A Culturally Responsive Indigenous Health Worker Spirometry Training and Mentoring Programme (IHWS) Increases
Leanne Rodwell1,2, Irene Schneider1,3, Anne Bernard4
1Indigenous Respiratory Outreach Care Program, Queensland Children's Hospital, South Brisbane, Queensland, Australia.
Objective:
Evaluate the impact on spirometry quality of a culturally responsive Indigenous Health Worker Spirometry Training and Mentoring programme (IHWS).
Methods:
Participation in two-day face-to-face IHWS including post-training telehealth mentoring DESIGN: Submission of spirometry reports before training (T1), after training (T2) and after telehealth mentoring (T3).
Setting:
Urban, rural and remote primary healthcare services in Queensland Australia.
Participants:
Primarily Australian First-Nations Health Workers.
Main Outcome Measures:
Two raters used nine-point quality criteria to score spirometry at T1, T2 and T3. Inter-rater reliability was assessed using Cohen's original kappa. Reports submitted at a minimum of two time-points were included in the analysis. A linear mixed model analysis and post hoc analysis assessed differences in total scores across different timepoints.
Results:
Between 2011 and 2018, 360 participants (75.5% Indigenous) attended 43 workshops. Of the 284 participants attending workshops #1-#34, 56.7% (161/284) hadn't performed spirometry before IHWS and were excluded from comparative analysis because spirometry reports could be submitted at only one timepoint (T2). Introduction of telehealth mentoring sessions from workshop #35, increased spirometry submission for assessment at T2 from 9.9% (28/284) to 68.4% (52/76). Thirty-six participants submitted reports at two timepoints or more. Spirometry quality improved across all timepoints (p < 0.001). Inter-rater reliability was good or very good (0.83-0.91).
Conclusion:
Two-day F2F culturally responsive IHWS training increases the quality of spirometry testing. Further increases in quality occur after telehealth mentoring. This model could be adapted to teach spirometry to First-Nation's health workers of other nations.
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