About the Ironbark Project

Background: Why the Ironbark project?

Aboriginal Elders are the keepers of our cultural knowledge, they are the educators in our communities teaching our young, supporting and maintaining connection to country and an integral part of Aboriginal culture.

Many older Aboriginal people are also the caregivers of their grandchildren and are seen as mothers and fathers rather than grandparents.

As the Aboriginal population ages, it is important to provide programs that meets their needs and supports older Aboriginal people to continue their important role in community.

The Ironbark: Standing Strong and Tall program is a falls prevention program developed in partnership with Aboriginal communities in NSW. It was then tested with six communities and the evaluation found:

  • 98 Aboriginal people registered for the program, ages ranging from 40-90 years old, mostly women (53 female participants, 69%).
  • The program significantly improved strength and balance
  • There was a significant average decrease of in average Body Mass Index
  • There was a noticeable increase in participants becoming involved with social activities and outings, including walking groups.

All participants enjoyed the program, and all were willing to recommend the program to others. The most popular element of the program was the Yarning Circles.

The Ironbark trial has now been funded by the National Health and Medical Research Council to test if the Ironbark program prevents falls, and improves the health and wellbeing of older Aboriginal people.

We also aim to contribute to the evidence that community based, Aboriginal led programs are culturally appropriate and acceptable to Aboriginal people across other states, and are cost effective.

For further information:

First Nation Elders’ perspectives on healthy ageing in NSW, Australia article

Ironbark: Standing Strong and Tall program


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Well, the program was actually more then what I thought it would be. It was very good. The information was great combined with the Yarning Circle. The people who come feel like a family now, it has helped with loneliness and death within our group. Each of us had each other it has enhanced our lives. We hope to keep coming so we can have our yarning and exercises.

IRONBARK PROGRAM PARTICIPANT

Background: Why the Ironbark project?

Aboriginal Elders are the keepers of our cultural knowledge, they are the educators in our communities teaching our young, supporting and maintaining connection to country and an integral part of Aboriginal culture.

Many older Aboriginal people are also the caregivers of their grandchildren and are seen as mothers and fathers rather than grandparents.

As the Aboriginal population ages, it is important to provide programs that meets their needs and supports older Aboriginal people to continue their important role in community.


Image

The Ironbark: Standing Strong and Tall program is a falls prevention program developed in partnership with Aboriginal communities in NSW. It was then tested with six communities and the evaluation found:

  • 98 Aboriginal people registered for the program, ages ranging from 40-90 years old, mostly women (53 female participants, 69%).
  • The program significantly improved strength and balance
  • There was a significant average decrease of in average Body Mass Index
  • There was a noticeable increase in participants becoming involved with social activities and outings, including walking groups.

All participants enjoyed the program, and all were willing to recommend the program to others. The most popular element of the program was the Yarning Circles.

The Ironbark trial has now been funded by the National Health and Medical Research Council to test if the Ironbark program prevents falls, and improves the health and wellbeing of older Aboriginal people.

We also aim to contribute to the evidence that community based, Aboriginal led programs are culturally appropriate and acceptable to Aboriginal people across other states, and are cost effective.

For further information:

First Nation Elders’ perspectives on healthy ageing in NSW, Australia article

Ironbark: Standing Strong and Tall program



Well, the program was actually more then what I thought it would be. It was very good. The information was great combined with the Yarning Circle. The people who come feel like a family now, it has helped with loneliness and death within our group. Each of us had each other it has enhanced our lives. We hope to keep coming so we can have our yarning and exercises.

IRONBARK PROGRAM PARTICIPANT

What people say about Ironbark





“There was a young man who had a lot of health issues and problems with balance. After participating in the project, towards the end of the program his strength and balance got so good he didn’t need his walking stick.”

- Liz Hillmann, Previous Ironbark site manager

Why Ironbark is important to me

The program has been important to me because now I’m doing more – I get out in the garden more. My balance and strength are great I don’t use a walking stick now, I have put it away. We really do need programs like this at Broken Hill and Cobar places like that. My culture should learn this, I enjoyed this very much.

