scholarly journals Experiences and views of a brokerage model for primary care for Aboriginal people

2015 ◽  
Vol 39 (1) ◽  
pp. 26 ◽  
Author(s):  
Sarah Dennis ◽  
Iqbal Hasan ◽  
Lisa Jackson Pulver ◽  
Ian Wilson ◽  
Nicholas Zwar
Keyword(s):  
Health Care ◽  
Health Services ◽  
Access To Health Care ◽  
Torres Strait Islander ◽  
Aboriginal People ◽  
Health Workers ◽  
Urban Setting ◽  
Structured Interviews ◽  
Torres Strait ◽  
Brokerage Service

Objective A mixed methods study was conducted to determine the views of Aboriginal people on their experiences of a brokerage model for access to community-based health services in an urban setting. Methods A broad range of approaches, using surveys, semi-structured interviews and community forums with Aboriginal people were used to find out people’s views and experiences of using the brokerage service. Results Of the 1304 people invited to participate, only 127 people provided feedback on the brokerage service model for Aboriginal people. Of these, 120 people identified as being Aboriginal. Participants said that the service helped them to navigate the system and access health care. Participants felt that the health professionals involved with the service were respectful of their needs. The service was not able to improve access to dental care. Conclusions The brokerage model implemented in this area appears to have been well received and is supporting urban Aboriginal people to access some of the health care needed. What is known about the topic? Aboriginal and Torres Strait Islander people often experience difficulty accessing health services. Urban brokerage models of care were funded by the Office for Aboriginal and Torres Strait Islander Health (OATSIH) under the Improving Indigenous Access to Health Care Services initiative and aimed to increase access to mainstream health services. What does this paper add? The brokerage model of care in South West Sydney has been well-received by the Aboriginal people receiving the service and participants are positive about the role of the service in increasing access to mainstream health care. What are the implications for practitioners? Navigating the healthcare system is difficult for some and a brokerage service with supportive Aboriginal health workers increases access.

What constitutes ‘support’ for the role of the Aboriginal and Torres Strait Islander child health workforce?

2013 ◽  
Vol 37 (1) ◽  
pp. 112 ◽  
Author(s):  
Karen Watson ◽  
Jeanine Young ◽  
Margaret Barnes
Keyword(s):  
Child Health ◽  
Health Services ◽  
Cultural Awareness ◽  
Torres Strait Islander ◽  
Health Workers ◽  
Overall Acceptability ◽  
Torres Strait ◽  
Use Of Health Services ◽  
Torres Strait Islander Health

As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship. What is known about the topic? Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this population. What does this paper add? Through consultation with a sample of Indigenous child health workers and child health workers key areas necessary to provide support for the individuals working in these roles have been identified. What are the implications for practitioners? The findings from this study will inform policy and program development in order to more comprehensively support health workers in the community and contribute towards workforce development and satisfaction, recruitment and retention.

The Centre of Clinical Research Excellence in Aboriginal and Torres Strait Islander Health: An Operational Rationale and Some Reflections on Progress so far

2006 ◽  
Vol 12 (2) ◽  
pp. 97 ◽  
Author(s):  
Glenn Giles ◽  
Merridy Malin ◽  
Peter Harvey
Keyword(s):  
Health Services ◽  
Clinical Research ◽  
Indigenous People ◽  
Torres Strait Islander ◽  
Aboriginal People ◽  
Aboriginal Health ◽  
Health Council ◽  
Torres Strait ◽  
Research Excellence ◽  
Torres Strait Islander Health

The Centre of Clinical Research Excellence (CCRE) in Aboriginal and Torres Strait Islander Health was established in late 2003 through a major National Health and Medical Research Council (NHMRC) grant involving collaboration between the Aboriginal Health Council of South Australia (AHCSA), Flinders University, and Aboriginal Health Services. Our foundation research communities are the Aboriginal communities served by these Aboriginal Health Services in the Spencer Gulf / Eyre Peninsula region. In recent years a number of collaborative research programs involving chronic illness management, self-management and coordinated care have been implemented in these communities and this work is the basis of the initial CCRE activities. Key objectives of the CCRE are to improve the health status of Indigenous people through conducting relevant and meaningful Aboriginal controlled health research, providing formal training for Indigenous health researchers and developing innovative approaches to health care that can be readily translated and applied to support communities. The inclusion, empowerment and engagement of Indigenous people in the process of managing community health represent tangible strategies for achieving more equitable health outcomes for Aboriginal people. This paper outlines the CCRE operational rationale and presents early activities and outcomes across the three strategic areas of CCRE operations: research, education and training, and translation. Some critical reflections are offered on the progress and experience of the CCRE thus far. A common obstacle this CCRE has encountered is that the limited (especially staff) resources available to the Aboriginal Health Services with which we are collaborating make it difficult for them to engage with and progress the projects we are pursuing.

