“HAVE YOU ASKED THE QUESTION?” PROJECT EVALUATION … · 2 T “HAVE YOU ASKED THE QUESTION?” PROJECT EVALUATION REPORT Acknowledgement of Traditional Owners of the Land, Past

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NORTH EAST PRIMARY CARE PARTNERSHIP

Sally Berger

NEPCP Koolin Balit Aboriginal Health Project Worker

September 2015

“HAVE YOU ASKED THE QUESTION?”

PROJECT EVALUATION REPORT

PLEASE HELP US TO IMPROVE THE HEALTH OF ABORIGINAL AND TORRES STRAIT ISLANDER VICTORIANS

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Acknowledgements

North East Primary Care Partnership acknowledges the contribution made by the many people involved in the development of the “Have You Asked the Question Are You of Aboriginal or Torres ” Self-Identification Project which included the Resource Kit and the provision of the “Have You Asked the Question?” Training. Many thanks to the following people:

• A major thanks to the Victorian Aboriginal Health Service (VAHS), in particular Jo Atkinson, the Closing the Health Gap Partnership Manager, who provided valuable feedback and advice throughout the development of the resources. Thanks also to Jason King, Executive Officer of the Victorian Aboriginal Health Service, who launched the Resource Kit at the first “Have You Asked the Question? training session on the 18th August 2014

• Queensland Health, in particular Lyndell Leitch, who kindly shared ideas, information and learnings from their experiences in the area of Indigenous self-identification in Queensland.

• To a myriad of Aboriginal community workers and mainstream agency employees who provided feedback on the initial draft of the self-identification resources-too many people to individually mention.

• Gary Saunders who designed the digital artwork element incorporated into these resources and on the training flyer, an element of the larger NEPCP Closing the Health Gap logo.

• Thanks to Karen Rumley at I.D Consulting who undertook the graphic design and resource production component of the project.

• The NEPCP Closing the Health Gap (now Koolin Balit) Working Group who supported the recommendations and activities that were proposed by the NEPCP CtHg Coordinator including the development of the “Have You Asked the Question?” Rresource Pack and accompanying training.

• Austin Health, a member agency of the Closing the Health Gap Working Group for supporting the training component of the project by agreeing to a member of their Aboriginal Health Team to provide the training sessions to support the Project.

• Nathan Leitch, an Austin Health trainer and educator, who provided the two “Have You Asked the Question?” training sessions and who gave very generously of his time despite having changed organizational role when the sessions were delivered.

Project artwork by Gary Saunders © This work and all artwork are copyright. It may be reproduced in whole or in part for study or training purposes subject to an acknowledgement of the source and no commercial use or sale. Reproduction for other purposes or by organisations requires the written permission of the copyright holders. Use of any quotations from this document should be appropriately acknowledged.

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“HAVE YOU ASKED THE QUESTION?” PROJECT

EVALUATION REPORT

Acknowledgement of Traditional Owners of the Land, Past and Present. The North East Primary Care Partnership (NEPCP) would like to acknowledge and pay respect to the

traditional owners of this land-the Wurundjeri people of the Kulin Nation, on which the office of the

NEPCP is located. The NEPCP would also like to pay respect to Wurundjeri Elders, past and present,

and extend that respect to all Aboriginal and Torres Strait Islander people.

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“HAVE YOU ASKED THE QUESTION?” PROJECT

EVALUATION REPORT

Contents

1. Executive Summary...................................................................5

2. Introduction.............................................................................6

2.1 Background Information.............................................................6

3. Overview of the Self-Identification Resources………………….……………………..7

3.1 Background..............................................................................7

3.2 Launch of resources....................................................................7

3.3 Distribution of Resource Pack........................................................7

4. Overview of the Training.............................................................8

4.1 The Trainer………........................................................................8

4.2 Training Days............................................................................8

4.3 Number of people Who Attended the Training....................................8

4.4 Training Content........................................................................8

4.5 Waiting List..............................................................................8

5. Purpose of the Evaluation……………………………………………………………………….…..9

3.1 Aims.......................................................................................9

3.2 Objectives ..............................................................................9

6. Methods.................................................................................10

6.1 The Training Study Area.............................................................10

6.2 Selection of the Training Target Population and Sample.......................10

6.3 Development of the Survey..........................................................10

6.4 Method of Data Collection...........................................................10

6.5 Method of Analysis....................................................................11

6.6 Limitations to the Study.............................................................11

7. Presentation of the Training/Resource Survey Respondent Results………13

7.1 Survey Respondent Information....................................................13 7.2 Agency Name..........................................................................13 7.3 Local Government Area (LGA) Representation...................................13 7.4 Respondent Role......................................................................13 7.5 Discussion of Respondent Results..................................................14

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8. Presentation of Training/Resource Survey Results............................15

8.1 Training day attended by respondents………………………………………………………….15 8.2 Previous attendance at training Related to Self-Identification……………………15 8.3 Type of Self-Identification Training Attended.…………………………………………….16 8.4 When was this Training Received?..………………………………………………………………16 8.5 Level of satisfaction with the Trainer and Training.……………………………………17 8.6 Overall experience of the “Have You Asked the Question?” Training…………18 8.7 Improvements in the 5 Key Concept areas of Yarning, Family, History, Identity and Healing….………………………………………………………………………………….20 8.8 What did you like most about the training? ………………………………………………..22 8.9 What if any, improvements could be made to the “Have You Asked the Question?” Training?..………………………………………………………………………..…………24 8.10 Certificate of Attendance….……………………………………………………………………….…25 8.11 Discussion of Training Survey results.……………………………………………………….….26

9. Presentation of Self-Identification Resource Pack Survey Results.........28 9.1 The Resources Toolkit is an A5 Booklet…Has this booklet been useful?...… 28 9.2 Did you receive the Resource Pack consisting of a mouse-mat, computer monitor sticker, a phone sticker and an A5 Sticker? ……………….…28 9.3 Have You Used the Resource pack? ………………………………………………..…………..29 9.4 Which resource components are important to the survey respondents?….…29 9.5 What did you like most about the “Have You Asked the Question”? Resources? ……………………………………………………………………………………………….……30 9.6 Ideas to improve the resources…………………………………………………………….………32 9.7 Discussion of Resource Pack Survey Results…………………………………………….…..32

10. Any Additional Feedback…………………………………………………………………….….34

11. Unintended Training and Resource Pack Outcomes……………………………..36

12. Conclusion............................................................................39

13. Recommendations..................................................................40

14. Appendices...........................................................................41

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1. Executive Summary This report provides an analysis and evaluation of the ‘Have You Asked the Question?’ training and the ‘Have You Asked the Question?’ “ Are You of Aboriginal or Torres Strait Islander Origin?” resource pack. The training was delivered in support of the launch and roll-out of the “Have You Asked the Question?” resource pack. The method of analysis included a training and resource pack survey and verbal and photographic feedback on the use of the resources within practice. Results of training data showed training satisfaction was very high and substantial improvements in worker knowledge in the areas of yarning, family, history, identity and healing were achieved. Resource pack feedback show that the mouse-mats and stickers were easily implemented into agency environments and proved a successful method to further prompt self-identification of Aboriginal and Torres Strait Islander community members in agencies. Results showed that the resources were simple, clear, easy to read and effective. The highly visual presence of the correct wording designed to be clear and within easy sight, was highly valued by workers. Other elements such as artwork, Aboriginal and Torres Islander Strait flags and Victorian Aboriginal Health Service (VAHS) contact details only added to their approval by agency employees. Report recommendations include:

Service providers require on-going Aboriginal and Torres Strait Islander cultural awareness training that incorporates identity and self-identification issues within a broad social determinants framework.

Opportunities for small group work or practical case-studies or scenarios on ‘asking the question’ could further enhance the training.

The ‘Have You Asked the Question’ resources should be promoted as an effective method to further prompt the self-identification of Aboriginal and Torres Strait Islander community members within mainstream agencies.

The implementation of the ‘Have You Asked the Question’ resources should be encouraged across agencies and sectors and across the North West and Metropolitan region.

This evaluation report concludes that self-identification of Aboriginal and Torres Strait Islander community members can be improved through multiple strategies such as targeted training and implementing the ‘Have You Asked the Question?’ resources. Delivered training demonstrated a marked increase in knowledge bases that support an improved understanding of identity and self-identification issues. Training, on its own however, does not assure that all community members are asked every time about their Aboriginal and Torres Strait Islander status. Identity and self-identification are complex issues. Multiple strategies need to be employed to improve self-identification outcomes and the resource kit has been effective as a continual reminder and in promoting employee confidence to ‘ask the question’. The “Have You Asked the Question?” self-identification resource kit (mouse-mat/stickers/ booklet) has proved to be an innovative way to provide clear, concise and easily accessible resources that support Aboriginal and Torres Strait Islander self-identification practices within universal services.

