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澳大利亚东阿尔尼姆地第一民族偏远社区中学生实施的联合卫生服务的共同创建。

Co-creation of a student-implemented allied health service in a First Nations remote community of East Arnhem Land, Australia.

机构信息

James Cook University, Cairns, Queensland, Australia.

Flinders NT, Darwin, Northern Territory, Australia.

出版信息

Aust J Rural Health. 2022 Dec;30(6):782-794. doi: 10.1111/ajr.12938. Epub 2022 Nov 15.

Abstract

OBJECTIVES

To co-create a culturally responsive student-implemented allied health service in a First Nations remote community and to determine the feasibility and acceptability of the service.

DESIGN

Co-creation involved a pragmatic iterative process, based on participatory action research approaches. Feasibility and acceptability were determined using a mixed-method pre/postdesign.

SETTING

The service was in Nhulunbuy, Yirrkala and surrounding remote First Nations communities of East Arnhem Land, Northern Territory, Australia.

PARTICIPANTS

Co-creation of the service was facilitated by the Northern Australia Research Network, guided by Indigenous Allied Health Australia leadership, with East Arnhem local community organisations and community members. Co-creation of the day-to-day service model involved local cultural consultants, service users and their families, staff of community organisations, students, supervisors, placement coordinators and a site administrator.

FINDINGS

A reciprocal learning service model was co-created in which culturally responsive practice was embedded. The service was feasible and acceptable: it was delivered as intended; resources were adequate; the service management system was workable; and the service was acceptable. Health outcome measures, however, were not appropriate to demonstrate impact, particularly through the lens of the people of East Arnhem. Recommendations for the service included: continuing the reciprocal learning service model in the long term; expanding to include all age groups; and connecting with visiting and community-based services.

CONCLUSION

The co-created service was feasible and acceptable. To demonstrate the impact of the service, measures of health service impact that are important to First Nations people living in remote communities of northern Australia are required.

摘要

目的

在一个原住民偏远社区共同创建一个对文化敏感的学生实施的联合卫生服务,并确定该服务的可行性和可接受性。

设计

共同创建涉及基于参与式行动研究方法的实用迭代过程。使用混合方法的前后设计来确定可行性和可接受性。

设置

该服务位于澳大利亚北领地东阿纳姆地区的 Nhulunbuy、Yirrkala 和周围的偏远原住民社区。

参与者

北部澳大利亚研究网络促进了服务的共同创建,由澳大利亚原住民联合健康领导指导,与东阿纳姆当地社区组织和社区成员合作。日常服务模式的共同创建涉及当地文化顾问、服务用户及其家属、社区组织工作人员、学生、主管、安置协调员和现场管理员。

结果

共同创建了一种互惠学习服务模式,其中嵌入了对文化敏感的实践。该服务是可行和可接受的:它按预期提供;资源充足;服务管理系统可行;服务是可接受的。然而,健康结果衡量标准并不适合展示影响,特别是从东阿纳姆人的角度来看。对该服务的建议包括:长期继续互惠学习服务模式;扩大到包括所有年龄组;并与来访的和社区为基础的服务建立联系。

结论

共同创建的服务是可行和可接受的。为了展示服务的影响,需要使用对居住在澳大利亚北部偏远社区的原住民有重要意义的卫生服务影响衡量标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6013/10099895/6ddd06b6ca01/AJR-30-782-g001.jpg

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