‘We Can Do This’: a web-based therapeutic program for reducing methamphetamine use and increasing help-seeking amongst Aboriginal and Torres Strait Islander people: Wait-list control, randomised trial protocol (Preprint)

2019 ◽  
Author(s):  
Rachel Reilly ◽  
Rebecca McKetin ◽  
Handan Wand ◽  
Julia Butt ◽  
Matthew Smout ◽  
...  
Keyword(s):  
Health Services ◽  
Help Seeking ◽  
Torres Strait Islander ◽  
Aboriginal People ◽  
Randomised Trial ◽  
Wait List ◽  
Web Based ◽  
Methamphetamine Use ◽  
Therapeutic Program ◽  
Torres Strait

BACKGROUND Methamphetamine use is of deep concern to Aboriginal and Torres Strait Islander communities, but access to culturally appropriate treatment resources and services is limited. Web-based programs have potential as flexible and cost-effective additions to the range of treatment options available to Aboriginal people. The We Can Do This web-based therapeutic program (WBTP) is designed to incorporate evidence-based therapies in a culturally-relevant format using narratives from Aboriginal people to contextualise the therapeutic content. OBJECTIVE The effectiveness of the WBTP will be tested in a wait-list control, randomised trial across multiple sites in urban, regional and remote locations. METHODS Recruitment will commence in May 2019, and results are expected in early 2021. RESULTS Participants will be Aboriginal and Torres Strait Islander people aged 16 or over who have used methamphetamine at least weekly for the previous three months. They will be recruited online and via health services. During the intervention phase, participants will have access to the WBTP for six weeks with optional telephone or face-to-face support provided by participating health services. The primary outcome measure will be the number of days the participant used methamphetamine over the past four weeks compared to wait-list controls, assessed at baseline, one, two and three months. Secondary outcomes will include help-seeking, readiness to change, severity of dependence and psychological distress. CONCLUSIONS The trial of this WBTP builds on existing research supporting the effectiveness of web-based therapies for a range of psychological and other health-related issues including substance use. If successful, the ‘We Can Do this’ WBTP will increase the range of options available to Aboriginal people seeking to reduce or stop methamphetamine use. It may provide a pathway into treatment for people who may otherwise be disengaged with health services for a range of reasons, and will be a culturally-appropriate, evidence-based resource for health practitioners to offer their clients. CLINICALTRIAL The trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000134123p.

scholarly journals Epidemiology of group A streptococcus in Australia

2009 ◽  
Vol 30 (5) ◽  
pp. 171
Author(s):  
Johnathan R Carpetis
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Torres Strait Islander ◽  
Group A Streptococcus ◽  
Australian Population ◽  
Access To Health ◽  
Rural Settings ◽  
Group A ◽  
Torres Strait ◽  
Industrialised Countries

The Australian population experiences the extremes of group A streptococcal (GAS) disease. The majority of our population lives an affluent, middle class existence and experiences the same types and rates of GAS disease as are found in most industrialised countries. By contrast, the Aboriginal and Torres Strait Islander populations, particularly those living in remote and rural settings, experience a developing-country profile of GAS disease, which is almost entirely attributable to poverty, particularly as it is manifest by overcrowded housing, poor environmental health and reduced access to health care.

Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service

2019 ◽  
Vol 43 (2) ◽  
pp. 217 ◽  
Author(s):  
Craig Wotherspoon ◽  
Cylie M. Williams
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Outcomes ◽  
Torres Strait Islander ◽  
Healthcare Services ◽  
Patient Experiences ◽  
Culturally Appropriate ◽  
Torres Strait ◽  
Healthcare Administrators ◽  
Culturally Appropriate Services

