Health service access for Aboriginal people associated with level of Aboriginal community engagement  — ASN Events
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Health service access for Aboriginal people associated with level of Aboriginal community engagement  (#288)

Patrick Rawstorne 1 , Rajah Supramaniam 2 , Anthony Dillon 3 , Dianne O'Connell 1 2 4 5
  1. School of Medicine and Public Health, University of Newcastle, Newcastle, NSW , Australia
  2. Cancer Council NSW, Woolloomooloo, NSW, Australia
  3. Institute of Positive Psychology and Education, Australian Catholic University , Sydney , NSW, Australia
  4. School of Public Health, University of Sydney, Sydney, NSW, Australia
  5. School of Public Health and Community Medicine , Univeristy of NSW, Sydney, NSW, Australia

Aim: We investigated whether a new three-item Aboriginal community engagement scale (ACES) and sociodemographic factors were associated with Aboriginal people’s awareness of cancer symptoms as well as pre-diagnosis access to health services.

Methods: We recruited 102 Aboriginal cancer survivors, diagnosed December 2010 to July 2013, from New South Wales hospitals and clinical cancer registries. Participants completed a telephone-administered questionnaire with trained Aboriginal interviewers. Internal consistency of ACES was assessed using Cronbach’s Alpha. Higher ACES scores indicated greater Aboriginal community engagement. Associations between ACES, sociodemographic factors and awareness of cancer symptoms and pre-diagnosis access to health services were examined using Chi-squared tests and t-tests.

Results: ACES was internally consistent (Cronbach’s alpha=0.83). Sex, age, place of residence, employment status, relationship status and education level were not consistently associated with either a person’s awareness of symptoms before a cancer diagnosis or with their access to health services. Higher ACES scores were positively associated (p=0.031) with an Aboriginal person being less aware of symptoms before their cancer diagnosis. People with higher ACES were also more likely to visit an Aboriginal Community Controlled Health Services (ACCHS) (p<0.001) and less likely to see a non-ACCHS GP (p=0.043) before their cancer diagnosis. ACES was not associated with accessing cancer screening or a hospital before a cancer diagnosis. People with lower ACES were more likely to be employed fulltime before diagnosis (p=0.025) but ACES did not vary with age, sex, place of residence, education level or relationship status.

Conclusions: ACES was associated with types of health services accessed and with awareness of cancer symptoms before diagnosis. ACES showed good predictive validity and is distinctly different to most of the usual sociodemographic factors. More work is needed to investigate whether using the ACES can help health services tailor their information and services to improve cancer outcomes for Aboriginal people. 

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