Strong Carers, Strong Communities: Testing a capacity building approach to empower Aboriginal family carers to address their needs.

Participatory Action Research (PAR)- community facilitation. Over a period of 9-12 months per community. i) Share community history. This will include relaying information from recent survey data on function, prevalence of dementia, falls, continence issues, chronic pain, depression, service utilisation and carer burden to the recruited community, via council members, local stakeholders and nominated community champions. A formal discussion about the PAR process will be undertaken, with permission sought from the council. This will take place in a workshop setting, and provide a means for the community members to express their knowledge and history. (ii) Create a common vision. At this workshop the health care area/areas to develop into a program, and selection of potential community health champions to employ will be discussed. Example of topics that may be chosen by the community may include ways to minimise depression, how to access services, how to minimise carer stress etc. The community can express their wishes regarding the topics to address. Support of project champions will be provided by researchers and project staff and will comprise regular face-to-face as well as telephone and email contact. (iii) Identify evaluation stakeholders. Other decisions to be made at this early stage with the community group include, the involvement of other partners (e.g. NGO, local groups, clinic staff, HACC staff and others), nomination of a steering committee, location and time of meetings, the role of a facilitator and establishing a conflict resolution process to manage any unresolved disagreements. (iv) Identify indicators and targets objectives. This includes determination of outcomes and utilising resources available in the community, and the documentation of an action plan. For example as part of a falls prevention model, a target outcome may be a medical review for all over 45 years. Alternatively it may be that a number of people in the community are supported to undergo Aged Care III certificates or other training. The community may choose to take part in a formal empowerment program. (v) Identify strategies to reach targets. This will be determined by each community, facilitated by health champions, and recorded in the action plan. One strategy for example may include an awareness raising campaign, or a recall system through Health Workers in the clinic to address a particular health issue. Available culturally appropriate programs may be utilised (e.g. Looking out for dementia, Alzheimer‘s Australia NT) (vi) Track indicators and collect data. Researchers and health champions will facilitate this process, that may include employment of local people to assist with data collection (see Outcome measures below). (vii) Analyse data. The frequency of data analysis and feedback will be determined by the group, aiming for a number of informal reviews every 2-3 months, with a formal review at 9 months. The 2-3 monthly reviews is to ensure adequate progression towards target objectives, with review of information collected. The reviews also comprise the reflection/evaluation stages of the PAR cycle. Researchers will be collaborating on a regular basis with local champions to trouble shoot any issues, and will call on the community committee as required. (viii) Communicate results. The data will be presented back to the community for the iterative cycle to continue. Within this process will be a discussion of the sustainability of programs developed, and how this will be achieved long term.