Applying collective impact to improve health services for Aboriginal people in rural and remote communities

Aim The aim of this thesis was to examine whether utilising a collective impact model of design, implementation and evaluation improves effectiveness and efficiency of health care services for Aboriginal Australians. Background Colonisation had a devastating impact on the culture, health, population and wellbeing of Aboriginal Australians. The impacts of colonisation are complex, long standing, entrenched and wide ranging. Collective Impact is a structured five-stage and three-phase process which facilitates community engagement in resolving highly complex or wicked problems. The purpose of this research is to determine the efficacy of utilising collective impact in the design, implementation and evaluation of health care services for Aboriginal people in Australia. Methods Mixed methods are utilised in this research including: systematic reviews; interviewer assisted surveys; semi-structured interviews; and retrospective comparison of two data sets. The data is analysed descriptively and thematically; and the retrospective comparative data is analysed quantitatively. Results and discussion Quantitative and qualitative evidence is provided in this research to support the finding that collective impact is efficacious in engaging Aboriginal people in the design, implementation and evaluation of health care services intended for them. The collective impact approach is demonstrated to result in successful, well designed programs and increase the efficacy of health services. Conclusions Collective impact is a suitable tool for health care policy makers, managers and funders to utilise to expedite progress with improving health outcomes for Aboriginal Australians. Key words Aboriginal, health outcomes, collective impact, service design, workforce development, program evaluation