The experiences of a regional Aboriginal community accessing primary health care during times of crisis.

INTRODUCTION: The importance of primary health care (PHC) to Aboriginal Australians is widely acknowledged, as is the underservicing of the Aboriginal Australian population. Aboriginal People continue to face significant obstacles when accessing and using health care services. OBJECTIVE: This study identifies environmental factors (beyond personal and service delivery) that functioned as barriers and enablers to Aboriginal Australians' experiences accessing PHC during crises and recommends approaches during future events. DESIGN: This research utilised a case study approach. Data were collected through in-depth interviews and analysed using thematic analysis. The study was set in Lakes Entrance, a regional Victorian locality with a sizable Aboriginal community, which was affected by bushfires during 2019/2020 and COVID-19 restrictions during 2020-2021. Participants were 18 Aboriginal People over the age of 18 living in the locality during either bushfires or COVID-19. FINDINGS: The barriers identified included the impact on PHC access of priorities other than health, including housing; financial constraints; difficulties with transport; medical bureaucracy and the physical environment of the health care setting, including appointment-making processes; interactions with medical reception staff; and waiting room environments. Enablers identified included the supportive role of the local Aboriginal Community Controlled Health Organisations (ACCHO) and their staff, which was highlighted in participant responses. DISCUSSION: The preference of many Aboriginal people to access PHC via their local ACCHO, rather than mainstream health care services, appears even more salient during crises than in normal times. This research identified that ACCHOs are ideally placed to promote and protect the health of Aboriginal communities during crises. CONCLUSION: Results may help direct interventions to improve PHC access and experiences for regional Aboriginal communities both during and outside periods of crisis.

Assessing organizational capacity for diffusion: A school-based social network analysis case study.

The purposeful design of social networks is increasingly recognized as a fundamental organizational improvement strategy. In the PK-12 education sector, school-based teacher collaboration is the primary vehicle through which educators are able to gain access to essential social capital, and through which leaders promulgate diffusion of innovation and continuous organizational learning. In partnership with school administrators, the authors undertook an evaluation to examine the size, structure, and composition of school-based networks. Social network analysis (SNA) was used to measure and visualize connections (or lack thereof) of ties between teams and between educators. Isolate and disconnected network actors were revealed through visual inspection of the sociograms. Administrators used findings to reconfigure team membership to enhance teacher ability to give and receive support and collaboratively problem-solve, and to ensure greater capacity for diffusion of instructional innovation and organizational learning. This paper contributes to the field's understanding of how evaluators and organizational leaders can use SNA to measure, visualize, and more purposefully design effective patterns of connection between people through which professional knowledge, support, and innovation will travel.

Evaluation of a cross-cultural training program for Pakistani educators: Lessons learned and implications for program planning.

In this paper, we share the results of a summative evaluation of PEILI, a US-based adult professional development/training program for secondary school Pakistani teachers. The evaluation was guided by the theories of cultural competence (American Psychological Association, 2003; Bamberger, 1999; Wadsworth, 2001) and established frameworks for the evaluation of professional development/training and instructional design (Bennett, 1975; Guskey, 2002; King, 2014; Kirkpatrick, 1967). The explicit and implicit stakeholder assumptions about the connections between program resources, activities, outputs, and outcomes are described. Participant knowledge and skills were measured via scores on a pre/posttest of professional knowledge, and a standards-based performance assessment rubric. In addition to measuring short-term program outcomes, we also sought to incorporate theory-driven thinking into the evaluation design. Hence, we examined participant self-efficacy and access to social capital, two evidenced-based determinants or "levers" that theoretically explain the transformative space between an intervention and its outcomes (Chen, 2012). Data about program determinants were collected and analyzed through a pre/posttest of self-efficacy and social network analysis. Key evaluation findings include participant acquisition of new instructional skills, increased self-efficacy, and the formation of a nascent professional support network. Lessons learned and implications for the design and evaluation of cross-cultural teacher professional development programs are discussed.