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2. Introduction

2.1 Background Information

The North East Primary Care Partnership (NEPCP) undertook a number of pieces of work in order to inform the Closing the Health Gap (now Koolin Balit) project including the ‘Collecting Stories’ Project. This project documented individual Aboriginal experiences of the primary health care system in the Northern region. Self-identification was highlighted as one of the key themes that arose from the project. A booklet and DVD were produced. The video can be found at: http://youtu.be/-x1HPd663QU and booklet at http://www.nepcp.org.au/nepcp-collecting-stories-booklet-2012 NEPCP also undertook the 2012 NEPCP Working with Aboriginal People and Communities Survey. This Survey is a very comprehensive workforce survey that was developed to identify trends, strengths and opportunities to develop the skills and capacity of NEPCP member agencies. The Survey elicited almost 500 responses and provided valuable qualitative and qualitative data. The Executive Summary and full Survey report can be found at: http://www.nepcp.org.au/survey From these two pieces of work, key informant interviews and a literature review, self-identification of Aboriginal and Torres Strait Islanders was highlighted as an important first-step in providing culturally responsive service delivery and options to Aboriginal and Torres Strait Islander community members. In order to address some of the issues raised in the Survey which included; use of consistent wording, the incorrect belief that asking the question may be discriminatory or staff stopping asking the question because they are challenged by a community member about why the question is asked, NEPCP felt that a range of resources could be developed to further support self-identification within agencies. Alongside the training, a number of permanent resources were devised to be on-going reminders of the need to continuously ‘ask the question’ using a consistent approach based on the Australian Institute of Health and Welfare( AIHW) guidelines.

The development of the resources is just one of many activities undertaken in the self-identification work space for NEPCP. For example, the distribution of the Queensland Health Self-Identification DVD to each Working Group member agency, the development of a Self-Identification Action Plan, sample policy and procedures, distribution of the updated AIHW Guidelines and various other pieces of work targeted the improvement of self-Identification of Aboriginal and Torres Islander community members within our member agencies.

http://youtu.be/-x1HPd663QU

http://www.nepcp.org.au/nepcp-collecting-stories-booklet-2012

http://www.nepcp.org.au/nepcp-collecting-stories-booklet-2012

http://www.nepcp.org.au/survey

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3. Overview of Self-identification Resources

3.1 Background The need for improvements in data and cultural responsiveness of services is inextricably linked to the self-identification of Aboriginal and Torres Strait Islander community members. A number of efforts have occurred at a federal and a state level to promote the identification issue, such as video clips, training, posters and resources around ‘asking the question’. Despite these efforts, our local evidence indicated that there was still significant work to be undertaken in this area.

The results of the 2012 NEPCP Working with Aboriginal People and Communities Workforce Survey were very clear. Whilst training is a valuable component of improving self-identification of Aboriginal and Torres Strait Islander community members at North East Primary Care Partnership (NEPCP) agencies, the 2012 Survey found that even with training, staff members can have difficulty consistently asking the identity question. The Survey provided evidence as to why staff members do not ask ‘the question’ and why they stop asking the question including; the lack of a consistent approach to correct wording to be used by staff. It was these issues that NEPCP wanted to specifically target in the development of the Have You Asked the Question? “Are You of Aboriginal or Torres Strait Islander Origin?” Resource Kit and accompanying training.

Without wanting to duplicate the work that were already available, NEPCP and the NEPCP Closing the Health Gap Working group decided that resources that were immediate and reinforced the ‘asking the question’ in a consistent way would assist their workers. Due to the complexity of self-identification and the importance of improving worker’s knowledge of why they were asking the question, it was felt that the distribution of resources should be linked and reflected in a training component.

For further background information about the Project see Appendix 1. ‘Have You Asked the Question’ “Are You of Aboriginal or Torres Strait Islander Origin?” Resource Kit.

3.2 Launch of Resources Jason King, the Executive Officer of the Victorian Aboriginal Health Service (VAHS) launched the Self-Identification Resource Kit on Monday 18th August 2014 following the delivery of the first “Have You Asked the Question?” training session.

3.3 Distribution of Resource pack The Resource Pack was available at the end of the training session to all who attended.

The pack consisted of 1 each of the Mouse-mat, computer monitor sticker, a phone

sticker and an A5 Sticker. The pack also included an A5 booklet which explained the

development of the resources and how to implement them in the workplace, including

photographic images demonstrating sample placement of resources. (See Appendix X for

Samples of each of these items)

Further requests for Resource packs continued after the training was completed. A

number of attendees had returned to their workplaces and showed the “Have You Asked

the Question? ”Resource Kit to their colleagues. This resulted in further requests from

agencies for extra Resource Kits for their workplace.

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4. Overview of Training 4.1 The Trainer As a member of the NEPCP Closing the Health Gap Working Group, Austin Health offered to support the Asking the Question project by asking a member of their Aboriginal Health Team who held an educator and training role to provide the training. Nathan Leitch, the trainer, is a Quandamooka man from South East Queensland, who has lived most of his life in Victoria. Nathan has a background in visual art, but more recently has worked in Aboriginal education and health, focused predominantly on the delivery of Cultural Awareness training, health promotion, advance care planning, and service improvement. Nathan is a resident of Northern Melbourne and is committed to supporting and improving the health experiences of local Aboriginal people

4.2 Training Days

Monday 18th August 2014 and Thursday 21st August 2014 were the 2 training dates.

Two alternate days of training were offered which took into consideration the part-time nature of workers. Therefore the sessions were offered;

On different days- a Monday and a Thursday

One session in morning, one session in afternoon

4.3 Number of People who Attended the Training

A total of 132 people attended the Have You Asked the Question? “Are You of Aboriginal or Torres Strait Islander Origin?” training sessions.

Two training sessions were provided; 68 people attended the training on Monday 18th August 2014. 64 people attended the training on Thursday 21st August 2014

4.4 Training Content

Training content was developed by the trainer and has been delivered previously as part of an education/training program at Austin Health for its staff. The training is based on 5 concept areas of Yarning, Family, History, Identity and Healing. NEPCP did wish to cover a number of points that had arisen as a result of the workforce survey results however these were already incorporated into the training components. Nathan delivered a more comprehensive self-identification/identity training than was envisaged by NEPCP.

4.5 Waiting List There were numerous agencies who wished to attend the “Have You Asked the

Question? Training. Training though was capped at 60 participants per session

although this number was increased slightly for both sessions. Many people

requested to be placed on a waiting list or to be informed about any future self-

identification training opportunities.

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5. Purpose of the Evaluation

3.1 Aims:

The Evaluation aims:

To gain a better understanding of the impact of the “Have You Asked the

Question?” Training on changes to level of knowledge and information held

by the NEPCP member agencies’ workforce in relation to identity and self-

identification of Aboriginal and Torres Strait Islander community members.

To gain knowledge around the usefulness and implementation of the “Have

You Asked the Question? Resources Toolkit by training attendees.

To identify any enablers and barriers (from a worker perspective) to

achieving accurate self-identification of Aboriginal and Torres Strait

Islander people that will support the provision of quality and culturally

appropriate health care

3.2 Objectives:

The Survey objectives include;

To distribute a “Have You Asked the Question?” Survey to all those who

attended the “Have You Asked the Question?” training with a focus on;

Identifying any improvements in the level of knowledge in the key

concept areas of Yarning, Family, History, Identity and Healing.

To Identify whether the “Have You Asked the Question? Resources

Toolkit is practical and can be effectively implemented by the

workforce.

Providing an opportunity for survey respondents to offer ideas for

improvement to the training and resources

To devise and develop recommendations that continue to support the self-

identification of Aboriginal and Torres Strait Islander community members.

To disseminate knowledge gained from survey results to inform individual

agency practices.

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6. Methods 6.1 The Study Area

The targeted study area for receipt of training and the Resource Pack were

NEPCP member agencies or agencies that operate within the Cities of Banyule,

Darebin and the Shire of Nillumbik.

6.2 Selection of the Target Population and Sample

The selected target population was the mainstream workforce of the 18 member

agencies of the North East Primary Care Partnership. It was envisaged that the

specific population group targeted for the sample would include;

Reception/ Administration roles at NEPCP member agencies

Service Coordination/Intake roles at NEPCP member agencies.

