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Type: Thesis
Title: [EMBARGOED] Utilisation of primary health care services by Aboriginal and Torres Strait Islander men
Author: Canuto, Kootsy (Justin)
Issue Date: 2018
School/Discipline: Adelaide Medical School
Abstract: Background: Aboriginal and Torres Strait Islander men experience worse health outcomes and are the most marginalised and disadvantaged population group in Australia. The nation’s sociopolitical environment remains a significant factor in their poor health and wellbeing, and its primary health care services (PHCSs) are likewise under-utilised by this sector. Employing an Indigenist research methodology, and through the lens of a Torres Strait Islander man, the work undertaken for this thesis aims to better understand the utilisation of PHCSs by Aboriginal and Torres Strait Islander men, including their physical and psychological barriers, motivators and enablers. In turn, this will help inform potential strategies and increase their use of such services, as well as improve the health and wellbeing of Aboriginal and Torres Strait Islander men. Methods: A systematic literature review assessed international evidence from studies that explored both the utilisation of health services by Indigenous men and the evaluation of implemented strategies for their subsequent improvement. A qualitative study was then conducted to document the perspectives and experiences of Aboriginal and Torres Strait Islander men with PHCSs. The study embraced the principles of Indigenist research methodologies, which values Indigenous knowledge and privileges such voices for the betterment of Indigenous lives. Results: Evidently, Australia’s sociopolitical landscape continues to disadvantage Aboriginal and Torres Strait Islander people. The dispossession of land, together with the social determinants of health, coupled with paternalism, transgenerational trauma and racism, contribute to the poor health and wellbeing of this population group. The systematic literature review identified several factors affecting the utilisation of PHCSs by Indigenous men. These were categorised into three primary organising themes: those related to health services, the attitudes of Indigenous men and their communities, and knowledge. The qualitative study included 19 interviews with Aboriginal and Torres Strait Islander men to explore their experiences, motives, barriers and enablers related to utilising PHCSs. The identified enabling factors included the perceived quality of such services, feeling culturally safe or a sense of belonging and having good rapport with their staff or services. Conversely, common barriers included feeling invincible, experiencing shame, not knowing when to go and for what reason, enduring long waiting times to secure an appointment and negative experiences due to culturally inappropriate staff or services. Informed by the literature and the Aboriginal and Torres Strait Islander men interviewed in the qualitative study, this thesis, therefore, presents six recommended steps to increase PHCS utilisation and 10 potential strategies to increase and improve access to such services for Aboriginal and Torres Strait Islander men. Conclusion: Currently, Australia’s health systems are limited in their ability to improve the health and wellbeing of Aboriginal and Torres Strait Islander males, should they remain without implementing strategies to increase access to PHCSs and improve utilisation. Equally, it is important to acknowledge the heterogeneity of these men, communities and PHCSs, as a one-size-fits-all approach will not work. Through evidence-based research, subsequent policies and programs can, in turn, be made and implemented to improve Aboriginal and Torres Strait Islanders men’s health.
Advisor: Wittert, Gary
Brown, Alex
Dissertation Note: Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 2018
Keywords: Aboriginal
Torres Strait Islander
primary health care
Provenance: This thesis is currently under Embargo and not available.
Appears in Collections:Research Theses

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