Reforming the management of diabetes: Striving for Aboriginal cultural competence in Patient Reported Outcome Measures

Ms Alicia Burgess1,2,3, Ms Jessica  Hawkins1,2, Catherine Kostovski1,4, Dr  Kerith  Duncanson5

1Illawarra Shoalhaven Local Health District, Wollongong, Australia, 2High Risk Foot Service, Illawarra Shoalhaven Local Health District, Wollongong, Australia, 3Rural Research Capacity Building Program, Health Education and Training Institute, Sydney, Australia, 4Aboriginal Chronic Care Unit, Illawarra Shoalhaven Local Health District, Wollongong , Australia, 5Rural and Remote Portfolio, Health Education and Training Institute, Sydney, Australia

Background: Patient-reported outcome measures (PROMs) provide patients with a platform to report on healthcare services and interventions. Given the major disparity in incidence and prevalence of diabetes between Aboriginal and non-Aboriginal people, it is crucial that PROMs meet the cultural, spiritual and medical needs of this high-risk population. Therefore, the study explored the perceptions of Aboriginal people in regional New South Wales, about the cultural appropriateness of a set of PROMs relating to diabetes management.

Methods/design: Aboriginal people with diabetes living in the Shoalhaven region attended a focus group/individual interview. Semi-structured questions were used to gather information about PROMs, the discussions were recorded for analysis. The next stage of the study will involve the Research team yarning about the data with Aboriginal co-researchers/community stakeholders to apply an Indigenous lens to thematic analysis.

Results: Preliminary coding and analysis indicates that existing PROMs do not capture accurate information about the healthcare of Aboriginal people with Type 2 diabetes. In this presentation, we will share study findings, along with insights and recommendations on Aboriginal health research implementation, particularly ethical considerations and engagement approaches for non-Aboriginal researchers embarking on research with and within Aboriginal communities.

Conclusion: Cultural appropriateness of tools used in government-initiated evaluation of health outcomes is paramount. We make recommendations about how these evaluations can be better suited to Aboriginal people. The learnings from this study are of interest to those conducting research or quality assessment activities related to PROMs, and those involved with Aboriginal-focused research and project implementation

Acknowledgements: AB is supported by the Health Education and Training Institute Rural Research Capacity Building Program. JH is supported by an Illuminate Innovation award from the Illawarra Shoalhaven Local Health District.


Ms Alicia Burgess has worked as a Podiatrist for the Illawarra Shoalhaven Local Health District (ISLHD) since March 2012 and is currently working with the ISLHD High Risk Foot Service. She is a current candidate of the 2019 Heath Education and Training Institute Rural Research Capacity Building Program.

Over the past 9 years, Alicia has been working with members of the Dharawal and Yuin nations to try and improve access to foot education, foot assessments and referral to appropriate Podiatry services, especially for people with Diabetes. Alicia has been recognised for this work at the 2016 and 2019 ISLHD Quality and Innovation Awards.

As part of Alicia’s current role and Leading Better Value Care Initiative, the High Risk Foot Service was required to implement the use of Patient Reported Outcome Measures. As a novice clinician researcher, Alicia and colleagues noted that Aboriginal patients attending the service had trouble completing the survey or commented to clinicians on the number of questions. Her strong relationship and her eagerness to improve the quality of care to this community has prompted the initiation of this current research.

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