scholarly journals “You Can’t Work with My People If You Don’t Know How to”: Enhancing Transfer of Care from Hospital to Primary Care for Aboriginal Australians with Chronic Disease

2021 ◽  
Vol 18 (14) ◽  
pp. 7233
Author(s):  
Ilse Blignault ◽  
Liz Norsa ◽  
Raylene Blackburn ◽  
George Bloomfield ◽  
Karen Beetson ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Success Factors ◽  
Cultural Safety ◽  
Indigenous Australians ◽  
Indigenous Research ◽  
Clinical Expertise ◽  
Patient Identification ◽  
Holistic Model ◽  
Patient Journey ◽  
Transfer Of Care

Indigenous Australians experience significantly poorer health compared to other Australians, with chronic disease contributing to two-thirds of the health gap. We report on an evaluation of an innovative model that leverages mainstream and Aboriginal health resources to enable safe, supported transfer of care for Aboriginal adults with chronic conditions leaving hospital. The multisite evaluation was Aboriginal-led and underpinned by the principles of self-determination and equity and Indigenous research protocols. The qualitative study documented processes and captured service user and provider experiences. We found benefits for patients and their families, the hospital and the health system. The new model enhanced the patient journey and trust in the health service and was a source of staff satisfaction. Challenges included staff availability, patient identification and complexity and the broader issue of cultural safety. Critical success factors included strong governance with joint cultural and clinical leadership and enduring relationships and partnerships at the service delivery, organisation and system levels. A holistic model of care, bringing together cultural and clinical expertise and partnering with Indigenous community organisations, can enhance care coordination and safety across the hospital–community interface. It is important to consider context as well as specific program elements in design, implementation and evaluation.

scholarly journals Indigenous mothers’ experiences of power and control in child welfare: Families being heard

2021 ◽  
pp. 146801732110091
Author(s):  
Suzanne C Robertson ◽  
Carey Sinclair ◽  
Andrew R Hatala
Keyword(s):  
Family Relationships ◽  
Daily Practice ◽  
Cultural Safety ◽  
Indigenous Research ◽  
Children And Families ◽  
Child And Family Services ◽  
Power And Control ◽  
Indigenous Children ◽  
Welfare Families ◽  
And Control

Summary There are upward of 11,000 Indigenous children and families in the Manitoba Child and Family Services (CFSs). Many factors coalesce as contributors to these high rates of care, including oppressive histories of Canadian settler colonialism, governmental policies and the Indian Residential Schools, and mass apprehensions of Indigenous children through “the 60’s scoop.” Although a process of “Devolution” began in Manitoba in 1999 to address Indigenous overrepresentation and improve cultural safety for children and families, the voices of women whose children are in care often remain silenced and marginal. Findings Utilizing an Indigenous Research lens, this qualitative study explored the stories and experiences of 12 Indigenous mothers involved with Manitoba CFS. The mothers’ stories revealed dynamics of power and control outlined in five core themes: (1) Being “set up to fail”; (2) Confronting “normalcy” and navigating case plans; (3) Dealing with tactics of intimidation; (4) Experiencing judgment and being labelled; and (5) Emotional politics. The mothers’ stories suggest that the CFS system continues to reflect colonial structures of oppression and that the “Devolution” did not fully have the intended impact on daily practice. Applications The womens' shared experiences highlight several areas for change, such as: enhanced family supports and worker relationships; utilization of capacity building frameworks; better institutional collaborations; increased efforts to maintain family relationships and units; and greater access to and quality of Indigenous cultural supports for mothers and children, including ceremony, healing, and access to Elders. Suggestions for more efficient and family-centered service provision are also offered.

Indigenous Research, Differing Value Systems

2000 ◽  
Vol 28 (1) ◽  
pp. 17-30 ◽  
Author(s):  
Dennis Foley
Keyword(s):  
Active Role ◽  
Value Systems ◽  
Indigenous Australians ◽  
Indigenous Research ◽  
Australian Society ◽  
Business Studies ◽  
Indigenous Australia ◽  
Business Principles ◽  
Indigenous Thought ◽  
Personal Research

The collective aim of many of this Journal's readers is to provide Indigenous Australians with a sound education to allow us (Indigenous Australia) to take a more active role in Australian society. My personal research interest is in business studies, training Indigenous Australians in management and business principles. I continually face the question of am I training my kin in a Western science that is often at the opposite end of the spectrum to Indigenous thought and practice?

scholarly journals Cultural safety training for allied health students in Australia

2020 ◽  
pp. 1-10
Author(s):  
Marion Gray ◽  
Yvonne Thomas ◽  
Marianne Bonassi ◽  
Jacinta Elston ◽  
Geraldine Tapia
Keyword(s):  
Cultural Identity ◽  
Allied Health ◽  
Cultural Safety ◽  
Cultural Humility ◽  
Indigenous Australians ◽  
Safety Education ◽  
Allied Health Students ◽  
Before And After ◽  
Education Workshop ◽  
Knowledge And Attitude

