Gretchen Miller [Host]: Hello, this is Prevention Works, welcome. I’m Gretchen Miller, coming to you from the unceded territory of the Darkinjung people. And our five guests today are joining us from Gamilaraay and the Bedegal Lands. It is going to be a wonderful conversation in which we explore the nuts and bolts of a community-led program to reduce childhood injury, but also zoom out to discuss the context of this work: a successful collaboration between the First Nations community at Walgett and researchers from the University of New South Wales.
Nellie Pollard-Wharton: I think for me it is because my focus is the co-designed research, Aboriginal-led research and Indigenous and First Nations’ communities having control of resources in order to ensure that what does get designed is appropriate for community, is a response to community needs, then stays in community, then can be improved, changed, amended as needed by that community, and then remain there as something that is owned by us and continues to be positive.
Gretchen: That’s Nellie Pollard-Wharton a Kooma woman and Associate Lecturer in Aboriginal and Torres Strait Islander Health in the School of Population Health at UNSW Sydney. This kind of engagement has been fraught territory. In the past, researchers of all stripes have gone to Indigenous lands and then disappeared again with both artifacts and data, leaving Indigenous communities with nothing to show but the advantage taken of their hospitality. And these practices continue but they are increasingly challenged from within and without Indigenous communities and measures are now being taken by some universities to ensure there is a fair exchange of benefit and further, that the research is led not by the universities, but by the communities themselves.
Rebecca Ivers: The research that we apply in Australia very much comes from a western biomedical framework. So, it’s run by people like me, the colonisers, the settlers, saying, “Well, this is the way we do research, I’ll come up with an idea and come and inflict my idea on a community”. It is about stepping back from that and saying, “What are the community’s priorities? What does the community want?” And in co-design, power has to be shared, power has to be equal, and the majority of power needs to come from the community.
Gretchen: Professor Rebecca Ivers there, Head of the School of Population Health from the University of New South Wales and as you can hear, it is a critical paradigm shift and we’ll get to hear more of this part of the conversation expanded at about 21 minutes into this episode.
With Rebecca and Nellie are three other guests: Amy Townsend, a proud Gamilaraay woman with extensive experience within the early childhood industry as a teacher, director and educational leader, now working as a Project Officer at UNSW in ageing well for Aboriginal Elders.
And we have Christine Corby AM, also Gamilaraay and the Chief Executive Officer (CEO) of Walgett’s Aboriginal Medical Service, or WAMS, as you’ll hear it referred to in this conversation. Plus, Melissa Nathan, who is a Chronic Disease Manager at WAMS. They have been working on a Child Injury Prevention Partnership, known as CHIPP, established to develop, deliver, and evaluate a culturally safe injury prevention program within an existing playgroup at WAMS. And that was informed by the Dharriwaa Elders Group. So, let’s get started and first up could you set the scene for our listeners and describe Walgett for us, Christine?
Christine Corby: [00:04:00] Walgett’s on two rivers in Namoi and the Barwon, eight and a half hours by road, north-west from Sydney, Gamilaraay country, population about two and a half thousand people. We say about 60% are Aboriginal people, and there’s two villages outside of Walgett levee bank, one is Namoi Village across the river and the other is called Gingie Reserve, which is 10 kilometres out. I suppose the demographics of Walgett, we are a bit of a service centre now. There are a few government agencies here, but as an organisation for Walgett, we’ve been operating for 37 years, come last June . And as an NGO and an Aboriginal organisation, we have been consistent in our business, and we believe we’ve certainly contributed to the economic growth of the town and the footprint that we cover.
Gretchen: And you’re speaking of the Walgett Aboriginal Medical Service?
Christine: I am indeed.
Gretchen: Could you tell us about the setting for the research, the Goonimoo Mobile Children’s Services, Amy?
Amy Townsend: It’s an outreach playgroup facility that provides outreach playgroup, but also has a playgroup that meets twice a week. So, during that time, the playgroup operated two days a week and the Walgett group, that was the participants who were involved in the CHIPP project.
Gretchen: So why was the program needed and why was it initiated, Rebecca?
