Hulme Chambers Alana, Tomnay Jane, Stephens Kylie, Crouch Alan, Whiteside Mary, Love Pettina, McIntosh Leonie, Waples Crowe Peter
Centre for Excellence in Rural Sexual Health, Department of Rural Health, The University of Melbourne, Wangaratta VIC, Australia
Centre for Excellence in Rural Sexual Health, Department of Rural Health, University of Melbourne, Shepparton VIC, AustraliaHealth, Department of Rural Health, University of Melbourne
Rural Remote Health. 2018 Apr;18(2):4245. doi: 10.22605/RRH4245. Epub 2018 Apr 15.
Community participation is a collaborative process aimed at achieving community-identified outcomes. However, approaches to community participation within Aboriginal health promotion initiatives have been inconsistent and not well documented. Smart and Deadly was a community-led initiative to develop sexual health promotion resources with young Aboriginal people in regional Victoria, Australia. The principles of community-centred practice, authentic participatory processes and respect for the local cultural context guided the initiative. The aim of this article is to report factors that facilitated community participation undertaken in the Smart and Deadly initiative to inform future projects and provide further evidence in demonstrating the value of such approaches.
A summative evaluation of the Smart and Deadly initiative was undertaken approximately 2 years after the initiative ended. Five focus groups and 13 interviews were conducted with a purposive sample of 32 participants who were involved with Smart and Deadly in one of the following ways: project participant, stakeholder or project partner, or project developer or designer. A deductive content analysis was undertaken and themes were compared to the YARN model, which was specifically created for planning and evaluating community participation strategies relating to Aboriginal sexual health promotion.
A number of factors that facilitated community participation approaches used in Smart and Deadly were identified. The overarching theme was that trust was the foundation upon which the facilitators of community participation ensued. These facilitators were cultural safety and cultural literacy, community control, and legacy and sustainability. Whilst the YARN model was highly productive in identifying these facilitators of community participation, the model did not have provision for the element of trust between workers and community. Given the importance of trust between the project team and the Aboriginal community in the Smart and Deadly initiative, a suggested revision to the YARN model is that trust is included as the basis upon which YARN model factors are predicated.
Adding trust to the YARN model as a basis upon which YARN model factors are grounded assists future Aboriginal health promotion projects in ensuring community participation approaches are more likely to be acceptable to the Aboriginal community.
社区参与是一个旨在实现社区确定成果的协作过程。然而，在原住民健康促进倡议中，社区参与的方法一直不一致，且记录不完善。“明智与致命”是一项由社区主导的倡议，旨在与澳大利亚维多利亚州地区的年轻原住民共同开发性健康促进资源。以社区为中心的实践原则、真实的参与过程以及对当地文化背景的尊重指导了该倡议。本文旨在报告促进“明智与致命”倡议中社区参与的因素，为未来项目提供参考，并进一步证明此类方法的价值。
在“明智与致命”倡议结束约两年后进行了总结性评估。对32名参与者进行了五次焦点小组讨论和13次访谈，这些参与者通过以下方式之一参与了“明智与致命”倡议：项目参与者、利益相关者或项目合作伙伴，或项目开发者或设计师。进行了演绎式内容分析，并将主题与YARN模型进行了比较，该模型是专门为规划和评估与原住民性健康促进相关的社区参与策略而创建的。
确定了一些促进“明智与致命”倡议中社区参与方法的因素。总体主题是信任是社区参与促进因素得以产生的基础。这些促进因素包括文化安全与文化素养、社区控制以及遗产与可持续性。虽然YARN模型在识别这些社区参与促进因素方面非常有效，但该模型没有考虑工作人员与社区之间的信任因素。鉴于项目团队与原住民社区之间的信任在“明智与致命”倡议中的重要性，建议对YARN模型进行修订，将信任作为YARN模型因素的基础。
将信任作为YARN模型因素的基础纳入其中，有助于未来的原住民健康促进项目确保社区参与方法更有可能被原住民社区接受。