First point of contact roles at NEPCP member agencies

6.3 Development of the Survey

The development of the survey was devised to meet the aims and objectives

of the evaluation of both the “Have You Asked the Question?” training and

resource pack. The survey tool was designed to elicit improvements in levels

of knowledge of the 5 key concept areas of Yarning, Family, History, Identity

and Healing presented by the trainer. The survey also aimed to ascertain

whether the “Have You Asked the Question? Resources Toolkit was practical

and could be effectively implemented by the workforce. The survey offered

an opportunity to gain other ideas for improving the training and further

developing the “Have You Asked the Question?” resources. A number of

open responses were also provided to give an opportunity for further

suggestions on the types of information or resources that would assist

agencies in improving accurate identification of Aboriginal and Torres Strait

Islander community members within mainstream workplaces.

6.4 Method of Data Collection

Online Survey

The evaluation outcomes of the “Have You Asked the Question?” training and

resources kit were identified using the web-based Survey Monkey software.

The Online survey link was distributed directly to all those who attended the

“Have You Asked the Question?” training.

The Evaluation link was sent out to participants 2 weeks post-training to give

attendees time to reflect on the training and provide enough time for

attendees to implement the resources within their workplace either by placing

the stickers on their computer monitor/keyboard/phone or the mouse-mat on

their desk.

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6.5 Method of Analysis

The web-based Survey Monkey software enables collection of results in real-

time. The use of this software allows the attainment of both qualitative and

quantitative data. A summary of results are available in multiple formats.

Quanitative Analysis

Statistical collection methods aid the understanding of improvements in the level of

knowledge of the 5 key concept areas based on the training experience. Data

collection can also assist in better understanding how the Resources Toolkit was

used and which components were more successful in their practical implementation.

The Survey Monkey software allows filtering and cross-tabulation of survey results.

A summary of survey results can be presented in multiple formats. The results were

then presented as either Bar Graphs or in Table format.

Qualitative Analysis In accordance with the project aims and objectives, the focus was on the

development of a survey that could provide both qualitative and quantitative data.

The Survey Monkey software enables the viewing of open-ended comments and also

provides textual analysis. The use of qualitative data deems particulars methods are

used when comparing results. Coding, which signifies that the researcher looks for

various categories that may arise from intuition, theory or from the data itself was the

basis for the analysis. Manual coding were used for the qualitative data gathered

from the web-based survey. Any use of qualitative data involved in this survey, with

exception of anonymous direct quotes, involved the use of this material in a

descriptive way only. Anonymous direct quotes were used throughout the report to

demonstrate real experiences which may have been lost within the coding practice.

Chosen direct quotes reflected the majority coded view at that particular question.

Other Feedback

Both written and verbal feedback was received from agency workers that received a

‘Have You Asked the Question? Resource Kit. Any use of the qualitative data

received as verbal and written feedback, with exception of anonymous direct quotes,

involved the use of this material in a descriptive way only.

Photographic Evidence

Previous experience has shown that resources can be disseminated with little or no

use in practice. A request for photographic evidence, to demonstrate whether

resources were used and how they were used in practice, was made of training

attendees. The project worker wanted to guarantee that the resources were actually

being used. In order to evaluate their implementation, the survey was sent out two

weeks after the training attendance. Despite providing visual examples in the A5

Booklet on how to use the resources, the project worker also wanted to evaluate if

the resources could be used in other innovative ways that had not been planned..

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6.6 Limitations to the Study

Overall, the short time-span to complete the survey from survey design and

collection and analysis of data signified that particular criteria had to be met to

complete the survey results within the specified period. The design and methods of

data collection were also restricted due to the above limitations. As the targeted

audience was reception/administration/first point-of-contact staff, it was noted that

these roles may not always provide ‘down time’ for workers to complete the survey.

The survey consisted of 19 questions and dependent on worker role it could take a

respondent approximately 15-20 minutes to complete. This meant that workers had

to dedicate a large amount of time to this survey in comparison to shorter, faster

online surveys. A number of training places had been booked by a team leader or

manager and in a few circumstances the direct email address of the trainee was not

available for survey distribution. Therefore it cannot be certain that the survey

reached all intended training attendees.

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7. Presentation of Training Survey Respondent

Results

7.1 Survey Respondent Information In total, 50 respondents commenced the survey with 49 surveys (98%) being fully completed. There were 132 training participants over the two training days. The total response rate for survey completion by participants was 37%.

7.2 Agency Name The most agency responses for the Survey were from Banyule Community Health, North West Aged Care Assessment Service, Darebin City Council, and Nillumbik Community Health who all had 5 respondents each A range of other agencies were represented amongst respondents including;, Banyule City Council , Children’s Protection Society, Moreland City Council , Northern Support Services , Southern Cross Care, Playgroup Victoria Inc., Banksia Palliative Care, Nillumbik Shire Council, Waratah Special Development School, Northern Support Services ,Youth Support and Advocacy Service ( YSAS), Whitelion, ISIS Primary care , Department of Education and Early Childhood development (DEECD), Merri Community Health Services, Tweddle Child and Family Services, City of Yarra, Melbourne City Mission, Eastern Victorian Aboriginal Child Care Agency (VACCA) and Neami National.

7.3 Local Government Area (LGA) Representation Respondents came from a variety of Local Government Areas (LGAs) although NEPCP principally targeted the LGAs of Banyule, Darebin and Nillumbik from whence the majority of respondents came. However, The LGAs of Moreland, Yarra, Whittlesea, Maroondah, Melbourne, Brimbank, Maribyrnong and Moonee Valley were represented.

7.4 Respondent Role Respondents represented a broad cross-section of agency employees and ranged from non-clinical roles such as reception and administration through to assessment officers, intake workers, nursing, counsellors/social work, project staff and managers. Intake/Service Coordination and Assessment roles had 16 respondents. Reception/Administration had 6 respondents. Counsellor/Social work 5 respondents, Nursing 5 respondents and Case Managers 3 respondents. There was a large number of responses from single roles which included but were not limited to; Youth Outreach Worker, Clinical Supervisor, Team Leader, Respite Manager, Aged Care Assessment Service, Maternal and Child Health, Immunization, Community Nurse, Project Officer, Student Wellbeing Officer, Aboriginal Liaison Worker Child FIRST, Koori Community Engagement Officer, Recreation Facilitator, Manager, Trainer and Pre-School Field Officer amongst other role types.

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Discussion of Respondent Results Of those who completed the survey, the respondents were representative of the targeted worker role type (first point of contact staff) and also the majority of respondents were from the targeted NEPCP catchment areas of Banyule, Darebin and Nilllumbik. Surpisingly, there was large interest from workers who were willing to travel large distances, such as from the Western and Eastern suburbs to attend the training, which may suggest a need for specific self-identification/identity training. Often identity and self-identification training is located within general cultural competency training and yet this topic is itself very complex and deserves to have specific training time dedicated to this topic as a separate unit.

The interest and potential need for this type of training did not highlight any particular role type that attended the training. Workers represented employment roles across the life-span including early years, youth and aged care services. The results indicate that self-identification training and resources are relevant to all and could potentially be ‘rolled out’ to all agencies irregardless of worker position, agency role or organization location.

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8. Presentation of Training Survey Results

8.1 Training Day attended by Respondents

Chart 1: Question 2: Which training day did you attend?

Of the respondents, 54% attended on Thursday 21st and 46% attended on Monday 18th August. Therefore similar numbers of respondents attended both training sessions.

8.2 Previous Attendance at Training Related to Self-Identification

Chart 2: Previous Attendance at Training related to Self-Identification

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The majority of respondents (56%) had never attended any training (including Staff orientations session) related to self-identification of Aboriginal and Torres Strait Islander community members or any training that included issues related to Aboriginal and Torres strait Islander identity (See Chart 2). Only 44% of respondents had participated in the above-mentioned type of training.

8.3 Type of Self-Identification Training Attended

Chart 3: Type of Self-Identification Training

Of those who had received some type of self-identification/identity training, 19 (n=22) respondents stated that this training was incorporated into general Aboriginal cultural competency training. Only 3 people had participated in Self-Identification/Identity only training (See Chart 3).

8.4 When was this Training received?

Table 1: Type of Self-Identification Training

Of those who had received some type of self-identification/identity training, 19 (n=22) respondents stated that this training was received within the last 2 years. Three people stated that they had received this training 2-4 years ago.

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8.5 Level of Satisfaction with the Trainer and Training

Chart 4: Level of Trainer Satisfaction

Please rate your level of satisfaction with the trainer and the training provided.

