Aboriginal Staff Research Articles

Integrating Aboriginal cultural values into water planning: a case study from New South Wales, Australia

ABSTRACTAustralia is the driest inhabited continent on Earth and has an acute need to manage its water resources effectively. Australian Aboriginal peoples have a profound knowledge of surface water and groundwater which has allowed them to thrive for thousands of generations even in the most arid parts of the landscape. Aboriginal peoples place a high priority on protecting water, but the challenge is to ensure that their values are integrated into water planning. The Australian New South Wales (NSW) government’s Aboriginal Water Initiative (AWI) (2012-2017) sought to include Aboriginal cultural and spiritual values in water management. The AWI operated under the NSW Government’s Water Management Act 2000, which seeks to protect the cultural and spiritual values of water and the benefits to flow to Aboriginal peoples. Speaking from the perspective of the previous leader of the AWI, this article will reflect on its inception and structure, particularly focussing on approaches of engagement and consultation. These were highly structured and included a focus on cultural training and protocols and benefited from having Aboriginal staff involved. While ultimately discontinued in 2017, a reflection on the AWI provides useful insights into how engagement and consultation can be operationalised in water management and policy.

Cultural validation of the structured clinical interview for diagnostic and statistical manual of mental disorders in Indigenous Australians.

This study determined the cultural appropriateness of the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) as an acceptable tool for diagnosing mental illness among Indigenous people. De-identified qualitative feedback from participants and psychologists regarding the cultural appropriateness of the SCID-I for Indigenous people using open-ended anonymous questionnaires was gathered. Aboriginal Medial Service staff and Indigenous Support Workers participated in a focus group. A total of 95.6% of participants felt comfortable during the 498 questionnaires completed. Psychologists also provided qualitative feedback for 502 (92.3%) interviews, of whom 40.4% established a good rapport with participants. Of the participants, 77.7% understood the SCID-I questions well, while 72.5% did not require any cultural allowances to reach a clinical diagnosis. When administered by a culturally safe trained psychologist, SCID-I is well tolerated in this group.

More than just numbers! Perceptions of remote area nurse staffing in Northern Territory Government health clinics.

The need for more Remote Area Nurses in the Northern Territory is clear. This paper investigates the perspectives of Remote Area Nurse workforce issues among multiple stakeholders. The aim is to identify how Remote Area Nurse staffing issues are perceived by clinic managers, Remote Area Nurses themselves, Aboriginal colleagues and community members in seven remote communities in the Northern Territory. This is a qualitative study that uses interviews and focus groups to identify key messages of local stakeholders about Remote Area Nurse workforce issues. A content analysis was used for data analysis. Seven diverse remote Aboriginal communities in the Northern Territory with government-run health clinics were visited. Non-random sampling techniques were used to target staff at the clinics at the time of field work. Staff and community members, who agreed to participate, were interviewed either individually or in groups. Interviews were conducted with 5 Managers, 29 Remote Area Nurses, 12 Aboriginal staff (some clinics did not have Aboriginal staff) and 56 community residents. Twelve focus groups were conducted with community members. Content analysis revealed that participants thought having the "right" nurse was more important than having more nurses. Participants highlighted the need for Remote Area Nurses to have advanced clinical and cultural skills. While managers and, to a lesser extent, Remote Area Nurses prioritised clinical skills, Aboriginal staff and community residents prioritised cultural skills. Participants identified the importance of clinical and cultural skills and reiterated that getting the "right" Remote Area Nurse was more important than simply recruiting more nurses. Thus, retention strategies need to be more targeted and cultural skills prioritised in recruitment.

Qualitative perspectives on the sustainability of sexual health continuous quality improvement in clinics serving remote Aboriginal communities in Australia

ObjectivesTo examine barriers and facilitators to sustaining a sexual health continuous quality improvement (CQI) programme in clinics serving remote Aboriginal communities in Australia.DesignQualitative study.SettingPrimary health care services serving remote Aboriginal...

