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Combined networks - Aboriginal child health project - Shake-a-leg

This is a collaborative project of the three Child Health Networks of NSW.

Aims and Objectives

This project aims to reduce morbidity for targeted preventable health conditions in Aboriginal children:

  • Through the provision of appropriate information to teach students, teachers and parents about preventive health methods
  • Strengthen the health knowledge of students, parents and teachers
  • Build expertise to improve health outcomes for Aboriginal children and their family
  • Improve the health behaviours and attitudes of students, teachers and parents through health lesson with students and teachers and health fact cards to parents

Description of Project

Indigenous Australians in general are the least healthy of all indigenous populations within comparable developed countries and have a significantly lower level of access to appropriate health care than non-indigenous Australians.

As stated in the National Strategic Framework for Aboriginal and Torres Strait Islander Health, its goal is to ensure that Aboriginal and Torres Strait Islander peoples enjoy a healthy life equal to that of the general population that is enriched by a strong living culture, dignity and justice. This requires concerted action both across and beyond the health sector to address the complex and inter-related factors that contribute to the causes and persistence of health problems amongst Aboriginal and Torres strait Islander peoples. Two of the main principles of the framework are:

  • Improving the health of Aboriginal and Torres Strait Islander individuals and communities is a core responsibility and a high priority for the whole of the health sector. Making all services responsive to the needs of Aboriginal and Torres Strait Islander peoples will provide greater choice in the services they are able to use.
  • Recognising that health promotion and illness prevention is a fundamental component of comprehensive primary health care and must be a core activity for specific and mainstream health services.

One of the aims of the Framework is to strengthen the service infrastructure essential to improving access by Aboriginal and Torres Strait Islander People to health services and responding to:

  • Communicable disease, particularly infections in children
  • Child and maternal health

A greater range and quality of research about the health of Aboriginal and Torres Strait Islander peoples is needed with a focus on interventions to improve health outcomes. Where possible, data collection activities should be linked at all levels of government between health services, housing agencies and other community and welfare programs to facilitate a cross-sectoral approach and support preventative and environmental health activities.

In the NSW Aboriginal Health Strategic Plan Conceptual Framework, key priorities are:

  • Improving access to health services
  • Addressing identified health issues
  • Increasing the effectiveness of health promotion
  • Creating an environment supportive of good health

This is in line with the expected outcome of accessible, culturally appropriate and quality services and programs.

Recognising the need for disease prevention in maternal, infant and child health is one of the areas identified in this document.

The Australian Bureau of Statistics 2003 states that around 40 % of the Indigenous populations under the age of 15. The population declines steadily after the age of 9 years.

Consultation with local Aboriginal communities in 2000 identified health education and promotion as a high priority for young people. Hunter New England Area Health Service (AHS) - Aboriginal Health in partnership with Awabakal Medical Service (AMS) have developed a school based Aboriginal Health Promotion Package “Shake a leg”.

The program utilises existing resources some specific to Aboriginal People others are mainstream resources delivered in a culturally sensitive way. The program is delivered by Aboriginal Health workers both from the AHS and AMS. Staff are trained and time tabled according to the topic and the expertise of staff.

The program is delivered in 40 minute sessions, 1 session per week for 10 weeks. It is written to meet key content areas of the school curriculum in Physical Education, Personal Development, Health and Welfare.

The program is structured so that it has a Primary and Secondary focus. The content is age appropriate. Issues covered include Oral Health, Otitis Media, Hygiene, Nutrition and Physical Activity.

This programme has been trialled at pilot sites across NSW utilising a project officer/trainer who would also liaise with the local Aboriginal Medical Service and the Dept of Education. A formal evaluation was attended.

Expected Outcomes

The expected outcomes are that:

  • Aboriginal communities will have a better understanding of disease processes and prevention and how to continue effective ongoing care for children by empowering the children with early intervention strategies to share in the home environment in the target group.
  • Greater understanding of health prevention strategies for teachers, parents and students
  • Long-term better health outcomes, and confidence for children, parents and carers and other key people who interact with children on a regular basis eg schools.

Performance indicators

The following performance indicators were used to measure the success of the project:

  • Teacher Student Satisfaction with the programme
  • Decreased incidence in communicable disease, particularly skin infection and scabies
  • Consumer participation
  • Audit of children’s knowledge
  • Formal evaluation of the programme


Teacher Student Satisfaction with the programme

Infants survey total (170)
Students satisfaction (86) stating the overall workshop/program was very good =56 (65.2%), good=28 (32.5%), poor=2 (2.3%)
Teachers Evaluation (144) with the scores being - excellent 65 (45.15%), Good 78 (54.15%), poor =1 (0.7%)
Parents Evaluation (73)

Decreased incidence in communicable disease, particularly skin infection and scabies

Given the constraints (ie time, resources, money and staff) an outcome such as this is not realistic. This was discussed at the steering committee meeting on 7 December, where it was agreed that the program would not attempt to meet this outcome. Such factors as human resources, environment factors, ethical approval etc.

Consumer participation

Worked in partnership with - Awabakal Medical Service, Kempsey Community Health, Durri Medical Service, Bourke Community Health, Bourke Aboriginal Medical Service, Wanders Aboriginal Outreach.

Seven schools participated in the Shake A Leg program from June 30 - December 31 2007. This included completing the 10 weeks/sessions of Shake a Leg program including Chifley Public for 2 session of Shake a Leg.


Kinchela Public - Term 3
Years K-2, 10 students

Milbank Public - Term 3
Years 3-6, 14students

Karuah Public 07 - Term 3
Year K, 17 students

Chifley Public School 07 - Term 3
Years 3 - 6, 12 students

Fennel Bay Public 07 - Term 3
Years 3 and 4, 30 students

Windale Public 07 - Term 3and4
Years 5 and 6, 25 students

St Ignatius Catholic 07 - Term 4
Years 3 and 4, 17 students

Audit of children’s knowledge

The audit has been conducted with Pre and Post Surveys collected by infants to date - 170. These results are included in the End of Year Report (pdf 188K).

Formal evaluation of the programme

An evaluation model was developed in consultation with experienced HNEPH staff. A data entry program was developed and continues to have completed surveys entered. Results are included in the End of Year Report (pdf 188K) for December 2007


An evaluation database has been set up to enter completed surveys (continuing process).

Due to the low number of non-clinical health workers - we are shifting more attention to training up more community members to deliver the program, not only in the schools but also the community.

Term 3 and 4 saw three community members complete the Shake-a-Leg program, with one Community member presenting a session on personal hygiene. These members will continue the Shake-a-Leg program next year at Windale Public School.

Leanne Crittenden presented and showcased the Shake-a-Leg DVD at the Changing Our Spots: Adapting to Lifestyle Trends Conference.

A Shake a Leg information workshop was held at Tamworth on December 13 for all Aboriginal Health Workers across HNE with great success and feedback.

The Shake a Leg DVD has been completed and is used as a promotional tool for Communities and Health workers as well as Schools.


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