Cultural respect in general practice: a cluster randomised controlled trial.

Area of Science:

• General Practice
• Indigenous Health
• Cultural Respect

Background:

• Culturally appropriate care is essential for Indigenous Australians.
• General practices require effective frameworks to improve cultural respect and clinical practice.
• The Ways of Thinking and Ways of Doing (WoTWoD) framework was developed to address these needs.

Purpose of the Study:

• To evaluate the effectiveness of the WoTWoD framework in enhancing clinically appropriate anticipatory care for Indigenous patients.
• To assess the impact of the WoTWoD framework on the cultural respect levels of general practice staff.

Main Methods:

• A mixed-methods, cluster randomized controlled trial with a participatory action research approach was employed.
• Fifty-six general practices in Sydney and Melbourne participated between 2014 and 2017.
• The intervention involved a toolkit, workshop, cultural mentor support, and local partnerships over 12 months.

Main Results:

• No statistically significant difference was observed in the rates of Medicare Benefits Schedule (MBS) item 715 claims (health assessments for Indigenous Australians) between intervention and control groups.
• Recording rates of chronic disease risk factors did not significantly differ between the groups.
• Mean changes in cultural quotient (CQ) scores for practice staff showed no significant improvement, irrespective of staff category or practice attributes.

Conclusions:

• The WoTWoD program did not lead to an increase in Indigenous health checks or improved cultural respect scores in general practice settings.
• Further investigation into conceptual, methodological, and contextual factors is required to enhance cultural mentorship and culturally respectful clinical practice for Indigenous healthcare.