Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service

2019 ◽  
Vol 43 (2) ◽  
pp. 217 ◽  
Author(s):  
Craig Wotherspoon ◽  
Cylie M. Williams
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Outcomes ◽  
Torres Strait Islander ◽  
Healthcare Services ◽  
Patient Experiences ◽  
Culturally Appropriate ◽  
Torres Strait ◽  
Healthcare Administrators ◽  
Culturally Appropriate Services

Objective There continue to be disparate health outcomes for people who are Aboriginal and Torres Strait Islander. The aim of the present study was to measure whether there were any differences in in-patient experiences between Aboriginal and Torres Strait Islander people and those without an Aboriginal or Torres Strait Islander background. Methods Random samples of people were invited to complete a survey following admission at the hospitals at Peninsula Health, Victoria, Australia. This survey was based on the Victorian Patient Satisfaction Monitor. Open-ended questions were also asked to gauge perspectives on how the services could better meet needs of Aboriginal and Torres Strait Islander patients. Results A total of 154 responses was obtained. There were differences between the two groups of participants in the following variables: respect of privacy, representation of culture, assistance with meals and access to a culturally specific worker if needed. This was reflected in thematic analysis, with three main themes identified: (1) interactions with staff; (2) the challenging environment; and (3) not just about me, but my family too. Conclusion There were systemic differences in in-patient experiences. Healthcare services have a responsibility to make systemic changes to improve the health care of all Australians by understanding and reforming how services can be appropriately delivered. What is known about the topic? There is a disparity in health outcomes between Aboriginal and Torres Strait Islander Australians and those who do not identify as Aboriginal and/or Torres Strait Islander. In addition, Aboriginal and Torres Strait Islanders have different interactions within healthcare services. Many rural health services have models that aim to deliver culturally appropriate services, but it is unknown whether the same challenges apply for this group of Australians within metropolitan health services. What does this paper add? This paper identifies the structural supports that are required to help close the gap in health care provision inequality. Many of the key issues identified are not people but system based. Healthcare administrators should consider the factors identified and address these at a whole-of-service level. What are the implications for practitioners? Many practitioners are aware of the challenges of providing culturally appropriate services. This research raises awareness of how traditional healthcare is not a one size fits all and flexibility is required to improve health outcomes.

scholarly journals Optimal Cancer Care for Aboriginal and Torres Strait Islander People: A Shared Approach to System Level Change

2020 ◽  
pp. 108-114 ◽  
Author(s):  
Jennifer Chynoweth ◽  
Meaghan M. McCambridge ◽  
Helen M. Zorbas ◽  
Jacinta K. Elston ◽  
Robert J.S. Thomas ◽  
...  
Keyword(s):  
Health Services ◽  
Health Professionals ◽  
Cancer Care ◽  
Torres Strait Islander ◽  
Care Pathway ◽  
System Level ◽  
Culturally Appropriate ◽  
Torres Strait Islander People ◽  
Cultural Appropriateness ◽  
Torres Strait

PURPOSE To improve cancer outcomes for Aboriginal and Torres Strait Islander people through the development and national endorsement of the first population-specific optimal care pathway (OCP) to guide the delivery of high-quality, culturally appropriate, and evidence-based cancer care. METHODS An iterative methodology was undertaken over a 2-year period, and more than 70 organizations and individuals from diverse cultural, geographic, and sectorial backgrounds provided input. Cancer Australia reviewed experiences of care and the evidence base and undertook national public consultation with the Indigenous health sector and community, health professionals, and professional colleges. Critical to the OCP development was the leadership of Aboriginal and Torres Strait Islander health experts and consumers. RESULTS The OCP received unanimous endorsement by all federal, state, and territory health ministers. Key elements of the OCP include attention to the cultural appropriateness of the health care environment; improvement in cross-cultural communication; relationship building with local community; optimization of health literacy; recognition of men’s and women’s business; and the need to use culturally appropriate resources. The OCP can be used as a tool for health services and health professionals to identify gaps in current cancer services and to inform quality improvement initiatives across all aspects of the care pathway. CONCLUSION The development of the OCP identified a number of areas that require prioritization. Ensuring culturally safe and accessible health services is essential to support early presentation and diagnosis. Multidisciplinary treatment planning and patient-centered care are required for all Aboriginal and Torres Strait Islander people, irrespective of location. Health planners and governments acknowledge the imperative for change and have expressed strong commitment to work with Indigenous Australians to improve the accessibility, cultural appropriateness, and quality of cancer care.

