Meaningful health care that matters to Indigenous people in Australia. That was the end goal of a project that surveyed over 2,000 Aboriginal and Torres Strait Islander adults over a five-year period.
Dr. Michelle Dickson, associate professor at the University of Sydney, spoke in Vancouver at Healing Our Spirit Worldwide (HOSW) about the What Matters 2 Adults project. An Aboriginal woman who is Darkinjung on her mother's side and Ngarigo on her father's, Dr. Dickson said that the journey began out of frustration of how health services in Australia have a deficit-base narrative—that is to say, health care often asks what is going wrong, rather than what is going right.
Dr. Dickson said when the project began in 2017, health care funding was not informed by Aboriginal or—in her region of the country—Torres Strait Islander needs. The problem, as identified, was that health care funding requires measurements, or metrics, and at the time there was not much data.
The What Matters 2 Adults study, conducted between 2017-2022, aimed to determine those metrics in a culturally relevant and accurate manner that was strengths-based.
“We wanted to look at the beautiful things that keeps us well," she said.
A strengths-based approach is one that doesn't ignore challenges and injustices but uses a lens that focuses on the aspirations of Indigenous culture and people.
Dr. Dickson said that all aspects of the study strove to bring Indigenous voices and perspectives to the forefront to ensure health care measurements are grounded in Indigenous values. This was important, knowing that clinical decision-making, service delivery, and policies will be shaped by these measurements.
The study used the tradition of yarning (weaving in British Columbia) to create a metaphor for the fabric of Indigenous wellbeing. The strands of family, community and culture intersect with belonging and connection, holistic health, purpose and control, dignity and respect, and basic needs.
Dr. Dickson said that the wellbeing score is measureable; the clinician or Aboriginal support workers are able to have more informal conversations than the usual “yes or no" clinical intake forms. Through this process, the support worker can identify needs and work on finding supports, something that wasn't possible before the creation of What Matters 2 Adults.
“What keeps them strong in their life and do they have it? And if they don't, how can we make this work?"
The most important part of the study is that Indigenous people have a means of using culturally relevant, strengths-based approaches on their health care journey.
“People say to me, 'Western medicine healed part of me, but culture healed the rest,'" said Dr. Dickson.
Now that there is a measurement for adults, she said the next step is to get measurements for youth and children. That project is expected to run from 2023-27, if they can secure funding.