title: Strengths and limitations of a tool for monitoring and evaluating First Peoples' health promotion from an ecological perspective.
abstract: BACKGROUND
  An ecological approach to health and health promotion targets individuals and the environmental determinants of their health as a means of more effectively influencing health outcomes. The approach has potential value as a means to more accurately capture the holistic nature of Australian First Peoples' health programs and the way in which they seek to influence environmental, including social, determinants of health.
  
  
  METHODS
  We report several case studies of applying an ecological approach to health program evaluation using a tool developed for application to mainstream public health programs in North America - Richard's ecological coding procedure.
  
  
  RESULTS
  We find the ecological approach in general, and the Richard procedure specifically, to have potential for broader use as an approach to reporting and evaluation of health promotion programs. However, our experience applying this tool in academic and community-based program evaluation contexts, conducted in collaboration with First Peoples of Australia, suggests that it would benefit from cultural adaptations that would bring the ecological coding procedure in greater alignment with the worldviews of First Peoples and better identify the aims and strategies of local health promotion programs.
  
  
  CONCLUSIONS
  Establishing the cultural validity of the ecological coding procedure is necessary to adequately capture the underlying program activities of community-based health promotion programs designed to benefit First Peoples, and its collaborative implementation with First Peoples supports a human rights approach to health program evaluation.
authors.affiliation: Onemda VicHealth Koori Health Group, Centre for Health Equity, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia. rowleyk@unimelb.edu.au.
authors.forename: Kevin
authors.initials: K
authors.lastname: Rowley
authors.affiliation: Onemda VicHealth Koori Health Group, Centre for Health Equity, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia. doyle@unimelb.edu.au.
authors.forename: Joyce
authors.initials: J
authors.lastname: Doyle
authors.affiliation: Onemda VicHealth Koori Health Group, Centre for Health Equity, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia. leah@unimelb.edu.au.
authors.forename: Leah
authors.initials: L
authors.lastname: Johnston
authors.affiliation: Wardliparringa Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, 5000, Australia. rachel.reilly@sahmri.com.
authors.forename: Rachel
authors.initials: R
authors.lastname: Reilly
authors.affiliation: Menzies School of Health Research, Alice Springs, NT, 0870, Australia. leisa.mccarthy@menzies.edu.au.
authors.forename: Leisa
authors.initials: L
authors.lastname: McCarthy
authors.affiliation: Onemda VicHealth Koori Health Group, Centre for Health Equity, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia. mayatili@hotmail.com.
authors.forename: Mayatili
authors.initials: M
authors.lastname: Marika
authors.affiliation: Centre for Excellence in Intervention and Prevention Science, Carlton, VIC, 3053, Australia. therese.riley@saxinstitute.org.au.
authors.forename: Therese
authors.initials: T
authors.lastname: Riley
authors.affiliation: Onemda VicHealth Koori Health Group, Centre for Health Equity, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia. Petah.Atkinson@monash.edu.
authors.forename: Petah
authors.initials: P
authors.lastname: Atkinson
authors.affiliation: Onemda VicHealth Koori Health Group, Centre for Health Equity, Melbourne School of Population & Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia. brad.firebrace@gmail.com.
authors.forename: Bradley
authors.initials: B
authors.lastname: Firebrace
authors.affiliation: Viney Morgan Aboriginal Medical Service, Barmah, VIC, 3639, Australia. ceo@vineymorganams.com.au.
authors.forename: Julie
authors.initials: J
authors.lastname: Calleja
authors.affiliation: School of Population Health, University of South Australia, Adelaide, SA, 5000, Australia. margaret.cargo@unisa.edu.au.
authors.forename: Margaret
authors.initials: M
authors.lastname: Cargo
mesh_terms: D001315:Australia; D054521:Cultural Competency; D004463:Ecology; D004777:Environment; D006293:Health Promotion / Q000379:methods*; D006806:Human Rights; D006801:Humans; D009656:North America; D015397:Program Evaluation / Q000379:methods*; D011634:Public Health; D064890:Social Determinants of Health; D012931:Social Environment