Successful chronic disease care for Aboriginal Australians requires cultural competence
Article first published online: 31 MAY 2011
© 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia
Australian and New Zealand Journal of Public Health
Volume 35, Issue 3, pages 238–248, June 2011
How to Cite
Liaw, S. T., Lau, P., Pyett, P., Furler, J., Burchill, M., Rowley, K. and Kelaher, M. (2011), Successful chronic disease care for Aboriginal Australians requires cultural competence. Australian and New Zealand Journal of Public Health, 35: 238–248. doi: 10.1111/j.1753-6405.2011.00701.x
- Issue published online: 31 MAY 2011
- Article first published online: 31 MAY 2011
- Submitted: June 2010 Revision requested: August 2010 Accepted: December 2010
- primary healthcare;
- family practice;
- health services;
- cultural competency;
- diabetes mellitus
Objective: To review the literature to determine the attributes of culturally appropriate healthcare to inform the design of chronic disease management (CDM) models for Aboriginal patients in urban general practice.
Methods: A comprehensive conceptual framework, drawing on the Access to Care, Pathway to Care, Chronic Care, Level of Connectedness, and Cultural Security, Cultural Competency and Cultural Respect models, was developed to define the search strategy, inclusion criteria and appraisal methods for the literature review. Selected papers were reviewed in detail if they examined a chronic disease intervention for an Aboriginal population and reported on its evaluation, impacts or outcomes.
Results: In the 173 papers examined, only 11 programs met the inclusion criteria. All were programs conducted in rural and remote Aboriginal community-controlled health services. Successful chronic disease care and interventions require adequate Aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems. These success factors fitted within the conceptual framework developed.
Conclusions: Research and development of culturally appropriate CDM models concurrently in both urban and rural settings will enable more rigorous evaluation, leading to stronger evidence for best practice. A partnership of mainstream and Aboriginal-controlled health services is essential to successfully ‘close the gap’.
Implications: Findings will inform and guide the development, implementation and evaluation of culturally appropriate CDM in mainstream general practice and primary care.