Healing the Past by Nurturing the Future (HPNF): factors impacting improved health equity in tertiary healthcare for Indigenous families
1
Indigenous Health Equity Unit, Onemda: Aboriginal and Torres Strait Islander Health and Wellbeing, University of Melbourne, Melbourne, Australia
2
Latrobe Regional Health, Traralgon, Australia
Popul. Med. 2026;8(Supplement Supplement 1):A694
ABSTRACT
INTRODUCTION:
Indigenous populations globally experience significant and persistent disparities in health and wellbeing outcomes. These disparities are linked to, and reinforced by, intergenerational trauma from colonisation and unequal access to health services. In Australia, Indigenous babies are twice as likely to die, and mothers are 3-5-times more likely to die in the perinatal period than non-Indigenous babies and mothers. Culturally safe, trauma-informed practice has the potential to close the gap on these maternal and child health and wellbeing disparities.
METHODS:
Our Indigenous-led participatory action research project was codesigned with community over four years. We aimed to improve support for Indigenous families at a large regional hospital in Victoria, Australia. The HPNF project consisted of service provider training, resources for providers and parents, a policy audit, and a ‘champions’ group to drive systems change. We tracked implementation barriers and enablers across the 18-month implementation period guided by the Consolidated Framework for Implementation Research (CFIR).
RESULTS:
The project improved service providers knowledge, attitudes and practice regarding care provided for Indigenous families. Barriers to implementation and sustainable change related to the inner setting: limited resources, policy and procedures, delays providing approvals; outer setting: poor understanding of patient’s needs and collaboration with external organisations; and characteristics of individuals. The strongest enablers related to HPNF intervention characteristics and processes. These included effective training and implementation team meetings, formation of the ‘champions’ group, and the ability to adapt activities in response to feedback. Additionally, characteristics of key stakeholders including securing buy-in from managers and executives was a strong facilitator.
CONCLUSIONS:
The HPNF project established processes and achieved attitude changes to address health and wellbeing disparities and improve access to healthcare. Project designs embedding robust and effective feedback processes that enable responsive adaptation to barriers can achieve systems change to support more inclusive health services globally.
Indigenous populations globally experience significant and persistent disparities in health and wellbeing outcomes. These disparities are linked to, and reinforced by, intergenerational trauma from colonisation and unequal access to health services. In Australia, Indigenous babies are twice as likely to die, and mothers are 3-5-times more likely to die in the perinatal period than non-Indigenous babies and mothers. Culturally safe, trauma-informed practice has the potential to close the gap on these maternal and child health and wellbeing disparities.
METHODS:
Our Indigenous-led participatory action research project was codesigned with community over four years. We aimed to improve support for Indigenous families at a large regional hospital in Victoria, Australia. The HPNF project consisted of service provider training, resources for providers and parents, a policy audit, and a ‘champions’ group to drive systems change. We tracked implementation barriers and enablers across the 18-month implementation period guided by the Consolidated Framework for Implementation Research (CFIR).
RESULTS:
The project improved service providers knowledge, attitudes and practice regarding care provided for Indigenous families. Barriers to implementation and sustainable change related to the inner setting: limited resources, policy and procedures, delays providing approvals; outer setting: poor understanding of patient’s needs and collaboration with external organisations; and characteristics of individuals. The strongest enablers related to HPNF intervention characteristics and processes. These included effective training and implementation team meetings, formation of the ‘champions’ group, and the ability to adapt activities in response to feedback. Additionally, characteristics of key stakeholders including securing buy-in from managers and executives was a strong facilitator.
CONCLUSIONS:
The HPNF project established processes and achieved attitude changes to address health and wellbeing disparities and improve access to healthcare. Project designs embedding robust and effective feedback processes that enable responsive adaptation to barriers can achieve systems change to support more inclusive health services globally.
| eISSN: | 2654-1459 |
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