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      Improving healthcare for Aboriginal Australians through effective engagement between community and health services

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          Abstract

          Background

          Effectively addressing health disparities between Aboriginal and non-Aboriginal Australians is long overdue. Health services engaging Aboriginal communities in designing and delivering healthcare is one way to tackle the issue. This paper presents findings from evaluating a unique strategy of community engagement between local Aboriginal people and health providers across five districts in Perth, Western Australia. Local Aboriginal community members formed District Aboriginal Health Action Groups (DAHAGs) to collaborate with health providers in designing culturally-responsive healthcare. The purpose of the strategy was to improve local health service delivery for Aboriginal Australians.

          Methods

          The evaluation aimed to identify whether the Aboriginal community considered the community engagement strategy effective in identifying their health service needs, translating them to action by local health services and increasing their trust in these health services. Participants were recruited using purposive sampling. Qualitative data was collected from Aboriginal participants and health service providers using semi-structured interviews or yarning circles that were recorded, transcribed and independently analysed by two senior non-Aboriginal researchers. Responses were coded for key themes, further analysed for similarities and differences between districts and cross-checked by the senior lead Aboriginal researcher to avoid bias and establish reliability in interpreting the data. Three ethics committees approved conducting the evaluation.

          Results

          Findings from 60 participants suggested the engagement process was effective: it was driven and owned by the Aboriginal community, captured a broad range of views and increased Aboriginal community participation in decisions about their healthcare. It built community capacity through regular community forums and established DAHAGs comprising local Aboriginal community members and health service representatives who met quarterly and were supported by the Aboriginal Health Team at the local Population Health Unit. Participants reported health services improved in community and hospital settings, leading to increased access and trust in local health services.

          Conclusion

          The evaluation concluded that this process of actively engaging the Aboriginal community in decisions about their health care was a key element in improving local health services, increasing Aboriginal people’s trust and access to care.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12913-016-1497-0) contains supplementary material, which is available to authorized users.

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          Most cited references35

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          Burden of disease and injury in Aboriginal and Torres Strait Islander Peoples: the Indigenous health gap.

          Disparities in health status between Aboriginal and Torres Strait Islander peoples and the total Australian population have been documented in a fragmentary manner using disparate health outcome measures. We applied the burden of disease approach to national population health datasets and Indigenous-specific epidemiological studies. The main outcome measure is the Indigenous health gap, i.e. the difference between current rates of Disability-Adjusted Life Years (DALYs) by age, sex and cause for Indigenous Australians and DALY rates if the same level of mortality and disability as in the total Australian population had applied. The Indigenous health gap accounted for 59% of the total burden of disease for Indigenous Australians in 2003 indicating a very large potential for health gain. Non-communicable diseases explained 70% of the health gap. Tobacco (17%), high body mass (16%), physical inactivity (12%), high blood cholesterol (7%) and alcohol (4%) were the main risk factors contributing to the health gap. While the 26% of Indigenous Australians residing in remote areas experienced a disproportionate amount of the health gap (40%) compared with non-remote areas, the majority of the health gap affects residents of non-remote areas. Comprehensive information on the burden of disease for Indigenous Australians is essential for informed health priority setting. This assessment has identified large health gaps which translate into opportunities for large health gains. It provides the empirical base to determine a more equitable and efficient funding of Indigenous health in Australia. The methods are replicable and would benefit priority setting in other countries with great disparities in health experienced by Indigenous peoples or other disadvantaged population groups.
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            Ways of knowing, being and doing: A theoretical framework and methods for indigenous and indigenist re‐search

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                Author and article information

                Contributors
                angela.durey@uwa.edu.au
                Suzanne.McEvoy@health.wa.gov.au
                Valerie.Swift-Otero@health.wa.gov.au
                k.taylor@curtin.edu.au
                judith.katzenellenbogen@uwa.edu.au
                dawn.bessarab@uwa.edu.au
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                7 July 2016
                7 July 2016
                2016
                : 16
                : 224
                Affiliations
                [ ]School of Dentistry, University of Western Australia, Perth, WA Australia
                [ ]Centre for Aboriginal Studies, Curtin University, Perth, WA Australia
                [ ]South Metropolitan Health Service, Fremantle, WA Australia
                [ ]Faculty of Health Sciences, Curtin University, Perth, WA Australia
                [ ]Western Australian Centre for Rural Health, University of Western Australia, Perth, WA Australia
                [ ]Centre for Aboriginal Medical and Dental Health, University of Western Australia, Perth, WA Australia
                Article
                1497
                10.1186/s12913-016-1497-0
                4936288
                27388224
                1d116a9f-f23a-4ee6-a342-0e31cccffa8a
                © Durey et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 23 January 2015
                : 28 June 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Health & Social care
                aboriginal health,community engagement,partnership,access
                Health & Social care
                aboriginal health, community engagement, partnership, access

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