Food and nutrition programs for Aboriginal and Torres Strait Islander Australians: an overview of systematic reviews

2018 ◽  
Vol 42 (6) ◽  
pp. 689 ◽  
Author(s):  
Jennifer Browne ◽  
Karen Adams ◽  
Petah Atkinson ◽  
Deborah Gleeson ◽  
Rick Hayes
Keyword(s):  
Health Outcomes ◽  
Torres Strait Islander ◽  
Healthcare Services ◽  
Current Evidence ◽  
Indigenous Australians ◽  
Multiple Components ◽  
Nutrition Programs ◽  
Food And Nutrition ◽  
Underlying Causes ◽  
Torres Strait

Objective To provide an overview of previous reviews of programs that aimed to improve nutritional status or diet-related health outcomes for Aboriginal and Torres Strait Islander peoples, in order to determine what programs are effective and why. Methods A systematic search of databases and relevant websites was undertaken to identify reviews of nutrition interventions for Aboriginal and Torres Strait Islander Australians. Pairs of reviewers undertook study selection and data extraction and performed quality assessment using a validated tool. Results Twelve papers reporting 11 reviews were identified. Two reviews were rated high quality, three were rated medium and six were rated low quality. The reviews demonstrated that a positive effect on nutrition and chronic disease indicators can be a result of: 1) incorporating nutrition and breastfeeding advice into maternal and child health care services; and 2) multifaceted community nutrition programs. The evidence suggests that the most important factor determining the success of Aboriginal and Torres Strait Islander food and nutrition programs is community involvement in (and, ideally, control of) program development and implementation. Conclusions Community-directed food and nutrition programs, especially those with multiple components that address the underlying causes of nutrition issues, can be effective in improving nutrition-related outcomes. What is known about the topic? More effective action is urgently required in order to reduce the unacceptable health inequalities between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Food insecurity and nutrition-related chronic conditions are responsible for a large proportion of the ill health experienced by Australia’s First Peoples. What does this paper add? This narrative overview of 11 reviews published between 2005 and 2015 provides a synthesis of the current evidence for improving Aboriginal and Torres Strait Islander nutrition across the lifespan. The findings suggest that community-based and community-controlled programs, especially those with multiple components that address the underlying causes of nutrition issues, have the greatest potential to improve nutrition-related health outcomes. What are the implications for practitioners? Food and nutrition programs that are initiated and designed by local Aboriginal and Torres Strait Islander people are most likely to be effective. Nutrition and breastfeeding education and advice should be consistently incorporated into maternal and child healthcare services. Nutrition issues should be addressed through multifaceted approaches that address improving individual knowledge and skills, as well as strategies that increase access to nutritious food and provide a healthy food environment.

Does attending Work It Out – a chronic disease self-management program – affect the use of other health services by urban Aboriginal and Torres Strait Islander people with or at risk of chronic disease? A comparison between program participants and non-participants

2019 ◽  
Vol 25 (5) ◽  
pp. 464
Author(s):  
Jie Hu ◽  
Tabinda Basit ◽  
Alison Nelson ◽  
Emma Crawford ◽  
Lyle Turner
Keyword(s):  
Chronic Disease ◽  
Health Services ◽  
Torres Strait Islander ◽  
Healthcare Services ◽  
Management Program ◽  
Torres Strait Islander People ◽  
Team Care ◽  
Management Plans ◽  
Torres Strait ◽  
Services Use

