Stewart, Jacqueline Maree (2010) Growing an evidence base for an Indigenous Australian model of social health care. Masters (Research) thesis, James Cook University.

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Abstract

To create a future characterised by improved, sustained social and emotional wellbeing for Aboriginal and Torres Strait Islander Australians practitioners and policy makers require evidence – evidence of how programmes work (or do not work), for whom they work and in what circumstance this is the case. This thesis tells the story of a research study undertaken in partnership with an Aboriginal and Torres Strait Islander community controlled health organisation, namely the Wuchopperen Health Service, to grow such an evidence base for their social health programmes. The study is a direct response to a need for research as identified by representatives of Wuchopperen. Its significance also stems from the paucity of systematic research that explores what works to address the disparities in the social and health status between Aboriginal and Torres Strait Islander Australians and the rest of the Australian population.

Informed by the principles of theory-based evaluation, the study investigated the conceptualisation and design of Wuchopperen's social health programmes. The qualitative investigation proceeded in three phases. In phase one document analysis, interviews and field research were completed in order to gather rich descriptions of the history and current day operations of the programmes. A preliminary analysis of these descriptions revealed a rudimentary outline of the key activities implemented across all programmes to achieve desired results. In phase two a workshop was organised to augment this basic plan. It focused not only on what was done, but also on how these activities or strategies were perceived by the programme staff as positively contributing to intended results. A thematic analysis of the entire data corpus was carried out to pinpoint prevalent patterns in beliefs or assumptions about how and why programmes functioned as they do. The results of this analysis were assembled into a model that reveals the approach to social health care as specific to Wuchopperen. In phase three, this model of social health care was assessed in light of existing evidence and documented practice experience on what works to enhance the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples.

Wuchopperen's model of social health care incorporates a complex interplay of factors. At its core is the primary goal of promoting coping and resilience. To accomplish this goal, the team simultaneously implements five key strategies: personalising support, responding to community priorities, integrating culture into programme delivery, advocating for system level change and exercising professionalism. All of these strategies are executed within an operational environment that presents both constraints and opportunities.

Strong support for Wuchopperen's model of social health care was found in existing research as well as in documented practice experience. In keeping with Wuchopperen's experience, many writers reinforced the worth of care that is tailored according to the unique needs and circumstances of Aboriginal and Torres Strait Islander Australians. Similarly, authors backed the significance that the Wuchopperen team places on integrating Aboriginal and Torres Strait Islander culture into programme delivery. For all this support there were also areas where Wuchopperen's approach extended current thinking. An emerging theme in the literature relates to the need for service providers to heighten their advocacy work given the many structural barriers to wellbeing. The Social Health experience provides insight into how this can be done. Furthermore, the model provided a unique opportunity to grant a voice to Aboriginal and Torres Strait Islander practitioners regarding the principles and practices that represent professional conduct in social health care.

This study contributes to the evidence base on effective social health care for both Wuchopperen and the broader health care profession. By undertaking this study Wuchopperen has increased their understanding of the capacity of their model of social health to deliver desired results for Aboriginal and Torres Strait Islander individuals, families and communities. Equally, in committing the documentation and critical analysis of this model Wuchopperen have provided a framework that other practitioners and researchers can draw on when considering how and why to deliver social health care with and for Aboriginal and Torres Strait Islander Australians.

Item ID:	39165
Item Type:	Thesis (Masters (Research))
Keywords:	Aboriginal people; Cairns; community control; First Australians; health care; healthcare; Indigenous Australians; North Queensland; social health; social wellness; Torres Strait Islanders; wellbeing; well-being; Wuchopperen Health Service
Copyright Information:	Copyright © 2010 Jacqueline Maree Stewart
Date Deposited:	05 Aug 2015 23:28
FoR Codes:	11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 100%
SEO Codes:	92 HEALTH > 9203 Indigenous Health > 920303 Aboriginal and Torres Strait Islander Health - Health System Performance (incl. Effectiveness of Interventions) @ 100%
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