Culture mediation approach in Aboriginal primary health care: Impacts on screening and treatment for risky alcohol consumption

Alcohol problems are a major cause of death, disability, and disadvantage among Aboriginal and Torres Strait Islanders (hereafter referred to as Indigenous Australians) and identifying alcohol misuse is fundamental to addressing these problems. Brief screening instruments and interventions are recommended for use in primary care settings to identify and respond to alcohol problems among Indigenous Australians. At present, few screening instruments have been validated for use among Indigenous populations and these instruments are often administered in a way that fails to elicit accurate health information from Indigenous patients because of the overly clinical approach taken to their administration. This is inconsistent with a holistic approach to the health and wellbeing of Indigenous Australians advocated by relevant bodies. Consequently, there is a need to assist general practitioners to administer screening instruments in a manner that ensures accurate information about alcohol consumption is obtained from patients.

This projects aims to assess the impact of a cultural mediation approach primary care and the administration of screening instruments for alcohol and mental health problems. This process involves the general practitioner spending two minutes with a patient at the beginning of an appointment to learn about the patient’s cultural background, including about the patient’s ‘mob’ and ‘country’. The purpose is to promote a holistic approach to primary care for Indigenous Australians and inform the evidence supporting good practice in screening for alcohol and mental health problems.