Falls are now the second most common cause of injury for all Aboriginal and Torres Strait Islander people in Australia
Recovery post fall with serious injury (fractured neck of femur, head injury etc.) does require ongoing care and therapy to optimise functional outcome and quality of life. Rehabilitation and Allied Health services in the Australian general population have been reported to be too inflexible and difficult to access.
Indigenous people report often when trying to access mainstream healthcare of discrimination, judgment and communication problems.
When targeting aboriginal people for health promotion programs there are seven key elements which have been identified by indigenous communities as necessary if it will be accessed and be effective.
A very consistent message is the need for the Health Programs to be indigenous specific. A lot of falls data is general populationwhich has different demographics to ATSI population. Having the ability to modify the program to incorporate community specific variances that is important for that community.
Kinship is a deep sense of family and community and is very strong amongst indigenous population. In communities everyone knows everyone and their family line. Self-determination is also strong in many communities. Preference is for an organisations/groups within the community to deliver any new program. Feeling safe to share their story and how they feel in a friendly environment is important for participants to interact.
No age limit
Along with Kinship is a need for the programs to have no age limit. That way children, carers and partners and family are welcome to attend. Family is not like family as in immediate family. Indigenous family is the community and a concept that whole of the local community is family.
Having a program that is of a longer duration so participants can drop out of and back in is required for any health promotion program. Things come up that prevents attending such as sickness, family reasons, and community responsibilities and the needs of country.
This six weeks or this eight weeks thing, it’s just no good for the Koori [Aboriginal] community because people get sick
You can’t offer Koori communities short term fixes because it doesn’t fix anything
Telling a yarn and sharing stories is the foundation of how Aboriginals interact with each other, as a community and the broader Australian community. Kinship is strong. Group based programs rather than one on one programs work best within this framework.
Low to no cost
Again the sharing of resources includes sharing of money. Health is high priority for the government and governmental agencies however for indigenous health is down low in their priorities. Indigenous communities are some of the poorest communities in Australia in terms of money. Preferably no cost programs are required to get people in and engaged.
Consideration for transport is also an important element which is also related to socio economic reasons. Even if people have a form of transport such as a car it may not be available due to sharing the car with family. Incorporating free transport into the program will remove a probable barrier and encourage greater participation.
Health programs specifically Falls Prevention require modification if wanting to deliver such programs within indigenous communities. Designing the program to be indigenous specific in a group setting factoring in low.no cost and transport is important. Opening the program up to all ages and deliver over a longer period allowing for drop out and in will be more effective with aboriginal communities. Aboriginal communities are best to deliver such programs from already established groups within the community. Underlying all these key elements are the principles of kinship, country and family.
- Lukaszyk C, Coombes J, Turner N J, Hillmann E, Keay L, Tiedemann A, Sherrington C & Ivers R (2018) Yarning about fall prevention: community consultation to discuss falls and appropriate approaches to fall prevention with older Aboriginal and Torres Strait Islander people BMC Public Health 18:77 DOI 10.1186/s12889-017-4628-6
- Australian Government Department of Health (2013) National Aboriginal And Torres Strait Islander Health Plan 2013-2023 Retrieved from health.gov.au ISBN: 978-1-74241-979-4
- Government of Western Australia Department of Health (2010) Falls Prevention for Aboriginal People A tool for Aboriginal Health workers and Aboriginal communities Retrieved from stayonyourfeet.com.au