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Kanyini Qualitative Study

Disparities in health status are well documented for Indigenous Australians, with the life‐expectancy gap between Indigenous and non‐Indigenous people constituting one of Australia’s most enduring health divides.

young aboriginal woman

Study Objectives

  • Understand patients’, communities’, health care providers’ and policy-makers’ views regarding barriers to and enablers of care;
  • Determine the key structural and organisational components of health services that affect their accessibility and the quality of care provided;
  • Explore the components of clinical interactions between health care providers and service users that affect perceived quality of care; and
  • Explore how barriers to care are experienced, understood and expressed differently in various health care settings, and between Aboriginal and/or Torres Strait Islander community members and health practitioners, with a view to developing integrated interventions in chronic disease across health care sectors.

Study Design

The Kanyini Qualitative Study (KQS) is an in-depth exploration of barriers and enablers to care for Indigenous Australians with chronic disease. A theoretical framework incorporating the concepts of health care accessibility, candidacy and the Aboriginal caring praxis of kanyini underpin the study.

To develop practical interview tools, five key domains to examine ‘care’ within health settings pertinent to Indigenous Australians were proposed. These thematic domains were distilled into five overarching research questions:

  1. What frames Indigenous Australians’ engagement with care?
  2. What does it mean to be looked after properly?
  3. What are Indigenous Australians’ experiences of chronic disease care?
  4. What are the primary barriers to and enablers of care for Indigenous Australians with chronic disease and their families?
  5. How do we develop better systems of care for Indigenous Australians?

Engaging study partners

In order to engage health services and communities as partners in this research study, the KQS relied on the effectiveness of working through peers in key stakeholder networks. This process was expedited through re-engaging with communities and their health services via relationships that had already been established during the conduct of the Kanyini Audit Study.

Integral to the appropriate and successful research-engagement process was the role of the local Indigenous Research Fellows (IRFs). KVC employs five IRFs across various sites within Central Australia, New South Wales and Queensland. The site-based IRFs and IRFs based at the George Institute and Baker IDI  have been actively involved in the KQS processes at local sites, from identifying potential participants, to brokering participation and facilitation of informed consent, conducting interviews, participating in data coding and contributing to data analysis for the purposes of feedback to local communities and health services.

Data collection approach to analysis

The KQS used a purposive, or maximum diversity sampling strategy. As at February 2012, semi-structured interviews had been conducted with 126 Indigenous community participants and 97 health care providers (Indigenous n=41) across participating sites. Interviews were transcribed and the resulting data analysed thematically. Indigenous perspectives in relation to interpretation of the data were maintained through the IRFs’ key contribution to data collection, coding and analysis. Building research capacity for these IRFs was an integral part of the project.

Knowledge translation

Analysis of site-specific data for the purposes of feedback to participants within study sites is currently in progress, and will be completed by June 2012. After feedback, the KQS research team will commence analysis of the national dataset. Anticipated outputs from analysis include reports to NHMRC and study stakeholders, as well as the development of publications for peer reviewed journals.

For further information regarding this project, please email Bernadette Rickards.