Developing a collaborative research system for Aboriginal health

372 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2007 vol. 31 no. 4© 2007 The Authors. Journal Compilation © 2007 Public Health Association of Australia

Developing a collaborative research

system for Aboriginal health

Jackie Street, Fran BaumDepartment of Public Health, Flinders University, South Australia

Ian AndersonOnemda VicHealth Koori Health Unit, University of Melbourne, Victoria

Even if Indigenous people [are] brought into the research process as researchers, without the transformation in the underlying paradigm or approach of the research activity (that is, a shift away from non-Indigenous, individualistic, investigator-driven research to some ‘new way’) then this will be, at best, a first step in the reform process.1

There is increasing acceptance of the

ethical basis for community input

into decision-making on health

research.2 There is also evidence that transfer

of research into practice is most successful

when policy makers, practitioners and

communities have significant input into the

research process.3-6 The usual practices of

academic peer review and investigator-driven

research largely bypass these stakeholders

and place decision-making in the hands of

researchers. This is particularly problematic

in Indigenous research, where there are

numerous calls for some ‘new way’ to

determine the direction and quality of

research.1 The response to date has been to

incorporate community consultation within

the framework of usual practice with little

exploration of alternative research processes.

This paper reports on a qualitative study

among Cooperative Research Centre for

Aboriginal Health (CRCAH) stakeholders

and looks at processes for research project

commissioning and funding. Participants were

asked to reflect on their experiences with the

grant review process and on what alternative

research processes might look like.

Abstract

Objective: Investigator-driven research

and the use of peer review are contentious

in community-based research and are

particularly problematic in Indigenous

research. In this project, we conducted a

qualitative study among stakeholders in an

Australian Aboriginal majority-controlled

research-funding organisation to examine

the research funding process.

Methods: A steering group guided the

project and contributed to the research

findings. In-depth interviews (n=18)

with stakeholders in the Cooperative

Research Centre for Aboriginal Health

were conducted to canvass views on the

research funding process and options

for alternate processes. A discussion

document, supported by an extensive

literature review, was provided prior to

interview. This research was an iterative

process where the discussion document

and interview schedule were revised as the

research findings informed the project.

Findings: Participants overwhelmingly

endorsed a move to a more collaborative

research culture, although the form the

culture might take varied. Suggested

elements included involvement of grant

funding bodies as brokers in building

collaborative networks and the substitution

of named ‘critical friends’ for blinded peer

review. Barriers to changing the research

culture to a more collaborative model were

described.

Conclusions and Implications:

A collaborative structure with targeted

project development would permit

redistribution of the time and effort

(previously expended on peer review) into

research development and would increase

community participation in decision-making

in the research funding process.

Key words: Community participation;

Indigenous; research; peer review;

research support; priority setting.

(Aust NZ J Public Health. 2007; 31:372-8)

doi:10.1111/j.1753-6405.2007.00090.x

Submitted: August 2006 Revision requested: January 2007 Accepted: May 2007Correspondence to: Dr Jackie Street, Discipline of Public Health, Faculty of Health Sciences, Mail Drop 207, University of Adelaide, South Australia 5005. Fax: (08) 8303 6885; e-mail: [email protected]

BackgroundWithin funding organisations, the quality

of research proposals is invariably assessed

by consideration of criteria including rigour,

innovation, track record and congruence with

funding priorities. Community priorities are

rarely considered, although research with

Indigenous communities garners greater

scrutiny. In Australia, research funded by

the National Health and Medical Research

Council (NHMRC) must conform to ethical

guidelines that encourage respectful research

relationships and consideration of Indigenous

health priorities and include guiding

principles about community engagement.6

The Australian Research Council (ARC)

addresses some of the issues of stakeholder

involvement through ‘Linkage’ projects

– Aboriginal-controlled organisations have

been ‘Linkage’ partners on a small number

of grants.

