Patient and family engagement offers a promising pathway toward better-quality health care, more-efficient care, and improved population health. Since definitions of patient engagement and conceptions of how it works vary, we propose a framework. We first present the forms engagement can take, ranging from consultation to partnership. We discuss the levels at which patient engagement can occur across the health care system, from the direct care setting to incorporating patient engagement into organizational design, governance, and policy making. We also discuss the factors that influence whether and to what extent engagement occurs. We explore the implications of our multidimensional framework for the development of interventions and policies that support patient and family engagement, and we offer a research agenda to investigate how such engagement leads to improved outcomes.

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The aim of this research was to work collaboratively with an urban Aboriginal community to understand meanings of food and food insecurity and strengthen responses to this issue. The project took place at the Wathaurong Aboriginal Cooperative in Geelong, South Eastern Australia in 2009-2010. Photo-voice research methods were used to explore meanings of food and food insecurity. This identified that food selections were influenced by family harmony, collectivism and satiation of hunger with cheap high carbohydrate and fat foods. People were also proud of their hunter-gatherer heritage and saw the Wathaurong Aboriginal Cooperative as leaders in healthy food provision. Action research cycles were used to develop responses including plates depicting healthy food portions, social cooking opportunities, development of a cooking television series and a specialised cook-book. The partnership required researchers to listen carefully to respond to needs of the Wathaurong Aboriginal Cooperative, and this meant adapting research plans to suit the local environment and community partner needs. There is potential for Aboriginal organisations to provide further leadership for healthy eating and food security through workplace food policies and partnerships with food security agencies. Use of Aboriginal nutrition knowledge to provide nutrition education may be useful in health promotion approaches.

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Culture is an important social and emotional wellbeing factor for Aboriginal peoples in Australia, particularly regarding recovery from colonization. However, little is understood about how culture and wellbeing interact for young urban Aboriginal people. This study used Yarning methods to explore experiences and perceptions of culture and wellbeing for young urban Aboriginal people in Narrm, Australia. Findings indicate that culture is experienced as connection, and that perceived connection or disconnection has an essential influence on the wellbeing of young people. Through sharing young people stories, a range of factors, including colonization, relationships, cultural knowledge, community support, and agency, were identified as affecting perceptions of connectedness, and therefore on wellbeing. Youth were able to develop strategies to increase connection and provided illuminating advice and suggestions for improving connection for future generations. This study thus contributes to efforts to improved understanding of Aboriginal perspectives about social and emotional wellbeing and culture.

Conclusions: Peer mentoring betweenAboriginal and non-Aboriginal health workforce was found to be a powerful mechanism to promote two-way learning that has the capacity to meet learning needs and promote practice improvement.Implications: Peer mentoring may be part of a multi-strategy approach to the development of the Aboriginal health workforce.

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