Background: The Thai population in Australia is relatively low, yet it has been increasing over the past decade. Knowledge about the health of this population is limited, with the results of existing health research conducted in 1990s possibly not being representative of the current Thai population. Nevertheless, it is evident that culturally and linguistically diverse (CALD) migrants, especially non-English speakers, are vulnerable to poor health because of a language barrier and their cultural beliefs. This may be the case for the Thai population in Australia.
The main purpose of health promotion is to improve the health of disadvantaged people, including non-English speakers, so that health inequity decreases in society. Strengthening a community is one of five strategies to promote health, and community empowerment is the heart of this strategy. Several studies illustrate that community empowerment can strengthen CALD communities to identify and address their health needs and consequently improve their health. These studies applied various health promotion models, one of which was the parallel track model (PTM). The PTM has been applied in several community contexts, yet little is known about the application of this model and its contribution to promoting health and empowerment in a small migrant community like the Thai community in Brisbane, Australia.
Aim: The main purpose of this research project was to understand the application of the PTM and its contribution to promoting health in a Thai community in Brisbane, Australia.
Methods: The researcher spent over a year to develop a relationship with the community, to establish a working group (called ìcore groupî), and to design this project. The community and researcher collaborated to identify and address local health needs. The project applied the PTM and comprised three phases: (a) problem definition, (b) implementation, and (c) evaluation. A combination of quantitative and qualitative methods was applied throughout the project. The problem definition phase aimed to identify the health needs using a nominal group process, health survey, and focus group discussions. In the implementation phase, the core group prioritised the identified health needs and worked together with the researcher to develop and implement a strategy and action plan. Simultaneously, the core group assessed and improved the community capacities to address the prioritised health needs. Community capacities were assessed using a Thai version of the empowerment assessment rating scale. The evaluation phase aimed to assess health and empowerment outcomes and also identify factors that facilitated and/or hindered the process of community empowerment.
Results: Local health needs identified in the problem definition phase included physical health (e.g. a high prevalence of chronic disease), mental health (e.g. loneliness), familial problems (e.g. domestic violence), and social problems (e.g. gambling addiction). Thai migrants mainly used the mainstream health services for physical health, but not for mental health, familial and social problems. Low English proficiency was perceived as the root of the local health needs. Thai culture and the Temple positively and/or negatively affected the health of Thai migrants.
In the implementation phase, the core group ranked the lack of health knowledge as the top priority and used menopause as an example. As a result, two health initiatives were developed: menopause pamphlets in the Thai language and health education workshops. At the same time, the core group assessed the level of community empowerment and found that the community leader (the Abbot) and community organisation (the Temple) were the communityís strengths, while skills in project management, problem assessment, and critical analysis were the communityís weaknesses. In the evaluation phase, the health initiatives were not fully implemented, therefore a change in health knowledge about menopause among Thai migrants could not be assessed. The assessment of community empowerment levels found that skills in project management, problem assessment, and critical analysis improved, while the leadership and community organisation worsened. Desire to gain health knowledge, desire to help the community, use of Thai language, and a doctor as a facilitator were identified as positive factors in the process of community empowerment, whereas low participation and time conflict between the community and local health organisations were hindering factors.
Conclusions: This project demonstrated that the PTM is compatible with a bottom-up approach and is appropriate to a small ethnic community like the Thai community in Brisbane. By applying the model, the local health needs were identified and prioritised in accordance with Thai culture, resulting in the development of two health initiatives that aimed to improve health knowledge about menopause among Thai migrants. The PTM was also effective in assessing and improving the communityís strengths and weaknesses within a short time frame. A longer time frame is required to observe an impact of the PTM on health outcomes.