• Siaw-Teng Liaw, Vicki Wade, John S Furler, Iqbal Hasan, Phyllis Lau, Margaret Kelaher, Wei Xuan, and Mark F Harris.
• UNSW Sydney, Sydney, NSW.
• Med. J. Aust. 2019 Apr 1; 210 (6): 263-268.

ObjectiveTo examine whether the Ways of Thinking and Ways of Doing (WoTWoD) cultural respect framework improves clinically appropriate anticipatory care in general practice and the cultural respect levels of medical practice staff.DesignMixed methods, cluster randomised controlled trial with a participatory action research approach.Setting, ParticipantsFifty-six general practices in Sydney and Melbourne, 2014-2017.InterventionWoTWoD encompasses a toolkit (ten scenarios illustrating cross-cultural behaviour in clinical practice), one half-day workshop, cultural mentor support for practices, and a local care partnership between participating Medicare locals/primary health networks and local Aboriginal Community Controlled Health Services for guiding the program and facilitating community engagement. The intervention lasted 12 months at each practice.Major OutcomesRates of claims for MBS item 715 (health assessment for Aboriginal and Torres Strait Islander People) and recording of chronic disease risk factors; changes in cultural quotient (CQ) scores of practice staff.ResultsComplete results were available for 28 intervention (135 GPs, 807 Indigenous patients) and 25 control practices (210 GPs, 1554 Indigenous patients). 12-Month rates of MBS item 715 claims and recording of risk factors for the two groups were not statistically significantly different, nor were mean changes in CQ scores, regardless of staff category and practice attributes.ConclusionThe WoTWoD program did not increase the rate of Indigenous health checks or improve cultural respect scores in general practice. Conceptual, methodologic, and contextual factors that influence cultural mentorship, culturally respectful clinical practice, and Indigenous health care require further investigation.Trial RegistrationAustralia New Zealand Clinical Trials Registry ACTRN12614000797673.© 2019 AMPCo Pty Ltd.

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