In teract ion or consul ta t ion wi th

stakeholders usually takes place after a

research project has been developed. It is

unusual for community-instigated research

or a community-based organisation to attract

funding from national peer review grant

agencies. In general, therefore, although

guidelines and funding systems within the

Australian research community encourage

attention to community priorities, research

remains primarily investigator-driven.7

In Aboriginal communities, anger towards

exploitative and unproductive research has

led to distrust. Critiques of the research

Community Issues Article

2007 vol. 31 no. 4 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 373© 2007 The Authors. Journal Compilation © 2007 Public Health Association of Australia

process provide clear evidence of divergent opinions on the value

of past projects, a desire for increased Aboriginal control and

criticism of the underlying epistemology.8,9 The 2002 NHMRC

Road Map attempted to “encourage the development of a research

environment conducive to the evolution of an effective Aboriginal

and Torres Strait Islander health research field”.10 This has

prompted debate on how research processes might be modified

to engage with the priorities of the Aboriginal health sector; that

is, those individuals and institutional structures with a substantive

focus on the delivery of health services or development of policy

for Aboriginal people.

The CRCAH, an Aboriginal majority-controlled, research-

funding organisation, is well situated to provide fresh views

about community involvement in research. It is a virtual national

organisation with 12 core partners (two Aboriginal community-

controlled health services, two government departments and eight

universities) and extensive networks into the Aboriginal health

sector.11 In this project, we asked stakeholders, Aboriginal and

non-Aboriginal, from a variety of backgrounds how they saw the

research funding process and how they might change it.

MethodsThis research project was a partnership between CRCAH and

the Department of Public Health, Flinders University. Danila

Dilba Biluru Butji Binnilutlum Medical Service Aboriginal

Corporation, Aboriginal Health Council South Australia (AHC

SA) and Central Australian Aboriginal Congress (CAAC) were

consulted through representatives on the steering group or through

interviews of representatives and through feedback on the interim

report. Danila Dilba and CAAC are large Aboriginal-controlled

service providers in the Northern Territory and are community

partners in the CRCAH. AHC SA is the leading South Australian

Aboriginal-controlled research organisation.

Steering group selection and role CRCAH, Yungorrendi (Flinders University), AHC SA,

Onemda VicHealth Koori Health Unit and the Northern Territory

Department of Health and Community Services were asked

to recommend nominees for a project steering group. People

interested and/or experienced in research, particularly in judging

the quality of research or who had shown interest in reflecting

on systems used for initiation, monitoring and dissemination of

research in the Aboriginal context, were sought. The final steering

group came from a broad sweep of organisations and government

departments engaged in Aboriginal research (see Box 1).

The terms of reference included four teleconference meetings

over a year to provide input on the development of research

questions, scope and focus of the literature review, development of

a discussion document, selection of participants, interview themes,

community consultation process and feedback on the final report.

Members were also encouraged to raise any issues that might have

an impact on the credibility and rigour of the project.

The interviewsInterviewees were selected using stratified purposive sampling

within a sampling frame of organisations associated with CRCAH.

Participants were categorised by disciplinary/work focus (social

scientist, biomedical scientist, academia, service provision) and

cross-categorised by their relationship to CRCAH. The latter

category included board members, CRCAH staff, research theme

leaders, research development group members and applicants for

research funding (successful, unsuccessful and potential future

applicants). All interviewees had many years of experience in

Aboriginal research or were directly involved with either CRCAH

or service provision to Aboriginal communities. Interviewees

were identified, on the basis of current primary employment,

as academic (A) or community-based (C), with an additional

unique identifying number. Particular efforts were made to

include Aboriginal participants; one-third of the interviewees

were Aboriginal.

Thirteen individuals who were approached were not interviewed.

Of these, five had significant input through other channels and two

were on leave. The remaining six did not reply to a letter or follow-

up e-mail. Aboriginal health policy makers were engaged in the

project through the steering group, but those we approached were

unable to participate as interviewees because of time constraints.

The 18 interviewees met the criteria set out in the sampling

framework (see Box 1). Although our data analysis suggested we

were approaching theoretical saturation, there was some residual

diversity of opinion among the stakeholders (see below).

A discussion document, prepared and distributed to all

interviewees two weeks prior to interview, synthesised information

gathered from an extensive literature review and presented

available evidence and conflicting views on quality assessment

processes in grant review.

