Optimising Health and Learning

Transcription

1 Optimising Health and Learning Health screening in Intensive English Centres July 2013 A/Prof Karen Zwi Community Paediatrician, Community Child Health, Sydney Children's Hospitals Network Lisa Woodland Program Manager, Multicultural Health Service, South Eastern Sydney Local Health District

2 Project Aim Aim: To improve health and educational outcomes in refugee and other vulnerable students by early detection and management of specific common treatable health conditions which impact on learning Target group: Refugee and other vulnerable newly arrived students Partnership: Public education, health services and non-government organisations Funding: NAB Schools First Awards program ($125,000) to pilot the project in Beverley Hills Intensive English Centre ( ) Evans Intensive English Centre ( ) Governance: Local Steering Committees Strategic Planing Group

3 Partners Beverley Hills Intensive English Centre South Eastern Sydney Local Health District Sydney Children s Hospitals Network Menai High School South Eastern Area Laboratory Services NSW Refugee Health Service South Eastern Sydney Medicare Local NAB Schools First Evans Intensive English Centre Western Sydney Local Health District WentWest Medicare Local Evans High School SydWest Multicultural Services

4 Cause and Effect : Poor access to health services and reduced health outcomes for refugee students and their families Cultural competency of health care providers Use of interpreters Skills in negotiating health beliefs Access to transport Financial constraints Knowledge of local area Social & cultural aspects of care Knowledge of refugee health issues and their mgt Barriers for GPs in providing care Co-ordination of care Dedicated resources English language proficiency Poor print literacy in first language Priorities: education, employment, housing Availability of health services Bulk billing GPs Time constraints & remuneration Access to interpreter services School health nurse program Knowledge of Australian health care system including role of GPs Assumption of good health No systematic linkage with health services Settlement support services No routine health Ax on arrival Access dependent on visa type Limited time frame for support Knowledge of local health services and support services Health literacy/ knowledge of health issues Poor access to health services and reduced health outcomes Practical barriers to accessing health care Language barriers Knowledge barriers

5 Key Activities Nurse-led screening clinic for hearing, vision and general health Provision of information about health and health services to parents Linkage of students and their families with local GPs On site blood collection service for refugee students Referral of students with identified health issues to appropriate services Intensive follow up support for at risk students Provision of professional education, information and support to local GPs Hospital tours for students and families

6 Outcomes Health High yield for health conditions All refugee students linked with GPs and specialist health services as required Learning Students are more engaged, confident, energized and focused on their learning Parents feel supported and informed about health issues and their impact on learning, Teachers and Student Learning Support Officers better recognise and support the students individual learning needs Students transitioning to mainstream high schools are more confident and prepared when starting at their local school. Partnerships Significant increase in the strength and number of relationships amongst partner schools, health services and related services

7 Outcomes: Partnerships

8 Health Screening Results Table 1: Results of screening tests Screening Test Beverley Hills IEC (8 terms, ) Evans IEC (2 terms, ) Number of students screened n = 130 n = 39 Abnormal vision screen 28 (22%) 11 (28%) Abnormal hearing screen 11 (8%) 0 (0%) Underweight 12 (9%) 4 (10%) Overweight 20 (15%) 4 (10%) Dental problems Not screened 28 (72%) Serology screening refugee students n = 91 n = 39 Hepatitis B non-immune 22 (24%) 13 (33%) Iron deficiency/low stores 24 (26%) 7 (18%) Chronic hepatitis B 9 (10%) 0 (0%) Schistosomiasis antibody positive 10 (11%) 1 (3%) Strongyloides antibody positive/equivocal 5 (5%) 5 (13%) Malaria 3 (3%) 1 (3%) Hepatitis C 0 (0%) 0 (0%) Vitamin D deficiency/insufficiency 54 (59%) 18 (46%) TBCMI positive (Tuberculosis screen) 21 (23%) Not screened

9 Case Study: Raneem Screening: Hearing impairment Vitamin D deficiency Management: Family linked with to Arabic speaking GP Referred to local hearing clinic GP treated vitamin deficiency and referred to ENT Classroom strategies implemented Follow up: Prioritised for surgery at SCHN

10 Future Directions Economic evaluation of the model Centre Health Economic Research and Evaluation (CHERE) Cost consequence analysis Advocacy for expansion of the pilot 8 Intensive English Centre across metropolitan Sydney Reach 1,200+ newly arrived students and their families per year Capture the majority of refugee high school students newly arrived to NSW Evaluate long term cost effectiveness of this approach

11 Thank you Pictures courtesy of Settling Dust: An Exhibition of Photographs by Christopher Lawrie Portraits of refugee and migrant teenagers from Beverly Hills Intensive English Centre