The Black Pearl Network grew out of an appeal for support and partnership by the Gereja Kristen Injili di Tanah Papua (GKI TP) to the Uniting Church of Australia. The appeal was taken up by the Uniting Church Floreat congregation in Perth in 2008 when they sent a small group to visit Papua on an exposure trip in September of that year.

Out of the friendships made and relationships initiated on that visit, the Black Pearl Network grew into a network of concerned people with an interest in Papua and the heart to want to make a difference.

The Black Pearl Papua Foundation employs over 14 staff funded principally by donation from the Black Pearl Network. It has always been our objective to follow the lead and support our Papuan friends.

West Papua, Indonesia currently faces internal conflict to add to the social issues faced by an Indigenous people under Indonesian control.

In 2019, over a quarter of Papua’s population of around 920,000 people was reported to be poor, with 25% of West Papua’s 214,000 people living in poverty. The dearth of research on the health, education and employment outcomes of Indigenous Papuans is due in large part to its being a difficult and risky place to visit (Matik, 2019).

Education is seen by the community as a “ticket out of poverty” but children can’t concentrate or learn if they miss breakfast or have inferior food. A recent study ( Al-faida, 2021) found that more than half of a sample of students in Nabire did not have appropriate breakfast habits.

Nabire continues to host Indigenous children seeking refuge from recent conflict in other regions in Papua: these families face significant changes to their diet. Many children, local and refugee, are malnourished, with significant effects on their education and health. We are concerned that parents have affordable and reliable access to health information, including the effect of changes in diet on their children’s health and the relationship between nutrition, health, and learning.

The Black Pearl Foundation offers English courses to more than 800 students in Papua, including Nabire, thus we are in contact with parents and GKI church groups. BPN is funding a respected and trusted local GP and a health assistant to gather data and provide much-needed education to the community.

Our work in Papua is very consistent with ACU’s mission based on the common good and human dignity. It is vital that the Indigenous peoples of Papua have the same opportunities as the Javanese immigrants. This work helps people strive for self-worth and good and equitable health and education outcomes.

BPN facilitates and funds church communities and language schools which include many families with young children, including those who are internally-displaced due to conflict. We want to determine whether providing nutritional and health information to these families via a trusted medical team is effective, and if so, what information is required, and what are the most appropriate modes of delivery. This requires establishing the baseline awareness of the community and a post-intervention evaluation.

Please note: The Advisory Group to the SESU has recommended that this project will need to be scaled back and appropriately scoped during the project planning phase. For instance, they suggested that we may focus our efforts on understanding the baseline awareness of the community regarding healthy nutritional practices and also the best way of communicating information about nutrition. The Black Pearl Network has been advised of this.

Our objective is to work with BPN staff (in-country) to determine the (local) current nutritional knowledge and practices and relate these to health status and outcomes, and then to co-create resources that will be accepted by and useful to this community.

These resources will include, though not be limited to, information on:

• the nutritional needs of infants, children and pregnant women (as proxy for the entire community)
• why this is important – link between nutrition and health/illness, educational success (eg, students who eat adequate breakfast are better able to concentrate and learn);
• the sorts of foods available and accessible to families that can provide these requirements;
• practical and appropriate ways of preparing and consuming these foods;
• alternative foods
• basic health advice for relevant groups as appropriate (infants, teenagers, pregnant women, elderly)

Community trust in health advice is a valuable and tenuous commodity that has been built over time, thus the BPN in-country team will communicate directly with the families and act as a conduit to the ACU partners. Baseline and post-intervention information will be collected from families at the English language school and/or the church. We expect that this will be via a survey prepared by ACU staff in conjunction with the BPN in-country staff, translated to Bahasa Indonesia and administered by a member of the team. The responses will then be translated back to English for analysis by ACU staff.

ACU staff will provide research and analytical capacity to determine the current nutritional status and the specialist knowledge to inform the development of resources as suggested and guided by BPN in-country staff.

