Mitigating the impacts of racism on Indigenous wellbeing through human rights, legislative and health policy reform

Dudgeon, Patricia; Bray, Abigail; Walker, Roz

doi:10.5694/mja2.51862

Cited by 11 publications

(6 citation statements)

References 11 publications

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“…This evaluation of a pilot training program provides preliminary evidence of beneficial impact of cultural safety training. This fills an important gap highlighted in previous literature regarding the lack of evidence of impact of cultural safety training [ 1 , 30 , 71 ]. By listening to the Specialist counterstories, which challenged the deficit narrative by offering alternative perspectives which have been silenced by colonisers [ 72 , 73 ], staff identified and critically reflected on the Eurocentric beliefs and practices that dominate healthcare.…”

Section: Discussionmentioning

confidence: 69%

“…In Australia, First Nations peoples report feeling culturally unsafe in hospitals [ 9 , 22 – 26 ]. Patients’ experiences of racism have contributed to high self-discharge rates, high levels of psychological distress, low rates of kidney transplantation, amputations without consent, and death [ 11 , 25 , 27 – 30 ]. Culturally unsafe care also contributes to healthcare providers experiencing burnout and professional dissatisfaction resulting in high staff turnover [ 31 , 32 ].…”

mentioning

confidence: 99%

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Evaluating the impact of ‘Ask the Specialist Plus’: a training program for improving cultural safety and communication in hospital-based healthcare

Kerrigan,

McGrath,

Doig

et al. 2024

BMC Health Serv Res

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Background First Nations peoples in colonised countries often feel culturally unsafe in hospitals, leading to high self-discharge rates, psychological distress and premature death. To address racism in healthcare, institutions have promised to deliver cultural safety training but there is limited evidence on how to teach cultural safety. To that end, we created Ask the Specialist Plus: a training program that focuses on improving healthcare providers intercultural communication skills to improve cultural safety. Our aim is to describe training implementation and to evaluate the training according to participants. Methods Inspired by cultural safety, Critical Race Theory and Freirean pedagogy, Ask the Specialist Plus was piloted at Royal Darwin Hospital in Australia’s Northern Territory in 2021. The format combined listening to an episode of a podcast called Ask the Specialist with weekly, one-hour face-to-face discussions with First Nations Specialists outside the clinical environment over 7 to 8 weeks. Weekly surveys evaluated teaching domains using five-point Likert scales and via free text comments. Quantitative data were collated in Excel and comments were collated in NVivo12. Results were presented following Kirkpatrick’s evaluation model. Results Fifteen sessions of Ask the Specialist Plus training were delivered. 90% of participants found the training valuable. Attendees enjoyed the unique format including use of the podcast as a catalyst for discussions. Delivery over two months allowed for flexibility to accommodate clinical demands and shift work. Students through to senior staff learnt new skills, discussed institutionally racist systems and committed to behaviour change. Considering racism is commonly denied in healthcare, the receptiveness of staff to discussing racism was noteworthy. The pilot also contributed to evidence that cultural safety should be co-taught by educators who represent racial and gender differences. Conclusion The Ask the Specialist Plus training program provides an effective model for cultural safety training with high potential to achieve behaviour change among diverse healthcare providers. The training provided practical information on how to improve communication and fostered critical consciousness among healthcare providers. The program demonstrated that training delivered weekly over two months to clinical departments can lead to positive changes through cycles of learning, action, and reflection.

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Section: Discussionmentioning

confidence: 69%

mentioning

confidence: 99%

Evaluating the impact of ‘Ask the Specialist Plus’: a training program for improving cultural safety and communication in hospital-based healthcare

Kerrigan,

McGrath,

Doig

et al. 2024

BMC Health Serv Res

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“…For example, since 2012 one of us (PD) has directed a nationwide Indigenous relational self-care intervention called the National Empowerment Project. 4 7…”

Section: Cultural Reclamationmentioning

confidence: 99%

“…Indigenous Australians have long recognised that the health of the land and people are entangled and many Indigenous relational self-care interventions in Australia are centred on strengthening cultural and spiritual connections to Country. 4 This includes learning Indigenous languages, traditional land management practices and food gathering, and practising cultural activities that strengthen people’s stewardship relationships with Country. 5 Indeed, culturally specific self-care practices that are aligned to cultural values are important to Indigenous people.…”

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confidence: 99%

Rethinking self-care through an Indigenous lens—the importance of community

Dudgeon,

Carlin,

Bray

2023

BMJ

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“…Racism and discrimination are fundamental determinants of health 9 . As highlighted by Pat Dudgeon and colleagues in the MJA in March this year, systemic racism — a legacy of colonisation — within and beyond the Australian health system remains prevalent and affects health directly: “Indigenous social and emotional wellbeing, and mental and physical health have been adversely affected by over 200 years of institutional, cultural and interpersonal racism.” 10 …”

mentioning

confidence: 99%

The MJA supports an Aboriginal and Torres Strait Islander Voice to Parliament

Barbour

2023

Medical Journal of Australia

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e are at a time when there have never been better opportunities to translate health policies, practices and medical research into improvements for Aboriginal and Torres Strait Islander health. Critical to these efforts is a health and research system -including in the publishing sectorthat recognises the importance of Indigenous leadership in producing and implementing health care and research in order to magnify research benefits across the communities it serves. 1 However, as noted by Michelle Kennedy and Janine Mohamed from the Lowitja Institute, research requires appropriate Aboriginal and Torres Strait Islander ethical governance: "All research involving Aboriginal and Torres Strait Islander peoples should be deemed safe and respectful by Aboriginal and Torres Strait Islander peoples." 2The health outcomes in Aboriginal and Torres Strait Islander populations during the COVID-19 pandemic provide an outstanding example of how outcomes are best when Aboriginal people have a voice. Aboriginal Community Controlled Health Organisations coordinated the response from the National Aboriginal Community Controlled Health Organisation down to remote communities. As a result, the health gap was reversed in the first year of the pandemic, with Aboriginal and Torres Strait Islander populations experiencing six times fewer cases than the non-Indigenous population, and no recorded deaths. 3,4 It is notable that research in New Zealand has included Māori ethical frameworks for over 30 years, 5 which has strengthened the design and the implementability of medical research.

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Mitigating the impacts of racism on Indigenous wellbeing through human rights, legislative and health policy reform

Cited by 11 publications

References 11 publications

Evaluating the impact of ‘Ask the Specialist Plus’: a training program for improving cultural safety and communication in hospital-based healthcare

Evaluating the impact of ‘Ask the Specialist Plus’: a training program for improving cultural safety and communication in hospital-based healthcare

Rethinking self-care through an Indigenous lens—the importance of community

The MJA supports an Aboriginal and Torres Strait Islander Voice to Parliament

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