Understanding burn injuries in Aboriginal and Torres Strait Islander children: protocol for a prospective cohort study

Abstract

IntroductionAlthough Aboriginal and Torres Strait Islander children in Australia have higher risk of burns compared with non-Aboriginal children, their access to burn care, particularly postdischarge care, is poorly understood, including the impact of care on functional outcomes. The objective of this study is to describe the burden of burns, access to care and functional outcomes in Aboriginal and Torres Strait Islander children in Australia, and develop appropriate models of care.Methods and analysisAll Aboriginal and Torres Strait Islander children aged under 16 years of age (and their families) presenting with a burn to a tertiary paediatric burn unit in 4 Australian States (New South Wales (NSW), Queensland, Northern Territory (NT), South Australia (SA)) will be invited to participate. Participants and carers will complete a baseline questionnaire; follow-ups will be completed at 3, 6, 12 and 24 months. Data collected will include sociodemographic information; out of pocket costs; functional outcome; and measures of pain, itch and scarring. Health-related quality of life will be measured using the PedsQL, and impact of injury using the family impact scale. Clinical data and treatment will also be recorded. Around 225 participants will be recruited allowing complete data on around 130 children. Qualitative data collected by in-depth interviews with families, healthcare providers and policymakers will explore the impact of burn injury and outcomes on family life, needs of patients and barriers to healthcare; interviews with families will be conducted by experienced Aboriginal research staff using Indigenous methodologies. Health systems mapping will describe the provision of care.Ethics and disseminationThe study has been approved by ethics committees in NSW, SA, NT and Queensland. Study results will be distributed to community members by study newsletters, meetings and via the website; to policymakers and clinicians via policy fora, presentations and publication in peer-reviewed journals.

Indigenous Research Methods: A Systematic Review

“…CBPR has been used to facilitate initiatives related to photovoice (Castleden et al, 2008), story-telling (Christensen, 2012), multi-method research including focus groups (Garakani, 2014), semi-structured interviews (Cameron et al, 2014;Ivers et al, 2015), web-based surveys (Fox et al, 2011), yarning (Russell-Mundine, 2007, and other mixed-method approaches (Le & Gobert, 2015). The adaptability of CBPR values has been praised as a way to ensure research is completed in accordance with local norms and customs of communities through their chosen research method (Christensen, 2012).…”

Indigenous and non‐Indigenous Australian children hospitalised for burn injuries: a population data linkage study

“…Indigenous Australian children are disproportionally affected: they are more than twice as likely to be hospitalised for a burn injury as non‐Indigenous children, and mortality is five times as high 2 . ‐ 4 Despite this high burden, little is known about the characteristics of burn injuries to Indigenous children or whether they differ from those to non‐Indigenous children 5 …”

Reducing the incidence of burn injuries to Indigenous Australian children

“…The authors also found that the proportion of burn injuries affecting more than 20% of total body surface area (TBSA) was greater for Indigenous than for non‐Indigenous children, as was that of burns to the feet or ankles; that the incidence of being treated in a tertiary burns facility was lower and their median overall hospital stay longer for Indigenous children; and that they were less likely to undergo surgery, but more frequently received treatment from allied health professionals. This important epidemiological study not only supports the hypothesis that burn injuries constitute a significant health burden in Indigenous children, it is also the prelude to a much larger prospective study 5 . Paediatric burns services throughout Australia are currently collaborating in a study funded by the National Health and Medical Research Council to examine the journey of the Indigenous child with a burn injury through the health system, including pre‐hospital care and outpatient follow‐up 5 …”

“…This important epidemiological study not only supports the hypothesis that burn injuries constitute a significant health burden in Indigenous children, it is also the prelude to a much larger prospective study 5 . Paediatric burns services throughout Australia are currently collaborating in a study funded by the National Health and Medical Research Council to examine the journey of the Indigenous child with a burn injury through the health system, including pre‐hospital care and outpatient follow‐up 5 …”