The Role of Aboriginal Kidney Health Mentors in the Transplant Journey: A Qualitative Evaluation

Abstract

Issue Addressed

Whilst Aboriginal and Torres Strait Islander people in Australia experience disproportionately high rates of chronic kidney disease, they have lower rates of kidney transplantation and face many barriers to accessing culturally safe health care. Aboriginal kidney health mentors with lived experience of transplantation have been proposed to improve the patient journey and increase health promotion, but there has been limited evaluation of the role of mentors.

Methods

A qualitative evaluation of the ‘Hunting Kidney Transplant’ patient mentoring project implemented by Purple House in the Northern Territory involved in-depth interviews, focus groups and participant observation with Aboriginal kidney health mentors and renal staff. Data analysis methods included inductive thematic coding and collaborative synthesis of emerging themes with Aboriginal co-researchers.

Results

Aboriginal kidney health mentors play a holistic and multi-directional role helping people to navigate the transplant process. The role of mentors encompasses both visible and invisible work and is centred on a ‘Right Way Working’ approach, including building trust, respect and taking time during the work-up period. Key enablers include kinship and community connections and ongoing support from Purple House. Key barriers include COVID-19 and institutional racism within the mainstream health service.

Conclusions

Aboriginal health mentors with lived experience of chronic conditions can play an important role in supporting people and promoting cultural safety in health services.

So What?

Further support and funding are needed to develop, evaluate and embed the mentor role into policy and practice to improve patient journeys, health promotion, transplant rates and health outcomes.