Delivery of culturally safe healthcare is critical to ensuring access to high‐quality care for indigenous people. A key component of this is for Aboriginal and Torres Strait Islander people to be participants in the health workforce. The proportion of indigenous people in the health workforce should at least equate to the proportion in the population served. We describe the development and implementation of a successful affirmative action employment policy at Monash Health, one of Australia's largest Academic Health Centres, and provide perspective on its adoption.

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Issues. The transgenerational impacts of colonisation-inclusive of dispossession, intergenerational trauma, racism, social and economic exclusion and marginalisation-places First Nations peoples in Australia at significant risk of alcohol and other drug (AOD) use and its associated harms. However, knowledge and evidence supporting community-based AOD treatment for First Nations adults is limited. Therefore, this review aimed to examine the impact and acceptability of community-based models of AOD support for First Nations adults in Australia. Approach. A systematic search of the empirical literature from the past 20 years was conducted. Key Findings. Seventeen studies were included. Nine studies evaluated the program's impact on substance use and 10 studies assessed program acceptability (two studies evaluated both). Only three out of nine studies yielded a statistically significant reduction in substance use. Acceptable components included cultural safety, First Nations AOD workers, inclusion of family and kin, outreach and group support. Areas for improvement included greater focus on holistic wrap-around psychosocial support, increased local community participation and engagement, funding and breaking down silos. Implications. Culturally safe, holistic and integrated AOD outreach support led by First Nations peoples and organisations that involves local community members may support First Nations peoples experiencing AOD concerns. These findings may inform the (re)design and (re)development of community-based AOD services for First Nations peoples. Conclusion. There is a limited evidence-base for community-based AOD programs for First Nations peoples. First Nations-led research that is controlled by and co-produced with First Nations peoples is necessary to extend our understanding of community-based programs within First Nations communities. [Krakouer J, Savaglio M, Taylor K, Skouteris H. Community-based models of alcohol and other drug support for First Nations peoples in Australia: A systematic review.