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

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.

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

10.2196/preprints.11573 ◽

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.

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A Qualitative Study Exploring the Experiences and Perspectives of Australian Aboriginal Women on Oral Health during Pregnancy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158061 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8061

Author(s):

Ariana Kong ◽

Michelle Dickson ◽

Lucie Ramjan ◽

Mariana S. Sousa ◽

Joanne Goulding ◽

...

Keyword(s):

Oral Health ◽

Health Care Providers ◽

Torres Strait Islander ◽

Health Workers ◽

Healthcare Providers ◽

Aboriginal Health ◽

Health Staff ◽

Care Providers ◽

Aboriginal Women ◽

Torres Strait

The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in a new model of care. A qualitative descriptive methodology underpinned the study. All participants in this study identified as Aboriginal, with no Torres Strait Islander participants, and were from New South Wales, Australia. The interviews were analysed using inductive thematic analysis. From the data, two themes were constructed. The first theme identified that oral health was not always the first priority for participants as poor accessibility alongside other competing commitments were challenges to accessing oral health services. The second theme highlighted how relationships with personal networks and healthcare providers were essential and could be used to support maternal oral health during pregnancy. Effective strategies to promote oral health during pregnancy for Aboriginal and Torres Strait Islander women should involve key stakeholders and health care providers, like Aboriginal Health Workers, to facilitate culturally safe support and tailored oral health advice.

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Poverty and mental health in Aboriginal Australia

Psychiatric Bulletin ◽

10.1192/pb.23.6.364 ◽

1999 ◽

Vol 23 (6) ◽

pp. 364-366 ◽

Cited By ~ 3

Author(s):

Jonathan Laugharne

Keyword(s):

Mental Health ◽

Respiratory Diseases ◽

Torres Strait Islander ◽

Aboriginal People ◽

Central Africa ◽

Aboriginal Health ◽

Aboriginal Australians ◽

Death Rates ◽

The World ◽

Torres Strait

When the Australian Governor General, Sir William Deane, referred in a speech in 1996 to the “appalling problems relating to Aboriginal health” he was not exaggerating. The Australia Bureau of Statistics report on The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples (McLennan & Madden, 1997) outlines the following statistics. The life expectancy for Aboriginal Australians is 15 to 20 years lower than for non-Aboriginal Australians, and is lower than for most countries of the world with the exception of central Africa and India. Aboriginal babies are two to three times more likely to be of lower birth weight and two to four times more likely to die at birth than non-Aboriginal babies. Hospitalisation rates are two to three times higher for Aboriginal than non-Aboriginal Australians. Death rates from infectious diseases are 15 times higher among Aboriginal Australians than non-Aboriginal Australians. Rates for heart disease, diabetes, injury and respiratory diseases are also all higher among Aboriginals – and so the list goes on. It is fair to say that Aboriginal people have higher rates for almost every type of illness for which statistics are currently recorded.

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Community Health Workers as Agents of Health Promotion: Analyzing Thailand’s Village Health Volunteer Program

Journal of Community Health ◽

10.1007/s10900-015-9999-y ◽

2015 ◽

Vol 40 (4) ◽

pp. 780-788 ◽

Cited By ~ 19

Author(s):

S. D. Kowitt ◽

D. Emmerling ◽

E. B. Fisher ◽

C. Tanasugarn

Keyword(s):

Health Promotion ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Volunteer Program ◽

Health Volunteer ◽

Village Health

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Use of most significant change (MSC) technique to evaluate health promotion training of maternal community health workers in Cianjur district, Indonesia

Evaluation and Program Planning ◽

10.1016/j.evalprogplan.2017.10.011 ◽

2018 ◽

Vol 66 ◽

pp. 102-110 ◽

Cited By ~ 10

Author(s):

Ralalicia Limato ◽

Rukhsana Ahmed ◽

Amelia Magdalena ◽

Sudirman Nasir ◽

Fiona Kotvojs

Keyword(s):

Health Promotion ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Most Significant Change ◽

Significant Change

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Community health workers as a sustainable health care innovation

Elem Sci Anth ◽

10.1525/elementa.2020.00008 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Katie Cueva ◽

Christine Ingemann ◽

Larisa Zaitseva ◽

Gwen Healey Akearok ◽

Josée G. Lavoie

Keyword(s):

Health Care ◽

Community Health ◽

Community Health Workers ◽

Culturally Relevant ◽

Health Workers ◽

Care Delivery ◽

Health Care Systems ◽

Health And Wellness ◽

Care Systems ◽

Circumpolar North

Health care delivery in the Circumpolar North is challenged by a scarcity of culturally relevant health care services, few medical providers trained in cross-cultural care, and high costs of transportation. Community health workers (CHWs) are primarily Indigenous individuals who provide on-the-ground health care and health promotion services in their own communities. The CHWs’ scope of work varies from health education to clinical care and often focuses on upstream factors that impact the public’s health. Although often overlooked and underutilized, the CHW role is an innovative approach to promoting more sustainable and culturally relevant care within health systems. Investigating and understanding the potential ways that CHW-integrated health care systems support health and wellness could allow for a clearer understanding of how to translate this approach to other regions seeking a transition to sustainability in health and wellness. Drawing on experiences with CHWs in the Circumpolar North, this article introduces a conceptual model summarizing pathways that describe how integrating CHWs supports wellness in their communities. The proposed model includes five pathways for how CHWs could support wellness: (1) the recruitment of CHWs from within a community promotes community capacity and control; (2) the CHW role allows them to advocate to address structural and systemic inequalities that contribute to ill health, if CHWs are supported to organize their communities around wellness; (3) CHWs have the potential to support and empower community members; (4) CHWs have the potential to develop culturally relevant, feasible, and effective health promotion strategies; and (5) CHWs have the potential to build on community strengths. This model allows for CHW-integrated health care systems to be critically examined to both test and refine this proposed model, and support and empower community health workers as a transition to a more sustainable health care delivery system that reduces inequities and promotes health.

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

Australian Journal of Primary Health ◽

10.1071/py06028 ◽

2006 ◽

Vol 12 (2) ◽

pp. 97 ◽

Cited By ~ 2

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.

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