800 Section - Addressing participation barriers in disability service access: A community-level case report using participatory action research with Brisbane's Somali refugee population

Brisbane's Somali refugee community, conceptualised as a population-level case, presented with systemic participation restrictions in disability service access. This aligned with WHO's International Classification of Functioning, Disability and Health (ICF) framework. Environmental factors included cultural stigma surrounding invisible disabilities, limited health literacy regarding allied health roles, and communication barriers. Personal factors included culturally-specific disability conceptualisations and historical trauma affecting trust in health systems.


Case Description:

The project was a collaboration with a local refugee advocacy charity, to improve their impact in the disability sector. We applied participatory action research (PAR) methodology using iterative Look-Think-Act cycles over 26 weeks. The Look phase involved 13 community conversations. The Think phase employed Problem and Objective Trees: collaborative diagrams where communities identify root causes, problems, and effects, then transform these into solutions. Community-driven problem statements emerged: "You can't look for help when you don't know what you're looking for" and "The health system doesn't know how to respond."


Discussions:

PAR methodology revealed awareness must precede clinical education in this cultural context. Rather than condition-specific information (ICF body functions), interventions addressed environmental and personal factors: recognising invisible disabilities exist and normalising help-seeking behaviours. The Act phase produced culturally-informed videos distributed via WhatsApp. This demonstrates how rehabilitation physician expertise can inform cultural health translation, when guided by community wisdom through structured participatory processes.


Conclusions:

Treating communities as cases requiring individualised diagnostic assessment offers a novel application of rehabilitation medicine principles to health disparities. This replicable PAR-based framework balanced evidence-based practice with community co-design, decreasing barriers to disability service access for culturally diverse populations. The methodology has applications across refugee and migrant communities facing similar systemic barriers, demonstrating opportunities for rehabilitation physicians to address health equity at population level.