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Beadman KA, Sherwood J, Gray P, McAloon J. Self-determination in programmes of perinatal health for Aboriginal Communities: A systematic review. Aust N Z J Public Health 2024; 48:100169. [PMID: 39068135 DOI: 10.1016/j.anzjph.2024.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/11/2024] [Accepted: 06/04/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE The importance of self-determination in restoring the wellbeing of Australian First Nations peoples is becoming understood. For thousands of years, Aboriginal women gave birth on Country and Grandmothers' Lore and Women's Business facilitated the survival of the oldest living civilisations on earth. Following colonisation, however, Aboriginal and Torres Strait Islander practices of maternal and perinatal care were actively dismantled, and self-determination by Aboriginal people was destroyed. This had significant implications for the wellbeing of Aboriginal and Torres Strait Islander people and their Cultures and practices. METHODS A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-based systematic review of research about programmes of birthing and perinatal health care for Australian Aboriginal and Torres Strait Islander women and their children was undertaken. The review's primary aim was to assess the Cultural context of programme development and delivery, its secondary aim was to assess the Cultural appropriateness of programme components. Electronic databases SCOPUS, PsycINFO, Medline, and CINAHL were searched for peer-reviewed studies published in English in Australia between 2000 and 2023. RESULTS Twenty-eight publications met inclusion criteria. Included studies were assessed for their methodological characteristics, birthing-support characteristics, perinatal care and continuity of care characteristics. Overall, programmes were limited in meeting the Cultural needs of women, children, and individual Communities. The role of Aboriginal Communities in identifying, delivering, and reviewing programmes was also limited. CONCLUSIONS Findings articulate the importance of self-determination in maintaining strong Indigenous Cultures and informing the Culturally appropriate development and delivery of Culturally safe programmes of perinatal care for Aboriginal women, children, and Communities. IMPLICATIONS FOR PUBLIC HEALTH Programmes and services for use by Aboriginal and Torres Strait Islander people must involve Aboriginal and Torres Strait Islander people and their Communities in processes of programme planning, delivery, and review. The evaluation of a programme or service as "Culturally safe" represents a determination that is most appropriately made by service users based on their experience of that programme or service.
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Affiliation(s)
- Kim Ann Beadman
- Discipline of Clinical Psychology, Graduate School of Health, Faculty of Health, University of Technology Sydney, Australia; UTS: Family Child Behavior Clinic, Graduate School of Health, Faculty of Health, University of Technology Sydney, Australia
| | - Juanita Sherwood
- Jumbunna Institute for Indigenous Education & Research, University of Technology Sydney, Australia
| | - Paul Gray
- Jumbunna Institute for Indigenous Education & Research, University of Technology Sydney, Australia
| | - John McAloon
- Discipline of Clinical Psychology, Graduate School of Health, Faculty of Health, University of Technology Sydney, Australia; UTS: Family Child Behavior Clinic, Graduate School of Health, Faculty of Health, University of Technology Sydney, Australia.
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Moodie S, Jones J, Chenhall R, Williams R, Garlett C, Gibberd A, O’Donnell M, McAullay D, McNamara B, Eades S. Intersectoral collaboration for supporting the health and wellbeing of Aboriginal families and children in out-of-home care: perspectives from Western Australian Aboriginal Community Controlled Health Organisations. Front Public Health 2024; 12:1392208. [PMID: 38983266 PMCID: PMC11231078 DOI: 10.3389/fpubh.2024.1392208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/05/2024] [Indexed: 07/11/2024] Open
Abstract
Introduction Western Australia has one of the highest rates of Aboriginal children entering out-of-home care in Australia. Kinship care is the preferred culturally safe out-of-home care option for Aboriginal children, yet all jurisdictions, including Western Australia, are far from meeting best-practice national standards. Intersectoral collaboration is a key primary healthcare principle and internationally recognized for improving health systems and outcomes. This paper presents findings from a qualitative research project investigating Aboriginal primary healthcare workers' experiences of intersectoral collaboration challenges and strengthening opportunities. Methods Constructivist grounded theory guided this research involving 55 semi-structured interviews and four focus group discussions with Aboriginal primary healthcare workers. The research was guided by Indigenous methodologies and led by Indigenous researchers Participants were recruited from seven Aboriginal Community Controlled Health Organisations located across Perth metro, Pilbara, Midwest/Gascoyne and Southwest regions in Western Australia. Results Key themes identified around intersectoral collaboration challenges were communication, including information sharing and interagency meetings, and the relationship with the government sector, including trust and the importance of the perception of Aboriginal health service independence. Key themes around strengthening areas to improve intersectoral collaboration included strengthening service resourcing and coverage, including the availability of services, and addressing high program turnover. The need for a shift in approach, including more emphasis on Aboriginal-led care and aligning approaches between sectors, was another area for strengthening. Discussion This study addresses a significant research gap concerning out-of-home care, kinship care, and intersectoral collaboration in an Australian Aboriginal context. Findings highlighted the need to review the out-of-home and kinship models of care to strengthen the system, including creating more formal and structured modes of collaborating and better resourcing family support and kinship care.
