Abstract
Background: Aboriginal and Torres Strait Islander peoples of Australia experience poorer health outcomes across the lifespan compared to non-Indigenous Australians, with infant mortality attributed to Sudden Unexpected Death in Infancy (SUDI) three times the rate of non-Indigenous infants. Previous research has demonstrated a) health professional knowledge and attitude gaps may have contributed to the poor uptake of safe infant sleeping messages by Aboriginal and Torres Strait Islander parents; b) and the identified need and request for a specific eLearning program appropriate to the needs of Aboriginal and Torres Strait Islander Health Workers. Objective: To develop and test a culturally appropriate, evidence-based eLearning program which increases the capacity of Aboriginal and Torres Strait Islander health professionals to confidently role model safe sleeping practices in their communities. Methods: An Indigenous Project Officer led consultation with Queensland Aboriginal and Torres Strait Islander networks regarding cultural appropriateness, suitability and acceptability of the program. The program was built in Provectus, the Queensland Health Clinical Skills Development Service (CSDS) designed eLearning platform, which allows for delivery of content in multiple interactive formats. The Aboriginal and Torres Strait Islander Safe Infant Sleeping eLearning Program consists of a course overview including orientation to e-learning environments; personal video address to participants from an experienced Aboriginal Health Worker; pre and post course knowledge and attitude quizzes; four modules each with a post-module quiz which must be successfully passed before advancing to next stage of course; novel interactions, Indigenous artwork and illustrations featuring culturally appropriate drawings and language. Pre-test-post-test changes were analysed using paired t-tests; sample subsets were compared using independent t-tests. Results: During the first 18 months (June 2012-January 2014) this free program attracted over 100 registrations with 39 completions. Participants identified as nursing (n=15), midwifery (n=10), medical (n=5) and Other Indigenous Health Workers (n=9) working in Indigenous communities. Pretest results (n=39) identified deficits in knowledge and application to risk factor assessment and evidence-based parent advice. Participant scores significantly increased posttest [pretest 67% Vs post-test average 91%,p<0.0001). Similar scores were achieved post-test for each of the learning modules indicating consistency in delivery across content (Post-test scores: 91%, 91%, 93%, 95% for Modules 1, 2, 3, 4 respectively). Several organisations have integrated this program into core professional support as part of staff preparation for safe infant sleeping health promotion in communities. Conclusion: Aboriginal and Torres Strait Islander families continue to be underexposed to safe sleeping public health messages. This eLearning program addressed a need identified by Indigenous Health Workers for culturally appropriate resources to assist them in supporting families to use safe sleeping recommendations. The culturally appropriate learning tool was effective in significantly and positively influencing health worker knowledge and knowledge application, and has continued to attract interest and participation with integration into service commitments for health worker support. Culturally appropriate and consistent methods of delivery will assist health workers and parents to use infant care practices that will ultimately reduce the risk of sudden unexpected deaths in infancy.