Reflecting on culturally responsive goal achievement with indigenous clients using the Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC)

Jodie A Copley; Alison Nelson; Anne E Hill; Catherine Castan; Chrisdell F McLaren; Julie Brodrick; Teresa Quinlan; Rebekah White

doi:10.1111/1440-1630.12735

Reflecting on culturally responsive goal achievement with indigenous clients using the Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC)

Aust Occup Ther J. 2021 Oct;68(5):384-394. doi: 10.1111/1440-1630.12735. Epub 2021 Jul 2.

Authors

Jodie A Copley^{1

2}, Alison Nelson^{3

2}, Anne E Hill^{1

2}, Catherine Castan³, Chrisdell F McLaren³, Julie Brodrick⁴, Teresa Quinlan¹, Rebekah White³

Affiliations

¹ School of Health and Rehabilitation Sciences, The University of Queensland, Qld, Australia.
² The Poche Centre for Indigenous Health, The University of Queensland, Qld, Australia.
³ The Institute for Urban Indigenous Health, Qld, Australia.
⁴ Royal Brisbane Women's Hospital, Qld, Australia.

PMID: 34213017
DOI: 10.1111/1440-1630.12735

Abstract

Introduction: Appropriate evaluation of health services for First Australians demands culturally responsive goal setting tools that can be used by inter-professional teams. The Australian Therapy Outcome Measure for Indigenous Clients (ATOMIC) is a purpose-designed tool for measuring therapy outcomes for First Australians. The aim of this study was to establish the clinical utility of the ATOMIC by investigating its alignment with the practice perspectives of an inter-professional First Australian health service.

Methods: Using action research cycles, 12 occupational therapists and 8 speech pathologists applied two successive versions of the ATOMIC in practice. Focus group feedback after use of the first version (ATOMICv1) prompted adaptations to the tool (ATOMICv2). Therapists participated in four focus groups, two after using ATOMICv1 and two after using ATOMICv2. Focus group transcripts were analysed inductively using a qualitative description approach.

Results: Challenges in setting SMART goals early in therapy and defining specific measurement increments in ATOMICv1 led to therapists favouring skill-based goals that were easier to measure rather than broader daily life goals, thereby impacting on occupation- and client-centred practice. ATOMICv2 allowed goal setting at any point in therapy, evaluated goals using visual analogue scales, and gathered evidence for rating goal achievement throughout the therapy process. Therapists found the ATOMICv2 to be a culturally responsive tool that aligned with practice perspectives by foregrounding relationship building, facilitating clinical reasoning, documenting daily life changes, and providing integrated inter-professional care.

Conclusion: The ATOMIC demonstrated good clinical utility in an inter-professional service for First Australian children. It aligned with a culturally responsive practice perspective and captured goal achievement in daily life contexts. Further research is needed to gain client perspectives across the lifespan and to investigate its application by other health professions.

Keywords: action research; goal-setting; indigenous health; occupational therapy professional attitudes and behaviours; working with communities.

MeSH terms

Australia
Child
Goals*
Humans
Occupational Therapists
Occupational Therapy*
Outcome Assessment, Health Care

Grants and funding

This research was supported by a Poche Centre for Indigenous Health Seed Funding Grant, administered through the Poche Centre for Indigenous Health at The University of Queensland.