Enablers and barriers to the implementation of primary health care interventions for Indigenous people with chronic diseases: a systematic review

Implementation Science

Alex Brown¹  Katharine McBride³  Dagmara Riitano²  Craig Lockwood²  Elaine Kite⁴  Edoardo Aromataris²  Carol Davy⁴  Karolina Lisy²  Odette Gibson¹ 

[1] University of South Australia, Adelaide, Australia;Joanna Briggs Institute, University of Adelaide, Adelaide, Australia;Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia;University of Adelaide, Adelaide, Australia

关键词: Indigenous peoples;    Chronic disease;    Intervention;    Primary health care;    United States;    Canada;    New Zealand;    Australia;   

Others  :  1219035
DOI  :  10.1186/s13012-015-0261-x

 received in 2014-11-14, accepted in 2015-05-11,  发布年份 2015

【 摘 要 】

Background

Access to appropriate, affordable, acceptable and comprehensive primary health care (PHC) is critical for improving the health of Indigenous populations. Whilst appropriate infrastructure, sufficient funding and knowledgeable health care professionals are crucial, these elements alone will not lead to the provision of appropriate care for all Indigenous people. This systematic literature review synthesised international evidence on the factors that enable or inhibit the implementation of interventions aimed at improving chronic disease care for Indigenous people.

Methods

A systematic review using Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed platform), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Excerpta Medica Database (EMBASE), ATSIHealth, Australian Indigenous HealthInfoNet via Informit Online and Primary Health Care Research and Information Service (PHCRIS) databases was undertaken. Studies were included if they described an intervention for one or more of six chronic conditions that was delivered in a primary health care setting in Australia, New Zealand, Canada or the United States. Attitudes, beliefs, expectations, understandings and knowledge of patients, their families, Indigenous communities, providers and policy makers were of interest. Published and unpublished qualitative and quantitative studies from 1998 to 2013 were considered. Qualitative findings were pooled using a meta-aggregative approach, and quantitative data were presented as a narrative summary.

Results

Twenty three studies were included. Meta-aggregation of qualitative data revealed five synthesised findings, related to issues within the design and planning phase of interventions, the chronic disease workforce, partnerships between service providers and patients, clinical care pathways and patient access to services. The available quantitative data supported the qualitative findings. Three key features of enablers and barriers emerged from the findings: (1) they are not fixed concepts but can be positively or negatively influenced, (2) the degree to which the work of an intervention can influence an enabler or barrier varies depending on their source and (3) they are inter-related whereby a change in one may effect a change in another.

Conclusions

Future interventions should consider the findings of this review as it provides an evidence-base that contributes to the successful design, implementation and sustainability of chronic disease interventions in primary health care settings intended for Indigenous people.

