Increase Cancer Prevention and Early Detection through immunisation and screening
Research Theme 1
Theme Leaders: A/Prof Lisa Whop and Prof Julia Brotherton
Uptake of the national screening programs for bowel, breast and cervical cancer is lower in Aboriginal and Torres Strait Islander people compared to other Australians.
Furthermore, although the national HPV vaccination program has been running successfully for over a decade, critical gaps exist in our understanding of Aboriginal and Torres Strait Islander people’s knowledge of and attitudes toward HPV vaccination.
These projects have contributed to the evidence-base to increase participation through intervention and address these gaps.
PROJECTS
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This is a completed project
Aim
The Pilot aimed to find out whether screening participation would be increased by offering National Bowel Cancer Screening Program kits to Indigenous clients through local primary health care centres, rather than the usual delivery via the post.
Outcomes
The Pilot ran from 1 November 2019 to 31 October 2020. Forty-seven primary health care centres enrolled in the Pilot, and distributed NBCSP kits to their Indigenous clients aged 50 to 74. More than 1000 Indigenous Australians were invited to screen. Results showed that Aboriginal and Torres Strait Islander people aged 50 to 74 were twice as likely to complete a bowel cancer screening test if invited through their local primary healthcare centre than by receiving the screening kit in the mail. A final report can be found on the Commonwealth Department of Health website.
For more information visit the Commonwealth Department of Health website.
Investigators
Prof Gail Garvey, Ms Jenny Brands, Dr Federica Barzi (The University of Queensland), Prof Joan Cunningham, Prof John Condon, Prof Alan Cass, Prof Ross Andrews (Menzies School of Health Research), Prof Ross Bailie (The University of Sydney), Prof John Zalcberg (Monash University), Profo Richard Reed (Flinders University), Dr Shaouli Shahid (Curtin University) and Dr Sandra Thompson (University of Western Australia).
Contact
Prof Gail Garvey
Professor of Indigenous Health Research at The University of Queensland
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This is a completed project
Preliminary Qualitative Work
Screening matters: Aboriginal and Torres Strait Islander women’s attitudes and perspectives on participation in cervical screening.
Aims
1) describe Aboriginal and Torres Strait Islander women’s beliefs and attitudes toward participation in cervical screening; and 2) describe Primary Health Care providers’ perspectives and approaches to facilitating screening for Aboriginal and Torres Strait Islander women, and to identify opportunities to maximise participation.
Outcomes
This project will identify the barriers and enablers to Aboriginal and Torres Strait Islander women who never or rarely screen and factors that support women already participating in screening. The project will also describe women’s attitudes toward the option for self-collection.
Next Steps
The results from the qualitative work will inform a primary health care centre-based intervention to increase cervical screening participation among never or rarely screened Aboriginal and Torres Strait Islander women.
Investigators
A/Prof Lisa Whop (Australian National University), Prof John Condon, Dr Suzanne Moore, Prof Joan Cunningham (Menzies School of Health Research), Prof Gail Garvey, Dr Kate Anderson, Dr Tamara Butler (The University of Queensland), Prof Julia Brotherton (University of Melbourne), Allison Jaure (neé Tong) (University of Sydney).
Contact
A/Prof Lisa Whop
Senior Research Fellow
National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University -
This is a current project due for completion in 2025.
Aim
Our team’s preliminary research (“Screening Matters”) and a growing body of evidence indicates that HPV self-collection is a safe, effective and acceptable method of cervical screening for Aboriginal and Torres Strait Islander people. Despite being available since 2018, <1% of estimated eligible women have been screened using self-collection. It is unknown how many Aboriginal & Torres Strait Islander women this included, or whether specific service level strategies have been successful in implementing self-collection to its maximum potential. The study aims to co-design, facilitate and test implementation models of self-collection in 12 Aboriginal Community Controlled Health Organisations (ACCHOs) across NT, NSW and QLD.
Methods
The research will use an Indigenist research approach, Health Equity Implementation Framework (HEIF) and the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework. Research phases will be:
1. Formative scoping to explore what is currently occurring and working to increase participation in ACCHO sector;
2. Co-design tailored implementation packages with ACCHOs;
3. Evaluation of implemented packages (uptake, acceptability, effectiveness, sustainability)
Investigators
A/Prof Lisa Whop (Australian National University), Prof Julia Brotherton, Dr Claire Nightingale (University of Melbourne), Prof Marion Saville (Australian Centre for the Prevention of Cervical Cancer), Prof Gail Garvey, Dr Tamara Butler (The University of Queensland), Dr Mark Wenitong (Apunipima Cape York Health Council), A/Prof Megan Smith (University of Sydney), Prof Rebecca Guy (University of NSW), Prof Joan Cunningham (Menzies School of Health Research)
Contact
A/Prof LIsa Whop
Senior Research Fellow
National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University -
This is a completed TACTICS-funded pilot project.
