Key UNSW staff
Skye Trudgett (PhD student, NDARC)
Anthony Shakeshaft (Prof and deputy director, NDARC)
What is the project and why is it needed?
For this project, high-risk young people are broadly defined as those engaged in multiple health-risk behaviours (e.g. substance misuse, physical inactivity, unprotected sex, self-harm, crime), the aetiology of which is strongly associated with a range of social determinants of poor health, including childhood abuse, exposure to crime at an early age, low socio-economic status (SES) and minority cultural identity. The history of colonisation and dispossession imposed on Australia’s Indigenous people has amplified the exposure of young Indigenous Australians to multiple health risks, meaning they are over-represented in the cohort of high-risk young people in Australia.
Despite these harms, a 2016 systematic review of evidence by NDARC identified only six published evaluations of programs for high-risk young people that were of moderate or strong methodological quality. This project responds to this insufficient evidence. Specifically, we have co-designed a model of care with NGO service providers that extracts the best available evidence from published studies and combines it with the expertise of service providers. A key innovation is that the model of care is standardised by best evidence but is able to be tailored to the different circumstances of different service providers. Similarly, we have established a best-evidence standardised data collection instrument, the intent of which is to simultaneously facilitate assessments by service providers for their program participants and allow evaluation of their programs over time. This project will report on the feasibility and findings of these tools, as well as examine how the sovereignty of Indigenous data can be upheld.
What are you hoping to achieve?
We are hoping to lay the groundwork for NGO delivered services to routinely collect best-evidence data and deliver a best-evidence model of care. In turn, this locally relevant evidence will help improve the policy responses needed to support NGO’s to deliver their programs on a more sustainable basis. We hope the model of care that is standardised but flexible, and the routine collection of high quality data, will eventually contribute to a national evidence base that can drive improvements in the effectiveness of programs for high-risk young people nationally. The current process of different government departments with separate mandates delivering individual components of a wholistic response is fragile, and could be addressed by funnelling expertise and appropriate resources through NGOs delivering a person-centred, whole of community response. This partnership approach respects the knowledge of Indigenous people and local communities to identify their own solutions, utilises the evaluation skills of researchers, and generates the reliable estimates of benefits and costs that governments need to assess the returns from their investment of public funds.
Who are the project team?
The team consists of Indigenous and non-Indigenous NGO service providers, and a team of academics with complementary skills in qualitative, quantitative and economic evaluation.
What impact do you imagine the project will have?
The project will be a catalyst for conversations about standardising and improving the evidence base for young people at risk. We believe that the research will provide tangible resources for new programs to get started in many more communities. Beyond these short-term impacts, we believe that longer term impacts will include policy change around the way in which governments structure the co-design and delivery of youth programs in Australia.
Is there any call to action or collaboration needs you would like to highlight?
We hope this research could function as a catalyst for government agencies, Indigenous agencies, Indigenous and non-Indigenous service providers and academics to collaborate more closely to improve the quality and sustainability of services. This is a challenging task, but it is the high-risk young people who will benefit most and this project is a blueprint for how this collaboration could be managed.
This project has also provided an opportunity for Skye Trudgett, an Indigenous person from the Kamilaroi nation, to undertake her PhD, which highlights the potential for Indigenous people to lead the evaluation of these programs. Skye strongly believes there is scope for government agencies to collaborate more closely with Indigenous services, such as Absec in NSW, around using this research; given the disproportionately high number of Indigenous high-risk young people, Indigenous agencies need to have a lead role in the response, including a more robust application of Indigenous Data Sovereignty principles. In her post-doctoral career, Skye would like to work closely with Indigenous and government agencies to take this research further.