Adapted Mainstream Screening and Assessment Tools

Kimberley Indigenous Cognitive Assessment (KICA)

What is it?

The Kimberley Indigenous Cognitive Assessment (KICA) is the only validated dementia assessment tool for older Indigenous Australians. It is recommended for use with rural and remote Indigenous Australians aged 45 years and above for whom other dementia assessments are not suitable.

The KICA-Cog section has been validated with Indigenous Australians aged 45 yrs and above from the Kimberley and Northern Territory. A short version (KICA-Screen) has been validated in Far North Queensland.

The questions in the KICA survey provide the first specific instrument for assessing cognitive decline in older Indigenous Australians.

Who developed it?

The Kimberley Indigenous Cognitive Assessment (KICA) was developed by Dr Dina LoGiudice (geriatrician, National Ageing Research Institute) and Ms Kate Smith (occupational therapist, Kimberley Aged and Community Services) in collaboration with the University of Western Australia in 2004-2005, using a Healthy Ageing Grant from the National Health and Medical Research Council. A second phase of the project addressed the prevalence of aged care issues including cognitive impairment in older Indigenous people of the Kimberley. 

Background to Development

The KICA was developed in response to the need for a validated cognitive screening tool for older Indigenous Australians living in rural and remote areas.  The KICA was adapted from cognitive assessment tools in current use and refined after extensive consultation with community members of the Kimberley, including members of the Kimberley Aboriginal Medical Service Council (KAMSC), Kimberley Aged and Community Services (KACS), Kimberley Interpreting Service (KIS), psychologists and linguists. The KICA was translated and back translated into Walmajarri, a commonly used language originating from a desert area of the Kimberley.  The KICA was validated with older Indigenous people of the Kimberley to assess cognitive status. 

Links to Further Information

http://www.wacha.org.au/kica.html

http://www.wacha.org.au/docs/misc/KICA-Instruction-Booklet.pdf

Indigenous Cognitive Assessment-Validation of the sKICA-Cog in Far North Queensland: http://www.istaysafe.com/cpic/documents/demen_sKICAReport.pdf

Assessing cognitive impairment in Indigenous Australians: Re-evaluation of the Kimberley Indigenous Cognitive Assessment in Western Australia and the Northern Territory:  http://www.informaworld.com/smpp/922475214-1022053/content~content=a907749434~db=all~order=page

Patient Health Questionnaire (PHQ-9) for use with Aboriginal and Torres Strait Islander People with Ischaemic Heart Disease

What is it?

A rapid assessment depression screening tool for use with Aboriginal and Torres Strait Islander adults with ischaemic heart disease.

Who developed it?

The ‘Sadness and Heart Disease' project was conducted by Danila Dilba Health Service in 2005 and 2006 in collaboration with GP Registrar Danielle Esler to examine the suitability of a depression screening tool for use with Aboriginal and Torres Strait Islander people with ischaemic heart disease. Dr Fay Johnson and Professor David Thomas (Menzies School of Health Research) were also involved in the project.  A National Health and Medical Research Council Capacity Building in Primary Health Care grant funded the research.  Danila Dilba retains intellectual property rights from the project.

Background to development

The project was initiated in response to the recognition that depression is a significant risk factor for ischaemic heart disease, the well-documented prevalence of ischaemic heart disease among the indigenous population, and suggestions of high depression rates in similar populations. 

Phase one of the project involved focus group discussions among Danila Dilba staff and patients to assess the acceptability of a rapid assessment instrument, the nine-item depression scale Patient Health Questionnaire (PHQ-9). The scale was then modified to improve the acceptability of administering a psychological assessment tool in this population.

During phase two, an Aboriginal Health Worker administered the modified PHQ-9 tool to 34 ischaemic heart disease patients attending an Aboriginal Community Controlled Health Service in Darwin. The results were compared with the outcomes of psychiatric diagnostic interviews.  The modified PHQ-9 showed promise in this setting, but further investigation is required with a larger number of Aboriginal and Torres Strait Islander participants.

Links to Further Information

The acceptability of a depression screening tool in an urban, Aboriginal community-controlled health service (abstract only).

The validity of a depression screening tool modified for use with Aboriginal and Torres Strait Islander people.

Analysis of the Negative Life Event Scale for use with Aboriginal People

What is it?

The Negative Life Events Scale measures stressful life events in national surveys and was examined for endorsement, discrimination, and internal and external reliability in two Aboriginal samples.

Who examined It?

Emma Kowal, Wendy Gunthorpe and Ross Bailie from the Menzies School of Health Research in the Northern Territory.

Background

The Australian Bureau of Statistics used a Negative Life Events Scale (NLES) to measure chronic stress in the Indigenous population in the 2002 National Aboriginal and Torres Strait Islander Social Survey and the 2004-5 National Aboriginal and Torres Strait Islander Health Survey. In an attempt to generate some consensus about the best scales to use to measure Indigenous Emotional and Social Wellbeing, the Negative Life Events Scale was evaluated in two samples of Aboriginal people living in remote communities in the Northern Territory (n=262 and n=373).  While not representative, it was a sample comprised of a diverse Indigenous population of many language groups, spread over a large geographical area.  Data collected using the Negative Life Event Scale as part of a Housing Improvement and Child Health Study in 2002 was examined for endorsement, discrimination, and internal and external reliability of the items.

The Negative Life Event Scale generally performed well in the diverse Indigenous population sampled and may be a good starting point for further research into Social and Emotional Wellbeing in Indigenous populations. 

Links to Further Information

Kowal, E., Gunthorpe, W. and Bailie, R. (2007). Measuring emotional and social wellbeing in Aboriginal and Torres Strait Islander populations: an analysis of a Negative Life Events Scale

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