Aim
To inform health-worker/practitioner-led models of care that can be trialed as part of a larger research project.
Research activities
This work is grounded in an Indigenist research approach, partnering with the National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP).
Health professionals’ experiences and aspirations will be highlighted and centred through:
A survey of NAATSIHWP membership to understand current and desired roles in cervical screening
Focus group discussions with Aboriginal and Torres Strait Islander health professionals to understand barriers and facilitators to implementing health worker/practitioner-led self-collection in practice
Interviews with key policy stakeholders to understand how health worker/practitioner-led models of care can be facilitated at the policy/system level.
Contact
A/Prof Lisa Whop
Senior Research Fellow
National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University -
This is a current project due for completion in 2024.
Aim
To identify factors that affect the participation of Aboriginal and Torres Strait Islander adolescents in the school-based human papillomavirus (HPV) vaccination program in Queensland.
Outcomes
Insight into factors that influence HPV vaccination uptake and completion for Aboriginal and Torres Strait Islander adolescents; strategies to improve HPV vaccination coverage and completion, and lessons that may be applicable to other school-based vaccination programs in Queensland and across Australia.
Investigators
A/Prof Lisa Whop (Australian National University), Prof Gail Garvey, Dr Kate Anderson, Dr Tamara Butler (The University of Queensland), Prof Joan Cunningham (Menzies School of Health Research), Prof Julia Brotherton (VCS Foundation), Allison Jaure (neé Tong) (The University of Sydney).
Contact
Dr Tamara Butler
Research Fellow at The University of Queensland
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This is a current project, due for completion in 2025.
Aim
This project aims to increase Aboriginal and Torres Strait Islander people’s participation in the National Bowel Cancer Screening Program., through understanding their values and preferences for screening.
Approach
Working with an industry partner, Australian Unity, we will deliver a preference-based bowel screening intervention through Aboriginal Home Health, a culturally appropriate service delivered to over 2300 First Nations clients in NSW. The study will occur across three phases:
Pre-implementation: Understanding bowel screening status and preferences across AHH customers, to develop a model of implementation
Implementation: Delivering preference-based screening through the NBCSP over a 12-month period according to the findings from Phase 1
Evaluation: Comparison of effectiveness and cost-effectiveness to usual NBCSP (mail-out).
The study will employ a co-design approach involving the research team, AHH management, front-line staff and customers, and Government stakeholders.
Contact
Prof Gail Garvey
Professor of Indigenous Health Research at The University of Queensland
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This is a completed project.
Aim
Menzies was contracted by Cancer Australia to develop a plan to improve identification, collection, collation and reporting of Indigenous status in the HPV vaccination and cervical screening programs.
Outcomes
This project has now been completed and through this project we:
Identified and documented current system and service-level requirements relating to data collection, collation and reporting in cervical cancer programs, including requirement and capacity for Indigenous identification;
Identified and documented current barriers and enablers to Indigenous identification in cervical cancer programs;
Developed and documented potential solutions (opportunities and strategies) for addressing identified system and service-level barriers regarding Indigenous identification in cervical cancer programs; and
Developed a plan documenting a robust approach to collecting, collating and reporting Indigenous status in cervical cancer programs, including proposed future approaches relating to these programs.
Investigators
A/Prof Lisa Whop (Australian National University), Prof John Condon, Prof Joan Cunningham (Menzies School of Health Research), Prof Gail Garvey, Dr Abbey Diaz (The University of Queensland), Prof Julia Brotherton (University of Melbourne).
Contact
A/Prof Lisa Whop
Senior Research Fellow
National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University -
This is a completed project.
Aim
To develop a Queensland Cancer Strategy (the Strategy) with a long-term aim to decrease cancer incidence and mortality rates, improve survival rates and quality of life for Aboriginal and Torres Strait Islander people in Queensland. The Strategy:
• Sets out a high-level roadmap to achieve the goal of improved cancer outcomes.
• Builds a shared understanding of the current landscape of cancer for Aboriginal and Torres Strait Islander people in Queensland
• Identifies priorities and goals for action
Outcomes
The Strategy, now completed, provides a basis for Queensland Health to work with the key stakeholders throughout Queensland to improve cancer outcomes for Aboriginal and Torres Strait Islander people.
Investigators
Prof Lisa Whop (Australian National University), Prof Gail Garvey, Dr Bronwyn Morris, Ms Jenny Brands (The University of Queensland), Prof John Condon (Menzies School of Health Research), Ms Kate Wilkinson (Australian Centre for the Prevention of Cervical Cancer).
Contact
Prof Gail Garvey
Professor of Indigenous Health Research at The University of Queensland