Some suggestions for how researchers and health services might do a better job of engaging with Aboriginal patients and communities have come from a research project spanning rural, regional and remote NSW.
The suggestions include taking time to develop trust and relationships (including with community members outside of the health sector), recruiting Aboriginal staff, and engaging patients and communities through art and social media.
The NHMRC-funded Gomeroi gaaynggal program recruits Aboriginal women in early pregnancy and monitors their health and that of their infants throughout pregnancy. It aims to promote the early detection, diagnosis and prevention of diabetes and kidney disease.
Work began on setting up the program in 2006, recognising that many Aboriginal women are deeply mistrustful of mainstream pregnancy-related healthcare services, and this contributes to low uptake of antenatal care.
Thanks to Lynsey Brown from the Primary Health Care Research and Information Service (PHC RIS), for reporting on a recent article about the program in the journal, Rural and Remote Health.
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Sharing some strategies that work for Aboriginal health
Lynsey Brown writes:
Based on their experiences in Walgett (NSW) and other regional, rural and remote Aboriginal communities, Dr Kym Rae and colleagues describe strategies to improve recruitment and retention of Aboriginal people in research and antenatal programs.
The lessons learnt stem from the NHMRC-funded Gomeroi gaaynggal program, which investigates health issues across pregnancy and the post-natal period.
The Gomeroi gaaynggal team also works in partnership with the Aboriginal community and a range of health service providers to deliver an ArtsHealth program that addresses health literacy and service use.
The authors describe key strategies for recruitment and retention that can be applied across diverse regions.
Promoting both ownership and engagement, they note how community consultation must occur across multiple levels. For example, when establishing a health service, it is important to include conversations with not only health professionals but also organisations and individuals working in different areas across a range of social determinants of health (eg, housing, education, justice system), and particularly engaging with local community Elders.
It is this open and trusting dialogue that enables partnerships between researchers, clinicians and communities.
Community consultation is a step towards building trust, which is necessary between researchers and the community, and between research teams and partner organisations. However, trust takes time.
The authors describe prioritising recruitment of Aboriginal staff to enable open discussions, friendships and a supportive mentored environment, which helps this trust and sense of collaboration to develop.
The use of new technologies (in areas with adequate internet connectivity) is also discussed in detail. Social media such as Facebook can be beneficial in establishing connections, maintaining contact, keeping up-to-date with developments, providing opportunity for private emails, and encouraging communication at less cost than a phone call.
The importance of addressing local needs is emphasised, with the authors identifying successful recruitment and retention strategies in different areas.
For regional areas, provision of food and transport vouchers reduces costs for families travelling to health services. Further, Aboriginal staff spend time liaising closely with community members and health services staff.
In rural areas arranging transport and improving local access to services are key strategies. Facebook is also particularly valuable in promoting connection between the program and participants in this space.
Additionally, the authors highlight the benefits of requesting details of three contact people for each participant, to enable connection with families who often change residences.
In the remote region, the key factor is collaboration between the research team and the local Aboriginal Medical Service – with co-located offices and matching uniforms promoting an ongoing partnership.
Despite centres in different locations determining their own approach, it seems the generated strategies are applicable to other health professionals working to close the gap.
• Lynsey Brown is Research Associate, PHC RIS
• Rae K, Weatherall L, Hollebone K, Apen K, McLean M, Blackwell C, et al. (2013). Developing research in partnership with Aboriginal communities – strategies for improving recruitment and retention. Rural and Remote Health 13: 2255. (Online)
This article, which can be accessed at http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=2255, features in the 11 April 2013 edition of PHC RIS eBulletin, available at http://www.phcris.org.au/publications/ebulletin/index.php.
The eBulletin is designed to inform readers of recently published articles and reports, news items, media releases, upcoming conferences and courses, research grants, scholarships and fellowships, PHC RIS products and services and relevant websites in the primary health care field. Those interested in receiving the weekly eBulletin are invited to subscribe to the free service at http://www.phcris.org.au/mailinglists/index.php.
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Previous PHCRIS columns at Croakey
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• The uncertain merits of pay for performance funding systems
• The impact of dementia on couples and a plan for more equitable healthcare
• Could this approach help make integrated care a reality?
• From nurse prescribing to an Australian experiment
• How best to improve management of childhood obesity and related health problems
• Sustaining small rural primary health care services
• What is the evidence on knowledge translation strategies?
• Should your doctor be asking after your pet too?
• Nurses add value to chronic disease management
• Some useful tips for finding health policy information on the web
• Pros and cons of telehealth for people in rural areas
• What helps GPs provide better mental healthcare (and what doesn’t)
• Improving collaboration in diabetes care
• Improving dementia management in general practice
• Pets and what they do for our health
• Improving the diagnosis of ovarian cancer
• Chronic health problems and depression
• Helping older patients with chronic diseases to navigate the health system
• Tackling overuse of antibiotics
• When doctors prescribe exercise, does it make any difference?
• Caring for country is also good for Aboriginal people
• The perils of surrogate markers
• Are Australians willing to pay more for better oral health?
• What helps encourage self-care for those with chronic illness?
• More effort needed to strengthen shared care for people with serious mental illness
