'Hey, We Are the Best Ones at Dealing with Our Own': Embedding a Culturally Competent Program for Māori and Pacific Island Children into a Mainstream Health Service in Queensland, Australia.

Abstract

We present the results of one component of an external evaluation of Good Start Program (GSP), a community-based program for the prevention of chronic disease among Maori and Pacific Island (MPI) communities living in the state of Queensland, Australia. An evaluation of the GSP was undertaken using a mixed methods approach. This paper reports on the qualitative component where interview and focus group data was collected, using Talanoa, a culturally tailored research methodology. Respondents included school students, community groups, teachers and parents, as well as the Good Start implementation team. The five broad themes that emerged from this evaluation related to (i) components of cultural-competence and (ii) perceived impact of the program. The views of all participants reinforced the importance of culturally appropriate programs and highlighted how the multicultural health workers (MHWs) contributed to the program's perceived success. The challenges in understanding restrictions of the mainstream health service framework were noted indicating the need for it to be flexible in incorporating culturally appropriate components if a program was to be embraced. The qualitative evaluation of the GSP suggests that culturally tailored programs, delivered by MHWs, have the potential to impact positively on community-level behavioural changes that improve health. These findings, supported by studies from other countries, contribute to the evidence that cultural-tailoring of programs is critical for ensuring that culturally appropriate initiatives are embedded in health care systems that support multicultural communities. Embedding includes the development of culturally appropriate policies, a culturally competent workforce and long-term funding to support culturally competent initiatives.