Journal Article

“I feel more comfortable speaking to a male”: Aboriginal and Torres Strait Islander men’s discourse on utilizing primary health care services

Harfield, Stephen, Wittert, Gary, Canuto, Kootsy, Brown, Alex

2018

Overview

Background Aboriginal and Torres Strait Islander men have the highest morbidity and mortality rates, and lowest rates of health service utilization in Australia. There is a current perception that Aboriginal and Torres Strait Islander men are disinterested in their health. This study aimed to identify the perceived motivators, barriers and enablers of Aboriginal and Torres Strait Islander men’s utilization of primary health care services, explore their experiences and obtain suggestions from them as to how services could be modified to improve utilization. Methods This study utilized the principles of Indigenist Research Methods. Semi-structured interviews with Aboriginal and Torres Strait Islander men ( N  = 19) took place in South Australia and far north Queensland. Participants were asked about their experiences with primary health care services, including what they could remember as a child. A thematic analysis of the qualitative data was completed without the use of computer software. Results Feelings of invincibility, shame, being uncomfortable, fearful, along with long waiting times, having a lack of knowledge, and culturally inappropriate staff/services were all found to be barriers to service utilization. Enabling factors included convenience, the perceived quality of the service, feeling culturally safe and/or a sense of belonging, and having a rapport with staff. Motivation for attending primary health care services included going when feeling sick/unwell, attending a particular service (dental or sexual health), visiting for check-ups and preventative health and family encouragement. This study also highlights strategies surrounding logistical factors, promotion of services and improved communications, having culturally appropriate services and providing gender specific services all of which were suggested by the participants to improve service utilization. Conclusion Contrary to common misperceptions, this study demonstrated that most of the Aboriginal and Torres Strait Islander men participants were motivated to engage with primary health care services for preventative health care. Even though there were men that fitted the stereo-type who avoid doctors, there were usually underlying reasons and barriers accounting for this reluctance. This study suggests that if primary health care services commit to better understanding the barriers, enablers and motivators their cohort of men face, then utilization could be greatly improved.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aboriginal / Aboriginal Australians / Australia / Australian Aboriginal and Torres Strait Islander Peoples / Demographic aspects / Equality and Human Rights / Female / Government agencies / Health aspects / Health care / Health Policy / Health Promotion and Disease Prevention / Health service utilization / Health services / Health Services Research / Health services utilization / Health Services, Indigenous / Humans / Indigenous / Interviews / Male / Males / Medical care utilization / Medicine / Medicine & Public Health / Men / Men's health / Mens health / Morbidity / Native peoples / Patient Acceptance of Health Care - psychology / Patient Acceptance of Health Care - statistics & numerical data / Patient Preference - psychology / Patient Preference - statistics & numerical data / Physicians / Primary care / Primary Health Care / Primary health care services / Psychological aspects / Public Health / Qualitative analysis / Qualitative research / Queensland / Research methods / Sexual health / Social Justice / Social Policy / South Australia / Studies / Torres Strait Islander / Torres Strait Islanders / Transportation services / Utilization