Developing health promotion methods in remote Aboriginal communities.

Abstract

This thesis investigates the development and implementation of health promotion strategies and methods in remote Aboriginal communities via the Kimberley Aboriginal Health Promotion Project (KAHPP), a project funded under a grant from the Commonwealth Department of Health and Family Services and conducted by the School of Public Health at Curtin University of Technology. The aim of the project was to investigate the effectiveness of health promotion strategies and methods in remote Aboriginal communities and to develop structures for implementing effective Aboriginal health promotion programs.There were three main research components in this study: an assessment of health indicators; an assessment of the intervention impact; and an assessment of the media component of the intervention. The research methodology included the development of a culturally appropriate survey instrument and the conduct of cross-sectional surveys of three remote Aboriginal communities with differing historical circumstances in the Kimberley region. The questionnaire and field study methods were piloted in 1990 and the main study conducted in 1991 1[superscript].A health promotion intervention was conducted based on an approach originally developed in the Northern Territory 2[superscript]. The intervention employed community development and mass media strategies. Community members nominated health issues that they wished to address, from which 'storyboards' were created for health promotion advertisements to appear on remote television on a paid schedule 3[superscript]. Representative random samples of adult males and females from three remote Aboriginal communities were surveyed according to a range of attitudinal and behavioural health indicators. A post-test survey assessed media reach and impact and pre-post surveys assessed relevant changes in the communities.The cross-sectional survey of health indicators found differences between communities in terms of self-assessed health and risk behaviours. These are discussed in terms of the historical differences between communities and with respect to each community's current situation. Respondents from all communities rated environmental factors as important in their contribution to health, and generally more so than individual lifestyle behaviours.The study demonstrated that television has the potential to reach the vast majority of Aboriginal people in remote communities in the Kimberley. There was some indication that participation in the development of advertisements was associated with higher recognition and more positive assessments of that advertisement. No significant differences in selected indicators of community 'empowerment' were detected following the intervention.The thesis methodology has contributed to the development of a set of guidelines for the conduct of survey research in remote Aboriginal communities, 4[superscript] and has guided the formation of Aboriginal health promotion units in Western Australia and elsewhere.1. Spark R, Binns C, Laughlin D, Spooner C, Donovan RJ. Aboriginal people's perceptions of their own and their community's health: results of a pilot study. Health Promotion Journal of Australia 1992; 2(2):60-61.2. Spark R, Mills P. Promoting Aboriginal health on television in the Northern Territory: a bicultural approach. Drug Education Journal of Australia 1988; 2 (3):191-198.3. Spark R, Donovan RJ, Howat P. Promoting health and preventing injury in remote Aboriginal communities: a case study. Health Promotion Journal of Australia 1991; 1(2):10-16.4. Donovan RJ, Spark. R. Towards guidelines for conducting survey research in remote Aboriginal communities. Australian and New Zealand Journal of Public Health 1997; 21:89-94.