Browsing by Author "Silburn S."
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Item Adaptation of the ages and stages questionnaire for remote Aboriginal Australia.(2017-03-23) D'Aprano A.; Silburn S.; Johnston V.; Robinson G.; Oberklaid F.; Squires J.A key challenge to providing quality developmental care in remote Aboriginal primary health care (PHC) centers has been the absence of culturally appropriate developmental screening instruments. This study focused on the cross-cultural adaptation of the Ages and Stages Questionnaires, 3rd edition (ASQ-3), with careful attention to language and culture. We aimed to adapt the ASQ-3 for use with remote dwelling Australian Aboriginal children, and to investigate the cultural appropriateness and feasibility of the adapted ASQ-3 for use in this context. We undertook a qualitative study in two remote Australian Aboriginal communities, using a six-step collaborative adaptation process. Aboriginal Health Workers (AHWs) were trained to use the adapted ASQ-3, and follow-up interviews examined participants' views of the cultural acceptability and usefulness of the adapted instrument. The adapted ASQ-3 was found to have high face validity and to be culturally acceptable and relevant to parents, AHWs, and early childhood development experts. Copyright © The Author(s) 2014.Item Challenges in monitoring the development of young children in remote Aboriginal health services: clinical audit findings and recommendations for improving practice.(20210615) D'Aprano A.; Silburn S.; Johnston V.; Bailie R.; Mensah F.; Oberklaid F.; Robinson G.Introduction: Early detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services. This study aimed to describe the developmental monitoring practice in two remote Australian Aboriginal primary healthcare services and to identify gaps in the delivery of developmental monitoring services. Method(s): A cross-sectional baseline medical record audit of all resident children aged less than 5 years in two remote Aboriginal health centres in the Northern Territory (NT) in Australia was undertaken between December 2010 and November 2011. Result(s): A total of 151 medical records were audited, 80 in Community A and 71 in Community B. Developmental checks were more likely among children who attended services more regularly. In Community A, 63 (79%) medical records had some evidence of a developmental check and in Community B there were 42 (59%) medical records with such evidence. However, there was little indication of how assessments were undertaken: only one record noted the use of a formal developmental screening measure. In Community A, 16 (16%) records documented parent report and 20 (20%) documented staff observations, while in Community B, the numbers were 2 (3%) and 11 (19%), respectively. The overall recorded prevalence of developmental difficulties was 21% in Community A and 6% in Community B. Conclusion(s): This is the first study to describe the quality of developmental monitoring practice in remote Australian Aboriginal health services. The audit findings suggest the need for a systems-wide approach to the delivery and recording of developmental monitoring services. This will require routine training of remote Aboriginal health workers and remote area nurses in developmental monitoring practice including the use of a culturally appropriate, structured developmental screening measure. Copyright © James Cook University 2016, http://www.jcu.edu.auItem Culturally appropriate training for remote Australian Aboriginal health workers: evaluation of an early child development training intervention.(2016-06-21) D'Aprano A.; Silburn S.; Johnston V.; Oberklaid F.; Tayler C.Objective: This study aimed to design, implement, and evaluate training in early childhood development (ECD) and in the use of a culturally adapted developmental screening tool, for remote Australian Aboriginal Health Workers (AHWs) and other remote health practitioners. METHOD: A case-study evaluation framework was adopted. Two remote Australian Aboriginal health services were selected as case-study sites. Materials review, semistructured interviews, posttraining feedback surveys, and workplace observations contributed to the evaluation, guided by Guskey's 5-level education evaluation model. Results: Remote health practitioners (including AHWs and Remote Area Nurses) and early childhood staff from the sites participated in a customized 21/2 day training workshop focusing on the principles of ECD and the use of the culturally adapted Ages and Stages Questionnaire, third edition. Consistent with adult learning theories and recommendations from the literature regarding culturally appropriate professional development methods in this context, the workshop comprised interactive classroom training, role-plays, and practice coaching in the workplace, including booster training. The qualitative findings demonstrated that mode of delivery was effective and valued by participants. The workshop improved practitioners' skills, knowledge, competence, and confidence to identify and manage developmental difficulties and