Improving equity and cultural responsiveness with marginalised communities: Understanding competing worldviews

Wilson, Denise; Heaslip, Vanessa; Jackson, Debra

doi:10.1111/jocn.14546

Cited by 52 publications

(51 citation statements)

References 42 publications

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“…For example, Hana the practice manager of Te Whānau Hauora, took offence to the assumption they would routinely enquire about IPV with patients as this did not reflect who they were as Māori. Understanding different IPV responses is particularly important for indigenous peoples whose voices are often unheard 28. We found exclusion of different response discourses at the health system level blocked transformation to more effective models of care for different populations, undermining health professional responsiveness.…”

Section: Discussionmentioning

confidence: 86%

Exploring sustainable primary care responses to intimate partner violence in New Zealand: Qualitative use of complexity theory

2019

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ObjectiveTo explore what affects sustainable responses to intimate partner violence within New Zealand primary care settings using complexity theory.DesignPrimary care professional interviews on intimate partner violence as a health issue are analysed using a complexity theory-led qualitative research methodology grounded in poststructuralism.SettingFour general practices in one region of the North Island of New Zealand, two serving a general patient population and two adopting an indigenous approach.ParticipantsSeventeen primary care professionals and management from the four recruited general practices.ResultsThe complex adaptive system approach the ‘Triple R Pathway’, calls attention to system interactions influencing intimate partner violence responsiveness across health system levels. Four exemplars demonstrate the use of the Triple R Pathway. Two key system areas challenge the emergence of primary care responsiveness: (1) Non-recognition of intimate partner violence as a key determinant of ill-health. (2) Uncertainty and doubt.ConclusionsThe relationship between intimate partner violence and ill-health is not well recognised, or understood in New Zealand, at both policy and practice levels. Inadequate recognition of socioecological determinants of intimate partner violence leads to a simple health system response which constrains primary care professional responsiveness. Constant intervention in system interactions is needed to promote the emergence of sustainable responses to intimate partner violence.

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Section: Discussionmentioning

confidence: 86%

Exploring sustainable primary care responses to intimate partner violence in New Zealand: Qualitative use of complexity theory

2019

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“…Global health diplomacy (GHD) should function on three levels: individual, domestic/national, and global/international [9]. Nursing training should also involve respectful acceptance of beliefs of others [10]. Finally GHD practitioners should receive training to successfully negotiate the intersection of global health and foreign affairs [11].…”

Section: Resultsmentioning

confidence: 99%

Navigating Turbulent Religious Diversity in Global Health

Goodman¹

2018

JSS

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Physicians who work internationally and in culturally diverse settings will on occasion be challenged by political upheavals, riots, or other disturbances. Medical professionals who work in global health need to be aware of the tensions and challenges that people of different religions experience. This editorial reviews the philosophy of several theological leaders who grappled with issues of social justices and the importance of respectful communication and understanding across religious differences. Physicians must have training and develop expertise in global health diplomacy to function on three levels: individual, national, and international.

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“…Also consistent with previous literature regarding health service delivery for Indigenous Australians, good relationships between staff and participants were also identified as critical to Work It Out clients’ decision to participate in the program. The importance of relationship‐based practice to providing culturally responsive health services is well established . Nelson's “Making Connections Framework” explains that the health professional must move beyond building a relationship with the individual, to establishing relationships with the clients’ family, community and other health services available to them.…”

Section: Discussionmentioning

confidence: 99%

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

Parmenter

Basit

Nelson

et al. 2019

Health Prom J of Aust

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Issue addressed Evidence suggests that participation in a Chronic Disease Self‐Management (CDSM) program improves the health of clients. Many factors are known to influence participation in these programs for the broader Australian population. However, less is known about why Aboriginal and Torres Strait Islanders choose to participate. This study identifies key factors that support or enable Aboriginal and Torres Strait Islanders to participate in a CDSM program in an urban setting. Methods Twelve focus groups were undertaken with a total of 102 participants who were diagnosed with or at risk of chronic disease. These participants were recruited from the Work It Out program, a CDSM program comprising exercise and health education. The Work It Out program is specifically designed for Aboriginal and Torres Strait Islanders and delivered by an Aboriginal led and community‐controlled organisation in South‐East and Central Queensland. The study received ethical clearance through the Behavioural and Social Sciences Ethical Review Committee at The University of Queensland (Approval Number 2011001283). Results Findings indicate that key features of program design based on a culturally responsive approach influences participation. The main features are as follows: providing easy access to the program; permitting flexibility in attendance; a group environment; the approach of program staff that prioritises relationship building; personalised and integrated care; communicating result regularly; and ensuring community ownership of the program. Conclusion These findings are useful to consider when designing a health program for Aboriginal and Torres Strait Islanders. Programs which are culturally responsive and include the design features identified in this study are more likely to increase participation amongst Aboriginal and Torres Strait Islanders. So What? Increasing participation of Aboriginal and Torres Strait Islanders in CDSM programs using the design features identified in the paper may contribute significantly in closing the health disparity gap.

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Improving equity and cultural responsiveness with marginalised communities: Understanding competing worldviews

Abstract: As nurses work with many different individuals and groups, we have to find ways of ensuring a more embracing, culturally responsive healthcare environment which respects and values the beliefs of others.

Cited by 52 publications

References 42 publications

Exploring sustainable primary care responses to intimate partner violence in New Zealand: Qualitative use of complexity theory

Exploring sustainable primary care responses to intimate partner violence in New Zealand: Qualitative use of complexity theory

Navigating Turbulent Religious Diversity in Global Health

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

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