"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

• Published in: PloS one Vol. 19; no. 1; p. e0288577
• Main Authors: Hosking, Kelly, De Santis, Teresa, Vintour-Cesar, Emily, Wilson, Phillip Merrdi, Bunn, Linda, Garambaka Gurruwiwi, George, Wurrawilya, Shiraline, Bukulatjpi, Sarah Mariyalawuy, Nelson, Sandra, Ross, Cheryl, Stuart-Carter, Kelly-Anne, Ngurruwuthun, Terese, Dhagapan, Amanda, Binks, Paula, Sullivan, Richard, Ward, Linda, Schroder, Phoebe, Tate-Baker, Jaclyn, Davis, Joshua S, Connors, Christine, Davies, Jane
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 24.01.2024; Public Library of Science (PLoS)
• Subjects: Analysis; Attitudes; Australia; Australian Aboriginal and Torres Strait Islander Peoples; Australian aborigines; Biology and Life Sciences; Care and treatment; Community; Development and progression; Diagnosis; Economic aspects; Education, Medical, Continuing; Empowerment; Global health; Health aspects; Health education; Health literacy; Health promotion; Health Services, Indigenous; Health Workforce; Hepatitis; Hepatitis B; Hepatitis B, Chronic; Humans; Knowledge acquisition; Labor supply; Language; Literacy; Liver; Liver cancer; Liver diseases; Medical personnel; Medicine and health sciences; Methods; Mortality; Native peoples; Network analysis; Northern Territory; Nurses; Pedagogy; People and Places; Physicians; Prevention; Primary care; Public health; Skills; Social aspects; Social Sciences; Statistical analysis; Training; Training evaluation; Workforce; Northern Territory; Australia; Torres Strait
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0288577

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. 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. 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. 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. 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.