The role of Aboriginal leadership in community health programmes

Stroud, Victoria; Adams, Josie; Champion, Doreen; Hogarth, Geraldine; Mahony, Anne; Monck, Ruth; Pinnegar, Trulie; Santos, Naomi Sprigg dos; Watson, Charles

doi:10.1017/s1463423621000414

Cited by 5 publications

(6 citation statements)

References 14 publications

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“…This reflected a call for self-determination and Aboriginal people having more decision-making power (76)(77)(78)(79). Increasing Aboriginal peoples' participation and leadership in the workforce is known to improve outcomes for Aboriginal populations (80). This can be addressed by improving pathways for Aboriginal people to receive training and qualifications, improve workforce skills and access leadership capacity development opportunities (81,82).…”

Section: Discussionmentioning

confidence: 99%

Intersectoral collaboration for supporting the health and wellbeing of Aboriginal families and children in out-of-home care: perspectives from Western Australian Aboriginal Community Controlled Health Organisations

Moodie,

Jones,

Chenhall

et al. 2024

Front. Public Health

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IntroductionWestern Australia has one of the highest rates of Aboriginal children entering out-of-home care in Australia. Kinship care is the preferred culturally safe out-of-home care option for Aboriginal children, yet all jurisdictions, including Western Australia, are far from meeting best-practice national standards. Intersectoral collaboration is a key primary healthcare principle and internationally recognized for improving health systems and outcomes. This paper presents findings from a qualitative research project investigating Aboriginal primary healthcare workers’ experiences of intersectoral collaboration challenges and strengthening opportunities.MethodsConstructivist grounded theory guided this research involving 55 semi-structured interviews and four focus group discussions with Aboriginal primary healthcare workers. The research was guided by Indigenous methodologies and led by Indigenous researchers Participants were recruited from seven Aboriginal Community Controlled Health Organisations located across Perth metro, Pilbara, Midwest/Gascoyne and Southwest regions in Western Australia.ResultsKey themes identified around intersectoral collaboration challenges were communication, including information sharing and interagency meetings, and the relationship with the government sector, including trust and the importance of the perception of Aboriginal health service independence. Key themes around strengthening areas to improve intersectoral collaboration included strengthening service resourcing and coverage, including the availability of services, and addressing high program turnover. The need for a shift in approach, including more emphasis on Aboriginal-led care and aligning approaches between sectors, was another area for strengthening.DiscussionThis study addresses a significant research gap concerning out-of-home care, kinship care, and intersectoral collaboration in an Australian Aboriginal context. Findings highlighted the need to review the out-of-home and kinship models of care to strengthen the system, including creating more formal and structured modes of collaborating and better resourcing family support and kinship care.

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Section: Discussionmentioning

confidence: 99%

Intersectoral collaboration for supporting the health and wellbeing of Aboriginal families and children in out-of-home care: perspectives from Western Australian Aboriginal Community Controlled Health Organisations

Moodie,

Jones,

Chenhall

et al. 2024

Front. Public Health

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“…Our interview participants attributed the unsuccessful normalization of these 2 components primarily to the loss of momentum caused by the departure of key champions. The value of champions in driving forward innovations has been recognized in ACCHS and other primary care settings [65,66], and Aboriginal leadership, in particular, remains an often untapped resource [67]. However, the National Framework for Continuous Quality Improvement in Primary Health Care for Aboriginal and Torres Strait Islander People 2018-2023 [68] advocates for systems change to be championed at the organizational level rather than by individual staff and recommends that leadership encourage a culture of "CQI is everyone's business.…”

Section: Principal Findingsmentioning

confidence: 99%

Exploring Whether the Electronic Optimization of Routine Health Assessments Can Increase Testing for Sexually Transmitted Infections and Provider Acceptability at an Aboriginal Community Controlled Health Service: Mixed Methods Evaluation

