Table 2 Characteristics of included studies

Burgess,

et al., 2011 [38]

Interrupted time series study (6 years); pre- and post-measures; 6-monthly follow ups pre- (3 years) and post-intervention (3 years)

Early identification/ preventative

Holistic CVD risk assessment as part of an adult health check

Indigenous participants (n = 64); remote primary health care service, Northern Territory

Questionnaires/charts review/ investigations

Improved delivery of preventive care services; improved medicine prescription; reduction in estimated absolute CVD risk; better and earlier identification of elevated CVD risk.

The program led to better and earlier identification of cardiac risk factors as well as generally improved delivery of preventive care services and cardiac treatment

Burgess,

et al.,

2015 [36]

Longitudinal clinical audits of cardiac prevention services; 3 monthly follow-ups for 2 years

Preventative

Chronic conditions management model

Indigenous participants (n = 12,428); remote primary health care services (n = 49), Northern Territory

Clinical audit of cardiac prevention services

Increased coverage of Indigenous population CVD risk assessment; assessment of modifiable cardiac risk factors); increased appropriate prescription of medication; achievement of clinical targets for risk reduction

The program demonstrated ability to reduce cardiac risk factors in rural Indigenous populations. It also enabled follow-up of patients

Canuto,

et al., 2012 [31]

Pragmatic RCT

Follow up 3 monthly (completed: n = 59, lost to follow up: n = 41)

Management/ treatment

12-week exercise and nutrition program

Indigenous participants (intervention n = 51, control n = 49);

metropolitan area, South Australia

Implementation of a structured exercise program

Reduction in weight and BMI

Low attendance but intervention had positive effects. Requires understanding the barriers to participation

Davey,

et al., 2014 [33]

Mixed methods

Pre- and post-program measures

Rehabilitation/ secondary prevention

8-week supervised exercise and educational session - cardiopulmonary rehabilitation and secondary prevention program

Indigenous participants (n = 92); Aboriginal community-controlled health services, Tasmania

Implemented an exercise and educational program with Indigenous community

Increased participation in rehabilitation; positive changes in health behaviours, functional exercise capacity and health related quality of life. Decreased weight, BMI, and waist circumference

Increased 6-min walk test results

Community based interventions have multiple positive impacts

Davidson,

et al., 2008 [34]

Mixed methods

Pre- and post-measures

Management/ treatment

A partnership model among key education providers, policy makers, non-government organisations, the local area health service and Aboriginal community controlled organisations

Indigenous participants (n = 21); metropolitan Technical and Further Education (TAFE), New South Wales

Mixed method evaluation using

questionnaires and semi structured interviews

Participants reported increased confidence in ability to provide CVD service to community and demonstrated enhanced CVD knowledge: post-course test mean score 70% vs pre-course score 42%

The model was useful in promoting cardiac knowledge in Aboriginal Health Workers while increasing Aboriginal health knowledge in the mainstream health setting. The model forged partnerships.

Daws,

et al., 2014 [37]

Pre- and post -evaluation program

Rehabilitation/ secondary prevention

Working together model of care - (Aboriginal hospital liaison officer and specialist cardiac nurse team)

Aboriginal and Torres Strait Islander participants (n = 13); metropolitan tertiary public hospital, Victoria

Retrospective audit

Increased referral rate (15 to 86%)

and attendance rate (0 to 62%)

The partnership model approach to care coordination and system changes that were implemented led to improved attendance at cardiac rehabilitation in the participating group

Dimer,

et al., 2013 [35]

Mixed methods

Pre- and post-program measures

Rehabilitation

Cardiac rehabilitation program; weekly exercise and education sessions

Indigenous participants (n = 48); Aboriginal medical services, Western Australia

Evaluation of exercise and educational program

Decreased weight, BMI, BP, waist girth; improved 6-min walk test

Aboriginal Medical Service based cardiac rehabilitation proved to be effective in improving attendance, and cardiac risk factor and health management

Peiris

et al., 2015 [32]

Parallel arm cluster-randomized controlled trial

Management/ treatment

Computer-guided quality improvement intervention

Aboriginal and Torres Strait Islander participants (n = 38,725); Australian primary healthcare centres (n = 60 services), New South Wales and Queensland

Implementation of computerised screening and management algorithm

The intervention was associated with improved overall risk factor measurements

There was minimal support required to implement the tool and had positive effects on improving cardiac risk measurement