Wakerman, John, Chalmers, Elisabeth, Humphreys, John S., Clarence, Christine L., Bell, Andrew I., Larson, Ann, Lyle, David, and Pashen, Dennis R. (2005) Sustainable chronic disease management in remote Australia. Medical Journal of Australia, 183 (10). pp. 64-68.

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Abstract

The Sharing Health Care Initiative (SHCI) is part of the Australian Government’s Enhanced Primary Care Package for older Australians and people with chronic and complex health conditions. The initiative aims to improve health service management and quality of life for people with chronic diseases.1 Between 2002 and 2004, the Australian Government Department of Health and Ageing funded eight such demonstration projects.

The Katherine West Health Board is an Aboriginal-community-controlled health organisation which trialled a model of self-care under the SCHI scheme in a context of high chronic disease prevalence among Indigenous people2 and successful self-management approaches in other populations.3 The project was implemented between April 2002 and June 2004 in four remote communities. The remote communities are situated between 420 km and 570 km from the town of Katherine, the regional centre (Box 1), and had a total population of 1937. The project used an “action research methodology . . . based on a community development model” as a response to the complex remote environment.4,5

The project included strategies to improve self-management by individuals and their families, and also aimed to encourage adaptive changes within existing health services. The project involved employing a male and female local Aboriginal Community Support Worker in each community; training these Support Workers and other Katherine West Health Board staff and board members in chronic disease self-management; community-based health promotion activities; and producing local resources (such as project information pamphlets and videos introducing the project and explaining self-management principles and practices) in local languages. The project included an evaluation which examined the process, impact and outcomes of the project.6-8

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