Steering groupa (n=12)

Aboriginal Health Council South Australia (AHC SA); Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS); Central Australian Aboriginal Congress (CAAC); Cooperative Research Centre for Aboriginal Health (CRCAH); Commonwealth Department of Health and Ageing; South Australian Community Health Research Unit (SACHRU); Menzies School of Health Research; Office of Aboriginal Health, Family and Social Policy, Northern Territory; University of Melbourne; University of Western Sydney; Onemda VicHealth Koori Health Unit.

Intervieweesa (n=18)

AHC SA; AIATSIS; Aboriginal Medical Services Alliance of the Northern Territory; CRCAH; Curtin University; Danila Dilba; Flinders University; La Trobe University; Menzies School of Health Research; University of Melbourne; remote-area Aboriginal-controlled organisation;b urban alcohol and drug centre.b

Notes:(a) Some organisations are represented more than once in each group.(b) Organisations not named, since doing so may compromise the

anonymity of the interviewee.

Box 1: Organisations represented in the steering group and interviewee group.

Community Issues A collaborative research system for Aboriginal health


Semi-structured in-depth interviews were conducted by

telephone or face-to-face. Interviewees were asked to reflect

on the discussion paper and their experiences (including as

applicant, reviewer, program leader, member of a review panel,

board member with final approval power, or as a member of a

community-based convocation involved in priority setting) with

the CRCAH funding and peer-review process. Interviews were

recorded and the transcripts thematically coded,12 initially using

the framework of the interview schedule (see Box 2) – codes such

as ‘EOI’ for ‘experience with expression of interest round’ were

used. Subsequent recoding led to new themes that cut across the

original codes. Some themes, such as ‘the desired qualities of

assessors’, persisted throughout the research process; others, such

as ‘transparency’, arose during the interview cycles; still others,

such as ‘tensions in the review process’, emerged from recoding.

The major theme that emerged from recoding was the need for a

system that better supported collaboration. The emerging themes

were more generic and less focused on past CRCAH process and

structure.

This research was an iterative process; the discussion document

and interview schedule were revised as findings and feedback

from the steering group informed the project. An interim report

was sent to the steering group, all participants and the community

organisations. Feedback was incorporated into the final report. All

the community organisations approved the final report.

FindingsAll participants agreed that central to the objectives of an

Aboriginal-controlled grant-funding body must be the desire to

improve Aboriginal health status, but that the translation of this

desire into effective outcomes is difficult. Participants described

how research that fell outside straightforward biomedical and

epidemiological methodology and strayed into more complex

social and cultural issues invariably encountered difficulties

in being funded within a conventional peer review assessment

system. Funding such projects was seen as a major role for an

Aboriginal-controlled grant-funding body:

Most of what we’re dealing with is hard to fund through conventional bodies which are set up to fund experiments. (A5)

A move to a collaborative culture?While the goal of developing and funding more complex social

research was seen as increasingly important, it was observed that

frequently with this type of research a competitive system of

grant funding was divisive. Research participants overwhelmingly

endorsed a move to a more collaborative culture, although with

some divergence in views about the configuration this culture

might take. As one steering group member commented, simply

removing the competitive process would not necessarily result

in a collaborative culture. Neither was collaboration seen as an

end in itself, but as an organisational tool for working together

effectively, bringing together the myriad skills of individuals

without the divisiveness of competition.

Interviewees were asked to reflect on their experience with one or more of: the priority-setting convocation, the expression of interest round or a previous grant review round, and to discuss their reactions to the experience: e.g. Did the process work well? What worked well? What didn’t? If not covered in the ensuing discussion the following areas were addressed:

1. Assessment: Who should assess quality?Prompts:

• Should academic reviewers be included? Do reviewers need to be experienced in research? Do reviewers need to have academic standing? Should service providers be reviewers?

• How should Aboriginal stakeholders be involved and at what level?

• If a range of peers are used what should the range include e.g. academics, service providers, research transfer experts, capacity building experts.

• Should international reviewers be included?

• Should review occur by individuals or by committee?

• Should review be external or internal with respect to the CRCAH?

Criteria: What criteria should underpin the assessment?

Prompts:

• Should different criteria be assessed by different people or should reviewers take a holistic approach?

• Can criteria such as collaboration be assessed? How?

