Evaluation of a health education initiative for urban Aboriginal and Torres Strait Islander people

The Lowitja institute awarded a Small Grant to the University of Queensland and the Institute for Urban Indigenous Health (IUIH) in 2013 to evaluate the IUIH’s Deadly Choices program. Deadly Choices in an initiative of the IUIH in south east Queensland and is funded by the Commonwealth Department of Health. Deadly Choices is a school and community-based chronic disease prevention and education initiative that encourages Aboriginal and Torres Strait Islander people in South East Queensland to make healthy choices; focusing on chronic diseases and their risk factors such as nutrition, physical activity, smoking and harmful substances. This evaluation investigated the impact of the Deadly Choices initiative, including the seven week school based health education program, community-group program and community events, between April and October 2013.

The research aimed to:

1.  describe in detail the base-line knowledge of urban-dwelling Aboriginal and Torres Strait Islander people regarding chronic disease and it’s risk factors
2. explore the impact of ‘Deadly Choices’ health promotion/education initiatives on a) knowledge, b) attitudes and c) behaviour of urban dwelling Aboriginal and Torres Strait Islander people in the topics covered by the ‘Deadly Choices’ Program
3. explore the reasons for healthy lifestyle choices in the lives of urban Aboriginal and Torres Strait Islander people
4. explore the impact of the ‘Deadly Choices’ program on urban Aboriginal and Torres Strait Islander people accessing local Aboriginal and Torres Strait Islander community health services.

This evaluation utilised a mixed methods approach including qualitative and quantitative data collection methods. This included pre/post questionnaires to assess changes in knowledge, attitudes and behaviours; interviews to explore in further detail the impact of Deadly Choices; and an audit trail to assess the impact of the health screening activities at community events.

Results indicated that the Deadly Choices school-based program improved the knowledge, attitudes, self-efficacy and behaviours of Aboriginal and Torres Strait Islander young people in South East Queensland regarding leadership, chronic disease and risk factors. The school-based program also facilitated the uptake of Aboriginal and Torres Strait Islander health checks (MBS item 715) for young people within the program. Results also indicate there are a range of barriers and facilitators and differing perceptions around health for these Aboriginal and Torres Strait Islander young people. Results suggest that the Deadly Choices community events improved participant’s health literacy regarding chronic disease risk factors; facilitated community engagement with local health services; provided an opportunity for Aboriginal and Torres Strait Islander people to increase social connections; and indirectly increased community awareness around health and physical activity. The results from this evaluation will inform improvements and enhancements to the Deadly Choices initiative relating to program and event education content; maximising health checks/screens; and improving program attendance. In addition, recommendations have been provided for ongoing program evaluation.

Related resources:

• Deadly Choices Health Promotion Initiative Evaluation Report
• Malseed, C., Nelson, A. & Ware, R. 2014, Evaluation of a School-Based Health Education Program for Urban Indigenous Young People in Australia. Health, 6(7), 587-587.
• Malseed, C., Nelson, Al., Ware, R., Lacey, I., Lander, K. 2014, Deadly Choices community health events: a health promotion initiative for urban Aboriginal and Torres Strait Islander people. Australian Journal of Primary Health, In Press.
• Malseed, C., Nelson, A., Lander, K. & Lacey, I. (submitted). The impact of Deadly Choices health promotion community events on the health of urban Aboriginal and Torres Strait Islander people, Health Promotion Journal of Australia.
• Malseed, C., Lander, K & Lacey, I., Nelson, A. 2014, Evaluation of the Deadly Choices School based Health Education Program for Urban Indigenous Young People. How are Queensland’s kids faring?: A symposium to further systems integration for children’s wellbeing, Australian Research Alliance for Children & Youth (ARACY), Brisbane.
• Malseed, C., Nelson, A., Lander, K. & Lacey, I. 2014, Evaluation of the Deadly Choices School based Health Education Program for Urban Indigenous Young People, ACHPER, Brisbane, 14 August.
• Malseed, C., Lander, K & Lacey, I. 2014, Evaluation of the Deadly Choices School based Health Education program for urban Indigenous young people, presentation to the PHAA 43rd Annual Conference, Perth, 15–17 September 2014.
• Malseed, C., Lander, K & Lacey, I. 2014, Evaluation of the Deadly Choices School based Health Education program for urban Indigenous young people, presentation to the 22nd National Australian Health Promotion Association Conference & 18th Chronic Diseases Network Conference, Alice Springs, 4–5 September 2014.
• Innovations in Aboriginal and Torres Strait Islander Health Symposium