What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care? Findings from an evidence mapping review
Abstract Background Chronic disease is the leading cause of morbidity and mortality among Aboriginal and Torres Strait Islander peoples in Australia. A comprehensive health assessment is available as an annual health check (HC) to Aboriginal and Torres Strait Islander peoples through the Medicare Be...
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2025-05-01
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| Online Access: | https://doi.org/10.1186/s12961-025-01325-9 |
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| author | Uday Narayan Yadav Stefan Thottunkal Jason Agostino Victoria Sinka Rosemary Wyber Belinda Hammond Danielle C. Butler Mary Belfrage Kate Freeman Megan Passey Emma Walke Matthew Smith Benjamin Jones Raymond Lovett Kirsty A. Douglas |
| author_facet | Uday Narayan Yadav Stefan Thottunkal Jason Agostino Victoria Sinka Rosemary Wyber Belinda Hammond Danielle C. Butler Mary Belfrage Kate Freeman Megan Passey Emma Walke Matthew Smith Benjamin Jones Raymond Lovett Kirsty A. Douglas |
| author_sort | Uday Narayan Yadav |
| collection | DOAJ |
| description | Abstract Background Chronic disease is the leading cause of morbidity and mortality among Aboriginal and Torres Strait Islander peoples in Australia. A comprehensive health assessment is available as an annual health check (HC) to Aboriginal and Torres Strait Islander peoples through the Medicare Benefits Schedule in primary health care settings. This review aims to systematically identify contextual and mechanistic factors that contribute to the success or failure of implementing effective HCs in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care (PHC). Methods We systematically searched for peer-reviewed and grey literature, including policy reports, theses, and guidelines, between 1 November 1999 and 30 June 2023, using a combination of keywords and subject headings related to “health checks”, “chronic disease”, and “Aboriginal and Torres Islander peoples” in seven databases. The extracted data were summarized using a content analysis approach, applying strength-based approaches. Results In total, 16 peer-reviewed articles and five grey literature that met the inclusion criteria were used for evidence synthesis that identified several contextual and mechanistic factors that influenced the implementation of HCs. Barriers included resource constraints driven by complexities in administrative, workforce and policy domains that significantly impeded the implementation of HCs. Within PHC, physical space constraints, competing demands and a focus on acute care over preventive measures hindered HC implementation. In addition, inconsistent identification of Aboriginal and Torres Strait Islander status, negative attitudes of PHC staff towards HC efficacy and patients’ fear of stigma or confidentiality breaches were barriers. Patients reported HCs as failing to address holistic health needs. To improve HC implementation, enablers included strong clinical leadership, recruitment of culturally competent non-Indigenous and Aboriginal and Torres Strait Islander staff, Indigenous partnership and community engagement and incentives for participation. Effective electronic records, transport provision and flexible scheduling also increased accessibility. Conclusions Our findings suggest that future implementation research must adopt a more comprehensive and holistic approach across different models of PHC, with clearly identified contextual and mechanistic factors linked to people-reported and service outcomes, to guide the implementation and evaluation of HCs. While undertaking future research, it is crucial to implement policy and practice reforms as identified in this review to create a culturally safe service at the PHC level required to drive the uptake of quality HCs that aligns with community priorities and aspirations for the prevention and early detection of chronic diseases. |
| format | Article |
| id | doaj-art-5cd6920f080749cfb597bc83166a4900 |
| institution | DOAJ |
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| language | English |
| publishDate | 2025-05-01 |
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| series | Health Research Policy and Systems |
| spelling | doaj-art-5cd6920f080749cfb597bc83166a49002025-08-20T03:22:30ZengBMCHealth Research Policy and Systems1478-45052025-05-0123112310.1186/s12961-025-01325-9What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care? Findings from an evidence mapping reviewUday Narayan Yadav0Stefan Thottunkal1Jason Agostino2Victoria Sinka3Rosemary Wyber4Belinda Hammond5Danielle C. Butler6Mary Belfrage7Kate Freeman8Megan Passey9Emma Walke10Matthew Smith11Benjamin Jones12Raymond Lovett13Kirsty A. Douglas14Yardhura Walani, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, The Australian National UniversityNational Centre for Epidemiology and Population Health, The Australian National UniversityYardhura Walani, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, The Australian National UniversityCentre for Kidney Research, Poche Centre for Indigenous Health, Sydney School of Public Health, The University of SydneyYardhura Walani, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, The Australian National UniversityRoyal Australian College of General Practitioners, Aboriginal & Torres Strait Islander HealthNational Centre for Epidemiology and Population Health, The Australian