University Centre for Rural Health and the Menzies Centre for Health Policy. The two programmes we delivered aimed to promote wellness and reduce the prevalence of obesity and its associated chronic conditions (e.g. The enormous reliance on one person raises concerns about the appropriateness and sustainability of the current model as-is, while also underscoring the amount of workplace pressure placed on Aboriginal people to deliver outcomes in potentially unsupportive institutional environments. Ideally, large programmes involving multiple, geographically dispersed CHPs would be resourced sufficiently to reflect the demands on the time and the range of duties such roles often require and, therefore, to support multiple SAPOs as warranted. Once selected, the financial outlay required to navigate the employment process and fulfil its requirements can be formidable. Finally, CHPs tailored messaging to make content culturally appropriate, thereby improving the relevance of the programme in the local context. Education resources in remote Australian Indigenous community dog health programs: a comparison of community and extra-community-produced resources. including health services, Aboriginal communities, families, individuals and organisations working in partnership. (, Ingram M., Chang J., Kunz S., Piper R., de Zapien J. G., Strawder K. (, Israel B. Shifting decision making to Aboriginal communities will require that non-Aboriginal professionals take a ‘backseat’ role, respect cultural differences and ways of doing things, be innovative, flexible and responsive in their approach, and support the CHPs in a discrete and collaborative manner. For individuals under financial stress, such expenses can prohibit them from completing the employment process and illustrate how institutional barriers impede the employment of vulnerable people (Ferdinand et al., 2014). Maori CHWs play a similar bridging role in New Zealand by linking community members with health interventions and clinical services, providing health education and also working alongside traditional healers and supporting tribal development (Boulton et al., 2009). Furthermore, the CHPs themselves have benefitted in several ways. We successfully addressed these barriers by working closely with the programme’s commissioning institution, conducting additional reference checks (in the case of prior convictions) and supporting CHPs to navigate, complete and submit paperwork for employment. The activities of the CHW reflected both ‘educator’ and ‘change agent’ roles, a combination that exemplifies the aims of health promotion. Senior staff, including the SAPO and more experienced CHPs, also worked with new CHPs before and after training to establish expectations, build self-confidence and follow-up with additional information to assist them to integrate and apply content learning from the State training into their local settings. Our aim is to put forward an argument in support of action and research that exposes and addresses ongoing structural barriers to Indigenous community involvement in health promotion and health initiatives in Australian and beyond. Strength training in community settings: impact of lay leaders on program access and sustainability for rural older adults, Primary Health Care. It is primarily within ACCHO-developed community programmes that other types of CHW roles and models for their delivery have been implemented, for example, lay-leader or peer-to-peer education models (McPhail-Bell et al., 2017). This experience came about from our 12 years of implementing two government-funded and prioritized healthy lifestyle behavioural and educational and research programmes to communities with large Aboriginal populations (Gwynn et al., 2014). However, combatting systemic racism and reorienting the institutions of the dominant non-Aboriginal culture—i.e. Information about NSW public education, including the school finder, high school enrolment, school safety, selective schools and opportunity classes. (, National Congress of Australia’s First Peoples.
Employing individuals with both limited employment experience and educational qualifications (some CHPs had not completed secondary school) was novel for the funding bodies of our programmes and presented challenges when setting up recruitment and hiring processes. Provide clear and supported pathways for to further education and professional development should CHPs be interested in pursuing such opportunities, but further education should not be a requirement to participation. First, AHWs are often (but not always) employed through a medical service (e.g. (, National Aboriginal and Torres Strait Islander Health Worker Association. The opening quote of this paper draws attention to this often-contested issue.
(p55). Targeted at upskilling programme deliverers from across the State, most of whom were health promotion professionals, this training was not designed to fit the needs of Aboriginal CHPs. (, Kane S., Kok M., Ormel H., Otiso L., Sidat M., Namakhoma I. et al.
These may include similar cultural, linguistic or demographic characteristics; health conditions or needs; shared experiences or simply living in the same area. One of the three elements of the Package was workforce expansion and included an entry-level Aboriginal Outreach Worker role. Following the British invasion and subsequent colonization of Australia, Aboriginal people across the nation suffered a sudden and complete rupture to all aspects of life including kinship, language, spirituality and culture.