Standing Tall

I enjoyed it, you learn so much. You go out now and stand tall, you feel confident and you don’t feel like a little old lady. It’s not just good physically, it is good mentally. I go around to others that live in my retirement village and move hazards. I never sit down at home and I like doing my exercises.

Yarning circles

Well, the program was actually more then what I thought it would be. It was very good. The information was great combined with the Yarning Circle. The people who come feel like a family now, it has helped with loneliness and death within our group. Each of us had each other it has enhanced our lives. We hope to keep coming so we can have our yarning and exercises.

We need Aboriginal programs

There are not many programs that are culturally appropriate for us, you know, like especially in this area. This is the only program around here for us. Yeah, it is very good and if we didn’t have it we would not have anything.

Getting out of the house

It’s helped me socialise, it’s helped me be around other people. Since I retired, I have gone into my own shell. By doing this it’s made me get out more. We need these sort of things keep us going. We have some Koori people in town and I spoke to them yesterday about doing this.

How this study works: Ironbark methodology

The Ironbark trial aims to show that the Ironbark: Standing Strong and Tall program reduces the rate of falls in Aboriginal people 45 years and older, compared to people who participate in the Ironbark: Healthy Community program.

We also aim to show that the Ironbark: Standing Strong and Tall program will improve older Aboriginal peoples:

  • social and emotional wellbeing
  • independence and mobility
  • strength and balance
  • overall physical activity levels

The study design is a cluster randomised controlled trial. This means groups of participants are randomly assigned to one of the two programs.  This will be done using a computer program, so the researchers have no control over which groups participate in which program.

We aim to ask 60 community-based groups (approximately 10 – 15 people per group) in NSW, SA and WA to participate in the study. We need at least 600 women and men to participate regularly for the research to be successful.

What is Randomisation?

Sites are randomised so that there is roughly the same spread of participants (age, men and women, locations) in each of the two programs. This reduces bias and allows us to compare similar groups of people across the two programs (apples with apples).

Everyone at the same site, will be doing the same program.

Sites that are randomised into the Ironbark: Healthy Community program (social based) will have the opportunity to deliver the Ironbark: Standing Strong and Tall (exercises and yarning circles) for a further 6 months.

We need Aboriginal programs. There are a lot of things with Aboriginal community that white community do not understand. Okay, we all bleed the same colour blood, but it goes deeper than that. You know, especially around here, we don’t have anyone to relate to, we need someone to sit down with and talk to on a different level.

- Ironbark program participant

How can the Ironbark project benefit me and my community?

  • The Ironbark program showed that people enjoyed coming together as a group, and also found the exercises appropriate for them.
  • Everyone will eventually have the chance to be involved in an Aboriginal specific falls prevention program, which has been shown to improve people’s strength and balance.
  • Being involved in this research is also an opportunity for older Aboriginal people to have a say about the kinds of programs that they like.
  • Services will benefit by being funded to deliver the program. They will also receive training on the Ironbark: Standing Strong and Tall program and all materials, so that the program can continue to be delivered after the research has finished.
  • We think this research will contribute to evidence that shows community based, Aboriginal led programs benefit older Aboriginal people, their families and community, and that these programs are cost effective.

What data will be collected?

We will collect data about the program from participants and sites.  All the data collected will be de-identified (ie, we won’t be able to identify individual people).

What data is being collected from participants Who is collecting it How is it being collected

Baseline data

  • A few simple tests to measure strength and balance
  • A yarn about your health, medications, physical activity, and social and emotional wellbeing.
Aboriginal Research Assistants Before the program starts, we will have a lunch and a data collection day.

Weekly questions

  • A short survey each week asking about services you used that week, and any falls you might have had
Locally based site managers On paper surveys, which is then entered by us into the database.

End of program data

  • The same simple tests and yarn that we had at the beginning. This will happen when the program finishes after 12 months.
Aboriginal Research Assistants We will have a lunch and a data collection day.
What data is being collected from participants

Baseline data

  • A few simple tests to measure strength and balance
  • A yarn about your health, medications, physical activity, and social and emotional wellbeing.
Who is collecting it

Aboriginal Research Assistants

How is it being collected

Before the program starts, we will have a lunch and a data collection day.

