Department of Rural Health, The University of Melbourne, Victoria.
Aust N Z J Public Health. 2021 Jun;45(3):227-234. doi: 10.1111/1753-6405.13105. Epub 2021 Apr 26.
To explore the complex factors influencing the implementation of cultural competency frameworks for Aboriginal and Torres Strait Islander peoples within rural, Victorian, mainstream health and community service organisations.
Semi-structured telephone interviews were conducted with key individuals from 20 public health and community services in rural Victoria who had participated in the Koolin Balit Aboriginal Health Cultural Competence Project (KB-AHCC project). Interviews were recorded and transcribed verbatim and a content analysis was undertaken. The findings informed the selection of six case study sites for more in-depth analysis. Following this, an expert reference group provided feedback on the findings. Findings from the different data were triangulated to identify eight factors.
Key factors acting as barriers and/or enablers to implementing cultural competence frameworks were: comprehensive, structured tools; project workers; communication; organisational responsibility for implementation; prioritising organisational cultural competence resourcing; resistance to focussing on one group of people; and accountability.
Embedding cultural competence frameworks within rural, mainstream health and community services requires sustained government resourcing, prioritisation and formal accountability structures. Implications for public health: Findings will inform and guide the future development, implementation and evaluation of organisational cultural competence projects for rural public health and community services.
探讨影响农村维多利亚州主流卫生和社区服务机构实施原住民和托雷斯海峡岛民文化能力框架的复杂因素。
对参与库林巴尔提原住民卫生文化能力项目(KB-AHCC 项目)的 20 个农村维多利亚州公共卫生和社区服务机构的关键人员进行了半结构化电话访谈。对访谈进行了录音和逐字转录,并进行了内容分析。调查结果为选择六个案例研究地点进行更深入的分析提供了依据。在此之后,一个专家参考小组对调查结果提供了反馈。不同数据的结果进行了三角分析,以确定八个因素。
实施文化能力框架的主要障碍和/或促进因素是:全面、结构化的工具;项目工作人员;沟通;组织对实施的责任;优先考虑组织文化能力资源;抗拒专注于一群人;和问责制。
在农村主流卫生和社区服务中嵌入文化能力框架需要持续的政府资源、优先事项和正式的问责制结构。对公共卫生的影响:研究结果将为农村公共卫生和社区服务机构的组织文化能力项目的未来发展、实施和评估提供信息和指导。