Improving self-regulation and executive functioning skills in primary school children in a remote Australian Aboriginal community: A pilot study of the Alert Program®

Self-regulation and executive functioning impairments are common in children with fetal alcohol spectrum disorder. Given the high rates of fetal alcohol spectrum disorder identified amongst children living in the remote Fitzroy Valley region of Western Australia, the Alert Program® was identified as a culturally safe intervention for use in local primary schools. Researchers collaborated with Aboriginal Elders, community members, and staff from a Fitzroy Valley primary school to trial the Alert Program®. Teachers were trained to deliver eight Alert Program® lessons to children in class. Self-regulation and executive functioning were measured using teacher and parent/caregiver questionnaires three times. Data were analyzed using repeated-measures ANOVA. Teacher-led delivery of the Alert Program® was feasible in a region with high fetal alcohol spectrum disorder rates. As measured by teacher and parent/caregiver ratings, this curriculum may improve the self-regulation and executive functioning of children for some outcomes and provide sustained effects for some children. This community partnered pilot research, evaluated a school-based program to reduce the behavioral impact of fetal alcohol spectrum disorder, and informed design of a larger trial across eight Aboriginal community schools.

Young Aboriginal People's Perspective on Access to Health Care in Remote Australia: Hearing Their Voices.

Young Australian Aboriginal people experience poor health outcomes, yet young people and Aboriginal people have low use of health care. To identify barriers and enablers of access for adolescent and young adult Aboriginal people at Derby Aboriginal Health Service (DAHS), a remote Western Australian Aboriginal Community Controlled Health Service (ACCHSs), to assist in improving access. This qualitative study was in the remote Kimberley town of Derby and three Aboriginal communities serviced by DAHS. Semistructured interviews with 26 young Aboriginal people in 2014 and 2015 were used to identify barriers and enablers to accessing local health care services. Participants appreciated interacting with Aboriginal staff, local staff, and longer term DAHS staff. This improved communication and interpersonal interactions, which were reported to be of prime importance for young Aboriginal people accessing health services. Maintaining confidentiality, minimizing shame, and gender matching with health staff were also key issues for young people. Seeking health care was often based on acute need rather than proactive or preventive care; however, participants recognized that providing health education and health promotion should be a priority for the service. A number of approaches to improving health service use by young remote Aboriginal people may be effective. Improving youth engagement seems to be central to increasing acceptability and, hence, use. This requires that staff able to engage with young people are recruited, trained, and retained. More immediately, a range of simpler changes to service provision focus and environment for young people could potentially make important differences.

Using Yarning to Improve Cardiac Care at a Metropolitan Hospital

Improving cultural safety for Aboriginal and Torres Strait Islander patients and staff has been identified as a means of addressing the cardiovascular diseases disparities that exist between this group and the broader Australian community. Yarning is an Aboriginal and Torres Strait Islander people's cultural practice that connects, validates and enhances cultural identities. Since 2013, on the cardiac wards at our metropolitan hospital in Melbourne, we have had a committee working alongside the Aboriginal Hospital Liaison Officers to review the journeys of Aboriginal and Torres Strait Islander patients. Care processes are reviewed from both cultural and clinical perspectives. Yarning is central to all our work; it has enhanced non-Aboriginal staffs’ understanding of culture and its relationship to health outcomes. It is used as a clinical tool for establishing therapeutic relationships with Aboriginal and Torres Strait Islander patients; nurses yarn around care interventions, with the intention of improving the patients’ sense of safety. Yarning establishes cultural safety for Aboriginal / Torres Strait Islander staff in meetings with non-Aboriginal staff and fosters working relationships. We are starting to use yarning for clinical handover to Aboriginal Medical Services. Yarning informs our decision making, implementation and evaluation of processes. We audit and yarn about our adherence to evidence based care for Aboriginal and Torres Strait Islander patients. We have improved identification of Aboriginal and Torres Strait Islander patients, developed guidelines for care, implemented strategies for discharge and improved access to medications. Yarning is sustainable and resource effective. This presentation will describe how we do this.

