A hospital-based behaviour change intervention to improve immunisations and access to health checks for Aboriginal and Torres Strait Islander infants — The Association Specialists
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  3. A hospital-based behaviour change intervention to improve immunisations and access to health checks for Aboriginal and Torres Strait Islander infants

A hospital-based behaviour change intervention to improve immunisations and access to health checks for Aboriginal and Torres Strait Islander infants (23826)

Natalie Strobel 1 , Daniel Christensen 1 , Kimberley McAuley 1 2 , Karen Edmond 3 , Peter Jacoby 4 , Dan McAullay 1 , Derek C Swe 1
  1. Edith Cowan University, Perth, WA, Australia
  2. Te Whatu Ora Health New Zealand Southern, Dunedin, Otago, New Zealand
  3. Kings College, London, United Kingdom
  4. The Kids Research Institute, Perth, WA, Australia

Background: Timely access to primary health care services is critical for improving health outcomes for Aboriginal and Torres Strait Islander (Aboriginal) infants. In Australia, continuity of care from hospital to community services remains challenging. Hospital discharge practices represent an important opportunity to support Medicare enrolment, and access to child health checks. This study evaluated whether a hospital‑based behaviour change intervention delivered to maternity staff improved access to child health services.

Methods: A quasi‑experimental study was conducted in Western Australia between January 2016 - June 2018. The intervention was implemented in five hospitals and focused on strengthening discharge planning through staff training, feedback, and continuous quality improvement strategies. Aboriginal infants born in intervention hospitals during the intervention period were compared with infants born in the same hospitals during the preceding six months. Outcomes were assessed using linked administrative data from the Medicare Benefits Schedule and the Australian Immunisation Register. Outcomes included Medicare enrolment within three months of birth, child health assessments and follow‑up appointments, hepatitis-B vaccination within eight days of birth, and on‑time receipt of two‑month vaccinations. Conditional logistic regression was used to estimate intervention effects.

Results: There were 383 infants (192 intervention; 191 control), with similar baseline characteristics between groups. Over 85% of infants in both groups were enrolled in Medicare and received on‑time two‑month vaccinations. Attendance at non‑government child health services was low in both groups (5%). There was little evidence that the intervention improved any outcomes after adjustment for demographic and geographic factors.

Conclusion: This hospital‑based behaviour change intervention did not improve Medicare enrolments and early immunisation beyond already high baseline levels. Findings highlight strong overall coverage for Medicare enrolment and two‑month vaccinations, alongside persistent gaps in birth hepatitis B vaccination and child health service use, indicating system‑level data capture and service access issues.