scholarly journals Research Protocol: Retention of the Aboriginal health, ageing, and disability workforce (Preprint)

2020 ◽  
Author(s):  
John Gilroy ◽  
Kim Bulkeley ◽  
Folau Talbott ◽  
Josephine Gwynn ◽  
Kylie Gwynne ◽  
...  
Keyword(s):  
Indigenous Peoples ◽  
Research Team ◽  
Aboriginal People ◽  
Aboriginal Health ◽  
Aged Care ◽  
Staff Retention ◽  
Methodological Framework ◽  
Aboriginal Community ◽  
Disability Service ◽  
Barriers And Enablers

BACKGROUND Despite Australia being one of the most developed nations in the world there is a significant and widening gap in health and welfare between Aboriginal and Torres Strait Islander (Aboriginal) people, and non-Aboriginal people. Aboriginal workers known or local to Aboriginal communities who access the health, ageing, and disability supports play a vital role in guiding their non-Aboriginal colleagues in ways to adapt their interactions, advice, and interventions to ensure they are culturally appropriate and safe for Aboriginal patients and clients. There is a need to identify the factors that inhibit (push) and promote (pull) staff retention or departure of this workforce from various sectors. This study aims to identify the barriers and enablers to retaining Aboriginal people who do not have university qualifications in the heath, disability and aged care workforces. OBJECTIVE This study aims to identify the barriers and enablers to retaining Aboriginal people who do not have university qualifications in the heath, disability and aged care workforces. In this paper, ‘frontline service delivery’ is defined as Aboriginal staff who are paid employees in the health, ageing, disability, community services sector in roles that involve direct client, participant, or patient support. METHODS This study is a mixed-method design situated within an Indigenous decolonising methodological framework which drives all phases of the research. Decolonisation centres on privileging the needs of Aboriginal people by analysing and dismantling the power imbalances that exist between Indigenous peoples and non-Indigenous peoples in how research is undertaken to inform government policy, practice, and praxis. The surveys will be sent through the Aboriginal community-controlled organisations, non-government industry groups, Local Health Districts, community interagency committees, and non-government and for-profit agencies. The alumni of the Poche Centre for Indigenous Health at the University of Sydney and Centre’s agency networks will be key recruitment targets. In addition, members of the research team will aim to attend Aboriginal community events and major conferences to connect with Aboriginal workers and community organisations where COVID restrictions permit.In-depth interviews or yarns will be conducted with a subset of 20 Aboriginal workers and 20 employers of Aboriginal workers who have completed the survey and consented to be interviewed. These may occur by zoom or phone dependant on COVID restrictions. RESULTS An Aboriginal workforce is essential to the delivery of high quality, culturally safe health and social services and to address structural barriers to service access. Aboriginal people experience higher rates of disability and chronic health conditions that non-Aboriginal people which heightens the need for responsive supports and services. A key strength of this this study is that it applies an Indigenous Methodological framework throughout which ensures that the research is designed and implemented with Aboriginal organisations and researchers. The research team includes Aboriginal and non-Aboriginal people, Aboriginal community-controlled organisations and one disability service peak body. The survey and interview questions and model were developed in partnership with Aboriginal health, ageing, and disability, service workers rather than relying only on research publications on the workforce or government policies and HR strategies. CONCLUSIONS By identifying the factors that influence the retention of the Aboriginal workforce from yarn ups and surveys completed by Aboriginal workers and their employers, this study will provide a cohesive set of strategies for organisations to apply in improving their retention of Aboriginal workers. CLINICALTRIAL N/A

scholarly journals Factors supporting retention of health and wellbeing staff in Aboriginal health services: a strength-based case study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara Deroy ◽  
Heike Schütze
Keyword(s):  
Health Service ◽  
Health Services ◽  
Aboriginal Health ◽  
Social Accountability ◽  
Cultural Safety ◽  
Staff Retention ◽  
Professional Advancement ◽  
Aboriginal Community ◽  
Health And Wellbeing

