Strengthening the JCU/UQ Empowerment Research Program

Strategic support for strengthening the JCU/UQ Empowerment Research Program Project summary

This research project aimed to:

a) undertake a metasynthesis of qualitative research findings across the 10-year Empowerment Research Program (ERP);

b) convene a workshop of informed specialists and stakeholders to evaluate progress and advice for the next steps of the development of a tool to measure empowerment and social and emotional wellbeing: and

c) produce a monograph/book that consolidates the rationale, learning and outcomes of the collaborative empowerment research.

Based on qualitative research findings, researchers hypothesise that adequately resourced Indigenous Men’s and Women’s Support Groups are cost-beneficial strategies (i.e. the benefits outweigh the costs) for promoting Indigenous social and emotional wellbeing (SEWB), with savings achieved mainly through reduced welfare and criminal justice costs and higher earnings. Future research aims to demonstrate this empirically.

A workshop of specialist stakeholders reviewed the Social and Emotional Wellbeing and Empowerment tool in April 2009, after which relevant adjustments were made to the tool. A peer review paper validating the tool was considered by the Australian and New Zealand Journal of Psychiatry. A synthesis of seven discrete Family Wellbeing (FWB) micro evaluative studies were published in Health and Social Care in the Community, while a meta-ethnography of five Indigenous Men’s Support Group action research papers was accepted by the Australian Journal of Primary Health. A proposal for a book synthesising key learnings from the ERP was developed.

A metasynthesis of research across two Indigenous men’s support groups between 2001 and 2008 demonstrated a range of SEWB outcomes for individual men, their families and communities (McCalman et al, in press). Coming from contexts of entrenched disadvantage, participation in support groups gave men involved hope and confidence that change was possible. They made changes through personal development, including:

• learning from mistakes;
• acceptance of personal responsibility;
• being open to communication;
• being no longer afraid to ask for help;
• being more aware of danger and warning signs for suicide; and
• identifying strategies to overcome personal problems.

The daily functioning of Indigenous Men’s Groups relied heavily on a few committed leaders but the size of their impact was significant: a total of 145 men participated in regular meetings and activities while an additional 928 men were supported mainly through the criminal justice system across the two groups over a one-year period. The key empowerment processes that men’s groups utilised towards improved social and emotional wellbeing of their members were:

• taking control and responsibility;
• influencing change through direct program delivery, partnerships and/or advocacy; and
• addressing challenging group and community issues through participatory action research.

A synthesis of FWB formative research findings across four study settings (148 adult and 70 school children participants) between 1998 and 2005 (Tsey et al 2009) revealed:

• that participants demonstrated enhanced capacity to exert greater control and autonomy over factors shaping their health and wellbeing;
• a heightened Indigenous and spiritual identity, respect for self and others, enhanced parenting, and capacity to deal with substance abuse and violence; and
• that changes at the personal level influenced other individuals and systems over time, suggesting a strong multiplier effect of the benefits of empowerment.

The research indicated that:

• Self-reported qualitative evidence to date suggests that promoting wellbeing and social cohesion through empowerment programs (men’s/women’s support groups and FWB education) saves costs associated with health care, welfare, imprisonment and higher unemployment.
• The empowerment and related SEWB attributes and outcomes qualitatively described in the ERP findings resonate strongly with Australian (Grew et el 2007) and internationally identified evidence-based cost effective or ‘best buy’ mental health promotion programs (UK Ministry of Health 2009).

Related resources:

• Bainbridge, R. 2009, ‘Cast all imaginations: Umbi speak’, PhD thesis, James Cook University, Cairns, Qld.
• Griew, R. 2007, ‘Family Centred Primary Health Care: Review of evidence and models’, paper prepared for Office of Aboriginal and Torres Strait Islander Health, Department of Health and Ageing, Canberra.
• Mayo, K. & Tsey, K. 2008, ‘The Research Dance: University and community research collaborations at Yarrabah, North Queensland’, Health and Social Care in the Community, vol. 17(2), pp. 133–40.
• McCalman, J. et al. 2009, ‘Indigenous Men’s Support Groups and Social and Emotional Wellbeing: A meta-synthesis of the evidence’, Australian Journal of Primary Health (in press).
• Tsey, K. 2008, ‘The ‘Control Factor’: Important but neglected social determinant of health’ (correspondence), The Lancet, vol. 372(9650), p. 1629.
• Tsey, K. et al. 2003, ‘Social Determinants of Health, the ‘Control Factor’, and the Family Wellbeing Empowerment Program’, Australasian Psychiatry, vol. 11 (supplement), pp. 34–9.
• Tsey, K. et al. 2005, ‘The Role of Empowerment through Life Skills Development in Building Comprehensive Primary Health Care Systems in Indigenous Australia’, Australian Journal of Primary Health, vol. 11(2), pp. 16–25.
• Tsey, K. et al. 2005, ‘Adapting the ‘Family Wellbeing’ Empowerment Program to the Needs of Remote Indigenous School Children’, Australian and New Zealand Journal of Public Health, vol. 29(2), pp. 112–16.
• Tsey, K. et al. 2007, ‘Empowerment-based Research Methods: A 10 year approach to enhancing indigenous social and emotional wellbeing’, Australasian Psychiatry, vol. 15 (supplement), pp. 34–8.
• Tsey, K. et al. 2009, ‘Empowerment and Indigenous Australian Health: A synthesis of findings from Family Wellbeing formative research’, Health and Social Care in the Community (in press).
• United Kingdom Department of Health 2009, Executive Summary, New Horizons: Towards a Shared Vision for Mental Health.
• Wallerstein, N. (ed.) 2006, What Is the Evidence on Effectiveness of Empowerment to Improve Health?, World Health Organization, Regional Office for Europe.
• Whiteside, M. 2009, ‘A Grounded Theory of Empowerment in the context of Indigenous Australia’, PhD thesis, James Cook University, Cairns, Australia.
• Whiteside, M. et al. 2006, ‘Empowerment as a Framework for Indigenous Workforce Development and Organisational Change’, Australian Social Work, vol. 59(4), pp. 422–34.
• Case Story: The Family Wellbeing program: Empowerment research, in Researching Indigenous Health: A Practical Guide for Researchers, Alison Laycock with Diane Walker, Nea Harrison & Jenny Brands 2011, The Lowitja Institute, Melbourne, chapter 3, p. 63.
• McEwan, A & Tsey, K. 2009, The Role of Spirituality in Social and Emotional Wellbeing Initiatives: The Family Wellbeing Program at Yarrabah, Discussion Paper No. 7, CRCAH, Darwin.
• CRCAH Project Fact Sheet: Empowerment as a Key to Improving Indigenous Health and Wellbeing
• CRCAH Project: The role of spirituality in social and emotional wellbeing initiatives: The Family Wellbeing Program at Yarrabah
• CRCAH Project: Researching the Control Factor and Empowerment in Addressing the Social Determinants of Aboriginal and Torres Strait Islander Health