“You didn’t just consult community, you involved us”: transformation of a ‘top-down’ Aboriginal mental health project into a ‘bottom-up’ community-driven process

Abstract

Objective: Recently, there has been a consistent call for Indigenous health research to be community-driven. However, for a variety of reasons, many projects, such as the one featured here, start as ‘top-down’. Using ten accepted principles for Aboriginal health research, the present article illustrates how a top-down project can be transformed into a ‘bottom-up’ community-driven project. Method: A table of examples is provided to show how the ten principles were translated into practice to create a bottom-up process. Results: We suggest that key elements for creating a bottom-up process are iterative conversations and community involvement that goes beyond notional engagement. A feature of community involvement is generating and sustaining ongoing conversations with multiple levels of community (organisations, health professionals, Elders, community members, project-specific groups) in a variety of different forums across the entire duration of a project. Local research teams, a commitment to building capacity in the local Indigenous workforce, and adequate timelines and funding are other factors that we hypothesise may contribute to successful outcomes. Conclusion: The article contributes to a much-needed evidence base demonstrating how appropriate structures and strategies may create bottom-up processes leading to successful outcomes.