Rebecca: There was an opportunity for some funding to look at a child injury prevention program and I am an injury prevention researcher and I have worked with a variety of different Aboriginal and Torres Strait Islander community groups for many years, in partnership doing injury prevention research. But UNSW had an existing partnership with Walgett, with the Dharriwaa Elders Group in Walgett and the partnerships called Yuwaya Ngarra-li and it’s a community university collaboration looking at community-led development, really aimed at improving wellbeing and the social environment and life pathways of Aboriginal people in Walgett, building on evidence. [00:06:00]
Because of this existing partnership, we came to the Dharriwaa Elders Group and said, there’s an opportunity for this project, is this something that could be delivered in Walgett? And they consulted with WAMS, with the Aboriginal Medical Service and Goonimoo and pretty much said, “Yes”, and introduced us to Christine Corby and to Amy and then this partnership developed up to co‑design this program of research.
Gretchen: I have got so many questions around this. I mean, firstly, how UNSW came to have this longer standing overarching relationship in Walgett, but also how the sort of need and the initiation got started in a bit more detail, Nellie?
Nellie: I was just going to say in terms of the longer-standing partnership, Yuwaya Ngarra‑li, so they’d been developing work for a number of years. What started off as quite a small research project with the Dharriwaa Elders Group in Walgett, which is the Elder’s Group out there, and as a result of that the partnership was built. From just a quick snapshot over the years, they’ve actually done a lot of community engagement and work to ensure that the community members through the Elder’s Group can highlight the needs that exist within the community. And, as a result, they’ve created a number of values and frameworks to drive what research comes in and out of Walgett to ensure that what is conducted in Walgett actually meets the needs of the residents and community members as outlined by them and highlighted through the work of the Dharriwa Elders Group in their partnership with the Yuwaya Ngarra-li.
Rebecca: [00:08:04] It was basically a co-designed family child injury prevention program that was delivered through the playgroup. So very much co-designed as the program went – there was a lot of consultation beforehand and a lot of input from the families saying what they wanted in a program and then as the program developed up, these training sessions were delivered in line with what the families actually wanted and what was needed in the community. So, it was an iterative process but was really built into this playgroup-based approach which was delivered over the course of several terms across the school year. So, the trainings weren’t delivered in isolation.
Gretchen: Thanks Rebecca. I’d like to get to that co-design in more detail as we go through the conversation, but I guess it’s very clear that this is practice-based research, so it’s not just researchers, it’s actually outcomes. The outcomes, as I understand it, is that there were three sets of community training on child safety: one in the home, one at the pool, and road safety – Amy, let’s have you back again?
Amy: The programs involved the home safety, road safety, and water safety. The training and the resources that were involved with that were all identified by the participants within the playgroup. So, they were things that they identified of car seats and just car safety, not having that available in the community. So, there were lots of lots of information they were seeking around heights and weights and ages so it was really good to have that information available, but also have the training, so Goonimoo staff as well as some of the community members, in Walgett and at the AMS, were able to do the child restraint training so that also included one of the other playgroup providers. They were also invited and trained to do the child restraints so that the information could be shared across the community because we also know that where we live, we spend lots of time in the car. It’s nothing for people to drive three hours down the road to have appointments and see specialists or go shopping and so it was really important to make sure that our seats were fitted safely.
With the water safety it was really identified within those yarning circles that we had in the beginning that not a lot of our children had access to swimming lessons, nor did the families have swimming lessons. So, it was something that was very new, but also, we had to look at it and deliver it in a way that was appropriate for our families. So, we did it during our playgroup times and we incorporated swimming lessons into playgroup. We would meet once a week at the pool during the summer, during that term.
Gretchen: Right, another super tangible outcome, and in the home, what was addressed in terms of safety in the home?
Amy: Each week we’d have a number of social media posts around home safety and injury prevention because a lot of the home safety happened during COVID, so we had a lot of the resources and home learning packs that each week would incorporate a different topic. Also, during that time we had flooding, and we’ve had lots of other events that had happened during that time and so we were able to put in all of that information that was relevant and happening at the time in the community.
Gretchen: That’s a really good point. A lot of this research happened during COVID, which was a global event and hugely impactful, but you also had droughts, as you say, you had flooding. The project started off one way and ended up focusing on these particular areas, which really indicates how adaptable it had to be. Why is that adaptability important, Nellie?
