aboriginal engagement with community services and health systems

Melbourne: Better evaluation. The questions were: (Additional file 1 provides supplementary questions that helped guide the evaluation). Controlling for age reduced the OR by 23% from 4.3 to 3.3 (2.5-4.5). Indigenous Australians and the health system This approach takes into account differences in world views and the expectations that each party brings to the evaluation relationship [29]. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. These presentations were held at two AAHAG meetings attended by community DAHAG representatives from each district and health professionals. By using this website, you agree to our The above perspective of doing things differently was something that emerged from the DAHAG process and was a surprise for the participant who articulated this. Aboriginal and Torres Strait Islander health performance framework 2012: detailed analyses. The feedback loop that was established fostered a sense of accountability, transparency and trust and has resulted in better healthcare for the Aboriginal community. Aboriginal and Torres Strait Islander Health Performance Framework, Indigenous Mental Health and Suicide Prevention Clearinghouse, Regional Insights for Indigenous Communities, National Mental Health Service Planning Framework, Click to open the social media sharing options, Engagement with Indigenous communities in key sectors. So that has been great that Aboriginal people are doing it. Please enable JavaScript to use this website as intended. End matter: Acknowledgments; Abbreviations; Terminology; Funding; Suggested citation; Copyright, Australian Institute of Health and Welfare 2022. This more innovative and inclusive approach enabled service providers to hear and respond to what people said they needed. What changes (if any) in trust/confidence in health services have been experienced at a personal, family or community level? Bessarab D, Durey A, Christou A, Katzenellenbogen JM, Taylor K, Brankovich J. Thus, it remains unknown whether community members who chose not to participate in the community engagement process were unhappy with the process or did not engage for other reasons. IHW 94. The aims were to identify areas of health need that could be funded through the COAG process; to inform ways to make health services more culturally secure and accessible; and to build relationships between service providers and the local Aboriginal community. It will support health services to assess whether there has been a measured approach towards the delivery of culturally safe and accessible health services for Aboriginal patients and clients. Yarning in this evaluation was guided by the evaluation questions and began with social yarning to develop rapport and a relationship with participants. Martin K. Ways of knowing, ways of being and ways of doing: a theoretical framework and methods for Indigenous research and Indigenist research. Aboriginal and Torres Strait Islander cultural safety Part of HHS Vulnerability Disclosure, Help Beyond the meetings, health service providers were responsible for implementing recommendations from the DAHAGs to improve health service delivery for Aboriginal people. Aust J Public Admin. The concept of community engagement was explored further to elicit a deeper understanding of its meaning. And maybe that is because they have not worked with Aboriginal people before, but I think (midwife) has been open to learning as well it is a two-way street, I think, and I appreciate that. Springer Nature. The nurse "cared deeply" for the health of Aboriginal children but she moved to a job in an aged-care home "due to a broken heart." passing on of cultural practices. AAHAG, Area Aboriginal Health Action Group; ABS, Australian Bureau of Statistics; AHT, Aboriginal Health Team; ASSU, Aboriginal Specific Service Users; COAG, Council of Australian Governments; CtG, Closing the Gap; DAHAG, District Aboriginal Health Action Group; HPAS, Health Providers of Aboriginal Services; IECD, Indigenous Early Childhood Development; MHSP, Mainstream Health Service Providers; NPA, National Partnership Agreement; PHU, Population Health Unit; SMHS, South Metropolitan Health Service; SMPHU, South Metropolitan Population Health Unit; WA, Western Australia. However, given the number of Aboriginal people who accessed various services such as diabetes or maternity care, it appeared that awareness within the broader community was good. The online version of this article (doi:10.1186/s12913-016-1497-0) contains supplementary material, which is available to authorized users. Findings from the evaluation concur with literature which states that reciprocity or shared knowledge and understanding of Aboriginal health needs and recognising the importance of Aboriginal knowledge and culture can help establish and build intercultural partnerships [13, 14]. This two-way process involves Aboriginal communities learning about health services and the health system, and health services building their knowledge and skills about Aboriginal ways of working and Aboriginal culture. Curtin University Human Research Ethics Committee has not approved the sharing of sensitive information such as transcripts of interviews and any such sharing would