In 2022, a small number of Faculty of Health Science students in Community Engagement (CE) units participated in a Uniservitate-funded pilot program to create sample resources for evaluation by the BPN in-country team. There is the potential that ACU students in relevant CE units could participate further in this project, thus enriching their understanding of ways in which their discipline knowledge can benefit vulnerable communities globally. ACU staff who are involved with some of these units (Dr Sharon Croxford, Dr Alison Hughes, Ms Laurine Hurley) are supportive of participation by their students.

Please note: The Advisory Group to the SESU has recommended that this project will need to be scaled back and appropriately scoped during the project planning phase. For instance, they suggested that we may focus our efforts on understanding the baseline awareness of the community regarding healthy nutritional practices and also the best way of communicating information about nutrition. The Black Pearl Network has been advised of this. The feasibility of the involvement of community engagement students as suggested here in their proposal will need to determined at a later stage in the planning process.

Our primary aim is for these communities to increase their understanding of the relationship between nutrition and health, and to learn how to best use the foods available to them, resulting in both short- and long-term improvements in health outcomes. We want to encourage parents to incorporate local foods into their children’s diet rather than resorting to high use of sugar, processed foods such as rice and Western fast foods as now increasing in major centres.

The BPN team is seen as an authoritative and trusted voice, so as material provided by them is accepted and disseminated, the community’s corporate knowledge would increase, and ideally community members would collate, share and distribute recipes, hints etc as they build self-reliance and confidence in seeking broader health care information.

We hope that children’s capacity to learn English will improve through better nutrition, and that this project will help to improve concentration in their general school classes as well as our English classes, leading to better educational and employment outcomes.

Maintaining and developing the mutually-respectful relationship between BPN and ACU that arose from the Uniservitate project (above) is also a key desired outcome for this project, as it is hoped that there will be a continuing role for Community Engagement involvement by students and staff. As such, the BPN would be encouraged to seek partnerships with other Australian universities, given its ‘hands on’ relationship with our closest international neighbour.

This is a model project which has great potential to be applied in other Centres across Papua.

Dr Robert Hoskin will lead the project for the Black Pearl Network. He has over twenty years experience with indigenous communities and has been a sessional teacher in Core at ACU. The BPN has a range of people with business, nursing, and other health related skills, and translation skills. The BPN (Australia) has a long-term relationship and experience with the people of Papua through our partnership with the BPPF. As indicated above, this project was initiated by the manager of BPPF. Fred Bundah, and his wife Dr Marey who is now employed to begin this work in Nabire. Dr Robert Hoskin has facilitated conversations in the initial project involving Laurine Hurley at ACU and will continue in this role. The BPPF (Papua) will employ a nurse to interview and collect the appropriate information.

Over 48,000 babies are admitted to Neonatal Intensive Care Units or Special Care Nurseries every year and premature birth is the most common cause of sickness and death in newborn babies.

Life’s Little Treasures Foundation (LLTF) is Australia’s leading charity dedicated to providing practical support and crucial information and connection to families of babies born prematurely or sick. LLTF services are available in 149 hospitals (NICU - Neonatal Intensive Care Units and SCN - Special Care Units) across Australia and in the community when families come home.

Founded in 2005 by parents who went through this traumatic experience themselves, LLTF supports families through pregnancy, birth and into the early years of childhood, and proudly addresses the wellbeing of the whole family which ensures children get the best possible start in life.

Resources created to benefit parents include our Special Care Nursery (SCN) Parents’ Handbook, Precious Prem Packs with information and beautiful items for baby, and tip sheets for family/ friends. Our services include NICU Connections peer support programs in hospitals and online, providing access to ‘veteran’ parents therefore reducing stress and alleviating concerns through storytelling and sharing.

For 18 years Life’s Little Treasures Foundation (LLTF) has supported families of premature and sick babies. From humble beginnings, today LLTF provides products and services to 20,000 families by working with 150 hospitals across Australia.

