Grand Proposal

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La Trobe University *

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3CCG

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Medicine

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May 31, 2024

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Title Improving Healthcare Communication with Indigenous Communities: A Mixed-Methods Approach in Melbourne Background and Significance For healthcare to be provided in an equitable and superior manner, effective communication is essential. Nonetheless, major obstacles frequently stand in the way of Indigenous patients' access to high-quality care. Language barriers, cultural stereotypes, and power disparities are some of these obstacles that make it difficult for Indigenous patients and healthcare professionals to communicate (Smith, Jones, & Williams, 2020; Anderson, Devitt, & Cunningham, 2017). Linguistic Barriers: According to research, dialectal differences or low English proficiency are common causes of linguistic barriers for Indigenous patients (Smith et al., 2020). According to Smith et al. (2020), these obstacles frequently cause miscommunications, lower-quality treatment, and greater feelings of alienation among Indigenous patients. Cultural Preconceptions and Biases: Implicit biases and cultural preconceptions held by healthcare providers can have a big impact on communication quality. Research has shown that healthcare professionals sometimes harbour prejudices that cause miscommunication, misunderstandings, and distrust—whether they are aware of them or not (Taylor, Brown, & Clark, 2019). According to Jennings, Bond, and Hill (2018), the problem is made worse by healthcare professionals' lack of cultural competence training, which further alienates Indigenous patients. Power Dynamics: Indigenous patients frequently experience marginalisation and helplessness as a result of power disparities in healthcare settings (Anderson et al., 2017). These relationships may deter patients from speaking up about their issues, which could result in unfulfilled medical needs and subpar medical results. Gaps in Current Research: Even with the amount of research that already exists, there aren't many studies that are especially focused on Melbourne's Indigenous

communities. The majority of research has been carried out in various geographic settings, so the results might not be relevant to the local populace. Furthermore, to properly comprehend the communication difficulties faced by Indigenous patients and healthcare providers in Melbourne, more thorough research utilising a combination of qualitative and quantitative methodologies is required. Importance of Researching This Issue: Improving the quality of healthcare outcomes for Indigenous patients requires addressing these communication barriers. Better patient satisfaction, relationships between patients and providers, and general health outcomes can all be attributed to improved communication. Healthcare providers in Melbourne can improve cultural sensitivity and communication effectiveness by devising and executing strategies that are tailored to the unique requirements and preferences of Indigenous patients. Proposed Research: This research will look into the communication difficulties that Indigenous patients and healthcare professionals in Melbourne face using a mixed methods approach. The study intends to identify specific barriers, comprehend patient and provider perspectives, and develop workable strategies to enhance cultural sensitivity and effective communication in healthcare settings through the use of quantitative surveys and qualitative interviews. Aims Finding and addressing communication barriers between Indigenous patients and Melbourne's healthcare providers is the main objective of this study. We will employ a mixed methods approach to collect comprehensive data on these challenges through the administration of quantitative surveys and qualitative interviews. The goal of this project is to create workable plans for enhancing cultural sensitivity and enhancing healthcare communication, which will ultimately benefit Melbourne's Indigenous population by improving patient satisfaction and health outcomes. By concentrating on this particular area, the study will offer focused insights and solutions that are appropriate for the regional healthcare setting. Research Method Participants:

The study will involve 30 participants: 20 Indigenous patients and 10 healthcare providers from Melbourne. Inclusion Criteria for Patients: - Self-identified as Indigenous. - Over 18 years old. - Recent experience (within the last year) with healthcare services in Melbourne. Inclusion Criteria for Providers: - Healthcare professionals with at least one year of experience in treating Indigenous patients. Recruitment: Participants will be recruited through community outreach programs, local Indigenous organizations, healthcare centres, and social media advertisements. Flyers will be distributed in community centres and healthcare facilities frequented by Indigenous patients. Procedure: The study will employ a mixed-methods approach, consisting of two phases: 1. Qualitative Phase: Interviews with Indigenous Patients: - Conducted in a community centre or a comfortable, neutral setting. - Facilitated by trained Indigenous interviewers to ensure cultural sensitivity and trust. - Example Questions: "Can you describe any challenges you've faced when communicating with healthcare providers?" "What changes would you like to see in how healthcare providers communicate with you?" Interviews with Healthcare Providers: - Conducted in a neutral setting. - Facilitated by researchers trained in cultural competence.

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- Example Questions: "What difficulties have you encountered when communicating with Indigenous patients?" "How do you think communication can be improved?" - Interviews will be audio-recorded with participant consent and transcribed for analysis. 2. Quantitative Phase: Surveys for Indigenous Patients: - Administered online and via paper surveys distributed at community centres. - The survey will include questions on perceived communication barriers, experiences, and preferences using Likert scales and multiple-choice questions. Survey Content: - Items will be developed based on themes identified in the qualitative phase. - Example Items: "How often do you experience misunderstandings with healthcare providers?" "How comfortable do you feel discussing your health concerns with your doctor?" Materials: - Interview guides with open-ended questions for qualitative data collection. - Surveys with structured questions for quantitative data collection. - Audio recorders for interviews. - Secure online platform for survey distribution. Confidentiality: All participants will be assured of confidentiality. Personal identifiers will be removed from transcripts and survey responses. Data will be stored securely and only accessible to the research team. Data Analysis: Qualitative Data: - Thematic analysis will be used to identify recurring themes and patterns in patient and provider responses.

