{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T23:17:37Z","timestamp":1764890257373,"version":"3.46.0"},"reference-count":46,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:00:00Z","timestamp":1760918400000},"content-version":"unspecified","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Health and Medical Research Council of Australia","award":["APP1086141"],"award-info":[{"award-number":["APP1086141"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,20]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Objectives<\/jats:title>\n The primary objective was to determine whether a behaviour change intervention delivered to hospital staff would (1) improve the proportion of Aboriginal and\/or Torres Strait Islander (Aboriginal) babies being registered and (2) reduce hospital admissions and emergency presentations for babies <6 months old. The secondary objective was an observational analysis to determine factors that might influence the proportion of registered Aboriginal births in Western Australia (WA).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Quasi-experimental design and cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Five tertiary birthing hospitals in WA.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n The intervention was delivered to health service providers who were in the five tertiary birthing hospitals. Outcome data were collected on Aboriginal babies born between 1 January 2016 and 30 June 2018 who were delivered within these hospitals. Babies in the control group (n=226) were born 6\u2009months before the intervention and intervention babies (n=232) were born 6\u2009months following the intervention. For the secondary objective, there were 4573 babies included in the analysis.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n A behaviour change intervention delivered to hospital staff in five hospitals.<\/jats:p>\n <\/jats:sec>\n \n Primary and secondary outcome measures<\/jats:title>\n The primary outcomes were the proportion of babies who were registered and whether a baby had been admitted to hospital or an emergency department by 3 and 6 months old. The secondary outcome was to determine factors that might influence the proportion of registered Aboriginal births in WA (cohort study).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There was evidence of a 38% reduction in emergency presentations within 6\u2009months for babies born to hospitals 6\u2009months following the staff training (OR 0.62, 95%\u2009CI 0.42 to 0.91), and little evidence of improvements in birth registrations, hospital admissions within 3 or 6\u2009months of birth or emergency department presentations within 3\u2009months of birth. Of the 4573 babies included in the cohort study, 3769 (82.4%) babies had their births registered and 804 (17.6%) babies did not. Factors that were associated with not having a birth registered included low birth weight babies with a 34% decrease in odds of having a registered birth compared with those with a normal birth weight (adjusted OR (aOR) 0.66, 95%\u2009CI 0.51 to 0.86). Timing of first antenatal visit was associated with reduced odds of having a birth registered if this occurred in the second (aOR 0.77, 95%\u2009CI 0.64 to 0.93) or third trimester (aOR 0.59, 95%\u2009CI 0.45 to 0.77) compared with the first trimester.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our study identifies the complexities surrounding birth registrations and improved hospital utilisation for Aboriginal babies, the importance of targeted interventions and ongoing efforts needed to address this issue comprehensively.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n ACTRN12615000976583.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-089098","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T08:00:13Z","timestamp":1761033613000},"page":"e089098","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes following a behaviour change intervention within hospitals to improve birth registrations and hospital utilisation for Aboriginal and\/or Torres Strait Islander infants: a quasi-experimental and cohort study"],"prefix":"10.1136","volume":"15","author":[{"given":"K","family":"McAuley","sequence":"first","affiliation":[{"name":"Te Whatu Ora Health New Zealand Southern, Dunedin, Otago, New Zealand"},{"name":"Kurongkurl Katitjin, Edith Cowan University, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2962-5704","authenticated-orcid":false,"given":"Natalie Ann","family":"Strobel","sequence":"additional","affiliation":[{"name":"Kurongkurl Katitjin, Edith Cowan University, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Christensen","sequence":"additional","affiliation":[{"name":"Kurongkurl Katitjin, Edith Cowan University, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen Margaret","family":"Edmond","sequence":"additional","affiliation":[{"name":"King\u2019s College London, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5092-7697","authenticated-orcid":false,"given":"Peter","family":"Jacoby","sequence":"additional","affiliation":[{"name":"Telethon Kids Institute, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"McAullay","sequence":"additional","affiliation":[{"name":"Kurongkurl Katitjin, Edith Cowan University, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,20]]},"reference":[{"key":"2025120415075784000_15.10.e089098.1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.5694\/mja2.50959","article-title":"Closing the Gap: where to now?","volume":"214","author":"Milroy","year":"2021","journal-title":"Med J Aust"},{"key":"2025120415075784000_15.10.e089098.2","doi-asserted-by":"crossref","first-page":"737","DOI":"10.5694\/mja13.11127","article-title":"Reports indicate that changes are needed to close the gap for Indigenous health","volume":"199","author":"Russell","year":"2013","journal-title":"Med J Aust"},{"key":"2025120415075784000_15.10.e089098.3","doi-asserted-by":"crossref","first-page":"12","DOI":"10.5694\/mja13.10726","article-title":"Improving the health of First Nations children in Australia","volume":"199","author":"Eades","year":"2013","journal-title":"Med J Aust"},{"key":"2025120415075784000_15.10.e089098.4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0154171","article-title":"Hospital Utilisation in Indigenous and Non-Indigenous Infants under 12 Months of Age in Western Australia, Prospective Population Based Data Linkage Study","volume":"11","author":"McAuley","year":"2016","journal-title":"PLoS ONE"},{"key":"2025120415075784000_15.10.e089098.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013492","article-title":"Effect of socioeconomic disadvantage, remoteness and Indigenous status on hospital usage for Western Australian preterm infants under 12\u2005months of age: a population-based data linkage study","volume":"7","author":"Strobel","year":"2017","journal-title":"BMJ Open"},{"unstructured":"Hill Z , Kirkwood B , Edmond K . 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