Field, Patricia, Franklin, Richard C., Barker, Ruth, Ring, Ian, Leggat, Peter, and Canuto, Karla (2023) Commentary: Improving access to cardiac rehabilitation (Heart: Road for health) for Aboriginal and Torres Strait Islander peoples in rural and remote areas of North Queensland. Australian Journal of Rural Health, 31 (1). pp. 152-158.

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Abstract

Aims: To focus on the needs, challenges and opportunities to improve access to cardiac rehabilitation (CR) (Heart: Road to health [HRH]) for Aboriginal and Torres Strait Islander peoples in rural and remote (R&R) areas of North Queensland.

Context: It is known that there is insufficient access to HRH for Aboriginal and Torres Strait Islander peoples in R&R areas of NQ, who have the highest rates of heart disease and socioeconomic disadvantage mainly due to poor social determinants of health. However, at least in part due to the impact of colonialism and predominantly western medicalised approach to health care, few gains have been made.

Approach: This commentary draws on recent research and literature and reflects on cultural issues that impact on improving access to an HRH for Aboriginal and Torres Strait Islander peoples in R&R areas. The underutilisation of the skills of Aboriginal and Torres Strait Islander Health Workers (ATSIHW) and a lack of a defined process to ensure access to culturally responsive HRH are discussed. Finally, a way forward is proposed that includes the development of policies, pathways and guidelines to ensure that appropriate support is available in the client's home community.

Conclusion: It is proposed that culturally responsive, accessible and effective HRH is achievable through the reorientation of current health systems that include a continuous client-centred pathway from hospital to home. In this model, ATSIHW will take a lead or partnership role in which their clinical, cultural brokerage and health promotion skills are fully utilised.

Item ID:	76300
Item Type:	Article (Commentary)
ISSN:	1440-1584
Keywords:	Aboriginal Health; access issues; community based rehabilitation; communication; policy
Copyright Information:	© 2022 The Authors. Australian Journal of Rural Health published by John Wiley & Sons Australia, Ltd on behalf of National Rural Health Alliance Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Funders:	Tropical Australian Academic Health Centre (TAAHC)
Date Deposited:	23 Nov 2023 03:04
FoR Codes:	42 HEALTH SCIENCES > 4203 Health services and systems > 420321 Rural and remote health services @ 100%
SEO Codes:	21 INDIGENOUS > 2103 Aboriginal and Torres Strait Islander health > 210303 Aboriginal and Torres Strait Islander health system performance @ 100%
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