1. The trainer was knowledgeable about the course material

2. The trainer delivered the content at a satisfactory pace

3. The trainer used appropriate and engaging training methods

4. The trainer was effective in using personal experiences to demonstrate key concepts

5. The trainer encouraged participation and interaction throughout the session

6. The trainer provided adequate time for questions and discussions

7. The trainer answered questions effectively

From the respondents, 94% agreed or strongly agreed that the trainer was

knowledgeable about the course material. Ninety two percent (92%) agreed or

strongly agreed that the trainer delivered the content at a satisfactory pace with the

same results for the use of appropriate and engaging training methods. Seventy six

percent (76%) strongly agreed that the trainer was effective in using personal

experiences to demonstrate key concepts. Ninety two percent (92%) agreed or

strongly agreed that the trainer encouraged participation and interaction throughout

the session. From the respondents, 96% agreed or strongly agreed that the trainer

provided adequate time for questions and discussions and 86% agreed or strongly

agreed that the trainer answered questions effectively. (See Chart 4)

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Comments

There were 15 responses to this question. Not all comments are displayed. Comments displayed reflect the general themes within the comments section.

8.6 Overall experience of the “Have You Asked the Question?” Training


Comments (8 responses displayed)

I was really impressed with the way Nathan used his personal experiences to help us understand the content and to see things from another point of view.

Thank you to Nathan for delivering the information in a genuine and heartfelt manner

Difficult subject for personal experiences to be separated from overall presentation in non-blaming manner

Very engaging, non-threatening speaker

Nathan provided an engaging, poignant and insightful presentation. He was a fantastic speaker and I thoroughly enjoyed the whole presentation.

The best training I have ever seen! It was fantastic.

The trainer was knowledgeable, engaging, honest and open with his presentation.

Friendly, funny and engaging

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1. The number of training hours was sufficient 2 The training room and facilities were adequate 3 The training met my professional expectations 4 The course was pitched at my level of experience 5 I have gained new skills and knowledge in identity and self-identification 6 I feel more confident to ask consumers about their Aboriginal and Torres Strait

Islander status 7 The training has provided an opportunity for me to improve Aboriginal and Torres

Strait islander self-identification practices within my organisation 8 I am very satisfied overall with the training in identity/self-identification 9 I would recommend this training to others.

Of those who had responded, ninety three percent (93%) agreed or strongly agreed that the length of training was sufficient.

Ninety-eight percent (98%) strongly agree or agreed that the training room/facilities were adequate.

Eighty-six percent (86%) agreed or strongly agreed that the training met personal professional expectations and that the course was pitched at their level of experience.

Eighty-six percent (86%) of respondents either agreed or strongly agreed that they had learnt new skills and knowledge in identity and self-identification.

Eighty-six percent (86%) of respondents either agreed or strongly agreed that they felt more confident to ask consumers about their Aboriginal and Torres Strait Islander status

Eighty percent (80%) of respondents agreed strongly or agreed that the training has provided an opportunity to improve Aboriginal and Torres Strait Islander self-identification practices within respondent organisations.

Eighty-six percent (86%) of respondents either agreed or strongly agreed that they were very satisfied overall with the training in identity/self-identification.

Eighty-eight percent (88%) of respondents either agreed or strongly agreed that they would recommend this training to others.

Comments There were 11 responses to this question. Not all comments are displayed. Comments displayed reflect the general themes within the comments section


Whilst our organization asks the question-it is in a very tokenistic way as we really don’t

take the time to promote/engage in a view that addresses equity.

It should be a simple issue in a way but I do feel more comfortable about this now. Also

descriptions of Indigenous family units and other cultural issues was really interesting and

useful and information I hadn’t really had explained before.

I am in my 60s and often experience 101 again. But I did update and increase awareness

and learn something new.

I have advised my managers that if ever this course is offered again, I would recommend

all team members from (the agency name) be given the option to attend.

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8.7 Improvements in the 5 Key Concept areas of Yarning, Family, History, Identity and Healing

Nathan Leitch-the presenter, spoke to 5 key areas of knowledge that will support you in your working with Aboriginal and Torres Strait islander community members, particularly in the area of self-identification. Have you improved your knowledge of the concepts of Yarning, Family, History, Identity and Healing with respect to Aboriginal and Torres Strait Islander community members?


1. Yarning (included; the Aboriginal concept of 'time' and of 'respect' between generations,

body language and use of silence)

2. Family (included Aboriginal concepts of family and kinship, family may not be related by

blood and a sense of connection to land and people)

3. History (included the impact of dispossession on Aboriginal and Torres Strait Islander

community members today resulting in various issues such as poverty and poor health,

historical mistrust and fear of various institutions and feeling culturally safe).

4. Identity (included; right to self-identify, stereotypes, appearance is not a factor related to

Aboriginality, identity is an individual issue with a number of people only recently

discovering their heritage)

5. Healing (Included; most individuals almost definitely have been affected by several inter-

generational traumas, respect the person's concept of family, traditional beliefs and

connection to country, take time to develop a connection)

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Of those who had responded, ninety percent (90%) agreed or strongly agreed that they improved their knowledge of Yarning, Family and Identity.

Ninety-two percent (92%) strongly agree or agreed that they improved their knowledge of Healing and

Seventy-eight percent (78%) agreed or strongly agreed that their knowledge of History was improved.

Comments

There were 11 responses to this question. Not all comments are displayed. Comments displayed reflect the general themes within the comments section


Nathan brilliantly painted a picture of all these concepts

I think I already had a good understanding of the negative impacts of

dispossession etc.. but I benefitted a lot from the information presented

regarding other areas.

The powerpoint visual slides were very powerful and provided a clear

message

Basically everyone in the community sector (not just health setting) would

benefit from this training.

Well presented.

I think discussing the above terms and concepts was really important but I

think people wanted more information. I understood it wasn’t a full history

lesson.

Went home and did some research. Now I’m hooked and need to know

more, more, more.

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8.8 What did you like most about the training?



The trainer had a complete understanding of Aboriginal issues.

I enjoyed listening to his (the trainers’) personal experience and his own family as

a way to understand the meaning

It is inspiring to hear what a difference it has made to improving services, just by

“asking the question”.

Understanding of how previous/older generations’ upbringing and childhood

experience can affect the younger generation

The generational photos shown by Nathan of his family were very impactful and

everything else was very educational.

Presented by someone who knows from his own experience

I really liked Nathan’s relaxed but respectful approach. I really learnt a lot.

Interaction between presenter and attendees.

I really appreciated Nathan’s sharing of his journey and family history.

Providing a forum for increasing Aboriginal Torres Strait islander awareness with

community workers.

I liked the fact that Nathan spoke about personal experience. Facts and

knowledge is great however when personal stories are told they really stick and

have extra meaning to those who have listened.

The greater cultural understanding of families that it provided.

Gave more of an understanding about the concept of family and a reminder of

how far Australia has to go in terms of Aboriginal health.

I feel more confident in able to answer people if they ask why I needed to ‘ask the

question’ and more likely to feel able to educate those people who make

comments like “would I get more if I was..?”

I definitely learnt some new things.

That it wasn’t blaming white Australia but acknowledged that past injustices

have led to current situation.

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(What did you like most about the training? Continued)


The speaker and the opportunity to ask questions

The training provided evidence that we need to keep promoting these messages and

creating opportunities for further training.

Its comprehensiveness and hearing Nathan’s personal story was extremely important.

I am personally very passionate about culturally appropriate practice and think this

training on its own has improved my work immensely.

It broadened my skills and gave a deeper understanding of why we ask that question.

Authenticity of presenter and how he opened and developed issues.

Nathan demonstrated and made information “real”.

Challenged me to think deeper about where my thoughts stand and how to

communicate respect.

To have a greater understanding of Aboriginal and Torres Strait Islander people ‘s

difficulties with the health systems. I feel I need to know more; this was a good

beginning.

The friendly manner in which it was presented and good practical tips

Enhanced my awareness of Aboriginal Health and lack of knowledge in this area

Nathan was very personable, used humour to good effect, demonstrated very good

knowledge of the subject and imparted that extremely well.

Nathan was funny but professional and engaging. I have now gone and watched a

documentary he recommended

The trainer was able to speak from direct knowledge; had a great sense of humour;

eloquent and good pace

I thought the use of Nathan's own personal family photos in the training helped engage

the audience as well as delivering a powerful message.

Non blaming approach- inviting one to be curious, added to previous knowledge I had

It had personality, soul and real life context.

Nathan reflected on his own family throughout the presentation. He made it authentic

and engaging for his audience.

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8.9 What (if any) improvements could be made to the “Have You Asked the Question?” Training?



More about adverse reactions - more examples of that - from Aboriginal and

non Aboriginal point of view

Please make the workshop longer - opportunities for discussion.

Extra time for more information to be passed on.....

Greater focus on what to do when/if someone does identify, it's not just

enough to 'ask the question', you need appropriate follow through if they do

identify.

More resources to distribute to our work places. Perhaps there is opportunity

for agencies to contribute funds to order more?

No changes-excellent presentation relevant to our work area.

It should be longer! This could easily be fleshed out into a whole day training

and I think workers across many sectors would benefit from detailed training

on cultural competence in working with Aboriginal people.

