Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia.
Freemasons Foundation Centre for Men's Health, University of Adelaide, Adelaide, Australia.
BMC Public Health. 2018 Oct 23;18(1):1198. doi: 10.1186/s12889-018-6093-2.
Aboriginal and Torres Strait Islander men experience worse health outcomes and are the most marginalized and disadvantaged population group in Australia. Primary health care services are critical to providing both clinical and social and emotional support, however, remain underutilized by Aboriginal and Torres Strait Islander men. This review aims to better understand the utilization of primary health care services by Indigenous men and assess the effectiveness of strategies implemented to improve utilization.
A four-step search strategy was employed across four databases to find peer-reviewed publications and grey literature from Australia, New Zealand, Canada and America. The search began in March 2015 and included the following databases PubMed, CINAHL, Informit (Indigenous collection) and Embase. Additional databases and websites were also searched for grey literature, reference lists of included publications were searched for additional studies and relevant experts were consulted.
The literature search found seven articles that met the inclusion criteria; four describing three research projects, plus three expert opinion pieces. The search was unable to find published research on strategies implemented to improve primary health care utilization by Indigenous men. There is limited published research focused on the utilization of primary health care by Indigenous men. From the identified papers Indigenous men described factors impacting utilization which were categorized into three primary organizing themes; those related to health services, the attitudes of Indigenous men and knowledge. It is evident from the identified papers that improvements in Indigenous health can only occur if future programs are developed in collaboration with health services and Indigenous men to address differing requirements.
Currently, health systems in Australia are limited in their ability to improve the health and wellbeing of Aboriginal and Torres Strait Islander males without such strategies. Future research should focus on evaluating the implementation of men specific utilization strategies. It is through evidence-based research that subsequent policies and programs can be made and implemented to improve Indigenous men's health.
澳大利亚的原住民和托雷斯海峡岛民男性的健康状况较差，是最边缘化和处境最不利的群体。初级卫生保健服务对于提供临床和社会及情感支持至关重要，但原住民和托雷斯海峡岛民男性对其利用不足。本综述旨在更好地了解原住民男性对初级卫生保健服务的利用情况，并评估为提高利用率而实施的策略的有效性。
采用四步搜索策略，在澳大利亚、新西兰、加拿大和美国的四个数据库中查找同行评议出版物和灰色文献。搜索始于 2015 年 3 月，包括以下数据库：PubMed、CINAHL、Informit（土著收藏）和 Embase。还搜索了其他数据库和网站以获取灰色文献，检索了纳入出版物的参考文献以获取其他研究，并咨询了相关专家。
文献搜索发现了七篇符合纳入标准的文章；其中四篇描述了三个研究项目，外加三篇专家意见文章。搜索未能找到关于为提高原住民男性对初级卫生保健的利用而实施的策略的已发表研究。关于原住民男性利用初级卫生保健的已发表研究有限。从确定的论文中可以看出，影响利用的因素可以分为三个主要的组织主题；与卫生服务、原住民男性的态度和知识有关。从确定的论文中可以明显看出，如果未来的项目不是与卫生服务和原住民男性合作制定以满足不同需求，那么改善原住民健康的目标将无法实现。
目前，澳大利亚的卫生系统在没有这些策略的情况下，改善原住民和托雷斯海峡岛民男性的健康和福祉的能力有限。未来的研究应侧重于评估针对特定男性的利用策略的实施情况。只有通过基于证据的研究，才能制定和实施后续的政策和方案，以改善原住民男性的健康。