LLTF’s Mission is to provide families, their support networks and health providers with the tools to ensure optimal outcomes for families of premature and sick babies.

To ensure we are providing tools that enable optimal outcomes, LLTF seeks the assistance of ACU to create a research framework for LLTF’s four main products and services (P&S). For these P&S we have only ever conducted adhoc surveys to ascertain feedback from families and health professionals in the past. We have had limited responses and have not been able to get a very clear picture of the need for our P&S.

This proposed new framework and the subsequent research conducted will enable LLTF to be continuously assessing and ‘tweaking’ our P&S to ensure we are providing what families truly need. The four main P&S at LLTF are;

• Guidebooks for families in NICU and SCN - We provide two guidebooks; One is for families in the Neonatal Intensive Care Unit (NICU) and the other is for families in the Special Care Nursery. These guidebooks have over 100 pages of information.
• NICU Connections - in Hospital and at Home - We have developed two support groups for parents, one in hospital when first navigating NICU/SCN, and one for when parents are discharged. Both groups are run through closed facebook groups to offer a safe space to connect. LLTF are also starting to return to hospitals and will be running up to 10 NICU Connections groups face to face.
• Precious Prem Packs - To help parents through their time in NICU and SCN, we have developed the ‘Precious Prem Pack’ to provide practical support, information and beautiful items for baby.
• Little Bag of Calm - with tips, tools and activities all aimed at encouraging parents to take a moment for Self-Care.

The three main questions that need to be answered by this research project are;

1. What is the best framework/model to adopt for evaluation that will provide the most accurate research results for LLTF’s four main products and services?
2. Exactly what do families believe optimal outcomes for their families look like?
3. With each of these products is LLTF helping parents reach optimal outcomes? E.g, by providing information guidebooks do parents feel more confident to advocate for their baby therefore delivering optimal outcomes.

There are a number of desired objectives for LLTF from creating an evaluation framework and conducting subsequent research according to that framework.

Firstly, by conducting robust research, with theories and a framework enforcing it, the team at LLTF will be confident in the results of the research. Rather than questioning our internal results from adhoc research we will know the new process of evaluation has theory and documented reasoning behind it. If anyone from our community or an organisation asks about LLTF’s research we will be able to say confidently why we chose to conduct research a certain way.

By analysing our four main P&S and receiving feedback, the data captured enables us to ensure we are delivering exactly what parents who have had a premature or sick baby need at this traumatic time. When the results are in, if we need to make tweaks or changes to P&S we will have the data to confirm this is needed. This will make communicating any changes to our Board of Directors, our community and our Partners much easier.

LLTF is not government funded and relies on fundraising to deliver all our P&S. Transparent data and results from research in collaboration with a third party - ACU, means we are in a position to convincingly communicate our impacts to government, philanthropic trusts and other funders. Government in particular want to know statistics and having results to communicate how much our P&S are needed assists with advocacy for funding for LLTF.

Our Vision
To be Australia's leading provider of critical information, education, and community support to ensure optimal outcomes for families who have had the life-changing experience of having a premature or sick baby. To meet this vision we need clarity around what optimal outcomes for families really look like which will be documented by this research. Whilst ‘optimal outcomes’ are different for all families this research ensures we will have a clearer picture of what this means for our community.

The first outcome of a new evaluation framework created for the team at LLTF means we can share with confidence results of our impact with Government, funders, partners and the community. This will lead to increased income for LLTF ensuring our longevity. This will inturn ensure we meet our our vision of being recognised as ‘Australia’s leading provider’ for families with prem/sick babies.

The outcome of the first set of data using the framework means we can start to document performance annually and feel confident we are providing what parents need in ensuring optimal outcomes for their families. Using the findings to ‘tweak’ products and services (if necessary) will ensure we are continually supplying the tools needed by the community and that we are always aligned with the needs of families.

