Strong Heart: It’s Time to Think Differently About Risk and Protective Factors for Aboriginal Women

Cardiovascular prevention often takes an individual behavioural risk approach, centred within a deficit model of illness and individual responsibility. The aim was to qualitatively explore from an Aboriginal worldview what keeps a woman’s heart strong and puts it at risk to inform health promotion and disease prevention. An adapted grounded theory approach, embracing partnerships with Aboriginal communities, was developed. Yarning circles with 28 women across five women’s groups in South and Central Australia explored six risk and protective constructs identified by a panel of senior Aboriginal women. Analysis and interpretation were undertaken by the same Panel. When family and community are strong and women can identify with their culture, the heart is spiritually and physically strong; in contrast stress and grief make the heart sick. Women want knowledge to have control over their health: requiring ongoing relationships with providers, understanding of protective and risk factors, and information on their personal risk profile. Having services close to home, affordable, and in a safe environment are important. Support groups enable women to seek health knowledge, gain skills and cope with stress. The heart is vital for a woman’s spiritual and physical wellbeing. Maintaining cardiovascular health enables women to be leaders and nurturers of family and community. Aboriginal women identified resources needed to keep their hearts healthy, our challenge is to embed this into models of care. These qualitative findings provide a framework to explore quantitative outcomes of exposure to risk and protective factors in a Central Australian cohort of Aboriginal women.