Objective There continue to be disparate health outcomes for people who are Aboriginal and Torres Strait Islander. The aim of the present study was to measure whether there were any differences in in-patient experiences between Aboriginal and Torres Strait Islander people and those without an Aboriginal or Torres Strait Islander background. Methods Random samples of people were invited to complete a survey following admission at the hospitals at Peninsula Health, Victoria, Australia. This survey was based on the Victorian Patient Satisfaction Monitor. Open-ended questions were also asked to gauge perspectives on how the services could better meet needs of Aboriginal and Torres Strait Islander patients. Results A total of 154 responses was obtained. There were differences between the two groups of participants in the following variables: respect of privacy, representation of culture, assistance with meals and access to a culturally specific worker if needed. This was reflected in thematic analysis, with three main themes identified: (1) interactions with staff; (2) the challenging environment; and (3) not just about me, but my family too. Conclusion There were systemic differences in in-patient experiences. Healthcare services have a responsibility to make systemic changes to improve the health care of all Australians by understanding and reforming how services can be appropriately delivered. What is known about the topic? There is a disparity in health outcomes between Aboriginal and Torres Strait Islander Australians and those who do not identify as Aboriginal and/or Torres Strait Islander. In addition, Aboriginal and Torres Strait Islanders have different interactions within healthcare services. Many rural health services have models that aim to deliver culturally appropriate services, but it is unknown whether the same challenges apply for this group of Australians within metropolitan health services. What does this paper add? This paper identifies the structural supports that are required to help close the gap in health care provision inequality. Many of the key issues identified are not people but system based. Healthcare administrators should consider the factors identified and address these at a whole-of-service level. What are the implications for practitioners? Many practitioners are aware of the challenges of providing culturally appropriate services. This research raises awareness of how traditional healthcare is not a one size fits all and flexibility is required to improve health outcomes.

scholarly journals Making space for Aboriginal and Torres Strait Islander community health workers in health promotion

2019 ◽  
Vol 35 (3) ◽  
pp. 562-574
Author(s):  
Kathleen P Conte ◽  
Josephine Gwynn ◽  
Nicole Turner ◽  
Claudia Koller ◽  
Karen E Gillham
Keyword(s):  
Health Promotion ◽  
Community Health ◽  
Community Health Workers ◽  
Torres Strait Islander ◽  
Aboriginal People ◽  
Health Workers ◽  
Health Care Systems ◽  
Aboriginal Health ◽  
Global Literature ◽  
Torres Strait

Abstract Despite a clear need, ‘closing the gap’ in health disparities for Aboriginal and Torres Strait Islander communities (hereafter, respectfully referred to as Aboriginal) continues to be challenging for western health care systems. Globally, community health workers (CHWs) have proven effective in empowering communities and improving culturally appropriate health services. The global literature on CHWs reflects a lack of differentiation between the types of roles these workers carry out. This in turn impedes evidence syntheses informing how different roles contribute to improving health outcomes. Indigenous CHW roles in Australia are largely operationalized by Aboriginal Health Workers (AHWs)—a role situated primarily within the clinical health system. In this commentary, we consider whether the focus on creating professional AHW roles, although important, has taken attention away from the benefits of other types of CHW roles particularly in community-based health promotion. We draw on the global literature to illustrate the need for an Aboriginal CHW role in health promotion; one that is distinct from, but complementary to, that of AHWs in clinical settings. We provide examples of barriers encountered in developing such a role based on our experiences of employing Aboriginal health promoters to deliver evidence-based programmes in rural and remote communities. We aim to draw attention to the systemic and institutional barriers that persist in denying innovative employment and engagement opportunities for Aboriginal people in health.

scholarly journals Participants’ views and experiences from setting up a shared patient portal for primary and specialist health services- a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Torunn Hatlen Nøst ◽  
Arild Faxvaag ◽  
Aslak Steinsbekk
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Services ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Patient Involvement ◽  
Patient Portal ◽  
Care Providers ◽  
Structured Interviews ◽  
Patient Portals

Abstract Background Recently, there has been an increasing focus among healthcare organisations on implementing patient portals. Previous studies have mainly focussed on the experiences of patient portal use. Few have investigated the processes of deciding what content and features to make available, in particular for shared portals across healthcare domains. The aim of the study was to investigate views on content and experiences from the configuration process among participants involved in setting up a shared patient portal for primary and specialist health services. Methods A qualitative study including 15 semi-structured interviews with persons participating in patient portal configuration was conducted from October 2019 to June 2020. Results Whether a shared patient portal for all the health services in the region should be established was not questioned by any of the informants. It was experienced as a good thing to have numerous participants present in the discussions on configuration, but it also was said to increase the complexity of the work. The informants considered a patient portal to be of great value for patient care, among other things because it would lead to improvements in patient follow-up and increased patient empowerment. Nevertheless, some informants advocated caution as they thought the patient portal possibly could lead to an increase in healthcare providers’ workloads and to anxiety and worries, as well as to inequality in access to health care among patients. The findings were categorized into the themes ‘A tool for increased patient involvement’, ‘Which information should be available for the patient’, ‘Concerns about increased workload’, ‘Too complex to use versus not interesting enough’, ‘Involving all services’ and ‘Patient involvement’. Conclusions Establishing a shared patient portal for primary and specialist health services was considered unproblematic. There was, however, variation in opinions on which content and features to include. This variation was related to concerns about increasing the workload for health care providers, causing anxiety and inequality among patients, and ensuring that the solution would be interesting enough to adopt.

