Abstract：
BACKGROUND: The importance of primary health care (PHC) to Aboriginal Australians is widely acknowledged, as is the underservicing of the Aboriginal Australian population. Aboriginal People continue to face significant obstacles when accessing and using health care services.
OBJECTIVE: This study identifies environmental factors (beyond personal and service delivery) that functioned as barriers and enablers to Aboriginal Australians\' experiences accessing PHC during crises and recommends approaches during future events.
METHODS: This research utilised a case study approach. Data were collected through in-depth interviews and analysed using thematic analysis. The study was set in Lakes Entrance, a regional Victorian locality with a sizable Aboriginal community, which was affected by bushfires during 2019/2020 and COVID-19 restrictions during 2020-2021. Participants were 18 Aboriginal People over the age of 18 living in the locality during either bushfires or COVID-19.
RESULTS: The barriers identified included the impact on PHC access of priorities other than health, including housing; financial constraints; difficulties with transport; medical bureaucracy and the physical environment of the health care setting, including appointment-making processes; interactions with medical reception staff; and waiting room environments. Enablers identified included the supportive role of the local Aboriginal Community Controlled Health Organisations (ACCHO) and their staff, which was highlighted in participant responses.
CONCLUSIONS: The preference of many Aboriginal people to access PHC via their local ACCHO, rather than mainstream health care services, appears even more salient during crises than in normal times. This research identified that ACCHOs are ideally placed to promote and protect the health of Aboriginal communities during crises.
CONCLUSIONS: Results may help direct interventions to improve PHC access and experiences for regional Aboriginal communities both during and outside periods of crisis.
OBJECTIVE: This study identifies environmental factors (beyond personal and service delivery) that functioned as barriers and enablers to Aboriginal Australians\' experiences accessing PHC during crises and recommends approaches during future events.
METHODS: This research utilised a case study approach. Data were collected through in-depth interviews and analysed using thematic analysis. The study was set in Lakes Entrance, a regional Victorian locality with a sizable Aboriginal community, which was affected by bushfires during 2019/2020 and COVID-19 restrictions during 2020-2021. Participants were 18 Aboriginal People over the age of 18 living in the locality during either bushfires or COVID-19.
RESULTS: The barriers identified included the impact on PHC access of priorities other than health, including housing; financial constraints; difficulties with transport; medical bureaucracy and the physical environment of the health care setting, including appointment-making processes; interactions with medical reception staff; and waiting room environments. Enablers identified included the supportive role of the local Aboriginal Community Controlled Health Organisations (ACCHO) and their staff, which was highlighted in participant responses.
CONCLUSIONS: The preference of many Aboriginal people to access PHC via their local ACCHO, rather than mainstream health care services, appears even more salient during crises than in normal times. This research identified that ACCHOs are ideally placed to promote and protect the health of Aboriginal communities during crises.
CONCLUSIONS: Results may help direct interventions to improve PHC access and experiences for regional Aboriginal communities both during and outside periods of crisis.
摘要：
背景：初级卫生保健（PHC）对澳大利亚原住民的重要性得到了广泛认可，澳大利亚原住民的服务不足。原住民在获得和使用医疗保健服务时继续面临重大障碍。
目的：这项研究确定了环境因素（除了个人和服务提供之外），这些因素是澳大利亚原住民在危机期间获得PHC的障碍和推动者，并在未来事件中建议了方法。
方法：本研究采用案例研究方法。通过深入访谈收集数据，并使用专题分析进行分析。这项研究是在湖泊入口进行的，一个维多利亚时代的地方，有相当大的原住民社区，在2019/2020年期间受到丛林大火和2020-2021年COVID-19限制的影响。参与者是在丛林大火或COVID-19期间居住在当地的18岁以上的原住民。
结果：确定的障碍包括除健康以外的优先事项对PHC访问的影响，包括住房；财政限制；交通困难；医疗官僚机构和医疗保健环境的自然环境，包括预约流程；与医疗接待人员的互动；和候诊室环境。确定的推动者包括当地土著社区控制的健康组织（ACCHO）及其工作人员的支持作用，这在参与者的回答中得到了强调。
结论：许多原住民倾向于通过当地ACCHO访问PHC，而不是主流医疗保健服务，在危机期间似乎比正常时期更加突出。这项研究确定，ACCHO处于理想的位置，可以在危机期间促进和保护土著社区的健康。
结论：结果可能有助于直接干预措施，以改善危机期间和危机以外地区土著社区的PHC获取和经验。
目的：这项研究确定了环境因素（除了个人和服务提供之外），这些因素是澳大利亚原住民在危机期间获得PHC的障碍和推动者，并在未来事件中建议了方法。
方法：本研究采用案例研究方法。通过深入访谈收集数据，并使用专题分析进行分析。这项研究是在湖泊入口进行的，一个维多利亚时代的地方，有相当大的原住民社区，在2019/2020年期间受到丛林大火和2020-2021年COVID-19限制的影响。参与者是在丛林大火或COVID-19期间居住在当地的18岁以上的原住民。
结果：确定的障碍包括除健康以外的优先事项对PHC访问的影响，包括住房；财政限制；交通困难；医疗官僚机构和医疗保健环境的自然环境，包括预约流程；与医疗接待人员的互动；和候诊室环境。确定的推动者包括当地土著社区控制的健康组织（ACCHO）及其工作人员的支持作用，这在参与者的回答中得到了强调。
结论：许多原住民倾向于通过当地ACCHO访问PHC，而不是主流医疗保健服务，在危机期间似乎比正常时期更加突出。这项研究确定，ACCHO处于理想的位置，可以在危机期间促进和保护土著社区的健康。
结论：结果可能有助于直接干预措施，以改善危机期间和危机以外地区土著社区的PHC获取和经验。
