Developing a musculo-skeletal screening survey for Indigenous Australians living in rural communities

Abstract

Indigenous Australians living in rural communities experience high levels of musculoskeletal conditions that significantly impair their daily activities. Aboriginal health workers (AHWs) have a close understanding of their communities' needs and play a central role in the assessment and management of these conditions. To assist in the musculoskeletal assessment process a screening survey was collaboratively developed, trialled and evaluated for use by AHWs. A cross-sectional survey was developed following discussions with key community informants, and a literature review for relevant survey instruments. It was piloted before being administered by AHWs and the findings compared with those of a clinical assessment conducted by musculoskeletal health professionals. The participants included 189 members of an Australian rural Indigenous community. The screening survey achieved face and content validity. It provided high sensitivity (above 70%) and moderately high specificity (above 60%) for measuring musculoskeletal conditions in this community. It did not achieve high enough Kappa scores when measuring agreement between the screening tool and clinical assessment. A significant correlation was, however, obtained between the most prevalent musculoskeletal condition and between reported overall pain as assessed by AHWs and chiropractors. The screening survey has applicability in this community and has the potential to be adapted in similar settings. Incorporating a basic range of motion and palpation assessment to localise painful anatomical sites may help to further improve the sensitivity and specificity of this instrument.