Excellent presentation relevant to our work area

I think some small group time around a couple of questions and large group

feedback...just to increase self awareness in participants

I would have appreciated advice or support on how to bring it back to my

centre. To look at tools to take it a step further in generating changes. The

information packs are great…but maybe also a thought poster or challenging

thoughts poster to put in the staff room..something to make people ask

questions...or discussion with each other. Or maybe a an A4 sheet or a box of

things to put on the staff room table –that generates grass root discussion.

More practical aspects around actually 'asking the question'

Actual cases with people talking about how they've been treated, to

demonstrate great service and unacceptable service.

That my whole team had attended and learnt the same amazing things that I

did.

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8.10 Certificate of Attendance

All participants were provided a Certificate of Attendance which outlined briefly what was included in the training.

Chart 5: Certificate of Attendance

1. The Certificate of Attendance was valuable as evidence of the specific professional

development received

2. The Certificate of Attendance is useful as a demonstration of specific training received for

future employment

3. Receiving a Certificate of Attendance demonstrates the importance of workers receiving

specific training on identity and self-identification of Aboriginal and Torres Strait Islander

Community members

Of those who had responded, eighty-six percent (86%) agreed or strongly agreed that the Certificate of Attendance was valuable as evidence of specific professional development.

Seventy-eight percent (78%) agreed or strongly agreed that the Certificate of Attendance is useful as a demonstration of specific training received for future employment.

Eighty-four percent (84%) strongly agree or agreed that receiving a Certificate of Attendance demonstrates the importance of workers receiving specific training on identity and self-identification of Aboriginal and Torres Strait Islander community members.

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8.11 Discussion of Training Survey results

Surprisingly the training survey results show that over half of the respondents had

never received prior training around identity or self-identification. As self-identification

of Aboriginal and Torres Strait Islander people is mandatory for a number of services

or incorporated into intake/assessment processes, a higher rate of training attendance

in this area would have been expected. A large number of people who missed out on

a training place asked to be wait-listed for future training opportunities. This interest

indicates a continued and on-going need for mainstream service providers to

undertake self-identification/identity training within a broad social determinants

framework.

Overall, there was strong agreement that the trainer that delivered the “Have You

Asked the Question?” training was knowledgeable, engaging, used personal

experience to great affect and there was adequate provision for questions and

discussion. In particular, a number of comments noted the benefits of Nathan’s use

of family photographs as a true demonstration of historical family experience and

impact on identity over time. The majority of respondents agreed that the number of

training hours was adequate and that the training met their professional expectations

and pitched to their knowledge level. Overwhelmingly (86%) of respondents felt that

this training had given them more confidence to ask consumers about their

Aboriginal and Torres Strait Islander status and had provided them an opportunity to

improve self-identification practices at their organization. The majority of

respondents were very satisfied with the training and would recommend this training

to others.

The training was based on 5 key concept areas of yarning, family, history, identity

and healing. Those who attended the training indicated that there were very strong

improvements in their awareness of these concept areas. In particular, ninety-two

(92%) and ninety percent (90%) respectively felt they had improved their knowledge

of Healing and secondly Yarning/Family and Identity.

From individual comments, the trainer’s style and use of personal experience and

stories added significant value to the learning experience. The training content that

covered five concept areas, broadened people’s understanding and comments

reflected that these new learnings were translatable to worker practice. Attending

the “Have You Asked the Question?” training had also motivated a number of

attendees to continue to increase their knowledge outside of the training experience.

Suggested improvements to the training included making the training longer or

breaking up into smaller groups and provision of more practical examples or case

scenarios around ‘asking the question’. There is opportunity to develop further

education opportunities that complement the training that was presented with a

session/sessions of practical case examples. Eighty six and seventy eight percent of

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training attendees respectively agreed that a Certificate of Attendance was valuable

as evidence of specific professional development and useful when seeking future

employment. The receipt of a Certificate of Attendance recognizes the importance of

this topic and should continue. Post-training, the project worker was contacted by a

number of attendees who had not received their Certificate of Attendance on the day

but saw value in having a Certificate as evidence for professional development

and/or future work opportunities.

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9. Presentation of Self-Identification Resource Pack

Survey Results

9.1 The Resources Toolkit is an A5 booklet that provides information on why the resources were developed and how the resources can be used. Has this booklet been useful?

Chart 6: Resources Toolkit

Of those who had received the A5 Booklet (n= 46), 26 people stated that they found the booklet useful, 1 person did not find it useful and 19 people were still to read the booklet. (See Chart 6)

9.2 Did you receive the Resource Pack consisting of a mouse-mat, computer monitor sticker, a phone sticker and an A5 Sticker?

Chart 7. Resource Pack

From the survey, 43 people received a Resource Pack and 3 people did not.

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9.3 Resource Pack: Mouse-mat, computer monitor sticker, a phone sticker and an A5 Sticker

If yes, since you returned to your office have you or a work colleague been able to use the resources, eg. Have you placed the monitor sticker on the monitor?


From the results, the most popular item was the mouse-mat with 31 people having

implemented the resource and another 9 intending to do so. The Monitor/Keyboard

sticker was the next most popular item with 34 people either implementing or intending

to use this sticker. The A5 Sticker saw 33 people either using or intending to use this

resource. The phone/mobile phone sticker was used by 13 people and 14 people

intending to use this item.

9.4 Which resource components are important to the survey respondents?


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1. The resources highlight the correct wording 'Are You of Aboriginal or Torres Strait Islander

Origin? (AIHW guidelines)

2. The resources (mouse-mat and A5 sticker) contain the Victorian Aboriginal Health Service

phone and website details

3. The resources contain a locally designed artwork

4. Aboriginal and Torres Strait Islander flags as symbols of importance

5. The mouse-mat highlights a number of things to consider: Don't guess, Ask Everyone, Be

sensitive etc.

6. The mouse-mat base is Eco friendly made from 100% recycled car tyre rubber

7. The A5 sticker addresses issues raised by workers such as whether the question is

discriminatory, the right to self-identify, asking all members of a family and not pre-

judging people based on appearance.

8. The A5 sticker provides possible staff responses if a consumer asks why you are asking

them whether they are Aboriginal or Torres Strait Islander

From the results, the four most popular items (being very important or important) in

order were; The correct wording ‘Are you of Aboriginal or Torres Strait Islander Origin?”,

Aboriginal and Torres Strait Islander flags, that the mouse mat is eco-friendly and that

the mouse-mat highlights things to consider in practice.

9.4 What did you like most about the “Have You Asked the

Question?” Resources?



“Don't guess, ask everyone” and the artwork

The design and it stands out.

It's direct and concise

The question "Are you of Aboriginal or Torres Strait Islander Orgin" is clear and

easily seen on all resources, the contact details of VAHS is available and there are

examples of how to answer possible responses

Increased awareness

Mouse-mat to prompt me asking the question.

They are colourful, distinctive and available on the day.

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(What did you like most about the ‘Have You Asked the Question?’ Resources? Continued)


They are simple and have very clear messages.

They have acted as a vehicle to open communication within my team. And

the artwork!!!

Reminders

Simple but effective

Easy to read and understand.

The keyboard sticker

Art work

Having the correct wording

I used to be in an Intake role previously, and I think that in that role these

resources would have been invaluable.

Great for prompts

That it gives responses if you're asked why you're asking the question.

Love the mouse pad the best.

Nice design, looks great

Mouse mat very practical and can be used daily without taking up

unnecessary space…

Just very useful to have such resources.

Easy to use in a practical way

The A5 sticker, as I will be putting it up on staff notice board.

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9.6 Ideas to Improve the Resources

What (if any) improvements could be made to the "Have You

Asked the Question?" resources? (Resources being mouse-mat/stickers)


From the 10 responses, 8 responses stated that no changes were required. There

were three responses that provided suggestions including; more

information/instructions on what to do once someone does self-identify, that there

were more resources available to distribute to kindergartens, schools and teams.

The final comment was that keep (the resources) up as they are fantastic!

9.7 Discussion of Resource Pack Survey results

From the survey results, the self-identification resources proved extremely successful

as a method to further promote the self-identification of Aboriginal and Torres Strait

Islander community members within mainstream agencies.

The Resources Toolkit that contained background on the development of the

resources, the use of local artwork and photographic examples of the resources and

how they can be practically used in the workplace was seen as very useful by

workers.

The most popular item from the Pack was the mouse-mat, keyboard sticker, A5

sticker and mobile/ phone sticker in that order. However, individual use of items was

often dependent on work spaces and work equipment. The flexible nature of the

resources was also noted with workers also placing stickers on a staff notice-board

and a filing cabinet. Whilst the Booklet provided suggested uses for the resources, it

was positive to note that workers were able to adapt the resources to their own

environment.

