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Public health
Protocol
Opportunistic screening to detect atrial fibrillation in Aboriginal adults in Australia
  1. Kylie Gwynne1,2,
  2. Yvonne Flaskas1,3,
  3. Ciaran O'Brien1,4,
  4. Thomas Lee Jeffries1,4,
  5. Debbie McCowen5,
  6. Heather Finlayson6,
  7. Tanya Martin1,7,
  8. Lis Neubeck7,8,
  9. Ben Freedman4,8
  1. 1Poche Centre for Indigenous Health, The University of Sydney, Camperdown, New South Wales, Australia
  2. 2Faculty of Health Sciences, The University of Sydney, Camperdown, New South Wales, Australia
  3. 3Faculty of Dentistry, The University of Sydney, Westmead, New South Wales, Australia
  4. 4Sydney Medical School, The University of Sydney, Camperdown, New South Wales, Australia
  5. 5Armajun Aboriginal Health Service, Inverell, New South Wales, Australia
  6. 6Brewarrina Multipurpose Service, Brewarrina, New South Wales, Australia
  7. 7Sydney Nursing School, The University of Sydney, Camperdown, New South Wales, Australia
  8. 8Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Kylie Gwynne; kylie.gwynne{at}sydney.edu.au

Abstract

Introduction There is a 10-year gap in life expectancy between Aboriginal and non-Aboriginal Australians. The leading cause of death for Aboriginal Australians is cardiovascular disease, including myocardial infarction and stroke. Although atrial fibrillation (AF) is a known precursor to stroke there are no published studies about the prevalence of AF for Aboriginal people and limited evidence about AF in indigenous populations globally.

Methods and analysis This mixed methods study will recruit and train Aboriginal health workers to use an iECG device attached to a smartphone to consecutively screen 1500 Aboriginal people aged 45 years and older. The study will quantify the proportion of people who presented for follow-up assessment and/or treatment following a non-normal screening and then estimate the prevalence and age distribution of AF of the Australian Aboriginal population. The study includes semistructured interviews with the Aboriginal health workers about the effectiveness of the iECG device in their practice as well as their perceptions of the acceptability of the device for their patients. Thematic analysis will be undertaken on the qualitative data collected in the study. If the device and approach are acceptable to the Aboriginal people and widely adopted, it may help prevent the effects of untreated AF including ischaemic stroke and early deaths or impairment in Aboriginal people.

Ethics and dissemination This mixed methods study received ethics approval from the Aboriginal Health and Medical Research Council (1135/15) and the Australian Health Council of Western Australia (HREC706). Ethics approval is being sought in the Northern Territory. The findings of this study will be shared with Aboriginal communities, in peer reviewed publications and at conferences. There are Aboriginal investigators in each state/territory where the study is being conducted who have been actively involved in the study. They will also be involved in data analysis, dissemination and research translation.

Trial registration number ACTRN12616000459426.

  • PUBLIC HEALTH

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-013576

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    Footnotes

    • Twitter Follow kylie gwynne at @kyleis43

    • Contributors KG, BF, LN, HF, DMcC, TM and YF designed the study. KG, YF and BF secured the funding for the trial. KG, YF, TLJ, CO'B and BF handled the ethical approval regarding the trial. KG was also involved in preparing of the manuscript and registered the trial. All authors reviewed and approved the final manuscript.

    • Funding This work was supported by the Poche Centre for Indigenous Health at the University of Sydney and a 2016 Heart Foundation Vanguard Grant (101059). In-kind support is provided by Poche Centres for Indigenous Health in Western Australia and Northern Territory, the Charles Perkins Centre at the University of Sydney, Sydney Medical School and Armajun Aboriginal Health Service. Additional funding is from an anonymous charitable foundation.

    • Competing interests BF has received research grants to conduct investigator-initiated studies by BMS/Pfizer, Bayer Pharma and Boehringer-Ingelheim, consultant for Bayer Pharma, BMS/Pfizer, Boehringer-Ingelheim, Servier, Astra-Zeneca and Gilead, and speaker for Bayer Pharma, BMS/Pfizer, AstraZeneca. LN has received grants and honoraria from Pfizer BMS, Boehringer Ingelheim and Bayer outside the submitted work.

    • Ethics approval Ethics approval has been granted for the NSW study through the Aboriginal Health and Medical Research Council (1135/15) and Western Australia by the Australian Health Council of Western Australia (HREC706).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All de-identified data will be shared with all investigators on the study.