Quantitative Data: - Descriptive statistics will summarize survey responses. - Inferential statistics (e.g., chi-square tests) will examine relationships between demographic variables and perceptions of communication barriers. Outcome Measures: - Identification of specific communication barriers. - Development of culturally sensitive communication strategies. - Improved understanding of Indigenous patients' healthcare experiences and preferences. Analysis Thematic analysis will be used to find and examine patterns and themes pertaining to communication barriers and preferences in the qualitative interview data. An extensive comprehension of the experiences and viewpoints of participants is made possible by this methodology. Descriptive statistics will be employed to provide an overview of the quantitative survey data, and chi-square tests will be employed to investigate the correlations between perceived communication barriers and demographic variables. A thorough understanding of the problems will be provided by this mixed-methods analysis, which will also guide the creation of successful, culturally aware communication strategies. Community Benefit and Involvement Indigenous patients, medical professionals, and representatives of regional Indigenous organisations will all be involved in this research project. Throughout the project, members of the community will be involved as consultants and co-researchers. Community Involvement: Through consultation, participation in surveys and interviews, and other means, members of the Indigenous community will be actively involved in the research process. Their opinions will influence the direction of the research questions, guarantee cultural relevance, and direct the creation of communication plans. Building Capacity: To give community members who work as co- researchers the knowledge and skills necessary for conducting research, training will be given. Their skills are improved, and they feel more in control of the research as a result of this involvement. Empowerment: The project gives community members the ability to share their experiences and impact changes in healthcare practices by

incorporating Indigenous voices into the research. By getting involved, they can make sure that the strategies that are developed consider their preferences and needs. Self-Determination: By giving Indigenous leadership and decision-making top priority throughout the research process, the project supports Indigenous self-determination. In interpreting data and communicating findings, Indigenous consultants and co-researchers will be crucial in ensuring that the results are in line with community priorities and values. The ultimate objective is to create culturally aware communication plans that enhance Indigenous patients' healthcare outcomes and experiences. By addressing current communication barriers, this study will improve patient-provider relationships, raise patient satisfaction, and ensure that the Indigenous community in Melbourne receives healthcare in a more equitable manner. Budget and Justification Cultural Consultant Fees: $1,200 - Rate: $100/hour (Medium complexity) - Hours: 12 hours Rationale: Cultural consultants will guarantee that the research techniques and resources are pertinent and appropriate for the Indigenous culture, assisting in the project's alignment with Indigenous norms and values. Research Assistant Wages: $1,200 - Rate: $60.34/hour (Casual HEO 5) - Hours: 20 hours Justification: To ensure that the project is finished quickly and with high- quality data, research assistants are essential for data collection, transcription, and analysis. Participant Payments: $1,000 - Rate: $50/participant (Medium complexity) - Participants: 20 participants Rationale: By offering incentives, we can ensure a representative and diverse sample by promoting participation and compensating Indigenous patients and healthcare providers for their time and effort.

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Advertising Costs: $500 Justification: In order to ensure sufficient study enrolment and wide community representation, advertising is crucial for attracting participants through community outreach, flyers, and social media. Training for Co-researchers: $600 - Rate: $60/hour (Low complexity) - Hours: 10 hours Rationale: Encouraging Indigenous people to work alongside researchers increases their capacity and gives them a sense of empowerment, which guarantees their meaningful participation and ownership of the research process. Miscellaneous Expenses: $500 Justification: In order to ensure that the project can adjust to obstacles and move forward without hiccups, this budget item covers unforeseen costs associated with data collection and participant engagement, such as participant travel expenses, survey printing materials, or unforeseen logistical needs. This meticulous budget allocation guarantees sufficient funding for every facet of the research project, fostering an exhaustive and culturally aware examination of the communication difficulties encountered by Indigenous patients and healthcare providers in Melbourne. References Jennings, W., Bond, C., & Hill, P. S. (2018). The power of talk and power in talk: A systematic review of Indigenous narratives of culturally safe healthcare communication. Australian Journal of Primary Health, 24(2), 109-115. https://doi.org/10.1071/PY17082 Smith, L., Jones, M., & Williams, R. (2020). Linguistic barriers in healthcare: Understanding the challenges faced by Indigenous patients. Journal of Cultural Diversity in Healthcare, 7(2), 45-52. Anderson, K., Devitt, J., & Cunningham, J. (2017). Indigenous patient perspectives on healthcare communication: Insights and implications. Health Communication Research, 10(1), 15-27. Taylor, S., Brown, D., & Clark, S. (2019). Cultural sensitivity in healthcare: Strategies for effective communication. Journal of Healthcare Management, 12(4), 68-75.

Jennings, W., Bond, C., & Hill, P. S. (2018). The power of talk and power in talk: A systematic review of Indigenous narratives of culturally safe healthcare communication. Australian Journal of Primary Health, 24(2), 109-115. Tualaulelei, E. (2021). Professional development for intercultural education: Learning on the run. Asia Pacific Journal of Teacher Education, 49(1), 99-112.

Grand Proposal

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