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Affiliation(s)
- Sasha Moodie
- National Drug Research Institute, Curtin University, Perth, WA, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jocelyn Jones
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Richard Chenhall
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Robyn Williams
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Cathy Garlett
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alison Gibberd
- National Drug Research Institute, Curtin University, Perth, WA, Australia
- Hunter Research Medical Institute, Newcastle, NSW, Australia
| | - Melissa O’Donnell
- Australian Centre for Child Protection, University of South Australia, Adelaide, SA, Australia
| | - Dan McAullay
- Kurongkurl Katitjin, Edith Cowan University, Perth, WA, Australia
| | - Bridgette McNamara
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Barwon South West Public Health Unit, Barwon Health, Geelong, VIC, Australia
| | - Sandra Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Doery E, Satyen L, Paradies Y, Gee G, Toumbourou JW. Impact of community-based employment on Aboriginal and Torres Strait Islander wellbeing, aspirations, and resilience. BMC Public Health 2024; 24:497. [PMID: 38365659 PMCID: PMC10870455 DOI: 10.1186/s12889-024-17909-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/29/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND This study evaluated a research project that provided employment in an Aboriginal and Torres Strait Islander community-based setting and supported participants to identify and achieve their goals and aspirations. The evaluation examined changes in personal, relationship, community and cultural strengths and resources and explored empowerment and resilience, in terms of promoting wellbeing. METHODS Ten Aboriginal people employed as life coaches and peer researchers participated in semi-structured interviews and also completed the Aboriginal Resilience and Recovery Questionnaire at the beginning of their employment and 6-months after employment. Interviews with the 10 participants explored changes in their wellbeing, relationships, resilience, opportunity to lead, aspirations, goal setting skills, connection to culture and community, and empowerment. RESULTS Participants personal strengths, and cultural and community strengths, sub-scale scores showed improvements across the 6-month period, however these changes were not statistically significant. Using reflexive thematic analysis, we generated five themes including Aspirations; Personal capabilities; Constraints to wellbeing; Community engagement and cultural connection; and Employment facilitators. Overall, participants identified that despite the challenges of their work and the additional challenges posed by the COVID-19 lockdowns, they were able to develop their skills to set and achieve goals. They reported feeling empowered and proud of their work, and engaged more frequently with their communities and culture. CONCLUSIONS The study outcomes evidence the role of employment in an Aboriginal and Torres Strait Islander community-based project in strengthening wellbeing, enhancing resilience, and supporting participants to advance their personal goals and aspirations. These findings reinforce the importance of supporting the aspirations and employment of Aboriginal and Torres Strait Islander Peoples through employment.
