Empowerment and Indigenous Australian health: a synthesis of findings from Family Wellbeing formative research.

This paper employs a thematic qualitative analysis to synthesise seven discrete formative evaluation reports of an Indigenous Australian family empowerment programme across four study settings in Australia's Northern Territory and Queensland between 1998 and 2005. The aim of the study, which involved a total of 148 adult and 70 school children participants, is to develop a deeper understanding of the contribution of community empowerment education programmes to improving Indigenous health, beyond the evidence derived from the original discrete micro evaluative studies. Within a context beset by trans-generational grief and despair resulting from colonisation and other discriminatory government policies, across the study sites, the participants demonstrated enhanced capacity to exert greater control over factors shaping their health and wellbeing. Evident in the participants' narratives was a heightened sense of Indigenous and spiritual identity, respect for self and others, enhanced parenting and capacity to deal with substance abuse and violence. Changes at the personal level influenced other individuals and systems over time, highlighting the ecological or multilevel dimensions of empowerment. The study reveals the role of psychosocial empowerment attributes as important foundational resources in helping people engage and benefit from health and other behaviour modification programmes, and take advantage of any reforms made within macro policy environments. A key limitation or challenge in the use of psychosocial empowerment programmes relates to the time and resources required to achieve change at population level. A long-term partnership approach to empowerment research that creatively integrates micro community empowerment initiatives with macro policies and programmes is vital if health gains are to be maximised.