The effectiveness of a sustained nurse home visiting intervention for Aboriginal infants compared with non-Aboriginal infants and with Aboriginal infants receiving usual child health care: a quasi-experimental trial - the Bulundidi Gudaga study

BackgroundIn Australia there is commitment to developing interventions that will ‘Close the Gap’ between the health and welfare of Indigenous and non-Indigenous Australians and recognition that early childhood interventions offer the greatest potential for long term change. Nurse led sustained home visiting programs are considered an effective way to deliver a health and parenting service, however there is little international or Australian evidence that demonstrates the effectiveness of these programs for Aboriginal infants. This protocol describes the Bulundidi Gudaga Study, a quasi-experimental design, comparing three cohorts of families from the Macarthur region in south western Sydney to explore the effectiveness of the Maternal Early Childhood Sustained Home-visiting (MECSH) program for Aboriginal families.MethodsMothers were recruited when booking into the local hospital for perinatal care and families are followed up until child is age 4 years. Participants are from three distinct cohorts: Aboriginal MECSH intervention cohort (Group A), Non-Aboriginal MECSH intervention cohort (Group B) and Aboriginal non-intervention cohort (Group C). Eligible mothers were those identified as at risk during the Safe Start assessment conducted by antenatal clinic midwives. Mothers in Group A were eligible if they were pregnant with an Aboriginal infant. Mothers in Group B were eligible if they were pregnant with a non-Aboriginal infant. Mothers in Group C are part of the Gudaga descriptive cohort study and were recruited between October 2005 and May 2007. The difference in duration of breastfeeding, child body mass index, and child development outcomes at 18 months and 4 years of age will be measured as primary outcomes. We will also evaluate the intervention effect on secondary measures including: child dental health; the way the program is received; patterns of child health and illness; patterns of maternal health, health knowledge and behaviours; family and environmental conditions; and service usage for mothers and families.DiscussionInvolving local Aboriginal research and intervention staff and investing in established relationships between the research team and the local Aboriginal community is enabling this study to generate evidence regarding the effectiveness of interventions that are feasible to implement and sustainable in the context of Aboriginal communities and local service systems.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12616001721493 Registered 14 Dec 2016. Retrospectively registered.

Aboriginal and Torres Strait Islander health-care delivery: The views of health-care professionals in Sydney's tertiary paediatric hospitals.

To determine the cultural competency training, knowledge and attitudes of health professionals about Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) health-care delivery. Survey of medical (n = 200), nursing (n = 200) and other health professionals (n = 210) working in two tertiary paediatric hospitals in December 2013. The main outcome measures were training in Aboriginal health-care delivery, knowledge of Aboriginal health and services, attitudes to identification of Aboriginal patients and suggested ways to improve health-care delivery to Aboriginal patients. We received responses from 286 of 572 (50.0%) staff with valid emails: 75 medical, 88 nursing and 123 other health professionals. A minority reported receiving specific Aboriginal health training (126/286, 44.8%) and Aboriginal cultural competency training (106/286, 37.1%). Medical staff were less likely than others to report Aboriginal health-care training (P = 0.01), cultural competency training (P < 0.001) and that their training equipped them to manage Aboriginal patients (P = 0.04). Few medical staff reported a good/very good knowledge of the services provided by the Aboriginal Community Controlled Health Services (20.0%), the Federal Government Closing the Gap initiative (14.7%) or the Royal Australasian College of Physicians' Reconciliation Action Plan (8.0%). Only 62 of 286 (21.7%) staff agreed that they usually asked patients/parents whether they identified as Aboriginal. Although 256 of 286 (89.5%) agreed that Aboriginal staff were an important resource, only 125 of 286 (43.7%) had referred Aboriginal patients to one. The opportunities we have identified to improve health-care delivery to Aboriginal patients include: increasing Aboriginal cultural competency training, correct identification of Aboriginal patients, referring Aboriginal patients to Aboriginal health-care services and increased awareness of Aboriginal Community Controlled Health Services.

Searching for the Songlines of Aboriginal education and culture within Australian higher education

