Above and Beyond: Fashioning an Accessible Health Service for Aboriginal Youth in Remote Western Australia.

Background: Young Aboriginal people are at an important stage in the development of their health and wellbeing. They experience significant morbidity and mortality, and their access to medical services may be limited by geographic remoteness and difficulty obtaining appropriate care. Aboriginal Community Controlled Health Services offer primary health care considered to be more accessible for Aboriginal people.

Objective: This study is one component of research aiming to enhance access for young Aboriginal people in a remote area of Western Australia. It aims to add to our previous study focusing on perceptions of local young people, through exploring the understandings of health care staff regarding access for young Aboriginal people.

Methods: This qualitative study involved semistructured individual and group interviews with 24 staff who work with young Aboriginal people at a remote Aboriginal Community Controlled Health Service. Transcripts were descriptively coded and thematically analyzed by the research team.

Results: Staff identified a number of challenges in working with 16- to 25-year-old Aboriginal people, which revolved around the interface between the service, its staff and the young people. They also suggested strategies designed to engage these young people. The strategies included relationship-building, communication, trust and confidentiality with individuals; and targeted clinics, partnerships, health promotion, and an open door policy by clinics. The strategies used by staff were flexible and expansive in nature.

Conclusions: Engagement can be enhanced by a health service willing to "go the extra mile," with a strategic, enveloping and innovative approach, resourcing and the right people with the right attitude.