【 授权许可】

   
2015 Gibson et al.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Gracey M, King M. Indigenous health part 1: determinants and disease patterns. Lancet. 2009; 374(9683):65-75.
• [2]The Health and Welfare of Australia’s Aboriginal and Torres Strait Islander Peoples, 2008. Australian Institute of Health and Welfare, Canberra; 2008.
• [3]Brown A, Walsh W, Lea T, Tonkin A. What becomes of the broken hearted? Coronary heart disease as a paradigm of cardiovascular disease and poor health among health among Indigenous Australians [editorial]. Heart, Lung and Circulation. 2005; 14(3):158-62.
• [4]Brown A. Bridging the survival gap between Indigenous and non-Indigenous Australians: priorities for the road ahead. Heart, Lung and Circulation. 2009; 18(2):96-100.
• [5]O’Dea K, Rowley KG, Brown A. Diabetes in Indigenous Australians: possible ways forward. Medical Journal of Australia. 2007; 186(10):494-5.
• [6]Cass A, Cunningham J, Wang Z, Hoy W. Regional variation in the incidence of end-stage renal disease in Indigenous Australians. Medical Journal of Australia. 2001; 175(1):24-7.
• [7]Zhao Y, Dempsey K. Causes of inequality in the life expectancy between Indigenous and non Indigenous people in the Northern Territory, 1981–2000: a decomposition analysis. Medical Journal of Australia. 2006; 184:490-4.
• [8]Wass A. Promoting Health: the primary health care approach. Australia, Harcourt Brace and Company; 1994.
• [9]Australian Institute of Health and Welfare: access to health services for Aboriginal and Torres Strait Islander people. Australian Institute of Health and Welfare. Canberra; 2011.
• [10]Lavoie J, Prakash T, Dahl M, Martens P, O’Neil J. Have investments in on-reserve health services and initiatives promoting community control improved First Nations’ health in Manitoba? Soc Sci Med. 2010; 71(4):717-24.
• [11]McMurray A, Param R. Culture-specific care for Indigenous people: a primary health care perspective. Contemp Nurse. 2008; 28:165-72.
• [12]Anderson I. Powers of health. Arena Magazine. 1994; 11:32-6.
• [13]Foley G. Aboriginal community controlled health services: a short history. Aboriginal Health Project Bulletin. 1982; 2(8):13-5.
• [14]McGrath P, Holewa H, Ogilvie K, Rayner R, Patton M. Insights on Aboriginal peoples’ views of cancer in Australia. Contemp Nurse. 2006; 22:240-54.
• [15]Davies P, Taylor F, Beswick A, Wise F, Moxham T, Rees K et al.. Promoting patient uptake and adherence in cardiac rehabilitation. Cochrane Database Syst Rev. 2010; 7(7):CD007131.
• [16]Gan J, Brammer J, Creedy D. Effectiveness of educational interventions to promote oral hypoglycaemic adherence in adults with type 2 diabetes: a systematic review. JBI Library of Systematic Reviews. 2011; 9(9):269-312.
• [17]Pearson A, Chalmers J. Oral hygiene care for adults with dementia in residential aged care facilities. JBI Library of Systematic Reviews. 2004; 2(3):65-113.
• [18]Davy C, Aromataris E, Gibson O, Brown A. Facilitators and barriers to the implementation of primary health care interventions for Aboriginal and Torres Strait Islander people with chronic diseases: a systematic review protocol. The JBI Library of Systematic Reviews. 2013; 11(7):299-311.
• [19]Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI) [http://joannabriggs.org/sumari.html]
• [20]Bailie R, Si D, Robinson G, Togni S, d’Abbs P. A multifaceted health-service intervention in remote Aboriginal communities: 3-year follow-up of the impact on diabetes care. Medical Journal of Australia. 2004; 181(4):195-200.
• [21]Barnett L, Kendall E. Culturally appropriate methods for enhancing the participation of Aboriginal Australians in health-promoting programs. Health Promot J Austr. 2011; 22(1):27-32.
• [22]Battersby M, Ah Kit J, Prideaux C, Harvey P, Collins J, Mills P. Implementing the Flinders model of self-management support with Aboriginal people who have diabetes: findings from a pilot study. Australian Journal of Public Health. 2008; 14(1):66-74.
• [23]Carey T. A qualitative study of a social and emotional well-being service for a remote Indigenous Australian community: implications for access, effectiveness, and sustainability. BMC Health Serv Res. 2013; 13(1):80. BioMed Central Full Text
• [24]d’Abbs P, Schmidt B, Dougherty K, Senior K. Implementing a chronic disease strategy in two remote Indigenous Australian settings: a multi-method pilot evaluation. Aust J Rural Health. 2008; 16(2):67-74.
• [25]Davidson P, Digiacomo M, Abbott P, Zecchin R, Heal P, Mieni L et al.. A partnership model in the development and implementation of a collaborative, cardiovascular education program for Aboriginal Health Workers. Aust Health Rev. 2008; 32(1):139-46.
• [26]DiGiacomo M, Davidson PM, Taylor KP, Smith JS, Dimer L, Ali M et al.. Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study. Qual Prim Care. 2010; 18(1):17-26.
• [27]DiGiacomo M, Thompson S, Smith J, Taylor K, Dimer L, Ali M et al.. ‘I don’t know why they don’t come’: barriers to participation in cardiac rehabilitation. Aust Health Rev. 2010; 34(4):452-7.
• [28]Gardner K, Dowden M, Togni S, Bailie R. Understanding uptake of continuous quality improvement in Indigenous primary health care: lessons from a multi-site case study of the Audit and Best Practice for Chronic Disease project. Implementation Science. 2010; 5:21. BioMed Central Full Text
