Abstract
BackgroundEffectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Health Action Groups (DAHAGs) to collaborate with health providers in designing culturally-responsive healthcare. The purpose of the strategy was to improve local health service delivery for Aboriginal Australians.MethodsThe evaluation aimed to identify whether the Aboriginal community considered the community engagement strategy effective in identifying their health service needs, translating them to action by local health services and increasing their trust in these health services. Participants were recruited using purposive sampling. Qualitative data was collected from Aboriginal participants and health service providers using semi-structured interviews or yarning circles that were recorded, transcribed and independently analysed by two senior non-Aboriginal researchers. Responses were coded for key themes, further analysed for similarities and differences between districts and cross-checked by the senior lead Aboriginal researcher to avoid bias and establish reliability in interpreting the data. Three ethics committees approved conducting the evaluation.ResultsFindings from 60 participants suggested the engagement process was effective: it was driven and owned by the Aboriginal community, captured a broad range of views and increased Aboriginal community participation in decisions about their healthcare. It built community capacity through regular community forums and established DAHAGs comprising local Aboriginal community members and health service representatives who met quarterly and were supported by the Aboriginal Health Team at the local Population Health Unit. Participants reported health services improved in community and hospital settings, leading to increased access and trust in local health services.ConclusionThe evaluation concluded that this process of actively engaging the Aboriginal community in decisions about their health care was a key element in improving local health services, increasing Aboriginal people’s trust and access to care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1497-0) contains supplementary material, which is available to authorized users.
Highlights
Addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue
The term Aboriginal will be used to describe the local Indigenous population which is the preferred terminology used by the Western Australian (WA) Department of Health [3]
Participants felt empowered to be actively involved in decisions about their health care, with training available in chairing and conducting District Aboriginal Health Action Group (DAHAG) meetings with local health providers on how services could be designed and delivered to better meet Aboriginal people’s needs
Summary
Addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Life expectancy amongst Aboriginal Australians is around 10 years less compared to other Australians [4] This disparity is the result of a range of complex causes, including the transgenerational negative effects of colonisation, dispossession and racism, and socioeconomic factors resulting from lower levels of education and employment, and higher rates of incarceration [5,6,7,8,9]. Aboriginal people can face many challenges when accessing mainstream services These include unwelcoming hospital settings, lack of transport, mistrust of mainstream health care, a sense of alienation, and inflexible treatment options. This has resulted in an overall reluctance to attend services [10]. Health services need to commit to developing respectful partnerships with local Aboriginal communities and increase the capacity of services to be more responsive to Aboriginal people’s requirements [13, 14]
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