Health Promotion in Aboriginal and Torres Strait Islander Communities

This article discusses the Culturally Appropriate Health Promotion (CAHP) framework and its impact on the health and well-being of Aboriginal and Torres Strait Islander communities. It explores the principles of CAHP, community involvement, and the use of sociocultural health promotion strategies. The article also highlights the importance of communication, holistic approaches, and the role of social and spiritual services in promoting health equity and sustainable development.

RUNNING HEAD: HEALTH PROMOTION
HEALTH PROMOTION
Name of Student
Name of University
Author note

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Response to Question 3
i)
Health promotion of Torres Strait Islander and Australian Aboriginal community
people had been reported to have poor sustainability and low efficacy. The health strategies
have failed to appreciate and recognize the vitality of local society and cultures. Most of the
strategies have shown limited emphasis on community empowerment, holistic sociocultural
practice changes and community involvement for a practice change. The Culturally
Appropriate Health Promotion (CAHP) is an integrated framework (Demaio, Drysdale and de
Courten 2012) of different unique principles which was developed first in the year of 2008
along with WHO and Global Alliance of the Healthcare (Lawler et al. 2015) and health
promotion. It still serves as a critical guide and enhancer for formulation of community-based
health promotions (Nichols et al. 2018) based out of evidence passed sociocultural health
alteration practices. Culturally Appropriate Health Promotion (CAHP) encourages the health
promoters and the policy makers (Uzochukwu et al. 2016) to have some sort of higher
understanding, mutual respect, empowerment attitudes towards the targeted communities so
that they can utilize the environmental resources (Laudine 2016) and human resources to
implement and manifest the cultural specific health protocols with much effectiveness. This
health promotional interventions of CAHP is aligned with action areas (Fry and Zask 2016)
of both Ottawa charter ( like building healthy public policy, create supporting environments,
strengthening community actions, developing personal skills and reorienting health services.
CAHP principles work within the vortex of health promotion framework (Northridge et al.
2016) in order to explore the indigenous human and environmental forces to bring about a
collaborative healthcare empowerment.

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Strengthening public policies (Browne et al. 2017) for the Aboriginal and Islander
communities has delivered limited but useful responses amongst the community people who
have become more aware about their health with introduction of these policies. The locals
have taken up ownerships and been more oriented to the healthcare services. The diversity of
cultural beliefs (Pert et al. 2015) which are strongly related to their environments has been
targeted as well as an important strategy of this CAHP intervention. Culture and people share
a cause and effect relationship that this health intervention incorporates social determinants
(Marmot 2018), community action (Freeman et al. 2016), holistic and spiritual health
practices (Barker, Lamb and Campbell 2016) as accelerators of fast shifting community
healthcare transformation. The cultural determinants (Kingsley et al. 2018) like history,
dynamics, values, personal beliefs and ethics are also addressed by the principles of CAHP in
order to foster an effective health awareness and disease prevention. Personal skills of the
Aboriginal people and Islander people are targeted and stimulated as a cardinal intervention
of this community health promotion strategy. It is important to develop a self-sustainable
system. The CAHP interventions are community based and has set its values on the
priorities of the community. The health officers, the clinicians, social workers and nurses
working towards a community growth has lot to learn from the community people still to
make the intervention a success. A methodological development is promoted. Traditional
healers who had been an integral part of Aboriginal and Torres Strait islander community for
centuries are empowered as well to share their knowledge and skills in collaboration with a
modern biomedical approach (Bober, Beisel, and Nair, 2018)
Community involvement, empowerment (Ellis, E.M and Kral 2016) and consultation
is the first and foremost principle of CAHP strategy that uses the sociocultural framework to
achieve effective and respectful Aboriginal health enhancement. It partners with the local
people and mystic healers to forge a persistent public empowerment and health improvement.