• [29]Kowanko I, Helps Y, Harvey P, Battersby M, McCurry B, Carbine R et al.. Chronic condition management strategies in Aboriginal communities: final report 2011. Flinders University and the Aboriginal Health Council of South Australia, Adelaide; 2012.
• [30]Lloyd J, Wise M, Weeramanthri T, Nugus P. The influence of professional values on the implementation of Aboriginal health policy. J Health Serv Res Policy. 2009; 14(1):6-12.
• [31]Lloyd J, Wise M, Weeramanthri T. Changing shape: workforce and the implementation of Aboriginal health policy. Aust Health Rev. 2008; 32(1):174-85.
• [32]Longstreet D, Griffiths M, Heath D, Marshall G, Morisco P, Geary N et al.. Improving diabetes care in an urban Aboriginal medical centre. Aust J Prim Health. 2005; 11(3):25-31.
• [33]Schierhout G, Brands J, Bailie R. Audit and best practice for chronic disease extension project, 2005–2009: final report. The Lowitja Institute, Melbourne; 2010.
• [34]Si D, Bailie R, Togni S, d’Abbs P, Robinson G. Aboriginal health workers and diabetes care in remote community health centres: a mixed method analysis. Medical Journal of Australia. 2006; 185(1):40-5.
• [35]Thompson S, Digiacomo M, Smith J, Taylor K, Dimer L, Ali M et al.. Are the processes recommended by the NHMRC for improving cardiac rehabilitation (CR) for Aboriginal and Torres Strait Islander people being implemented?: an assessment of CR Services across Western Australia. Australia and New Zealand Health Policy. 2009; 30:6-29.
• [36]Tracey K, Cossich T, Bennett P, Wright S, Ockerby C. A nurse-managed kidney disease program in regional and remote Australia. Renal Society of Australasia Journal. 2013; 9(1):28-34.
• [37]Wakerman J, Chalmers E, Clarence C, Humphreys J, Bell A, Larson A et al.. Sustainable chronic disease management in remote Australia. Medical Journal of Australia. 2005; 183(10):64-8.
• [38]Ratima M, Fox C, Fox B, Karu H, Gemmell T, Slater T et al.. Long-term benefits for Maori of an asthma self-management program in a Maori community which takes a partnership approach. Aust N Z J Public Health. 1999; 23(6):601-5.
• [39]Porter T, Le Lievre C, Lawrenson R. Why don’t patients with diagnosed diabetes attend a free ’get checked’ annual review? J Prim Health Care. 2009; 1(3):222-5.
• [40]Barney D, Rosenthal C, Speier T. Components of successful HIV/AIDS case management in Alaska Nnative villages. AIDS Educ Prev. 2004; 6(3):202-17.
• [41]Reilley B, Redd J, Kittredge J, Speakman R, Bigbey M, Giberson S. Expanded HIV Testing in Two Service Units, July-December 2007. The IHS primary care provider. 2009; 34(2):37-41.
• [42]Reilley B, Redd JT, Giberson S, Lee JK, Haverkamp D, Cheek J. Physician and nurse perspectives on implementation of Universal Adult HIV Screening Guidelines in the Indian health service: results of a randomized survey. J Public Health Manag Pract. 2010; 16(5):450-6.
• [43]Dwyer J, O’Donnell K, Lavoie J, Marlina U, Sullivan P. The overburden report: contracting for Indigenous health services. Cooperative Research Centre for Aboriginal Health, Darwin; 2009.
• [44]Dwyer J, Lavoi J, O’Donnell K, Marlina U, Sullivan P. Contracting for Indigenous health care: towards mutual accountability. Australian Journal of Public Administration. 2011; 70(1):34-46.
• [45]Wakerman J, Humphreys J. Sustainable primary health care services in rural and remote areas: innovation and evidence. Australian Journal of Rural Health. 2011; 19(3):118-24.
• [46]Gray D, Saggers S, Drandich M, Wallam D, Plowright P. Evaluating government health and substance abuse programs for Indigenous peoples: a comparative review. Aust J Public Health. 1995; 19(6):567-72.
• [47]Minkler M, Wallerstein N. Introduction to CBPR: new issues and emphases. In: Community-based Participatory Research for Health from Process to Outcomes. Minkler M, Wallerstein N, editors. John Wiley & Sons, San Fancisco; 2008: p.5-19.
• [48]Health workforce 2025: consumer edition. [http://hwa.gov.au/sites/default/files/HWA_Health-Workforce%202025_Consumer-edition.pdf]
• [49]Durey A, Wynaden D, Thompson S, Davidson P, Bessarab D, Katzenellenbogen J. Owning solutions: a collaborative model to improve quality in hospital care for Aboriginal Australians. Nurs Inq. 2012; 19(2):144-52.
• [50]King M, Smith A, Gracey M. Indigenous health part 2: the underlying causes of the health gap. Lancet. 2009; 374(9683):76-85.
• [51]Brannelly T, Boulton A, te Hiini A. A relationship between the ethics of care and Māori worldview—the place of relationality and care in Maori mental health service provision. Ethics and Social Welfare. 2013; 7(4):410-22.
• [52]The inclusion of Indigenous status on pathology request forms. Australian Insittute of Health and Welfare, Canberra; 2013.
• [53]Brown A, Blahki G. Indigenous male health disadvantage. Aust Fam Physician. 2005; 34(10):813-9.
• [54]Thiede M, Akweongo P, McIntyre D. Exploring the dimensions of access. The Economics of Health Equity. McIntyre D, Mooney G, editors. Cambridge University Press, Cambridge; 2007.
• [55]Browne A, Fiske J. First Nations women’s encounters with mainstream health care services. West J Nurs Res. 2001; 23(2):126-47.