2. Should the CRCAH be involved in development of a proposal? To what extent?

3. How can conflicts of interest be managed given the small pool of ‘expert peers’?

4. Should there be special Indigenous-initiated research pathways? If yes, should these proposals be assessed with the same criteria as other proposals?

5. How do we reconcile community-driven research with peer review?

6. How do we balance nationally focused research with local research?

7. How can the desire for transparency be balanced with the conflicting agendas of the organisation’s partners?a

8. What do you see as the role of peer review?a

9. How might a collaborative approach to research programs work?a

Note:(a) These questions were added to the schedule in response to the initial

interviews.

Box 2: Interview schedule.

Not that there’s anything wrong with competition, but … this is a better process, rather than everybody competing. (C1)

Two participants dissented, suggesting that because of limited

funds a competitive environment was essential.

. . . you’ve got to have competition . . . one assumes . . . that the demand from applications is greater than the sum of money available and I think that will continue. There has to be some rationing process. (A9)

Barriers to a collaborative cultureBarriers to changing the organisational culture were described,

including pressure on funds by collaborative development costs

and by academic institutional partners struggling to maintain

funding levels. Academics may be loath to share information

in a collaborative format if it compromises their ability to gain

grants:

Street, Baum and Anderson Article


From the university the bottom line is always, “what is in it for us”? (A8)

Existing systems of quality control place large demands on

individuals – short deadlines, the demands of peer review and

a limited pool of skilled researchers contribute to a ‘pressure

cooker’ atmosphere that is detrimental to the development

of a collaborative culture. Distrust of research in Aboriginal

communities, competition between the needs of research and the

needs of service provision, and fluid community membership are

additional factors – it is “more difficult for community-based

projects to arise in response to a timeline” (C4).

Additionally, many Indigenous research projects are locally

based; collaboration with a community organisation in research

prescribes that the research will be local and interests of

stakeholders involved in building the collaboration may be

predominantly local. Several specific examples described in the

interviews suggested that pressure to provide funding only for

projects that address issues on a national scale may conflict with

the ability to fund good collaborative research.

More community control of research will invariably run

counter to the widely accepted belief-model of investigator-driven

research. At least half the participants directly or through examples

identified a gulf in ideology between the conventional model of

research conduct and the needs of stakeholders. One participant

encapsulated the divide:

I know researchers are stuck in a paradigm in terms of how they conduct research and it’s often frustrating for them because they’re trying to do research how they know how to do research. But there hasn’t been a paradigm shift to actually do research in a way that industry sees or perceives research, in how industry understands research and how industry would actually know where it benefits within that, within service delivery for instance. (C6)

What might a collaborative culture look like?At least two-thirds of respondents stressed the importance of

funding-body involvement in the development of proposals. A

funding organisation can act as a broker, building collaborative

links between communities, service organisations and academic

researchers. This brokerage could be underscored by a requirement

for continued involvement of the funding organisation in the

development and improvement of proposals throughout the

research process. One community-based researcher summarised

the response of the majority:

. . . there needs to be a lot more participation in terms of consultation with community groups and that’s active collaboration, and that’s right from when the idea about the research has been conceived right through to conducting the research … and right through to assisting, once the research comes out, in getting information back to the community and then … how can we further assist you in looking at how to get funding, how to actually set up programs. (C6)

To implement this effectively, paid program managers could

play a vital role. Several participants identified adequate time for

consultation as important for building a collaborative culture.

One academic suggested the choice of program co-ordinator was

crucial:

. . . the co-ordinator position is actually a very difficult one, so selecting the people to co-ordinate that, I think they need to be full time . . . the choice of those individuals is absolutely crucial. (A6)

Other elements identif ied as essential for an effective

collaborative culture included financial support for research

development; capacity building of Aboriginal people to engage

in the research process, either as academics or community

representatives; mentoring Aboriginal researchers in grant writing,

research practice and research dissemination; and mentoring

non-Aboriginal researchers in appropriate conduct in Aboriginal

communities, community participation and research transfer.

However, as one steering group member suggested, it is not

necessary to have every available expert included in a research

program. A resource-effective approach might involve selection

of a small but diverse group, including experts in research transfer

and capacity building.