Nellie: To answer that, it speaks to a number of things, like obviously the initial design of the project and the way in which we’re working because true co-design is iterative and it’s constantly changing, depending on the reality of the situation in which you’re delivering a program or developing it or having to run it, essentially.
But I think the Goonimoo team and the WAMS team, the way in which they were able to be so innovative and flexible around how they could on-the-fly change up what needed to be changed each week during COVID and those natural disasters to ensure that family members and participants were able to still access the information was incredible and really had nothing to do with the broader research. It was just more them and their ability to, when you work in an area such as Walgett or that is geographically so far from lots of things, to just pivot and work the way they do.
And that was really driven by the Goonimoo team and WAMS and by Amy just being there on the ground and trying to not only be a core part of the research and deliver the program but also doing their own jobs simultaneously and also being researchers themselves now as a part of the project that were just able to to pivot with everything that just happened. And Amy’s amazing and just came up with solutions every step of the way.
Gretchen: How fantastic, I wonder Christine, if you want to reflect on that process of adaptation and flexibility?
Christine: Did we actually have the supermarket burned down at the same time?
Amy: Yep, we did.
Christine: You know, we had a comedy of errors in Walgett. Now we’re on two rivers, we had a drought, we had a flood, the IGA burned down, for the second time, the only supermarket in town and you talk about versatility, innovation, well, certainly Amy was it, and still thinks like that. And Melissa, of course, having worked remotely, she walked into a community where you have to think on your feet and you do use the word pivot and I suppose we just change our hats and do what needs to be done. Every day is different, every hour of the day is different, and we can’t really explain it until, as you say, you reflect back on how you achieved it and all the hurdles. And I call them hurdles that we encountered in this program, which happens everywhere. We had the capacity with Amy’s leadership to do that and the community were willing to, you know, the participants were happy to and recognise that was needed. So, we had a willing audience, a willing leader, and it all worked together.
Gretchen: That’s a really lovely reflection. Thank you. I want to ask before we get to the collaboration and the idea of co-design and how critical it is, what were the original intentions and aims of the project that changed to fit the circumstances? Maybe Rebecca, you want to talk to that?
Rebecca: Look, it’s a really interesting question and I think it actually speaks to what co-design actually is because when we first started the project, we had an idea about what it might be, that it would be a program embedded in Goonimoo and co-designed but it would be delivering a child injury prevention program across the year. And we had ideas, we had injury researchers on the team and Aboriginal and non-Aboriginal researchers. I’m a non-Aboriginal researcher so we had ideas and I had spent a bit of time in Walgett but not that much.
We had a vision of this fairly fixed curricula, I guess it’s fair to say, where we would have a manual that would be co-designed with training embedded and it would be delivered in a pretty systematic way at each of the playgroup sessions. And again, that was after Nellie had run some focus groups early on with the playgroup to ask the families and also some of the community members and stakeholders about what they needed and what would work.
But as soon as we started delivering it, or as soon as Amy started setting it up, designing the program, and implementing it, it became pretty clear that that kind of really fixed didactic curricula wasn’t going to work at all. It needed to be much more adaptable and Amy and the team, with WAMS, said we’re going to support it in a much more flexible way and say, well, we need this, this is when we want to have the pool day. These are the kind of things that we need…we need an Aboriginal person trained as a swimming instructor to give access to the pool and a range of other things. So, it did change and that’s part of the process I guess, is actually just being able to just let it go where it needs to go and respond to the community priorities and the families, and Amy as a Goonimoo leader really did an amazing job in directing that process.
Gretchen: Rebecca, in academic discourse, you describe it as co-designed multi-methods evaluation adopting decolonising Indigenous, methodological approaches. It’s a very rich sentence, what does it mean on the ground, like each one of those words is very powerful?
Rebecca: The decolonising aspect of it is really about saying, well, whose knowledges are we valuing? We’re not just valuing a western biomedical framework, we’re valuing Indigenous research methodologies, that’s yarning, it’s talking, it’s not just didactic question and answer interviews, it’s actually about deep understanding. It is really just taking a different approach and part of that is actually the process. So, with Amy, as a very active participant in the research, not just as the worker at Goonimoo, but as an active co-researcher.
