Background The Aboriginal health workforce provide responsive, culturally safe health care. We aimed to co-design a culturally safe course with and for the Aboriginal health workforce. We describe the factors which led to the successful co-design, delivery, and evaluation of the “Managing hepatitis B” course for the Aboriginal health workforce.Methods A Participatory Action Research approach was used, involving ongoing consultation to iteratively co-design and then develop course content, materials, and evaluation tools. An Aboriginal and Torres Strait Islander research and teaching team received education in chronic hepatitis B and teaching methodologies. Pilot courses were held, in remote communities of the Northern Territory, using two-way learning and teach-back methods to further develop the course and assess acceptability and learnings. Data collection involved focus group discussions, in-class observations, reflective analysis, and use of co-designed and assessed evaluation tools.Results Twenty-six participants attended the pilot courses. Aboriginal and Torres Strait Islander facilitators delivered a high proportion of the course. Evaluations demonstrated high course acceptability, cultural safety, and learnings. Key elements contributing to success and acceptability were acknowledging, respecting, and integrating cultural differences into education, delivering messaging and key concepts through an Aboriginal and Torres Strait Islander lens, using culturally appropriate approaches to learning including storytelling and visual teaching methodologies. Evaluation of culturally safe frameworks and findings from the co-design process led to the creation of a conceptual framework, underpinned by meeting people’s basic needs, and offering a safe and comfortable environment to enable productive learning with attention to the following: sustenance, financial security, cultural obligations, and gender and kinship relationships.Conclusions Co-designed education for the Aboriginal health workforce must embed principles of cultural safety and meaningful community consultation to enable an increase in knowledge and empowerment. The findings of this research can be used to guide the design of future health education for First Nations health professionals and to other non-dominant cultures. The course model has been successfully transferred to other health issues in the Northern Territory.
Background In 2014 The Menzies hep B team released the first hepatitis B educational app in an Aboriginal language, the “Hep B Story”, addressing the need for chronic hepatitis B information in a patient’s first language. In 2018 the “Hep B Story” was assessed and adapted prior to translation into a further 10 Aboriginal languages. Whilst we initially thought the task would be simple, this was not so. The translation process developed iteratively and evolved into a model that may be applied when creating any health resource in Aboriginal languages. Methods The adaptation and translation of the “Hep B Story” process involved ten key steps: 1. Focus groups with language speakers to assess cultural suitability of content. 2. Adaptation of content or images as required. 3. Forward and back translation of script using translators. 4. Translations checked for content accuracy. 5. Queries discussed and corrected with translators. 6. Voiceovers recorded. 7. Revised versions of the app produced. 8. Revised versions of the app reviewed by focus group members and translators. 9. Final edits and corrections made and reviewed. 10. Finalisation and publication of the new language version. Results The process of adaptation and translation appears straightforward, and in planning the project, we naively allowed 12 months to complete 10 language translations, in reality it took five years. Forming consultation groups, finding translators to write in language, and removing barriers to work was not easy, while simultaneously dealing with the remoteness of Australia’s Northern Territory. The consultation process for each language group resulted in extensive chronic hepatitis B education community wide, with many participants sharing the story with their family and encouraging them to get a hepatitis B check-up. Conclusions With more than 100 people involved in the project and thousands of kilometres travelled across the Northern Territory we produced not only an education tool for many Aboriginal people in their preferred language but developed a model for working with translators to develop health resources for different cultural and linguistic groups across the Northern Territory.
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