A collaborative approach may be valuable in providing a broad

consultative framework that is lacking in traditional approaches

to research.

The process of applying and getting funding can be such private business. You might consult a few people who will support the application but you do not consult … the whole research community on that topic, because they will be your competitors. (C8)

Monitoring quality in a collaborative systemWhen asked specifically how quality might be monitored in

a collaborative system, the majority of participants envisaged

a system where the research would be fostered in the crucible

of a program committee or review group of stakeholders

including academics, representatives from community-controlled

organisations, service providers and policy makers. One participant

saw it as:

A continuing of the constructive suggestion process and so at a particular point your panel of constructive suggestions say, look, I can’t think of anything else to say. (A4)

A broad view of who might be considered a stakeholder might

be adopted:

That is what I mean by a stakeholder: someone who has a reputation for understanding the communities and who would not be afraid to talk. (C5)

Elements of the traditional peer review process were seen as useful.

Participants suggested that academic peer review early in the research

process would protect grant funding organisations from allegations

of bias and nepotism, prevent duplication, ensure rigour and provide

a vehicle for leverage of funding from outside sources.

Two participants (C1, A3) used the term ‘critical friend’ to

describe the role of a reviewer within the collaborative process;

however, the term reflected the views of many participants, who

wanted a “constructive suggestion process” (A4) where reviewers

may not be involved in the funding decision but would provide

constructive criticism on the strengths and weaknesses of the

proposal. This might come from a “roundtable process” (A1)

and/or from a more remote but trusted ‘critical friend’. Unlike the

traditional framework, the critical friend would not be in direct

competition with the grant applicants.



Secrecy and transparencyAnonymity in peer review has been essential – so “they can

feel absolutely free to say what they like” (A6) – but there was

strong feeling from some participants that this undermines

collaboration. A recurring theme was the need for a clear and

transparent process. It was also apparent that the vagaries of the

peer review process, which does not allow for negotiation, could

generate enormous anger and distress. One participant described

a recent review round:

I’ve been reviewed and I’ve been knocked back . . . but this was an utterly, totally incompetent, biased, clearly done by somebody who hadn’t a clue . . . I don’t think anything has angered me as much as the incompetence. (A9)

Peer review can generate similar responses in the broader

research community, but our findings suggest that traditional peer

review may more fundamentally undermine efforts to incorporate

community priorities in research. One community-driven project

that was rejected evoked the response:

We thought that we must be a priority, because we were trying to articulate an Indigenous community response to issues which had been described by people in [placename] over a number of years. (C7)

A developmental process would allow a good community idea

to be worked into a methodologically sound project without the

divisive impact of peer review. One participant summed up the

core issue when transparency was lacking:

If there’s anything that people are unsure about, then it has a poisoning effect, far, far greater that what it cost to have [transparency], so … within the organisation or at least within the decision-making bodies of the organisation there has to be, to the maximum extent possible, transparency. (A7)

These recommendations were tempered with the understanding

of issues such a system might face, such as the difficulty associated

with giving blunt but essential feedback. However, there was strong

recognition of the need for a system that better reflected community

priorities as “something we can’t afford not to do” (A4).

GeneralisabilityWhile the sample for this project was defined by the institutional

reach of CRCAH, the key findings may be generalised more

broadly to the Aboriginal health sector on the basis that CRCAH

is a national research organisation with extensive networks. A

caveat to this view is that, given the focus of the organisation

on developing a research agenda responsive to the priorities of

this sector, its stakeholders will tend to be those who value the

role of research in Aboriginal health and possibly those willing

to look beyond the usual constructs for research processes.

Consequently, these views may reflect a culture biased towards

active engagement of Aboriginal people (particularly Aboriginal

community organisations) and acutely responsive to community

and service priorities.

Patterns of responseThe breadth of views on many issues fell across academic and

industry boundaries, although industry/community participants

tended to push harder for a collaborative culture and were more

scathing about the value of peer review. However, this was not

universal; there were a couple of dissenters from both camps. The

breadth of views fell in a similar manner across other possible

divides such as Indigenous/non-Indigenous participants or

CRCAH employee /non-CRCAH employee.