And that’s coming out by Amy leading one of the research papers, writing that up, and working in very close partnership with the research. And Nellie is the other lead researcher, she will be leading the other publications that come out of the project, so having Aboriginal voices and the Aboriginal community members having input into what goes into those publications as well, as full participation as we can with both the design, the conduct, the implementation and the evaluation, and then the community feedback as part of that. I’m sure Nellie and Amy can speak to that and be much more articulate about that process from their perspective.
Gretchen: Yes, I want to throw that open to all of you, what are your reflections?
Nellie: I’m happy to jump in briefly. And I guess I’ll speak a little more from that broader perspective around what you touched on about the infiltration into Indigenous communities and just taking our knowledges with no tangible outcomes or anything left for us to benefit from. I think for me it’s because my focus is the co-design research, Aboriginal-led research, and Indigenous and First Nations communities having control of resources in order to ensure that what does get designed is appropriate for community responses to community needs, then stays in community, then can be improved, changed, amended as needed by that community and then remain there as something that is owned by us and continues to be positive.
And we can only do that if we can control the funding and I guess with some of the negative outcomes of those aspects of research that you were speaking to was that it would often be a dip-in and dip-out of communities and there wouldn’t be any lasting positive impacts.
But I think a part of their work around the community-led research was to try and ensure that that sort of dip-in and -out work done by researchers external to an area would stop to ensure that community members would, and the Elders Group and WAMS, and everyone would be able to have a stronger say in what did actually come into community and what research was able to occur but for me co-design and community-led go hand in hand, especially in, Aboriginal spaces where you can’t have one without the other.
Gretchen: Christine, do you have any reflections on that?
Christine: As an organisation operating for the length of time that we have been, researchers have come knocking on our door for different purposes. Some have accepted, some we haven’t, but the bottom line for us as Aboriginal people in our own community and the language you use about co-design and multi- whatever, it’s about working together, partnering, respecting. We never talked about what happens in the community, unfortunately for our community, I think we’ve had about five weeks of sorry business and that’s never heard of, but you often have [government] departments, when we say the timing is not right for you to come back in a month’s time, then we are called non-compliant, not being a partner, and all the other negative connotations, from their rights, not our eyes, our priorities, looking after the community and knowing when to conduct a program. And that is very rarely respected and appreciated and acknowledged. So, when you are talking about decolonising and you’re saying, we do our own research as Aboriginal people in a structure and we know what’s right and then we use it again or we don’t, all the evaluation and all the language, and I just say with all these words here, throw out the Oxford dictionary and be practical in your application so people actually understand what you are trying to deliver, what we wanted them to receive, then you’ll actually get successes on the ground.
As I say, we were very fortunate with Amy being local, Aboriginal, understanding. community respected her. That was her success. If there was no acceptance and no acknowledgement of the way in which she approached the program – researchers, universities, and any other partner that wants to be a partner here wouldn’t have had a foot in the door and we would’ve had to show them the levee bank without any qualms. And I think that’s the bottom line with it all isn’t it, Amy? To be accepted as an equal partner we have to have a quality all the way. The planning, designing, the whole kit and caboodle and sometimes it gets lost when people can see their publication just down the road. We want to see what’s left behind for the community and that they have good memories and they say, oh, we need to do that again for the next generation. That’s your success, it’s not being published.
Gretchen: Amy, what is your feeling on the discourse because you straddle both the boots on the ground and working at the university but also that ongoing big picture issue of fly-in, fly-out research. Do you think change is happening more broadly?
Amy: I think change is beginning to happen. I think it’s from projects like CHIPP that’s happened where we’re able to talk to other communities and to other researchers and showcase the actual project and how it was delivered but also not in a way that we knew the statistics around child injury rates but we were talking about the importance of it within our community, but we weren’t doing it in a lecturing way to point it out. We were giving that power back to our playgroup participants who then came up with on their own to know, that at the end of the day, this whole project and what was delivered was all based on what our families wanted. And I think that’s the important part of this research, that it was sustainable too, because it’s also left WAMS and Goonimoo staff with training, but also the resources that now they have the knowledge to continue having all this safety injury prevention information there and available and it’s always been about what our community needed.
Gretchen: Something we haven’t spoken about but it would be great to talk a little bit more about is how you gathered feedback and community response so that you were able to further tailor the training and the programs within Goonimoo?