The introduction of spaces that encouraged the participation of Aboriginal and Torres Strait Islander peoples in higher education became a reality in the early 1980s. Since then, Aboriginal and Torres Strait Islander educators and leaders have worked tirelessly to find their ‘fit’ within the Western academy, which continues to impose a colonial, Western educative framework onto Aboriginal and Torres Strait Islander peoples. More recently, universities are attempting to move towards a ‘whole of university’ approach to Aboriginal and Torres Strait Islander higher education. To achieve such a major shift across the academy, Indigenous values, perspectives and knowledges need to be acknowledged as a strong contributor to the environments of universities in all core areas: student engagement, learning and teaching, research and workforce. In a move to achieving a ‘whole of university’ approach which revolves around Aboriginal culture and knowledges, the Wollotuka Institute at the University of Newcastle developed a set of cultural standards, as part of an international accreditation process, to guide a culturally affirming environment for Aboriginal and Torres Strait Islander students and staff. This environment acknowledges the unique cultural values and perspectives of Aboriginal and Torres Strait Islander peoples. In this paper, the authors explore, from an Indigenous Standpoint, the creation of a university environment that privileges Aboriginal values, principles, knowledges and perspectives. The paper exposes how traditional Aboriginal Songlines, particularly in Aboriginal education, were disrupted, and how the creation and emergence of a contemporary environment of Aboriginal educational and cultural affirmation works towards the re-emergence of Songlines within higher education.

Long-term trends in supply and sustainability of the health workforce in remote Aboriginal communities in the Northern Territory of Australia

BackgroundInternational evidence suggests that a key to improving health and attaining more equitable health outcomes for disadvantaged populations is a health system with a strong primary care sector. Longstanding problems with health workforce supply and turnover in remote Aboriginal communities in the Northern Territory (NT), Australia, jeopardise primary care delivery and the effort to overcome the substantial gaps in health outcomes for this population. This research describes temporal changes in workforce supply in government-operated clinics in remote NT communities through a period in which there has been a substantial increase in health funding.MethodsDescriptive and Markov-switching dynamic regression analysis of NT Government Department of Health payroll and financial data for the resident health workforce in 54 remote clinics, 2004–2015. The workforce included registered Remote Area Nurses and Midwives (nurses), Aboriginal Health Practitioners (AHPs) and staff in administrative and logistic roles. Main outcome measures: total number of unique employees per year; average annual headcounts; average full-time equivalent (FTE) positions; agency employed nurse FTE estimates; high and low supply state estimates.ResultsOverall increases in workforce supply occurred between 2004 and 2015, especially for administrative and logistic positions. Supply of nurses and AHPs increased from an average 2.6 to 3.2 FTE per clinic, although supply of AHPs has declined since 2010. Each year almost twice as many individual NT government-employed nurses or AHPs are required for each FTE position.Following funding increases, some clinics doubled their nursing and AHP workforce and achieved relative stability in supply. However, most clinics increased staffing to a much smaller extent or not at all, typically experiencing a “fading” of supply following an initial increase associated with greater funding, and frequently cycling periods of higher and lower staffing levels.ConclusionsOverall increases in workforce supply in remote NT communities between 2004 and 2015 have been affected by continuing very high turnover of nurses and AHPs, and compounded by recent declines in AHP supply. Despite substantial increases in resourcing, an imperative remains to implement more robust health service models which better support the supply and retention of resident health staff.

Corrigendumto: Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach.

Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs.

Is There a Case for Mandatory Reporting of Racism in Schools?

This paper explores how the colonial hegemony of racism in Australia could be disrupted in schools by introducing mandatory reporting of racism by teachers in Australia, and addresses the benefits and risks of mandatory reporting of racism. Using Aboriginal and Torres Strait Islanders as a case study, the ongoing prevalence of racism in schools is established. I then draw on the literature associated with teachers’ mandatory reporting of child abuse and neglect to construct racism as a form of emotional abuse of children. The complexity of racism as evidenced from the literature limits the mandatory reporting to interactional racism by teachers as an antiracist practice. The justification for mandatory reporting covers the emotional stress caused by racism to students and can also be extended to support Aboriginal and Torres Strait Islander staff in schools. The evidence of learning success where antiracism strategies have been introduced in schools, the opportunity to normalise bystander antiracism by teachers, and the alignment of this reporting initiative with the professional standards of teachers together support a case for mandatory reporting of racism in schools. The arguments against mandatory reporting of racism draw on the generative practices of teachers integrating antiracist discourses in schools.

