Community-based model of care to improve access to and utilization of health services for common non-communicable diseases among culturally and linguistically diverse populations in Australia: an implementation research protocol

Abstract

BACKGROUND: Australia's increasingly diverse population includes a nearly one third from Culturally and Linguistically Diverse (CALD) backgrounds, who often face significant challenges in accessing and utilizing healthcare services, particularly for non-communicable diseases (NCDs). These challenges stem from various factors including understanding and communication barriers in English, cultural differences, limited health literacy and healthcare system related limitations. This project aims to co-develop and test a culturally responsive community-based, multi-packaged model of care to enhance access to and utilization of health services for common NCDs (screening of hypertension and diabetes mellitus, and initiation of treatment for those diagnosed) among CALD communities in Australia. METHODS: This project will follow a four-phased approach, based on the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework. Other complementary frameworks including the consolidated framework for implementation research will also be utilized depending on contextual requirements. In Phase I, formative research will be conducted through a scoping review, quantitative survey, and qualitative interviews with service users and healthcare providers to identify successful care models, service preferences, and key facilitators and/or barriers to service access and utilization. Phase II of the project will focus on co-developing a culturally responsive care model informed by the findings of the first phase, which will then be reviewed and standardized with input from stakeholders, including healthcare providers and CALD community members. The Phase III activities will involve capacity building and collecting baseline data and implementing the care model. Finally, in Phase IV, implementation outcomes will be assessed by collecting follow‑up data using the same tools from Phase III, but not necessarily from the same individuals. The quantitative follow up window for outcome assessment is 6 to 12 months after site activation, with any longer activity focused on qualitative work, sustainment assessments, and dissemination. CONCLUSIONS: Overall, this project may play a pivotal role in enhancing the accessibility, quality, and cultural responsiveness of healthcare for CALD communities and reducing health disparities. We believe the lessons learned and the model developed through this process will be useful not only in Australia but also in other countries with similar multicultural communities.