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Leaders at the Waminda Aboriginal Community Controlled Health Organisation (ACCHO) in Nowra, NSW, have partnered with researchers at Charles Darwin University (CDU) to evaluate the Bulwul Balaang program for young Indigenous women. Outcomes included increased access to health checks, but researchers say that more importantly, the program lays the foundations for lifelong health.
The Bulwul Balaang (Young Women’s) Program is an in-school and after-school program for Aboriginal women aged 12-24, with a focus on connections to Culture, access to holistic, culturally safe health care, and to study or employment pathways. The sessions also cover social and emotional wellbeing, healthy relationships, as well as building skills and confidence.
A study evaluating the program and will be published in The Lowitja Journal V4 in June 2026.
One of the authors, Dr Jenne Roberts, is a researcher at the Molly Wardaguga Institute for Indigenous Birth Rights at CDU.
“At first you might think, ‘Oh, it’s cultural activities, drawing, painting, dance, arts and crafts,” said Dr Roberts.
“Included throughout are strategies that build resilience, relationships and life skills.”
“It happens naturally, through sharing stories about how their grandmothers hold families and culture strong, how their mothers and aunties draw on strengths to navigate change and challenges. The learning happens organically through relationships, storytelling and yarning.”
“It’s not like, ‘Now we’re going to do a health literacy module on smoking.’”
“The youth workers will weave into it. They might say, ‘Oh yeah, I used to smoke. But as I gained more respect for myself as an Aboriginal woman, I felt more strongly that I wanted to take care of my body. That gave me the motivation to quit smoking.’”
ACCHOs create outstanding health results
Dr Roberts said that the study further validates the success of programs run by Aboriginal Community Controlled Health Organisations (ACCHOs).
“ACCHOs demonstrate how culturally strong, holistic, relationship-based practice leads to connections with health services, and better health outcomes,” said Dr Roberts.
“They create environments where families feel safe to send their girls, and where girls and young women feel respected,” she said.
Dr Roberts said that it’s important that evaluations such as these tell the full story.
“Evaluations of programs like Bulwul Balaang often just show things like attendance and how often the young women come to the group. They might only count episodes of care. But at Waminda, the evaluation shows that participants thrive, and what ACCHOs do to make that thriving possible.”
“It’s hard to measure changes in health outcomes over a short period of time, like the three years covered by this initial evaluation. But during this time, 88 (48.35%) participants had a health assessment at Waminda, including during the era of COVID-19 restrictions.”
“That health assessment and the connections are critical. The program lays the groundwork that could ensure young women are connected to and using primary healthcare services, and then those services contribute to good health outcomes.”
“Another outcome, which was evident in the participants’ feedback, was an increased understanding of healthy relationships and confidence in expressing themselves.”
“These experiences appear to support young women to grow as leaders in their communities.”
Warm Handovers: fostering health confidence
Dr Roberts said that a key component of the research was a ‘warm handover.’
“The youth workers don’t just write a referral slip and say, ‘Now you can go here to get that other health issue seen to.’”
“Once a young woman knows and trusts a Bulwul Balaang youth worker, the worker will go with her, make the introduction, and stay while the new relationship is established.”
“They might say, ‘Oh, this is Rebecca; she’s part of Bulwul Balaang. Rebecca’s really interested in seeing a dentist today. She hasn’t had a dental checkup for the last year or two. Do you mind if I just stay here with her for this first appointment while you get to know each other?’”
“As part of the evaluation, I went several times with one of the Waminda youth workers and participants, with their consent, to Centrelink and the housing office.”
“For the young women, this improves their access to services and seeing the youth workers speak up for them builds trust and models advocacy.”
“It shows young women that their concerns matter and they are worthy of care and support.”
“As they see their own value reflected in the eyes and actions of their workers over time, they learn to recognise their strengths, and their ability to advocate for themselves grows and grows.”
Ensuring ethical, culturally safe research
While the evaluation used the RE-AIM framework, Dr Roberts emphasised that research methods alone are not enough to produce useful, credible evaluations. To be beneficial, program evaluations require Indigenous leadership, and respect for cultural authority and knowledge.
Dr Roberts, who does not have Indigenous heritage, said the team could not have done this work without the leadership provided by the Aboriginal women at Waminda.
“My Indigenous co-authors from Waminda, Hayley Longbottom, Cleone Wellington and Betty Smith, bought cultural authority and local insights. The relationships that they had with the young women participating in the program were central to every part of the work.”
“Every member of the evaluation team sees research as something that should serve communities, not extract from them.”
“Not all research is trusted, used, and acted on by First Nations communities.”
“When the community defines what evidence matters, lead the process and interpret the data alongside the researchers, the results resonate. The findings are used and the recommendations are acted upon.”
“For doctors and other health professionals, the message is that trust, relationships and cultural responsiveness are not optional, extra factors.”
“They require time, and are central to improving access to care, to engagement, to service quality and improving outcomes.”
“This evaluation strengthens the evidence base for programs run by ACCHOs.”
Warming the ground
Dr Roberts said that one of the most important aspects of the evaluation was ‘warming the ground,’ or building trust with communities.
“It is spending time in the community, building relationships, learning the protocols, and demonstrating accountability and respect before what we would think of as ‘formal research’ begins.”
“It allows community members to assess whether the researchers are trustworthy, adequately prepared, and respectful. It’s an ongoing process.”
“Cleone Wellington — one of my co-authors and Waminda’s Cultural Manager — said to me, ‘I’m not letting you out there until I know I can trust you, and you know you can trust me.’ This provided the mutual protection and respect that supports good evaluation.”
Dr Roberts said that evaluations play an important role in accountability and sustainability.
“Evaluations aren’t ‘discovering’ that ACCHO programs are effective for the first time. The purpose of an evaluation like this one is to produce evidence of what is working. The challenge is in making sure the programs continue to be resourced and central to Closing the Gap.”
Becca Whitehead is a freelance journalist and health writer. She lives in Naarm and is a regular contributor to the MJA’s InSight+.
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