Alison Nelson (centre) with staff at the Institute for Urban Indigenous Health.”
When Dr Alison Nelson graduated from UQ with her Bachelor of Occupational Therapy she knew she wanted to work in Indigenous health services.
After a stint working in country Queensland and NSW she moved back to Brisbane and started looking at Queensland Health jobs in locations where she expected there would be large Aboriginal and Torres Strait Islander populations.
“I was told ‘They don’t really access our services’, and I wondered why that was; is it because people don’t know what an occupational therapist is or does, or is there some other reason?” she explains.
“Then I thought ‘What if I took the services to people rather than expecting people to come to Queensland Health?’, so that’s what I did as part of my master’s degree. I set up a visiting occupational therapy (OT) service to two schools and two pre-schools that had large numbers of Aboriginal and Torres Strait Islander kids, and then evaluated the program looking at what worked and what didn’t work.”
One of those places was The Murri School, The Aboriginal and Torres Strait Islander Independent Community School, where UQ’s visiting student clinic continues to this day.
Now in its twentieth year, the visiting clinic has grown to include speech pathology students along with the OT students on practical placement.
Dr Nelson also collaborated with The Murri School during her PhD studies where she looked at the place and meaning of health and physical activity in the lives of urban Indigenous young people. She tracked a cohort of pre-teens as they transitioned from late primary school to early high school, exploring the ways in which they perceived public health messages and how that corresponded to their own health and lifestyle choices.
Finishing up her PhD coincided with the establishment of the Institute for Urban Indigenous Health (IUIH).
The IUIH was formed in 2009 by the four Aboriginal and Torres Strait Islander Community Controlled Health Services in South East Queensland (SEQ) to lead the planning, development and delivery of comprehensive primary health care services to the Indigenous population of SEQ.
The IUIH collaborates with health care providers, research bodies and academia, government departments and other community-based agencies, to improve the health of the urban Aboriginal and Torres Strait Islander population.
UQ’s relationship with the IUIH involves, among other things, student placements and research support. IUIH is a key partner in the UQ Poche Centre for Indigenous Health, a University-level centre located within the Faculty of Health and Behavioural Sciences.
By utilising data and an evidence-based approach, the IUIH has successfully grown SEQ health services from six to 19 over the past seven years, responding to the rapidly growing urban population of 65,000 Aboriginal and Torres Strait Islander people.
As Director of Allied Health & Workforce Development at IUIH, Dr Nelson has been able to grow the student placements model she developed at The Murri School.
“When we started we had about 30 students, mostly from medicine, nursing and OT. Last year we had 388 students across 19 different disciplines. It’s given us an opportunity to provide a lot more exposure for students but also value adding to our service.
“Student placements are now much more sector driven than when we started, and we have a huge list of projects that we want students to do each year. We even place students from disciplines such as political science to tackle governance projects, but by far the majority of our students come from UQ’s health disciplines.
“I’m proud to say that every 4th year occupational therapy student at UQ participates in a meaningful opportunity working with Aboriginal and Torres Strait Islander people. These kinds of initiatives can only happen with strong partnerships with staff in the School of Health and Rehabilitation Sciences and with places like The Murri School.
“We love students! Our students are a hugely integral part of the story of Aboriginal and Torres Strait Islander health across SEQ.”
Dr Nelson’s love of students, and the contributions they make to IUIH, is evident as she describes some of the successful outcomes of projects they’ve worked on.
“The Work It Out program is our chronic disease and rehabilitation self-management program. At the time, we had no allied health team but we had a couple of students on placement with us. The students researched other programs and came up with a template for what a chronic disease and rehabilitation self-management program might look like for urban Aboriginal and Torres Strait Islander people.
“The following semester we partnered with a local gym who had physiotherapy and exercise physiology students on placement and they helped us run the program. Then we had OT students evaluate the program.
“This interdisciplinary approach enabled us to produce a report to table to the federal government and get funding to roll the program out across SEQ. Today, we self-fund the program across 10 SEQ locations and Queensland Health funds the program in Central Queensland.
“It’s a great example of our workforce development strategy in action. We started with five staff members and we now have over 500.”
Deadly Choices is another example. It began with support from a student project and is now a successful school and community based education program targeting chronic disease, nutrition, physical activity and tobacco education, while encouraging Indigenous people to be healthy role models. Evaluation of the Deadly Choices school program showed that 100 per cent of participants ate breakfast more often, 57 per cent increased their physical daily exercise, and smoking decreased by 14 per cent.
Dr Nelson believes the success of the programs is due to strong leadership from the IUIH management team, staff commitment, and the interprofessional approach taken both in education and in practice.
“We spend considerable time and effort on integration. Allied health service delivery only works because it is embedded in, and integrated with our primary health clinics and aged care services. It requires an ongoing vigilance to work out the systems and the structures, while also continuing to encourage individual staff to do the same.
“A lot of our placements are interprofessional placements. For example, all our speech and OT students do joint appointments, they work together, plan together, write notes together. It works incredibly well.
“In both the teaching that I do back into UQ and when students come here, it’s about getting them to think in terms of how they connect with clients, with their colleagues, with staff, and on a broader community level.”
This story first appeared in Game Changers, an annual publication by the Faculty of Health and Behavioural Sciences at The University of Queensland.