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ii)
CAHP has definitely impacted on the daily lives of indigenous people by embedding
its venations into the obscure interplay of socioeconomic, cultural and even the educational
determinants. The health promotion strategy has aimed to reduce barriers like poverty,
illiteracy which affects the illness adversely. Holistic approach (Dunn, 2019) to the targeted
and planned health change has shown to be very crucial in the Aboriginal community where
traditional and biomedical are used concurrently. In this way, CAHP has improved the daily
lives of community people by impacting their economic, social and of course the health
status. Education, unemployment, housing and poverty have been addressed by the CAHP
program both directly and indirectly through multifactorial socio-psychological interplays.
Power, resources and money share a complex dynamics in a society or a community
but so far, CAHP has addressed the intricacies of the inequitable distributions of three things
in a very justified and skilled way. It has up-skilled the local researchers with equal
distribution of social and environmental resources who has instead worked for their own
community people, towards a common goal but has bought in economy as well for they have
been recruited in different social and medical missions. Through community action – the
autonomic self- sufficient healthcare system has been fostered through recognition of
community assets, community autonomy (Allard, 2015) and social strata (Reading, and
Greenwood 2015) equity. Program sustainability (Lennox, Maher, and Reed 2018) along with
Aboriginal ownership has improved the prospect of health promotion effectively.
With promotion of equity comes cultural homogeneity amongst the cultural diversity.
Community people play an integral role in the intervention assessment and feedback process.
Community action and community engagement process are vital to a positive trust worthy
relation building with the community members and raise public awareness (Wardle and

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Marlow 2018). For engagement, collaboration and assessment of the health program -
community consultation (Hsu et al. 2018), focus groups (Carey et al. 2016), interviews and
surveys along with guided feedback forms are pertinent to the quality check. Cultural assets
can be utilized to build a culturally active workforce and for this, CAHP has trained the local
community researchers, healers (Schmit, 2018) social workers on biomedical routines and
preventive awareness strategies to create a closed, autonomic, cooperative, collaborative
indigenous, culturally rich health change professionals. Community meetings (Nakamura,
Umeki and Kato 2017), decision making (Tranberg et al. 2016) and action taking are fostered
by CAHP’s external workers in collaboration with the indigenous workers to make the
preventive, transformational and interventional health promotion change – an experiential
journey for the Aboriginal people. The program coordinators are specifically trained for this
purpose so that they blend transparently and easily with the indigenous people on social,
cultural and communicative aspects. The program managers have indeed improved the social
consciousness of Aboriginal and Torres Strait islander people about their own social
groundings and economic, cultural perspectives from where they can use their knowledge
about social determinants of health to initiate a change in their own community and make it
last.
iii)
CAHP work chiefs on these principles which are - 1) Community involvement,
empowerment and consultation 2) Sociocultural health promotion strategies. 3) Community
assessment and feedback. 4) Utilization of communication techniques 5) Maximization of
local dialects and language 6) community healthcare autonomy and sustainable development
7) Holistic redress of a person 8) Social and spiritual services as health determinants.

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These principles primarily act on the social and environmental determinants of health.
Given the geographical location and social isolation of aboriginal and Torres Strait islander
people from rest of the urbanized Australians – it becomes vertically and laterally important
for the health promotion strategy or program to work intensively with the environment that is
both cultural and environmental environment to integrate the most appropriate, meaningful
health problem solving approaches with the culturally persistent values and ethics of the
indigenous people. Secondly, due to lack of education and knowledge – the social strata of
these aboriginal people has remained at a basal level but with a lot of potentialities and hence,
this health promotion intervention has permeated the aboriginal population with health
literacy and awareness so that they can themselves be experts and solve their own health
issues effectively and socially.
v)
System’s thinking approach uses the characteristics of social decision making,
multiple faceted thinking, purposeful planning and it integrates the contextual
interrelationship of a system with other overlapping and bigger systems. Communication and
consequent interpretation of the work processes applied the CAHP has been done with
purposeful planning certainly. Local communication along with community demographics,
values and cultures has been studied by CAHP beforehand and while experiencing the
feedback from the community system regarding the delivered community care - has improved
the decision making processes of the clinicians, nurses, healthcare administrators, health
promotion officers, local social workers, mystic and traditional healers, the local community
people. They have made better decisions about delivering and receiving a specific care for a
specific community disease. Use of locally relevant allegorical symbols that appeals to the
locals of the Aboriginal and Torres Strait islander people has definitely increased the appeal
and involvement of community in obtaining and sustenance of a treatment and health

