A project examining the management of chronic conditions through personalised support programs has resulted in health improvements for 36 Aboriginal clients of three community controlled health centres in South Australia, according to the final project report released earlier this year.
Chronic Conditions Management Strategies in Aboriginal Communities project began in 2008 with funding from the former CRC for Aboriginal Health and was supported by the Lowitja institute through to its end in 2011. The goal was to evaluate – and where possible develop and demonstrate – effective and transferable chronic condition management strategies, and to generate research evidence about their processes, impacts and health outcomes.
It was known from previous research that certain strategies for managing chronic conditions could be tailored to suit Aboriginal and Torres Strait Islander settings and clients. Those strategies included structured care planning focused on clients’ problems and goals, training in chronic disease management and self-management support for staff and peer leaders, as well as coordinated holistic team care. However, little was known about the health impacts and outcomes, sustainability or transferability of such promising chronic condition management strategies.
The health care services involved were Port Lincoln Aboriginal Health Service (PLAHS), Nunkuwarrin Yunti in Adelaide and Riverland Community Health Service in Berri. All had different levels of expertise and experience in dealing with chronic conditions, so the project team’s role differed in each location. However, all three sites were supported to introduce or enhance client-centred care plans and self-management.
At the end of the trial, group analysis of the longitudinal clinical data from the 36 clients showed statistically significant and small, but clinically important, improvements over time in key indicators of health: body mass index, total cholesterol, triglyceride and LDL (the ‘bad’ cholesterol) and HbA1c (a measure of diabetes control).
The clients also reported feelings of improved control over their own lives, including:
- new knowledge about chronic conditions and how to manage them
- empowerment and taking control of their own health
- setting and achieving personal goals
- reassurance and keeping track of progress
The Chronic Conditions Management Strategies in Aboriginal Communities: Final Report also showcases clients’ individual experiences of health services and the program through a series of interviews, which cover such topics as transport, affordable services, cultural safety, clinical management practices and peer support activities.
Other project outputs include capacity development for Aboriginal staff members at the health centres, a Community Storybook about the development and activities of the Riverland Aboriginal Chronic Disease Support Group and the development of health promotion posters in collaboration with PLAHS to encourage health checks. The project has also informed modification to existing training courses, such as the Flinders Program for Chronic Condition Management based at Flinders University.
ISSUE 6 / APRIL 2012 Page 8