This year, the SWSR Small Grant Scheme sought to address the needs of marginalised local communities as the application priority area. Following an independent review process, grants were awarded to three high quality projects that both recognised the burden of health issues within local CALD communities and proposed to establish interventions/processes that would demonstrate direct measurable outcomes for their respective target populations.
The three successful applicants are: Dr Michael Tam, Dr Bernadette Brady and Dr Clarice Tang.
Find out about their exciting new research projects which aim to improve health services for our region, below:
“Do you understand me?”
A research project led by Dr Michael Tam
Like all hospital emergency departments, Fairfield Hospital’s ED is a busy one. Coupled with this busy-ness however is a significant challenge faced by staff and patients. This challenge is one posed by language, or more specifically, the difficulty patients and doctors have in fully understanding one another due to a patient’s limited English.
Fairfield houses a large community of Arabic-speaking people many of who speak limited or no English. Often, upon being admitted to ED, patients with limited English require translation services. Whilst the ideal scenario is to use a professional translator, it is more often the case that a bilingual staff member or family member translates communication from the doctor to the patient.
This research seeks to examine and measure the communication between Arabic-speaking people and their doctors in Fairfield Hospital’s Emergency Department to ascertain the degree of concordance in communication.
“We will be asking questions to ascertain the following three things: What was the reason for coming to the ED? What was the diagnosis and what were the discharge instructions,” explains Project Lead, Dr Michael Tam.
These questions will be asked to both the patient upon discharge from the hospital and the doctor who treated them.
“There is always some degree of non-concordance in health communication. However, we think we will find that people with low to no-English will experience a higher degree of non-concordance (greater levels of miscommunication.”
“In addition to looking at the quantitative data, we will also examine the nature of the non-concordance, for example, the type of non-concordance could potentially be serious if the patient has not understood the diagnosis or discharge instructions,” Dr Tam explains.
It is hoped that this research will provide evidence to drive policy towards additional funding for professional health translators in the hospital.
The study is a collaboration between the Academic Primary and Integrated Care Unit, and the Fairfield Hospital Emergency Department.
“Recruiting natural helpers: supporting the healthcare journey of CALD communities”
A research project led by Bernadette Brady
As the term suggests, “natural helpers” are people who are naturally driven to help others or “give back.” Used frequently in community and health promotion settings, natural helpers have not played as big a role in formal healthcare settings.
This is where senior physiotherapist and lead researcher, Dr Bernadette Brady, has recognised the potential benefit of using natural helpers. Specifically, her project will evaluate if natural helpers can be effectively integrated into the clinical service delivery of rehabilitating musculoskeletal pain conditions. Her project will also explore and evaluate the influence that natural helpers have on service delivery, patient engagement and the health system’s cultural responsiveness.
To do this, Bernadette and her team will focus on three different service settings and will utilise ex-patients from specific CALD population as natural helpers.
“Natural helpers will be there to support patients by providing their first-hand experience of the service that patients are attending,” explains Bernadette.
“The helpers will be able to chat with the patients in their own language and talk to them about their own experiences. This additional, non-therapeutic assistance, is a nice way to support the patient’s journey.”
The three service delivery areas which will run the project are: the Liverpool Pain Clinic from which Mandean and Arabic-speaking helpers will be recruited, a group physiotherapy exercise class at Fairfield Hospital in which Assyrian-speaking helpers will be assigned and finally, in an orthopaedic setting where CALD helpers will be recruited based on the greatest need rather than the largest CALD group.
“Investigating three different healthcare settings will facilitate evaluation of the model, identify essential elements and define context where natural helpers are likely to have the greatest impact,” explains Bernadette.
“Seeing tangible evidence of the benefits of utilising natural helpers will allow us to target expansion beyond this project.”
Investigating low participation rates in Pulmonary Rehabilitation in CALD communities
A research project led by Dr Clarice Tang
Despite a high prevalence of chronic respiratory diseases amongst CALD communities, participation in structured programs of exercise and education (Pulmonary Rehabilitation or PR) in SWSLHD is low.
A recent study conducted within SWSLHD found that only three out of 39 (8%) participants in a PR program were from a CALD background. Given the high percentage of people in the district coming from a CALD backgrounds (64%), these low participation rates warrant further investigation.
This is exactly what lead researcher, Dr Clarice Tang and her team, will investigate. Specifically, they will explore why Mandarin, Vietnamese and Arabic-speaking communities are under-represented in PR programs.
Dr Tang explains that the aim of the project is to explore the perception of PR from both the referrer and the end-user’s perspective.
“This will provide a thorough picture on why people with COPD from CALD communities may not engage in PR,” Dr Tang explains.
There could be a number of reasons for their non-participation and, Dr Tang believes, these reasons may differ between cultural groups. For example, In the older Mandarin-speaking community, it may appear incongruous to participate in exercises which are perceived as exerting the lungs. Dr Tang explains that another possible reason for the low attendance rates could be due to low referral rates.
“We want to find out whether are patients not coming because they don’t want to come or because health professionals are not referring them,” she says.
It is hoped that the results of the project will provide information enabling the design of culturally responsive PR programs that enhance CALD patient engagement.