title: Principles for the development of Aboriginal health interventions: culturally appropriate methods through systemic empathy.
abstract: OBJECTIVE
  To increase Aboriginal participation in mainstream health services, it is necessary to understand the factors that influence health service usage. This knowledge can contribute to the development of culturally appropriate health services that respect Aboriginal ways of being.
  
  
  METHODS
  We used a community-based participatory approach to examine the reasons for underutilization of health services by Aboriginal Australians.
  
  
  RESULTS
  Based on three focus groups and 18 interviews with Aboriginal health professionals, leaders, and community members in rural, regional, and urban settings, we identified five factors that influenced usage, including (1) negative historical experiences, (2) cultural incompetence, (3) inappropriate communication, (4) a collective approach to health, and (5) a more holistic approach to health.
  
  
  CONCLUSIONS
  Given that these factors have shaped negative Aboriginal responses to health interventions, they are likely to be principles by which more appropriate solutions are generated. Although intuitively sensible and well known, these principles remain poorly understood by non-Aboriginal health systems and even less well implemented. We have conceptualized these principles as the foundation of an empathic health system. Without empathy, health systems in Australia, and internationally, will continue to face the challenge of building effective services to improve the state of health for all minority populations.
authors.affiliation: a Griffith Health Institute , Griffith University , Meadowbrook , Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kendall
authors.forename: Leda
authors.initials: L
authors.lastname: Barnett
mesh_terms: D001315:Australia; D055812:Community-Based Participatory Research; D054521:Cultural Competency; D065246:Culturally Competent Care / Q000208:ethnology / Q000379:methods*; D004645:Empathy; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006303:Health Services, Indigenous; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000523:psychology; D011369:Professional-Patient Relations; D036301:Qualitative Research
keywords: Australian Aboriginal health; Murri health; cultural competence; empathy; health reform