National UniversityDepartment of Medicine, Royal Melbourne Hospital, Melbourne Medical School, Faculty of Medicine Dentistry & Health Sciences, University of MelbourneRoyal Australian College of General Practitioners, Aboriginal & Torres Strait Islander HealthThe Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, the University of SydneyUniversity Centre for Rural Health, The University of SydneyAustralian National University Medical School, The Australian National UniversityHealth Systems Collaborative Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of OxfordYardhura Walani, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, The Australian National UniversityAustralian National University Medical School, The Australian National UniversityAbstract Background Chronic disease is the leading cause of morbidity and mortality among Aboriginal and Torres Strait Islander peoples in Australia. A comprehensive health assessment is available as an annual health check (HC) to Aboriginal and Torres Strait Islander peoples through the Medicare Benefits Schedule in primary health care settings. This review aims to systematically identify contextual and mechanistic factors that contribute to the success or failure of implementing effective HCs in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care (PHC). Methods We systematically searched for peer-reviewed and grey literature, including policy reports, theses, and guidelines, between 1 November 1999 and 30 June 2023, using a combination of keywords and subject headings related to “health checks”, “chronic disease”, and “Aboriginal and Torres Islander peoples” in seven databases. The extracted data were summarized using a content analysis approach, applying strength-based approaches. Results In total, 16 peer-reviewed articles and five grey literature that met the inclusion criteria were used for evidence synthesis that identified several contextual and mechanistic factors that influenced the implementation of HCs. Barriers included resource constraints driven by complexities in administrative, workforce and policy domains that significantly impeded the implementation of HCs. Within PHC, physical space constraints, competing demands and a focus on acute care over preventive measures hindered HC implementation. In addition, inconsistent identification of Aboriginal and Torres Strait Islander status, negative attitudes of PHC staff towards HC efficacy and patients’ fear of stigma or confidentiality breaches were barriers. Patients reported HCs as failing to address holistic health needs. To improve HC implementation, enablers included strong clinical leadership, recruitment of culturally competent non-Indigenous and Aboriginal and Torres Strait Islander staff, Indigenous partnership and community engagement and incentives for participation. Effective electronic records, transport provision and flexible scheduling also increased accessibility. Conclusions Our findings suggest that future implementation research must adopt a more comprehensive and holistic approach across different models of PHC, with clearly identified contextual and mechanistic factors linked to people-reported and service outcomes, to guide the implementation and evaluation of HCs. While undertaking future research, it is crucial to implement policy and practice reforms as identified in this review to create a culturally safe service at the PHC level required to drive the uptake of quality HCs that aligns with community priorities and aspirations for the prevention and early detection of chronic diseases.https://doi.org/10.1186/s12961-025-01325-9Aboriginal and Torres Strait Islander peopleChronic diseaseEarly detectionPrimary health carePolicy and practicePreventive health |
| spellingShingle | Uday Narayan Yadav Stefan Thottunkal Jason Agostino Victoria Sinka Rosemary Wyber Belinda Hammond Danielle C. Butler Mary Belfrage Kate Freeman Megan Passey Emma Walke Matthew Smith Benjamin Jones Raymond Lovett Kirsty A. Douglas What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care? Findings from an evidence mapping review Health Research Policy and Systems Aboriginal and Torres Strait Islander people Chronic disease Early detection Primary health care Policy and practice Preventive health |
| title | What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care? Findings from an evidence mapping review |
| title_full | What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care? Findings from an evidence mapping review |
| title_fullStr | What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care? Findings from an evidence mapping review |
| title_full_unstemmed | What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care? Findings from an evidence mapping review |
| title_short | What influences the implementation of health checks in the prevention and early detection of chronic diseases among Aboriginal and Torres Strait Islander people in Australian primary health care? Findings from an evidence mapping review |
| title_sort | what influences the implementation of health checks in the prevention and early detection of chronic diseases among aboriginal and torres strait islander people in australian primary health care findings from an evidence mapping review |
| topic | Aboriginal and Torres Strait Islander people Chronic disease Early detection Primary health care Policy and practice Preventive health |
| url | https://doi.org/10.1186/s12961-025-01325-9 |
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