Abstract Background Aboriginal Community Controlled Health Services are fundamental to improving the health and welfare of Aboriginal peoples. A key element that contributes to the effectiveness of these services are Aboriginal health and wellbeing staff. However, Aboriginal health and wellbeing staff often suffer high rates of stress and burnout. Current literature focuses on proposed strategies to increase staff retention in Aboriginal Health Services, yet, there is limited information available showcasing what has actually worked. Method This was an intrinsic strengths-based case study of one regional Aboriginal Community Controlled Health Service. Semi-structured research yarning interviews were conducted with past and present staff employed in health and wellbeing roles to highlight the factors that staff felt contributed to their retention. Results Ten interviews were conducted between February and April 2018. Six key themes emerged: social accountability, teamwork and collaboration, cultural safety, supervision, professional advancement, and recognition. We add to the literature by identifying the importance of bi-directional communication, and showing that social accountability, teamwork and collaboration, cultural safety, supervision, professional advancement, and recognition continue to be important factors that contribute to health and wellbeing staff retention in Aboriginal Health Services. Conclusion This exemplar Aboriginal Health Service may provide insights into future strategies to improve staff retention in other health services.

scholarly journals Supporting Aboriginal Community Controlled Health Services to deliver alcohol care: protocol for a cluster randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e030909 ◽  
Author(s):  
Kristie H Harrison ◽  
KS Kylie Lee ◽  
Timothy Dobbins ◽  
Scott Wilson ◽  
Noel Hayman ◽  
...  
Keyword(s):  
Research Ethics ◽  
Indigenous Peoples ◽  
Brief Intervention ◽  
Relapse Prevention ◽  
Aboriginal Health ◽  
Ethics Committee ◽  
Aboriginal Community ◽  
Research Ethics Committee ◽  
Human Research Ethics ◽  
Treatment Provision

IntroductionIndigenous peoples who have experienced colonisation or oppression can have a higher prevalence of alcohol-related harms. In Australia, Aboriginal Community Controlled Health Services (ACCHSs) offer culturally accessible care to Aboriginal and Torres Strait Islander (Indigenous) peoples. However there are many competing health, socioeconomic and cultural client needs.Methods and analysisA randomised cluster wait-control trial will test the effectiveness of a model of tailored and collaborative support for ACCHSs in increasing use of alcohol screening (with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)) and of treatment provision (brief intervention, counselling or relapse prevention medicines).SettingTwenty-two ACCHSs across Australia.RandomisationServices will be stratified by remoteness, then randomised into two groups. Half receive support soon after the trial starts (intervention or ‘early support’); half receive support 2 years later (wait-control or ‘late support’).The supportCore support elements will be tailored to local needs and include: support to nominate two staff as champions for increasing alcohol care; a national training workshop and bimonthly teleconferences for service champions to share knowledge; onsite training, and bimonthly feedback on routinely collected data on screening and treatment provision.Outcomes and analysisPrimary outcome is use of screening using AUDIT-C as routinely recorded on practice software. Secondary outcomes are recording of brief intervention, counselling, relapse prevention medicines; and blood pressure, gamma glutamyltransferase and HbA1c. Multi-level logistic regression will be used to test the effectiveness of support.Ethics and disseminationEthical approval has been obtained from eight ethics committees: the Aboriginal Health and Medical Research Council of New South Wales (1217/16); Central Australian Human Research Ethics Committee (CA-17-2842); Northern Territory Department of Health and Menzies School of Health Research (2017-2737); Central Queensland Hospital and Health Service (17/QCQ/9); Far North Queensland (17/QCH/45-1143); Aboriginal Health Research Ethics Committee, South Australia (04-16-694); St Vincent’s Hospital (Melbourne) Human Research Ethics Committee (LRR 036/17); and Western Australian Aboriginal Health Ethics Committee (779).Trial registration numberACTRN12618001892202; Pre-results.

