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EMPOWERMENT THROUGH COMMUNICATION; GUIDING OUR ABORIGINAL AND TORRES STRAIT ISLANDER COMMUNITIES THROUGH THE PANDEMIC

Dr Hung The Nguyen talks through the challenge of providing accurate health information that is culturally appropriate for Aboriginal and Torres Strait Islander Communities and how his clinic addressed this challenge.

Disclaimer

The Challenge:

Addressing the risk to Aboriginal and Torres Strait Islander communities during a pandemic (00:01:13).

The Solution:

The speed at which accurate information is disseminated is crucial, however, this information also has to be culturally appropriate and distributed through channels that are going to be used. Bunurong Health Service utilised Facebook and received help from a senior Aboriginal Health worker in order to create content that was evidence-based and culturally safe (00:04:11). 

The Impact:

Bunurong Health Service has seen sustained high engagement and community participation from their social media posts. These posts have also been shared by community services outside of their catchment. As a result, health professionals have seen the highest flu vaccine uptake ever this year within the indigenous community (00:06:30).

Resources:

Bunurong Health Services Facebook page

Prof George Braitberg

Dr Hung The Nguyen

Hung The Nguyen has a long term commitment to Aboriginal and Torres Strait Islander Health and cultural competency training and education. Medical and cultural education is his number one passion as it allows him to make a greater impact on people's lives through education and training. He has worked extensively as a GP and Medical and Cultural educator in urban and rural and remote Aboriginal community health services throughout the Northern Territory and Victoria. 

He currently works as a GP at Bunuron Health Service in Dandenong. He was the Inaugural Censor for RACGP Aboriginal and Torres Strait Islander health for nine years and Director of Medical and Cultural Education for NGTPE for five years where he oversaw GP education for the Territory. 

Hung sits on a number of Primary Care and Health Education boards (Health Education Australia Limited, Therapeutic Guidelines, South Eastern Melbourne PHN) and Councils (AMA Victoria, Executive Committee for the Victorian Clinical Council, Safer Care Victoria and Chair SEMPHN Clinical Council).

Through his appointments, he is concerned with positive patient journeys through the health system and patient engagement in the quality improvement process in health care.

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Video transcript

Melanie Hay:

Welcome to another episode of the AICG Connecting Clinicians: COVID-19 Clinical Governance Challenge Series. Today, we're welcoming Hung Nguyen from Bunurong Aboriginal Health Services in Dandenong. Welcome Hung.

Hung Nguyen:

Thanks Mel. It's good to be here.

Melanie Hay:

Hung, could you just start by telling us a little bit about the Aboriginal Health Services, please?

Hung Nguyen:

I work in an Aboriginal Community Controlled Health Service. It's in Dandenong. There's about 250 services like these around Australia, and there's about two in Melbourne. Basically, the thrust of the health service is to provide a comprehensive, continuous, and culturally safe primary healthcare to its community. Then, there's also a big focus on preventive care health promotion to ensure that we empower the community, their families, and the individuals that visit our service.

Melanie Hay:

So Hung, could you tell us a little bit about the challenges of working with the aboriginal communities, particularly in this point in time?

Hung Nguyen:

(00:01:13) During the pandemic, we realised that we're servicing a community that's most at risk and most vulnerable to COVID-19. Some of the reasons people are quite aware of, that is the high rate of chronic diseases, high rate of mental health illness, overcrowding, low unemployment and educational attainment, low access to healthcare, low-level health literacy, and of course cultural safety concerns when they visit hospitals, testing sites, and other primary care services. So, that's a challenge for us.

In terms of communicating with aboriginal communities, we realise that there's poor access to reliable information. When the reliable information is available, the information gets to these vulnerable communities quite late. The information is poorly targeted to the community as well, and when it's targeted, the messaging is not maintained at the level that it needs to be because things change so quickly on a daily basis, if not on a weekly basis that this messaging needs to reach every state's community.

The other challenge for us that we realise is that health literacy in the community is quite poor. I don't just mean the literacy and numeracy issue, but the conceptual understanding of science and medicine to explain what happens in the pandemic. The other thing is, the literacy of systems. So healthcare systems that people have to navigate through to get the care they need.

Lastly, the other issue that we notice is one of culture or culturally appropriate information reaching the local communities. Advice that they get may sound strange to them. For example, social distancing and avoiding family doesn’t make sense to a collectivist society. The information may be misinterpreted. For example, staying at home, don't go to the clinic, use telehealth, gives the impression that I shouldn't attend the clinic at all.

The other thing is that the format of the information is sometimes quite lengthy and it focuses on things that may not matter to the Aboriginal Torres Strait Islander community and families. So, those are some of the challenges that we noticed.

Melanie Hay:

Hung, if you could talk us through the solutions that you've put in place to address this challenge that you found?

Hung Nguyen:

(00:04:11) So, I just want to talk about one solution that we did that we're really proud of and that's worked quite well is the use of social media. The social media platform we used was Facebook. We realised we needed something that can disseminate information fairly quickly. We realised that a lot of community members have ownership of mobile phones including the older people.

We know that the community is quite a collectivist community, which means information will be shared even if people don't have a Facebook account for example. We enlist a GP, that's me, and a senior aboriginal health worker to do the posts. This ensures that the information provided is reliable, it's evidence-based information, but it also maintains some cultural safety in terms of the language of the post, the length of the post, the illustrations, the images used, and also that the topics matter to the community.

Some of these topics may relate to elder's safety, children's safety, scammers that are in the webspace and online, vaccines, rate of infection in the Aboriginal community, which is not presented widely elsewhere but that matters to the aboriginal community. We had planned campaigns, for example, flu vaccine, COVID-19 testing, safe social distancing on Facebook. We featured people that really engage the community. So, kids engage the community very well and also elders. Through Facebook, we're able to nudge people behaviour in such a way that it benefits their health. So, I encourage people to have a look. It is public. A lot of people are engaging outside of our community. So if you like, you can engage through our Facebook.

Melanie Hay:

So lastly Hung, if you could talk us through the impact or the outcome that implementing these solutions has had?

Hung Nguyen:

(00:06:30) So, we're very proud of the outcome. I think it allowed that rapid engagement that I spoke about. It's proven to be the best platform, that is the Facebook page. There's sustained engagement at a very high level to all the posts that we notice. This shows through the community's participation in the campaigns that we had. So, we've had the highest rate of flu vaccination uptake ever this year because of the communication. We have continuing in-person consultations for patients without symptoms.

We communicate that our clinic has flexible options for care that's acceptable to the community when explained to them quite clearly on the post. So it's been great, the engagement. It's also been used by other communities outside our catchment, where they shared our post to their own community because the information is so helpful. They actually help us to promote our post to a wider audience as well. Sometime, these people are in position of high regard. For example, councils in the local area, a CEO of other Aboriginal Community Controlled Health Services, staff of the Victorian Aboriginal Community Controlled Health Organisation because they connect with a lot of other people. We call these guys connectors or influencers, and it allowed the post to go a little bit more viral.

I think that's good because it allows other communities to see what can be done to communicate to empower aboriginal community members. So those are some of the outcomes. That's been really good.

Melanie Hay:

Hung, I'd just like to take the opportunity to thank you for taking part today, but also for the wider work that's going on within general practice. So the work of yourselves, your colleagues, and the general practice community, so just a very heartfelt thanks from us at this time.

Just again, we continue to reach out to other clinicians across the board who might like to share a challenge that they're also facing, or if you've got a suggestion for something that you'd like to see hosted during one of the series interviews, reach out to us at info@aicg.edu.au. So until next time, stay safe and Kia Kaha.