Healing at home: Developing a model for ambulatory alcohol "detox" in an Aboriginal community controlled health service

Introduction: Indigenous Peoples who have been colonized face a higher burden of harm from alcohol and increased risk of alcohol use disorders. Yet they often also have limited access to alcohol treatment. Limited access to withdrawal management (“detox” in particular) can be a barrier to recovery. Ambulatory or “outpatient” alcohol detox can offer improved treatment access, but no research has examined its feasibility and acceptability in Indigenous populations. Aim: To develop a model for outpatient detox delivered by an Australian Aboriginal community controlled health service (ACCHS), and to describe its feasibility and acceptability. Methods: This report describes a framework for alcohol treatment service development within an ACCHS through community, staff, and client consultation. Thematic analysis of focus groups and phone interviews were used to gain insight into the views and experiences of Aboriginal community stakeholders, service clients, and staff regarding alcohol detox services and the pilot of the outpatient detox program service model. Results: Individual, family, and community support was regarded as key to recovery from alcohol dependence. Outpatient detox was seen as a way of keeping the individual near this support. Reported positive aspects include satisfaction with the approach to care that was considered accessible, holistic, and integrated. Challenges and suggested improvements were identified. Discussion: Outpatient detox within an ACCHS was assessed as feasible and acceptable for carefully selected clients and was reported to aid access to treatment. More clinical experience is needed to fully delineate effectiveness and safety.

Aboriginal staff leading partnership in remote Australia.

Aboriginal staff leading partnership in remote Australia.

Patient, staffing and health centre factors associated with annual testing for sexually transmissible infections in remote primary health centres.

In high-incidence Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) settings, annual re-testing is an important public health strategy. Using baseline laboratory data (2009-10) from a cluster randomised trial in 67 remote Aboriginal communities, the extent of re-testing was determined, along with the associated patient, staffing and health centre factors. Annual testing was defined as re-testing in 9-15 months (guideline recommendation) and a broader time period of 5-15 months following an initial negative CT/NG test. Random effects logistic regression was used to determine factors associated with re-testing. Of 10559 individuals aged ≥16 years with an initial negative CT/NG test (median age=25 years), 20.3% had a re-test in 9-15 months (23.6% females vs 15.4% males, P<0.001) and 35.2% in 5-15 months (40.9% females vs 26.5% males, P<0.001). Factors independently associated with re-testing in 9-15 months in both males and females were: younger age (16-19, 20-24 years); and attending a centre that sees predominantly (>90%) Aboriginal people. Additional factors independently associated with re-testing for females were: being aged 25-29 years, attending a centre that used electronic medical records, and for males, attending a health centre that employed Aboriginal health workers and more male staff. Approximately 20% of people were re-tested within 9-15 months. Re-testing was more common in younger individuals. Findings highlight the importance of recall systems, Aboriginal health workers and male staff to facilitate annual re-testing. Further initiatives may be needed to increase re-testing.

Fall prevention services for older Aboriginal people: investigating availability and acceptability.

Falls and fall-related injury are emerging issues for older Aboriginal people. Despite this, it is unknown whether older Aboriginal people access available fall prevention programs, or whether these programs are effective or acceptable to this population. To investigate the use of available fall prevention services by older Aboriginal people and identify features that are likely to contribute to program acceptability for Aboriginal communities in New South Wales (NSW), Australia. A questionnaire was distributed to Aboriginal and mainstream health and community services across NSW to identify the fall prevention and healthy ageing programs currently used by older Aboriginal people. Services with experience in providing fall prevention interventions for Aboriginal communities, and key Aboriginal health services that delivered programs specifically for older Aboriginal people, were followed up and staff members were nominated from within each service to be interviewed. Service providers offered their suggestions as to how a fall prevention program could be designed and delivered to meet the health and social needs of their older Aboriginal clients. Of the 131 services that completed the questionnaire, four services (3%) had past experience in providing a mainstream fall prevention program to Aboriginal people; however, there were no programs being offered at the time of data collection. From these four services, and from a further five key Aboriginal health services, 10 staff members experienced in working with older Aboriginal people were interviewed. Barriers preventing services from offering appropriate fall prevention programs to their older Aboriginal clients were identified, including limited funding, a lack of available Aboriginal staff, and communication difficulties between health services and sectors. According to the service providers, an effective and acceptable fall prevention intervention would be evidence based, flexible, community-oriented and social, held in a familiar and culturally safe location and delivered free of cost. This study identified a gap in the availability of acceptable fall prevention programs designed for, and delivered to, older Aboriginal people in NSW. Further consultation with older Aboriginal people is necessary to determine how an appropriate and effective program can be designed and delivered. Terminology: The authors recognise the two distinctive Indigenous populations of Australia: Aboriginal and Torres Strait Islander people. Because the vast majority of the NSW Aboriginal and Torres Strait Islander population is Aboriginal (95.4%)1, this population will be referred to as 'Aboriginal' in this manuscript.