Work It Out is a holistic chronic disease self-management program for urban Aboriginal and Torres Strait Islander people in Queensland, which is part of an integrated and comprehensive system of care for chronic disease management. This study examines differences in primary healthcare services use between Work It Out participants and non-participants. This retrospective observational study of services use, analysed data extracted from the clinical medical records system and Work It Out program assessments. General practitioner and allied health services use were compared among the participants and non-participants using logistic regression models and zero-truncated Poisson and negative binomial regression models. Compared with non-participants, Work It Out participants were more likely to use GP management plans, GP team care arrangements, GP mental health consultation and subsequent allied health services. Among those who used the services more than once, Work It Out participants had higher service use rates than non-participants for Aboriginal and Torres Strait Islander health assessments, GP management plans, team care arrangements and podiatry, physiotherapy and dietetic services. Engagement in Work It Out can facilitate the use of primary healthcare services, which are important for chronic disease management for urban Aboriginal and Torres Strait Islander people.

scholarly journals Experiences and views of a brokerage model for primary care for Aboriginal people

2015 ◽  
Vol 39 (1) ◽  
pp. 26 ◽  
Author(s):  
Sarah Dennis ◽  
Iqbal Hasan ◽  
Lisa Jackson Pulver ◽  
Ian Wilson ◽  
Nicholas Zwar
Keyword(s):  
Health Care ◽  
Health Services ◽  
Access To Health Care ◽  
Torres Strait Islander ◽  
Aboriginal People ◽  
Health Workers ◽  
Urban Setting ◽  
Structured Interviews ◽  
Torres Strait ◽  
Brokerage Service

Objective A mixed methods study was conducted to determine the views of Aboriginal people on their experiences of a brokerage model for access to community-based health services in an urban setting. Methods A broad range of approaches, using surveys, semi-structured interviews and community forums with Aboriginal people were used to find out people’s views and experiences of using the brokerage service. Results Of the 1304 people invited to participate, only 127 people provided feedback on the brokerage service model for Aboriginal people. Of these, 120 people identified as being Aboriginal. Participants said that the service helped them to navigate the system and access health care. Participants felt that the health professionals involved with the service were respectful of their needs. The service was not able to improve access to dental care. Conclusions The brokerage model implemented in this area appears to have been well received and is supporting urban Aboriginal people to access some of the health care needed. What is known about the topic? Aboriginal and Torres Strait Islander people often experience difficulty accessing health services. Urban brokerage models of care were funded by the Office for Aboriginal and Torres Strait Islander Health (OATSIH) under the Improving Indigenous Access to Health Care Services initiative and aimed to increase access to mainstream health services. What does this paper add? The brokerage model of care in South West Sydney has been well-received by the Aboriginal people receiving the service and participants are positive about the role of the service in increasing access to mainstream health care. What are the implications for practitioners? Navigating the healthcare system is difficult for some and a brokerage service with supportive Aboriginal health workers increases access.

scholarly journals Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e021236
Author(s):  
Bridgette McNamara ◽  
Lina Gubhaju ◽  
Louisa Jorm ◽  
David Preen ◽  
Jocelyn Jones ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health Services ◽  
Health Outcomes ◽  
Torres Strait Islander ◽  
Service Use ◽  
Infants And Children ◽  
Data Sources ◽  
Torres Strait ◽  
Aboriginal Children ◽  
The Impact

IntroductionEmpirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years.Methods and analysisThe study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA.Ethics and disseminationEthics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations.

scholarly journals Building trust and enhancing localization to improve access to women’s health services in Afghanistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F R Rab ◽  
S S Stranges ◽  
A D Thind ◽  
S S Sohani
Keyword(s):  
Health Care ◽  
Health Services ◽  
Vulnerable Populations ◽  
Time Trend ◽  
Health Workers ◽  
Healthcare Services ◽  
Delivery Of Healthcare ◽  
Care Services ◽  
Women And Children ◽  
Delivery Of Health Services