Weekly questions

A short survey each week asking about services you used that week, and any falls you might have had

Who is collecting it

Locally based site managers

How is it being collected

On paper surveys, which is then entered by us into the database.

End of program data

The same simple tests and yarn that we had at the beginning. This will happen when the program finishes after 12 months.

Who is collecting it

Aboriginal Research Assistants

How is it being collected

We will have a lunch and a data collection day.

All data will be stored at The George Institute for Global Health.  
 
We will provide a report back to all the sites about the overall findings, but we won’t identify individuals or sites.

Aboriginal governance

Good Aboriginal governance of this project is important to us. We have a number of ways to make sure Aboriginal researchers, participating sites and participants have input into our study design, program delivery, interpretation of results and final outcomes. Some of our governance structures are:

  • Aboriginal cultural mentor
  • Aboriginal academics on our investigator committee
  • Steering committee with at least ½ membership Aboriginal people or represent Aboriginal organisations
  • Aboriginal staff
  • Aboriginal research assistants to collect the data
  • Policy working group with peak Aboriginal health organisation representation.

Who we are

The study is being conducted by researchers from The George Institute for Global Health, The University of NSW, The University of Sydney, Flinders University, Wollongong University and Curtin University. The George Institute for Global Health is the study sponsor.

Chief Investigators

Prof Rebecca Ivers, Prof Cathie Sherrington, Prof Kathleen Clapham, Prof Lisa Keay, Prof Lindy Clemson, A/Prof Anne Tiedemann, Prof Judy Simpson, Dr Tamara Mackean, Ms Courtney Ryder, Prof Anne-Marie Hill


Associate Investigators

Prof Robert Cumming, Dr Anne-Marie Eades, Prof Kirsten Howard, Dr Catherine Hunter, Prof Stephen Jan, Dr Kris Rogers, Dr Josephine Gwynn, A/Prof Kim Delbaere, Prof Marion Kickett, Prof Keith Hill


Operational team

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Aaron Simon

NSW Project Officer

School of Public Health and Community Medicine, University of NSW

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Roland Wilson

Research Associate

Southgate Institute, Flinders University

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Julieann Coombes

Senior Aboriginal Project Officer

Injury Division, The George Institute for Global Health

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Layne Brown

Aboriginal and Torres Strait Islander Project Coordinator

Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre University of Wollongong

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Sallie Cairnduff

Project Manager

School of Public Health and Community Medicine, University of NSW

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Kate Patten

Research Assistant

School of Public Health and Community Medicine, University of NSW

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Dr Rona Macniven

Research Fellow

School of Public Health and Community Medicine, University of NSW

Chief Investigators

Prof Rebecca Ivers, Prof Cathie Sherrington, Prof Kathleen Clapham, Prof Lisa Keay, Prof Lindy Clemson, A/Prof Anne Tiedemann, Prof Judy Simpson, Dr Tamara Mackean, Ms Courtney Ryder, Prof Anne-Marie Hill


Associate Investigators

Prof Robert Cumming, Dr Anne-Marie Eades, Prof Kirsten Howard, Dr Catherine Hunter, Prof Stephen Jan, Dr Kris Rogers, Dr Josephine Gwynn, A/Prof Kim Delbaere, Prof Marion Kickett, Prof Keith Hill


Operational team

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Aaron Simon

New South Wales Project Officer

School of Public Health and Community Medicine, University of NSW

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Carolyn Lewis

Western Australia Project Officer

Curtin University

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Julieann Coombes

Senior Aboriginal Project Officer

Injury Division, The George Institute for Global Health

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Dr Rona Macniven

Research Fellow

School of Public Health and Community Medicine, University of NSW

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Sallie Cairnduff

Project Manager

School of Public Health and Community Medicine, University of NSW

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Kate Patten

Research Assistant

School of Public Health and Community Medicine, University of NSW