Appropriate health promotion for Australian Aboriginal and Torres Strait Islander communities: crucial for closing the gap

Abstract

Health promotion for Australian Aboriginal and Torres Strait Islander communities and their people has generally had limited efficacy and poor sustainability. It has largely failed to recognise and appreciate the importance of local cultures and continues to have minimal emphasis on capacity building, community empowerment and local ownership. Culturally Appropriate Health Promotion is a framework of principles developed in 2008 with the World Health Organization and the Global Alliance for Health Promotion. It serves as a guide for community-focused health promotion practice to be built on and shaped by the respect for understanding and utilisation of local knowledge and culture. Culturally Appropriate Health Promotion is not about targeting, intervening or responding. Rather, it encourages health programme planners and policymakers to have a greater understanding, respect, a sense of empowerment and collaboration with communities, and their sociocultural environment to improve health. This commentary aims to examine and apply the eight principles of Culturally Appropriate Health Promotion to the Australian Aboriginal and Torres Strait Islander context. It proposes a widespread adoption of the framework for a more respectful, collaborative, locally suitable and therefore appropriate approach to Australian Aboriginal and Torres Strait Islander health promotion.

Developing a culturally appropriate branding for a social and emotional wellbeing intervention in an Aboriginal community

“…Aboriginal communities, and particularly geographically defined, selfcontained communities in regional and remote areas, as per Demaio et al's principles for culturally appropriate health promotion. 17…”

“…Although a number of Aboriginal groups have initiated or taken part in many Act‐Belong‐Commit events in participating communities, there has been neither a specific focus on Aboriginal groups, nor any attempt to deliver the Act‐Belong‐Commit messages in a specifically culturally appropriate manner. Although the fundamental principles of Act‐Belong‐Commit appear to apply across cultures and ethnicities, a more culturally appropriate framework for communication channels and intervention strategies could be more efficacious for Aboriginal communities, and particularly geographically defined, self‐contained communities in regional and remote areas, as per Demaio et al's principles for culturally appropriate health promotion . Given Aboriginal people's focus on family, community and the social care of others, it was anticipated that the principles underlying the Act‐Belong‐Commit framework would readily translate to an Aboriginal cultural framework for mental health promotion.…”

Understanding remote Aboriginal drug and alcohol residential rehabilitation clients: Who attends, who leaves and who stays?

“…There is no simple way to reduce the burden of substance-related harm experienced by Aboriginal Australians [8] and, as such, a range of effective and culturally safe approaches are required. Gray et al [9] identify appropriate strategies including: acute treatment (sobering-up centres, detoxification) [10]; counselling and residential treatment [11][12][13][14]; support services (health services, accommodation, crisis care) and prevention (health promotion, cultural initiatives, supply reduction) [4,15,16]. Regardless of the strategy, access to Aboriginal community-controlled health services is vital to an Aboriginal person's right to selfdetermination [13,17], even if some Aboriginal patients prefer to access non-Aboriginal-specific services [18].…”

Developing a guide for community-based groups to reduce alcohol-related harm among African migrants

“…1 Culturally sensitive health promotion (also known as culturally appropriate, culturally competent, multicultural or culturally tailored) is underpinned by community involvement and ownership, learns from the expertise of community members and provides opportunities for building on existing community strengths and capacity. [1][2][3] These approaches ensure that health promotion is relevant, effective and supports community empowerment. [3][4][5] In 2013, the Hunter Multicultural Community Drug Action Team (CDAT) was made aware of concerns about alcohol-related harm in communities originating from Sub-Saharan Africa (hereafter 'African'), which included a large number of humanitarian arrivals.…”