Comments (4 responses)

Instruction on what to do if someone does self identify.

More of them that we can distribute to teams, schools, kindergartens etc.

No changes neccessary keep them up they are fantastic!

No changes!

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Workers valued the clear use of the correct wording “Are you of Aboriginal or Torres

Strait Islander Origin? (AIHW guidelines). Other important components were the

presence of the Aboriginal and Torres Strait Islander flags, that the mouse-mat is

eco-friendly and that the mouse-mat highlighted things to consider in practice such

as “Don’t Guess, Ask Everyone. Be sensitive”. Overall, all components contained on

the resources were deemed to be of value including; the Victorian Aboriginal Health

Service (VAHS) contact details, the locally designed artwork and that the A5 sticker

provided some possible staff responses if consumers asked why they are being

asked whether they are of Aboriginal or Torres Strait Islander origin.

The artwork was highly praised in individual comments with many people finding the

design and artwork of the resources visually pleasing. People liked the colour and

how the artwork had been incorporated into the resource design. People also

enjoyed that the wording was simple, easy to read and had the correct wording

(AIHW Guidelines) within easy sight. It was noted in a number of comments that the

resources did not take up unnecessary space on a desk and could easily be placed

on the computer monitor/keyboard or work station and be used/seen on a daily basis.

A number of people also felt that having these resources was a continual prompt and

reminder of why and how to ask the question. One of the aims of the project was to

find a more permanent prompt to reinforce the need to ask the self-identification

question as part of standard work practice. Previous research had noted that some

workers did not ask the question, had stopped asking the question once challenged

or made assumptions about identity in their practice however based on survey

feedback the permanent reminder and use of clear wording in the resources has

ensured a consistent approach and continual reminder to employees workers to ask

all people accessing their services about their Aboriginal or Torres Strait identity

status.

The chosen wording, artwork and design were all seen as highly effective.

Suggested improvements to the resources were “to not make any changes” at all

Access to further resources (each trainee received one pack of resources) for other

workers or teams was the only suggestion provided. Feedback indicates that there a

is no need to modify the resources and their successful implementation is

demonstration of their relevance and usefulness in supporting self-identification of

Aboriginal and Torres Strait Islander community members within mainstream

workplaces.

The “Have You Asked the Question?” self-identification resource kit (mouse-

mat/stickers/booklet) proved to be an innovative way to provide clear, concise and

easily accessible resources that support self-identification practices within

mainstream workplaces. The resources themselves, despite being a locally

produced resource, are very applicable to all work place roles, across agencies and

sectors and have demonstrated that they can be implemented across geographical

regions.

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10. Any Additional Feedback

Please provide any additional feedback that you think would

enhance the training and resources or other ideas for improving

self-identification of Aboriginal and Torres Strait Islander

consumers within agencies.

There were 10 responses to this question. All comments are displayed. Comments

displayed reflect the general themes within the comments section.

Comments (10 responses)

Smaller group setting

Breaking up into groups and having some 'yarn' style presentation would be a

lived experience of how Aboriginal Torres Strait Islander people prefer working

Another training session in six months to check in with people and see if the

training/resources has made a difference

My program is currently attempting to engage Aboriginal young people across

Metropolitan Melbourne. Lack of self-identification is a huge barrier to

receiving our service among other reasons. I would like to discuss this further,

potentially with Nathan if it is within his capacity to do so. I will attempt to

contact him by email.

The resources are great but it is the change in attitude that is most important.

This is a very hard point to quality and quantify. The resourses aim could be to

ignite the discussion and action. Putting it into practice that leads to

acceptance, openess and change in behaviour. The resources are lovely but

just a step in the direction. I think being an agenda item at a meeting to

remind people on a regular basis. Doing a quizz with a message that

stimulates reflections. I think Nathan's passion invites and attracts people ...

We need the beautiful, well considered and greatly thought about resources as

one part. Maybe we need more leaders in organisations to promote and

include the question but also what the question is leading too.

I would have liked to have had more positive conversations and also role plays

or videos of how to approach sensitive issues and what are the sensitive issues.

More toolkits to pass on throughout our team

Thank you so much for this training experience, like I said earlier it is useful to

the entire community and health sector and needs expansion! Thanks Nathan!

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(Any Additional Feedback Continued)

There were a number of suggestions/comments that training attendees made at the

end of the survey. Suggestions included; small group work, a repeat training session

in six months to see if resources/training had made a difference, opportunity for role

plays or videos on how to approach sensitive issues in a practical sense and more

toolkits to be available for other team members. Comments included; that the

resources were great but it is attitude that is hard to change and they (the resources)

can be a starting point to open discussion and start action. The influence of leaders

in an organization was also noted and that this training experience would be

expanded to the entire health and community sector.

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11. Unintended Training and Resource Pack

Outcomes

There were a number of other outcomes from the development of the project that

were unintended.

Interest in the ‘Have You Asked the Question?’ Training exceeded all

expectations and the available places outnumbered those interested to attend.

The training which principally targeted NEPCP catchment agencies saw interest from

a large number of organisations representing various geographical regions of

Melbourne. A number of these agencies from the Western and Eastern regions were

allocated places at one of the training days. A number of people requested to attend

the “Have You Asked the Question?” training that came from rural and regional areas

however a place was not able to be made available due to high local demand. Due

to the high interest, NEPCP initially capped the training at 120 places but slightly

extended this to 132 workers for the two sessions. A number of agencies also

requested that large numbers of staff (up to 12 people) or a whole team attend the

training. However, in order to provide opportunity to the majority it was decided that

a number of agencies send just one worker to represent an agency who could then

share some of the learnings back to their team/agency. A number of agencies who

missed out on a place also offered to pay for a training place.

Training Resource Pack Distribution and Offers to Pay for Resources

All attendees at the training received a Resource Pack however a number of the

agencies made follow-up requests for further resources to be acquired for their

staff/team. A number of agencies also offered to pay for further resources to

distribute to other team/agency staff. However at the time it was decided that the

resource packs should be distributed when the individual had received some training

around identity or self-identification issues. Therefore this request was not taken up.

HealthWest a Primary Care Partnership, who also was offering training, requested

120 packs for distribution in the Western region and a due to the size of the order a

minimal re-order fee was charged.

Follow-up Requests for Further Information Related to Agency Self-

Identification Policies/Guidelines and Practices.

A number of agencies made contact with Sally Berger, the project worker, to discuss

a number of issues related to self-identification policies, procedures and

opportunities to make change at their agency. The project worker sent sample self-

identification policy documents to two agencies, provided feedback on a query that a

health service had around their self-identification procedure and forwarded relevant

self-identification posters as requested. A number of links to the AIHW Guidelines

and sample policy and procedures were forwarded on request.

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(Unintended Training and Resource Pack Outcomes Continued)

Follow-up Requests for Further Training Opportunities

A variety of agencies were wait-listed for the training, in case a place became

available at either of the sessions. A number of these organisations made follow-up

phone calls to ascertain if the training would be repeated in the future. For the

agencies that resided in the Western region, HealthWest training details were

forwarded to them. The disability services sector were also provided with a number

of spaces at the HealthWest training due to NEPCP’s participation on the Balit

Narrum Working Group and the opportunity to support work in this area. The

opportunity was advertised through Balit Narrum and a number of agencies took up

the offer and attended the HealthWest training. A number of agencies also made a

enquires as to whether they could pay to have the same session delivered to their

staff by the same trainer. Agencies were referred to the trainer or details of other

trainers were provided.

Follow-up Request for General Support

A number of agencies made general requests after the self-identification training

including an agency who had had difficulty engaging with young people and wanted

general advice about strategies they could implement to improve access to their

services. Another agency also wanted specific information about Aboriginal-specific

resources in her area of focus. One agency wanted to have further information about

employment, recruitment and retainment of Aboriginal workers. On all these

occasions, NEPCP was able to provide advice or refer the agency to available

resources/supports.

Agency Request to Adapt Resources for their Agency

The NEPCP Worker also had a number of requests by agencies to pay for the

replication of the resources and potentially add their own logos or artwork to the

resources. These requests were not within the scope of the project.

Opportunity for Partnership Work with Other PCPs

A number of agencies from the Western suburbs wanted to attend the NEPCP’s Have You Asked the Question? Training however places had been filled. With consent their details were provided to HealthWest as they had also planned to run Cultural Awareness training sessions. NEPCP was able to support the training by sharing the ‘Have You Asked the Question?’ Resource Kit with HealthWest including permission to use the flyer detail. HealthWest ordered 120 Resource Kits which were distributed to the agencies who attended the cultural awareness training that HealthWest was facilitating in the Western region. Agencies who received a “Have You Asked the Question? Resource Pack included; Councils, Community Health, Not for Profit Organisations, Acute Health and General Practice. (See Appendix 4 for a List of agencies attending HealthWest Cultural Awareness training)

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(Unintended Training and Resource Pack Outcomes Continued)

Email and Photographic Feedback

Many agencies provided positive feedback via emails directly to the Project Worker.

