Cultural sensitivity in working with Indigenous Peoples: a model proposed and evaluated towards culturally sympathetic methodology for capacity building and social change

Evidence-based parenting and family support interventions have had slow uptake in Indigenous communities (Kumpfer, Magalhaes & Xie, 2012). Given that most interventions are designed and implemented with a predominantly Western focus, a critical examination of the effects of colonialism and experiences of assimilation for Indigenous peoples needs to be incorporated into program development and outcome research (Benzies 2014). Slower uptake and lack of sustainability of interventions could be mitigated by collaborative efforts from the ground up to ensure the contextual fit of interventions, increase community acceptance, and maximise reach and benefit. In accordance with such aims, this series of research evaluates processes of collaborative community engagement in the development of a model of working effectively with Indigenous peoples and in introducing a community-chosen evidence-based parenting program (the Triple P – Positive Parenting Program; Sanders, 2012) in remote Indigenous communities in the Kimberly region of Western Australia.Study 1 assessed how others have adapted and implemented Western interventions for non- Western cultures through a systematic literature review which identified 59 studies exploring culturally adapted interventions. The knowledge gained informed the theoretical development of the Model of Engaging Communities Collaboratively (MECC) which synthesises community identified concerns and solutions; community consultation; engagement of locals, leaders and organisations; identification of cultural traditions, values and beliefs; collaborative adaptation; tailored implementation; and enhanced ecological fit and sustainability.Study 2 sought to further inform development of the MECC based on international feedback from Indigenous communities gathered through in-person semi-formal interviews, story-telling opportunities and focus groups including Indigenous peoples from Australia, Canada, the United States, Panama and New Zealand. This feedback showed overall acceptance of the processes included, influenced the development of the MECC process checklists, and led to the addition of the final step of the MECC processes: dissemination approval.Study 3 evaluated the use of the MECC in remote communities in Western Australia. The communities’ response to the MECC processes and the change in levels of empowerment of co- researchers (advisory group, trained practitioners) and participants (families receiving the program) involved in the processes was evaluated through interview-style or self-administered surveys, semi- formal interviews, focus group discussions and storytelling opportunities. Findings included overall acceptance of the MECC processes (response means showing 3.86 and higher on a 5 point scale of acceptability), and significantly increased perceived levels of empowerment for those directly and indirectly involved (from a mean of 4.97 to 6.18, and 5.93 to 6.50 respectively on a 7 point scale of empowerment). Qualitative data supported and gave context to the quantitative findings.This research advances our understanding of key community consultation and support processes that can increase the contextual fit and acceptability of evidence-based parenting support interventions in Indigenous communities. It also provides evidence of an increased sense of empowerment in advisors, practitioners and the broader community following this approach to program dissemination. These findings may inform the development of future dissemination efforts to ensure the contextual fit of program content and delivery processes, and thus enhance access to empirically-supported intervention services in communities that do not typically access mainstream programs.

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