Amy: Each week, during our yarning sessions, we would keep a reflection of our day. So, each playgroup session, we would talk to the participants about different aspects, of the injury prevention that they’d learn and highlight anything that was noted, or anything that they would talk about. Each week, they’d let what they were learning and what they’ve, what they’re now doing at home differently or what they’ve shared with other family members. We recorded it, each week, so it was something we’d already had in place, but just adapted, around the CHIPP project. And so, we were able to look back at these weekly reflections of the information that was shared and what our participants were saying, what they were enjoying or what they were needing.
Gretchen: Melissa, I know that you came in after, but have you noticed any sort of response to this project and what happened with it?
Melissa Nathan: Not specifically to the project but in terms of the continuation of safety, that I guess could be attributed to the project because it’s not really something it can measure, but the continuation of the car seat installation has been quite a successful day here in the community. The pool events are also successful days in the community. So, you’d never be able to measure that, you know, whether it came from the project or not. But the car installation day that we had at the end of last year stands out in my mind as being very well attended so the knowledge is there in the community.
Gretchen: So, one of the overarching questions is how the project evolved through that community-led process because obviously that’s key to being community-led. Everyone involved is considered the researcher as you’ve pointed out before and they all need to be responsive and engaged and ready to switch directions. Apart from responding to the enormous event that was COVID, what other adaptations have you had to make as you went along?
Amy: Just being responsive there and having to make those adaptations. I think it was more so going down the avenue of, okay, we can’t meet face-to-face but our parents still need that support from us. And so, it was a complete game changer, we had an at-home delivery service. We would have a week of packing and getting organised to send these activities home to keep the families busy and have arts and crafts and have learning stuff, but also how do we keep it going? [00:28:00]
So, during that time we were going to do swimming and then it was going to be road safety but we just couldn’t do it at that time and then said, okay, we have to change this now and let’s do home safety because we’re going to have our families at home all the time. But to be resourceful for that too, we had to think when can we make arrangements to get people to come in and to do training with them, how we are going to get these people to visit during COVID? We had to really think carefully about how we were going to do it and it just all came together in the end and I felt that they were really supported in the end of what we could do outside with no sessions and just not having that face-to-face contact.
Christine: Can I just add for Amy and what she just mentioned, it was also sustaining the mental health of the people, holistically. It wasn’t just a delivery of a program, it was asking: Are you okay? How are you going? There was other aspects of that delivery apart from delivering goods. Look, checking a family’s kids are okay? Anything you need? All that general chitchat. There was a lot of subliminal messages that Amy conveyed and how do you measure that? Like you say, that was really, we said social welfare check, social engagement in those deliveries, and that’s exactly what it was.
Rebecca: I guess it just speaks to the, you can’t ever just run a program and say, this is an injury prevention program that’s been delivered through Goonimoo. What’s most important is what the needs are of the families and Goonimoo and WAMS. It’s the actual project. So, the injury prevention bit is just something that you get to deliver if it works alongside everything else but in times like that, there’s no way that that’s a priority. As Christine says, “it’s about social and emotional health and wellbeing of the families and, and what they actually need at that time”. And you have to actually respond to that. You couldn’t possibly just say, you can’t do that, you have to do an injury prevention message. It would be completely inappropriate.
Gretchen: I was going to ask you, Rebecca, speaking directly to our listeners who are largely other researchers and policy makers, I’d love for you to outline hypothetically, what might have happened if you had not collaborated, if it was the kind of project that you described where you just bring something in from the outside, why has that approach failed in the past? Look, I mean, it, it seems self-evident to me that you’ve got to co-design, you’ve got to collaborate, I mean, we’ve all worked for organisations where they say, oh, we’re going to, consult you and we know what consultation means. It means asking a few polite questions and then doing what you’re going to anyway and why we really have to change as a research community to never approach other communities in such a top-down way.
Nellie: Hey Rebecca, before you answer like academically, can I make a little just response? I just think academics actually need to just stop and look back at themselves and say, why on earth do I think it’s okay for me to be a part of this research? Why is it okay for me to be the one leading this research?
