Background:

Indigenous Australians suffer high rates of chronic disease and their associated complications.  Many of these complications can be prevented with better access to culturally appropriate primary health care. The aim of the Getting Better at Chronic Care (GBACC) project is to evaluate the effectiveness of an Indigenous health worker (IHW)  led case management approach to the care of Indigenous adults with poorly controlled type 2 diabetes (T2DM) in remote communities in northern Queensland

Methods:

The project is a randomised control trial of a family-centred model of primary health care with IHWs undertaking intensive case management of clients with uncontrolled T2DM and other chronic conditions.  IHWs had training at commencement of employment to provide them with the skills needed to fulfil their role.  This included clinical skills update, motivational interviewing and CQI approach. They receive ongoing support from a clinical support team based in Cairns who deliver education and training and provide mentorship

Results/Discussions:

 The project was successful in achieving the primary outcome measure of a 1% reduction in Hba1c in the intervention communities. A key factor contributing to this success is the health education delivered by IHWs to clients enrolled in the project.  The intensive education and training regarding chronic disease prevention and management has enabled the IHWs to feel more confident and capable to spend time imparting health information and educating clients. The IHWs are able to tailor the education in language with storytelling and use of analogies which has improved client self-reported understanding of their medicines and other self-management strategies.

Conclusions/implications:Health literacy is more than a health professional with the same language sharing information with their client. When IHWs understand the theoretical basis for health promotion and education they are able to “interpret” information in a way that is understood by the client and which subsequently influences health behaviors, attitudes and ultimately health outcomes.