Abstract Background Over 34 million people in Afghanistan have suffered from death and devastation for the last four decades as a result of conflict. Women and children have borne the brunt of this devastation. Afghanistan has some of the poorest health indicators in the world for women and children. In the midst of armed conflict, providing essential healthcare in remote regions in the throws of conflict remains a challenge, which is being addressed the Mobile Health Teams through Afghan Red Crescent (ARCS). To overcome socio-cultural barriers, ARCS MHTs have used local knowledge to hire female staff as part of the MHTs along with their male relatives as part of MHT staff. The present study was conducted to explore the impact of engaging female health workers as part of MHTs in conflict zones within Afghanistan on access, availability and utilization of maternal and child health care. Methods Quantitative descriptive and time-trend analysis were used to evaluate impact of introduction of female health workers. Qualitative data is being analyzed to assess the possibilities and implications of engaging female health workers in the delivery of health services. Results Preliminary results show a 96% increase in uptake of services for expectant mothers over the last four years. Average of 18 thousand services provided each month by MHTs, 70% for women and children. Service delivery for women and children significantly increased over time (p < 0.05) after inclusion of female health workers in MHTs. Delivery of maternity care services showed a more significant increase (p < 0.001). Time trend and qualitative analyses is ongoing. Conclusions Introduction of female health workers significantly improved uptake of health care services for women and children especially in extremely isolated areas controlled by armed groups in Afghanistan. Engaging with local stakeholders is essential for delivery of health services for vulnerable populations in fragile settings like Afghanistan. Key messages Understanding cultural norms results in socially acceptable solutions to barriers in delivery of healthcare services and leads to improvements in access for women and children in fragile settings. Building local partnerships and capacities and using local resources result in safe, efficient and sustainable delivery of healthcare services for vulnerable populations in fragile settings.

scholarly journals Release of the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025; the impacts for podiatry in Australia: a commentary

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
James M. Gerrard ◽  
Shirley Godwin ◽  
Vivienne Chuter ◽  
Shannon E. Munteanu ◽  
Matthew West ◽  
...  
Keyword(s):  
Health Outcomes ◽  
First Nations ◽  
Torres Strait Islander ◽  
Collective Responsibility ◽  
Cultural Safety ◽  
Main Body ◽  
Torres Strait ◽  
The Impact ◽  
Torres Strait Islander Health ◽  
Safety Strategy

Abstract Background Developing since colonisation, Australia’s healthcare system has dismissed an ongoing and successful First Nations health paradigm in place for 60,000 years. From Captain James Cook documenting ‘very old’ First Nations Peoples being ‘far more happier than we Europeans’ and Governor Arthur Phillip naming Manly in admiration of the physical health of Gadigal men of the Eora Nation, to anthropologist Daisy Bates’ observation of First Nations Peoples living ‘into their eighties’ and having a higher life expectancy than Europeans; our healthcare system’s shameful cultural safety deficit has allowed for an Aboriginal and Torres Strait Islander child born in Australia today to expect to live 9 years less than a non-Indigenous child. Disproportionately negative healthcare outcomes including early onset diabetes-related foot disease and high rates of lower limb amputation in Aboriginal and Torres Strait Islander Peoples contribute to this gross inequity. Main body In 2020, the Australian Health Practitioner Regulation Authority released the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020–2025 - empowering all registered health practitioners within Australia to provide health care to Aboriginal and Torres Strait Islander Peoples that is inclusive, respectful and safe, as judged by the recipient of care. This recently released strategy is critically important to the podiatry profession in Australia. As clinicians, researchers and educators we have a collective responsibility to engage with this strategy of cultural safety. This commentary defines cultural safety for podiatry and outlines the components of the strategy in the context of our profession. Discussion considers the impact of the strategy on podiatry. It identifies mechanisms for podiatrists in all settings to facilitate safer practice, thereby advancing healthcare to produce more equitable outcomes. Conclusion Aboriginal and Torres Strait Islander Peoples access health services more frequently and have better health outcomes where provision of care is culturally safe. By engaging with the National Scheme’s Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy, all registered podiatrists in Australia can contribute to achieving equity in health outcomes for Aboriginal and Torres Strait Islander Peoples.

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