Outputs desired from this body of work include;

• The entire team at LLTF become more research savvy and better able to talk to results and outcomes.
• An annual research project plan for LLTF to monitor and gauge the success of these products and services.
• A report that can be shared with the community about the results from the first questionnaires/surveys and interviews using the new evaluation model.
• LLTF would like to take the results and create some information graphics to be shared with our hospitals across the country so they understand how beneficial these products and services are to parents. We would then hope more resources are distributed and more health professionals encourage parents to join our NICU Connections events and sign up for new activities moving forward.

Life’s Little Treasures Foundation would be in a position to fund $10,000 towards this research project. We would expect these funds to be used to pay for interviewing, sampling, data analysis and the researchers time writing the final report.

As part of the collaboration we would also be in a position to provide;

• Access to our Boardroom in Ringwood for interviews or focus groups
• A staff lead to help with project management and implementation
• Administrative support provided by your organisation to collate reports on numbers of users, demographics etc. from existing data
• Access to our community of families and health professionals for testing, feedback and the final research.
• Volunteer assistance to help with researching competitors, other research that is relevant and whatever else the researcher deems helpful.
• LLTF would also be able to provide a graphic designer for assisting with presentation of the final report and infographics.
• LLTF is also committed to ensuring the framework created is adopted by LLTF moving forward and results from following years are shared with ACU researchers.

St Vincent’s Hospital Melbourne (SVHM) is a tertiary public healthcare service. We provide a range of services, including acute medical and surgical services, emergency and critical care, aged care, diagnostics, rehabilitation, allied health, mental health, palliative care and residential care. We work with an extensive network of collaborative partners to deliver high quality treatment, teaching, education and research. We have more than 7,000 staff and 880 beds in daily use across our services.

Our mission
As a Catholic health and aged care service, our mission is to bring God’s love to those in need through the healing ministry of Jesus. We are especially committed to people who are poor or vulnerable. We draw on the talents of our people and collaborate with others who share our vision and values to continue the pioneering spirit of Mary Aikenhead and the Sisters of Charity. We are committed to providing compassionate and innovative care, enabling hope for those we serve.

Our vision
To lead transformation in health care inspired by the healing ministry of Jesus.

Our values
Our values of compassion, integrity, justice and excellence underpin all we do and are demonstrated through our everyday actions, giving our mission life.

Persons experiencing homelessness (PEH) endure significant health inequalities, high rates of morbidity and premature mortality. In addition, they are known to be frequent users of hospital services, with high rates of co-occurring physical, mental health and substance use issues. Access to traditional healthcare services is an ongoing challenge for this cohort owing to a range of systemic, structural and individual factors.

St Vincent’s Hospital Melbourne (SVHM) recognised the need for a more flexible approach to providing healthcare to PEH. During the latter part of 2022, SVHM Healthcare for the Homeless Department spent time scoping the local landscape and undertaking a current state analysis to understand how a Mobile Health and Outreach Service (MHOS) could be of benefit to the local community. A Model of Care was developed based on the gap analysis with the MHOS commencing service provision in March 2023.

Staffed by care coordinators (nurses and allied health), a lived experience worker and a harm reduction worker, the MHOS operates Monday to Friday from 8:30am – 5pm with the capacity for expansion. The mobile van visits local services who provide housing and welfare support to PEH, for example, the Salvation Army at 614 Bourke Street.

The MHOS aims to bring high quality healthcare to priority populations, especially PEH, who face barriers to accessing basic healthcare, so that they experience improved health and wellbeing.

Based on the underlying principle of ensuring equity of access to healthcare for all, the MHOS delivers care that is consumer led, trauma informed and culturally safe. It is governed by the Integrative Practice Framework which draws on principles of trauma informed care and a person-centred approach.

This service model is congruent with recommendations from State and National policy frameworks and aligns closely with the identity and purpose of SVHM.