Develop opportunities for ongoing skill and capacity building within Aboriginal CHP programmes. Syntheses of literature on CHWs illustrate that the tasks they undertake are highly varied but often inadequately or inconsistently defined (Jaskiewicz and Tulenko, 2012; Kim et al., 2016). From working in or operating an early childhood education centre, complaints and feedback, information for parents & carers to news. Emerging research suggests a network of social support is preferable to one-way mentoring relationships typically found in workplace mentoring programmes (Bainbridge et al., 2014). Increase the capacity of Aboriginal Health Promotion Officers in community controlled Aboriginal and Torres Strait Islander health organisations and government health services to promote nutrition and physical activity. For example, the lack of progress on key strategies such as Closing the Gap is indicative of the need for a new organizational framework of service delivery and employment. Through this work, we identified a need for a CHW role distinct from that of an AHW given the contextual and theoretical factors underlying the content and settings in which the programmes were delivered. Closing the Gap is a commitment by all Australian governments to improve the lives of Aboriginal and/or Torres Strait Islander peoples. We draw on the global literature to illustrate the need for an Aboriginal CHW role in health promotion; one that is distinct from, but complementary to, that of AHWs in clinical settings. Previous research (Kane et al., 2016) also showed that the experience of having been a CHP increased an individual’s employment opportunities; improved their own, their families and their community’s knowledge and health literacy and has a consequent impact on the health behaviours of community members. AHWs also experience barriers similar to those described here, including difficulties in accessing training, lack of role clarity, poor recognition of their value and insufficient support (Gwynne and Lincoln, 2016; Schmidt et al., 2016). In the spirit of this recommendation, we now shift to describing our experience of implementing one such potential health promotion programme model in which we employed local Aboriginal community members. BACKGROUND: Conducting effective and culturally sensitive dog health education programs in Aboriginal communities requires an understanding of appropriate adult education and community development principles.
Communicable diseases in rural and remote Australia: the need for improved understanding and action. The difficulties we encountered in setting up and running health promotion programmes delivered by CHPs illustrate how organizational practices, procedures, policies and infrastructure sustain racial inequalities (Ferdinand et al., 2014; Schmidt et al., 2016).
This is particularly important in small communities where people may feel singled-out if included or overlooked if excluded.
The resulting evaluation, however, found this role was conceptualized differently across settings resulting in inflated role expectations and, therefore, problems in establishing appropriate training and supervision systems (Bailie et al., 2013). The impetus for writing this paper came from the experiences of two of the authors (NT and JG), an Aboriginal and a non-Aboriginal woman, who have worked in partnership for more than 15 years delivering and evaluating health promotion programmes in Australia. The CHPs delivered programmes in school settings to both Aboriginal and non-Aboriginal children. As Avery and Fernandez (Avery and Fernandez, 2012) pertinently discuss, the terms by which CHWs are classified are not simply semantics; they carry important implications about the work performed, the training needs for each role, how CHWs should be recruited for particular roles, and how their success will be measured. A key quality of the mentoring approach was to provide clear, focused, non-paternalistic and tailored direction to support the development of social and practical job skills among CHPs in a manner that reduces anxiety and shame and increases self-confidence. For some, more usually Aboriginal men than women, convictions for prior and often minor offences committed at a young age further complicated the criminal background check, a requirement for such positions. The result is that some AHWs experience inflated role expectations that can contribute to unmanageable workloads and stress, reduced job satisfaction, and barriers to integration with other members of the health workforce (Bailie et al., 2013; Schmidt et al., 2016). This variation is problematic as it impedes research into how CHWs influence health outcomes. communication for pregnant Aboriginal women, their families and health care workers. And while most bring cultural and community knowledge to the role, many CHWs have little or no training in Western medicine or in navigating its health systems prior to becoming CHWs (Olaniran et al., 2017).
A ‘companion’, for example, could provide social support and friendship to an infirm neighbour simply by drawing on shared cultural values or experiences, so may or may not require training and/or affiliation with an organized programme. This paper came about when NT and JG shared with KC the barriers they experienced developing a non-AHW type position in the context of the programmes described herein. Their families also benefitted from the CHPs applying their knowledge about nutrition and physical activity at home. Closing gaps in disparities, requires new ways of thinking and acting and, therefore, a firm commitment to ensuring that health-promoting policies and programmes are culturally relevant and meaningful.
Employing individuals with both limited employment experience and educational qualifications (some CHPs had not completed secondary school) was novel for the funding bodies of our programmes and presented challenges when setting up recruitment and hiring processes. Provide clear and supported pathways for to further education and professional development should CHPs be interested in pursuing such opportunities, but further education should not be a requirement to participation. First, AHWs are often (but not always) employed through a medical service (e.g. (, National Aboriginal and Torres Strait Islander Health Worker Association. The opening quote of this paper draws attention to this often-contested issue.
(p55). Targeted at upskilling programme deliverers from across the State, most of whom were health promotion professionals, this training was not designed to fit the needs of Aboriginal CHPs. (, Kane S., Kok M., Ormel H., Otiso L., Sidat M., Namakhoma I. et al.
