Community events to increase uptake of Indigenous-specific health assessments: a scoping review

Introduction: Innovative, culturally safe strategies are required to address the disproportionate level of poorer health outcomes for Indigenous people in Australia compared to non-Indigenous populations. An emerging body of evidence supports the efficacy of Indigenous-specific health assessments, or Health Checks, despite poor uptake since their introduction in Australia. This poor uptake is attributed to a range of system, patient, and provider barriers. Services have begun to deliver preventative health assessments as a community event to address barriers faced by Indigenous people in accessing quality preventative care. However, there is a lack of literature exploring how community events have increased the uptake of Indigenous-specific health assessments to date. We expect this review will underpin a larger study to better understand how community engagement supports increased uptake of Health Checks.
Objectives: The objective of this scoping review was to investigate what is currently known about how community events have been used to increase uptake of Indigenous-specific health assessments.
Methods: A scoping review guided by the Joanna Briggs Institute methodology for scoping reviews was conducted. A search was completed in eight electronic databases using keywords relating to Indigenous health, community engagement and preventative health assessments. Published and unpublished sources of evidence were included in the review. As this study aims to explore the entire published literature on the topic and given there was an expectation that the subject itself is specific, no date ranges were included in the search criteria. Extracted data was reviewed using numerical analysis and conventional content analysis to conduct a narrative synthesis, allowing a summary of the main findings, and addressing the research question.
Results: Eighteen sources met the eligibility criteria and were included in the scoping review. Programs varied widely in the characteristics of program design and delivery across geographical location, setting of delivery, program format and target population. Programs employed a range of methods to engage with community, including incentivising participation, identifying, and addressing specific community healthcare needs, and utilising cultural or sporting ambassadors to promote the program. The conventional content analysis identified three key themes regarding how community events have been used to increase uptake of Health Checks: 1) adapting the program to the community; 2) providing a culturally safe participant experience; and 3) prioritising community engagement.
Discussion: The findings indicate that an individualised approach to community events is important to their success. Aboriginal Controlled Community Health Services may be best placed to have responsibility for program design and implementation to ensure community control of programs. Aboriginal Health Workers play a critical role in ensuring the programs deliver culturally safe healthcare, and a clear role for Aboriginal Health Workers in program delivery is important in their success. An authentic commitment to community engagement is important for program uptake, including the use of passionate cultural ambassadors and individualised cultural programs.
Conclusions: Community events are a promising and well-regarded strategy to increase uptake of Indigenous-specific health assessments. Future research that explores how specific community supports increase engagement with Health Check Day programs and evaluates the delivery of Health Check programs will strengthen the capacity of Aboriginal Community Controlled Health Services to delivery this intervention effectively.
Keywords: Aboriginal Health Check, community engagement, Aboriginal Community Controlled Health Services, Indigenous Health.