scholarly journals Chronic disease self-management in Aboriginal Communities: Towards a sustainable program of care in rural communities

2003 ◽  
Vol 9 (3) ◽  
pp. 168 ◽  
Author(s):  
J Ah Kit ◽  
C Prideau x ◽  
PW Harve y ◽  
J Collin s ◽  
M Battersb y ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Illness ◽  
Goal Setting ◽  
Aboriginal People ◽  
Health Workers ◽  
Aboriginal Health ◽  
Self Management ◽  
Pilot Program ◽  
Aboriginal Communities ◽  
One Year

The Chronic Disease Self-Management (CDSM) strategy for Aboriginal patients on Eyre Peninsula, South Australia, was designed to develop and trial new program tools and processes for goal setting, behaviour change and self-management for Aboriginal people with diabetes. The project was established as a one-year demonstration project to test and trial a range of CDSM processes and procedures within Aboriginal communities and not as a formal research project. Over a one-year period, 60 Aboriginal people with type-2 diabetes in two remote regional centres participated in the pilot program. This represents around 25% of the known Aboriginal diabetic population in these sites. The project included training for four Aboriginal Health Workers in goal setting and self-management strategies in preparation for them to run the program. Patients completed a Diabetes Assessment Tool, a Quality of Life Questionnaire (SF12), the Work and Social Adjustment Scale (WASAS) at 0, 6 and 12 months. The evaluation tools were assessed and revised by consumers and health professionals during the trial to determine the most functional and acceptable processes for Aboriginal patients. Some limited biomedical data were also recorded although this was not the principal purpose of the project. Initial results from the COAG coordinated care trial in Eyre suggest that goal setting and monitoring processes, when modified to be culturally inclusive of Aboriginal people, can be effective strategies for improving self-management skills and health-related behaviours of patients with chronic illness. The CDSM pilot study in Aboriginal communities has led to further refinement of the tools and processes used in chronic illness self-management programs for Aboriginal people and to greater acceptance of these processes in the communities involved. Participation in a diabetes self-management program run by Aboriginal Health Workers assists patients to identify and understand their health problems and develop condition management goals and patient-centred solutions that can lead to improved health and wellbeing for participants. While the development of self-management tools and strategies led to some early indications of improvements in patient participation and resultant health outcomes, the pilot program and the refinement of new assessment tools used to assist this process has been the significant outcome of the project. The CDSM process described here is a valuable strategy for educating and supporting people with chronic conditions and in gaining their participation in programs designed to improve the way they manage their illness. Such work, and the subsequent health outcome research planned for rural regions, will contribute to the development of more comprehensive CDSM programs for Aboriginal communities generally.

Supporting chronic disease self-management: translating policies and principles into clinical practice

2012 ◽  
Vol 18 (1) ◽  
pp. 80 ◽  
Author(s):  
Rosemary Higgins ◽  
Barbara Murphy ◽  
Marian Worcester ◽  
Angela Daffey
Keyword(s):  
Chronic Disease ◽  
Health Professionals ◽  
Health Workers ◽  
Aboriginal Health ◽  
Practice Change ◽  
Self Management ◽  
Collaborative Approach ◽  
Allied Health Professionals ◽  
Major Barrier ◽  
Training Support

To support self-management, health professionals need to adopt a client-centred approach and learn to deliver evidence-based behaviour change interventions. This paper reports on the evaluation of 1- and 2-day training programs developed to improve health professionals’ capacity to support chronic disease self-management (CDSM). The 321 participants attended one of eighteen supporting CDSM courses held in urban and rural settings. Participants included nurses, allied health professionals, Aboriginal health workers and general practitioners. Data were collected at three time points: before participation; immediately after the training; and, for a sub-sample of 37 participants, 2 months after the training. Results revealed a significant and sustained increase in CDSM self-efficacy following training regardless of participants’ gender, age or qualifications. A thematic analysis of the responses concerning intended practice revealed four main areas of intended practice change, namely: use behavioural strategies; improve communication with clients; adopt a client-centred approach; and improve goal setting. The number of practice changes at 2 months reported by a sub-sample of participants ranged from 1 to 20 with a mean of 14 (s.d. = 4). The three most common areas of practice change point to the adoption by health professionals of a collaborative approach with chronic disease patients. Lack of staff trained in CDSM was seen as a major barrier to practice change, with lack of support and finance also named as barriers to practice change. Participants identified that increased training, support and awareness of the principles of supporting CDSM would help to overcome barriers to practice change. These results indicate a readiness among health professionals to adopt a more collaborative approach given the skills and the tools to put this approach into practice.

