scholarly journals Enablers and barriers to primary healthcare for Aboriginal and Torres Strait Islander adolescents: study protocol for participatory mixed-methods research that builds on WHO global standards

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046459
Author(s):  
Tirritpa Ritchie ◽  
Tara Purcell ◽  
Seth Westhead ◽  
Mark Wenitong ◽  
Yvonne Cadet-James ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Primary Healthcare ◽  
Torres Strait Islander ◽  
Barriers To Care ◽  
Assessment Tools ◽  
Far North ◽  
Global Standards ◽  
Health Council ◽  
Cape York ◽  
Torres Strait

IntroductionOne-third of Australia’s Aboriginal and Torres Strait Islander population are adolescents. Recent data highlight their health needs are substantial and poorly met by existing services. To design effective models of primary healthcare, we need to understand the enablers and barriers to care for Aboriginal and Torres Strait Islander adolescents, the focus of this study.Methods and analysisThis protocol was codesigned with Apunipima Cape York Health Council that supports the delivery of primary healthcare for 11 communities in Far North Queensland. We framed our study around the WHO global standards for high-quality health services for adolescents, adding an additional standard around culturally safe care. The study is participatory and mixed methods in design and builds on the recommended WHO assessment tools. Formative qualitative research with young people and their communities (exploring concepts in the WHO recommended quantitative surveys) seeks to understand demand-side enablers and barriers to care, as well as preferences for an enhanced response. Supply-side enablers and barriers will be explored through: a retrospective audit of clinic data (to identify current reasons for access and what can be strengthened); an objective assessment of the adolescent friendliness of clinical spaces; anonymous feedback from adolescent clients around quality of care received and what can be improved; and surveys and qualitative interviews with health providers to understand their perspectives and needs to provide enhanced care. This codesigned project has been approved by Apunipima Cape York Health Council and Far North Queensland Human Research Ethics Committee.Dissemination and implicationsThe findings from this project will inform a codesigned accessible and responsive model of primary healthcare for Aboriginal and Torres Strait Islander adolescents.

Engaging with Aboriginal Shire Councils in remote Cape York communities to address smoke-free environments

2019 ◽  
Vol 25 (5) ◽  
pp. 419
Author(s):  
Kiarah E. Cuthbert ◽  
Clare Brown ◽  
Melinda Hammond ◽  
Tiffany A. Williams ◽  
Desmond Tayley ◽  
...  
Keyword(s):  
Health Services ◽  
Tobacco Smoking ◽  
Torres Strait Islander ◽  
Service Providers ◽  
Critical Role ◽  
Torres Strait Islander People ◽  
Aboriginal Community ◽  
Health Council ◽  
Cape York ◽  
Torres Strait

The high prevalence and health effect of tobacco smoking and secondhand smoke exposure among Aboriginal and Torres Strait Islander people is well known. Due to its significance, the responsibility of tackling smoking among Aboriginal and Torres Strait Islander people should not remain solely with health service providers. The creation of supportive environments and collaboration beyond the health sector are critical elements of comprehensive primary health care practised by Aboriginal Community Controlled Health Services. This paper discusses how Apunipima Cape York Health Council worked with three Aboriginal Shire Councils to create more smoke-free places, using local working groups, information sessions and community-based health promotion. The flexibility and the time allocated to the engagement process with councils, community leaders, organisations and community members were important. All three communities acknowledged the benefits of role modelling and working together to improve health, with addressing tobacco smoking seen as ‘everyone’s business’ and ‘not just service providers’. Aboriginal Shire Councils can play a critical role, in partnership with Aboriginal Community Controlled Health Services, in creating healthy places that enable healthy choices.

scholarly journals ‘We’re here to listen and help them as well’: a qualitative study of staff and Indigenous patient perceptions about participating in social and emotional wellbeing research at primary healthcare services

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara Farnbach ◽  
◽  
Graham Gee ◽  
Anne-Marie Eades ◽  
John Robert Evans ◽  
...  
Keyword(s):  
Indigenous Peoples ◽  
Primary Healthcare ◽  
Torres Strait Islander ◽  
Healthcare Services ◽  
Healthcare Staff ◽  
Emotional Wellbeing ◽  
Research Project ◽  
Social And Emotional ◽  
Torres Strait ◽  
Social And Emotional Wellbeing

Abstract Background Research can inform culturally-appropriate care to strengthen social and emotional wellbeing (SEWB) among Aboriginal and Torres Strait Islander (hereafter, the term ‘Indigenous Peoples’ is respectfully used and refers to all Aboriginal and/or Torres Strait Islander Peoples of Australia). We acknowledge the cultural diversity of Australia’s Indigenous First Peoples and they do not represent a homogenous group.) (hereafter Indigenous) Peoples. We explore the perspectives of primary healthcare staff and Indigenous patients about their willingness to and experiences participating in SEWB research. Method Process evaluation using grounded theory approaches of Getting it Right: The validation study, a national validation designed Indigenous SEWB research project (N = 500). Primary healthcare staff (n = 36) and community members (n = 4) from nine of ten primary healthcare services involved with the research project completed qualitative semi-structured interviews. Interview data were triangulated with participant feedback (responses to structured questions and free-text feedback collected during Getting it Right), study administrative data (participant screening logs, communication logs, study protocol, deviation logs and ethics correspondence) and interviewer field notes. Results Three themes about staff, patient and community perspectives concerning research participation developed: (1) considering the needs, risk, preferences and impact of participation in research for staff, patients and community; (2) building staff confidence speaking to patients about research and SEWB problems and (3) patients speaking openly about their SEWB. Some staff described pressure to ensure patients had a positive experience with the research, to respond appropriately if patients became upset or SEWB problems were identified during interviews, or due to their dual role as community member and researcher. Patients and staff reported that patients were more likely to participate if they knew the staff outside of the service, especially staff with a shared cultural background, and they perceived SEWB as a community priority. Staff reported their skills speaking to patients about the research and SEWB improved during the research, which built their confidence. Contrary to staff preconceptions, staff and patients reported that many patients appreciated the opportunity to speak about their SEWB and contributing to research that may eventually enhance SEWB in their community. Conclusion Our research project was considered acceptable by most staff and patients. The positive outcomes reported by staff and feedback from patients highlights the importance of providing opportunities for people to speak about their SEWB and for research-informed SEWB PHC care. Trial registration Getting it Right is registered on ANZCTR12614000705684.

