‘Strong Men’: Aboriginal community development of a cardiovascular exercise and health education program

Research output: ThesisDoctoral Thesis

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Abstract

Cardiovascular disease (CVD) is a major health problem for Aboriginal and Torres Strait Islander peoples and is responsible for one-third of all deaths in this group, which occur at a younger age than for non-Indigenous Australians. The leading cardiovascular conditions contributing to higher mortality rates are coronary heart disease, cerebrovascular disease and hypertensive disease. Factors contributing to CVD among Aboriginal and Torres Strait Islander peoples are complex; they reflect a combination of broad historical, socio-cultural and economic factors, as well as specific risk factors. Aboriginal men’s health in particular is a complex issue, with the continuing impacts of colonisation, marginalisation and disempowerment leading to reduced access to primary health care services and disengagement with activities that promote health and wellbeing.
The Indigenous Research Framework was utilised to inform research with and not on Aboriginal people, to provide outcomes and benefits as negotiated by and with the respective communities. The philosophical principles guiding this research were informed by social constructivist grounded theory. Using an exploratory sequential mixed methods approach, the iterative research design was comprised of three phases: Phase 1—exploring Aboriginal men’s perceptions of health and perceived barriers to health care; Phase 2—evaluating the impact of a culturally appropriate tailored exercise and health education program on the physiological risk factors associated with CVD; and Phase 3—exploring the experiences of Aboriginal men who participated in the exercise and health education program.
Sixteen Aboriginal men were recruited from the local community in Albury Wodonga, NSW, Australia. Qualitative data derived through group yarning sessions and one-to-one interviews during Phases 1 and 3 were analysed using a social constructivist grounded theory approach. Major themes that emerged were Aboriginal men’s attitudes towards health; communication; commitment to change; accessing health care; engaging Aboriginal men in health programs; health screening; group exercise; education sessions; and participants’ messages to health professionals.
Quantitative data derived from pre- and post-assessment of 10 Aboriginal men engaging with the 10-week exercise and health education program in Phase 2 demonstrated a statistically significant increase in strength and aerobic fitness and a statistically significant decrease in participants’ waist circumference, body weight, systolic blood pressure and blood glucose level (BGL).
The study findings informed the development of the ‘Strong Men’ model, co-created by the Aboriginal men and the lead researcher. This model provides a visual illustration of the grounded theory that emerged during this study and represents the experiences of the Aboriginal men during this study. Strong Men depicts four interdependent categories: Privileging Aboriginal men’s voices; Influencing Aboriginal men’s attitudes towards health and changing health behaviours; Culturally safe practice for Aboriginal men’s health and wellbeing; and Sustainable model of practice.
It is clear that Aboriginal men want to have an active voice in improving their health and wellbeing outcomes. Recommendations based on the study findings are made for health professionals, Aboriginal Community Control Health Services (ACCHS) and researchers working with, or intending to work with, Aboriginal and Torres Strait Islander communities.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Charles Sturt University
Supervisors/Advisors
  • Robinson, Caroline, Principal Supervisor
  • Jelinek, Herbert, Co-Supervisor
Award date09 Nov 2020
Place of PublicationAustralia
Publisher
Publication statusPublished - 09 Nov 2020

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