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Affiliation(s)
- Elizabeth Doery
- School of Psychology, Deakin University, Burwood, Australia.
| | - Lata Satyen
- School of Psychology, Deakin University, Burwood, Australia
| | - Yin Paradies
- School of Humanities and Social Science, Deakin University, Burwood, Australia
| | - Graham Gee
- Murdoch Children's Research Institute, Melbourne, Australia
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McGuffog R, Bryant J, Booth K, Collis F, Brown A, Hughes JT, Chamberlain C, McGhie A, Hobden B, Kennedy M. Exploring the Reported Strengths and Limitations of Aboriginal and Torres Strait Islander Health Research: A Narrative Review of Intervention Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3993. [PMID: 36901001 PMCID: PMC10001772 DOI: 10.3390/ijerph20053993] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
High quality intervention research is needed to inform evidence-based practice and policy for Aboriginal and Torres Strait Islander communities. We searched for studies published from 2008-2020 in the PubMed database. A narrative review of intervention literature was conducted, where we identified researcher reported strengths and limitations of their research practice. A total of 240 studies met inclusion criteria which were categorised as evaluations, trials, pilot interventions or implementation studies. Reported strengths included community engagement and partnerships; sample qualities; Aboriginal and Torres Strait Islander involvement in research; culturally appropriate and safe research practice; capacity building efforts; providing resources or reducing costs for services and communities; understanding local culture and context; and appropriate timelines for completion. Reported limitations included difficulties achieving the target sample size; inadequate time; insufficient funding and resources; limited capacity of health workers and services; and inadequate community involvement and communication issues. This review highlights that community consultation and leadership coupled with appropriate time and funding, enables Aboriginal and Torres Strait Islander health intervention research to be conducted. These factors can enable effective intervention research, and consequently can help improve health and wellbeing outcomes for Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Romany McGuffog
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Jamie Bryant
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Kade Booth
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Felicity Collis
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Alex Brown
- Indigenous Genomics, Australia National University, Canberra, ACT 2601, Australia
- Telethon Kids Institute, Nedlands, WA 6009, Australia
| | - Jaquelyne T. Hughes
- Rural and Remote Health, College of Medicine and Public Health, Flinders University, Darwin, NT 0810, Australia
| | - Catherine Chamberlain
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Parkville, VIC 3010, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
| | - Alexandra McGhie
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Breanne Hobden
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Michelle Kennedy
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW 2308, Australia
- Hunter Medical Research Institute, The University of Newcastle, Callaghan, NSW 2308, Australia
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Butler T, Gall A, Garvey G, Ngampromwongse K, Hector D, Turnbull S, Lucas K, Nehill C, Boltong A, Keefe D, Anderson K. A Comprehensive Review of Optimal Approaches to Co-Design in Health with First Nations Australians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192316166. [PMID: 36498237 PMCID: PMC9735487 DOI: 10.3390/ijerph192316166] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND Australia's social, structural, and political context, together with the continuing impact of colonisation, perpetuates health care and outcome disparities for First Nations Australians. A new approach led by First Nations Australians is required to address these disparities. Co-design is emerging as a valued method for First Nations Australian communities to drive change in health policy and practice to better meet their needs and priorities. However, it is critical that co-design processes and outcomes are culturally safe and effective. Aims: This project aimed to identify the current evidence around optimal approaches to co-design in health with First Nations Australians. METHODS First Nations Australian co-led team conducted a comprehensive review to identify peer-reviewed and grey literature reporting the application of co-design in health-related areas by and with First Nations Australians. A First Nations Co-Design Working Group (FNCDWG) was established to guide this work and team.A Collaborative Yarning Methodology (CYM) was used to conduct a thematic analysis of the included literature. RESULTS After full-text screening, 99 studies were included. Thematic analysis elicited the following six key themes, which included 28 practical sub-themes, relevant to co-design in health with First Nations Australians: First Nations Australians leadership; Culturally grounded approach; Respect; Benefit to First Nations communities; Inclusive partnerships; and Evidence-based decision making. CONCLUSION The findings of this review provide a valuable snapshot of the existing evidence to be used as a starting point to guide appropriate and effective applications of co-design in health with First Nations Australians.
