Carers' perspectives on an effective Indigenous health model for childhood asthma in the Torres Strait

Abstract

Objective: To describe parents'/carers' views of the characteristics of a clinical service model shown to improve asthma outcomes.

Design: A randomised controlled study on education intervention for childhood asthma by Indigenous health care workers.

Setting: Thursday Island, Horn Island and Bamaga.

Participants: Thirty-five children received the intervention and 53 were in the control group. At the last study visit 12 months after enrolment, carers were asked to give feedback about the clinical service delivered by paediatric respiratory physicians and the asthma education intervention.

Intervention: Additional asthma education.

Main outcome measures: Carers' responses to the open-ended questions were analysed separately by three Indigenous investigators who assigned codes and developed the themes. These were then cross-checked and combined to develop an overall interpretation of the data.

Results: The carers (n = 81) of 88 children in the Torres Strait region of North Queensland reported positively to the clinical service delivery. Service was rated as excellent = 26.8%, very good = 51.2%, good = 19.5% and poor = 2.4%. Parents'/carers' views about the clinical service model were grouped into seven themes: clear communication by health professionals, service delivery, professional approach, clear transfer of knowledge and education/clinical knowledge of asthma, established rapport/caregiver satisfaction, importance of coming into the local community, and areas of concern for the carers/parents.

Conclusion: Community-based perspectives of an effective health service model include empowered Indigenous health care workers currently attached to the medical specialist service with elements of high expertise and appropriate cultural awareness that enabled clear communication and transfer of knowledge.

Keywords: Indigenous; Torres Strait; children; education; respiratory.