Considering the Impact of Social Media on Contemporary Improvement of Australian Aboriginal Health: Scoping Review (Preprint)

2018 ◽  
Author(s):  
Troy Walker ◽  
Claire Palermo ◽  
Karen Klassen
Keyword(s):  
Social Media ◽  
Scoping Review ◽  
Torres Strait Islander ◽  
Aboriginal People ◽  
Aboriginal Health ◽  
Health Messages ◽  
Community Control ◽  
Torres Strait Islander People ◽  
Australian Aboriginal ◽  
Torres Strait

BACKGROUND Social media may have a significant role in influencing the present and future health implications among Australian Aboriginal and Torres Strait Islander people, yet there has been no review of the role of social media in improving health. OBJECTIVE This study aims to examine the extent of health initiatives using social media that aimed to improve the health of Australian Aboriginal communities. METHODS A scoping review was conducted by systematically searching databases CINAHL Plus; PubMed; Scopus; Web of Science, and Ovid MEDLINE in June 2017 using the terms and their synonyms “Aboriginal” and “Social media.” In addition, reference lists of included studies and the Indigenous HealthInfonet gray literature were searched. Key information about the social media intervention and its impacts on health were extracted and data synthesized using narrative summaries. RESULTS Five papers met inclusion criteria. All included studies were published in the past 5 years and involved urban, rural, and remote Aboriginal or Torres Strait Islander people aged 12-60 years. No studies reported objective impacts on health. Three papers found that social media provided greater space for sharing health messages in a 2-way exchange. The negative portrayal of Aboriginal people and negative health impacts of social media were described in 2 papers. CONCLUSIONS Social media may be a useful strategy to provide health messages and sharing of content among Aboriginal people, but objective impacts on health remain unknown. More research is necessary on social media as a way to connect, communicate, and improve Aboriginal health with particular emphasis on community control, self-empowerment, and decolonization.

scholarly journals Building trust and enhancing localization to improve access to women’s health services in Afghanistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F R Rab ◽  
S S Stranges ◽  
A D Thind ◽  
S S Sohani
Keyword(s):  
Health Care ◽  
Health Services ◽  
Vulnerable Populations ◽  
Time Trend ◽  
Health Workers ◽  
Healthcare Services ◽  
Delivery Of Healthcare ◽  
Care Services ◽  
Women And Children ◽  
Delivery Of Health Services

Abstract Background Over 34 million people in Afghanistan have suffered from death and devastation for the last four decades as a result of conflict. Women and children have borne the brunt of this devastation. Afghanistan has some of the poorest health indicators in the world for women and children. In the midst of armed conflict, providing essential healthcare in remote regions in the throws of conflict remains a challenge, which is being addressed the Mobile Health Teams through Afghan Red Crescent (ARCS). To overcome socio-cultural barriers, ARCS MHTs have used local knowledge to hire female staff as part of the MHTs along with their male relatives as part of MHT staff. The present study was conducted to explore the impact of engaging female health workers as part of MHTs in conflict zones within Afghanistan on access, availability and utilization of maternal and child health care. Methods Quantitative descriptive and time-trend analysis were used to evaluate impact of introduction of female health workers. Qualitative data is being analyzed to assess the possibilities and implications of engaging female health workers in the delivery of health services. Results Preliminary results show a 96% increase in uptake of services for expectant mothers over the last four years. Average of 18 thousand services provided each month by MHTs, 70% for women and children. Service delivery for women and children significantly increased over time (p < 0.05) after inclusion of female health workers in MHTs. Delivery of maternity care services showed a more significant increase (p < 0.001). Time trend and qualitative analyses is ongoing. Conclusions Introduction of female health workers significantly improved uptake of health care services for women and children especially in extremely isolated areas controlled by armed groups in Afghanistan. Engaging with local stakeholders is essential for delivery of health services for vulnerable populations in fragile settings like Afghanistan. Key messages Understanding cultural norms results in socially acceptable solutions to barriers in delivery of healthcare services and leads to improvements in access for women and children in fragile settings. Building local partnerships and capacities and using local resources result in safe, efficient and sustainable delivery of healthcare services for vulnerable populations in fragile settings.

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