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Hey, We Are the Best Ones at Dealing with Our Own’: Embedding a Culturally Competent Program for Māori and Pacific Island Children into a Mainstream Health Service in Queensland, Australia

Abstract

Objective

We present the results of one component of an external evaluation of Good Start Program (GSP), a community-based program for the prevention of chronic disease among Maori and Pacific Island (MPI) communities living in the state of Queensland, Australia.

Design

An evaluation of the GSP was undertaken using a mixed methods approach. This paper reports on the qualitative component where interview and focus group data was collected, using Talanoa, a culturally tailored research methodology. Respondents included school students, community groups, teachers and parents, as well as the Good Start implementation team.

Result(s)

The five broad themes that emerged from this evaluation related to (i) components of cultural-competence and (ii) perceived impact of the program. The views of all participants reinforced the importance of culturally appropriate programs and highlighted how the multicultural health workers (MHWs) contributed to the program’s perceived success. The challenges in understanding restrictions of the mainstream health service framework were noted indicating the need for it to be flexible in incorporating culturally appropriate components if a program was to be embraced.

Conclusion

The qualitative evaluation of the GSP suggests that culturally tailored programs, delivered by MHWs, have the potential to impact positively on community-level behavioural changes that improve health. These findings, supported by studies from other countries, contribute to the evidence that cultural-tailoring of programs is critical for ensuring that culturally appropriate initiatives are embedded in health care systems that support multicultural communities. Embedding includes the development of culturally appropriate policies, a culturally competent workforce and long-term funding to support culturally competent initiatives.

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Notes

  1. Karakia are prayers or incantations. They are generally used to ensure a favourable outcome to important events and undertakings such as tangihanga (the ritual of farewell to our deceased), hui (meetings), unveilings etc.; however, they can cover every aspect of life. http://maori.otago.ac.nz/reo-tikanga-treaty/te-reo/karakia

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Acknowledgments

All participants in the evaluation The Good Start Program team Participants in the Good Start Program University of Queensland student volunteers.

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Corresponding author

Correspondence to Lisa Vaughan.

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Funding

This 2-year evaluation was funded by Queensland Health.

Ethical Approval and Informed Consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom potentially identifying information is included in this article.

Three ethics committees approved the evaluation of the GSP: Queensland Health (ref: HREC/13/QRCH/150), the University of Queensland (ref: 201,400,196) and Education Queensland (ref: 550/27/1439).

Conflicts of Interest

The authors declare that they have no conflict of interest.

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Vaughan, L., Schubert, L., Mavoa, H. et al.Hey, We Are the Best Ones at Dealing with Our Own’: Embedding a Culturally Competent Program for Māori and Pacific Island Children into a Mainstream Health Service in Queensland, Australia. J. Racial and Ethnic Health Disparities 5, 605–616 (2018). https://doi.org/10.1007/s40615-017-0406-5

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Keywords

  • Māori
  • Pacific Islander
  • Culturally competent
  • Community
  • Evaluation
  • Strength-based approaches