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1.
Health Promot Int ; 33(6): 925-937, 2018 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-29106515

RESUMEN

The Driving Change programme was developed to facilitate access to licensing in Aboriginal communities in Australia. This process evaluation aimed to explore whether Driving Change was implemented as intended and was addressing the needs of the communities. A mixed methods approach was used, with triangulation of client data (n = 984), semi-structured interviews (n = 18) and client discussion groups (n = 21). Descriptive and regression analyses of quantitative and thematic analysis of qualitative data were drawn together to develop an integrated understanding of implementation barriers and facilitators. The programme reached 984 clients, with the majority from the target age group 16-24 years (56-89%). In multivariate analysis, clients who had supervised driving practice were 2.4 times more likely to attain a licence (95% CI: 1.9-3.1) and clients who received a high level of case management were 1.8 times more likely to progress to attain a licence than those who received low levels of case management (95% CI: 1.3-2.6). Implementation was facilitated by community partnerships and this was attributed to local delivery, Aboriginal leadership, connections with community networks and community ownership of solutions. Driving Change is engaging communities and reaching clients with a high level of need for licensing support. The programme is working with communities, benefiting from the input of cultural values and sharing ownership of local solutions. Community partnerships were critical to successfully supporting clients to overcome challenging barriers to participation. The learnings from this programme are relevant to complex community programme implementation and evaluation, particularly with diverse or hard to reach populations.


Asunto(s)
Conducción de Automóvil/estadística & datos numéricos , Conducción de Automóvil/normas , Concesión de Licencias/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Adolescente , Adulto , Australia , Relaciones Comunidad-Institución , Femenino , Humanos , Entrevistas como Asunto , Concesión de Licencias/legislación & jurisprudencia , Masculino , Nativos de Hawái y Otras Islas del Pacífico/psicología , Nueva Gales del Sur , Análisis de Regresión , Red Social , Apoyo Social , Adulto Joven
2.
Int J Equity Health ; 15(1): 134, 2016 08 31.
Artículo en Inglés | MEDLINE | ID: mdl-27581443

RESUMEN

INTRODUCTION: Aboriginal and Torres Strait Islander people are overrepresented in transport-related morbidity and mortality. Low rates of licensure in Aboriginal communities and households have been identified as a contributor to high rates of unlicensed driving. There is increasing recognition that Aboriginal people experience challenges and adversity in attaining a licence. This systematic review aims to identify the barriers to licence participation among Aboriginal people in Australia. METHOD: A systematic search of electronic databases and purposive sampling of grey literature was conducted, two authors independently assessed publications for eligibility for inclusion. RESULTS: Twelve publications were included in this review, of which there were 11 reporting primary research (qualitative and mixed methods) and a practitioner report. Barriers identified were categorised as individual and family barriers or systemic barriers relating to the justice system, graduated driver licensing (GDL) and service provision. A model is presented that depicts the barriers within a cycle of licensing adversity. DISCUSSION: There is an endemic lack of licensing access for Aboriginal people that relates to financial hardship, unmet cultural needs and an inequitable system. This review recommends targeting change at the systemic level, including a review of proof of identification and fines enforcement policy, diversionary programs and increased provision for people experiencing financial hardship. CONCLUSION: This review positions licensing within the context of barriers to social inclusion that Aboriginal people frequently encounter. Equitable access to licensing urgently requires policy reform and service provision that is inclusive, responsive to the cultural needs of Aboriginal people and accessible to regional and remote communities.


Asunto(s)
Conducción de Automóvil/estadística & datos numéricos , Concesión de Licencias/estadística & datos numéricos , Nativos de Hawái y Otras Islas del Pacífico , Australia/epidemiología , Humanos , Concesión de Licencias/economía
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