TY - JOUR
T1 - Stakeholder perspectives on the implementation and impact of Indigenous health interventions
T2 - A systematic review of qualitative studies
AU - Chando, Shingisai
AU - Tong, Allison
AU - Howell, Martin
AU - Dickson, Michelle
AU - Craig, Jonathan C.
AU - DeLacy, Jack
AU - Eades, Sandra J.
AU - Howard, Kirsten
PY - 2021/6
Y1 - 2021/6
N2 - Background: Evaluations of health interventions for Indigenous peoples rarely report outcomes that reflect participant and community perspectives of their experiences. Inclusion of such data may provide a fuller picture of the impact of health programmes and improve the usefulness of evaluation assessments. Aim: To describe stakeholder perspectives and experiences of the implementation and impact of Indigenous health programmes. Methods: We conducted a systematic review of qualitative studies evaluating complex health interventions designed for Indigenous communities in high-income countries. We searched 6 electronic databases (through to January 2020): MEDLINE, PreMEDLINE, Embase, PsycINFO, EconLit and CINAHL and hand-searched reference lists of relevant articles. Results: From 28 studies involving 677 stakeholders (mostly clinical staff and participants), six main themes were identified: enabling engagement, regaining control of health, improving social health and belonging, preserving community and culture, cultivating hope for a better life, and threats to long-term programme viability. Conclusion: The prominence of social, emotional and spiritual well-being as important aspects of the health journey for participants in this review highlights the need to reframe evaluations of health programmes implemented in Indigenous communities away from assessments that focus on commonly used biomedical measures. Evaluators, in consultation with the community, should consistently assess the capacity of health professionals to meet community needs and expectations throughout the life of the programme. Evaluations that include qualitative data on participant and community-level outcomes can improve decision-makers' understanding of the impact that health programmes have on communities. Patient or public contribution: This paper is a review of evaluation studies and did not involve patients or the public.
AB - Background: Evaluations of health interventions for Indigenous peoples rarely report outcomes that reflect participant and community perspectives of their experiences. Inclusion of such data may provide a fuller picture of the impact of health programmes and improve the usefulness of evaluation assessments. Aim: To describe stakeholder perspectives and experiences of the implementation and impact of Indigenous health programmes. Methods: We conducted a systematic review of qualitative studies evaluating complex health interventions designed for Indigenous communities in high-income countries. We searched 6 electronic databases (through to January 2020): MEDLINE, PreMEDLINE, Embase, PsycINFO, EconLit and CINAHL and hand-searched reference lists of relevant articles. Results: From 28 studies involving 677 stakeholders (mostly clinical staff and participants), six main themes were identified: enabling engagement, regaining control of health, improving social health and belonging, preserving community and culture, cultivating hope for a better life, and threats to long-term programme viability. Conclusion: The prominence of social, emotional and spiritual well-being as important aspects of the health journey for participants in this review highlights the need to reframe evaluations of health programmes implemented in Indigenous communities away from assessments that focus on commonly used biomedical measures. Evaluators, in consultation with the community, should consistently assess the capacity of health professionals to meet community needs and expectations throughout the life of the programme. Evaluations that include qualitative data on participant and community-level outcomes can improve decision-makers' understanding of the impact that health programmes have on communities. Patient or public contribution: This paper is a review of evaluation studies and did not involve patients or the public.
KW - health policy
KW - health services
KW - impact evaluation
KW - Indigenous health
KW - outcomes
UR - http://www.scopus.com/inward/record.url?scp=85102638763&partnerID=8YFLogxK
UR - http://purl.org/au-research/grants/NHMRC/358457
UR - http://purl.org/au-research/grants/NHMRC/512685
UR - http://purl.org/au-research/grants/NHMRC/1023998
UR - http://purl.org/au-research/grants/NHMRC/1035378
U2 - 10.1111/hex.13230
DO - 10.1111/hex.13230
M3 - Review article
AN - SCOPUS:85102638763
VL - 24
SP - 731
EP - 743
JO - Health Expectations
JF - Health Expectations
SN - 1369-6513
IS - 3
ER -