“I Am Getting Healthier”. Perceptions of Urban Aboriginal and Torres Strait Islander People in a Chronic Disease Self-Management and Rehabilitation Program

Abstract

Chronic disease is a main contributor to the disproportionately high burden of illness experienced by Aboriginal and Torres Strait Islander Australians. However, there are very few programs addressing chronic disease self-management and rehabilitation which are designed specifically for urban Aboriginal and Torres Strait Islander people. This paper aims to explore client and staff perceptions of the Work It out Program, a chronic disease rehabilitation and self-management program designed for urban Aboriginal and Torres Strait Islander people. The study used a mixed methods approach to explore the success, barriers and self-reported outcomes of the program. Quantitative data were collected through a structured survey, comprising social and demographic data. Qualitative data were collected through interviews using Most Significant Change theory. Twenty-eight participants were recruited, 6 staff and 22 clients (M = 7, F = 21) with an age range between 21 and 79 years of age (Mean = 59.00, SD = 17.63). Interviews were completed in 2013 across four Work It out locations in Southeast Queensland. Semi-structured interviews were conducted either individually or in groups of two or three, depending on the participants' preference. Thematic analysis of the data revealed six main themes; physical changes, lifestyle improvements, social and emotional well-being, perceptions about the successful features of the program, perceived barriers to the program and changes for the future. This exploratory study found that clients and staff involved in the Work It out Program perceived it as an effective self-management and rehabilitation program for urban Aboriginal and Torres Strait Islander Australians. Further evaluation with a larger sample size is warranted in order to establish further outcomes of the program. A. Nelson et al. 539

Chronic disease self‐management programs for Aboriginal and Torres Strait Islander people: Factors influencing participation in an urban setting

“…The results of this study support previous research that attributed the success of Work it Out to its flexibility, comfortable setting and the approach of staff (“skilled, accepting, friendly, culturally aware”) . Importantly, Work It Out puts relationships at the centre of program design and staff consider program participants as the “owners” of the program.…”

Self-management programs for Aboriginal and Torres Strait Islander Peoples with chronic conditions: A rapid review

“…Five peer-reviewed papers were identified through the peer-reviewed literature search; 9,10,19–21 an additional two peer-reviewed papers were identified through the grey literature search. 22,23 Twenty-eight sources (including self-management programs and resources) were identified in the grey literature 24–28 (see full list in Table 4).…”

“…20 Two studies included elements of peer-led group programs (Stanford Program), 9,19 one study used the volunteer-led Complete Health Improvement Program (CHIP), 23 and one study used a structured self-management program specifically developed for application in a particular setting. 19 Four studies focused on chronic conditions in general; 9,19,21,22 two studies focused on diabetes 10,23 and one study focused on mental health. 19 Five studies were integrated into routine care.…”

“…19 Five studies were integrated into routine care. 9,10,19,21,22 A Cochrane Collaboration systematic review supports the need for integration, noting that outcomes appear greater when CCSM programs are ‘more comprehensive, more intensive, and better integrated into routine care’ (p.3). 29 See Table 3 for a more detailed summary of the peer-reviewed literature and its research quality, the summary of which has been informed by the Taxonomy for Disease Management developed by Krumholz et al 30…”

“…19 Five studies were integrated into routine care. 9,10,19,21,22 A Cochrane Collaboration systematic review supports the need for integration, noting that outcomes appear greater when CCSM programs are 'more comprehensive, more intensive, and better integrated into routine care' (p.3). 29 See Table 3 for a more detailed summary of the peer-reviewed literature and its research quality, the summary of which has been informed by the Taxonomy for Disease Management developed by Krumholz et al 30 Structured self-management, assessment and goal setting One study reporting on the baseline measures from a randomised controlled trial proposed a structured self-management, assessment and goal setting CCSM program approach to treating Aboriginal and Torres Strait Islander Peoples with mental health conditions including schizophrenia, depression and bipolar affective disorder.…”