Abstract Culturally safe health practitioners are essential for effective service provision to culturally diverse populations, including Indigenous Australians. Therefore, cultural safety education during training as a health care professional is an essential component in helping improve the health of Indigenous Australians. This study examined whether the implementation of an Indigenous cultural safety education workshop increased self-rated cultural safety knowledge and attitudes of allied health students. The study employed a quantitative before-and-after design using pre- and post-surveys to determine the level of attitudinal change in students who attended a day long workshop. The study sample consisted of 1st year (n = 347) and 4th year (n = 149) allied health students at a regional Australian university over the years 2007–2011. Whilst the results of this current study are varied in terms of achieving positive change across all of the taught items of knowledge and attitude, they provide some evidence around the value of this type of curriculum intervention in helping develop culturally safe practitioners. An important finding was around the student's becoming self-aware about their own values and cultural identity, combined with acknowledging the importance of this cultural identity to interactions with clients. This form of ‘cultural humility’ appears to be an important step to becoming a culturally safe practitioner. These types of interventions would be enhanced through embedding and scaffolding throughout the curricula.

scholarly journals Systematic review to inform prevention and management of chronic disease for Indigenous Australians: overview and priorities

2015 ◽  
Vol 40 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Judith Streak Gomersall ◽  
Karla Canuto ◽  
Edoardo Aromataris ◽  
Annette Braunack-Mayer ◽  
Alex Brown
Keyword(s):  
Systematic Review ◽  
Chronic Disease ◽  
Indigenous Australians

Review of the cultural safety of a national Indigenous point-of-care testing program for diabetes management

2016 ◽  
Vol 22 (4) ◽  
pp. 368 ◽  
Author(s):  
Mark Shephard ◽  
Christopher O'Brien ◽  
Anthony Burgoyne ◽  
Jody Croft ◽  
Trevor Garlett ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Diabetes Management ◽  
Health Workers ◽  
Point Of Care ◽  
Cultural Safety ◽  
Medical Services ◽  
Indigenous Australians ◽  
Point Of Care Testing ◽  
Group Setting ◽  
Torres Strait

In Australia, Aboriginal and Torres Strait Islander people have approximately three-fold higher rates of diabetes than non-Indigenous Australians. Point-of-care testing, where pathology tests are conducted close to the patient, with results available during the patient consultation, can potentially deliver several benefits for both the Indigenous client and the health professional team involved in their care. Currently, point-of-care testing for diabetes management is being conducted in over 180 Aboriginal and Torres Strait Islander Medical Services as part of a national program called Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS). The cultural safety of the Program was reviewed by sourcing the views of the QAAMS Indigenous Leaders Team in a focus group setting and by surveying the point-of-care testing operators enrolled in QAAMS, via an electronic questionnaire. The current study confirms that QAAMS remains a culturally safe program that fills a permanent and positive niche within the Indigenous health sector. The study demonstrates that QAAMS provides a convenient and accessible ‘one-stop’ pathology service for Indigenous clients with diabetes and empowers Aboriginal Health Workers to have a direct role in the care of their diabetes clients.

scholarly journals Determinants of access to chronic illness care: a mixed-methods evaluation of a national multifaceted chronic disease package for Indigenous Australians

BMJ Open ◽  
2015 ◽  
Vol 5 (11) ◽  
pp. e008103 ◽  
Author(s):  
Jodie Bailie ◽  
Gill Schierhout ◽  
Alison Laycock ◽  
Margaret Kelaher ◽  
Nikki Percival ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Chronic Disease ◽  
Chronic Illness ◽  
Indigenous Australians ◽  
Chronic Illness Care ◽  
Mixed Methods Evaluation

scholarly journals A cohort of Indigenous Australian women and their children through pregnancy and beyond: the Gomeroi gaaynggal study

2016 ◽  
Vol 7 (4) ◽  
pp. 357-368 ◽  
Author(s):  
A. M. Ashman ◽  
C. E. Collins ◽  
L. Weatherall ◽  
L. J. Brown ◽  
M. E. Rollo ◽  
...  
Keyword(s):  
Later Life ◽  
Indigenous Australians ◽  
Indigenous Research ◽  
Indigenous Australian ◽  
Smoking During Pregnancy ◽  
Time Points ◽  
South Wales ◽  
Pregnancy And Postpartum ◽  
Women And Children ◽  
And Function

