Menzies School of Health Research, Charles Darwin University, Northern Territory.
Lúrra Language and Culture Unit, Maningrida College, Northern Territory.
Aust N Z J Public Health. 2021 Jun;45(3):212-219. doi: 10.1111/1753-6405.13100. Epub 2021 May 10.
A high prevalence of acute rheumatic fever (ARF) and rheumatic heart disease (RHD) among Aboriginal children in northern Australia is coupled with low understanding among families. This has negative impacts on children's health, limits opportunities for prevention and suggests that better health communication is needed.
During an RHD echocardiography screening project, Aboriginal teachers in a remote community school created lessons to teach children about RHD in their home languages, drawing on principles of community-led development. Access to community-level RHD data, previously unknown to teachers and families, was a catalyst for this innovative work. Careful, iterative discussions among speakers of four Aboriginal languages ensured a culturally coherent narrative and accompanying teaching resources.
The evaluation demonstrated the importance of collective work, local Indigenous Knowledge and metaphors. As a result of the lessons, some children showed new responses and attitudes to skin infections and their RHD treatment. Language teachers used natural social networks to disseminate new information. A community interagency collaboration working to prevent RHD commenced. Conclusions and implications for public health: Action to address high rates of RHD must include effective health communication strategies that value Indigenous Knowledge, language and culture, collaborative leadership and respect for Indigenous data sovereignty.
澳大利亚北部的原住民儿童中急性风湿热(ARF)和风湿性心脏病(RHD)的高发率,加上家庭对此的了解程度低,对儿童的健康产生了负面影响,限制了预防的机会,这表明需要更好的健康沟通。
在一项 RHD 超声心动图筛查项目中,偏远社区学校的原住民教师利用社区主导发展的原则,用他们的母语为孩子们教授 RHD 知识,创建了课程。对社区层面 RHD 数据的获取——教师和家长以前并不知道这些数据——是这项创新工作的催化剂。在四位原住民语言使用者之间进行了仔细的、迭代的讨论,以确保一个具有文化一致性的叙述和相应的教学资源。
评估表明了集体工作、本地原住民知识和隐喻的重要性。由于这些课程,一些孩子对皮肤感染及其 RHD 治疗表现出了新的反应和态度。语言教师利用自然的社交网络传播新信息。一个旨在预防 RHD 的社区机构间合作开始了。结论和对公共卫生的启示:解决 RHD 高发病率的行动必须包括重视原住民知识、语言和文化、协作领导和尊重原住民数据主权的有效健康沟通策略。