Abstract
Population-based studies have associated poor living conditions with the persistent disparity in the health of Aboriginal and non-Aboriginal Australians. This project assesses the applicability of the Health Community Assessment Tool and its role in improving the environment of a small community in the Midwest of Western Australia (WA). The action research cycles started with the initial reflection on the suitability of the HCAT version 2 for the local community context and whether it was fit-for-purpose. The researcher provided ‘critical companionship’, while the participants of the study were invited to be co-researchers (the Assessors) who critically examined the HCAT and assess the community. The relevant domains to the serviced town (an outer regional community) were pest control and animal management; healthy housing; food supply; community vibrancy, pride and safety; reducing environmental tobacco smoke; and promoting physical activity. The Assessors found the HCAT descriptors mostly aligned with their community context but found some of the items difficult to apply. Based on participant’s suggestions, some of the original scoring scales were reformatted. School attendance and illicit drug use were identified as a key outcome indicator for youth but were missing from the HCAT. The HCAT domains applied helped streamlining core business of agencies in the local community. The face validity of HCAT items were confirmed in this research with minor adjustments to reflect local context. Youth engagement to education is of high community concern and the development of an item would create similar interagency collaborative dialogues.
Highlights
There are significant health disparities for residents of small rural and remote communities compared to metropolitan Australian populations, for Aboriginal people where the gap in life expectancy is variously reported as being between 11 and 18 years [1]
One mainstream organisation representative identified as an Australian Aboriginal descent and one participant from the local Aboriginal Community Organisation was a non-Aboriginal descent; both participants were involved in the baseline and follow-up assessments
Five staff from the regional Aboriginal environmental health program participated in the trial of Midwest Healthy Community Assessment Tool (HCAT) v1 and all of whom were local Aboriginal men and work directly with
Summary
There are significant health disparities for residents of small rural and remote communities compared to metropolitan Australian populations, for Aboriginal people where the gap in life expectancy is variously reported as being between 11 and 18 years [1]. Given the complexity of life circumstances and the multi-morbidities of many Aboriginal people which make care needs more complex, partnerships between Aboriginal controlled and mainstream agencies are essential for expediting improvements in Aboriginal health outcomes [2,3,4]. While to date there have been few reports where tools have been used to assess the strength of inter-organisational partnerships between Aboriginal and mainstream organisations, quality improvement tools that focus on clinical care have been more widely adopted [6]. Public Health 2018, 15, 1159; doi:10.3390/ijerph15061159 www.mdpi.com/journal/ijerph
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