Exposure to the Family Wellbeing program and associations with empowerment, health, family and cultural wellbeing outcomes for Aboriginal and Torres Strait Islander peoples: A cross-sectional analysis

Abstract Background: Empowerment is a concept commonly incorporated into Aboriginal and Torres Strait Islander health and wellbeing programs. The Family Wellbeing Program is an empowerment program developed in partnership with Aboriginal and Torres Strait Islander peoples that has been widely delivered to Aboriginal and Torres Strait Islander communities across Australia for close to 30 years. To date, there has been limited quantitative analysis of how this program may be linked to health and empowerment outcomes. Methods: Cross sectional analysis of Mayi Kuwayu, the National Study of Aboriginal and Torres Strait Islander Wellbeing, baseline data (n= 9,843). Binary regression models were performed to calculate Prevalence Ratios (PRs) and 95% Confidence Intervals (CIs) to examine the association between personal control, life satisfaction, general health, family functioning and cultural wellbeing outcomes for Family Wellbeing participants (n=718) compared to non-participants (n=9,125) Results: Compared to non-FWB participants, FWB participants are more likely to be female (67.1% versus 58.4%), be aged 35-54 (41.8% versus 32%) and live in a remote area (17.7% versus 10.4%). FWB participants were more likely to have experienced both prison and youth detention Non-FWB (3.5% versus 1.4% of Non-FWB) and reported being removed from their families as children (Stolen) (7.0% versus 4.1% Non-FWB). Significant associations were observed between FWB participation and a 13% increase in higher family functioning, a 74% increase in higher cultural wellbeing and a 21% in higher levels of local decision making in the local community compared to non-FWB participation. There was also significantly higher reporting of precursory health outcomes amongst the FWB participants such as quitting alcohol (26.4% versus 20.4%), regular exercise (67.7% versus 66.3%), quitting smoking (33.4% versus 31.9%) and educational attainment at the Year 12 level or above (57.8% FWB versus 53.2% in the Non-FWB). Conclusion: There are significant associations between Family Wellbeing program and higher organisation and community level empowerment outcomes and some precursory health risk factors. Including physical exercise, alcohol use and smoking; and educational attainment among FWB participants compared to non-FWB participants. The results may suggest that community level relational and cultural indicators are highly relevant to an Aboriginal and Torres Strait Islander community empowerment model, while the process of when and how individual or psychological empowerment outcomes occur in such a model needs to be explored further.