Empowerment and Indigenous Australian health: a synthesis of findings from Family Wellbeing formative research

Abstract

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.

Improving health service access and wellbeing of young Aboriginal parents in an urban setting: mixed methods evaluation of an arts‐based program

“…7 Creating employment opportunities for this population is particularly relevant to selfagency, as is improving health literacy. 13 The study found improved empowerment and wellbeing of both individual participants and the group as a whole. Although only a few participants completed the GEM measure, this finding was supported from the qualitative data obtained through focus groups, interviews and observations.…”

“…Literature supports the value of measuring group change, as empowered groups create empowering environments for individuals. 12,13 This study has shown that when assessed with a Critical Effectiveness Factor framework, NNM operationalises all six critical ingredients and exhibits strengths in all 10 Critical Effectiveness Factors used for program quality assessment. This means that the program facilitates working from strengths, focusing on empowerment, emphasising relationship development, demonstrating Aboriginal leadership, providing reliable and consistent services, facilitating connection to culture, fostering connections to other services, maximising opportunities for choice making and enabling creative pathways for growth.…”

“…11,13 As such, NNM has improved access to health services and promoted health-seeking behaviour. Participants consider the health services accessible and express trust in the health service providers.…”

“…12 Empowerment is a key determinant of health with more empowered communities consistently having better health outcomes. 13,14 Community connectedness is also linked with improved child health. 14 Mainstream interventions focusing on antenatal care have had limited impact on Aboriginal birth outcomes.…”

Facilitating Empowerment and Self-Determination Through Participatory Action Research

“…Empowerment and community participation are considered major strategies used worldwide to increase self-esteem, social cohesion, and interaction at the family and community levels. They are strategies increasingly applied to support community capacity to address key social determinants and, in Australia, the barriers preventing many Indigenous people from achieving their potential (Tsey et al, 2010).…”