Breathe Easy Walk Easy, Lungs for Life (BE WELL): Partnering with Aboriginal Community Controlled Health Services to implement pulmonary rehabilitation and contribute to lung health service provision.

Abstract

Background: Colonisation continues to negatively impact Aboriginal peoples, contributing to a higher prevalence of chronic health conditions, such as chronic obstructive pulmonary disease (COPD).

Aim: To understand the lived experiences of Aboriginal people with COPD, build workforce capacity to provide pulmonary rehabilitation (PR) within Aboriginal Community Controlled Health Services (ACCHS), map the respiratory services provided by ACCHS

Methods: The BE WELL project partnered with ACCHS using implementation science methodologies. Methods were used were: Ch 2 systematic review; Ch 4 qualitative methods using interviews; Ch 5 quantitative survey and qualitative interviews; Ch 6 quantitative survey.

Results: Ch 2 illustrated the lack of research about PR interventions, for Indigenous adults with COPD. Ch 3 provided the BE WELL protocol. In Ch 4 Aboriginal people with COPD reported low knowledge and awareness of COPD and PR and expressed feelings of shame and social isolation on receiving a COPD diagnosis. Ch 5 demonstrated the use of videoconferencing to provide education for ACCHS staff to increase COPD knowledge and build skills in leading ‘yarning’ education in PR programs. Ch 6 reported main respiratory services provided by NSW-based ACCHS were smoking cessation and spirometry, but no PR with the main barriers being lack of staff, inadequate staff training, lack of funding and limited space.

Discussion: This thesis provides evidence that collaborating with ACCHS guided by Aboriginal knowledges and methodologies alongside implementation science-based research builds workforce capability and enhances the delivery of culturally safe COPD care, particularly PR. Given the disproportionate impact of COPD within Aboriginal communities, compounded by limited access to PR in culturally safe ACCHS environments future investments are imperative to advance ACCHS-led COPD care.