to manage the response to this public health incident of state significance. It highlights the role communication and relationships play in an effective public health response. The fourth chapter is a combined Data Analysis and Epidemiological study. This retrospective cross-sectional study examined data collected from the adult client populations of two urban ATSICHS within the IUIH network during 2020-2023. A descriptive analysis was conducted to develop a wellbeing client profile for each clinic. This was followed by regression analysis to explore the relationship between relational care, client enablement and wellbeing outcomes. The final chapter in this volume describes my experiences teaching field epidemiology, including delivering a tutorial on How to create a simple survey using Qualtrics and REDcap to the first year MAE scholars, and delivering a lesson from the field on What can I or should I do about my missing data? Show more