Addressing health inequities using cultural responsiveness in a student-implemented remote area health service

Background and Objective: In Australia’s most remote regions, insufficient health workforce to prevent and manage serious chronic disease is one contributor to a high burden of poor health. The discourse around Australian First Nations people generally focuses on disadvantage while overlooking their cultural strength, capability and diversity. Our Objective was to co-design and deliver a culturally responsive student-implemented rehabilitation and disability service through a partnership that demonstrated strengths of First Nations Yolŋu culture, while at the same time, filled a workforce gap, addressed health inequities, and educated future clinicians in-place in remote East Arnhem Land (Northern Territory). Methods: In 2019, we co-designed, delivered and evaluated a student-implemented service with an emphasis on cultural immersion for the students. Our aim was to understand (via interview and service data) the feasibility and acceptability of the service to Yolŋu community members. Resuming post-covid, a 2022 project has involved an economic analysis of the student implemented service compared with other service models, and in 2023, the evaluation will specifically focus on a culturally responsive cardiac rehabilitation and prevention service. ResultsTo date, 17 students, more than 100 Yolŋu community members, and more than eight organisations have contributed to the service and the students learning. Cultural education and support have been provided through employed Yolŋu cultural experts. The service has been shown to be acceptable and feasible with two-way learning between students and Yolŋu participants as a key underpinning of the service demonstrating cultural responsiveness. The economic analysis is underway with Results available by the conference; the initial implementation of the cardiac rehabilitation service will also be described. 

Conclusions: Embracing the strengths of First Nations Peoples is a critical component of culturally responsive healthcare to manage and/or prevent decline in chronic disease while addressing health inequities through student-implemented services.