Elements of cultural competence in an Australian Aboriginal maternity program.

Pregnancy, labour and neonatal health outcomes for Australian Aboriginal women and their infants are frequently worse than those of the general population. Provision of culturally competent services may reduce these differences by improving access to timely and regular antenatal care. In an effort to address these issues, the Aboriginal Maternity Group Practice Program commenced in south metropolitan Perth, Western Australia, in 2011. The program employed Aboriginal Grandmothers, Aboriginal Health Officers and midwives working in a partnership model with pre-existing maternity services in the area. To identify elements of the Aboriginal Maternity Group Practice Program that contributed to the provision of a culturally competent service. The Organisational Cultural Competence Assessment Tool was used to analyse qualitative data obtained from surveys of 16 program clients and 22 individuals from partner organisations, and interviews with 15 staff. The study found that the partnership model positively impacted on the level of culturally appropriate care provided by other health service staff, particularly in hospitals. Two-way learning was a feature. Providing transport, team home visits and employing Aboriginal staff improved access to care. Grandmothers successfully brought young pregnant women into the program through their community networks, and were able to positively influence healthy lifestyle behaviours for clients. Many elements of the Aboriginal Maternity Group Practice Program contributed to the provision of a culturally competent service. These features could be considered for inclusion in antenatal care models under development in other regions with culturally diverse populations.

Early Parenting Education to Strengthen Aboriginal Parents in a Remote Area: The Development and Piloting of a Group Programme

In this article, the authors describe the development, piloting and evaluation of a parenting programme delivered to Aboriginal families of young children in remote NSW. The parenting programme was based on Parents as Teachers, an evidence-based early intervention and prevention home visiting programme that draws on child development theory, and was developed in collaboration with representatives from the local Aboriginal community. The impetus for the programme came from concern about the poor early learning and child wellbeing indicators in this community, pointing to the need for early parenting support that could be effectively delivered by trained Aboriginal workers in a remote area where early childhood resources were very limited. The sessions, implemented within a group setting, were structured and intensive. Six topics identified as being most important to parents of children aged from birth to 18 months, and six topics for parents of children aged from 18 months to 3 years were presented, with three sessions developed for each topic. An evaluation of the programme to date revealed that parent satisfaction with the programme was very high, as were reports of increased knowledge of child development and parenting skills, and increased connection with other families. Aboriginal staff valued the structured programme and resources that were developed. They reported increased knowledge of child development and how to run groups effectively, and observed positive changes in the participating families.

The WA Goldfields Aboriginal Community Antenatal Program—A community midwifery initiative

AimTo investigate the acceptability and satisfaction with the Aboriginal Community Antenatal Program by staff in the program and partner agencies. DesignA Strengths, Weaknesses, Opportunities and Threats framework guided the research and data collection methods. Mixed methodology was used, accessing qualitative and quantitative information from data bases, program and supporting agency staff. Quantitative data were analysed through a social sciences statistical package. Qualitative data were identified through questionnaires and analysed using thematic analysis. SettingRemote Aboriginal communities in the Goldfields region of Western Australia. Participant sourcesTwenty two participants including program and supporting agency staff. Main outcome measuresThis study measures acceptability and satisfaction of program antenatal and pre-conception activities by program staff and partner agencies. ResultsQualitative results indicate acceptability and satisfaction with the program, identifying a range of organisational, staffing, cultural and interagency issues relating to a model of service provision. Quantitative data suggested positive program outputs from service delivery. ConclusionFindings suggest the Aboriginal Community Antenatal Program and partner agencies are increasing provision of community based pre-conception and antenatal health services and enhancing collaboration between a range of health provider agencies, with partnerships between Aboriginal and non-Aboriginal program staff contributing to an emerging model of community antenatal care.