title: Health professional and community perspectives on reducing barriers to accessing specialist health care in metropolitan Aboriginal communities: A semi-structured interview study.
abstract: OBJECTIVE
  To describe the perspectives of health professionals and communities on an innovative health service delivery project, Hearing EAr health and Language Services (HEALS). HEALS was a government funded initiative to improve access to specialist ear, nose and throat and speech pathology services for Aboriginal families living in metropolitan areas.
  
  
  METHODS
  Semi-structured interviews were conducted with 21 health-care professionals (clinicians, health service managers and Aboriginal health workers) and 16 care givers of children who participated in HEALS. Interviews took place at four Aboriginal Community Controlled Health Services in metropolitan Australia or by telephone. Interview transcripts were analysed thematically.
  
  
  RESULTS
  We identified five major themes: leveraging partnerships (building on collaborative research, integrating and expanding existing networks, engaging the Aboriginal community), intrinsic and extrinsic motivation (seizing opportunities for altruism, empowered by collegiality, taking pride in achievements), removing common barriers (circumventing waiting times and cost, providing culturally appropriate services, raising awareness), strategic service delivery (proactive service delivery, encouraging flexibility and innovation, offering convenience and support), and service shortfall (pressured timeframes, desire for more sustainable services).
  
  
  CONCLUSIONS
  HEALS facilitated improved health-care access by providing prompt, no-cost services that were strategically targeted to address multiple barriers. HEALS' model of care was built upon strong pre-existing research partnerships, the knowledge and support of five Aboriginal Community Controlled Health Services, and the willingness and motivation of local health-care professionals to help Close the Gap. HEALS highlights the importance of tailoring health services to the needs of Aboriginal families, and provides a framework for other health service delivery initiatives.
authors.affiliation: Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.|Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
authors.forename: Christian
authors.initials: C
authors.lastname: Young
authors.affiliation: Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.|Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Tong
authors.affiliation: Discipline of Child and Adolescent Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Hasantha
authors.identifier: http://orcid.org/0000-0003-4900-1277
authors.initials: H
authors.lastname: Gunasekera
authors.affiliation: The Sax Institute, Sydney, New South Wales, Australia.|Poche Centre for Indigenous Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Simone
authors.initials: S
authors.lastname: Sherriff
authors.affiliation: The Sax Institute, Sydney, New South Wales, Australia.
authors.forename: Deanna
authors.initials: D
authors.lastname: Kalucy
authors.affiliation: The Sax Institute, Sydney, New South Wales, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Fernando
authors.affiliation: Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.|Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001315:Australia; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology; D036301:Qualitative Research; D013038:Specialization; D013066:Speech-Language Pathology; D055815:Young Adult
keywords: ear, nose and throat; indigenous health services; speech pathology