title: Improving access to primary care for Aboriginal babies in Western Australia: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Despite a decade of substantial investments in programs to improve access to primary care for Aboriginal mothers and infants, more than 50% of Western Australian Aboriginal babies are still not receiving primary and preventative care in the early months of life. Western Australian hospitals now input birth data into the Western Australian electronic clinical management system within 48 hours of birth. However, difficulties have arisen in ensuring that the appropriate primary care providers receive birth notification and clinical information by the time babies are discharged from the hospital. No consistent process exists to ensure that choices about primary care are discussed with Aboriginal families.
  
  
  METHODS
  We will undertake a population-based, stepped wedge, cluster randomized controlled trial of an enhanced model of early infant primary care. The intervention is targeted support and care coordination for Aboriginal families with new babies starting as soon as possible during the antenatal period or after birth. Dedicated health professionals and research staff will consult with families about the families' healthcare needs, provide information about healthcare in the first 3 months of life, offer assistance with birth and Medicare forms, consult with families about their choice for primary care provider, offer to notify the chosen primary care provider about the baby's health needs, and offer assistance with healthcare coordination at the time of discharge from the hospital. We will evaluate this model of care using a rigorous stepped wedge approach. Our primary outcome measure is a reduced hospitalization rate in infants younger than 3 months of age. Secondary outcome measures include completed Aboriginal and Torres Strait Islander child health screening assessments, immunization coverage, and satisfaction of the families about early infant primary care. We will also assess the cost effectiveness of the model of care.
  
  
  CONCLUSIONS
  This study will be conducted over a 4-year period in partnership with birthing hospitals and primary care providers including Western Australian Aboriginal Community Controlled Health Services and the new Primary Health Networks. The results of our trial will be used to develop improved primary care models and to improve health outcomes for all Aboriginal infants. These are vital steps toward more equitable health service delivery for the Aboriginal and Torres Strait Islander children in Australia.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry Registration number: ACTRN12615000976583 Date registered: 17 September 2015.
authors: University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. mcaullay@gmail.com.|Edith Cowen University, 2 Bradford St, Mount Lawley, WA, 6050, Australia. mcaullay@gmail.com.
authors: Daniel
authors: D
authors: McAullay
authors: University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. kimberley.mcauley@uwa.edu.au.
authors: Kimberley
authors: K
authors: McAuley
authors: Murdoch University, 90 South St, Murdoch, WA, 6150, Australia. R.Marriott@murdoch.edu.au.
authors: Rhonda
authors: R
authors: Marriott
authors: Telethon Kids Institute, 100 Roberts Rd, Subiaco, WA, 6008, Australia. Glenn.Pearson@telethonkids.org.au.
authors: Glenn
authors: G
authors: Pearson
authors: Telethon Kids Institute, 100 Roberts Rd, Subiaco, WA, 6008, Australia. Peter.Jacoby@telethonkids.org.au.
authors: Peter
authors: P
authors: Jacoby
authors: Western Australia Department of Health, 189 Royal Street, East Perth, WA, 6004, Australia. Chantal.Ferguson@health.wa.gov.au.
authors: Chantal
authors: C
authors: Ferguson
authors: University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. elizabeth.geelhoed@uwa.edu.au.
authors: Elizabeth
authors: E
authors: Geelhoed
authors: Geraldton Regional Aboriginal Medical Service, Holland St, Geraldton, WA, 6530, Australia. Juli.Coffin@grams.asn.au.
authors: Juli
authors: J
authors: Coffin
authors: University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. charmaine.green@uwa.edu.au.|Geraldton Regional Aboriginal Medical Service, Holland St, Geraldton, WA, 6530, Australia. charmaine.green@uwa.edu.au.
authors: Charmaine
authors: C
authors: Green
authors: University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. selina.sibosado@uwa.edu.au.|Geraldton Regional Hospital, 51-85 Shenton St, Geraldton, WA, 6530, Australia. selina.sibosado@uwa.edu.au.
authors: Selina
authors: S
authors: Sibosado
authors: Derbarl Yerrigan Aboriginal Medical Service, 156 Wittenoom St, East Perth, WA, 6004, Australia. henryb@dyhs.org.au.
authors: Barbara
authors: B
authors: Henry
authors: University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. dorota.doherty@uwa.edu.au.|King Edward Memorial Hospital, 374 Bagot Rd, Subiaco, WA, 6008, Australia. dorota.doherty@uwa.edu.au.
authors: Dorota
authors: D
authors: Doherty
authors: University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. karen.edmond@uwa.edu.au.|Princess Margaret Hospital for Children, Roberts Rd, Subiaco, WA, 6008, Australia. karen.edmond@uwa.edu.au.
authors: Karen
authors: K
authors: Edmond
mesh_terms: D002985:Clinical Protocols; D003625:Data Collection; D006297:Health Services Accessibility; D006303:Health Services, Indigenous; D006801:Humans; D011320:Primary Health Care; D018401:Sample Size; D014904:Western Australia; D000095283:Australian Aboriginal and Torres Strait Islander Peoples