A community-based co-designed genetic health service model for Aboriginal Australians

Elsum, Imogen, Massey, Libby, McEwan, Callum, LaGrappe, Desiree, Kowal, Emma, Savarirayan, Ravi, Baynam, Gareth, Jenkins, Misty, Garvey, Gail, and Kelaher, Margaret (2020) A community-based co-designed genetic health service model for Aboriginal Australians. PLoS ONE, 15. e0239765.

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Abstract

Background: Aboriginal and Torres Strait Islander people experience a greater burden of disease and die younger than non-Indigenous Australians, with Aboriginal people living in remote areas of the Northern Territory of Australia having the lowest life expectancy estimates. Despite a high burden of chronic disease among Aboriginal and Torres Strait Islander people, access to specialist health services remains low and models of care that increase engagement, may improve health outcomes.

Methods: We describe client and staff perspectives of a model of clinical genetics services provided by the MJD Foundation (MJDF) in geographically and culturally complex contexts within the Northern Territory of Australia. We seek to understand the MJDF model’s success in supporting Aboriginal families with the familial, neurodegenerative condition Machado-Joseph disease and how it could be applied in the provision of other specialist services. Thematic analysis was undertaken on semi-structured interviews with primary health care staff (n = 2), Non-Aboriginal MJDF Staff (n = 7) and Aboriginal MJDF Clients / Community workers (n = 13).

Results: Four key themes regarding the MJDF model of service delivery were identified with the service being; 1) client led 2) accepting of various understandings of genetic disease causation 3) focused on relationships, continuity and trust between the service provider and the clients, and 4) committed to incorporating an inclusive whole-of-family practice. The MJDF model takes a community-based, person-and family-centred approach to successfully deliver effective specialist genetic health services in remote community settings. We propose that these approaches have broad application in the future design and delivery of specialist health services particularly in culturally complex settings.

Item ID: 66700
Item Type: Article (Research - C1)
ISSN: 1932-6203
Copyright Information: © 2020 Elsum et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funders: Lowitja Institute (LI), National Health and Medical Research Council (NHMRC)
Projects and Grants: LI Project Code: 1364, NHMRC 1114437
Date Deposited: 27 Apr 2021 01:33
FoR Codes: 45 INDIGENOUS STUDIES > 4504 Aboriginal and Torres Strait Islander health and wellbeing > 450499 Aboriginal and Torres Strait Islander health and wellbeing not elsewhere classified @ 100%
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