Bridge to Better Health: Capacity Building in Intellectual Disability Health for General Practice

INTERVENTION: The Bridge to Better Health Intervention is made up of 3 arms. This intervention is targeted at Practice Nurses who are supporting patients with intellectual disability. Arm 1: Access to a specialised intellectual disability nurse ‐ The specialist intellectual disability nurse will have received training and/or detailed experience supporting people with intellectual disability prior to their involvement in their study. ‐ The specialist disability nurse will provide direct support to the practice nurses through monthly check‐ins via phone or video call (approximately 15‐30 minutes depending on the practice nurses needs). In addition to the monthly check ins, the specialist intellectual disability nurse will also be available to provide advice as needed and where required, will travel within a 150km radius of the Mater Hospital to provide additional support. Arm 2: Online Education ‐ The education content/modules are being specifically designed for this study, with members of the project having recently designed similar education as part of the EASY health project. ‐ Examples of topics include; health risks of patients with intellectual disability, barriers to accessing healthcare, reasonable adjustments and a CHAP health assessment information video. ‐ The education will be designed in modules, with short videos, written text and infographics. It will be available through a secure web portal and receive a log in to do so. This will not be available to the general public. ‐ We aim to have a maximum of si Xmodules that can be completed in one sitting (as to ensure the completion of them) and run for roughly 1 hour in total. Arm 3: Online Resources ‐ Online resources will be available in a secure web portal and not open to the gen CONDITION: Intellectual Disability Health Care; ; Intellectual Disability Health Care Mental Health ‐ Learning disabilities Public Health ‐ Health service research PRIMARY OUTCOME: An economic evaluation from the health sector perspective will be undertaken to determine the value for money of Bridge to Better Health versus usual care. Incremental cost per quality adjusted life year gained. Cost data will be collected from the Medicare Benefits Scheme database accessed through ABS DataLab. [ The efficacy of the primary outcome will be determined one year post intervention, after researchers have accessed health data a year post intervention.] The determine whether practice nurses who are supported by a specialised intellectual disability health nurse to complete health assessments will change the number preventative health actions assessed through hearing tests (Whisper test, Webber test, Renne test or Rub test). ; ; The number of participants completing hearing tests including a Whisper test, Webber test, Renne test and/or Rub test will be assessed as a composite primary outcome. The number of participants completing the tests will be determined through practice medical records and access to health data. [ The efficacy of the primary outcome will be determined one year post intervention, after researchers have accessed health data a year post intervention.] To determine the number of potentially preventable hospitalisations according to the set of clinical indicators identified by the advisory group. Hospitalisation data will be collected from Queensland Health Admitted Patient Data Collection and Emergency Data Collection and assessed against the set of clinical indicators identified by the advisory group including Pneumonia, Urinary Tract Infections, Dental conditions and more.[ The efficacy of the primary outcome will be determined one year post intervention, after researchers have accessed health data a year post intervention.] SECONDARY OUTCOME: Any change in the uptake of preventative health actions including vaccination, smoking cessation, and cancer screening will be assessed. Uptake of any preventative health action will be assessed as a composite secondary outcome. The uptake of preventative health actions will be determined through an audit of general practice records and access to MBS/PBS data. ; [ The efficacy of this secondary outcome will be determined one year post intervention, after researchers have accessed health data a year post intervention.] Hospitalisation data will be collected from Queensland Health Admitted Patient Data Collection and Queensland Health Non‐Admitted Patient Data Collection, Emergency Data Collection and assessed against a previously developed list of non‐impactable hospital admissions from disease management programs (Falster & Jorm, 2017; Health Quality & Safety Commission New Zealand, 2016) [ The efficacy of this secondary outcome will be determined one year post intervention, after researchers have accessed health data a year post intervention.] Outcome is primary: ; To determine the difference in general nurses self‐perceived knowledge, confidence and attitudes in providing healthcare to people with intellectual disability pre and post intervention measured using the TCS‐ID & MCPS‐ID questionnaires. These will be assessed as a composite secondary outcome. [ This outcome will be explored after the completion of the education and online resources (within si Xmonths of the education being completed).] To determine the impact of specialised disability support nurses on general practice nurses’ ability to provide healthcare to people with intellectual disabilities. This will be determined by semi‐structured telephone or video call interviews with a member of the research team. [ Interviews will be conducted within 6 months of the intervention ending] To determine the impact of the intervention on the healthcare experiences of patients with intellectual disability. This will be determined by semi‐structured telephone or video call interviews with a member of the research team.[ Interviews will be conducted within 6 months of the intervention ending] INCLUSION CRITERIA: General practices in the Greater Brisbane area, including the catchments of Brisbane North, Brisbane South and Darling Downs and West Moreton PHNs (approx. 750 practices), will be eligible to participate in screening for the RCT. Individual practices will be eligible for study inclusion if they i. employ at least one practice nurse who consents to be part of the project ii. the practice provides services to at least 5 patients with intellectual disability. Individuals with intellectual disability will be eligible to participate if they: i. have intellectual disability (self‐identify or confirmed by GP), ii. are aged 15 years and above iii. provide informed consent or if required, have a substitute decision‐maker to provide informed consent. Support people of individuals with intellectual disability will be eligible to participate if they: i. support a person aged 15 years and above with intellectual disability (support perso