Why do I as a non-Indigenous researcher have to have anything to do with this space apart from increasing the number of papers I have so I can get more grants and then get a better pay check and then further my career because it’s blatantly obvious and as younger Indigenous researchers coming into the space, we can see it clearly. Community members can see it clearly. I think it’s like, we want to see the stuff happening on the ground, the research has occurred, so why are people continuing to put themselves in that space when you’re not invited there?
Gretchen: Rebecca, could you speak to that, to our listeners, our other researchers now, policy makers, why things don’t work?
Rebecca: Well, we know it doesn’t work because we’ve got 200 years of colonised history to show that it doesn’t work. People going in and saying, “I know best, I’m going to do research on people not with people”. And as Nellie said, and I’m obviously guilty of that myself, the focus is on publications and grants.
I think what has to be different is the leadership, the community prioritisation, the capacity development, and it’s not even capacity development, it’s recognising the knowledges and experiences of Aboriginal people and their rightful place to lead this research and their capacity to do that.
I think things have changed though now, as Christine said before, without the leadership of Amy at Goonimoo and that partnership, and I think without that partnership that UNSW had with Dharriwaa Elders Group, we wouldn’t have had the privilege of actually working with Amy and with Goonimoo and WAMS on this project. It came about because of that long engagement and known people and processes and ways of doing things and an understanding of the way in which the Aboriginal community in Walgett wanted research to be done.
And I think as a non-Aboriginal researcher part of it is reflexivity. Again, it’s one of those words, but it just means looking at yourself and thinking about what you do and being honest about your place and where should you be. And the next pieces of research that are done have to be led by Aboriginal people.
The publications are always something that we focus on as researchers, but actually what’s most important is actually getting a program delivered that actually has meaningful impact in the community, changes people’s lives and that people want to keep running. Without that authentic, deep understanding of what is actually needed and whose place it is to do research, you’ve got no business in being there.
And I don’t pretend that I get it right all the time, I absolutely don’t. I think it’s about actually sitting back and going, wow, really what did you think you were doing there? And I’ve had a lot of those conversations with myself and I’m very fortunate to work with people like Amy and Nellie and Christine, who would tell me frankly when you need to do better.
Gretchen: In terms of Aboriginal communities protecting themselves from this long history of data mining and artifact mining but in this regard, it’s data mining, what are your thoughts?
Christine: What’s the guarantee that we aren’t going to get burnt and publicised in a negative way? I suppose reflecting back again on previous research in this community, research was conducted in the late eighties and it was de-identified but you knew, eight hours northwest of Sydney, population of two and a half thousand people on two rivers. You knew who you were and unfortunately at that time it was about sexually transmitted diseases. So, we all had the pox up here, so interpretation and just the, if you say no, you say no. Don’t create your own. I mean, I know there’s such a thing as desktop research, so you research everybody else’s research and then you create your own research from their research. I believe in information gathering. I believe in data. What I don’t believe is wolves in sheep’s clothing who say, like you what was mentioned earlier, we know what’s good for you. And like Nellie said, and I say too, you’re just one step away from the next publication – Can’t do that, really, really need to rethink.
Gretchen: So, what next for Goonimoo? What next for the collaboration, Nellie?
Nellie: I guess what next, I’m unsure. I hope that what’s been produced by the team, our manuals and everything are just so beautiful and something to be so proud of. Really, the work in them is amazing and it’s beautiful to have something that’s come out of a specific place that’s been built up with really good collaborative efforts.
So, I don’t know what happens on the ground in Walgett, because obviously we are not there, but if, obviously it’s something that WAMS owns and is able to continue to implement at their discretion as much or as little as they want within Goonimoo but to the future it’d be nice again with the permissions of WAMS and collaborative work from WAMS and Amy and other people to see what parts of this project could be used with other Indigenous early childhood groups elsewhere, depending on interest.
Gretchen: This has been such a meaningful conversation. I want to thank you all so much for sharing your knowledge and experience: Amy Townsend, Nellie Pollard-Wharton, Christine Corby, Melissa Nathan and Rebecca Ivers. Brilliant work.
You will find more links on The Australian Prevention Partnership Centre website and please, if you have enjoyed this conversation, do share us on your socials and leave us a review. We really love those. For now, I’m Gretchen Miller. This is Prevention Works see you next time. [37:48]