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framework. The bigger systems like global economy, Australian social stratification and
cultural disparity have a very little effect in this areas for they are very detached from the
continent both socio-culturally and ecologically but this in a human society no matter how
much it is detached or isolated from a mainstream central socioeconomic system – the waves
of central system alteration and systemic changes affects everything contemporary of time. In
every human system say suppose a society or a culture – there exists a complex cultural and
behavioral dynamics which has to be tackled in a well-planned and multi thoughtful manner
coupled with purposeful planning and central problem solving approaches which has exactly
been done by CAHP. The practitioners of CAHP has profoundly studied, analyzed and
determined the effects of factual transformation amongst the impoverished and socio-
economically backward population such as Aboriginal and Torres Strait people. Then they
have applied the systems thinking theory and approach to construct an orchestrated health
promotion plan that would fuse rapidly and profusely with the interests of the Aboriginal
people. CAHP, as the above mentioned principles suggests, uses the already present
‘systems’ of the Aboriginal community such as a coherent culture, laborious individuals and
traditional healers and spiritualists to devise a bigger system of self-sustainable, sociocultural
health delivery system. For this, understanding the local communication and interaction
pathways is the key and this is how, CAHP made a breakthrough in the Aboriginal
community by designing its principles around communication techniques in order to blend
with ideas and psychosocial thought processes of the community people. Finally, after a
period of first interaction and initial medical point of contact with effective usage of
communication – the collaboration could be forged between the visiting practitioners of
CAHP and indigenous population of Aboriginals.
vi)

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The interventions of CAHP, surely addresses health equity and environmental
sustainability with its principals and areas of action. The program utilizes the social and
natural environmental resources of the Aboriginal community to plan, implement and deliver
a healthcare service. The community population has their own systems and networks of
sociocultural framework and health care as they have their own traditional healers and mystic
healers along with spiritualists who have been integral and embedded with their social system
since their origin. They know a lot more and in fact, they know most their own culture,
people, families, the health problems and the indigenous curative techniques which has been
their whole and sole treatment and healing ways for ages even before the emergence of
medical science and scientific technologies. Their practice has seen its own development and
has evolved with the progress of their own community over the periods when they had no
other medical or therapeutic assistance from the external world. With advancement in
technologies and global communication – the central modern world could connect to them
but has found out ways to reach them and save their culture and lives from fangs of appalling
community diseases that hinders the progress and development of the indigenous people. But
in order to foster a health change and imbue them knowledge of great diseases does not mean
uprooting their core values and beliefs and setting up something completely new that is
completely unethical. This is where CAHP program has used the right interventions with
correct scientific, evidence based and ethical approaches to address the community needs in
terms of health directly and in terms of social, cultural, economic requirements as well. Then,
it has collaborated with the people effectively transmitting the ‘disease knowledge’ to the
community so that they can use their own existent holistic medicine strategies in tandem or
together with the modern biomedical strategies to improve the overall situation rapidly
enough. It has promoted health equity by distributing the health resources equally amongst
the community people of different age groups, genders and social standings and has enhanced

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the community environment by empowering the local community people to take up the
responsibility of their own culturally safe health practice and health preventive measures.
References:
Demaio, A., Drysdale, M. and de Courten, M., 2012. Appropriate health promotion for
Australian Aboriginal and Torres Strait Islander communities: crucial for closing the gap.
Global Health Promotion, 19(2), pp.58-62.
Lawler, M., Siu, L.L., Rehm, H.L., Chanock, S.J., Alterovitz, G., Burn, J., Calvo, F.,
Lacombe, D., Teh, B.T., North, K.N. and Sawyers, C.L., 2015. All the world's a stage:
facilitating discovery science and improved cancer care through the global alliance for
genomics and health. Cancer discovery, 5(11), pp.1133-1136.
Laudine, C., 2016. Aboriginal environmental knowledge: rational reverence. Routledge.
Nichols, N., McFarlane, K., Gibson, P., Millard, F., Packer, A. and McDonald, M., 2018.
Skills, systems and supports: an Aboriginal Community Controlled Health Service
(Apunipima) approach to building health promotion evaluation capacity of staff. Health
Promotion Journal of Australia, 29(1), pp.18-22.
Uzochukwu, B., Onwujekwe, O., Mbachu, C., Okwuosa, C., Etiaba, E., Nyström, M.E. and
Gilson, L., 2016. The challenge of bridging the gap between researchers and policy makers:
experiences of a Health Policy Research Group in engaging policy makers to support
evidence informed policy making in Nigeria. Globalization and health, 12(1), p.67.
Fry, D. and Zask, A., 2016. Applying the Ottawa Charter to inform health promotion
programme design. Health promotion international, 32(5), pp.901-912.