An evaluation of the Mobile Health and Outreach Service for the purpose of understanding:

1. To what extent the program was implemented in line with the model of care including challenges and enablers?
2. Who received care through the program?
3. How satisfied clients were with the program?
4. For whom are outcomes (short and medium term) being achieved, in what ways and in what circumstances?
5. How the program can be enhanced and scaled?

The aim of the MHOS is to bring high quality healthcare to priority populations, especially PEH, who face barriers to accessing basic healthcare, so that they experience improved health and wellbeing.

Below identifies the research questions, likely data sources and methods for data extraction. We would be seeking SESU support to work through this proposal and adapt it to ensure our evaluation plan aligns with our evaluation research questions.

To what extent the program was implemented in line with the model of care including challenges and enablers?

Data Sources:

• Model of Care document
• Program staff
• Patient Administration System (PAS)
• Medical Records Online (MRO)

Methods:

• Data extraction by SVHM project lead
• Staff surveys

Who received care through the program?

Data sources:

• PAS

Methods:

• Data extraction by SVHM project lead

How satisfied clients were with the program?

Data sources:

• MHOS clients

Methods:

• Client interviews

For who are outcomes (short and medium term) being achieved, in what ways and in what circumstances?

Data sources:

• PAS
• MRO care plans
• Program staff
• MHOS clients

Methods:

• Data extraction by SVHM project lead
• Staff surveys
• Client interviews 

How the program can be enhanced and scaled?

Data sources:

• Program and leadership staff

Methods:

• Staff surveys

Through undertaking an evaluation of the MHOS during its first year in operation, we seek to understand:

• The process of implementation and it’s alignment or deviation from the documented model of care
• Derive learnings that are meaningful to enable more streamlined implementation for future similar services
• Identify areas for expansion through better understanding the population who are accessing the service in the local area; this understanding could support targeted outreach/intervention to clients whom the program may not yet have reached
• How satisfied clients are with the service, why they are or are not satisfied with it and therefore how the program can be improved to better meet client needs
• Whether clients are on a trajectory to improve their health and wellbeing. This will support identification of whether MHOS is on track to meet the programs longer term aim of improving the health and wellbeing of clients utilising the MHOS program
• Recommendations regarding future expansion of the program. Ideally this would include client, service and organisational perspectives. These recommendations would support program investment decisions, determine if expansion of program hours would enhance client outcomes as well as identify where SVHM should concentrate efforts with regards to partnership growth
• An evaluation report with a supporting presentation would be valuable outputs. The evaluation report and presentation will be shared with SVHM program staff, governance and executive, partner agencies and will be used to support future service planning activities and to promote the service.

Yes. Aboriginal and Torres Strait Islander people are over-represented in the PEH population. First Nations clients make up 0.5 per cent of the population in the St Vincent’s Hospital’s surrounding local government areas, however First Nations people comprise 16 per cent of ED presentations for people experiencing homelessness.

Registry Week data collected since 2010 in Melbourne using the Vulnerability Index Tool similarly identifies an average of 15.3% of the rough sleepers in the Melbourne CBD area are of Aboriginal or Torres Strait Islander background.

It is anticipated the MHOS service will work closely with SVHM Aboriginal identified staff and with Aboriginal health, housing and support agencies to ensure service cultural safety and to link with the most appropriate ongoing services for service users.

At SVHM we are closely integrated with the Aboriginal Health Liaison Officers and would seek to include them as part of the evaluation team.

The SVHM project lead is the Senior Research and Evaluation Officer with the Healthcare for the Homeless Department. With growing experience in the evaluation space, the project lead will be able to offer support with project design, ethics applications, implementation, data extraction and reporting.

Skills or experience we are seeking assistance from ACU: We are seeking ACU support with identifying staff who are skilled at program evaluation. More specifically, we are seeking ACU to lead the evaluation as the Principal Investigator with SVHM contributing as an Associate Investigator.