Effectiveness of ear, nose and throat outreach programmes for Aboriginal and Torres Strait Islander Australians: a systematic review

Anna Gotis-Graham; Rona Macniven; Kelvin Kong; Kylie Gwynne

doi:10.1136/bmjopen-2020-038273

Effectiveness of ear, nose and throat outreach programmes for Aboriginal and Torres Strait Islander Australians: a systematic review

BMJ Open. 2020 Nov 26;10(11):e038273. doi: 10.1136/bmjopen-2020-038273.

Authors

Anna Gotis-Graham^{1

2}, Rona Macniven^{3

2

4

5}, Kelvin Kong⁶, Kylie Gwynne^{1

2

5}

Affiliations

¹ Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia.
² Sydney Medical School, University of Sydney Poche Centre for Indigenous Health, Camperdown, New South Wales, Australia.
³ Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia r.macniven@unsw.edu.au.
⁴ School of Population Health, The University of New South Wales, Sydney, New South Wales, Australia.
⁵ School of Medicine and Public Health, The University of Newcastle, New Lambton Heights, New South Wales, Australia.
⁶ The University of Newcastle, John Hunter Hospital, Newcastle, New South Wales, Australia.

Abstract

Objective: To examine the ability of ear, nose and throat (ENT) outreach programmes to improve health outcomes among Aboriginal and Torres Strait Islander people.

Methods: We conducted a systematic literature search of nine databases (Medline, CINAHLS, PsycINFO, Embase, Cochrane, Scopus, Global health, Informit Rural health database and Indigenous collection) and grey literature sources for primary studies evaluating ENT outreach services for Aboriginal and Torres Strait Islander people. This review included English language studies of all types, published between 2000 and 2018, that supplied ENT outreach services to Aboriginal and Torres Strait Islander Australians and provided data to evaluate their aims. Two authors independently evaluated the eligible articles and extracted relevant information. Risk of bias was assessed using the Mixed Methods Assessment Tool.

Results: Of the 506 studies identified, 15 were included in this review. These 15 studies evaluated eight different programs/activities. Studies were heterogeneous in design so a meta-analysis could not be conducted. Seven studies measured health-related outcomes in middle ear or hearing status; six reported overall positive changes one reported no clinically significant improvements. Five programmes/activities and their corresponding studies involved Aboriginal and Torres Strait Islander people and organisations in delivery and evaluation, but involvement in programme or study design was unclear.

Conclusion: While some studies demonstrated improved outcomes, the overall ability of ENT programmes to improve health outcomes for Aboriginal and Torres Strait Islander children is unclear. The impact of ENT outreach may be limited by a lack of quality evidence, service coordination and sustainability. Community codesign and supporting and resourcing local capacity must be a component of outreach programmes and ongoing evaluation is also recommended. Improvements in these areas would likely improve health outcomes.

Prospero registration number: CRD42019134757.

Keywords: community child health; oral medicine; public health.

Publication types

Systematic Review

MeSH terms

Australia
Child
Humans
Native Hawaiian or Other Pacific Islander*