Abstract
BackgroundIndigenous people make up approximately 3% of the total Australian population and score poorer on all health indices, including back pain. Chiropractors are well placed to alleviate back pain, yet there is no research that considers chiropractors’ readiness to treat Indigenous patients. This study explores chiropractors` experience working with Indigenous Australians, describes perceived barriers and facilitators to chiropractors’ participation in Indigenous Healthcare and their willingness to engage in cultural competency training.MethodsThis study used a non-representative cross-sectional design and a convenience sample. Participants were recruited via email invitation to complete an online survey and encouraged to send the invitation on to colleagues. A 17-item online-survey measured demographic data, perceived barriers and facilitators related to caring for Indigenous Australians, participants` level of comfort when working in Indigenous health, and their willingness to participate in cultural competency programs to enhance their skills, knowledge and cultural capacity when engaging with Indigenous Australians. Analysis of the data included descriptive statistics as well as thematic analysis of qualitative free text.ResultsOne hundred and twenty-five chiropractors participated in the survey. The majority of participants (86%, n = 108) were employed in private practice. 62% of respondents were members of the Chiropractors' Association of Australia, 41% were Chiropractic and Osteopathic College of Australasia members. 60% of chiropractors considered that they had, or do treat Indigenous patients yet only 4% of respondents asked their patients if they identified as Indigenous. A majority of participants expressed a high level of ‘comfort’ or confidence in working with Indigenous people while only 17% of respondents had undertaken some form of cultural proficiency training. A majority of respondents (62.7%, n = 74) expressed an interest in working with Indigenous Australians and a majority (91%, n = 104) were willing to participate in training to develop Indigenous cultural competency.ConclusionsThe study points to a need for chiropractors to have access to cultural proficiency training in order to develop the capability and confidence to engage respectfully with their Indigenous patients. This preliminary study has provided the researchers with valuable insights aiding the development and implementation of an Indigenous cultural proficiency program for chiropractors.
Highlights
Indigenous people make up approximately 3% of the total Australian population and score poorer on all health indices, including back pain
Indigenous-specific item results To meet the aims of this research, participants were asked about their experience working with Indigenous patients
Given that recent Australian Bureau of Statistics (ABS) [12] figures estimated that 35% of Aboriginal and Torres Strait Islander people lived in major cities, 45% lived in inner and outer regional areas and only 20% lived in remote and very remote areas this view of geographical location of Aboriginal and Torres Strait Islander people points to an added learning opportunity for chiropractors to recognise that Indigenous people may well live in their midst and that a respectful request whether an individual identifies as Indigenous becomes part of routine initial patient data collected
Summary
Indigenous people make up approximately 3% of the total Australian population and score poorer on all health indices, including back pain. This study explores chiropractorsexperience working with Indigenous Australians, describes perceived barriers and facilitators to chiropractors’ participation in Indigenous Healthcare and their willingness to engage in cultural competency training. While there are no census data measuring LBP across all geo-locations of Indigenous Communities, Lin et al [3] recorded back pain as ‘profoundly disabling’ in some Indigenous Communities, and Vindigni et al [4] demonstrated that in regional and remote Indigenous communities, LBP is the most prevalent musculoskeletal condition with financial disadvantage, limited geographical access to allied health professionals (such as chiropractors, osteopaths and physiotherapists) and sociocultural barriers identified as contributing to the burden of illness. Accessible and effective strategies for managing musculoskeletal pain experienced by Indigenous peoples are indicated. The underlying causes relate to disadvantage across a spectrum of determinants including include social, political, educational, economic, geographical and cultural determinants of health [7]
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