Facilitating engagement through strong relationships between primary healthcare and Aboriginal and Torres Strait Islander peoples

2016 ◽  
Vol 40 (6) ◽  
pp. 535-541 ◽  
Author(s):  
Carol Davy ◽  
Alan Cass ◽  
John Brady ◽  
Joanne DeVries ◽  
Barry Fewquandie ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Torres Strait Islander ◽  
Torres Strait ◽  
Strong Relationships

scholarly journals Process evaluation of a primary healthcare validation study of a culturally adapted depression screening tool for use by Aboriginal and Torres Strait Islander people: study protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017612 ◽  
Author(s):  
Sara Farnbach ◽  
John Evans ◽  
Anne-Marie Eades ◽  
Graham Gee ◽  
Jamie Fernando ◽  
...  
Keyword(s):  
Process Evaluation ◽  
Primary Healthcare ◽  
Torres Strait Islander ◽  
Screening Tool ◽  
Depression Screening ◽  
Healthcare Staff ◽  
Torres Strait Islander People ◽  
Research Project ◽  
Culturally Adapted ◽  
Torres Strait

IntroductionProcess evaluations are conducted alongside research projects to identify the context, impact and consequences of research, determine whether it was conducted per protocol and to understand how, why and for whom an intervention is effective. We present a process evaluation protocol for the Getting it Right research project, which aims to determine validity of a culturally adapted depression screening tool for use by Aboriginal and Torres Strait Islander people. In this process evaluation, we aim to: (1) explore the context, impact and consequences of conducting Getting It Right, (2) explore primary healthcare staff and community representatives’ experiences with the research project, (3) determine if it was conducted per protocol and (4) explore experiences with the depression screening tool, including perceptions about how it could be implemented into practice (if found to be valid). We also describe the partnerships established to conduct this process evaluation and how the nationalValues and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Researchis met.Methods and analysisRealist and grounded theory approaches are used. Qualitative data include semistructured interviews with primary healthcare staff and community representatives involved with Getting it Right. Iterative data collection and analysis will inform a coding framework. Interviews will continue until saturation of themes is reached, or all participants are considered. Data will be triangulated against administrative data and patient feedback. An Aboriginal and Torres Strait Islander Advisory Group guides this research. Researchers will be blinded from validation data outcomes for as long as is feasible.Ethics and disseminationThe University of Sydney Human Research Ethics Committee, Aboriginal Health and Medical Research Council of New South Wales and six state ethics committees have approved this research. Findings will be submitted to academic journals and presented at conferences.Trial registration numberACTRN12614000705684.

scholarly journals Understanding practitioner professionalism in Aboriginal and Torres Strait Islander health: lessons from student and registrar placements at an urban Aboriginal and Torres Strait Islander primary healthcare service

2017 ◽  
Vol 23 (5) ◽  
pp. 446 ◽  
Author(s):  
Deborah A. Askew ◽  
Vivian J. Lyall ◽  
Shaun C. Ewen ◽  
David Paul ◽  
Melissa Wheeler
Keyword(s):  
Health Care ◽  
Primary Healthcare ◽  
Healthcare Service ◽  
Torres Strait Islander ◽  
Medical Curriculum ◽  
Aboriginal Health ◽  
Aboriginal Peoples ◽  
Medical Professionalism ◽  
Clinical Placements ◽  
Torres Strait

Aboriginal and Torres Strait Islander peoples continue to be pathologised in medical curriculum, leaving graduates feeling unequipped to effectively work cross-culturally. These factors create barriers to culturally safe health care for Aboriginal and Torres Strait Islander peoples. In this pilot pre-post study, the learning experiences of seven medical students and four medical registrars undertaking clinical placements at an urban Aboriginal and Torres Strait Islander primary healthcare service in 2014 were followed. Through analysis and comparison of pre- and post-placement responses to a paper-based case study of a fictitious Aboriginal patient, four learning principles for medical professionalism were identified: student exposure to nuanced, complex and positive representations of Aboriginal peoples; positive practitioner role modelling; interpersonal skills that build trust and minimise patient–practitioner relational power imbalances; and knowledge, understanding and skills for providing patient-centred, holistic care. Though not exhaustive, these principles can increase the capacity of practitioners to foster culturally safe and optimal health care for Aboriginal peoples. Furthermore, competence and effectiveness in Aboriginal health care is an essential component of medical professionalism.

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