Enhancing rehabilitation services for Aboriginal Australians after brain injury.

This project involves implementation of the first culturally secure intervention package for Aboriginal survivors of brain impairment in Australia. Aboriginal Australians experience stroke up to three times more frequently than non-Aboriginal Australians, with traumatic brain injury due to assault occurring up to 21 times more often. Yet Aboriginal people remain under-represented in rehabilitation programs. The proposed project follows on from the team's Missing Voices study (NHMRC ID#1046228) that investigated the extent and impact of communication disorders after brain injury in Aboriginal people across Western Australia. Findings suggested significant changes in service delivery are warranted and wanted by Aboriginal brain injury survivors, their families and health service providers. The project aims to improve accessibility to rehabilitation services for all Aboriginal people post brain injury in Western Australia, improve health outcomes for this population, and establish an economic model for the above which will contribute to sustainability and planning of future services. Utilising a stepped wedge cluster randomised control design, the study will involve a complex intervention consisting of a) cultural security training for hospital staff tailored to the delivery of services to Aboriginal people with brain injury, b) use of culturally appropriate educational materials, and c) introduction of a specialist Aboriginal Brain Injury Coordinator to provide an in-reach service to participating hospitals as well as coordination of care and advocacy after hospital discharge. The service and costing models developed in the project will provide a basis for future planning of brain injury services as well as services for a variety of other conditions in WA and nationally.