constitute a breach of the Australian Privacy Act 1988 (Cth). IHW 140. Throughout the process the Curtin team was committed to working in partnership with the AHT to ensure that the evaluation process was respectful of the Aboriginal community. Australian Bureau of Statistics (ABS) Census data show that in 2011, the resident population of SMHS was 867,371, of whom 15,317 were Aboriginal, accounting for 1.8% of the population [23]. The DAHAG process facilitated engagement and discussion between the community and health services. Notably, community members were compensated for their time. The overall positive responses to the evaluation questions from the four stakeholder groups confirm the effectiveness of this community engagement approach. no. What programs do you want to see? Needs were identified and then we built it on from that way and I think that is where the success of the DAHAG came from. The data supporting this article cannot be shared as it contains information about participants that is sensitive related to their ethnic background and health. A positive cultural identity can provide an individual with a sense of belonging, purpose, social support & self-worth [].This process may occur through an attachment to a cultural group whereby belief systems, values, obligations and practices are shared and reinforced by in-group members [].The potential health benefits of sustaining a strong cultural identity and/or participating in . The Aboriginal community became an active decision maker and Aboriginal DAHAG members made up the majority on the committees where there is definitely a real sense that the power balance is much more evened out (MHSP 5). Med J Aust. These factors not only helped to build trust and gain acceptance but were necessary before implementing any interventions. Hence, a non-participant would know who to ask for assistance about any health services queries. The engagement framework will be informed by conversations with key Aboriginal leaders, community members and organisations, and departmental and other government stakeholders. Engagement with Indigenous communities in key sectors Improving healthcare for Aboriginal Australians through effective An outcome of these forums that was was the establishment of five District Aboriginal Health Action Groups (DAHAGs) in 2010 that were based on action rather than simply consultation, and were located within the organisational structure of the Department of Health in Western Australia (see Fig. The Aboriginal Community Engagement and Partnership Framework (engagement framework) is being developed to provide a platform for informing policy direction, program development, and the monitoring, implementation and accountability of coordinated responses for Aboriginal Victorians. This included 30 DAHAG members, one HPAS and 12 ASSU, all of whom were Aboriginal whilst the 14 MHSP comprised both Aboriginal and non-Aboriginal participants and three HPAS were non-Aboriginal. PMC legacy view Key objectives of the DAHAG process were to move beyond talk to action; avoid tokenism; identify local solutions to local Aboriginal health priorities; identify and action ways to deliver tailored Aboriginal health services; increase health service access for Aboriginal patients and improve coordination between local health services. Book 1: An Introdcution to Engagement. While there may be very specific requirements for engaging with Indigenous individuals across specific sectors, there are some common lessons about engagement with Indigenous communities across the sectors identified above. A.4.1 The guideline development process includes participation by representatives of Aboriginal and Torres Strait Islander People and culturally and linguistically diverse communities (as appropriate to the clinical need and context), and the processes employed to recruit, involve and support these participants are described. There was Aboriginal representation at each level, whether as community members or as Aboriginal staff members. 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The second program (Aboriginal Maternity Group Practice) provides antenatal care for Aboriginal women living in the SMHS area and has shown a considerable increase in the proportion of Aboriginal women choosing to birth locally and significantly improved neonatal outcomes [36]. (HPAS 4). Participants were provided with an information sheet that included the purpose of the evaluation, confidentiality assurances, the nature of their involvement and option to withdraw at any time without implications. This respondent linked community engagement with best practice and the provision of a user-friendly and welcoming service for Aboriginal people. Impact on Indigenous Australians - Queensland Mental Health Commission Looking at the engagement with the service providers and the DAHAG group, it has made it a lot more comfortable to speak up Because I think ideally, we are sort of asked what we thought about certain things or how we would go about doing things We help the different service providers, or give them ideas so that they can go away and look at some strategies. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. (HPAS 4). Canberra: AIHW. However, despite attempts of a team member to contact and follow up people by phone, recruiting Aboriginal people who had not participated in the community engagement process proved challenging. The structure of the DAHAG supported Aboriginal governance and leadership by ensuring that the chairperson was a community member with the meeting agenda and priorities set by the community, thereby helping to create a culturally safe space. Aust N Z J Public Health. And with the service providers, they always come back to the DAHAG meetings, so you are getting updates, Okay, this worked and that didnt work. WA Health Aboriginal Workforce Strategy 20142024. A mainstream health service provider added another perspective: Community engagement is having a two-way conversation that is respectful and that takes in the needs of the community and also best practices with the delivery building trust and making people feel welcome. Setting up the DAHAGs was a critical factor in the community engagement process. Durey A. I appreciate not being treated like a child and not being assumed to be on my second marriage because I had so many children and, you know, just the attitude that they get. A community health nurse has resigned after 18 years in the job because she could no longer cope with the abuse and neglect of children in the Aboriginal community she was working for. 2011;35:297308. Aboriginal respondents speculated that information was disseminated via the grapevine from DAHAG or community forum attendees. 2009;38(2):4707. Enabling factors included recognising the importance of local Aboriginal knowledge and cultural traditions, becoming familiar with the local Aboriginal community, and developing a local leadership network. In this paper, the term Aboriginal will be used to describe the local Indigenous population which is the preferred terminology used by the Western Australian (WA) Department of Health [3]. Effective engagement with local Aboriginal communities as integral to improving Aboriginal health and increasing access to services was recognised by a metropolitan health service in the Department of Health, Western Australia. DAHAG members were also accountable to the community they represented. This responsibility was twofold: not only to disseminate information on DAHAG business to the community, but also to feedback and discuss with health service providers any health concerns raised by the community. In a Queensland study [18], enablers and barriers to engaging Aboriginal people in a health promotion program were elucidated. Task - Your own culture and Western systems and structures influence the engagement of Aboriginal and Torres Strait Islander people with community services, such as health services.. This more innovative and inclusive approach enabled service providers to hear and respond to what people said they needed. Aboriginal people identify themselves with the idea of being part of 'community'; it gives us a sense of unity and strength. 2014;38:4923. (MHSP 3). Evaluation of the South Metropolitan Health Service Community Engagement Process Perth: Curtin University. Participants referred to DAHAGs being cultural governance committees where community was responsible for selecting who represented them on the DAHAGs: Aboriginal people have been the consultants. The evaluation team identified key concerns that need to be addressed if the process of community engagement is to be sustained. Failure to do this can compound past government and mainstream failures in addressing Aboriginal health, frustrating communities and sabotaging the community engagement process [19]. The term collectively talks about indigenous beings from all across Australia and Torres Strait islanders. Vos T, Barker B, Begg S, Stanley L, Lopez A. (HPAS 4). Aust N Z J Public Health. And with the service providers, they always come back to the DAHAG meetings, so you are getting updates, Okay, this worked and that didnt work. Many participants discussed the value of increasing the capacity of DAHAGs by encouraging members to choose their representatives, which placed authority in the hands of the Aboriginal community. That is the difference. The process was enhanced by the aforementioned Council of Australian Governments (COAG) funding for Aboriginal health. Each of the five south metropolitan districts formed a DAHAG. To resolve this, health services need to commit to developing respectful partnerships with local Aboriginal communities and increase the capacity of services to be more responsive to Aboriginal peoples requirements [13, 14]. Evaluation rubrics: how to ensure transparent and clear assessment that respects diverse lines of evidence. Article From a top down model, where mainstream health services determined the care of Aboriginal people, to a grassroots model that encouraged the participation of the Aboriginal community. Sixty participants across the five districts participated in one-on-one interviews and yarning circles which were conducted in 2012. PubMed Google Scholar. It happened because of the entrance of western culture. The Aboriginals lived in a small group linked by a large group of different languages and boundaries of the territory. Forums were held with up to 80 Aboriginal people attending area-wide gatherings. 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