These may include similar cultural, linguistic or demographic characteristics; health conditions or needs; shared experiences or simply living in the same area. One of the three elements of the Package was workforce expansion and included an entry-level Aboriginal Outreach Worker role. Following the British invasion and subsequent colonization of Australia, Aboriginal people across the nation suffered a sudden and complete rupture to all aspects of life including kinship, language, spirituality and culture.
Develop opportunities for ongoing skill and capacity building within Aboriginal CHP programmes. Syntheses of literature on CHWs illustrate that the tasks they undertake are highly varied but often inadequately or inconsistently defined (Jaskiewicz and Tulenko, 2012; Kim et al., 2016). From working in or operating an early childhood education centre, complaints and feedback, information for parents & carers to news. Emerging research suggests a network of social support is preferable to one-way mentoring relationships typically found in workplace mentoring programmes (Bainbridge et al., 2014). Increase the capacity of Aboriginal Health Promotion Officers in community controlled Aboriginal and Torres Strait Islander health organisations and government health services to promote nutrition and physical activity. For example, the lack of progress on key strategies such as Closing the Gap is indicative of the need for a new organizational framework of service delivery and employment. Through this work, we identified a need for a CHW role distinct from that of an AHW given the contextual and theoretical factors underlying the content and settings in which the programmes were delivered. Closing the Gap is a commitment by all Australian governments to improve the lives of Aboriginal and/or Torres Strait Islander peoples. We draw on the global literature to illustrate the need for an Aboriginal CHW role in health promotion; one that is distinct from, but complementary to, that of AHWs in clinical settings. Previous research (Kane et al., 2016) also showed that the experience of having been a CHP increased an individual’s employment opportunities; improved their own, their families and their community’s knowledge and health literacy and has a consequent impact on the health behaviours of community members. AHWs also experience barriers similar to those described here, including difficulties in accessing training, lack of role clarity, poor recognition of their value and insufficient support (Gwynne and Lincoln, 2016; Schmidt et al., 2016). In the spirit of this recommendation, we now shift to describing our experience of implementing one such potential health promotion programme model in which we employed local Aboriginal community members. BACKGROUND: Conducting effective and culturally sensitive dog health education programs in Aboriginal communities requires an understanding of appropriate adult education and community development principles.
Communicable diseases in rural and remote Australia: the need for improved understanding and action. The difficulties we encountered in setting up and running health promotion programmes delivered by CHPs illustrate how organizational practices, procedures, policies and infrastructure sustain racial inequalities (Ferdinand et al., 2014; Schmidt et al., 2016).
This is particularly important in small communities where people may feel singled-out if included or overlooked if excluded.
The resulting evaluation, however, found this role was conceptualized differently across settings resulting in inflated role expectations and, therefore, problems in establishing appropriate training and supervision systems (Bailie et al., 2013). The impetus for writing this paper came from the experiences of two of the authors (NT and JG), an Aboriginal and a non-Aboriginal woman, who have worked in partnership for more than 15 years delivering and evaluating health promotion programmes in Australia. The CHPs delivered programmes in school settings to both Aboriginal and non-Aboriginal children. As Avery and Fernandez (Avery and Fernandez, 2012) pertinently discuss, the terms by which CHWs are classified are not simply semantics; they carry important implications about the work performed, the training needs for each role, how CHWs should be recruited for particular roles, and how their success will be measured. A key quality of the mentoring approach was to provide clear, focused, non-paternalistic and tailored direction to support the development of social and practical job skills among CHPs in a manner that reduces anxiety and shame and increases self-confidence. For some, more usually Aboriginal men than women, convictions for prior and often minor offences committed at a young age further complicated the criminal background check, a requirement for such positions. The result is that some AHWs experience inflated role expectations that can contribute to unmanageable workloads and stress, reduced job satisfaction, and barriers to integration with other members of the health workforce (Bailie et al., 2013; Schmidt et al., 2016). This variation is problematic as it impedes research into how CHWs influence health outcomes. communication for pregnant Aboriginal women, their families and health care workers. And while most bring cultural and community knowledge to the role, many CHWs have little or no training in Western medicine or in navigating its health systems prior to becoming CHWs (Olaniran et al., 2017).
A ‘companion’, for example, could provide social support and friendship to an infirm neighbour simply by drawing on shared cultural values or experiences, so may or may not require training and/or affiliation with an organized programme. This paper came about when NT and JG shared with KC the barriers they experienced developing a non-AHW type position in the context of the programmes described herein. Their families also benefitted from the CHPs applying their knowledge about nutrition and physical activity at home. Closing gaps in disparities, requires new ways of thinking and acting and, therefore, a firm commitment to ensuring that health-promoting policies and programmes are culturally relevant and meaningful.