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Northridge, M.E., Kum, S.S., Chakraborty, B., Greenblatt, A.P., Marshall, S.E., Wang, H.,
Kunzel, C. and Metcalf, S.S., 2016. Third places for health promotion with older adults:
using the consolidated framework for implementation research to enhance program
implementation and evaluation. Journal of Urban Health, 93(5), pp.851-870.
Browne, J., de Leeuw, E., Gleeson, D., Adams, K., Atkinson, P. and Hayes, R., 2017. A
network approach to policy framing: a case study of the National Aboriginal and Torres Strait
Islander Health Plan. Social Science & Medicine, 172, pp.10-18.
Marmot, M., 2018. Social Determinants, Capabilities and Health Inequalities: A Response to
Bhugra, Greco, Fennell and Venkatapuram.
Pert, P.L., Hill, R., Maclean, K., Dale, A., Rist, P., Schmider, J., Talbot, L. and Tawake, L.,
2015. Mapping cultural ecosystem services with rainforest aboriginal peoples: integrating
biocultural diversity, governance and social variation. Ecosystem Services, 13, pp.41-56.
Barker, B., Lamb, L. and Campbell, G., 2016. The Mine Island Aboriginal stone
arrangements: spiritual responses to late Holocene change on the central Queensland
coast. Australian Archaeology, 82(3), pp.232-247.
Freeman, T., Baum, F., Lawless, A., Labonté, R., Sanders, D., Boffa, J., Edwards, T. and
Javanparast, S., 2016. Case study of an aboriginal community-controlled health service in
Australia: Universal, rights-based, publicly funded comprehensive primary health care in
action. Health and human rights, 18(2), p.93.
Kingsley, J., Munro-Harrison, E., Jenkins, A. and Thorpe, A., 2018. “Here we are part of a
living culture”: Understanding the cultural determinants of health in Aboriginal gathering
places in Victoria, Australia. Health & place, 54, pp.210-220.

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Ellis, E.M. and Kral, I., 2016. I see something better soon: how a remote Community Was
transformed through Empowerment.
Bober, J.R., Beisel, C.L. and Nair, N.U., 2018. Synthetic biology approaches to engineer
probiotics and members of the human microbiota for biomedical applications. Annual review
of biomedical engineering, 20, pp.277-300.
Dunn, P.A. ed., 2019. Holistic Healing: Theories, Practices, and Social Change. Canadian
Scholars’ Press.
Allard, C., 2015. Relations between Canada and First Nations in the West (1867-1900): The
Numbered Treaties, Indian Act, and Loss of Aboriginal Autonomy. HPS: The Journal of
History and Political Science, 4.
Reading, C. and Greenwood, M., 2015. Structural determinants of aboriginal people's
health (p. 1). Toronto, Ontario, Canada: Canadian Scholars’ Press.
Lennox, L., Maher, L. and Reed, J., 2018. Navigating the sustainability landscape: a
systematic review of sustainability approaches in healthcare. Implementation Science, 13(1),
p.27.
Wardle, J. and Marlow, L.A., 2018. Public awareness of cancer screening. Cancer Prevention
and Screening: Concepts, Principles and Controversies, pp.57-68.
Hsu, C.H., Fowler, J., Cranford, J.A., Thomas, M.P. and Neumar, R.W., 2018. Integration of
Social Media With Targeted Emails and interviews for Exception From Informed Consent
Community Consultation. Circulation, 138(Suppl_2), pp.A135-A135.
Carey, D.J., Fetterolf, S.N., Davis, F.D., Faucett, W.A., Kirchner, H.L., Mirshahi, U.,
Murray, M.F., Smelser, D.T., Gerhard, G.S. and Ledbetter, D.H., 2016. The Geisinger

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MyCode community health initiative: an electronic health record–linked biobank for
precision medicine research. Genetics in medicine, 18(9), p.906.
Schmit, D.T., 2018. Warren Felt Evans: 19th-century mystic, wounded healer, and seminal
theorist-practitioner of mind cure. History of psychology, 21(3), p.187.
Nakamura, H., Umeki, H. and Kato, T., 2017. Importance of communication and knowledge
of disasters in community-based disaster-prevention meetings. Safety Science, 99, pp.235-
243.
Tranberg, R., Alexander, S., Hatcher, D., Mackey, S., Shahid, S., Holden, L. and Kwok, C.,
2016. Factors influencing cancer treatment decision‐making by indigenous peoples: a
systematic review. Psycho‐Oncology, 25(2), pp.131-141.