Northern Institute, Charles Darwin University, Darwin, Australia.
Yalu Marŋgithinyaraw Indigenous Coporation, Galiwin'ku, Australia.
Health Promot J Austr. 2021 Feb;32 Suppl 1:166-178. doi: 10.1002/hpja.405. Epub 2020 Sep 28.
Access to meaningful health information is limited in remote regions of Australia where Indigenous languages and culture are strong but the prevalence of chronic conditions is extremely high. This qualitative study aimed to support and understand the evolution of an educational approach to improve communication about chronic conditions for Yolŋu (Aboriginal people of Northeast Arnhem Land).
Within a culturally responsive research design, data were gathered through participant observation and semi-structured interviews with educators and community members. An iterative and continuous process of data collection and inductive analysis, exploring key elements of the process as it evolved, supported the Project Team to modify and refine their approach as the project progressed.
A high level of community participation and control was a critical element of the project. Collaboration between Yolŋu educators and community experts, with culturally competent support from others, enabled Yolŋu to share health information in ways that could not be achieved by outsiders. Yolŋu and biomedical knowledges were integrated to build and share meaningful, in-depth (not simplified or directive) oral explanations in local languages using culturally responsive communication processes. The urgent need for ongoing, sufficient and meaningful health education was a consistent and recurring theme in this context where chronic conditions are having a devastating impact.
Sustained and equitable access to meaningful information, using a culturally responsive approach led by community educators, is crucial to improve health literacy and to enable genuinely informed decisions in prevention and management of chronic conditions. Long-term funding is needed to support ongoing programs. These findings may have relevance for others who do not share the culture and language of the majority population. SO WHAT?: Equity of access to meaningful health information through sustained support for community-led education processes is essential to improve First Nations health outcomes.
在澳大利亚偏远地区，原住民语言和文化强大，但慢性病患病率极高，因此获取有意义的健康信息受到限制。本研究旨在支持和了解一种教育方法的演变，以改善对 Yolŋu（东北阿纳姆地的土著人）慢性疾病的沟通。
在文化响应式研究设计中，通过参与者观察和与教育者和社区成员的半结构化访谈收集数据。数据收集和归纳分析的迭代和持续过程，探索了该过程演变的关键要素，为项目团队在项目进展过程中修改和完善他们的方法提供了支持。
高水平的社区参与和控制是项目的关键要素。Yolŋu 教育者和社区专家之间的合作，以及其他具有文化能力的支持，使 Yolŋu 能够以无法由局外人实现的方式分享健康信息。将 Yolŋu 和生物医学知识整合起来，使用文化响应式沟通流程，以当地语言构建和分享有意义的、深入的（非简化或指令性的）口头解释。在这种慢性病产生破坏性影响的情况下，持续、充足和有意义的健康教育的迫切需求是一个一致和反复出现的主题。
通过由社区教育者领导的文化响应式方法，持续和公平地获得有意义的信息，对于提高健康素养和使人们能够在慢性病的预防和管理中做出真正知情的决策至关重要。需要长期资金来支持持续的项目。这些发现可能对其他不共享多数人口的文化和语言的人具有相关性。
通过持续支持社区主导的教育过程，实现公平获得有意义的健康信息，对于改善第一民族的健康结果至关重要。
