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1.  Improving access to primary care for Aboriginal babies in Western Australia: study protocol for a randomized controlled trial 
Trials  2016;17:82.
Background
Despite a decade of substantial investments in programs to improve access to primary care for Aboriginal mothers and infants, more than 50 % of Western Australian Aboriginal babies are still not receiving primary and preventative care in the early months of life. Western Australian hospitals now input birth data into the Western Australian electronic clinical management system within 48 hours of birth. However, difficulties have arisen in ensuring that the appropriate primary care providers receive birth notification and clinical information by the time babies are discharged from the hospital. No consistent process exists to ensure that choices about primary care are discussed with Aboriginal families.
Methods/Design
We will undertake a population-based, stepped wedge, cluster randomized controlled trial of an enhanced model of early infant primary care. The intervention is targeted support and care coordination for Aboriginal families with new babies starting as soon as possible during the antenatal period or after birth. Dedicated health professionals and research staff will consult with families about the families’ healthcare needs, provide information about healthcare in the first 3 months of life, offer assistance with birth and Medicare forms, consult with families about their choice for primary care provider, offer to notify the chosen primary care provider about the baby’s health needs, and offer assistance with healthcare coordination at the time of discharge from the hospital.
We will evaluate this model of care using a rigorous stepped wedge approach. Our primary outcome measure is a reduced hospitalization rate in infants younger than 3 months of age. Secondary outcome measures include completed Aboriginal and Torres Strait Islander child health screening assessments, immunization coverage, and satisfaction of the families about early infant primary care. We will also assess the cost effectiveness of the model of care.
Discussion
This study will be conducted over a 4-year period in partnership with birthing hospitals and primary care providers including Western Australian Aboriginal Community Controlled Health Services and the new Primary Health Networks. The results of our trial will be used to develop improved primary care models and to improve health outcomes for all Aboriginal infants. These are vital steps toward more equitable health service delivery for the Aboriginal and Torres Strait Islander children in Australia.
Trial Registration
Australian New Zealand Clinical Trials Registry
Registration number: ACTRN12615000976583 
Date registered: 17 September 2015
doi:10.1186/s13063-016-1206-7
PMCID: PMC4751713  PMID: 26869181
Primary care; Aboriginal; Care coordination; Infants; Intervention; Health services
2.  Adjusting for under-identification of Aboriginal and/or Torres Strait Islander births in time series produced from birth records: Using record linkage of survey data and administrative data sources 
Background
Statistical time series derived from administrative data sets form key indicators in measuring progress in addressing disadvantage in Aboriginal and Torres Strait Islander populations in Australia. However, inconsistencies in the reporting of Indigenous status can cause difficulties in producing reliable indicators. External data sources, such as survey data, provide a means of assessing the consistency of administrative data and may be used to adjust statistics based on administrative data sources.
Methods
We used record linkage between a large-scale survey (the Western Australian Aboriginal Child Health Survey), and two administrative data sources (the Western Australia (WA) Register of Births and the WA Midwives’ Notification System) to compare the degree of consistency in determining Indigenous status of children between the two sources. We then used a logistic regression model predicting probability of consistency between the two sources to estimate the probability of each record on the two administrative data sources being identified as being of Aboriginal and/or Torres Strait Islander origin in a survey. By summing these probabilities we produced model-adjusted time series of neonatal outcomes for Aboriginal and/or Torres Strait Islander births.
Results
Compared to survey data, information based only on the two administrative data sources identified substantially fewer Aboriginal and/or Torres Strait Islander births. However, these births were not randomly distributed. Births of children identified as being of Aboriginal and/or Torres Strait Islander origin in the survey only were more likely to be living in urban areas, in less disadvantaged areas, and to have only one parent who identifies as being of Aboriginal and/or Torres Strait Islander origin, particularly the father. They were also more likely to have better health and wellbeing outcomes. Applying an adjustment model based on the linked survey data increased the estimated number of Aboriginal and/or Torres Strait Islander births in WA by around 25%, however this increase was accompanied by lower overall proportions of low birth weight and low gestational age babies.
Conclusions
Record linkage of survey data to administrative data sets is useful to validate the quality of recording of demographic information in administrative data sources, and such information can be used to adjust for differential identification in administrative data.
doi:10.1186/1471-2288-12-90
PMCID: PMC3493324  PMID: 22747850
3.  Web Screening of US Nursing Homes by Location and Quality 
To assist American families that will one day need to find a nursing home for a loved one, NLM is developing a “Web 2.0” interface to important evaluative information about nursing homes in the US. Currently in prototype form, our “Nursing Home Screener” locates homes on a Google Map. It allows nursing home quality, indicated by map icons, to be surveyed in any of four major categories: staffing, fire safety deficiencies, healthcare deficiencies, and quality of care inferred from residents’ health. Within each category, options can be tailored to user preferences. Furthermore, home attributes can be used to selectively hide home markers of less interest. The goal is to offer the public a timely, easy to use site for the rapid location and comparison of nursing homes, thus identifying those worth further review or a personal visit.
PMCID: PMC2656091  PMID: 18998890
4.  A Pattern Language for Identifying Data Points from Multisample Clinical Instruments 
Many clinical instruments handle multiple sequential samples in a run, and produce a corresponding list of data points. Such instruments require post-run identification of each sample. The impact of this requirement upon program design is discussed, with several alternative approaches reviewed. An application-oriented pattern language is proposed as the best approach.
PMCID: PMC2581161

Results 1-4 (4)