Southgate Institute for Health, Society and Equity, Flinders University, South Australia.
National Centre for Cultural Competency, University of Sydney, New South Wales.
Aust N Z J Public Health. 2019 Dec;43(6):532-537. doi: 10.1111/1753-6405.12938. Epub 2019 Oct 2.
This paper provides a case study of the responses to alcohol of an Aboriginal Community Controlled Health Service (The Service), and investigates the implementation of comprehensive primary health care and how it challenges the logic of colonial approaches.
Data were drawn from a larger comprehensive primary health care study. Data on actions on alcohol were collected from: a) six-monthly service reports of activities; b) 29 interviews with staff and board members; c) six interviews with advocacy partners; and d) community assessment workshops with 13 service users.
The Service engaged in rehabilitative, curative, preventive and promotive work targeting alcohol, including advocacy and collaborative action on social determinants of health. It challenged other government approaches by increasing Aboriginal people's control, providing culturally safe services, addressing racism, and advocating to government and industry.
This case study provides an example of implementation of the full continuum of comprehensive primary health care activities. It shows how community control can challenge colonialism and ongoing power imbalances to promote evidence-based policy and practice that support self-determination as a positive determinant for health. Implications for public health: Aboriginal Community Controlled Health Services are a good model for comprehensive primary health care approaches to alcohol control.
本文通过对一个土著社区控制的医疗服务机构（该服务机构）对酒精的反应进行案例研究，调查了综合初级卫生保健的实施情况，以及它如何挑战殖民主义方法的逻辑。
数据来自一项更大的综合初级卫生保健研究。关于酒精行动的数据来自：(a) 每六个月一次的服务活动报告；(b) 对 29 名工作人员和董事会成员的访谈；(c) 对 6 个倡导伙伴的访谈；以及 (d) 与 13 名服务使用者一起进行的社区评估研讨会。
该服务机构针对酒精开展了康复、治疗、预防和促进工作，包括倡导和针对健康社会决定因素的合作行动。它通过增加土著人民的控制、提供文化安全服务、解决种族主义问题以及向政府和行业倡导，挑战了其他政府的做法。
本案例研究提供了综合初级卫生保健活动全面实施的范例。它展示了社区控制如何能够挑战殖民主义和持续存在的权力失衡，以促进循证政策和实践，支持自决作为健康的积极决定因素。对公共卫生的启示：土著社区控制的医疗服务机构是控制酒精的综合初级卫生保健方法的良好模式。
