Included studies.

Indigenous communities internationally have demonstrated remarkable strength despite significant challenges. Health disparities among Indigenous peoples persist due to historical injustices and ongoing racial discrimination, not inherent vulnerabilities. Disparities are rooted in a legacy of colonisation, systemic exclusion, and socio-economic inequities impacting access to healthcare, education, and employment. Preliminary searches show limited literature on models of care for remote living Indigenous children. This review aimed to identify internationally, effective models of care for Indigenous children in rural and remote areas. A scoping review was conducted, analysing literature on models of care for remote Indigenous children. This study followed the JBI’s Scoping Review Guidance and PRISMA Scoping Review guideline. Inclusion criteria were aged ≤18, rural or remote areas, majority Indigenous, reported health outcomes, described a model of care, in English, and published since 1990. Data were systematically extracted, quality appraised using the ‘Aboriginal and Torres Strait Islander Quality Appraisal Tool’ then analysed using descriptive-analytical methodology. This review included 16 papers: 8 case series, 3 qualitative studies, and 5 trials. Of these, 7 studies were in Australia, 7 in the USA and 2 in Canada. All studies primary aim was to improve quality of care. Models of care described in the included papers varied, being delivered in traditional healthcare settings, homes, and elsewhere in the community. This review provides insights into the design and implementation of models of care in remote communities with primarily Indigenous populations. The authors recommend 1) that future reviews privilege ‘realist evaluation’ when examining models of care, 2) designers consider whether a model of care will run for a fixed-period versus ongoing as they have different requirements for success and 3) a toolkit approach to model of care development like the Qungasvik toolkit which provides evidenced modules adaptable to local conditions, easing workload on local people developing programs.

全球原住民社区尽管面临诸多严峻挑战，仍展现出非凡的韧性。原住民群体的健康差距持续存在，其根源在于历史不公与持续存在的种族歧视，而非先天的脆弱性。这些差距根植于殖民主义遗留问题、系统性排斥以及社会经济不平等，这些因素均影响着原住民在医疗保健、教育与就业领域的可及性。初步检索显示，针对偏远地区原住民儿童的照护模式相关文献较为匮乏。本范围综述旨在全球范围内识别适用于农村及偏远地区原住民儿童的有效照护模式。本研究遵循JBI范围综述指南与PRISMA范围综述指南开展。纳入标准为：研究对象年龄不超过18岁、所处地区为农村或偏远地区、研究群体以原住民为主、报告了健康结局、描述了照护模式、以英语发表且发表时间为1990年及以后。研究人员采用系统方式提取数据，并使用《原住民与托雷斯海峡岛民质量评价工具》（Aboriginal and Torres Strait Islander Quality Appraisal Tool）进行质量评价，随后采用描述性分析方法开展数据分析。本综述共纳入16篇文献：其中8篇为病例系列研究、3篇为质性研究、5篇为临床试验。纳入的研究中，7项开展于澳大利亚、7项开展于美国、2项开展于加拿大。所有研究的核心目标均为提升照护质量。纳入文献中所描述的照护模式各不相同，服务提供场景涵盖传统医疗场所、家庭及社区其他场所。本综述为针对以原住民为主要群体的偏远社区的照护模式设计与实施提供了参考见解。作者提出三项建议：1）未来开展照护模式相关研究或综述时，优先采用‘实在论评估（realist evaluation）’方法；2）照护模式设计者需考量该模式采用固定周期运行还是持续运行模式，二者的成功实施条件存在差异；3）可采用类似Qungasvik工具包的照护模式开发工具包思路，该工具包提供可适配本地实际情况的循证模块，能够减轻本地项目开发人员的工作负担。