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Table 1 Case study: Aboriginal and Torres Strait Islander CVD guideline development and alignment to ensure early detection and management of CVD risk

From: Output-orientated policy engagement: a model for advancing the use of epidemiological evidence in health policy

Timeline dates

Activity

OOPE focus

2003–present

Team- and system-based work on leadership and capacity-building, emphasis on policy needs, generating awareness of work, engagement with key stakeholders in CVD, population health and Aboriginal and Torres Strait Islander health, building research partnerships and producing policy-relevant research

Foundational work

2015–2016

Identification of absolute CVD risk assessment and management in the general population as an output of likely shared policy interest, within a broader programme of work

Engagement with stakeholders on CVD risk assessment and management in the general population, including Department of Health, Heart Foundation, Australian Bureau of Statistics

Input into general population paper and identification of Aboriginal and Torres Strait Islander absolute CVD risk as an area of interest for future work in the programme

Initial engagement, considering the broader program of work, forming and furthering partnership work

May 2016

Publication of paper on CVD risk assessment and management in the general population [2]

Release of research output and positioning for implementation

2016

Australian National University CVD program Aboriginal Reference Group identifies early CVD in Aboriginal and Torres Strait Islander peoples, prior to the age when assessment is recommended nationally, as a key concern

Forming and furthering partnership work and continued engagement

2016

Analyses of Australian Bureau of Statistics data on Aboriginal and Torres Strait Islander CVD risk, identifying early onset of risk, with results fed back to reference group. Commencement of drafting of paper

June 2016

All-staff forum and roundtable 1: all-staff presentation and senior policy roundtable on early results on Aboriginal and Torres Strait Islander CVD risk at the Australian Government Department of Health

June 2017

Work commissioned on risk assessment of CVD for Aboriginal and Torres Strait Islander population by the Department of Health; meetings every 3 weeks with staff from the Indigenous Health Division, Department of Health, from this time until June 2020, as part of this work

November 2017

All-staff forum and roundtable 2: All-staff presentation and senior policy roundtable on implementation gaps in CVD prevention and proposed policy levers to improve uptake of absolute CVD risk at the Australian Government Department of Health. Roundtable focused on possible enhancements to Aboriginal and Torres Strait Islander health checks to improve CVD prevention

December 2017

Submission of report to Australian Department of Health reviewing evidence for the alignment of guidelines on Aboriginal and Torres Strait Islander CVD risk

February 2018

Stakeholder workshop on guideline alignment for Aboriginal and Torres Strait Islander CVD risk, including presentation of findings on absolute CVD risk in this population

March 2018

Submission of report to the Department of Health outlining a strategy to support revision and alignment of guidelines for Aboriginal and Torres Strait Islander CVD assessment and management

Release of research output and positioning for implementation

April 2018

Findings on CVD risk in Aboriginal and Torres Strait Islander adults and Aboriginal and Torres Strait Islander health checks presented to the General Practice and Primary Care Clinical Committee Assessments Working Group of the Medicare Benefits Schedule Review

Continued engagement

June 2018

Australian National University CVD Aboriginal Reference Group supports lowering the age for commencing CVD risk assessment to 18 years and recommends communication strategies to promote community awareness of CVD risk assessment

Partnership work and continued engagement

June 2018

Workshop of representatives of organizations responsible for Aboriginal and Torres Strait Islander CVD guideline development: Australian Chronic Disease Prevention Alliance, Royal Australian College of General Practitioners (RACGP) and Central Australian Rural Practitioners Association. The group agreed on the need for systematic universal clinical CVD risk assessment from age 18 and to work together on a consensus statement

June 2018

Paper on CVD risk in Aboriginal and Torres Strait Islander adults published online and launched by Minister Wyatt at Parliament House

Release of research output and positioning for implementation

July 2018

Findings on CVD risk in Aboriginal and Torres Strait Islander adults and Aboriginal and Torres Strait Islander health checks presented to Indigenous Reference Group of the Medicare Benefits Schedule Review

Continued engagement

June 2018–July 2019

Additional analysis on the prevalence of vascular risk factors in Aboriginal and Torres Strait Islander adults aged 18–29 was completed using data from the Australian Bureau of Statistics 2012–2013 Australian Aboriginal and Torres Strait Islander Health Survey. These results were presented to the Aboriginal Reference Group and Guidelines Working Group to guide discussions on extending a CVD risk assessment and management to adults younger than 30 [30]

Drafting of consensus statement to lower age at CVD risk assessment in Aboriginal and Torres Strait Islander adults to 18 [31], with Aboriginal and Torres Strait Islander community representatives and leaders in CVD research as partners and authors, including representatives from guideline development groups: Heart Foundation, RACGP, National Aboriginal Community Controlled Health Organisation and the Central Australian Rural Practitioners Association

Endorsement of consensus statement by the Heart Foundation Clinical Committee and Heart Health Committee, Chair of the RACGP Quality Care Committee and representatives from the Stroke Foundation, Kidney Health Australia and Diabetes Australia

Furthering partnership work, continued engagement and positioning for implementation

May 2019

Participation and presentation at roundtable held by RACGP on enhancements to Aboriginal and Torres Strait Islander health checks

Partnership work and continued engagement

August 2019

Consensus statement updating guidelines on CVD risk assessment in Aboriginal and Torres Strait Islander adults submitted to peer-reviewed journal

Release of research output and positioning for implementation

December 2019

All-staff forum and roundtable 3: all-staff presentation and senior policy roundtable on findings from review of Aboriginal and Torres Strait Islander health assessments and chronic disease prevention

Continued engagement

March 2020

Consensus statement updating guidelines on CVD risk assessment in Aboriginal and Torres Strait Islander adults published online [31]. This is the first time all relevant guidelines have been aligned for Aboriginal and Torres Strait Islander peoples and that age ranges for assessment have been based on representative empirical evidence

Release of research output and positioning for implementation

November 2020

National Aboriginal Community Controlled Health Organisation and RACGP publish Aboriginal and Torres Strait Islander health check templates that incorporate many of the key recommendations from the Australian National University review [34]

Release of research output, incorporating our research findings

February 2021

Paper on sociodemographic factors and CVD risk factors among Aboriginal and Torres Strait Islander peoples having health checks published [32]

Release of research output and positioning for implementation