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Cultural bias initiatives to improve kidney transplantation among Aboriginal and Torres Strait Islander people - a scoping review.

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Date

2021-01-19

Journal Title

Journal ISSN

Volume Title

Publisher

Affiliation(s)

(Kelly, Schwartzkopff, O'Donnell) University of Adelaide
(Dent) Lowitja Institute
(Owen) National Indigenous Kidney Transplantation Taskforce

Year

2020

Citation

Nephrology. Conference: 55th Annual Scientific Meeting of the Australian and New Zealand Society of Nephrology, ANZSN 2020. Virtual. Vol.25(SUPPL 3), 2020, pp. 78.

Journal

Nephrology

Conference name

55th Annual Scientific Meeting of the Australian and New Zealand Society of Nephrology, ANZSN 2020

Conference location

Virtual

Grant information

Abstract

Aim: To synthesize existing evidence on health services initiatives that target cultural bias to improve models of care for Indigenous Australians with kidney disease. Background(s): In 2019, the TSANZ report, 'Improving Access to and Outcomes of Kidney Transplantation for Aboriginal and Torres Strait Islander People in Australia' identified systemic biases in relation to kidney transplantation for Indigenous Australians. Following this, the TSANZ established a National Indigenous Kidney Transplantation Taskforce (NIKTT), who commissioned a scoping review to summarize initiatives that support and inform culturally safe access and outcomes to kidney transplantation for Indigenous people. Method(s): A systematic review of peer reviewed and 'grey' literature was undertaken to identify cultural bias initiatives in renal health and other relevant areas. We analysed the efficacy of these from patient, health professional and clinical outcomes perspectives, and identified key enablers for establishing and evaluating cultural bias initiatives. A panel of NIKTT members assisted with the detection and interpretation of key themes. Result(s) and Conclusion(s): We identified 20 Australian health care initiatives that reported evaluation of cultural bias initiatives: renal (2), maternity (10), cancer (5), diabetes (1), emergency department (1) and general hospital (1). Enablers of successful initiatives across all studies were arranged under four main themes: inclusion of patients/families/community in care and decision making; Indigenous workforce and overall staff skills; service delivery, approach and models of care; and structures and policies. Initiatives that improved cultural safety, communication, coordination, collaboration, resources, policies, and organizational commitment were identified. A further 7 NIKTT initiatives are currently underway to address inequities in transplant access and outcomes. These projects will add significantly to the evidence.

PubMed ID

Type

Conference Abstract

Study type

Review article (e.g. literature review, narrative review)

Subjects

Organ transplantation
Quality improvement

Keywords