Research Themes and Major Projects
Joining health and education interventions in early childhood
Aims: In the first instance, to conduct a comprehensive review of the available evidence around school readiness, particularly interventions focusing on key developmental, emotional and physical outcomes in the first four years of life, with particular emphasis on Indigenous populations and populations from whom useful information can be extrapolated. Based on review findings, to use these data to prepare study protocols and funding applications for large-scale randomised, controlled trials of practical interventions that may improve the likelihood of Indigenous children entering school in a fit state to learn.
Rationale: The connection between poor education attainment and poor health has been identified in many different contexts. Until now, research into Aboriginal health has focused largely on developing biomedical and health systems interventions that may lead to reductions in mortality or morbidity in the short to medium term while research in indigenous education has been case study based and not sufficient for generalisable findings. Educational policy in Australia, particularly indigenous education, is based on historical practice rather than high quality and proven interventionary knowledge. Experimental research data is particularly lacking. In short, we have no idea how to rapidly improve educational outcomes, particularly in remote Aboriginal communities (where, for example, only approximately 20% of year 3 and year 5 children achieve standard reading benchmarks).
The Menzies School of Health Research (MSHR), Australia’s leading indigenous health research institution, will work together with the School for Social and Policy Research (SSPR) at Charles Darwin University, the leading educational policy research organisation in the NT, to bring together the Aboriginal health and educational research agendas for the first time. The initial aim is to focus on the concept of “school readiness”: i.e. what can be done during the early years of life to ensure that Aboriginal children are fully prepared developmentally, emotionally and physically to enter formal schooling? We will develop a research agenda that includes descriptive epidemiology and rigorous interventional studies, based largely around randomised controlled trials. Eventually, this work will expand to include studies of educational techniques in school-aged Aboriginal children.
Stage One: Situational Analysis (2007)
1. Literature Review
The principal question for the literature review is:
What early childhood development programs are most likely to improve the school readiness of children ≤5 years of age in the Australian remote Indigenous community context?
In answering this question, we also expect to describe the following:
(i) How is school readiness defined? Do definitions of school readiness have any particular implications in the context of research in Indigenous communities? E.g. high rates of hearing deficit, reduced access to services, different child rearing practices.
(ii) What are the modifiable risk and protective factors that impact on school readiness? What relevance do these factors have in an Indigenous context?
(iii) How is school readiness measured? What measures (if any) have been validated in an Indigenous/analogous population?
The search for relevant publications will be undertaken in three stages. The first stage will focus on identifying relevant systematic reviews; the second stage will identify relevant primary studies (both quantitative and qualitative); and the third will involve searching for relevant reports in the grey literature. These reviews will also include identifying appropriate tools for measurement of early childhood development and school readiness in an Indigenous context.
2. Expert network
With funding from the ARACY Network Seed Funding (provide link to newsletter extract), and drawing from the literature reviews, discussion papers will be prepared and a workshop convened with expert researchers (in the areas of early childhood development, school readiness, literacy and Indigenous education and health), policy makers, service providers and community representatives.
The Darwin workshop or roundtable, scheduled for October/November 2007 (tbc) will provide hands-on background about the current state of knowledge and what research has already been conducted around school readiness, learn from other populations about research or policy successes and failures, and in particular to highlight the most important research questions to be addressed in an Australian Indigenous context.
3. Research Reference Group
Building from the workshop, a research reference group will be established to guide and track activities and make recommendations towards the establishment of longer term applied research capacity in northern Australia orientated toward improving school readiness for Indigenous children.
4. Consultations
The situational analysis includes consultations with families and communities, Aboriginal and mainstream service providers, local policy makers to:
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Map current initiatives in the territory to deliver early childhood services to remote/rural communities;
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Map other existing or planned local and national research endeavours, with a view to potential collaboration; and to
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Establish families and communities current needs and aspirations in the area of early childhood/school readiness programs.
Stage Two: Empirical Research Phase (2008 onwards)
In the second stage of the research we propose to evaluate (ideally using a randomised controlled trial study design if feasible) an early childhood development intervention in a possible range of childcare settings (e.g. home, playgroups, health clinic, mobile preschools) to test its short-term impact on health status (e.g. clinic presentations, hospitalisations, nutritional status, ear disease, anaemia), development (as assessed in standardised developmental scales) and other measures of cognitive functioning. This intervention will be modelled on the best evidence available for early childhood programs in other “high-risk” populations, as well as being informed by the situational analysis, including literature reviews and consultations.
Key considerations in the research design phase will include:
- A focus on the child in the context of family/community.
- The need to base the intervention around a strong theoretical foundation and the best available evidence.
- Consideration of sustainability and the possibility for replication. This means identifying the core elements of successful programs and allowing for the capacity for local flexibility.
- The aim to identify what works (using an experimental design) and why (this will require nested qualitative work).
- Significant follow-up of outcomes.
- Contribute to building local capacity and ownership of program.
- Consultation with families and communities from the earliest stage possible.
- Local research capacity building and reflection on collaboration processes.
Outputs:
- Joint appointment MSHR/SSPR
- Discussion papers
- Roundtable of local, national and international experts to discuss and progress proposed research agenda
- Publication of systematic review of early interventions for school readiness
- Joint submission for scientific research program based on review findings.
Project team: A Prof Tess Lea; A Prof Gary Robinson; Dr Nick McTurk; Susan Emmett
Partners: Prof Jonathan Carapetis, MSHR (Chief Investigator); Dr Vanessa Johnston
Funding: ARACY Network Seed Funding (successful), OATSIH Early Child Health Research and Evaluation proposals (negotiations underway); Financial Markets Foundation for Children (shortlisted for second round; outcome pending)
Channel Seven (submitted)
Timeframe: 2007 systematic review; 2008 larger interventionary research program
