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

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.

Exploring physiotherapy education in Australia from the perspective of Muslim women physiotherapy students.

BACKGROUND: Despite Australia's multiculturalism, physiotherapists from minority ethnic groups, including Muslim women, may experience social exclusion in physiotherapy training based on research in other countries. OBJECTIVE: Explore Muslim women's experiences of physiotherapy education in Australia and how these experiences could be improved (if needed). METHODS: Qualitative research approach. Data were produced through semi-structured interviews and analyzed with reflexive thematic analysis. RESULTS: Eleven participants were interviewed. Four main themes were produced: 1) omnipresent concerns about disrobing, physical proximity and touch in mixed-gender settings; 2) physiotherapy seen as a culturally inappropriate profession for Muslim women; 3) prevalence of an "Aussie" student environment; and 4) lack of systemic inclusivity. Suggestions to improve inclusivity, involved: systemically embedding measures such as alternatives for disrobing and proximity between genders; and promoting diverse social activities. CONCLUSION: Results suggest Australian physiotherapy education lacks systemic cultural sensitivity for Muslim women. To reduce the burden for change being placed on Muslim women students, culturally responsive institutional protocols and staff training could be established.