This paper employs a thematic qualitative analysis to synthesise seven discrete formative evaluation reports of an Indigenous Australian family empowerment programme across four study settings in Australia's Northern Territory and Queensland between 1998 and 2005. The aim of the study, which involved a total of 148 adult and 70 school children participants, is to develop a deeper understanding of the contribution of community empowerment education programmes to improving Indigenous health, beyond the evidence derived from the original discrete micro evaluative studies. Within a context beset by trans-generational grief and despair resulting from colonisation and other discriminatory government policies, across the study sites, the participants demonstrated enhanced capacity to exert greater control over factors shaping their health and wellbeing. Evident in the participants' narratives was a heightened sense of Indigenous and spiritual identity, respect for self and others, enhanced parenting and capacity to deal with substance abuse and violence. Changes at the personal level influenced other individuals and systems over time, highlighting the ecological or multilevel dimensions of empowerment. The study reveals the role of psychosocial empowerment attributes as important foundational resources in helping people engage and benefit from health and other behaviour modification programmes, and take advantage of any reforms made within macro policy environments. A key limitation or challenge in the use of psychosocial empowerment programmes relates to the time and resources required to achieve change at population level. A long-term partnership approach to empowerment research that creatively integrates micro community empowerment initiatives with macro policies and programmes is vital if health gains are to be maximised.

The use of a long-term (10-year) community research strategy focussing directly on empowerment has demonstrated the power of this approach to facilitate Indigenous people's capacity to regain social and emotional wellbeing and begin to rebuild the social norms of their families and community.

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The 2:1 student placement model is likely to be a model of choice in the future. There are challenges and opportunities associated with its use. This study identifies these as well as strategies for maximising opportunities and mitigating challenges.

Objective: To adapt the Family Wellbeing empowerment program, which was initially designed to support adults to take greater control and responsibility for their decisions and lives, to the needs of Indigenous school children living in remote communities. Method: At the request of two schools in remote Indigenous communities in far north Queensland, a pilot personal development and empowerment program based on the adult Family Wellbeing principles was developed, conducted and evaluated in the schools. The main aims of the program were to build personal identity and to encourage students to recognise their future potential and be more aware of their place in the community and wider society. Results: Participation in the program resulted in significant social and emotional growth for the students. Outcomes described by participating students and teachers included increased analytical and reflective skills, greater ability to think for oneself and set goals, less teasing and bullying in the school environment, and an enhanced sense of identity, friendship and ‘social relatedness’. Conclusion: This pilot implementation of the Family Wellbeing Program adapted for schools demonstrated the program's potential to enhance Indigenous young people's personal growth and development. Challenges remain in increasing parental/ family involvement and ensuring the program's sustainability and transferability. The team has been working with relevant stakeholders to further develop and package the School‐based Family Wellbeing program for Education Queensland's New Basics curriculum framework.

Indigenous men's support groups are designed to empower men to take greater control and responsibility for their health and wellbeing. They provide health education sessions, counselling, men's health clinics, diversionary programs for men facing criminal charges, cultural activities, drug- and alcohol-free social events, and advocacy for resources. Despite there being approximately 100 such groups across Australia, there is a dearth of literature on their strategies and outcomes. This paper is based on participatory action research involving two north Queensland groups which were the subject of a series of five 'phased' evaluative reports between 2002 and 2007. By applying 'meta-ethnography' to the five studies, we identified four themes which provide new interpretations of the data. Self-reported benefits included improved social and emotional wellbeing, modest lifestyle modifications and willingness to change current notions of 'gendered' roles within the home, such as sharing housework. Our qualitative research to date suggests that through promoting empowerment, wellbeing and social cohesion for men and their families, men's support groups may be saving costs through reduced expenditure on health care, welfare, and criminal justice costs, and higher earnings. Future research needs to demonstrate this empirically.

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Objective:To explore links between the social determinants of health, the 'control factor', and an Aboriginal empowerment program.Methods: The evidence that rank or social status is one of the most important determinants of health is briefly presented. This is followed by a critique of the Australian policy and intervention framework for tackling and reducing social inequalities. The concept of 'control' as an important element in addressing social determinants of health is examined next and the Family Wellbeing empowerment program is analysed to illustrate how the concept of control might be operationalised at program or intervention level. Implications for health practitioners are identified.Results: By providing a safe group environment for participants to explore sets of critical questions about themselves, their families and communities, through the process of participatory action research, Family Wellbeing has demonstrated its potential to 'enable' Indigenous people to take greater control and responsibility for their situation. While program participants first address personal and immediate family issues, evidence is emerging of a ripple effect of increasing harmony and capacity to address issues within the wider community Conclusions:The social determinants of health are complex and multilayered and so addressing them needs to involve multilevel thinking and action. The control factor is only one element, albeit an important one, and Family Wellbeing is providing evidence that 'control' can be addressed in Indigenous settings. For empowerment programs to achieve their full potential, however, there is a need to ensure that such programs reach a critical mass of the target group. It is also imperative that policy-makers and practitioners take a longer-term approach, including properly resourced longitudinal studies to document and enhance the evidence base for such interventions. As health practitioners it is vital we consider our work within this broader context, creatively seek to enhance linkages between services and programs, and support processes for change or intervention at other levels.