A Partnership Model in the Development and Implementation of a Collaborative, Cardiovascular Education Program for Aboriginal Health Workers

Article excerpt

Abstract

A partnership model was established among key education providers, policy makers, non-government organisations, the local area health service and Aboriginal community controlled organisations aimed at increasing collaboration, skill development, cultural competence and increasing access to mentorship and expertise for Aboriginal Health Workers (AHWs). A group of 21 AHWs, within two cohorts, undertook the program between October 2005 and June 2006. A mixed-method evaluation using quantitative and qualitative data collection methods was undertaken prospectively.

Knowledge and confidence scores significantly increased for all participants over the course duration. Student evaluation demonstrated a desire for groupbased activities and the high value placed on clinical visits. Feedback on both outcome and process measures will inform course delivery and design.

Aust Health Rev 2008: 32(1): 139-146

CARDIOVASCULAR DISEASE (CVD), and in particular coronary heart disease (CHD), is the leading cause of death in the Australian Indigenous population.1 Walsh2 has summarised some of the barriers and facilitators to improving the health of Indigenous Australians. Aboriginal people often feel more comfortable if Aboriginal people are involved in their care due to the level of cultural understanding.2 A perception of prejudice, both tacit and overt, and a lack of cultural competence in interactions mean that many Indigenous Australians feel that the unique knowledge, values, and beliefs of their culture are ignored, and as a consequence, they feel marginalised in interactions with mainstream health services.3"4 Increasingly, there is recognition that mainstream health workers should be culturally competent, that is, that they should exhibit respectful and knowledgeable behaviours sustained by an enabling policy environment that supports cross-cultural interaction.5 Culturally appropriate health care interventions occur as a result of culturally competent practitioners, and an enabling policy and institutional environment.

Aboriginal Australians should lead, with support from the broader health community, on issues such as planning, implementation, and evaluation of health care services and health programs to ensure that they are culturally appropriate. Equally important is for non-Indigenous health professionals to strive to understand Indigenous peoples and to make services culturally appropriate.6

The role of Aboriginal Health Workers in service planning and delivery

Aboriginal and Torres Strait Islander Health Workers are defined as Aboriginal or Torres Strait Islander people who work within a holistic primary health care framework as determined by the local Aboriginal or Torres Strait Islander community to achieve better health outcomes for Aboriginal and Torres Strait Islander individuals/families and their communities.7 Aboriginal Health Workers (AHWs) can play an active role in the continuum of health care for local populations.8 This is because of their appreciation of Indigenous issues, knowledge and skill base, and accessibility, as well as their standing within their communities. In order to support AHWs in these roles, it is important that AHWs are aware of local resources and health professionals to support them, but perhaps more importantly, feel comfortable in dealing with a range of service providers.

In order to address these issues, a number of organisations involved in the formulation of policy, service provision, and education came together in a partnership to facilitate and drive change in respect of the cardiovascular health of Aboriginal Australians. This partnership involved the National Heart Foundation of Australia, the Sydney West Area Health Service, the Department of Technical and Further Education (New South Wales), New South Wales Health, the University of Western Sydney and the Western Sydney Aboriginal Community Controlled Medical Service. …