Implementing a chronic disease strategy in two remote Indigenous Australian settings: a multi-method pilot evaluation.
OBJECTIVE
To test an evaluation framework designed to evaluate implementation of the North Queensland Indigenous communities between August and December 2005.


METHODS
Both communities are located in Cape York, North Queensland. Community A has an estimated population of around 600 people; Community B has an enumerated population of 750, although health centre records indicate a higher number.


METHODS
Process evaluation involved health centre staff in both communities; clinical audits used random samples from the adult population (each sample n = 30); ethnographic fieldwork was conducted with resident population.


METHODS
Health centre scores and qualitative findings using a System Assessment Tool; clinical audits--extent to which scheduled services recorded; selected primary health performance indicators; qualitative ethnographic findings.


RESULTS
On almost all indicators, implementation of NQICDS had progressed further in Community A than in Community B; however, some common issues emerged, especially lack of linkages between health centres and other groups, and lack of support for client self-management.


CONCLUSIONS
The evaluation framework is an effective and acceptable framework for monitoring implementation of the NQICDS at the primary health centre level.
d'Abbs
Peter
P
School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Cairns, Queensland, Australia. peter.dabbs@jcu.edu.au
Schmidt
Barbara
B
Dougherty
Kathryn
K
Senior
Kate
K
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D008485:Medical Audit / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D010865:Pilot Projects; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D011793:Queensland; D019035:Rural Health Services / Q000458:organization & administration*