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Cultural respect in general practice: a cluster randomised controlled trial
Author(s) -
Liaw SiawTeng,
Wade Vicki,
Furler John S,
Hasan Iqbal,
Lau Phyllis,
Kelaher Margaret,
Xuan Wei,
Harris Mark F
Publication year - 2019
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/mja2.50031
Subject(s) - indigenous , cluster randomised controlled trial , mentorship , participatory action research , intervention (counseling) , medicine , health care , cultural competence , nursing , randomized controlled trial , family medicine , medical education , psychology , sociology , political science , pedagogy , ecology , anthropology , law , biology , surgery
Objective To examine whether the Ways of Thinking and Ways of Doing (Wo TW oD) cultural respect framework improves clinically appropriate anticipatory care in general practice and the cultural respect levels of medical practice staff. Design Mixed methods, cluster randomised controlled trial with a participatory action research approach. Setting, participants Fifty‐six general practices in Sydney and Melbourne, 2014–2017. Intervention Wo TW oD encompasses a toolkit (ten scenarios illustrating cross‐cultural behaviour in clinical practice), one half‐day workshop, cultural mentor support for practices, and a local care partnership between participating Medicare locals/primary health networks and local Aboriginal Community Controlled Health Services for guiding the program and facilitating community engagement. The intervention lasted 12 months at each practice. Major outcomes Rates of claims for MBS item 715 (health assessment for Aboriginal and Torres Strait Islander People) and recording of chronic disease risk factors; changes in cultural quotient ( CQ ) scores of practice staff. Results Complete results were available for 28 intervention (135 GP s, 807 Indigenous patients) and 25 control practices (210 GP s, 1554 Indigenous patients). 12‐Month rates of MBS item 715 claims and recording of risk factors for the two groups were not statistically significantly different, nor were mean changes in CQ scores, regardless of staff category and practice attributes. Conclusion The Wo TW oD program did not increase the rate of Indigenous health checks or improve cultural respect scores in general practice. Conceptual, methodologic, and contextual factors that influence cultural mentorship, culturally respectful clinical practice, and Indigenous health care require further investigation. Trial registration Australia New Zealand Clinical Trials Registry ACTRN 12614000797673.