Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
REVIEW (Open Access)

Health and wellbeing outcomes of programs for Indigenous Australians that include strategies to enable the expression of cultural identities: a systematic review

Sarah MacLean A B D , Rebecca Ritte A , Alister Thorpe A , Shaun Ewen C and Kerry Arabena A
+ Author Affiliations
- Author Affiliations

A Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Vic. 3010, Australia.

B Department of Community and Clinical Allied Health, La Trobe University, Bundoora, Vic. 3086, Australia.

C Melbourne Poche Centre for Indigenous Health, University of Melbourne, Vic. 3010, Australia.

D Corresponding author. Email: s.maclean@latrobe.edu.au

Australian Journal of Primary Health 23(4) 309-318 https://doi.org/10.1071/PY16061
Submitted: 17 May 2016  Accepted: 19 March 2017   Published: 16 June 2017

Abstract

Indigenous people have long maintained that strong cultural identities are critical to health and wellbeing. The purpose of this systematic review is to examine whether interventions that entail strategies to enable expression of cultural identities for Australian Indigenous peoples are associated with measurable improvements in health and wellbeing. Peer-reviewed articles that reported quantitatively expressed health and wellbeing outcomes involving Indigenous Australian participants only were included. The cultural intervention component was defined and assessed by Indigenous researchers on the team. A narrative analysis was conducted. The protocol was registered on PROSPERO (CRD42015027387). Thirteen articles describing eleven studies were identified, including one randomised control trial (RCT), one cluster RCT and two studies with non-randomised controls. Other studies reported on case series or cross-sectional studies. All except two studies described multiple intervention strategies. Eight studies showed significant improvement in at least one psychosocial, behavioural or clinical measure, with two showing a positive direction of effect and one showing no improvement. Publication bias may discourage researchers to report negative findings of these interventions. Although studies vary in quality, this review provides evidence that interventions that include opportunities for expression of cultural identities can have beneficial effects for Australian Indigenous peoples.


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