Exploring the Systemic Structures That Affect Access to Physical Therapist Services for Non-Indigenous Black People in Australia.

Publisher: Oxford University Press Country of Publication: United States NLM ID: 0022623 Publication Model: Print Cited Medium: Internet ISSN: 1538-6724 (Electronic) Linking ISSN: 00319023 NLM ISO Abbreviation: Phys Ther Subsets: MEDLINE

Publication: 2017- : New York : Oxford University Press
Original Publication: Alexandria, VA : American Physical Therapy Association

Black People* ; Health Services Accessibility* ; Physical Therapy Modalities*; Humans ; Australia ; Communication Barriers ; Adolescent ; Young Adult ; Adult

Objective: Physical therapy is generally considered to be a white profession in Western nations. Australia's increasingly diverse population, driven largely by growth in immigration, invites Australian health systems to be responsive to factors that may impact on non-white Australian population's access to health care. Here, the authors sought to explore non-Indigenous Black people's perspectives of physical therapy in Australia.
Methods: Eligible participants (n = 12) took part in semistructured, in-depth interviews and were prompted to discuss their experiences and perceptions of physical therapy. Interview data were analyzed using critical discourse analysis, underpinned by critical race theory.
Results: Participants were on average 29.4 years (SD = 12.9) from diverse cultural and linguistic backgrounds. Participants described mostly positive experiences with physical therapists, but they noted that it was not widely accessed by their communities, with 2 key discourses underpinning these discussions. Discourse 1, "physiotherapy is a solution for white people," established physical therapy as primarily accessed by and welcoming of white people. "Whiteness" and the perpetuation of Western norms in physical therapy resulted in little consideration of other cultural practices. Participants' discussions also pointed to the intersections of systemic racism and social inequities such as low income and language barriers, impacting Black people's engagement with physical therapy. Discourse 2, "physiotherapists are white," was mostly concerned with how the perceived "whiteness" of professionals and lack of Black physical therapists impacts cultural safety and comfort when accessing physical therapy.
Conclusion: Our results suggest that Westernization and whiteness persist among discourses surrounding physical therapy. Such discourses are likely to inform Black people's perceptions and experiences of physical therapy. Our analyses suggest avenues to enhance the cultural diversity of the profession and improve physical therapy accessibility for Black people in Australia by providing culturally appropriate material, including critical reflexivity, epistemic and cultural humility in the curricula, recruiting staff from diverse backgrounds, and providing outreach services to underserved populations.
Impact: These findings highlight the need for increased cultural safety and diversity within the physical therapy profession to improve equity.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the American Physical Therapy Association. All rights reserved. For permissions, please e-mail: [email protected].)

University of Queensland Stimulus Fellowship; APP1157199 National Health and Medical Research Council of Australia

Keywords: Black People; Culture; Discourse Analysis; Equity; Health Care Access; Physical Therapy

Date Created: 20231015 Date Completed: 20240205 Latest Revision: 20240205

20240205

10.1093/ptj/pzad139

37839057