DiscussionThis project was framed by the growing interest in the

development of research processes in Aboriginal health that

are inclusive of the Aboriginal community. What is meant by

‘community’ is contentious and this idea is debated vigorously

in social sciences. Here we focus on research processes in

relation to the Aboriginal health sector with a particular emphasis

on Aboriginal-controlled health organisations. Although the

relationship between Aboriginal people and such organisations

is complex, these Aboriginal community organisations play a

significant role in the provision of Indigenous-specific primary

heath care; the delivery of health sector-specific strategies; and in

health advocacy in relation to other sectors and agencies.

Grant-funding processes set the tenor of the research culture,

even if at odds with the underlying values of the researchers,

the community group around which the research is centred or

the wider culture. Clearly, the intersection between traditional

academic culture and Aboriginal community processes is fraught

with difficulty. This has, in part, led to the call for a new approach

to research that might better incorporate community values and

priorities.13-15 Our research highlights the challenges in designing a

system to meet often-conflicting requirements for setting research

priorities, assessing rigour, developing collaborative research

projects and ensuring effective uptake of research findings.

There are working alternative models to peer review. The Dutch

Technology Foundation has a process that includes peer review

(by up to six reviewers) followed by merit review by a panel of

12 non-peers from academia or industry. The peer reviewers do

not ‘grade’ the submission but comment on its strengths and

weaknesses. The panel undertaking the merit review makes

funding recommendations.16 In another example, the United

Kingdom Engineering and Physical Sciences Research Council

reformed the system of peer review by including industrialists in

several colleges of peers, organised according to interest areas.

The colleges were established by nomination from people who

had applied for grants over the previous three years.16

Some evidence of reform is also apparent in national research

funding bodies. The Canadian Institute of Health Research

reviewed its grant review system to include “community members

on peer review committees, where additional perspectives add

value to the evaluation of applications for funding”.17 In Australia,

NHMRC research proposals that focus on Indigenous health are,

following peer review, reviewed by a Indigenous Health Research

Review Panel (IHRRP). The panel assesses the proposal in terms of:

community engagement; benefit; sustainability and transferability;

priority; and significance. Indigenous reviewers on this panel have

been drawn from the health and research sector.18



Based partly on our findings, the CRCAH reviewed its research

development and funding processes.19 The CRCAH established

five research programs in which research activity is integrated with

capacity development and research transfer processes.11 Through

a series of industry roundtables, policy, service and community

stakeholders articulated a range of desired research outcomes

that were subsequently prioritised by the CRCAH board. Project

leaders and teams were established to develop proposals that

addressed the priority outcomes. Proposals developed by project

proponents have been subjected to a quality assurance process

in which research ‘peers’, community members, practitioners

and policy makers assess proposals against agreed criteria (such

as rigour, benefit, feasibility, value for money, capacity building

and collaborative potential). The quality assurance process is

developmental in focus (following the idea of a ‘critical friend’)

and integrated into project implementation processes. The

CRCAH oversees the roll-out of these processes and brokers the

development of partnerships between researchers, policy makers,

community-controlled organisations, service providers and the

communities themselves.

Arguably, melding the skills of all parties enhances the research

and its potential for transfer. Inclusion of service providers and

community-controlled organisations broadens the review process

into ‘merit’ review and helps to establish credibility of the

research in the service-delivery arena while ensuring appropriate

community engagement takes place. Innovative review techniques,

including interviews and site visits, may also be needed to meet

the needs of assessment of community-based research. Training

or mentoring must support participants in the program-building

process and it is important that academic researchers make

difficult technical issues such as statistical analyses and qualitative

techniques clear so that informed decisions can be made by the

entire program committee.

Indigenous health research increasingly relies on co-operation of

individuals from various sectors. Building a collaborative culture

to span these groups is not an easy task.3-6 Levesque and Chopyak,20

discussing collaboration in a multi-sector research project, point

out that “collaboration has at least two definitions: to co-labour

or share the effort of a difficult task and to work with the enemy

as a collaborator”. Successful collaboration may be more about

conflict resolution than any other factor.

Not surprisingly, our research participants described the need to

meet the criteria of both scientific rigour and community values.