Contribution of Aboriginal Community-Controlled Health Services to improving Aboriginal health: an evidence review

2018 ◽  
Vol 42 (2) ◽  
pp. 218 ◽  
Author(s):  
Megan Ann Campbell ◽  
Jennifer Hunt ◽  
David J. Scrimgeour ◽  
Maureen Davey ◽  
Victoria Jones
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Conceptual Framework ◽  
Aboriginal People ◽  
Aboriginal Health ◽  
Well Being ◽  
Aboriginal Peoples ◽  
Aboriginal Community ◽  
Primary Health

Objective Aboriginal Community-Controlled Health Services (ACCHSs) deliver comprehensive, culturally appropriate primary health care to Aboriginal people and communities. The published literature acknowledging and supporting the roles of ACCHSs in improving Aboriginal health is limited. This paper seeks to collate and analyse the published evidence supporting the contribution of ACCHSs to improving the health of Aboriginal people. Methods A conceptual framework for exploring the contribution of ACCHSs was developed, drawing on the literature on the core functions of ACCHSs and the components of quality primary health care. This framework was used to structure the search strategy, inclusion criteria and analysis of the review. Results ACCHSs contribute to improving the health and well being of Aboriginal peoples through several pathways, including community controlled governance, providing employment and training, strengthening the broader health system and providing accessible, comprehensive primary health care. Conclusions ACCHSs make a range of important contributions to improving the health of Aboriginal peoples that are under-acknowledged. Consideration of the different ways ACCHSs contribute to improving Aboriginal health is of value in the design and evaluation of programs and policies that aim to improve the health of Aboriginal peoples. What is known about the topic? Aboriginal communities have long argued the vital role of ACCHSs in improving Aboriginal health. What does this paper add? This paper provides a comprehensive collation and analysis of the evidence supporting the contributions ACCHSs are making to improving Aboriginal health. What are the implications for practitioners? The conceptual framework and findings outlined in this paper illustrate that ACCHSs are making important contributions to improving Aboriginal health through several pathways. This information can be used to ensure actions to improve Aboriginal health are appropriate and effective. There are important gaps in the literature that researchers need to address.

scholarly journals Participatory Action Research-Dadirri-Ganma, using Yarning: methodology co-design with Aboriginal community members

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hepsibah Sharmil ◽  
Janet Kelly ◽  
Margaret Bowden ◽  
Cherrie Galletly ◽  
Imelda Cairney ◽  
...  
Keyword(s):  
Mental Health ◽  
Action Research ◽  
Participatory Action Research ◽  
Health Professionals ◽  
Research Team ◽  
Aboriginal People ◽  
Participatory Action ◽  
Community Members ◽  
Aboriginal Community ◽  
Drug And Alcohol

Abstract Background Appropriate choice of research design is essential to rightly understand the research problem and derive optimal solutions. The Comorbidity Action in the North project sought to better meet the needs of local people affected by drug, alcohol and mental health comorbidity. The aim of the study focused on the needs of Aboriginal peoples and on developing a truly representative research process. A methodology evolved that best suited working with members of a marginalised Aboriginal community. This paper discusses the process of co-design of a Western methodology (participatory action research) in conjunction with the Indigenous methodologies Dadirri and Ganma. This co-design enabled an international PhD student to work respectfully with Aboriginal community members and Elders, health professionals and consumers, and non-Indigenous service providers in a drug and alcohol and mental health comorbidity project in Adelaide, South Australia. Methods The PhD student, Aboriginal Elder mentor, Aboriginal Working Party, and supervisors (the research team) sought to co-design a methodology and applied it to address the following challenges: the PhD student was an international student with no existing relationship with local Aboriginal community members; many Aboriginal people deeply distrust Western research due to past poor practices and a lack of implementation of findings into practice; Aboriginal people often remain unheard, unacknowledged and unrecognised in research projects; drug and alcohol and mental health comorbidity experiences are often distressing for Aboriginal community members and their families; attempts to access comorbidity care often result in limited or no access; and Aboriginal community members experience acts of racism and discrimination as health professionals and consumers of health and support services. The research team considered deeply how knowledge is shared, interpreted, owned and controlled, by whom and how, within research, co-morbidity care and community settings. The PhD student was supported to co-design a methodology that was equitable, democratic, liberating and life-enhancing, with real potential to develop feasible solutions. Results The resulting combined Participatory Action Research (PAR)-Dadirri-Ganma methodology sought to create a bridge across Western and Aboriginal knowledges, understanding and experiences. Foundation pillars of this bridge were mentoring of the PhD student by senior Elders, who explained and demonstrated the critical importance of Yarning (consulting) and Indigenous methodologies of Dadirri (deep listening) and Ganma (two-way knowledge sharing), and discussions among all involved about the principles of Western PAR. Conclusions Concepts within this paper are shared from the perspective of the PhD student with the permission and support of local Elders and Working Group members. The intention is to share what was learned for the benefit of other students, research projects and community members who are beginning a similar journey.

scholarly journals Participatory Action Research with Daddiri and Ganma: Methodology Co-Design with Aboriginal Community members.