promote child development, evidenced on self-report and workplace clinical observation. Conclusion: The findings suggest that the practical, culturally appropriate training led to positive learning outcomes in developmental practice for AHWs and other remote health practitioners. This is an important finding that has implications in other Indigenous contexts, as effective training is a critical component of any practice improvement intervention. Further research examining factors influencing practice change is required.Item Early influences on developmental outcomes among children, at age 5, in Australia's Northern Territory.Guthridge S.; Li L.; Silburn S.; Li S.Q.; McKenzie J.; Lynch J.Redressing developmental and school learning inequalities among children requires an understanding of the factors that influence development across population groups. This study utilized the 2009 Australian Early Development Census (AEDC) to explore the association of perinatal health and socio-demographic factors with early development of children in the Northern Territory of Australia. The study cohort included 1110 Aboriginal and 812 non-Aboriginal children, most aged 5 years, whose developmental status was assessed during their first year of full-time school enrollment. Individual-level information was probabilistically linked across three administrative datasets. Logistic regression models were used to estimate the association (odds ratio (OR)) between early life characteristics of children and teacher-rated vulnerability on one or more of five domains of development. The crude OR for developmental vulnerability was much greater for Aboriginal than non-Aboriginal children (OR: 6.93, 95% CI: 5.62-8.56). After adjustment for other variables, the increased risk of developmental vulnerability for Aboriginal children was substantially moderated (OR: 1.68, 95% CI: 1.21-2.32). Influential factors in the adjusted model included: English as a second language (OR: 3.11, 95% CI: 2.27-4.26), gestational age at birth of 34-36 weeks (OR: 2.08, 95% CI: 1.27-3.39) and living in a very remote area (OR: 1.68, 95% CI: 1.19-2.37). There was a gradient in the strength of the association with the level of primary caregiver's education. An additional risk, for Aboriginal children only, was not having attended a day care or pre-school program (OR: 1.43, 95% CI: 1.01-2.04). The study demonstrates the emerging capacity for linkage of data across administrative datasets to inform our understanding of the extent to which multiple factors in early-life operate in their association with children's early development. Our findings are of particular relevance to initiatives to improve outcomes for Aboriginal children by demonstrating that potentially modifiable health and socio-economic factors account for almost all of the difference in developmental vulnerabilities observed between Aboriginal and non-Aboriginal children. (PsycInfo Database Record (c) 2021 APA, all rights reserved)Item Impact of perinatal health and socio-demographic factors on school education outcomes: a population study of Indigenous and non-Indigenous children in the Northern Territory.(2015-03-12) Guthridge S.; Li L.; Silburn S.; Li S.Q.; McKenzie J.; Lynch J.Aim: This study investigated the association between early-life risk factors and school education outcomes. Methods This is an historical cohort study of 7601 children (61% were Indigenous) born in the Northern Territory between 1999 and 2004. Information was linked, for each child on: perinatal health, student enrolment and National Assessment Program - Literacy and Numeracy (NAPLAN) Year 3 results. Logistic regression was used to estimate the association between selected risk factors and a NAPLAN result 'below' the national minimum standard (NMS) in reading and numeracy. Results Indigenous children had much higher odds, than non-Indigenous children, of a result below the NMS for both reading (odds ratio (OR): 8.58, 95% confidence interval (CI): 7.55-9.74) ) and numeracy (OR: 11.52, 95% CI: 9.94-13.35). When adjusted for all other variables, the increased odds were attenuated for both reading (OR: 2.89, 95% CI: 2.46-3.40) and numeracy (OR: 3.19, 95% CI: 2.65-3.84). Common risk factors for Indigenous and non-Indigenous children included higher birth order, maternal smoking in pregnancy and being a boy. There were gradients of decreasing risk with increasing education level of primary care giver and increasing maternal age. Among Indigenous children only, risks increased when living in remote areas, with younger age (<8 years) and low birthweight. Conclusions The study highlights that many of the risk factors associated with poor education outcomes among Indigenous children are shared with the general population. The results inform a targeted, cross-agency response to address modifiable early-life risk factors for educational disadvantage. Data linkage, using existing administrative datasets, provides a useful addition to methods that identify priority areas for prevention and early intervention.Copyright © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).