National Guide to a preventive health assessment in Aboriginal and Torres Strait Islander peoples
Couzos, Sophia, and Chronic Disease Alliance, Consultants (2005) National Guide to a preventive health assessment in Aboriginal and Torres Strait Islander peoples. Manual. The Royal Australia College of General Practitioners, Melbourne, VIC, Australia.
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Abstract
The National guide to a preventive health assessment in Aboriginal and Torres Strait Islander peoples (National guide) is an initiative of the National Aboriginal Community Controlled Health Organisation (NACCHO), lead agency of the Chronic Disease Alliance of Non- Government Organisations. The Royal Australian College of General Practitioners (RACGP) supported the development of the guide. The National guide is intended for all health professionals delivering primary health care to the Aboriginal and Torres Strait Islander population. This includes general practitioners (GPs), Aboriginal health workers, nurses and those specialists with a role in deliveringprimary health care. The National guide package consists of: The National guide • Recommendations compiled from the review of the Evidence base • Child and adult preventive health life cycle summaries.
The Chronic Disease Alliance determined that recommendations in the National guide should be based on a review of the evidence, seeking where possible existing systematic reviews addressing questions related to preventive health care, expert opinion and consensus statements of relevance to the Aboriginal and Torres Strait Islander population. The Evidence base documents the research literature used to form the National guide and can be accessed on the RACGP website at: www.racgp.org.au and on the NACCHO website at: www.naccho.org.au. Users of this guide are encouraged to access this Evidence base for more information. Health care providers (particularly in regional and remote areas) are also encouraged to refer to local guidelines (where they are appropriate and available) in order to optimise preventive health assessments. Many of the recommendations in the National guide describe health problems that may be of concern only in certain regional areas. For example, trichiasis screening is not appropriate in Victoria except when an elderly Aboriginal person from northern Australia is assessed. Consequently, many recommendations highlight the importance of clinical discretion in decision making. The National guide makes specific recommendations regarding the elements of a preventive health assessment in the non-pregnant adult Aboriginal and Torres Strait Islander population as well as children. The aim is to provide a national evidence based resource that can inform health care providers and policy makers on a defined set of activities that are of particular relevance to this population, or that are different from those for the non-Indigenous population. These activities may prevent disease, detect early and unrecognised disease, and promote health in the Aboriginal and Torres Strait Islander population while allowing for variations based on regional and local circumstances. General practitioners should use the recommendations to enhance the clinical care that they provide to their Aboriginal and Torres Strait Islander clients.
The National guide aims to complement the RACGP Guidelines for preventive activities in general practice (known as the ‘red book’) by dealing with health issues that are specific to the Aboriginal and TorresStrait Islander population. The chosen subject areas represent key health issues that are amenable to primary health care intervention and contribute to morbidity and mortality in the Aboriginal and Torres Strait Islander population. Where issues common in the general Australian population have not been dealt with in this guide (eg. osteoporosis), GPs are encouraged to cross reference with the ‘red book’ which is available on the RACGP website at: www.racgp.org.au/document.asp?id=4169. To assist health care providers, the Evidence base used to form the National guide provides a summary of recommendations from the ‘red book’ and from other groups, such as the Central Australian Rural Practitioners Association and the Northern Zone Management Unit of Queensland Health in north Queensland. The authors have presented the information in this guide so that it can apply to both Aboriginal and Torres Strait Islander peoples. It is recognised that, while the health of Torres Strait Islanders is very similar to the Aboriginal population, they represent a distinct Indigenous Australian population. Health care providers should use the National guide to systematically appraise current preventive practice, especially where recommendations for the general population have previously been applied to Aboriginal and Torres Strait Islander clients. Providers may also benefit by appraising certain screening activities for which there is little evidence. These activities may draw resources away from other activities to improve the health of the Aboriginal and Torres Strait Islander population, eg. risk factor modification and immunisation programs. General practitioners may undertake preventive health assessment activities as part of their normal consultations. Medicare benefits are payable for a medical examination or test on a symptomless patient by that patient’s own medical practitioner in the course of normal medical practice, to ensure the patient receives any medical advice or treatment necessary to maintain his or her state of health.
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