- Title
- “Footprints for Life” foot health of Aboriginal and Torres Strait Islander Peoples
- Creator
- West, Matthew
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2021
- Description
- Research Doctorate - Doctor of Philosophy (Phd)
- Description
- The limited available data shows Aboriginal and Torres Strait Islander Peoples have disproportionately high rates of diabetes-related foot disease, and experience amputation up to 38 times more frequently than non-Indigenous Australians. The high rate of diabetes-related foot disease in this population results in reduced quality of life, elevated hospitalisation rates and associated expenditure, and significantly contributes to preventable deaths. The reasons for higher rates of diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples are complex, with a lack of available culturally safe care, low socioeconomic status and poor engagement with Western health services significantly contributing to the current catastrophic outcomes. To effectively address diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples, a better understanding of the extent of the problem is required, and, there needs to be improved access to culturally safe foot care through better service provision and a more culturally capable health workforce. This thesis had the overarching aims of establishing the foot health of Aboriginal and Torres Strait Islander Peoples in the local Central Coast community, and developing methods to improve access to, and delivery of, culturally safe foot care. This thesis investigated, via systematic review, the current state of diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples and the availability and effectiveness of foot care services to reduce diabetes-related foot complications in this population. The reviews demonstrated there is a lack of nationwide data relating to diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples, and, that most data focuses on amputation rates, with little information available regarding specific types of diabetes-related foot complications. Nevertheless we found Aboriginal and Torres Strait Islander Peoples had between a 3 to 6 fold increased likelihood of both foot ulcer and minor or major amputation, and, that these occurred at a younger age. Furthermore, we found no evidence of state- or nation-wide foot health programs for prevention of diabetes-related foot disease in Aboriginal and Torres Strait Islander Peoples. Existing services were localised and there was little evaluation of the acceptability of these programs, levels of community engagement or impact on foot disease. Subsequently through an extensive community consultation process we used an effective co-design approach to develop a foot care service embedded in an undergraduate podiatry program. Key design elements included; integrating ongoing community consultation; involvement of Aboriginal health workers and practitioners connected to their local community; recognising the role of community in cultural capability training of health students; and, creating a flexible and accessible care model that is aligned with the community foot care priorities. To conduct a comprehensive evaluation of the foot care service model, we used culturally appropriate methods to determine the Aboriginal and Torres Strait Islander perspective of program success through research yarns and customised surveys, as well as service utilisation data. These data demonstrated that service elements including yarning circles and group appointments, as well as student placements, increased participant engagement with, and ownership of the clinic. Increasing accessibility to the clinic was flagged as a mechanism to further increase engagement. In addition, student placement in a culturally safe clinic significantly improved students’ understanding of multiple aspects of cultural capability (e.g. understanding of culture, history, and their interrelationship with health and health care delivery), and level of confidence with providing culturally appropriate and safe foot care. In summary this research highlights the devastating impact of diabetes-related foot disease for Aboriginal and Torres Strait Islander people and the importance of a co-designed approach to delivery of culturally safe foot health care, as well as the central role of immersive experiences for developing a culturally safe future podiatry workforce.
- Subject
- Aboriginal; diabetes; foot; disease; Indigenous
- Identifier
- http://hdl.handle.net/1959.13/1445698
- Identifier
- uon:42646
- Rights
- Copyright 2021 Matthew West
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 1 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 342 KB | Adobe Acrobat PDF | View Details Download |