Challenges and Benefits of Implementing a Chronic Disease Self-management Program in an Aboriginal Community Controlled Health Setting

2007 ◽  
Vol 13 (3) ◽  
pp. 35 ◽  
Author(s):  
PA Abbott ◽  
JE Davison ◽  
LF Moore
Keyword(s):  
Chronic Disease ◽  
Health Workers ◽  
Aboriginal Health ◽  
Management Program ◽  
Self Management ◽  
Aboriginal Community ◽  
Medical Practitioners ◽  
Health Measures ◽  
Major Benefit ◽  
General Medical Practitioners

The experience of Aboriginal health workers and general medical practitioners at the Aboriginal Medical Service Western Sydney in using patient-centred health measures as a part of chronic disease self-management program is discussed. Challenges encountered were lack of confidence in using these tools, adaptation of the tools without full understanding of their background and adequate testing, and lack of take-up of the care planning component by GPs. Benefits included improved communication between Aboriginal health workers, GPs and patients. The major benefit noted was that Aboriginal health workers felt the tools helped them to understand the barriers their most challenging patients faced to changing their health behaviour. This was motivating and encouraging for Aboriginal health workers, who often provide extensive support-both emotional and practical-to patients with high burdens of chronic disease and self-management difficulties.

scholarly journals Developing an Indigenous goal-setting tool: Counting Coup

2020 ◽  
Vol 1 (1) ◽  
pp. 49-57
Author(s):  
Iitáa Dáakuash ◽  
Alma McCormick ◽  
Shannen Keene ◽  
John Hallett ◽  
Suzanne Held
Keyword(s):  
Chronic Illness ◽  
Goal Setting ◽  
Indigenous Communities ◽  
Self Management ◽  
Future Research ◽  
Goal Theory ◽  
Management Intervention ◽  
Management Interventions ◽  
Indigenous Paradigm ◽  
Relational Accountability

Chronic illness self-management best practices include goal-setting as an important tool for developing better self-management habits and are often included as elements of chronic disease self-management interventions. However, the goal theory that many of these tools employ relies on individualistic principles of self-efficacy that are not culturally consonant within many Indigenous communities. During the creation of the [blinded] program, a chronic illness management intervention, we developed a goal-setting tool specific to the [blinded] Nation. Emerging from an Indigenous paradigm and methodology, Counting Coup serves as a goal-setting tool that promotes the [blinded] culture, connects individuals with their ancestors, and focuses on achievement of goals within relationships. Future research and practice should be grounded in the historical and cultural contexts of their communities when designing and implementing goal-setting tools. Limitations to Counting Coup as a goal-setting tool include the need for program facilitators to have a relationship with participants due to Counting Coup’s foundation in relational accountability and that the environmental context may pose difficulties for participants in moving towards behavior change.

Keepin Ya Mob Healthy: Aboriginal Community Participation and Aboriginal Health Worker Training in Victoria

2001 ◽  
Vol 7 (1) ◽  
pp. 116 ◽  
Author(s):  
Karen Adams ◽  
Merilyn Spratling
Keyword(s):  
Training Program ◽  
Health Worker ◽  
Aboriginal People ◽  
Health Workers ◽  
Aboriginal Health ◽  
Successful Implementation ◽  
Community Consultation ◽  
Worker Training ◽  
Health Worker Training ◽  
Aboriginal Health Worker

This article outlines the development of accredited Aboriginal Health Worker training in Victoria. The processes of community consultation are presented as the primary reason for the successful implementation of the training program in its first year of delivery. The most important community consultation processes involved the active input of Elders and Aboriginal Health Workers. The training was seen as more credible by other Koorie people because of the input of these groups. The supportive role played by both the State and Commonwealth governments as well as industry groups are also explored. The successful implementation of the Aboriginal Health Worker training program demonstrates that Aboriginal people know what is best for them and can effectively initiate, organise and deliver their own culturally appropriate training programs.

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

Sexual Health ◽  
2017 ◽  
Vol 14 (3) ◽  
pp. 274 ◽  
Author(s):  
Belinda Hengel ◽  
Handan Wand ◽  
James Ward ◽  
Alice Rumbold ◽  
Linda Garton ◽  
...  
Keyword(s):  
Aboriginal People ◽  
Health Workers ◽  
Health Centre ◽  
Randomised Trial ◽  
Laboratory Data ◽  
Aboriginal Health ◽  
Guideline Recommendation ◽  
Cluster Randomised Trial ◽  
Factors Associated ◽  
Sexually Transmissible Infections

Background: 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. Methods: 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. Results: Of 10 559 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. Conclusions: 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.

The chronic disease self-management project at Katherine West Health Board Aboriginal Corporation in the Northern Territory: A report of the first year

2003 ◽  
Vol 9 (3) ◽  
pp. 160 ◽  
Author(s):  
Robyn Mobbs ◽  
Hung The Nguyen ◽  
Andrew Bell
Keyword(s):  
Chronic Disease ◽  
Service Sector ◽  
Community Support ◽  
Aboriginal Health ◽  
Health Service Delivery ◽  
Governance Structure ◽  
Northern Territory ◽  
Self Management ◽  
Health Board ◽  
Local Health

Katherine West Health Board Aboriginal Corporation (KWHB) at Katherine in the Northern Territory is an Aboriginal health service delivery organization directed by the Indigenous Board. The Chronic Disease Self-Management Demonstration Project (CDSM) commenced in April, 2002 at KWHB with funding from the Commonwealth Department of Health and Ageing Sharing Health Care initiative, as one of eight demonstration projects across the country. The project is under the direction of the KWHB Board, which is made up of 18 members elected by their own communities that lie within the KWHB service sector. The full Board or the Board Executive meet routinely throughout each year and members are actively involved with the project at both community and Board levels. The project governance structure also includes a Steering Committee and the Project Management Group that meets monthly. The project is well supported by the various management and administrative sections of KWHB. In the communities, the project reports to the local health committees that have been established by KWHB with community support, and to the local CDSM committees made up of members of the target group.

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