Indigenous Australians have high rates of chronic diseases, the causes of which are complex and include social and environmental determinants. Early experiences in utero may also predispose to later-life disease development. The Gomeroi gaaynggal study was established to explore intrauterine origins of renal disease, diabetes and growth in order to inform the development of health programmes for Indigenous Australian women and children. Pregnant women are recruited from antenatal clinics in Tamworth, Newcastle and Walgett, New South Wales, Australia, by Indigenous research assistants. Measures are collected at three time points in pregnancy and from women and their children at up to eight time points in the child’s first 5 years. Measures of fetal renal development and function include ultrasound and biochemical biomarkers. Dietary intake, infant feeding and anthropometric measurements are collected. Standardized procedures and validated tools are used where available. Since 2010 the study has recruited over 230 women, and retained 66 postpartum. Recruitment is ongoing, and Gomeroi gaaynggal is currently the largest Indigenous pregnancy-through-early-childhood cohort internationally. Baseline median gestational age was 39.1 weeks (31.5–43.2, n=110), median birth weight was 3180 g (910–5430 g, n=110). Over one third (39.3%) of infants were admitted to special care or neonatal nursery. Nearly half of mothers (47.5%) reported tobacco smoking during pregnancy. Results of the study will contribute to knowledge about origins of chronic disease in Indigenous Australians and nutrition and growth of women and their offspring during pregnancy and postpartum. Study strengths include employment and capacity-building of Indigenous staff and the complementary ArtsHealth programme.

scholarly journals Creating Culturally Safe Vocational Rehabilitation Services for Indigenous Australians: A Brief Review of the Literature

2016 ◽  
Vol 22 (2) ◽  
pp. 93-103 ◽  
Author(s):  
Vanette McLennan ◽  
Natalie Taylor ◽  
Amanda Rachow ◽  
Grant South ◽  
Kelsey Chapman
Keyword(s):  
Vocational Rehabilitation ◽  
Research Evidence ◽  
Service Providers ◽  
Cultural Safety ◽  
Rehabilitation Service ◽  
Rehabilitation Services ◽  
Indigenous Australians ◽  
Context Sensitive ◽  
Vocational Rehabilitation Services ◽  
Vocational Rehabilitation Service

This article reviews the research evidence on vocational rehabilitation services and rehabilitation counselling practice with Indigenous Australians. It applied a context sensitive, cultural safety and reflexivity approach to construct salient themes from the research evidence. Findings suggest Indigenous Australians with disabilities experience significant ‘double-disadvantage’, and that vocational rehabilitation service providers lack the knowledge and skills in culturally safe practice in order to enhance the opportunities for social and economic inclusion of Indigenous Australians. A whole-of-profession approach, incorporating and ensuring Indigenous client equity and cultural safety in vocational rehabilitation, is critically and urgently needed.

scholarly journals P141: Education innovation: Equity, Diversity, Advocacy, and Cultural Safety (EDACS) curriculum

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S115-S115
Author(s):  
C. Acton ◽  
E. Dell ◽  
K. Hayman
Keyword(s):  
Clinical Care ◽  
Healthcare Providers ◽  
Cultural Safety ◽  
Needle Exchange Program ◽  
Structural Level ◽  
Clinical Expertise ◽  
Clinical Environment ◽  
Skill Sets ◽  
Walking Tour ◽  
Structural Competency

Innovation Concept: Upon completion of training, Canadian physicians are expected to respond to patient needs to advocate for change both within and beyond the immediate clinical environment.1 In the current EM curriculum, residents are not explicitly taught skills necessary to engage in clinical care nor policy change that would improve the social determinants of health (SDOH) of patients. In response to this challenge, we have developed and are piloting a 2 year curriculum on “Equity, Diversity, Advocacy, and Cultural Safety (EDACS), to equip EM trainees with the knowledge and skills to advocate and influence policy - to empower residents to act on healthcare inequities rather than simply be aware of them. Methods: We developed the curriculum utilizing the Structural Competency paradigm, a theoretical framework within which clinical and advocacy skills to address the SDOH at a structural level can be taught and practiced. This paradigm includes five intersecting skill-sets, including recognizing the structures that shape clinical interactions, developing an extra-clinical language of structure, and imagining structural interventions. Curriculum, Tool, or Material: The educational intervention will consist of 8 hour-long sessions and one 3-hour long session held over a 2-year period. The 3-hour long session will consist of a walking tour of sites accessed by individuals living in poverty in the Toronto downtown core, including a homeless shelter, a needle exchange program, and others. This session will be facilitated by a physician lead, with input at each site from community organizers. Prior to the walking tour, residents will receive an introductory session outlining themes to reflect on during and after the walking tour. Hour-long sessions will be delivered by invited healthcare providers with specific clinical expertise in the topics of discussion, which will address the care of and advocacy for various marginalized populations. Conclusion: To our knowledge, this is the first curriculum of its kind being implemented in an EM training program in Canada. Upon completion of the curriculum, students will be able to apply the five skillsets outlined in the Structural Competency Framework to address and improve upon inequitable conditions that influence patients treated in the emergency department. We intend to use formal and informal feedback from residents, clinicians, and lecturers to refine future curriculum cycles, and hope to inform similar programs elsewhere.

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