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In Australia, a significant number of culturally and linguistically diverse (CALD) grandparents are sole carers for their grandchildren. Available information on the impact of caring on CALD grandparents and the ability of service providers to respond to their needs is limited. Our needs-gap analysis quality improvement project aimed to uncover 'hidden issues' for CALD grandparent carers so that services can be improved. One hundred service providers, such as community and aged-care services, child and/or grandparent support services and CALD-specific services, were approached using six structured questions. Six consultative forums on the caring role, issues encountered, and what needed to be done, were conducted with African, Asian, Spanish, Middle Eastern, European, Pacific Island andMaori grandparent carers in Queensland. The data were qualitatively analysed. Six themes emerged: 1) service provider and grandparent carer perception that there was limited research on CALD grandparents; 2) inadequate legal and financial support; 3) barriers to accessing information; 4) lack of childcare options; 5) transport difficulties; and 6) inadequate technological skills. Our findings provide insight to health service providers on the 'hidden issues' so that they can better assist CALD grandparent carers by improving access to relevant information, referrals and resources. [ABSTRACT FROM AUTHOR]

The community navigator model was developed to assist four culturally and linguistically diverse communities (Sudanese, Burmese, Pacific Islander Group, Afghani) in south-east Queensland to negotiate the Australian health system and promote health. Using participatory action research, we developed the model in partnership with community leaders and members, the local health department and two non-governmental organisations. Following implementation, we evaluated the model, with the results published elsewhere. However, our evaluation revealed that although the model was accepted by the communities and was associated with positive health outcomes, the financial, social and organisational durability of the model was problematic. Ironically, this situation was inadvertently created by critical decisions made during the development process to enhance the durability and acceptability of the model. This paper explores these critical decisions, our rationale for making those decisions and the four hidden tensions that subsequently emerged. Using a reflective case study method to guide our analysis, we provide possible resolutions to these tensions that may promote the longevity and utility of similar models in the future. [ABSTRACT FROM AUTHOR]

Background: Culturally and linguistically diverse (CALD) communities in Queensland, Australia, do not access health services, contributing to poor health outcomes. To improve health in CALD communities, a partnership was formed between the state government, two nongovernment CALD-specific organizations (NGOs), and a university to develop a service that could facilitate health service use. This qualitative research explored the partners' perspectives on how the partnership functioned and its outcomes., Objectives: We sought to (1) explore how participants engaged with the principles of partnership, the processes they used, and their beliefs about the facilitators and barriers to intersectoral collaboration and (2) gain insights into how the partners perceived the development and functioning of the partnership., Methods: Qualitative, semistructured interviews were conducted with each of the key stakeholders in the partnership (n = 4). A focus group was also conducted with those working within the two NGO partners in the delivery of the service (n = 8). Open-ended questions drawn from the literature on partnership principles were used to guide the interviews and focus group data collection. The data were transcribed and analyzed using thematic principles., Results: The four themes identified were: (1) Perceived benefits of the partnership outweighed organizational differences; (2) respectful relationships sustained the partnership; (3) mitigating conflict enabled the purpose of the partnership to be fulfilled; and (4) a neutral interpersonal space enabled the partnership to be enacted., Conclusions: Our study showed how contextual pressures created within the system can damage tenuous connections that have been developed between otherwise competitive organizations, leading to dissolution of partnerships. However, the study has also shown that partnerships may be purpose and time bound, not necessarily with respect to longevity. Through strategic negotiations, partnerships can be sustained until the goal of the partnership is attained, which in this instance was the development of a new service delivery model.

The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive sample of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly diverse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in community development and capacity building, often through a multidisciplinary partnership, which requires them to have sound brokerage and facilitation skills to enable community inclusion and inter-agency collaboration at the local level. The study has highlighted the importance and multifaceted nature of the role of the community-based child health nurse. To enable them to function optimally, the following suggestions/recommendations are offered. These being: More physical resources be allocated to community-based child health nursing More resources allocated to assist community-based child health nurses to support culturally and linguistically diverse families Mapping of child health nurses' workloads The development of community health client dependency rating criteria reflecting the social determinants of health in order for health service refinement of staffing allocations based on an acuity scale Specific staff development opportunities to reflect the increased workload complexity Managerial support for the implementation of formal clinical (reflective) supervision Additional clerical assistance with non-nursing duties.

With 28% of Australia's population having a culturally and linguistically diverse (CALD) background, the health system faces an increasing challenge to provide accessible and culturally competent health care. The view that all CALD communities are homogenous and solutions can be developed for the entire nation is detrimental. Despite available health services, CALD communities are reluctant to use them due to cultural differences, perceived racism and misunderstandings leading to the existing health disparities. Therefore, gathering data from four prominent CALD communities, such as the Sudanese, Afghani, Pacific Islander and Burmese communities in Logan, Queensland, about how they perceive and use health services can provide insightful information towards development of a service model that will better suit these CALD communities. The objective of the study was to examine the extent to which four prominent CALD communities (Sudanese, Afghani, Pacific Islander and Burmese) access and use health services in Logan, Queensland. Six focus group interviews using interpreters were conducted in English with Sudanese, Afghani, Pacific Islander and Burmese people. The results indicated that even long-standing CALD communities, such as the Pacific Islander people, were unfamiliar with health services and experienced difficulties accessing appropriate health care. Most wanted doctors to use traditional healing methods alongside orthodox medicine, but did not feel respected for their beliefs. Language difficulties impeded communication with health professionals who were hindered by ineffective use of interpreters. In conclusion, a clear role for bilingual community-based navigators was identified by CALD participants to address concerns about the health system, and to improve accessibility and health service usage.