A number of people wanted to thank Nathan for the training and to report the

success of the “Have You Asked the Question? Resources in practice. These emails

expressed positive responses around the artwork, the design and colours, the

practicality of the resources and inparticular, the easy to read exact wording based

on AIHW guidelines. One person proudly sent a photo of how they had used the

resources in their workplace. From this initial image, the project worker made a

request of other employees who had received the resources to send the project

worker photographic evidence on how they were being used in the workplace.

Numerous photographs were received with employees being quite innovative in how

the resources could be adapted for different purposes. (See Appendix 8 for some of

the photographic images received by the project worker).

Continued Resource Pack Distribution

The Resource Pack (mouse-mat and stickers) continues to be distributed widely. On

8th May 2015, Jo Atkinson (VAHS) and Sally Berger, the project worker, made a

presentation to the Victorian Maternal and Child Health Coordinator’s Meeting

including the ‘Have You Asked the Question?’ project. After this meeting, there were

requests by MCH Coordinator’s from eight Local Government Areas (LGAs) to have

enough resources to provide one resource pack for each MCH centre in their LGA.

Over 150 “Have You Asked the Question?” Packs were distributed across the State,

including two regional and rural LGAs. A further four LGAs are committed to

implementing the resources in all their Maternal and Child Health centres. A recent

request from Queensland after a referral from a NACCHO worker has also resulted

in a number of GP clinics in Queensland making use of the “Have You Asked the

Question?” mouse-mat and stickers. Through this interstate contact, NEPCP was

also able to link this Queensland agency back in with a NEPCP Queensland Health

contact that could also provide other locally relevant resources on self-identification.

Up to the writing of this report, requests for “Have You Asked the Question?”

Resource Kits continue to be made demonstrating the popularity and easy

applicability of these resources to local, regional, rural and interstate agencies.

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12. Conclusion

From past research undertaken by North East Primary Care Partnership (NEPCP), training alone does not ensure that there is sustained behaviour change when it comes to asking consumers about their Aboriginal or Torres Strait Islander status. Alongside training, an innovative but clear method for keeping the Indigenous identity question in clear view was required. Feedback from NEPCP agencies enabled the development of the “‘Have You Asked the Question?” Resource Kit. The Kit consists of a mouse-mat, computer/keyboard monitor, phone/iPad sticker, A5 sticker and booklet. Based on the evaluation, both the ‘Have You Asked the Question?’ training and the ‘Have You Asked the Question?’ Resource Kit were successful. Comprehensive training is important in providing a context for ‘asking the question’ and reinforcing why the question needs to be asked. . Allowing workers to gain a broad insight into how colonisation has impacted on Aboriginal social determinants of health leads to a greater awareness on the value of ‘asking the question’. The evaluation showed that when training is demonstrates that Aboriginality is not about skin colour but actually about relationships and cultural connections to community and history, there is a marked increase in understanding of why each person needs to be asked ‘the question’ Resources that are easy to use and easy to implement within workplaces are successful. The “Have You Asked the Question?” self-identification resource kit (mouse-mat/stickers/ booklet) has proved to be an innovative way to provide clear, concise and easily accessible resources that support Aboriginal and Torres Strait Islander self-identification practices within universal services. Consistent wording, based on the AIHW guidelines, located in full view provides a prompt and removes any uncertainty around wording. The presence of local Aboriginal artwork also reinforces the value of Aboriginal culture and having the Victorian Aboriginal Health Service details in plain view also encourages service options for Aboriginal community members. The resources are adapatable to a variety of environments due to the accessible and clear messages they contain. From the evaluation, the ‘Have You Asked the Question?’ Resource Kit is suitable to implement across a wide range of roles, agencies and geographical regions. In conclusion, self-identification of Aboriginal and Torres Strait Islander community members can be improved through multiple strategies such as targeted training and implementing the ‘Have You Asked the Question?’ resources. Delivered training demonstrated a marked increase in knowledge bases that support an improved understanding of identity and self-identification issues. Training, on its own however, does not assure that all community members are asked every time about their Aboriginal and Torres Strait Islander status. Identity and self-identification are complex issues. Multiple strategies need to be employed to improve self-identification outcomes and the resource kit has been effective as a continual reminder and in promoting employee confidence to ‘ask the question’. The “Have You Asked the Question?” self-identification resource kit (mouse-mat/stickers/ booklet) has proved to be an innovative way to provide clear, concise and easily accessible resources that support Aboriginal and Torres Strait Islander self-identification practices within universal services.

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13. Recommendations

Training Training evaluation recommendations include:

Self-identification training should be regarded as one component of a multi-level strategy that can improve self-identification of Aboriginal and Torres Strait Islander community members within mainstream agencies.

Training should not be one-off. Service providers require on-going Aboriginal and Torres Strait Islander cultural awareness training that incorporates identity and self-identification issues within a broad social determinants framework.

Opportunities for small group work or practical case-studies or scenarios on ‘asking the question’ could be incorporated to further enhance training.

“Have You Asked the Question?” Resource Pack Resource Kit evaluation recommendations include:

No changes are required to components/design of the ‘Have You Asked the Question?” Resource Pack

The ‘Have You Asked the Question’ resources form part of a multi-level strategy for improving the self-identification of of Aboriginal and Torres Strait Islander community members within mainstream agencies.

The distribution of the ‘Have You Asked the Question’ resources should preferably accompany some form of cultural awareness training so that there is understanding and reinforcement about self-identification and identity issues.

The ‘Have You Asked the Question’ resources should be promoted as an effective method to further prompt the self-identification of Aboriginal and Torres Strait Islander community members within mainstream agencies.

The implementation of the ‘Have You Asked the Question’ resources should be encouraged across all worker roles, agencies and sectors and across the North West and Metropolitan region.

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14. Appendices

Appendix 1: Have You Asked the Question? “Are You of Aboriginal or Torres Strait Islander Origin?” Resource Pack The Resource Pack consists of an A5 Booklet, one mouse-mat, one monitor/keyboard sticker, one phone sticker and A5 Sticker.

1. Have You Asked the Question? “Are you of Aboriginal or Torres Strait islander Origin? A5 Booklet. 8 page booklet.

Sample Page 1 Booklet Sample Page 2 Booklet Sample Page 3 Booklet Sample Page 4 Booklet

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(A5 Booklet Continued)

Sample Page 5 Booklet Sample Page 6 Booklet Sample Page 7 Booklet Sample Page 8 Booklet

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2. Have You Asked the Question? “Are you of Aboriginal or Torres Strait islander Origin? Mouse- mat. The mouse-mat was designed to consider and address a number of issues. The mouse-mat includes: Are You of Aboriginal or Torres Strait Islander Origin?’ wording in accessibly placed print as a

reminder to staff to use consistent wording as per AIHW guidelines every time

Locally designed artwork element. Feedback from agency staff and consumers showed the importance of incorporating locally designed artwork.

The Aboriginal and Torres Strait Islander flags. The use of the flags on the resources aims to promote the importance of these symbols.

Victorian Aboriginal Health Service(VAHS) logo and contact details. Easy access to VAHS phone and website details for staff use but also to provide contact details to Aboriginal and Torres Strait Islander community members as a service option.

The listing of practice reminders for staff such as Be sensitive, Use exact wording, Don’t guess, ask everyone etc... reflecting some of the issues raised in the Workforce Survey.

Mouse-mat base

is made from

100% recycled

tyres.

Sample Mouse-mat

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3. Have You Asked the Question? “Are you of Aboriginal or Torres Strait Islander Origin? Monitor/Keyboard Sticker This sticker was designed to consider and address a number of issues, including; Are You of Aboriginal or Torres Strait Islander Origin?’ wording in accessibly placed print as a




Sample Monitor/ keyboard Sticker

COMPUTER MONITOR/ KEYBOARD STICKER This sticker has been designed to be located on the outside of a computer monitor in a horizontal fashion. The sticker can also be placed on the top of a desk-top keyboard or the keyboard of a laptop above the keys. These stickers are made from a durable material that should resist general wear and tear.

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4. Have You Asked the Question? “Are you of Aboriginal or Torres Strait islander Origin? Phone Sticker This sticker was designed to consider and address a number of issues, including; Are You of Aboriginal or Torres Strait Islander Origin?’ wording in accessibly placed print as a




PHONE HANDSET OR MOBILE PHONE STICKER This sticker has been designed to be placed on the hand-set for a desk-top based phone.

