Healing Right Way: A Stepped Wedge Cluster Randomised Controlled Trial Aiming to Enhance Quality of Life for Aboriginal Australian Survivors of Stroke and Traumatic Brain Injury

Elizabeth Armstrong; Tapan Rai; Judith M Katzenellenbogen; Sandra J Thompson; Meaghan McAllister; Natalie Ciccone; Deborah Hersh; Leon Flicker; Dominique A Cadilhac; Erin Godecke; Graeme J Hankey; Neil Drew; Colleen Hayward; Deborah Woods; Mel Robinson; Ivan Lin; Sanita Kratina; Jane White; Juli Coffin

doi:10.1111/ajr.70106

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Healing Right Way: A Stepped Wedge Cluster Randomised Controlled Trial Aiming to Enhance Quality of Life for Aboriginal Australian Survivors of Stroke and Traumatic Brain Injury

Journal article

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Healing Right Way: A Stepped Wedge Cluster Randomised Controlled Trial Aiming to Enhance Quality of Life for Aboriginal Australian Survivors of Stroke and Traumatic Brain Injury

Elizabeth Armstrong, Tapan Rai, Judith M Katzenellenbogen, Sandra J Thompson, Meaghan McAllister, Natalie Ciccone, Deborah Hersh, Leon Flicker, Dominique A Cadilhac, Erin Godecke, …

The Australian journal of rural health, Vol.33(5), e70106

2025

DOI: https://doi.org/10.1111/ajr.70106

PMID: 41131785

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Abstract

aboriginal

clinical trial

indigenous

rehabilitation

stroke

traumatic brain injury

Objective To determine the effect of cultural security training (CST) for health professionals and access to an Aboriginal Brain Injury Coordinator (ABIC) for Aboriginal Australians with stroke or traumatic brain injury (TBI). Design A stepped wedge cluster randomised controlled trial; the intervention package consisted of CST for hospital professionals and 6-month access to ABICs providing education, support, liaison and advocacy; the commencement order of the intervention phase was randomised. Setting Four urban and four rural hospitals in Western Australia, 2018–2022. Participants Aboriginal adults ≥ 18 years hospitalised with stroke or TBI. Main Outcome Measures Primary outcome was quality of life (Euro QOL–5D-3L Visual Analogue Scale (EQ-VAS)) score at 26 weeks post-injury. Secondary outcomes were modified Rankin Scale, Functional Independence Measure, Hospital Anxiety and Depression Scale, Modified Caregiver Strain Index at 12 and 26 weeks, rehabilitation occasions of service, hospital compliance with minimum processes of care (MPC), acceptability of interventions, feasibility of ABIC role and costs. Results In total, 108 participants recruited (target 312), 75% rural residents; 26-week outcomes assessment completed for 78% of participants. The adjusted mean QoL showed no significant difference (p = 0.83). The MPC outcome favored the intervention group, adjusted difference in means 6.8% at 26 weeks, 95% CI (0.40%, 13.26%). There were no significant differences between control and intervention groups for other secondary outcomes. Conclusions CST and implementation of an ABIC were feasible, acceptable and improved care processes for a predominantly rural population. Health outcomes did not differ. The effects of the COVID-19 context are discussed. Trial Registration ACTRN12618000139279

Details

Title: Healing Right Way: A Stepped Wedge Cluster Randomised Controlled Trial Aiming to Enhance Quality of Life for Aboriginal Australian Survivors of Stroke and Traumatic Brain Injury
Authors/Creators: Elizabeth Armstrong - Edith Cowan University
Tapan Rai - University of Technology Sydney
Judith M Katzenellenbogen - The University of Western Australia
Sandra J Thompson - The University of Western Australia
Meaghan McAllister - Edith Cowan University
Natalie Ciccone - Edith Cowan University
Deborah Hersh - Curtin University
Leon Flicker - The University of Western Australia
Dominique A Cadilhac - Monash University
Erin Godecke - Edith Cowan University
Graeme J Hankey - The University of Western Australia
Neil Drew - Edith Cowan University
Colleen Hayward - Edith Cowan University
Deborah Woods - Geraldton Regional Aboriginal Medical Service, Geraldton, Western Australia, Australia
Mel Robinson - Ngangk Yira Institute for Change, Murdoch University, Murdoch, Western Australia, Australia
Ivan Lin - The University of Western Australia
Sanita Kratina - Edith Cowan University
Jane White - Edith Cowan University
Juli Coffin - Murdoch University
Publication Details: The Australian journal of rural health, Vol.33(5), e70106
Publisher: WILEY
Number of pages: 16
Grant note: Western Australian Department of Health Royal Perth Hospital Medical Research Foundation 1132468 / National Health and Medical Research Council
Identifiers: 991005823313607891
Murdoch Affiliation: Ngangk Yira Institute for Change
Language: English
Resource Type: Journal article

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.156 Healthcare Policy; 1.156.1502 Indigenous Health and Education
Web Of Science research areas: Nursing; Public, Environmental & Occupational Health
ESI research areas: Clinical Medicine