This echoes the wider literature,17 but may also reflect fear of

external criticism. A small government-funded organisation must

invariably be compared with larger entities doing similar work;

so, the CRCAH performance will be compared to the NHMRC

and/or the ARC, which have funding programs that rely heavily

on peer review. There is potential conflict between collaborative

and traditional peer review processes. However, in a recent ARC

publication it is argued that “Australia’s innovation system needs

both excellence and impact in research but that they are not

necessarily required simultaneously in all research or research

institutions”, and further recommends a system that will reduce the

“risk of labelling as mediocre, research or research groups rated

highly on one measure and more poorly on the other”.21 We concur.

Not all research funding agencies have the capacity to broker

collaborative partnerships actively. However, despite the potential

for conflict, the values underpinning a collaborative system and

traditional peer review are not entirely mutually exclusive. The

NHMRC, through the IHRRP, has developed processes that reflect

some of the values of a collaborative system. The CRCAH quality

review process also assesses scientific rigour. The difference

between a collaborative and a peer review system may lie not in

the values attached to the research funding processes, but in the

relative importance attached to those values.

Research developed through a collaborative research system

potentially supports community empowerment, capacity building,

improved infrastructure and stronger community voice in policy.22

Additionally, the promotion of collaborative partnerships may

provide a better platform for investigator-initiated research projects

in Aboriginal health. There is both need and potential for further

research and discussion on the impact of current research funding

systems on research in this context.

We have focused on a single Aboriginal research organisation in

this study but, given the breadth of the organisations sampled, the

findings have implications beyond this context and even outside

the Aboriginal research arena in contexts where attention to

community priorities is important or where the research attempts to

address community issues. However, the true value of a “shift away

from non-Indigenous, individualistic, investigator-driven research

to some ‘new way’”1 described in this work lies in its potential

to provide a system that more accurately reflects Indigenous

community priorities and values in research processes.

AcknowledgementsThis research was carried out as a collaborative project between

CRCAH and the Department of Public Health (DPH), Flinders

University, with collaboration from Danila Dilba, AHC SA and

CAAC. The research design was by Dr Jackie Street and Professor

Fran Baum (DPH) with input from Professor Tony Barnes and

Professor Ian Anderson (CRCAH). Further development of

the project was carried out in conjunction with the board of the

CRCAH, a steering group of interested parties and CRCAH staff

including Dr Danielle Campbell, Ms Jenny Brands and Ms Nea

Harrison. Dr Street and Dr Danielle Campbell carried out an

extensive literature search and interviews under the guidance

of Professor Baum. The data were analysed and paper written

by Dr Street with guidance from Professor Baum and Professor

Anderson. The authors would like to thank all the participants

in this project, Associate Professor Annette Braunack-Mayer for

helpful suggestions on presentation of qualitative research, and

Ms Jane Yule for encouragement and support.

Ethics approval for this project was obtained from Flinders

University Social and Behavioural Research Ethics Committee and

the Aboriginal Health and Research Ethics Committee (SA).



References1. Henry J, Dunbar T, Arnott A, Scrimgeour M, Mathews S, Murakami-Gold L, et

al. Indigenous Research Reform Agenda Links. Darwin (AUST): Cooperative Research Centre for Aboriginal and Tropical Health; 2002. p. 3. Monographs Series No.: 1.

2. Kowal E, Anderson I, Baillie R. Moving beyond good intentions: Indigenous participation in Aboriginal and Torres Strait Islander health research. Aust NZ J Public Health. 2005;29(5):468-70.

3. Lomas J. Using ‘Linkage and Exchange’ to move research into policy at a Canadian Foundation. Health Aff (Millwood). 2000;19(3):236-40.

4. Canadian Health Services Research Foundation [resources page on the Internet]. Leveraging Knowledge: Tools and Strategies for Action. Proceedings of the 7th CHSRF Annual Invitational Workshop; 2005 March 3 [cited 2006 Aug 7]; Montreal, Quebec, Canada. Available from: http://www.chsrf.ca/knowledge_transfer/pdf/2005_workshop_report_e.pdf

5. Canadian Research Transfer Network [resources page on the Internet]. Knowledge transfer in health. Proceedings of the 2nd Annual Canadian Research Transfer Network Conference; 2002 Oct 24-25 [cited 2006 Aug 7]; Calgary, Alberta, Canada. Available from: http://www.chsrf.ca/knowledge_transfer/pdf/ktransfer2002_e.pdf

6. National Health and Medical Research Council. Values and Ethics – Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. Canberra (AUST): NHMRC; 2003.

