School of Population Health

Toolkit - Effectiveness of an Indigenous Cultural Respect Program in general practice - Improving GP ways of thinking and ways of doing (WoTWoD) Indigenous and Cross Cultural Health

Image Cultural RespectProject Rationale: The majority (60%) of Aboriginal people live in urban Australia. Despite various strategies to “close the gap” in access to care and social services, health inequities and culturally inappropriate care persist. The WoTWoD program and the Toolkit aims to improve the delivery of clinically and culturally appropriate health care for Indigenous people who attend mainstream urban general practices.

Project Aim and research question: Can the “Ways of Thinking and Ways of Doing (WoTWoD)” program and toolkit lead to culturally and clinically appropriate care for Indigenous people who attend mainstream urban general practices?

Project Design and Method: This is a multi-centre cluster randomised control trial being conducted at two sites – Sydney and Melbourne. The staff in the intervention practices attended a half-day cultural respect workshop and then supported by trained Indigenous cultural mentors for 12 months. Baseline and 12 month data collection to demonstrate improvement in cultural respect among general practice staff (measured by the Cultural Quotient), clinical care (measured as use of MBS Iitem #715) and cardiovascular risk factors (measured by practice records audit). Interviews of patients and practice staff conducted after 12 months to assess the feasibility, appropriateness, acceptability, and effectiveness of the WoTWoD.

Findings: The WoTWoD improved all measures, but the improvement did not reach statistical significance. Nevertheless, the qualitative perceptions of the participants to the program and toolkit were very positive. The publications below can be examined for details of the WoTWoD program as it evolved from inception to the cluster RCT.

Future plans: Further evaluation of the rollout of the Toolkit is planned, pending resources.

The Toolkit is currently available for download here. Alternatively, can download by using the following QR code. Please register and provide feedback so that the Toolkit can be improved over time and use in the field.

QR Code

Research Team:

  • Prof Siaw-Teng Liaw – Principal Investigator; Vicki Wade – Indigenous Lead Investigator
  • Dr Iqbal Hasan – Project Coordinator, Sydney; Dr Phyllis Lau – Project Coordinator, Melbourne
  • Investigators: Lisa Jackson-Pulver, Mark Harris, John Furler, Margaret Kelaher 

Publications on the WoTWoD program & Toolkit:

  1. Liaw ST and Wade V. Cultural respect in general practice: a cluster randomised controlled trial (Letter in Reply). Medical Journal of Australia. 2019; 0. DOI: 10.5694/mja2.50214.
  2. Liaw ST, Wade V, Hasan I, Furler J, Lau P, Kelleher M, Wei X, Harris M. Ways of Thinking and Ways of Doing (WoTWoD) Cultural Respect in general practice: a cluster randomised controlled trial. Med J Australia. 2019; 210: 263-268.
  3. Liaw S-T, Wade V, Lau P, et al. Safe and effective cultural mentorship in general practice. Aust Fam Physician 2016; 45: 431-436.
  4. Liaw ST, Hasan I, Wade V, Canalese R, Kelaher M, Lau P, Harris M. Improving cultural respect to improve Aboriginal health in general practice: a multi-methods and multi-perspective pragmatic study. Aust Fam Physician 2015; 44(6): 387-392.
  5. Liaw ST, Lau P, Pyett P, Furler J, Burchill M, Rowley K, Kelaher M. Successful chronic disease care for Aboriginal Australians requires cultural competence. Aust NZ J Public Health 2011: 238-248.
  6. Burchill M, Lau P, Pyett P, Kelly S, Waples-Crowe P, Liaw ST. Reflections on Aboriginalising the Research Process. Int J Critical Indigenous Studies 2011; 4(2): 29-38.

Project Status: Completed 2018