Children as health ambassadors: an approach to improving health, wellbeing and learning outcomes for Australian Aboriginal children and communities

Abstract

Significant challenges exist in addressing child health and development inequities experienced within Aboriginal communities. The resolution in providing effective access to health care is complex because of challenges associated with the availability and physical proximity of services for those in remote areas, service affordability and cultural aspects of acceptability. This thesis presents research grounded in acknowledgement that the inequities experienced by Aboriginal people today result from the devastating effects of colonisation and embedded cultural hegemony within current policy and service systems. It also is guided by a commitment to voice and power in decision-making, including the right of children to have their voices heard. Currently, limited Australian research engages children as active agents for change and is aimed at improving health outcomes for Aboriginal communities. This research fills an essential gap in the literature and is clinically important, as a child-focused approach to improved health literacy could lead to improved health outcomes for Aboriginal communities. For this purpose, the researcher explored the effect of a program that aims to be child centred, community embedded, co-designed and strengths based to improve the health and wellbeing of Aboriginal children in their middle childhood years. The Young Doctors for Life program is delivered by the Malpa Project and seeks to enhance children’s knowledge of health and wellbeing so that they become health ambassadors within their communities. When opportunities were available during the 2020–2022 COVID-19 lockdowns and around major bushfires and floods, the field researcher (thesis author) visited a regional community in New South Wales where the Young Doctors for Life program was being implemented to build relationships with Aboriginal research partners and participants. The research involved 22 Aboriginal children, their parents and two of the children’s schoolteachers, alongside Aboriginal community members who were the program facilitators. The data were collected using two focus groups with the program implementation team, semi-structured interviews with the children, written survey responses from the children’s parents and semi-structured interviews with the children’s schoolteachers. The findings explored the children’s experiences of being part of the Young Doctors for Life program and the self-reported effect it had. It also examined parents’ experiences of how the program had affected their children’s behaviour at home and in the community and schoolteachers’ experiences of the effects on the classroom environment. The qualitative data analysis used the techniques of thematic analysis. This thesis makes a case for the following: (a) the importance of engaging with children as key stakeholders in initiatives to address health inequities; (b) the importance of co-designing and co-adapting programs to ensure local relevance, bringing the old and new ways of healing together by way of a participatory, community-driven, strengths based approach; and (c) the importance of supporting children’s rights to express themselves on matters that affect their lives and to give their views due weight. The initial positive findings from this research highlight the need for further evaluation of a child health educational approach in other locations to determine wider effects on health literacy for Aboriginal children and the model’s impact over time and in diverse locations.

Date of Award	2023
Original language	English
Awarding Institution	Western Sydney University
Supervisor	Rebekah Grace (Supervisor)