National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, ACT, Australia.
Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
Health Res Policy Syst. 2024 Mar 21;22(1):34. doi: 10.1186/s12961-024-01121-x.
More than 35% of Aboriginal and Torres Strait Islander adults live with cardiovascular disease, diabetes, or chronic kidney disease. There is a pressing need for chronic disease prevention and management among Aboriginal and Torres Strait Islander people in Australia. Therefore, this review aimed to synthesise a decade of contemporary evidence to understand the barriers and enablers of chronic disease prevention and management for Aboriginal and Torres Strait Islander People with a view to developing policy and practice recommendations.
We systematically searched for peer-reviewed published articles between January 2014 to March 2023 where the search was performed using subject headings and keywords related to "Aboriginal and Torres Strait Islander peoples," "Chronic Disease," and "Primary Health Care". Quality assessment for all included studies was conducted using the Aboriginal and Torres Strait Islander Quality Appraisal Tool. The data were extracted and summarised using a conventional content analysis approach and applying strength-based approaches.
Database searches identified 1653 articles where 26 met inclusion criteria. Studies varied in quality, primarily reporting on 14 criteria of the Aboriginal and Torres Strait Islander Quality Appraisal Tool. We identified six key domains of enablers and barriers of chronic disease prevention and management programs and implied a range of policy and practice options for improvement. These include culturally acceptable and safe services, patient-provider partnerships, chronic disease workforce, primary health care service attributes, clinical care pathways, and accessibility to primary health care services. This review also identified the need to address social and cultural determinants of health, develop the Aboriginal and Torres Strait Islander and non-Indigenous chronic disease workforce, support multidisciplinary teams through strengthening clinical care pathways, and engage Aboriginal and Torres Strait Islander communities in chronic disease prevention and management program design and delivery.
Enabling place-based partnerships to develop contextual evidence-guided strategies that align with community priorities and aspirations, with the provision of funding mechanisms and models of care through policy and practice reforms will strengthen the chronic disease prevention and management program for Aboriginal and Torres Strait Islander people.
超过 35%的原住民和托雷斯海峡岛民成年人患有心血管疾病、糖尿病或慢性肾病。澳大利亚原住民和托雷斯海峡岛民急需进行慢性病预防和管理。因此，本综述旨在综合十年来的当代证据，了解原住民和托雷斯海峡岛民慢性病预防和管理的障碍和促进因素，以期制定政策和实践建议。
我们系统地检索了 2014 年 1 月至 2023 年 3 月期间发表的同行评议文章，使用与“原住民和托雷斯海峡岛民”、“慢性病”和“初级卫生保健”相关的主题词和关键词进行搜索。所有纳入研究的质量评估均使用原住民和托雷斯海峡岛民质量评估工具进行。使用常规内容分析方法和应用基于优势的方法提取和总结数据。
数据库搜索共确定了 1653 篇文章，其中 26 篇符合纳入标准。研究质量差异较大，主要报告了原住民和托雷斯海峡岛民质量评估工具的 14 项标准。我们确定了慢性病预防和管理计划的六个关键促进因素和障碍领域，并提出了一系列改进政策和实践的选择。这些包括可接受且安全的服务、医患伙伴关系、慢性病劳动力、初级卫生保健服务属性、临床护理路径以及初级卫生保健服务的可及性。本综述还确定了需要解决健康的社会和文化决定因素、发展原住民和托雷斯海峡岛民和非原住民慢性病劳动力、通过政策和实践改革支持多学科团队、并使原住民和托雷斯海峡岛民社区参与慢性病预防和管理计划的设计和实施。
建立基于地点的伙伴关系以制定符合社区优先事项和愿望的基于背景证据的策略，并通过政策和实践改革提供资金机制和护理模式，将加强原住民和托雷斯海峡岛民的慢性病预防和管理计划。
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