Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service

Reeve, Carole; Humphreys, John Stirling; Wakerman, John; Carroll, Vicki; Carter, Maureen; O’Brien, Tim; Erlank, Carol; Mansour, R; Smith, Bec

doi:10.1071/py14073

Cited by 24 publications

(42 citation statements)

References 10 publications

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“…All of this additional guidance may be especially useful for situations where the first aider is required to be engaged as the primary support for longer periods of time. This is particularly relevant in remote areas where access to immediate ‘professional’ help is not always available or culturally appropriate for Aboriginal and Torres Strait Islander people [ 28 ], and situations where the suicidal person is reluctant to talk with others about their suicidal feelings. The extended emphasis on communication tips gives first aiders a greater suite of skills to use when talking to a suicidal person, without detracting from the need to work with the person to identify sources of appropriate help from relevant professionals, family or community leaders.…”

Section: Discussionmentioning

confidence: 99%

Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait islanders who are experiencing suicidal thoughts and behaviour

Armstrong

Ironfield

Kelly³

et al. 2018

BMC Psychiatry

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BackgroundSuicide is a leading cause of death among Indigenous Australians. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is suicidal. Culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islander persons who are experiencing suicidal thoughts or behaviour were developed in 2009. This study describes the re-development of these guidelines to ensure they contain the most current recommended helping actions.MethodsThe Delphi consensus method was used to elicit consensus on potential helping statements to be included in the guidelines. These statements describe helping actions that Indigenous community members and non-Indigenous frontline workers can take, and information they should have, to help someone who is experiencing suicidal thoughts or displaying suicidal behaviour. A panel was formed, comprising 27 Aboriginal and Torres Strait Islander people who have expertise in Indigenous suicide prevention. The panellists were presented with the helping statements via online questionnaires and were encouraged to suggest re-wording of statements and any additional helping statements that were not included in the original questionnaire. Statements were only accepted for inclusion in the guidelines if they were endorsed by ≥90% of panellists as essential or important.ResultsFrom a total of 301 statements shown to the expert panel, 172 were endorsed as helping statements to be including in the re-developed guidelines.ConclusionsAboriginal and Torres Strait Islander suicide prevention experts were able to reach consensus on appropriate strategies for providing mental health first aid to an Aboriginal or Torres Strait Islander person experiencing suicidal thoughts or behaviour. The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version, for which the panel had rated 166 helping statements and had endorsed 52. These re-developed guidelines can be used to inform Indigenous suicide gatekeeper training courses.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1809-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait islanders who are experiencing suicidal thoughts and behaviour

Armstrong

Ironfield

Kelly³

et al. 2018

BMC Psychiatry

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“…In Australia, Reeve et al. () identified community participation or collaborative partnerships as a factor in successful health sector reform in a remote location. From another perspective, there is a move to base community participation guidelines in a quality and safety premise, for example the Australian Safety and Quality in Healthcare guidelines about community participation (https://www.safetyandquality.gov.au/).…”

Section: Introductionmentioning

confidence: 99%

Implementation of oral health initiatives by Australian rural communities: Factors for success

Taylor

Carlisle

Farmer

et al. 2017

Health Soc Care Community

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In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014)(2015)(2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents.Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community. K E Y W O R D Scommunity participation, implementation, oral health services, rural health, success

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“…• Community-based reform: Four of the seven evaluations reported on community-based services: two innovative comprehensive PHC services -one in a remote Western Australian Indigenous community [9][10][11] and the other in a small rural community in Victoria 7,8 , and one aged care service and one social and emotional wellbeing service -in remote Indigenous communities from the Northern Territory and Kimberley region of Western Australia respectively 12,13 .…”

Section: Contextmentioning

confidence: 99%

What do evaluations tell us about implementing new models in rural and remote primary health care? Findings from a narrative analysis of seven service evaluations conducted by an Australian Centre of Research Excellence

Lyle

Saurman

Kirby

et al. 2017

Rural Remote Health

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A B S T R A C TIntroduction: A Centre of Research Excellence (CRE) in Rural and Remote Primary Healthcare was established in 2012 with the goal of providing evidence to inform policy development to increase equity of access to quality health care and the identification of services that should be available to the diverse communities characterising Australia. This article reports on the key findings from seven CRE service evaluations to better understand what made these primary health care (PHC) models work where they worked, and why. Methods: We conducted a narrative synthesis of 15 articles reporting on seven CRE service evaluations of different PHC models published between 2012 and 2015.Results: Three different contexts for PHC reform were evaluated: community, regional and clinic based. Themes identified were factors that enabled changes to PHC delivery, processes that supported services to improve access to PHC and requirements for © D Lyle, E Saurman, S Kirby, D Jones, J Humphreys, J Wakerman 2017. A Licence to publish this material has been given to James Cook University, http://www.jcu.edu.au 2 service adaptation to promote sustainability. In both Indigenous and mainstream community settings, the active engagement with local communities, and their participation in, or leadership of, shared decision-making was reported across the three themes. In addition, local governance processes, informed by service activity and impact data, enabled these service changes to be sustained over time. The considerations were different for the outreach, regional and clinic services that relied on internal processes to drive change because they did not require the cooperation of multiple organisations to succeed. Conclusions:The review highlighted that shared decision-making, negotiation and consultation with communities is important and should be used to promote feasible strategies that improve access to community-based PHC services. There is a growing need for service evaluations to report on the feasibility, acceptability and fit of successful service models within context, in addition to reach and effectiveness in order to provide evidence for local dissemination, adaption and implementation strategies.

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Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service

Cited by 24 publications

References 10 publications

Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait islanders who are experiencing suicidal thoughts and behaviour

Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait islanders who are experiencing suicidal thoughts and behaviour

Implementation of oral health initiatives by Australian rural communities: Factors for success

What do evaluations tell us about implementing new models in rural and remote primary health care? Findings from a narrative analysis of seven service evaluations conducted by an Australian Centre of Research Excellence

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