The sticker can be placed on the back of a mobile phone handset.

The sticker can also be used on the cover of an iPad or other mobile tablet device or a laptop as a reminder when undertaking home-visiting or external assessments where a worker may need to input data on a mobile device/lap-top.

On phone handset

Inside Laptop

On front of iPad

On mobile phone

On mobile phone

On front of Laptop

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5. Have You Asked the Question? “Are you of Aboriginal or Torres Strait Islander Origin? A5 Sticker The sticker was designed to consider and address a number of issues. The mouse-mat includes: Are You of Aboriginal or Torres Strait Islander Origin?’ wording in accessibly placed print as a




Victorian Aboriginal Health Service(VAHS) logo and contact details. Easy access to VAHS phone and website details for staff use but also to provide contact details to Aboriginal and Torres Strait Islander community members as a service option. Answers to Why you need to ask and possible staff responses were included based on the workforce development survey.

A5 STICKER The A5 sticker can be placed on a wall, notice board, desk, filing cabinet or other area that is within easy sight when workers are making contact with community members. If equipment/furniture is being leased or there are concerns about sticker removal in the future, Blue-Tack can be placed on the back of the sticker to attach it to your desk, board etc. This will ensure you have no difficulty removing it in the future. The sticker can be peeled and placed on a thick piece of cardboard and pinned to a noticeboard or other place where it is in view when you ‘Ask the Question’. The A5 sticker contains local art work, VAHS contact details, tips on how and why we need to ‘Ask the Question” as well as providing you some simple responses if either a community member or non-Aboriginal person asks you why are ‘Asking the Question’. These stickers are made from durable material that should resist general wear and tear.

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Appendix 2: Project Resources

2.1 Sample Training Flyer

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2.2 Sample Certificate of Attendance

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Appendix 3: List of Agencies who received “Have You Asked the Question?” Resource Packs at NEPCP’s Have You Asked the question? Training held in August 2014. *Note: Multiple employees from these agencies may have attended sessions.

1. Annecto

2. Austin Health

3. Australian College of Optometry

4. Banksia Palliative Care

5. Banyule City Council

6. Banyule Community Health

7. Basketball Victoria

8. Bubup Wilam Children's Centre

9. Bridgehaven

10. City of Yarra

11. City of Moreland

12. Children’s Protection Society (CPS)

13. Darebin City Council

14. Darebin Community Health

15. North and West Metropolitan Region Department of Education and Training

16. Interact Australia

17. Gambler’s Help Northern

18. ISIS Primary care

19. Life Without Barriers

20. McKillop Family Services

21. Melbourne City Mission

22. Merri Community Health

23. Nillumbik Community Health

24. NEAMI

25. Northern Psychology Clinic

26. Northern Support Services

27. Playgroup Victoria Inc

28. Mercy Health

29. Northern Aged Care Assessment Service

30. Relationships Australia

31. Salvation Army

32. Shire of Nillumbik

33. Southern Cross Care

34. Tweddle Child and Family Health Service

35. Victorian Aboriginal Child Care Agency Eastern

36. Waratah Special Development School

37. Whitelion

38. Yarra City Council

39. Youth Support and Advocacy Service (YSAS)

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Appendix 4: List of Agencies who received “Have You

Asked the Question? Resource Packs at HealthWest

Cultural Awareness Training held at Melton, Werribee and

Wyndham sites in December 2014 –February 2015

*Note: Multiple employees from these agencies may have attended sessions.

1. Active Medical 2. Baptcare, 3. BreastScreen Victoria 4. Brimbank Council 5. Care Connect 6. Carers Victoria 7. Department of Health and Human Services North and West 8. Department of Health and Human Services DHS Grampians 9. Diabetes Victoria 10. Dianella Community Health 11. Djerriwarrh Health Service 12. Evans St Clinic (Sunbury) 13. Gap Rd Medical Centre (Sunbury) 14. Hobsons Bay Council 15. ISIS Primary Care, 16. Lifeworks 17. Melbourne City Mission 18. Melton City Council 19. Royal District Nursing Servive (RDNS ) 20. Sunbury Community Health 21. Scott St Clinic (Melton), 22. Sunshine City Medical, 23. The Clinic (Sunshine) 24. Wyndham City Council 25. Watervale Medical Centre 26. Westcare Clinic (Melton) 27. Western Health

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Appendix 5: List of Agencies who attended the “Through

Aboriginal Eyes” - Orientation to Early Years Services.

Each passenger received a “Have You Asked the Question? Resource Pack in their

“Through Aboriginal Eyes” Calico Bag.

*Note: Multiple employees from these agencies may have attended.

1. Annie Dennis Children’s Centre

2. Banyule City Council*

3. Darebin Child Care and Kindergaten

4. Darebin City Council*

5. Darebin Community Health

6. Early Childhood Intervention Services (ECIS)

7. Goodstart Early Learning Centre Bundoora

8. Gower Street Kindergarten

9. Hellier Street Children’s Centre

10. Kalparrin Early Intervention Centre

11. Noah’s Ark

12. Services Connect –North East

13. Shire of Nillumbik*

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Appendix 6: List of Maternal and Child Health Services that

have received or requested the ‘Have You Asked the

Question?’ Resource Packs

1. Victorian Maternal and Child Health(MCH) Coordinators -8th May 2015

Meeting at Municipal Association of Victoria (50 packs)

2. City of Ballarat MCH staff

3. City of Kingston MCH

4. City of Maribyrnong MCH

5. Knox City Council MCH.

6. Glen Eira City Council MCH

7. Moira Shire Counci MCH

8. Wyndhum City Council MCH

9. City of Melbourne MCH

10. City of Moreland MCH*

11. City of Darebin MCH*

12. Banyule City Council MCH*

13. Nillumbik Shire Council MCH*

*MCH Agencies of the Strong Culture, Strong Future Working Group have agreed to implement the

‘Have You Asked the Question?” Resource Kit across their LGAS

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Appendix 7: List of Other Agencies that received resources

or further resources “Have You Asked the Question?

Resource Packs at

1. Peninsula Health

2. BreastScreen Victoria (25 Packs)

3. Albanycare 7 Day Medical Centre –Queensland (4 packs)

4. PANDA National Perinatal Depression Helpline (15 packs)

5. Mercy Hospital for Women (Heidelberg & Werribee Maternity sites) (30 packs)

6. Banyule Community Health Dietetics Team (4 packs)

7. NEPCP Governance Group October 2014 meeting attendees.

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Appendix 8: Samples of Photographic Evidence of use of

Have You Asked the Question Resources by universal

service providers*

*Images displayed with permission are a selection only of received photographs

City of Ballarat

Maternal and Child Health Centres

City of Hume.

Breastcreen Victoria

123 Clinic, Broadmeadows.

Shire of Nillumbik

Aged and Disability Team

City of Banyule.

Banyule Community Health

West Heidelberg site

Front reception desks.

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(Appendix 8: Photographic Evidence Continued)

City of Banyule

HACC Assessment Team-

Phone sticker on outreach

folder.

City of Moreland

Merri Community Health.

Vic Place site.

City of Maribyrnong

ANNECTO, Footscray

City of Kingston

Maternal and Child

Health Centre

City of Yarra

PANDA National Perinatal

Depression Helpline

City of Darebin

Children, Families and

Community Team

x

“HAVE YOU ASKED THE QUESTION?”

PROJECT EVALUATION REPORT

“The session I attended gave me confidence in ’asking the question’ which I had

hitherto felt uncomfortable with. Having the mouse-mat was a great aid in giving me

confidence to go ahead. I always glance at the bottom right where it says ‘Don’t

Guess, Ask Everyone, Use Exact Wording” and now I do that, without hesitation”

Local Council Worker

“It should be a simple issue in a way- but I do feel more comfortable about this now.

The descriptions of family units and cultural issues was interesting and useful

information and I hadn’t really had them explained to me before”

Early Childhood Worker

HAVE YOU ASKED THE QUESTION? “ARE YOU OF ABORIGINIAL OR TORRES STRAIT ISLANDER ORIGIN? PROJECT EVALUATION REPORT

NORTH EAST PRIMARY CARE PARTNERSHIP AND VICTORIAN ABORIGINAL HEALTH SERVICE, 2015.

PLEASE HELP US TO IMPROVE THE HEALTH OF ABORIGINAL AND TORRES STRAIT ISLANDER VICTORIANS

“HAVE YOU ASKED THE QUESTION?” PROJECT EVALUATION … · 2 T “HAVE YOU ASKED THE QUESTION?” PROJECT EVALUATION REPORT Acknowledgement of Traditional Owners of the Land, Past

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