McCormack,

Wand,

Newman

et al. 2023

JMIR Med Inform

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Background In the context of a syphilis outbreak in neighboring states, a multifaceted systems change to increase testing for sexually transmitted infections (STIs) among young Aboriginal people aged 15 to 29 years was implemented at an Aboriginal Community Controlled Health Service (ACCHS) in New South Wales, Australia. The components included electronic medical record prompts and automated pathology test sets to increase STI testing in annual routine health assessments, the credentialing of nurses and Aboriginal health practitioners to conduct STI tests independently, pathology request forms presigned by a physician, and improved data reporting. Objective We aimed to determine whether the systems change increased the integration of STI testing into routine health assessments by clinicians between April 2019 and March 2020, the inclusion of syphilis tests in STI testing, and STI testing uptake overall. We also explored the understandings of factors contributing to the acceptability and normalization of the systems change among staff. Methods We used a mixed methods design to evaluate the effectiveness and acceptability of the systems change implemented in 2019. We calculated the annual proportion of health assessments that included tests for chlamydia, gonorrhea, and syphilis, as well as an internal control (blood glucose level). We conducted an interrupted time series analysis of quarterly proportions 24 months before and 12 months after the systems change and in-depth semistructured interviews with ACCHS staff using normalization process theory. Results Among 2461 patients, the annual proportion of health assessments that included any STI test increased from 16% (38/237) in the first year of the study period to 42.9% (94/219) after the implementation of the systems change. There was an immediate and large increase when the systems change occurred (coefficient=0.22; P=.003) with no decline for 12 months thereafter. The increase was greater for male individuals, with no change for the internal control. Qualitative data indicated that nurse- and Aboriginal health practitioner–led testing and presigned pathology forms proved more difficult to normalize than electronic prompts and shortcuts. The interviews identified that staff understood the modifications to have encouraged cultural change around the role of sexual health care in routine practice. Conclusions This study provides evidence for the first time that optimizing health assessments electronically is an effective and acceptable strategy to increase and sustain clinician integration and the completeness of STI testing among young Aboriginal people attending an ACCHS. Future strategies should focus on increasing the uptake of health assessments and promote whole-of-service engagement and accountability.

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“…Culturally appropriate Aboriginal and Torres Strait Islander-led strategies are critical to improving the health of Aboriginal and Torres Strait Islander peoples in Australia and ‘closing the gap’ in health inequities [ 24 , 34 , 35 ]. Aboriginal and Torres Strait Islander culture is a source of strength and resilience [ 34 ], with studies highlighting that incorporating culture into public health programs and research is integral to achieving positive outcomes [ 36 ].…”

Section: Introductionmentioning

confidence: 99%

“…Aboriginal and Torres Strait Islander culture is a source of strength and resilience [ 34 ], with studies highlighting that incorporating culture into public health programs and research is integral to achieving positive outcomes [ 36 ]. Engagement with Aboriginal and Torres Strait Islander peoples “enables, reflects and integrates culture in its essence” p. 2 [ 35 ], and increases people’s trust and access to care [ 37 ]. Aboriginal and Torres Strait Islander leadership is empowering and ensures that cultural values and practices are embedded within healthcare delivery [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

“…Engagement with Aboriginal and Torres Strait Islander peoples “enables, reflects and integrates culture in its essence” p. 2 [ 35 ], and increases people’s trust and access to care [ 37 ]. Aboriginal and Torres Strait Islander leadership is empowering and ensures that cultural values and practices are embedded within healthcare delivery [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

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A Culturally Responsive Trauma-Informed Public Health Emergency Framework for Aboriginal and Torres Strait Islander Communities in Australia, Developed during COVID-19

Graham

Kamitsis

Kennedy

et al. 2022

IJERPH

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The Coronavirus Disease 2019 (COVID-19) pandemic impacted peoples’ livelihoods and mental wellbeing. Aboriginal and Torres Strait Islander peoples in Australia continue to experience intergenerational trauma associated with colonization and may experience trauma-related distress in response to government responses to public health emergencies. We aimed to develop a culturally responsive trauma-informed public health emergency response framework for Aboriginal and Torres Strait Islander peoples. This Aboriginal and Torres Strait Islander-led study involved: (i) a review of trauma-informed public health emergency responses to develop a draft framework (ii) interviews with 110 Aboriginal and Torres Strait Islander parents about how COVID-19 impacted their lives, and (iii) a workshop with 36 stakeholders about pandemic experiences using framework analysis to refine a culturally responsive trauma-informed framework. The framework included: an overarching philosophy (cultural humility, safety and responsiveness); key enablers (local leadership and Eldership); supporting strategies (provision of basic needs and resources, well-functioning social systems, human rights, dignity, choice, justice and ethics, mutuality and collective responsibility, and strengthening of existing systems); interdependent core concepts (safety, transparency, and empowerment, holistic support, connectedness and collaboration, and compassion, protection and caring); and central goals (a sense of security, resilience, wellbeing, self- and collective-efficacy, hope, trust, resilience, and healing from grief and loss).

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The role of Aboriginal leadership in community health programmes

Cited by 5 publications

References 14 publications

Intersectoral collaboration for supporting the health and wellbeing of Aboriginal families and children in out-of-home care: perspectives from Western Australian Aboriginal Community Controlled Health Organisations

Intersectoral collaboration for supporting the health and wellbeing of Aboriginal families and children in out-of-home care: perspectives from Western Australian Aboriginal Community Controlled Health Organisations

Exploring Whether the Electronic Optimization of Routine Health Assessments Can Increase Testing for Sexually Transmitted Infections and Provider Acceptability at an Aboriginal Community Controlled Health Service: Mixed Methods Evaluation

A Culturally Responsive Trauma-Informed Public Health Emergency Framework for Aboriginal and Torres Strait Islander Communities in Australia, Developed during COVID-19

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