Journal Article

Culturally competent communication in Indigenous disability assessment: a qualitative study

Cullen, Jennifer, Savarirayan, Ravi, Baynam, Gareth, Paradies, Yin, Ferdinand, Angeline, Temple, Jeromey, Meiselbach, Kristy, Kelaher, Margaret, Massey, Libby

2021

Overview

Background Indigenous people tend to exhibit a higher burden of disability than their non-Indigenous counterparts, and are often underserved by disability services. Engaging appropriately with Indigenous communities, families and individuals in the initial stages of disability assessment and planning is crucial in order to build trust and understanding of disability service models and ensure that Indigenous people receive support that is tailored to their needs and cultural realities. This article aims to identify key elements of culturally competent communication in Indigenous disability assessment and planning, and provide recommendations for strengthening capacity in this area. Methods This qualitative research was designed to involve Aboriginal and Torres Strait Islander people at all stages and to reflect the views of Aboriginal and Torres Strait Islander researchers, people and families affected by disability and the community-controlled health sector. Semi-structured individual interviews were undertaken with staff implementing the National Disability Insurance Scheme (NDIS) ( n  = 4), NDIS participants ( n  = 24), disability support providers and organisational partners ( n  = 19) and Community Connectors ( n  = 8) in Queensland and the Northern Territory of Australia. Key themes derived from thematic analysis included appropriate and adequate engagement of individuals with disability and their families, the role of trusted relationships, and culturally safe and appropriate communication during planning meetings. Results Overall, the research findings highlight that a low level of cultural competence in the initial stages of the disability assessment and planning process exacerbated participant confusion and distrust towards assessment staff and the NDIS. Given difficulties in communication, participant understanding of the NDIS was generally limited. The necessity of culturally safe and appropriate use of interpreters was stressed, as was the role of trusted individuals, including existing service providers, Community Connectors and family members in providing a solid base for participant understanding of the NDIS. Conclusions Cultural competence in disability assessment and planning can be strengthened through multi-level engagement with the Aboriginal community-controlled sector and community leaders. Implementing mechanisms to enable the involvement of families, trusted service providers and Community Connectors can support a more meaningful understanding of individuals’ needs within their cultural context and in relation to their cultural roles.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Australia / Australian Aboriginal and Torres Strait Islander Peoples / Australian aborigines / Communication / Community Health Services - organization & administration / Community-Based Participatory Research / Connectors / Cultural competence / Cultural Competency / Culturally Competent Care / Demographic aspects / Design / Disability / Disability Evaluation / Disability insurance / Disabled services / Equality and Human Rights / Funding / Health aspects / Health care / Health Policy / Health Promotion and Disease Prevention / Health Services Research / Health Services, Indigenous / Humans / Indigenous health / Indigenous peoples / Influence / Interpreters / Interviews / Interviews as Topic / Medicine / Medicine & Public Health / Native peoples / Northern Territory / People with disabilities / Public Health / Qualitative Research / Social aspects / Social Justice / Social Policy