Indigenous safety promotion program evaluation: lessons and challenges
The purpose of this paper is to share key lessons and identify ongoing challenges for the evaluation of interventions which address complex Indigenous health and safety issues. The paper draws on a review of the available literature as well as our experience in intervention studies which address injury and safety issues in Indigenous communities. We demonstrate that while there is no one correct approach to evaluation of policy and programs in this field, there is a need for multidisciplinary approaches, cultural sensitivity and Indigenous leadership.
Injury which occurs in Indigenous communities must be understood within a broad context of historical, social and economic Indigenous disadvantage (Ivers et al 2007, Helps and Harrison 2006, Harrison et al 2001, Moller et al 2004). Preventing or reducing injury requires multi-level approaches and collaboration across government, non-government and community sectors to promote safety by addressing the multiple and often interrelated factors underlying the high rates of injury and violence in Indigenous, compared to non-indigenous sectors of the Australian population. Action is needed at many levels including systems level changes, workforce development and capacity building in addition to programs which address educational and behavioural change.
Indigenous injury prevention and safety promotion has received some specific policy attention, for example, the National Aboriginal and Torres Strait Islander Safety Promotion Strategy (National Public Health Partnership, 2004). Community safety is one of the Closing the Gap building blocks (Department of Families, Housing, Community Services and Indigenous Affairs, 2009). However there have been few rigorous evaluations of interventions and therefore a lack of evidence on which to base sound policy and programs to address the safety issues which affect Indigenous people (Boufous et al., 2010, Martiniuk et al., 2010, Senserrick et al., 2010).
Findings from research in New South Wales highlight the need for the evaluation of Indigenous safety programs which focus strongly on culturally appropriate evaluation processes. In addition to leadership, capacity building and community engagement (Anderson, 2011), studies point to the need for a greater understanding of the contextual factors for the successful implementation of interventions, the collection and analysis of both qualitative and quantitative data and the value of participatory approaches. They also indicate the need for broad and critical thinking around what constitutes evidence and how to more effectively translate evidence into policy and practice.