2020 ◽  
Author(s):  
Hepsibah Sharmil ◽  
Janet Kelly ◽  
Margaret Bowden ◽  
Imelda Cairney ◽  
Joanne Else ◽  
...  
Keyword(s):  
Mental Health ◽  
Participatory Action Research ◽  
Health Professionals ◽  
Research Team ◽  
Aboriginal People ◽  
Research Projects ◽  
Participatory Action ◽  
Community Members ◽  
Aboriginal Community ◽  
Drug And Alcohol

Abstract Background: This paper discusses the process of co-design of a de-colonising participatory methodology that enabled an international PhD student to work respectfully with Aboriginal community members and Elders, health professionals and consumers, and non-Indigenous service providers in a drug and alcohol and mental health comorbidity project in Adelaide, South Australia. The Comorbidity Action in the North project sought to redesign services to better meet the needs of local people affected by drug, alcohol, and mental health comorbidity. This arm of the study focused on the needs of Indigenous peoples. Methods: The PhD student, Aboriginal Elder mentor, Aboriginal Working Party and supervisors (the research team) sought to co-design a methodology that could address the following challenges: many Aboriginal people deeply distrust Western research due to past poor practices and a lack of implementation of findings into practice; Aboriginal people often remain unheard, unacknowledged and unrecognised in research projects; drug and alcohol and mental health comorbidity experiences are often distressing for Aboriginal community members and their families; attempts to access comorbidity care often result in limited or no access; Aboriginal community members experience acts of racism and discrimination as health professionals and consumers of health and support services; and, the PhD student was an international student with no existing relationship with local Aboriginal community members. The research team considered deeply how knowledge is shared, interpreted, owned and controlled, by whom and how, within research, co-morbidity care and community settings. The PhD student was supported to co-design a methodology that was equitable, democratic, liberating and life-enhancing, with real potential to develop feasible solutions. Results: The resulting combined Participatory Action Research (PAR)-Dadirri-Ganma methodology sought to create a bridge across Western and Aboriginal knowledges, understanding and experiences. Combined mentoring by senior Elders, Indigenous methodologies Dadirri (deep listening) and Ganma (two-way knowledge sharing), and Western PAR.Conclusions: Concepts within this paper are shared from the perspective of the PhD student with the permission and support of local Elders and Working Group members. The intention is to share what was learned for the benefit other students, research projects and community members who are beginning a similar journey.

Aboriginal Community Controlled Comprehensive Primary Health Care: The Central Australian Aboriginal Congress

2001 ◽  
Vol 7 (3) ◽  
pp. 74 ◽  
Author(s):  
Ben Bartlett ◽  
John Boffa
Keyword(s):  
Aboriginal People ◽  
Social Issues ◽  
Aboriginal Health ◽  
Community Control ◽  
Aboriginal Community ◽  
Australian Aboriginal ◽  
Comprehensive Primary Health Care ◽  
High Quality Medical Care ◽  
Dominant Society

Aboriginal community controlled PHC services have led the way in Australia in developing a model of PHC service that is able to address social issues and the underlying determinants of health alongside high quality medical care. This model is characterised by a comprehensive style rather than the selective PHC model that tends to be more common in mainstream services. Central to comprehensive PHC is community control, which is critical to the bottom up approach rather than the top down approach of selective PHC. The expansion of Aboriginal Community Controlled Health Services (ACCHSs) in Australia is a product of the colonial relationship that persists between Aboriginal and non-Aboriginal Australia. It is this relationship that explains why community control has been a feature of Aboriginal PHC services while similar attempts in the dominant society have tended to be incorporated into the mainstream. The mechanisms of control occur through community processes and should not be confused with day to day management processes, although the two are related. The Core Functions of PHC is a framework that reflects the experience of ACCHSs and allows for the development and assessment of comprehensive PHC. This framework is applied to a case study of the Central Australian Aboriginal Congress (Congress) which is the major Aboriginal health service in central Australia. The case study illustrates increasing utilisation of PHC services by Aboriginal people, and the capacity of community controlled organisations to respond to demographic and health pattern changes in their client populations.

