The need for a more flexible, culturally appropriate and accessible cardiac rehabilitation and prevention service – one that supports Aboriginal and Torres Strait Islander people in rural communities – is more crucial than ever as cardiovascular disease continues to be the leading cause of premature ill health and death among First Nations people.
Tamworth Aboriginal Medical Service Aboriginal Corporation (TAMS-AC), based in the New England Northwest region of New South Wales, in partnership with a local gym and Hunter New England Local Health District (HNELHD), have been running a hugely successful cardiac rehabilitation and prevention group for over 12 months. The group, formed during the COVID‑19 pandemic and supported by grant funding from the Hunter New England Central Coast Primary Health Network (HNECC PHN), provides a culturally safe and welcoming alternative for First Nations people who have, or are at risk of having, a heart condition.
Despite being potentially preventable through lifestyle changes that improve mobility and decrease risk factors related to heart injury, First Nations people are 1.3 times more likely to have cardiovascular disease compared with other Australians. Aboriginal people are also three times more likely to have a major coronary event such as a heart attack and more than twice as likely to die in hospital from coronary heart disease.
Cardiac rehabilitation is a medically supervised program that helps people recover from heart injury or diagnosis. Historically, participation rates in cardiac rehabilitation by First Nations people in the Gomeroi area have been extremely poor. More broadly, less than five per cent of eligible First Nations patients are attending traditional cardiac rehabilitation programs in a tertiary setting in Australia.
Listening to community feedback, a 12-week recurring program was developed that embraces First Nations culture. The culturally secure hub – facilitated by a multidisciplinary team including personal trainers, nurses and Aboriginal health practitioners – enables the mob to exercise in a safe space.
The TAMS-AC team explains, ‘We know regular exercise improves strength and energy levels and can help improve your mood and emotional health. Teamed with our education and yarning on a wide range of health issues, [the program] can significantly reduce the chance of future heart health problems for our mob.’
One of the regular participants (who is the sole carer for his elderly mother who suffers dementia and his disabled brother) stated, ‘The gym sessions are my only opportunity to socialise with other people during the week …. I can de-stress and talk with the other guys about how I’m feeling.’
The group environment has provided an opportunity for TAMS-AC to partner with a wide range of services including podiatrists, dietitians, diabetes educators and mental health workers to provide a ‘one-stop shop’ for participants in a fun, yet meaningful, way. It’s also an opportunity for participants to meet and yarn with others who have undergone a heart event or diagnosis, in a non-judgemental and welcoming environment.
Adam Brook (REVFIT gym proprietor) says, ‘This program is a great example of what our gym is about. We love being able to provide this program to the TAMS-AC clients each week. Seeing the clients’ progressive improvement in health, fitness and confidence is exactly why we do what we do.’
Key features of the program are:
- The group is free and runs one or two days per week, with separate sessions for woman and men.
- The group is run in a well-equipped local gym in a convenient location in town, without the ‘glitz and glamour’ of modern gyms.
- Transport to and from the group is available, to maximise attendance and convenience.
- The program is delivered in an informal setting, where fun, humour, cultural needs and socialising are encouraged, to support realistic goals.
- Clients are encouraged to see a general practitioner or cardiologist prior to commencement and are assessed prior to every session by a clinician.
- The program follows traditional cardiac rehabilitation baseline clinical assessments at commencement, such as a six-minute walk test and physical observations.
The program has seen some fantastic results, with 12 to 15 people regularly attending each week.
This evolving program is unique to the Tamworth local government area and is rapidly gaining momentum, with high participation rates and improved clinical outcomes. Many referrals to the program have come through word of mouth.
Recently TAMS-AC were winners in the HNECC PHN Quality Innovation Awards in the First Nations Award category. We now have plans to expand the program into additional rural communities.