title: Successful chronic disease care for Aboriginal Australians requires cultural competence.
abstract: OBJECTIVE
  To review the literature to determine the attributes of culturally appropriate healthcare to inform the design of chronic disease management (CDM) models for Aboriginal patients in urban general practice.
  
  
  METHODS
  A comprehensive conceptual framework, drawing on the Access to Care, Pathway to Care, Chronic Care, Level of Connectedness, and Cultural Security, Cultural Competency and Cultural Respect models, was developed to define the search strategy, inclusion criteria and appraisal methods for the literature review. Selected papers were reviewed in detail if they examined a chronic disease intervention for an Aboriginal population and reported on its evaluation, impacts or outcomes.
  
  
  RESULTS
  In the 173 papers examined, only 11 programs met the inclusion criteria. All were programs conducted in rural and remote Aboriginal community-controlled health services. Successful chronic disease care and interventions require adequate Aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems. These success factors fitted within the conceptual framework developed.
  
  
  CONCLUSIONS
  Research and development of culturally appropriate CDM models concurrently in both urban and rural settings will enable more rigorous evaluation, leading to stronger evidence for best practice. A partnership of mainstream and Aboriginal-controlled health services is essential to successfully 'close the gap'.
  
  
  CONCLUSIONS
  Findings will inform and guide the development, implementation and evaluation of culturally appropriate CDM in mainstream general practice and primary care.
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales, Australia.
authors.forename: Siaw Teng
authors.initials: ST
authors.lastname: Liaw
authors.forename: Phyllis
authors.initials: P
authors.lastname: Lau
authors.forename: Priscilla
authors.initials: P
authors.lastname: Pyett
authors.forename: John
authors.initials: J
authors.lastname: Furler
authors.forename: Marlene
authors.initials: M
authors.lastname: Burchill
authors.forename: Kevin
authors.initials: K
authors.lastname: Rowley
authors.forename: Margaret
authors.initials: M
authors.lastname: Kelaher
mesh_terms: D001315:Australia; D002908:Chronic Disease / Q000208:ethnology* / Q000628:therapy; D003466:Cultural Characteristics; D054521:Cultural Competency; D003469:Culture; D003695:Delivery of Health Care / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D008962:Models, Theoretical; D011320:Primary Health Care / Q000458:organization & administration; D014505:Urban Population