Understanding lived experiences of Aboriginal people with type 2 diabetes living in remote Kimberley communities: diabetes, it don't come and go, it stays!

2019 ◽  
Vol 25 (5) ◽  
pp. 486 ◽  
Author(s):  
Sarah Straw ◽  
Erica Spry ◽  
Louie Yanawana ◽  
Vaughan Matsumoto ◽  
Denetta Cox ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Collaborative Research ◽  
Diabetes Management ◽  
Aboriginal People ◽  
Health Workers ◽  
Aboriginal Health ◽  
Community Members ◽  
Remote Communities ◽  
Aboriginal Community

This study aimed to explore the lived experiences of Kimberley Aboriginal people with type 2 diabetes managed by remote Aboriginal Community Controlled Health Services using phenomenological analysis. Semi-structured interviews formulated by Aboriginal Health Workers, researchers and other clinicians were used to obtain qualitative data from 13 adult Aboriginal patients with type 2 diabetes managed in two remote communities in the Kimberley. Together with expert opinion from local Aboriginal Health Workers and clinicians, the information was used to develop strategies to improve diabetes management. Of 915 regular adult patients in the two communities, 27% had type 2 diabetes; 83% with glycated haemoglobin A >10%. Key qualitative themes included: the need for culturally relevant education and pictorial resources; importance of continuous therapeutic relationships with healthcare staff; lifestyle management advice that takes into account local and cultural factors; and the involvement of Aboriginal community members and families in support roles. Recommendations to improve diabetes management in the remote communities have been made collaboratively with community input. This study provides a framework for culturally relevant recommendations to assist patients with diabetes, for collaborative research, and for communication among patients, Aboriginal Health Workers, community members, researchers and other clinicians. Interventions based on recommendations from this study will be the focus of further collaborative research.

Beyond the rhetoric: how can non-government organisations contribute to reducing health disparities for Aboriginal and Torres Strait Islander people?

2011 ◽  
Vol 17 (4) ◽  
pp. 384 ◽  
Author(s):  
Lisa Wood ◽  
Trevor Shilton ◽  
Lyn Dimer ◽  
Julie Smith ◽  
Timothy Leahy
Keyword(s):  
Health Disparities ◽  
Aboriginal People ◽  
Action Plan ◽  
Aboriginal Health ◽  
Well Being ◽  
Aboriginal Community ◽  
Hospital System ◽  
Health Reforms ◽  
Lessons Learnt ◽  
Heart Foundation

The prevailing disparities in Aboriginal health in Australia are a sobering reminder of failed health reforms, compounded by inadequate attention to the social determinants shaping health and well-being. Discourse around health reform often focuses on the role of government, health professionals and health institutions. However, not-for-profit health organisations are also playing an increasing role in health policy, research and program delivery across the prevention to treatment spectrum. This paper describes the journey of the National Heart Foundation of Australia in West Australia (Heart Foundation WA hereafter) with Aboriginal employees and the Aboriginal community in taking a more proactive role in reducing Aboriginal health disparities, focusing in particular on lessons learnt that are applicable to other non-government organisations. Although the Heart Foundation WA has employed and worked with Aboriginal people and has long identified the Aboriginal community as a priority population, recent years have seen greater embedding of this within its organisational culture, governance, policies and programs. In turn, this has shaped the organisation’s response to external health reforms and issues. Responses have included the development of an action plan to eliminate disparities of cardiovascular care in the hospital system, and collaboration and engagement with health professional groups involved in delivery of care to Aboriginal people. Examples of governance measures are also described in this paper. Although strategies and the lessons learnt have been in the context of cardiovascular health disparities, they are applicable to other organisations across the health sector. Moreover, the most powerful lesson learnt is universal in its relevance; individual programs, policies and reforms are more likely to succeed when they are underpinned by whole of organisation ownership and internalisation of the need to redress disparities in health.

