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Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis.

Green A, DiGiacomo M, Luckett T, Abbott P, Davidson PM, Delaney J, Delaney P - Int J Equity Health (2014)

Bottom Line: Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level.The policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families.The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.

View Article: PubMed Central - PubMed

Affiliation: Center for Cardiovascular and Chronic Care, Faculty of Health, University of Technology, Sydney, PO Box 123, Broadway, NSW, 2007, Australia. Anna.Green-1@uts.edu.au.

ABSTRACT

Introduction: Aboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice.

Methods: A systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework.

Results: Thirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level.

Conclusions: The policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.

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Related in: MedlinePlus

Factors of inter- and intra-sector collaboration in Aboriginal and Torres Strait Islander childhood disability.Source: Adapted from the Australian Institute of Health and Welfare 2012 [45].
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Fig2: Factors of inter- and intra-sector collaboration in Aboriginal and Torres Strait Islander childhood disability.Source: Adapted from the Australian Institute of Health and Welfare 2012 [45].

Mentions: Quality appraisal of the articles published in a peer-reviewed journal was conducted as part of a systematic approach to provide an overview of quality, but was not given weighting in the analysis and synthesis of data due to the lack of formal methods for this in integrative reviews. Quality appraisal of all included articles published in a peer-reviewed journal was conducted independently by two researchers (AG-MD or AG-TL) who met to establish agreement on the final rating. Any disagreements were resolved through discussion. The following critical appraisal tools were used: criteria for assessing qualitative literature [38], the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist [39], the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) checklist [40], the Mixed Methods Appraisal Tool (MMAT) [41], and the Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist [42] to assess qualitative, observational, intervention, mixed methods, and review studies, respectively. All included articles were evaluated using the Level of Evidence ranking system by MeInyk and Fineout-Overholt [43]. Data analysis was guided by the narrative synthesis approach by Popay et al. [44]. After developing the preliminary synthesis of findings we searched for a conceptual model. The model needed to provide a holistic framework centered on the child and their family that encompassed the different system levels of collaboration and how they interact with one another. An adaptation [45] of Bronfenbrenner’s ecological model for child development [46] represented a conceptual model in which the relationships in the data could be explored at the macro- (government), exo- (organizational) and meso- (provider) system levels (see Figure 2). The ecological model has previously been referenced in the context of addressing factors influencing equitable service access for underserved populations with a communication disability [47]. To our knowledge, it hasn’t before been applied specifically to service access issues in Aboriginal and Torres Strait Islander childhood disability. This organizing framework reflects factors that interact to achieve a desired outcome and also the impact of social interaction. Addressing each element discretely without considering the interdependency of elements is unlikely to achieve desirable outcomes.Figure 2


Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis.

Green A, DiGiacomo M, Luckett T, Abbott P, Davidson PM, Delaney J, Delaney P - Int J Equity Health (2014)

Factors of inter- and intra-sector collaboration in Aboriginal and Torres Strait Islander childhood disability.Source: Adapted from the Australian Institute of Health and Welfare 2012 [45].
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307173&req=5

Fig2: Factors of inter- and intra-sector collaboration in Aboriginal and Torres Strait Islander childhood disability.Source: Adapted from the Australian Institute of Health and Welfare 2012 [45].
Mentions: Quality appraisal of the articles published in a peer-reviewed journal was conducted as part of a systematic approach to provide an overview of quality, but was not given weighting in the analysis and synthesis of data due to the lack of formal methods for this in integrative reviews. Quality appraisal of all included articles published in a peer-reviewed journal was conducted independently by two researchers (AG-MD or AG-TL) who met to establish agreement on the final rating. Any disagreements were resolved through discussion. The following critical appraisal tools were used: criteria for assessing qualitative literature [38], the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist [39], the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) checklist [40], the Mixed Methods Appraisal Tool (MMAT) [41], and the Measurement Tool to Assess Systematic Reviews (AMSTAR) checklist [42] to assess qualitative, observational, intervention, mixed methods, and review studies, respectively. All included articles were evaluated using the Level of Evidence ranking system by MeInyk and Fineout-Overholt [43]. Data analysis was guided by the narrative synthesis approach by Popay et al. [44]. After developing the preliminary synthesis of findings we searched for a conceptual model. The model needed to provide a holistic framework centered on the child and their family that encompassed the different system levels of collaboration and how they interact with one another. An adaptation [45] of Bronfenbrenner’s ecological model for child development [46] represented a conceptual model in which the relationships in the data could be explored at the macro- (government), exo- (organizational) and meso- (provider) system levels (see Figure 2). The ecological model has previously been referenced in the context of addressing factors influencing equitable service access for underserved populations with a communication disability [47]. To our knowledge, it hasn’t before been applied specifically to service access issues in Aboriginal and Torres Strait Islander childhood disability. This organizing framework reflects factors that interact to achieve a desired outcome and also the impact of social interaction. Addressing each element discretely without considering the interdependency of elements is unlikely to achieve desirable outcomes.Figure 2

Bottom Line: Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level.The policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families.The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.

View Article: PubMed Central - PubMed

Affiliation: Center for Cardiovascular and Chronic Care, Faculty of Health, University of Technology, Sydney, PO Box 123, Broadway, NSW, 2007, Australia. Anna.Green-1@uts.edu.au.

ABSTRACT

Introduction: Aboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice.

Methods: A systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework.

Results: Thirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level.

Conclusions: The policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.

Show MeSH
Related in: MedlinePlus