Developing Integrated Healthcare Models for Indigenous People: Insights from a Relational Systematic Scoping Review

Integrated healthcare models show great promise for addressing health disparities affecting Indigenous people, which are often rooted in the enduring effects of colonisation. These models align with Indigenous holistic views of health, recognizing the importance of community, cultural knowledge, and connection to land. To understand how these models are being developed and implemented, we conducted a systematic scoping review. Guided by Indigenous methodologies and community needs, we searched four databases (Web of Science, PubMed, Scopus and ProQuest) for peer-reviewed literature on integrated healthcare for Indigenous communities in Australia, Canada, the United States, and New Zealand. Included articles were appraised using the Indigenous quality appraisal tool and analysed from a relational perspective supported by the Joanna Briggs Institute's convergent integrated method. Nineteen publications met the inclusion criteria. Most studies were from Australia (53%) and Canada (26%), and most (74%) were published in the last five years, indicating a recent surge in interest. The review identified several key factors critical to the effective implementation of these models. These included strong community leadership and ownership, culturally and contextually relevant approaches, meaningful partnerships with stakeholders, and flexible service delivery. The review further highlights the importance of having motivated and well-trained health providers, as well as adequate funding. The wide variety of methods found in the studies reflects the complexity of integrated care and the influence of distinct cultural, disciplinary and contextual factors. The findings suggest that to improve healthcare and well-being for Indigenous populations, it is crucial to strategically address these key elements.