scholarly journals Sharing Our Wisdom: A Holistic Aboriginal Health Initiative

2016 ◽  
Vol 11 (1) ◽  
pp. 111 ◽  
Author(s):  
Teresa Howell ◽  
Monique Auger ◽  
Tonya Gomes ◽  
Francis Lee Brown ◽  
Alannah Young Leon
Keyword(s):  
Role Models ◽  
Aboriginal People ◽  
Aboriginal Health ◽  
Health And Wellness ◽  
Participatory Action ◽  
Community Members ◽  
Aboriginal Community ◽  
Cultural Orientations ◽  
Health Circles ◽  
Cultural Belonging

<p>Colonization has had a profound effect on Aboriginal people’s health and the deterioration of traditional Aboriginal healthcare systems. Health problems among Aboriginal people are increasing at an alarming pace, while recovery from these problems tends to be poorer than among other Canadians. Aboriginal people residing in urban settings, while maintaining strong cultural orientations, also face challenges in finding mentors, role models, and cultural services, all of which are key determinants of health. Using a participatory action framework, this study focused on understanding and describing Aboriginal traditional healing methods as viable approaches to improve health outcomes in an urban Aboriginal community. This research investigated the following questions: (a) Do traditional Aboriginal health practices provide a more meaningful way of addressing health strategies for Aboriginal people? (b) How does participation in health circles, based on Aboriginal traditional knowledge, impact the health of urban Aboriginal people? Community members who participated in this project emphasized the value of a cultural approach to health and wellness. The project provided a land-based cultural introduction to being of <em>nə́c̓aʔmat tə šxʷqʷeləwən ct</em> (one heart, one mind) and learning ways of respectful listening <em>x<sup>w</sup>na:mstəm</em> (witness) <em>tə slaχen</em> (medicines) (listen to the medicine), through a series of seven health circles. The circles, developed by Aboriginal knowledge keepers, fostered a healthy sense of identity for participants and demonstrated the ways of cultural belonging and community. Participants acknowledged that attending the health circles improved not only their physical health, but also their mental, emotional, and spiritual health.<strong></strong></p>

The Space of Difference in Law: Inquests into Aboriginal Deaths in Custody

Somatechnics ◽  
2011 ◽  
Vol 1 (1) ◽  
pp. 87-123 ◽  
Author(s):  
Sherene H. Razack
Keyword(s):  
Aboriginal People ◽  
The Body ◽  
Police Brutality ◽  
Canadian Society ◽  
Aboriginal Community ◽  
Police Custody ◽  
Homo Sacer ◽  
Clear Sign ◽  
A Site ◽  
Deaths In Custody

Paul Alphonse, a 67 year-old Aboriginal died in hospital while in police custody. A significant contributing factor to his death was that he was stomped on so hard that there was a boot print on his chest and several ribs were broken. His family alleged police brutality. The inquest into the death of Paul Alphonse offers an opportunity to explore the contemporary relationship between Aboriginal people and Canadian society and, significantly, how law operates as a site for managing that relationship. I suggest that we consider the boot print on Alphonse's chest and its significance at the inquest in these two different ways. First, although it cannot be traced to the boot of the arresting officer, we can examine the boot print as an event around which swirls Aboriginal/police relations in Williams Lake, both the specific relation between the arresting officer and Alphonse, and the wider relations between the Aboriginal community and the police. Second, the response to the boot print at the inquest sheds light on how law is a site for obscuring the violence in Aboriginal people's lives. A boot print on the chest of an Aboriginal man, a clear sign of violence, comes to mean little because Aboriginal bodies are considered violable – both prone to violence, and bodies that can be violated with impunity. Law, in this instance in the form of an inquest, stages Aboriginal abjection, installing Aboriginal bodies as too damaged to be helped and, simultaneously to harm. In this sense, the Aboriginal body is homo sacer, the body that maybe killed but not murdered. I propose that the construction of the Aboriginal body as inherently violable is required in order for settlers to become owners of the land.

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