Open Access Highly Accessed Research article

A pilot study of Aboriginal health promotion from an ecological perspective

Rachel E Reilly1*, Marion Cincotta2, Joyce Doyle3, Bradley R Firebrace14, Margaret Cargo5, Gemma van den Tol3, Denise Morgan-Bulled6, Kevin G Rowley1 and the Heart Health Project Steering Committee

Author Affiliations

1 Onemda VicHealth Koori Health Unit, Centre for Health and Society, School of Population Health, the University of Melbourne VIC 3010, Australia

2 Victorian Aboriginal Community Controlled Health Organisation, Fitzroy VIC 3065, Australia

3 Rumbalara Aboriginal Co-operative, Mooroopna VIC 3629, Australia

4 Rumbalara Football Netball Club, Shepparton VIC 3630, Australia

5 School of Health Sciences, University of South Australia, Adelaide SA 5001, Australia

6 Viney Morgan Aboriginal Medical Service, via Barmah VIC 3639, Australia

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BMC Public Health 2011, 11:749  doi:10.1186/1471-2458-11-749

Published: 30 September 2011

Abstract

Background

For health promotion to be effective in Aboriginal and Torres Strait Islander Communities, interventions (and their evaluation) need to work within a complex social environment and respect Indigenous knowledge, culture and social systems. At present, there is a lack of culturally appropriate evaluation methods available to practitioners that are capable of capturing this complexity. As an initial response to this problem, we used two non-invasive methods to evaluate a community-directed health promotion program, which aimed to improve nutrition and physical activity for members of the Aboriginal community of the Goulburn-Murray region of northern Victoria, Australia. The study addressed two main questions. First, for members of an Aboriginal sporting club, what changes were made to the nutrition environment in which they meet and how is this related to national guidelines for minimising the risk of chronic disease? Second, to what degree was the overall health promotion program aligned with an ecological model of health promotion that addresses physical, social and policy environments as well as individual knowledge and behaviour?

Methods

Rather than monitoring individual outcomes, evaluation methods reported on here assessed change in the nutrition environment (sports club food supply) as a facilitator of dietary change and the 'ecological' nature of the overall program (that is, its complexity with respect to numbers of targets, settings and strategies).

Results

There were favourable changes towards the provision of a food supply consistent with Australian guidelines at the sports club. The ecological analysis indicated that the design and implementation of the program were consistent with an ecological model of health promotion.

Conclusions

The evaluation was useful for assessing the impact of the program on the nutrition environment and for understanding the ecological nature of program activities.