Relationships | Include the family for medical visits and for self-management (family’s responsibility rather than solely the individual’s)28 29 33 36 38 42 67 Include kinship and build strong and respectful relationships (crowshow)38 40 43 44 Ensure nonverbal responses are respectful40 Share meals with patients29 Accept Indigenous child behaviour40 Show interest in them and their lives27 Include grandchildren in care activities38 Spend adequate time with patients29 43 Avoid staff turn-over43 Hire Indigenous health providers and staff27 40 Invite other Indigenous people in group sessions33 38 39 Provide care with a staff trained for cultural safety19 41 43 66 67
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Cultural landmarks | Have Indigenous cultural landmarks in clinics (eg, music, art pieces)30 33 40 66 and create a culturally familiar environment33 Use relevant and accessible wording31 33 35 38 44 and visuals31 44 Use pictorial layouts31 35 44 Offer health promotion bush trips39 Use storytelling and yarning approach29 31 44
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Spirituality and holistic health | Use indigenous traditional therapeutic approaches (eg, lomilomi (Hawaiian therapeutic massage) and medicine herbs)39 63–65 67 Focus on well-being rather than medical targets31 37 62 Focus on patient’s own goals27 43 and use a holistic approach27 37 38 43 63 Use Indigenous protocols and cultural processes, such as starting and ending meetings with prayer and songs29 38 Use smudging39 67 Not be constrained by Western models of disease33 Have an Elder involved (in medical visits or as a caregiver)29 32 34 35 Provide care at home37 41
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Access to healthcare | Use technology (eg, audio-visual and social media) and electronic health tools to deliver health information at the time, in the place and in multiple formats and languages to meet consumers’ needs66 Make home visits (minimising the inconvenience and cost of having to travel to the clinic)27 37 41 Offer transportation to clinic, pharmacy, local laboratory for tests, etc33 37 65 Use relevant and accessible wording31 33 35 38 44 and translate health material65 66 Offer financial support for medication28 30 or drop it off to patients28 Cooperate with local pharmacy to ensure medication adherence41 Have an interpreter66 or indigenous liaison client representative65 Have an indigenous patient navigator64 67
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