Improving Eye Care Service Delivery with Appropriate Identification of Aboriginal and Torres Strait Islander Status

There has been much progress in reducing the eye health gap between Aboriginal and Torres Strait Islander Peoples and other Australians over the past decade however a number of eye health inequities and outcomes continue to exist. An estimated 94% of vision loss among Aboriginal and Torres Strait Islander Peoples is preventable and treatable, though barriers of access to and utilisation of services remain. These are reflected in lower rates of eye examinations and treatments, and inequitable waiting times compared with other Australians.

The identification of Aboriginal and Torres Strait Islander status can have a significant positive impact for Aboriginal and Torres Strait Islander eye health outcomes, enhance cultural safety, and ensure that patients can access appropriate pathways to care. Additionally, improving reporting and monitoring of access to eye health services through identification of Aboriginal and Torres Strait Islander status is an essential step to close the gap for vision.

Asking the question:

The Australian Institute of Health and Welfare recommends the use of a standard national question to identify, record and report the Aboriginal and Torres Strait Islander status of patients of health services.

Are you of Aboriginal or Torres Strait Islander Origin?

The standard Aboriginal and Torres Strait Islander status question should be asked of all individuals to establish their Aboriginal or Torres Strait Islander or non-Indigenous status.

Establishing Aboriginal and Torres Strait Islander status by ‘asking the question’ using the above wording is recommended best-practice by a number of key medical and health organisations, including the Australian Indigenous Doctors Association and the Royal Australian College of General Practitioners, who identify this as a key element in establishing cultural safety in mainstream practices. Strengthening cultural safety across the health system is an element of both The Roadmap to Close the Gap for Vision, and Vision 2020 Australia’s Strong Eyes, Strong Communities plan.

The need to bring light to this issue has also been raised in many regions across Australia working under the guidance of The Roadmap to Close the Gap for Vision to improve eye health outcomes.

Indigenous Eye Health (IEH) has responded to this need and developed resources (with input from a number of key Aboriginal and Torres Strait Islander informants from these regions) to help improve the identification of Aboriginal and Torres Strait Islander status in the delivery of eye care services in mainstream practices and clinics.

These include:

• A ‘toblerone’ (or 'tent' shaped) desktop resource* that can be used on a reception or consulting desk as a simple prompt to ensure ‘the question’ is asked, and;
• A supporting AtQ information sheet with explanations about why Indigenous identification is important for the delivery of eye health services, details on ‘asking the question’ appropriately, and where to get more information, resources and support

Please note, due to COVID-19 we have very limited access to these resources and may not be able to complete your order at the current time.

Order AtQ resources (for use in eye care services)

Please Note: The AtQ resources have been produced by IEH to support appropriate identification of Aboriginal and Torres Strait Islander status specifically for use in eye care services.

The AtQ resources are also available to download:

Download 'Toblerone' desktop resource*

Download AtQ Information Sheet

Please Note: IEH encourages local community adaptations of the ‘toblerone’ desktop resource* and development of other resources to prompt and support ‘asking the question'.

Please refer to your local Aboriginal organisation for further support, information, training on cultural safety and ‘asking the question’.

If you have any questions or for further information please contact IEH, Indigenous-EyeHealth@unimelb.edu.au or call (03) 8344 9320.

Further information, training and a list of available resources and tools to support identification of Aboriginal and Torres Strait Islander status can be found below:

• Australian Indigenous Doctors Association - Position Statement on Aboriginal and Torres Strait Islander Patient Identification
• Australian Institute of Health and Welfare - Patient Fact Sheet: ‘Are you of Aboriginal or Torres Strait Islander Origin?’
• North West Metropolitan Region (NWMR) Koolin Balit Primary Care Partnership (PCP) Consortium Project
• North East Healthy Communities (previously North East Primary Care Partnership -  "Have you Asked the Question?" Resources
• Inner North West Primary Care Partnership - ‘Asking the Question’ Training Package
• Royal Australian College of General Practitioners - Identification of Aboriginal and Torres Strait Islander people in Australian General Practice

Online Training and Videos

• VACCHO in collaboration with Mungabareena Aboriginal Cooperative and Rumbalara Aboriginal Cooperative. Recording Aboriginal and Torres Strait Islander Status
• Inner North West Primary Care Partnership. 'Asking the Question' DVD
• Aboriginal Experiences of the Primary Health Care System in Northern Melbourne. 'Collecting Stories'

Guidelines

Australian Institute of Health and Welfare - National Best Practice Guidelines for Collecting Indigenous Status in Health Data Sets

*Acknowledgment:

Indigenous Eye Health, University of Melbourne has used with permission the existing wording and artwork from the ‘Have you Asked the Question?’ joint project by North East Healthy Communities (previously North East Primary Care Partnership) and Victorian Aboriginal Health Service (VAHS). Project artwork by Gary Saunders.

IEH acknowledges a number of key informants who provided input to the further development of the resources.

IEH also acknowledges the support of Optometry Australia, The Royal Australian and New Zealand College of Ophthalmologists and Vision 2020 Australia in disseminating and encouraging the use of this resource.

References:

1. Taylor HR, National Indigenous Eye Health Survey Team. National Indigenous Eye Health Survey. Melbourne: Indigenous Eye Health Unit, The University of Melbourne 2009. Available at: https://mspgh.unimelb.edu.au/__data/assets/pdf_file/0004/1984144/niehs_full_report.pdf
2. Foreman J, Keel S, van Wijngaarden P, Crowston J, Taylor H. R, and Dirani M. The National Eye Health Survey 2016. Available at: http://www.vision2020australia.org.au/resources/national-eye-health-survey-report/
3. Australian Institute of Health and Welfare. Indigenous Eye Health Measures 2018. Cat. no: IHW 210. Available at: https://www.aihw.gov.au/reports/indigenous-australians/indigenous-eye-health-measures-2018/contents/summary
4. Australian Institute of Health and Welfare. National best practice guidelines for collecting indigenous status in health data sets. 2010. Available at: https://www.aihw.gov.au/getmedia/ad54c4a7-4e03-4604-a0f3-ccb13c6d4260/11052.pdf.aspx?inline=true
5. Australian Indigenous Doctors Association. Australian Indigenous Doctors Association - Position Statement on Aboriginal and Torres Strait Islander Patient Identification. 2019. Available at: https://www.aida.org.au/wp-content/uploads/2019/03/Identification-final.pdf
6. Royal Australian College of General Practitioners. Identification of Aboriginal and Torres Strait Islander people in Australian general practice. Available at: https://www.racgp.org.au/the-racgp/faculties/aboriginal-and-torres-strait-islander-health/guides/aboriginal-and-torres-strait-islander-people
7. Taylor HR, Anjou MD, Boudville AI, McNeil RJ. The Roadmap to Close the Gap for Vision: Full Report. Indigenous Eye Health Unit, Melbourne School of Population and Global Health, University of Melbourne. 2012. Available at: https://mspgh.unimelb.edu.au/__data/assets/pdf_file/0008/1984166/roadmap_full_report.pdf
8. Vision 2020 Australia. Strong Eyes, Strong Communities: A five year plan for Aboriginal and Torres Strait Islander eye health and vision 2019-2024. Vision 2020 Australia, 2019. Available at: http://www.vision2020australia.org.au/resources/strong-eyes-strong-communities/
9. North East Healthy Communities (previously North East Primary Care Partnership). ‘’Have you asked the question?’’ resources. Available at: https://www.nehc.org.au/self-identification-aboriginal-torres-strait-islander-consumers/