7. National Health and Medical Research Council. Applying for Strategic Awards. Canberra (AUST): NHMRC; 2006.

8. Mathews S, Jenkin R, Frommer M, Tjhin M, Rubin G. When Research Reports and Academic Journals are Clearly Not Enough. Darwin (AUST): Cooperative Research Centre for Aboriginal and Tropical Health. 2001 (April). Occasional Papers Series No.: 4.

9. Humphery K. Dirty questions: Indigenous health and ‘Western research’. Aust NZ J Public Health. 2001;25(3):197-202.

10. National Health and Medical Research Council. The NHMRC Road Map: A Strategic Framework for Improving Aboriginal and Torres Strait Islander Health through Research. Canberra (AUST): NHMRC; 2002. p. 17.

11. Co-operative Research Centre for Aboriginal Health. An Integrated Programmatic Approach to the CRCAH’s Research and Development Activities. Canberra (AUST): The CRC for Aboriginal Health; 2004 October [cited 2007 Mar 6]. Available from: http://www.crcah.org.au/index.cfm

12. Ezzy D. Qualitative Analysis: Practice and Innovation. Sydney (AUST): Allen & Unwin; 2002. p. 86-94.

13. Boughton B. Popular Education, Capacity-building and Action Research: Increasing Aboriginal Community Control of Education and Health Research. Darwin (AUST): Cooperative Research Centre for Aboriginal and Tropical Health; 2001. Occasional Paper Series No.: 5.

14. Cooperative Research Centre for Aboriginal and Tropical Health. Indigenous Research Reform Agenda Links. Darwin (AUST): The CRC for Aboriginal Health; 2002 [cited 2006 Aug 10]. Monographs Series No.:1-4. Available from: http://www.crcah.org.au

15. Humphery K. The Development of the National Health and Medical Research Council Guidelines on Ethical Matters in Aboriginal and Torres Strait Islander Health Research: A Brief Documentary And Oral History. Melbourne (AUST): Onemda VicHealth Koori Health Unit: 2002. Discussion Paper No.: 8.

16. Wood FQ. The Peer Review Process: Commissioned Report No. 54. Canberra (AUST): National Board of Employment, Education and Training, Australian Research Council; 1997.

17. Canadian Institutes of Health Research [peer review page on the Internet]. CIHR is Focusing on Continuous Improvements to its Peer Review System. Ottawa (CAN): CIHR; 2007 [cited 2007 Apr 27]. Available from: http://www.cihr-irsc.gc.ca/e/4675.html

18. National Health and Medical Research Council [home page on the Internet]. Criteria for Health and Medical Research of Indigenous Australians. Canberra (AUST): NHMRC; 2005 Dec 12 [cited 2007 Apr 27]. Available from: http://www.nhmrc.gov.au/funding/_files/indighth.pdf

19. Brands J, Gooda M. Putting the users of research in the driver’s seat: the Cooperative Research Centre for Aboriginal Health’s new approach to research development. Australian Aboriginal Studies. 2006;2:27-35.

20. Levesque P, Chopyak J. Managing multi-sector research projects: Developing models for effective movement from problem identification to problem solving. Proceedings of the 5th International Research Symposium on Public Management; 2001; Barcelona, Spain. p. 8.

21. Australian Research Council [publication page on the Internet]. ARC Support Paper: Assessing Research Impact in the RQF. Canberra (AUST): Australian Government; 2005 [cited 2006 Aug 10]. p. 6. Available from: http://www.dest.gov.au/NR/rdonlyres/F5166FC3-B20C-4931-AD6E-B86AAFEF96F6/7862/Assessingresearchimpact.pdf

22. Macaulay ACL, Freeman WL, Gibson N, McCabe ML, Robbins CM, Twohig PL. Participatory research maximises community and lay involvement. Br Med J. 1999;319:774-8.


Documents

Developing a collaborative research system for Aboriginal health