The Daalbirrwirr Gamambigu (Safe Children) Model: Embedding Cultural Safety in Child Protection Responses for Australian Aboriginal Children in Hospital Settings

Tara Flemington; Jennifer Fraser; Clinton Gibbs; Joanne Shipp; Joe Bryant; Amanda Ryan; Devika Wijetilaka; Susan Marks; Mick Scarcella; Dimitra Tzioumi; Shanthi Ramanathan; Liesa Clague; Donna Hartz; Bob Lonne; Mark Lock Ngiyampaa

doi:10.3390/ijerph19095381

The Daalbirrwirr Gamambigu (Safe Children) Model: Embedding Cultural Safety in Child Protection Responses for Australian Aboriginal Children in Hospital Settings

Int J Environ Res Public Health. 2022 Apr 28;19(9):5381. doi: 10.3390/ijerph19095381.

Authors

Tara Flemington^{1

2}, Jennifer Fraser^{2

3}, Clinton Gibbs⁴, Joanne Shipp⁵, Joe Bryant⁶, Amanda Ryan⁷, Devika Wijetilaka⁸, Susan Marks⁹, Mick Scarcella¹⁰, Dimitra Tzioumi^{11

12

13}, Shanthi Ramanathan^{14

15}, Liesa Clague¹⁶, Donna Hartz¹⁷, Bob Lonne¹⁸, Mark Lock Ngiyampaa¹⁹

Affiliations

¹ Nursing, Midwifery and Service Reform, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia.
² Faculty of Medicine and Health, Susan Wakil School of Nusing and Midwifery, University of Sydney, Camperdown, NSW 2006, Australia.
³ Nursing, Midwifery and Education, The Sydney Children's Hospitals Network, Westmead, NSW 2145, Australia.
⁴ Health Reform, Opportunities and Transition, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia.
⁵ Integrated Child, Youth and Family Wellbeing, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia.
⁶ Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia.
⁷ Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia.
⁸ Paediatrics, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia.
⁹ Child Protection Unit, The Sydney Children's Hospitals Network, Westmead, NSW 2145, Australia.
¹⁰ Aboriginal Health, The Sydney Children's Hospitals Network, Westmead, NSW 2145, Australia.
¹¹ Child Protection Unit, The Sydney Children's Hospitals Network, Randwick, NSW 2031, Australia.
¹² Child Protection and Wellbeing, Ministry of Health, St Leonards, NSW 2065, Australia.
¹³ Faculty of Medicine, School of Women's and Children's Health, University of New South Wales, Kensington, NSW 2052, Australia.
¹⁴ Health Research Economics, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia.
¹⁵ College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia.
¹⁶ School of Nursing, Midwifery, Health Science and Physiotherapy, The University of Notre Dame, Darlinghurst, NSW 2010, Australia.
¹⁷ School of Nursing and Midwifery, College of Medicine Health & Wellbeing, University of Newcastle, Gosford, NSW 2250, Australia.
¹⁸ School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
¹⁹ Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW 2007, Australia.

Abstract

The aim of this paper is to describe the development of a model of care to embed cultural safety for Aboriginal children into paediatric hospital settings. The Daalbirrwirr Gamambigu (pronounced "Dahl-beer-weer gum-um-be-goo" in the Gumbaynggirr language means 'safe children') model encompasses child protection responses at clinical, managerial and organisational levels of health services. A review of scholarly articles and grey literature followed by qualitative interviews with Aboriginal health professionals formed the evidence base for the model, which then underwent rounds of consultation for cultural suitability and clinical utility. Culturally appropriate communication with children and their families using clinical yarning and a culturally adapted version of ISBAR (a mnemonic for Identify, Situation, Background, Assessment and Recommendation) for interprofessional communication is recommended. The model guides the development of a critical consciousness about cultural safety in health care settings, and privileges the cultural voices of many diverse Aboriginal peoples. When adapted appropriately for local clinical and cultural contexts, it will contribute to a patient journey experience of respect, dignity and empowerment.

Keywords: Australia; aboriginal; child protection; critical consciousness; cultural safety; emergency department; healthcare; hospital; interprofessional collaboration; model of care; paediatric; translational research.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Australia
Child
Cultural Competency
Culturally Competent Care*
Health Services, Indigenous*
Hospitals
Humans

Grants and funding

This research was funded by NSW Regional Health Partners—MRFF Rapid Applied Research Translation Grant—GA59722.