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Targeted Call for Research - public call for research priorities in Aboriginal and Torres Strait Islander health

This submission reflects the views of
Organisation Name: 
Western NSW Primary Health Network
Personal Details
Specific Questions
1. What is the research priority (a significant research knowledge gap or unmet need) you are nominating? How would a TCR in this area greatly advance our understanding of this issue? (200 word maximum): 
The WNSW PHN is responsible for providing a range of primary health services to more than 309,000 people across 433,379 square kilometres of NSW with approximately 11.7% identifying as Aboriginal and Torres Strait Islander peoples. Problems exist in getting Aboriginal and Torres Strait Islander peoples to seek appropriate services in a timely manner and to remain engaged with the services. This situation also hampers the opportunities to initiate and promote prevention, health promotion and self-management initiatives. A survey by WNSW PHN of existing services is demonstrating cultural, competency training for staff is cursory. No demonstrable and endorsed standards are available to guide the development of culturally competent services. No measures exist to assess service tenderers or to monitor and evaluate services. Research is required to – A. Develop a cultural safety/ competency framework B. Develop a corresponding compliance/ assessment tool C. Conduct a pilot project to test the draft framework and the tool. This research and development would not only assist the PHN but also service providers who seek guidance in how to develop culturally competent and safe services which area attractive to Aboriginal and Torres Strait Islander peoples
2. What are the relevant Australian Government Priorities, and/or Ministerially-agreed State and Territory health research priorities linked to your nominated priority? (200 word maximum): 
A. Australian Government vision for Aboriginal health and wellbeing equity, as stated in the National Aboriginal and Torres Strait Islander Health Plan, 2013-2023: The Australian Health System is free of racism and inequality and all Aboriginal and Torres Strait Islander peoples have access to health services that are effective, high quality, appropriate and affordable. Together with strategies to address social inequalities and determinants of health, this provides the necessary platform to realise health equity by 2031. B. NSW Aboriginal Health Plan, 2013 – 2023: Strategic Directions of this plan align with the aims of the proposed framework: • Building trust through partnerships • Implementing what works and building the evidence • Ensuring integrated planning and service delivery • Strengthening the Aboriginal workforce • Providing culturally safe work environments and health services • Strengthening performance monitoring, management and accountability. C. Improvements in Aboriginal health are the highest priority of the WNSW PHN. D. Developing a cultural competency framework is the second highest priority of the Western Health Alliance Aboriginal Health Council.
3. How would a TCR in this area contribute to Aboriginal and Torres Strait Islander health and improve health outcomes for the individual and/or community? (200 word maximum): 
Enhanced cultural competency would require services to have the following six key capabilities: Key capability Outcome/ benefit 1. Respect for centrality of culture • Aboriginal and Torres Strait Islander peoples are placed at the centre of their care. • Holistic approaches to health and wellbeing are achieved across the life span by an appreciation of cultural values and differences at every stage. 2. Staff self-awareness • Clarity about own cultural identity, personal beliefs, assumptions, values, perceptions, attitudes and expectations, and active reflection on how they impact relationships with Aboriginal and Torres Strait Islanders peoples. • Aboriginal and Torres Strait Islander peoples experience health and wellbeing services that are respectful and free from overt and covert personal racism. 3. Proactivity • Health and wellbeing care that is free from institutional racism and delivered by organisations focussed on cultural safety as an essential element of their core business. • Aboriginal and Torres Strait Islander individuals, families and communities experience equitable access to appropriate services that can help them achieve health and wellbeing. 4. Inclusive engagement Aboriginal and Torres Strait Islander peoples: • actively engaged in collaborative and inclusive decision-making. • participate in planning, monitoring and evaluations. • feel respected and included in relationships with professionals and are more likely to access services in the future. 5. Leadership • Increasing numbers of Australians who are passionate and committed contributors to access to affordable, appropriate and acceptable health care for Aboriginal and Torres Strait Islander peoples. • Significant numbers of Aboriginal and Torres Strait Islander peoples are employed with defined education and career pathways to lead culturally competent practice. 6. Responsibility and accountability • Evidenced-based action leading to continuous improvement in outcomes for Aboriginal and Torres Strait Islander peoples.
4. How will the TCR reduce the burden of disease on the health system and Australian economy? (200 word maximum): 
• Earlier and consistent engagement by Aboriginal and Torres Strait Islander peoples with primary health services provides enhanced opportunities for early detection, health promotion and healthy lifestyle initiatives to be offered and adopted. • Ongoing engagement of Aboriginal and Torres Strait Islander peoples with an appropriate and sensitive health service promotes self-management strategies for chronic disease processes, which provide improved long-term outcomes (e.g. diabetes, heart disease, respiratory disease). • The development of models of care and service delivery methods along with dialogues on health outcomes for specific primary health services in which Aboriginal and Torres Strait Islander peoples are active contributors
5. Are there any reports or findings that support your nomination for the suggested topic? (200 word maximum): 
Australian Institute of Health and Welfare, Australian Institute of Family Studies, Cultural competency in the delivery of health services of health services for Indigenous people, Issues paper no. 13 produced for Closing the Gap Clearinghouse, July 2015. Australian Institute of Aboriginal and Torres Strait Islander Studies, Reconciliation Action Plan, 2014-2016 The Nursing Council of New Zealand, Guidelines for Cultural Safety, the Treaty of Waitangi and Maori Health in Nursing Education and Practice, 2011. United Nations, Department of Economics & Social Affairs, State of the World’s Indigenous Peoples, Volume 2: Indigenous Peoples’ Access to Health Services, 2015. Harvey, A., Russell-Mundine, G., Hoving, E. (2016). Modelling interdisciplinary collaboration to build cultural competence and academic literacy. Journal of Academic Language and Learning, 10(1), A101-A117. Power, T., Virdun, C., Sherwood, J., Parker, N., Van Balen, J., Gray, J., Jackson, D. (2016). REM: A collaborative framework for building Indigenous cultural competence. Journal of Transcultural Nursing, In Press, 1-8. Russell-Mundine, G., Sherwood, J.,Harvey, A., Riley, L., Maakrun J., An interdisciplinary model and resources for culturally competent service learning in Aboriginal Community Controlled Organisations, National Centre for Cultural Competence (current research project funded by Office of Learning and Teaching grant).

Page reviewed: 30 August, 2018