None listed
Conditions
Brief summary
Aboriginal’ & 'Indigenous’ are used to respectfully refer to Aboriginal and/ or Torres Strait Islander peoples. We are testing a practical solution to improve engagement of Aboriginal young people with primary care for mental health. Currently <25% of Aboriginal adolescents attend a health clinic to receive a Medicare-funded annual health check. We will compare a new model of health care to standard primary health care to test which best supports the mind, body and spirit of Aboriginal youth. It was developed with Noongar young people, parents/ carers, health workers and Elders in Perth and Bunbury. The new model of care supports the wellbeing of young people in two ways. - A new online health check tool to use before visiting a GP. - A new type of health worker to help young people with their wellbeing needs. This is a specially-trained outreach health support worker role. This health worker supports all the decision made by a young person. They might help with making health appointments, or finding activities to help a young person feel good (like job training or taking part in cultural events). They will have $500 per youth to support wellbeing activities. To be a part of this trial, a person must: – Be an Aboriginal person aged 15 – 24 years – Be living in or near Perth – Have high levels of distress (youth must consent to answer short 10 question tool to measure distress level) A trial research assistant will identify and recruit potential participants via connections with the Aboriginal community, peer group leaders, organisations working with young Aboriginal people and ‘snowball’ sampling of young Indigenous people. For recruitment, trial promotion may include, but is not limited to, the following: brochures, radio, newsletters, websites and private study page on social media. A young person must consent to join the trial before being assigned to a group. Two groups are being compared. A youth is put into a group by random chance, like flipping a coin. Briefly, the: • Intervention group receive guided care though an Outreach Service Navigator in Perth for up to 5 months. They complete an online health check tool which is not the current standard tool used by GPs. A GP at Derbarl Yerrigan Health Service will develop a mental health care plan with the youth based on the new health check. • Waitlist control group receive standard care at Derbarl Yerrigan Health Service in Perth for up to 5 months. The control treatment includes the standard Indigenous health check (Medicare 715) and GP care at DYHS. A GP will develop a mental health care plan with the youth. After the 10 month assessment, a control participant can choose to receive Intervention treatment. At 3 timepoints, participants complete assessments (baseline, 5 months & 10 months). Baseline is after consent and before randomisation. Assessments will measure level of distress, quality of life, social factors, use of health services, work/ study and government support.
Interventions
This study arm (also known as Program 1) involves guided care though an Outreach Service Navigator in Perth;
– A young person meets with the Outreach Service Navigator every 2 to 4 weeks (with or without family/ support person), in a safe space agreed to by the young person. This should begin within 2 weeks of randomisation.
– For the first 4 weeks, the Outreach Service Navigator meets with the youth (+/- family or support person) to build rapport. Once good rapport has been established, the Ou
This study arm (also known as Program 1) involves guided care though an Outreach Service Navigator in Perth; – A young person meets with the Outreach Service Navigator every 2 to 4 weeks (with or without family/ support person), in a safe space agreed to by the young person. This should begin within 2 weeks of randomisation. – For the first 4 weeks, the Outreach Service Navigator meets with the youth (+/- family or support person) to build rapport. Once good rapport has been established, the Outreach Service Navigator and youth (+/- family or support person) will complete a new online health assessment tool that is currently not the standard tool used by General Practitioners (GPs). This online assessment is modelled on the Check Up GP app, which was co-designed with young people and is based on the HEEADSSS (Home environment, Education and employment, Eating, peer-related Activities, Drugs, Sexuality, Suicide and depression, Safety from injury and violence) preventive health framework for interviewing adolescents. Based on the results of the new online health assessment, the Outreach Service Navigator provides feedback and negotiates a plan for their unmet needs. – A GP at Derbarl Yerrigan Health Service, an Aboriginal-community controlled health service in Perth, will develop a mental health care plan with the youth based on the new health check. They can refer the young person to other providers, support groups, support material as necessary. – Each 2-4 weekly session with the youth is used to understand the level of support that is needed, organise and follow through with a mental health care plan, prioritise needs, facilitate access to wellbeing activities, track progress or reassess plans. This continues for up to 5 months. Each visit is likely to last from 30 minutes to 1 hour, or longer as needed. There is no minimum or maximum number of visits within the 5 month period. – With the support and guidance of the service navigator, the type and level of support suitable for the young person's needs is determined on an individual basis by the young person. At the 5 month data collection timepoint, after the participant has completed their allocated 5 months of care in the intervention arm, participants will be asked if they want to be interviewed about the trial as part of a process evaluation of the trial (assessing fidelity, acceptability, potential harms). The Outreach Service Navigator supports the health and wellbeing needs of the young person as identified by the young person, which includes their mind, body and spirit. A young person may want help with job training or taking part in Aboriginal cultural events. The Service Navigator will have up to $500 to use for activities supporting the young person’s wellbeing. Contact between an Outreach Service Navigator and a participant will primarily be in person, unless the youth advises of another preferred form of contact (e.g. text message, phone or video call). Typically a session occurs between one participant and the Service Navigator, however some group activities may be appropriate, such as cultural activities, where there may be a small group of participants working with one Service Navigator. The Service Navigator is a specially-trained outreach health support worker (with a background in social work, psychology and/ or health sciences) and has experience working with Australian Aboriginal communities, especially with young people and in health care or social services settings, such as case management or service coordination. Participant adherence will be captured during the scheduled discussions at the 5 and 10 month follow-up timepoints which will record changes in the participant’s clinical health management and/ or participation in wellbeing activities at any time during the 10 month follow-up period. Also, data relating to health/ wellbeing activities will be collected from the participant at each successive visit with the service navigator which will also be used to directly assess adherence to this study arm.
Sponsors
The University of Melbourne
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
15 Years to 24 Years
Healthy volunteers
No
Inclusion criteria
• Young Aboriginal person residing in or close to Perth, WA • Aged 15 to 24^ years at time of consent (^must consent before 25th birthday) • Score high to very high (score 22 or above) using the K10 measure of psychological distress • Has legal capacity to give consent, or has a legally acceptable representative who understands the consent document and can consent on behalf of the participant
Exclusion criteria
A young Aboriginal person meeting any of the following criteria will be excluded from trial enrolment: • Expresses suicidal ideation • Unable to think clearly and make safe decisions (e.g. severe anorexia, immediate risk of harm) • Unable to speak or understand English
Outcome results
None listed