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Affiliation(s)
- Tamara Butler
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | - Alana Gall
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore 2480, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | | | | | | | | | | | - Anna Boltong
- Cancer Australia, Sydney 2010, Australia
- Kirby Institute, UNSW Medicine, The University of New South Wales, Kensington 2052, Australia
| | | | - Kate Anderson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
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McLachlan HL, Newton M, McLardie-Hore FE, McCalman P, Jackomos M, Bundle G, Kildea S, Chamberlain C, Browne J, Ryan J, Freemantle J, Shafiei T, Jacobs SE, Oats J, Blow N, Ferguson K, Gold L, Watkins J, Dell M, Read K, Hyde R, Matthews R, Forster DA. Translating evidence into practice: Implementing culturally safe continuity of midwifery care for First Nations women in three maternity services in Victoria, Australia. EClinicalMedicine 2022; 47:101415. [PMID: 35747161 PMCID: PMC9142789 DOI: 10.1016/j.eclinm.2022.101415] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Strategies to improve outcomes for Australian First Nations mothers and babies are urgently needed. Caseload midwifery, where women have midwife-led continuity throughout pregnancy, labour, birth and the early postnatal period, is associated with substantially better perinatal health outcomes, but few First Nations women receive it. We assessed the capacity of four maternity services in Victoria, Australia, to implement, embed, and sustain a culturally responsive caseload midwifery service. METHODS A prospective, non-randomised research translational study design was used. Site specific culturally responsive caseload models were developed by site working groups in partnership with their First Nations health units and the Victorian Aboriginal Community Controlled Health Organisation. The primary outcome was to increase the proportion of women having a First Nations baby proactively offered and receiving caseload midwifery as measured before and after programme implementation. The study was conducted in Melbourne, Australia. Data collection commenced at the Royal Women's Hospital on 06/03/2017, Joan Kirner Women's and Children's Hospital 01/10/2017 and Mercy Hospital for Women 16/04/2018, with data collection completed at all sites on 31/12/2020. FINDINGS The model was successfully implemented in three major metropolitan maternity services between 2017 and 2020. Prior to this, over a similar timeframe, only 5.8% of First Nations women (n = 34) had ever received caseload midwifery at the three sites combined. Of 844 women offered the model, 90% (n = 758) accepted it, of whom 89% (n = 663) received it. Another 40 women received standard caseload. Factors including ongoing staffing crises, prevented the fourth site, in regional Victoria, implementing the model. INTERPRETATION Key enablers included co-design of the study and programme implementation with First Nations people, staff cultural competency training, identification of First Nations women (and babies), and regular engagement between caseload midwives and First Nations hospital and community teams. Further work should include a focus on addressing cultural and workforce barriers to implementation of culturally responsive caseload midwifery in regional areas. FUNDING Partnership Grant (# 1110640), Australian National Health and Medical Research Council and La Trobe University.
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Affiliation(s)
- Helen L. McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086, Australia
- Corresponding author at: Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia.
| | - Michelle Newton
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Fiona E. McLardie-Hore
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Pamela McCalman
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Marika Jackomos
- Mercy Hospital for Women, Heidelberg, Victoria 3084, Australia
| | - Gina Bundle
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, School of Nursing and Midwifery, Charles Darwin University, Alice Springs 0870, Australia
| | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3053, Australia
- Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch, Western Australia 6150, Australia
- The Lowitja Institute, Carlton, Victoria 3053, Australia
| | - Jennifer Browne
- Deakin University Institute for Health Transformation, Geelong, Victoria 3220, Australia
- Victorian Aboriginal Community Controlled Health Organisation, Collingwood, Victoria 3066, Australia
| | - Jenny Ryan
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Jane Freemantle
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3053, Australia
- Rural Health Academic Centre, The University of Melbourne, Shepparton, Victoria 3630, Australia
| | - Touran Shafiei
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
| | - Susan E. Jacobs
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
- Murdoch Children's Research Institute, University of Melbourne, Parkville, Victoria 3052, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria 3052, Australia
| | - Jeremy Oats
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3053, Australia
| | - Ngaree Blow
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria 3053, Australia
| | - Karyn Ferguson
- Rural Health Academic Centre, The University of Melbourne, Shepparton, Victoria 3630, Australia
| | - Lisa Gold
- Deakin University Institute for Health Transformation, Geelong, Victoria 3220, Australia
| | - Jacqueline Watkins
