'I'm not sure it paints an honest picture of where my health's at' - identifying community health and research priorities based on health assessments within an Aboriginal and Torres Strait Islander community: a qualitative study.

Aboriginal and Torres Strait Islander health assessments are conducted annually in Australian primary care to detect risk factors, chronic diseases and implement preventive health measures. At the Inala Indigenous Health Service, health assessment data have also been used for research purposes. This research has been investigator-driven, which risks misinterpreting or ignoring community priorities compared with community-led research. The objective of this research was to learn about the Aboriginal and Torres Strait Islander community's health priorities that could be translated into research themes, and investigate these using health assessment data. A thematic analysis of data was conducted from 21 semi-structured interviews with purposively selected key informants from an urban Aboriginal and Torres Strait Islander community. Key informants articulated an authoritative understanding of how interrelated, inter-generational, social, cultural and environmental determinants operated in a 'cycle' to influence the community's health. Key informant views supported the inclusion of these determinants in health assessments, reinforced the importance of comprehensive primary healthcare and strengthened referral pathways to community resources. Some key informants were ambivalent about Aboriginal and Torres Strait Islander health assessments because of their biomedical emphasis. This research also revealed limitations of health assessment-based research and the biomedical emphasis of the health system more broadly.

[1]  Wendy Foley,et al.  “It puts a human face on the researched” – A qualitative evaluation of an Indigenous health research governance model , 2016, Australian and New Zealand journal of public health.

[2]  J. Dimmock,et al.  Factors Affecting Indigenous West Australians’ Health Behavior , 2016, Qualitative health research.

[3]  Deborah A. Askew,et al.  Implementing computerised Aboriginal and Torres Strait Islander health checks in primary care for clinical care and research: a process evaluation , 2013, BMC Medical Informatics and Decision Making.

[4]  F. Baum,et al.  The potential for multi-disciplinary primary health care services to take action on the social determinants of health: actions and constraints , 2013, BMC Public Health.

[5]  S. Morton,et al.  From developmental origins of adult disease to life course research on adult disease and aging: insights from birth cohort studies. , 2013, Annual review of public health.

[6]  E. Waters,et al.  Strengths and challenges for Koori kids: Harder for Koori kids, Koori kids doing well – Exploring Aboriginal perspectives on social determinants of Aboriginal child health and wellbeing , 2012 .

[7]  J. Craig,et al.  The health of urban Aboriginal people: insufficient data to close the gap , 2010, The Medical journal of Australia.

[8]  K. Rowley,et al.  Setting and meeting priorities in Indigenous health research in Australia and its application in the Cooperative Research Centre for Aboriginal Health , 2009, Health research policy and systems.

[9]  Laura Johnson,et al.  How Many Interviews Are Enough? , 2006 .

[10]  Eileen M. Crimmins,et al.  Inflammatory Exposure and Historical Changes in Human Life-Spans , 2004, Science.

[11]  I. Harvey,et al.  A randomised controlled trial and economic evaluation of a referrals facilitator between primary care and the voluntary sector , 2000, BMJ : British Medical Journal.

[12]  M. Mathison.  The Complicity of Essentializing Difference , 1997 .