Accessibility of Primary, Specialist, and Allied Health Services for Aboriginal People Living in Rural and Remote Communities: Protocol for a Mixed-Methods Study

Macniven, Rona; Hunter, Kate; Lincoln, Michelle; O'Brien, C J; Jeffries, Thomas Lee; Shein, Gregory; Saxby, Alexander J.; Taylor, Donna; Agius, Tim; Finlayson, Heather; Martin, Robyn; Kong, Kelvin; Nolan-Isles, Davida; Tobin, Susannah; Gwynne, Kylie

doi:10.2196/11471

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…The study reflects the concerns expressed by local Aboriginal people about the availability, connectedness and reliability of services and the priority to improve the match between healthcare services and community needs. The full protocol for this study has been described elsewhere [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia

Nolan-Isles

Macniven

Hunter

et al. 2021

IJERPH

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Background: Australia’s healthcare system is complex and fragmented which can create challenges in healthcare, particularly in rural and remote areas. Aboriginal people experience inequalities in healthcare treatment and outcomes. This study aimed to investigate barriers and enablers to accessing healthcare services for Aboriginal people living in regional and remote Australia. Methods: Semi-structured interviews were conducted with healthcare delivery staff and stakeholders recruited through snowball sampling. Three communities were selected for their high proportion of Aboriginal people and diverse regional and remote locations. Thematic analysis identified barriers and enablers. Results: Thirty-one interviews were conducted in the three communities (n = 5 coastal, n = 13 remote, and n = 13 border) and six themes identified: (1) Improved coordination of healthcare services; (2) Better communication between services and patients; (3) Trust in services and cultural safety; (4) Importance of prioritizing health services by Aboriginal people; (5) Importance of reliable, affordable and sustainable services; (6) Distance and transport availability. These themes were often present as both barriers and enablers to healthcare access for Aboriginal people. They were also present across the healthcare system and within all three communities. Conclusions: This study describes a pathway to better healthcare outcomes for Aboriginal Australians by providing insights into ways to improve access.

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Section: Methodsmentioning

confidence: 99%

Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia

Nolan-Isles

Macniven

Hunter

et al. 2021

IJERPH

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“…Both interviewers were experienced in conducting interviews in Aboriginal communities and had several years of experience working in Aboriginal health and ongoing cultural training and mentorship. The full protocol for the original mapping study is described elsewhere [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

“No One Manages It; We Just Sign Them Up and Do It”: A Whole System Analysis of Access to Healthcare in One Remote Australian Community

Osborn

Ritha

Macniven

et al. 2022

IJERPH

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Objective: To assess the accessibility, availability and utilisation of a comprehensive range of community-based healthcare services for Aboriginal people and describe contributing factors to providing effective healthcare services from the provider perspective. Setting: A remote community in New South Wales, Australia. Participants: Aboriginal and non-Aboriginal health and education professionals performing various roles in healthcare provision in the community. Design: Case study. Methodology: The study was co-designed with the community. A mixed-methods methodology was utilised. Data were gathered through structured interviews. Descriptive statistics were used to analyse the availability of 40 health services in the community, whilst quotations from the qualitative research were used to provide context for the quantitative findings. Results: Service availability was mapped for 40 primary, specialised, and allied health services. Three key themes emerged from the analysis: (1) there are instances of both underservicing and overservicing which give insight into systemic barriers to interagency cooperation; (2) nurses, community health workers, Aboriginal health workers, teachers, and administration staff have an invaluable role in healthcare and improving patient access to health services and could be better supported through further funding and opportunities for specialised training; and (3) visiting and telehealth services are critical components of the system that must be linked to existing community-led primary care services. Conclusion: The study identified factors influencing service availability, accessibility and interagency cooperation in remote healthcare services and systems that can be used to guide future service and system planning and resourcing.

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“…Strengthening the rural deployment of stakeholders may attract and motivate graduates to work in rural areas, although the factors influencing recruitment of health professionals are varied [27]. If individual knowledge of successful aging and the associated economic outcomes, such as financial planning for retirement wellbeing, are to be harnessed, stakeholder management can help put pressure on the state to improve the current health insurance system, making it possible to offer a universal social pension that prioritizes people deprived of income due to a disability, severely debilitating disease, or lost work opportunity during their younger years [28].…”

Section: Theoretical Basismentioning

confidence: 99%

How Geographical Isolation and Aging in Place Can Be Accommodated Through Connected Health Stakeholder Management: Qualitative Study With Focus Groups

Chen¹,

Liu²,

Wang³

et al. 2020

J Med Internet Res

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Background In remote areas, connected health (CH) is needed, but as local resources are often scarce and the purchasing power of residents is usually poor, it is a challenge to apply CH in these settings. In this study, CH is defended as a technological solution for reshaping the direction of health care to be more proactive, preventive, and precisely targeted—and thus, more effective. Objective The objective of this study was to explore the identity of CH stakeholders in remote areas of Taiwan and their interests and power in order to determine ideal strategies for applying CH. We aimed to explore the respective unknowns and discover insights for those facing similar issues. Methods Qualitative research was conducted to investigate and interpret the phenomena of the aging population in a remote setting. An exploratory approach was employed involving semistructured interviews with 22 participants from 8 remote allied case studies. The interviews explored perspectives on stakeholder arrangements, including the power and interests of stakeholders and the needs of all the parties in the ecosystem. Results Results were obtained from in-depth interviews and focus groups that included identifying the stakeholders of remote health and determining how they influence its practice, as well as how associated agreements bring competitive advantages. Stakeholders included people in government sectors, industrial players, academic researchers, end users, and their associates who described their perspectives on their power and interests in remote health service delivery. Specific facilitators of and barriers to effective delivery were identified. A number of themes, such as government interests and power of decision making, were corroborated across rural and remote services. These themes were broadly grouped into the disclosure of conflicts of interest, asymmetry in decision making, and data development for risk assessment. Conclusions This study contributes to current knowledge by exploring the features of CH in remote areas and investigating its implementation from the perspectives of stakeholder management. It offers insights into managing remote health through a CH platform, which can be used for preliminary quantitative research. Consequently, these findings could help to more effectively facilitate diverse stakeholder engagement for health information sharing and social interaction.

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Accessibility of Primary, Specialist, and Allied Health Services for Aboriginal People Living in Rural and Remote Communities: Protocol for a Mixed-Methods Study

Cited by 9 publications

References 16 publications

Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia

Enablers and Barriers to Accessing Healthcare Services for Aboriginal People in New South Wales, Australia

“No One Manages It; We Just Sign Them Up and Do It”: A Whole System Analysis of Access to Healthcare in One Remote Australian Community

How Geographical Isolation and Aging in Place Can Be Accommodated Through Connected Health Stakeholder Management: Qualitative Study With Focus Groups

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