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Aboriginal health workers and diabetes care in remote community health centres: a mixed method analysis
Author(s) -
Si Damin,
Bailie Ross S,
Togni Samantha J,
DˈAbbs Peter H N,
Robinson Gary W
Publication year - 2006
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2006.tb00451.x
Subject(s) - medicine , guideline , diabetes mellitus , health care , chronic care , family medicine , community health , glycated hemoglobin , service delivery framework , nursing , gerontology , type 2 diabetes , chronic disease , service (business) , public health , endocrinology , economy , pathology , economics , economic growth
Objective: To assess the effect of employing Aboriginal health workers (AHWs) on delivery of diabetes care in remote community health centres, and to identify barriers related to AHWs’ involvement in diabetes and other chronic illness care. Design, setting and participants: Three‐year follow‐up study of 137 Aboriginal people with type 2 diabetes in seven remote community health centres in the Northern Territory. Main outcome measures: Delivery of guideline‐scheduled diabetes services; intermediate outcomes (glycated haemoglobin [HbA 1c ] and blood pressure levels); number and sex of AHWs at health centres over time; barriers to AHWs’ involvement in chronic illness care. Results: There was a positive relationship between the number of AHWs per 1000 residents and delivery of guideline‐scheduled diabetes services (but not intermediate health outcomes). Presence of male AHWs was associated with higher adherence to the guidelines. Barriers to AHWs’ involvement in chronic illness care included inadequate training, lack of clear role divisions, lack of stable relationships with non‐Aboriginal staff, and high demands for acute care. Conclusions: Employing AHWs is independently associated with improved diabetes care in remote communities. AHWs have potentially important roles to play in chronic illness care, and service managers need to clearly define and support these roles.