title: Cancer support services--are they appropriate and accessible for Indigenous cancer patients in Queensland, Australia?
abstract: BACKGROUND
  In Queensland, Australia, the incidence of cancer (all cancers combined) is 21% lower for Indigenous people compared with non-Indigenous people but mortality is 36% higher. Support services play an important role in helping cancer patients through their cancer journey. Indigenous cancer patients are likely to face greater unmet supportive care needs and more barriers to accessing cancer care and support. Other barriers include the higher proportion of Indigenous people who live remotely and in regional areas, a known difficulty for access to health services. This study describes the availability of cancer support services in Queensland for Indigenous patients and relevant location.
  
  
  METHODS
  Using a set criteria 121 services were selected from a pre-existing database (n = 344) of cancer services. These services were invited to complete an online questionnaire. ArcGIS (http://www.esri.com/software/arcgis/index.html) was used to map the services' location (using postcode) against Indigenous population by local government area. Services were classified as an 'Indigenous' or 'Indigenous friendly' service using set criteria.
  
  
  RESULTS
  Eighty-three services (73.6%) completed the questionnaire. Mapping revealed services are located where there are relatively low percentages of Indigenous people compared with the whole population. No 'Indigenous-specific' services were identified; however, 11 services (13%) were classed 'Indigenous-friendly'. The primary support offered by these services was 'information'. Fewer referrals were received from Indigenous liaison officers compared with other health professionals. Only 8.6% of services reported frequently having contact with an Indigenous organisation; however, 44.6% of services reported that their staff participated in cultural training. Services also identified barriers to access which may exist for Indigenous clientele, including no Indigenous staff and the costs involved in accessing the service, but were unable to address these issues due to restricted staff and funding capacity.
  
  
  CONCLUSIONS
  Further research into the best models for providing culturally appropriate cancer support services to Indigenous people is essential to ensure Indigenous patients are well supported throughout their cancer journey. Emphasis should be placed on providing support services where a high Indigenous population percentage resides to ensure support is maintained in rural and remote settings. Further efforts should be placed on relationships with Indigenous organisations and mainstream support services and encouraging referral from Indigenous liaison officers.
authors.affiliation: Epidemiology and Health Systems, Menzies School of Health Research, Brisbane, Queensland, Australia.  Lisa.Whop@menzies.edu.au.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Whop
authors.forename: Gail
authors.initials: G
authors.lastname: Garvey
authors.forename: Kamalini
authors.initials: K
authors.lastname: Lokuge
authors.forename: Kylie A
authors.initials: KA
authors.lastname: Mallitt
authors.forename: Patricia C
authors.initials: PC
authors.lastname: Valery
mesh_terms: D000288:Administrative Personnel / Q000523:psychology / Q000706:statistics & numerical data; D002173:Cancer Care Facilities / Q000191:economics / Q000706:statistics & numerical data*; D002391:Catchment Area, Health / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000379:methods; D005380:Financing, Government / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards*; D006303:Health Services, Indigenous / Q000600:supply & distribution*; D006801:Humans; D007255:Information Services / Q000600:supply & distribution; D009369:Neoplasms / Q000628:therapy*; D009862:Online Systems; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D044382:Population Groups / Q000706:statistics & numerical data*; D011793:Queensland; D012944:Social Support; D011795:Surveys and Questionnaires; D000078329:Workforce