"Putting the power back into community": A mixed methods evaluation of a chronic hepatitis B training course for the Aboriginal health workforce of Australia's Northern Territory

Kelly Hosking, Teresa De Santis, Emily Vintour-Cesar, Phillip Merrdi Wilson, Linda Bunn, George Garambaka Gurruwiwi, Shiraline Wurrawilya, Sarah Mariyalawuy Bukulatjpi, Sandra Nelson, Cheryl Ross, Kelly Anne Stuart-Carter, Terese Ngurruwuthun, Amanda Dhagapan, Paula Binks, Richard Sullivan, Linda Ward, Phoebe Schroder, Jaclyn Tate-Baker, Joshua S. Davis, Christine ConnorsJane Davies

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Abstract

Background 

Chronic hepatitis B (CHB) is endemic in the Aboriginal and Torres Strait Islander population of Australia's Northern Territory. Progression to liver disease can be prevented if holistic care is provided. Low health literacy amongst health professionals is a known barrier to caring for people living with CHB. We co-designed and delivered a culturally safe "Managing hepatitis B"training course for the Aboriginal health workforce. Here, we present an evaluation of the course. 

Objectives

1. To improve course participants CHB-related knowledge, attitudes, and clinical practice. 2. To evaluate the "Managing hepatitis B"training course. 3. To enable participants to have the skills and confidence to be part of the care team. 

Methods 

We used participatory action research and culturally safe principles. We used purpose-built quantitative and qualitative evaluation tools to evaluate our "Managing hepatitis B"training course. We integrated the two forms of data, deductively analysing codes, grouped into categories, and assessed pedagogical outcomes against Kirkpatrick's training evaluation framework. 

Results 

Eight courses were delivered between 2019 and 2023, with 130 participants from 32 communities. Pre- and post-course questionnaires demonstrated statistically significant improvements in all domains, p<0.001 on 93 matched pairs. Thematic network analysis demonstrated high levels of course acceptability and significant knowledge acquisition. Other themes identified include cultural safety, shame, previous misinformation, and misconceptions about transmission. Observations demonstrate improvements in post-course engagement, a deep understanding of CHB as well as increased participation in clinical care teams. 

Conclusions 

The "Managing hepatitis B"training course led to a sustained improvement in the knowledge and attitudes of the Aboriginal health workforce, resulting in improved care and treatment uptake for people living with CHB. Important non-clinical outcomes included strengthening teaching and leadership skills, and empowerment.

Original languageEnglish
Article numbere0288577
Pages (from-to)1-23
Number of pages23
JournalPLoS One
Volume19
Issue number1 January
DOIs
Publication statusPublished - Jan 2024

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