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Original research
What was the impact of a participatory research project in Australian Indigenous primary healthcare services? Applying a comprehensive framework for assessing translational health research to Lessons for the Best
  1. Shanthi Ann Ramanathan1,2,
  2. Sarah Larkins3,
  3. Karen Carlisle3,
  4. Nalita Turner3,
  5. Ross Stewart Bailie4,
  6. Sandra Thompson5,
  7. Roxanne Bainbridge6,
  8. Simon Deeming2,
  9. Andrew Searles2
  1. 1Health Research Economics, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
  2. 2School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
  3. 3College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
  4. 4The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
  5. 5University of Western Australia, Western Australian Centre for Rural Health, Geraldton, Western Australia, Australia
  6. 6Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Sciences, Central Queensland University, Cairns, Queensland, Australia
  1. Correspondence to Dr Shanthi Ann Ramanathan; shanthi.ramanathan{at}


Objectives To (1) apply the Framework to Assess the Impact from Translational health research (FAIT) to Lessons from the Best to Better the Rest (LFTB), (2) report on impacts from LFTB and (3) assess the feasibility and outcomes from a retrospective application of FAIT.

Setting Three Indigenous primary healthcare (PHC) centres in the Northern Territory, Australia; project coordinating centre distributed between Townsville, Darwin and Cairns and the broader LFTB learning community across Australia.

Participants LFTB research team and one representative from each PHC centre.

Primary and secondary outcome measures Impact reported as (1) quantitative metrics within domains of benefit using a modified Payback Framework, (2) a cost-consequence analysis given a return on investment was not appropriate and (3) a narrative incorporating qualitative evidence of impact. Data were gathered through in-depth stakeholder interviews and a review of project documentation, outputs and relevant websites.

Results LFTB contributed to knowledge advancement in Indigenous PHC service delivery; enhanced existing capacity of health centre staff, researchers and health service users; enhanced supportive networks for quality improvement; and used a strengths-based approach highly valued by health centres. LFTB also leveraged between $A1.4 and $A1.6 million for the subsequent Leveraging Effective Ambulatory Practice (LEAP) Project to apply LFTB learnings to resource development and creation of a learning community to empower striving PHC centres.

Conclusion Retrospective application of FAIT to LFTB, although not ideal, was feasible. Prospective application would have allowed Indigenous community perspectives to be included. Greater appreciation of the full benefit of LFTB including a measure of return on investment will be possible when LEAP is complete. Future assessments of impact need to account for the limitations of fully capturing impact when intermediate/final impacts have not yet been realised and captured.

  • impact assessment
  • indigenous primary healthcare
  • continuous quality improvement
  • capacity strengthening

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  • Contributors SAR and AS drafted the manuscript. SL and KC sourced the required data and provided considerable support in the preparation of the manuscript. SL, KC, ST, RSB, NT, RB and SD reviewed drafts of the manuscript and provided feedback. All authors reviewed the final version approved for submission.

  • Funding This work was funded by a competitive Australian National Health and Medical Research Council Centre (NHMRC) Centre of Research Excellence Grant (GNT ID 1078927). The work being assessed (LFTB and LEAP) was funded by an NHMRC Project Grant (GNT ID 1062377) and an NHMRC Partnership Grant (GNT ID 1148660), respectively.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The impact study received ethics approval from the University of Newcastle’s Human Research Ethics Committee (Ethics ID: H-2017-0026). Interviews with the PHC staff, conducted later in 2019, were covered by an additional approval from the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (Ethics ID: 2018-3156).

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

  • Data availability statement No data are available.