Developing a community rehabilitation and lifestyle service for a remote indigenous community

Abstract

Purpose

Community rehabilitation is an essential health service that is often not available to remote Australians. This paper describes the first cycle of a collaborative project, between local community members, allied health professionals and a university, to co-design a community rehabilitation and lifestyle service to support adults and older people to stay strong and age well in place.

Methods

An action research framework was used to develop the service for adults in two remote communities, one being a discrete Aboriginal community. The first cycle involved planning for, and trialling of a service, with observations, reflections and feedback from clients, community members, university students and health service providers, to inform the subsequent service.

Results

Over two years, stakeholders worked collaboratively to plan, trial, reflect and replan an allied health student-assisted community rehabilitation service. The trial identified the need for dedicated clinical and cultural supervision. During replanning, three key elements for culturally responsive care were embedded into the service: reciprocity and yarning; holistic community-wide service; and Aboriginal and Torres Strait Islander mentorship.

Conclusions

An action-research approach to co-design has led to the establishment of a unique community rehabilitation service to address disability and rehabilitation needs in two remote Australian communities.

Implications for rehabilitation

• Co-design of community rehabilitation services between Aboriginal and Torres Strait Islander community members and the local allied health professionals can lead to development of an innovative service model for remote Aboriginal communities.

• Culturally responsive community rehabilitation services in Aboriginal and Torres Strait Islander communities requires holistic and community-wide perspectives of wellbeing.

• Incorporating Aboriginal and Torres Strait Islander ways of engaging and communicating, and leadership and mentorship for non-Indigenous allied health professionals and students are essential components for students-assisted culturally responsive services.

Keywords:

• Aboriginal
• Torres Strait Islander
• First Nations
• allied health
• rehabilitation
• community rehabilitation
• rural
• action research
• cultural safety

Acknowledgements

The authors wish to acknowledge the contribution of many community members in guiding the research team and the clinicians in developing this project and the service. In particular, we would like to acknowledge the Aboriginal and Torres Strait Islander Elders who shared so much of their ideas at the conception of this project and are continuing to teach us how to provide a better service. We would also like to acknowledge the Hospital and Health Service who supported this project.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Funding for this project was supported by the Far North Queensland Hospital Foundation and the Far North Queensland Primary Health Network. AC is supported by an Early Career Fellowship, NHMRC-funded “Improving Health Outcomes in the Tropical North: A multidisciplinary collaboration (Hot North),” grant identification number 1131932.