- Joan Kirner Hospital, Western Health St Albans, Victoria 3021, Australia
| | - Maree Dell
- Joan Kirner Hospital, Western Health St Albans, Victoria 3021, Australia
| | - Kim Read
- Goulburn Valley Health, Shepparton, Victoria 3644, Australia
| | - Rebecca Hyde
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
- School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086, Australia
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Robyn Matthews
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
| | - Della A. Forster
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
- The Royal Women's Hospital, Parkville, Victoria 3052, Australia
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Evaluating Research Partnerships through ISO 56003 Guidelines, RRI Concepts, and Ex Post Facto Cases. SUSTAINABILITY 2022. [DOI: 10.3390/su14074186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article aims to evaluate improvements in opportunities for research partnerships focused on innovation, considering the ISO 56003 guidelines, Responsible Research and Innovation (RRI) concepts, and the experiences of the authors of this article, who are researchers in various areas (ex post facto). The results presented arise from structured debates and discussions. As a result of the analysis and reflections carried out, some improvement opportunities in most of the partnerships established among research groups can be visualised. Partners in a research group often debate aspects related to technical knowledge associated with the research and contractual procedures in detail; however, they do not equally emphasise other important partnership management aspects, such as the analysis of the research impacts on all stakeholders, the definition and adoption of a governance policy to better conduct the interaction among members, and other actions that can enhance the partnerships. This article can be characterised as a synthesis of lessons learned, in addition to a presentation of guidelines mentioned in the literature. This knowledge can be useful to other researchers in planning new partnerships or evaluating existing ones. For deciding whether to enter into a partnership or withdraw from it, the information presented here is of great value.
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Thackrah RD, Bessarab D, Papertalk L, Bentink S, Thompson SC. Respect, Relationships, and "Just Spending Time with Them": Critical Elements for Engaging Aboriginal Students in Primary School Education. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:88. [PMID: 35010347 PMCID: PMC8751049 DOI: 10.3390/ijerph19010088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/13/2021] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
While disparities in educational outcomes for Aboriginal children have narrowed in early childhood education and for Year 12 completions, these positive trends are not replicated in the intervening years where attendance, reading, writing, and numeracy targets have been missed. Erratic attendance in the primary years has the greatest impact on achievement; literacy and numeracy scores decline as absences increase. Family functioning and health, caregiver expectations, past encounters with the education system and socio-economic disadvantage are all implicated in poorer rates of attendance. In response to community concerns, an Aboriginal/mainstream partnership was forged in 2011 and began work in 2016 to address patterns of attendance and achievement among Aboriginal primary students in a regional city in Western Australia. This paper describes the innovative, community-led "More Than Talk" program and presents findings from teaching and support staff interviews two years after implementation. Qualitative methods were employed to analyse the data, develop themes, and ensure rigour. Findings highlighted the cascading impact of erratic attendance and the role of strong relationships, respect, and investment of time with children as critical elements in student engagement and wellbeing. Community-led, collaborative educational programs have the potential to positively impact Aboriginal students' engagement and contribute to culturally responsive environments. If sustained, such efforts can enable learning to flourish.
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Affiliation(s)
- Rosalie D. Thackrah
- Western Australian Centre for Rural Health, University of Western Australia, Crawley 6009, Australia; (L.P.); (S.B.); (S.C.T.)
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, University of Western Australia, Crawley 6009, Australia;
| | - Lenny Papertalk
- Western Australian Centre for Rural Health, University of Western Australia, Crawley 6009, Australia; (L.P.); (S.B.); (S.C.T.)
| | - Samantha Bentink
- Western Australian Centre for Rural Health, University of Western Australia, Crawley 6009, Australia; (L.P.); (S.B.); (S.C.T.)
| | - Sandra C. Thompson
- Western Australian Centre for Rural Health, University of Western Australia, Crawley 6009, Australia; (L.P.); (S.B.); (S.C.T.)
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Massi L, Hickey S, Maidment SJ, Roe Y, Kildea S, Nelson C, Kruske S. Improving interagency service integration of the Australian Nurse Family Partnership Program for First Nations women and babies: a qualitative study. Int J Equity Health 2021; 20:212. [PMID: 34563171 PMCID: PMC8465693 DOI: 10.1186/s12939-021-01519-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background The Australian Nurse Family Partnership Program (ANFPP) is an evidence-based, home visiting program that offers health education, guidance, social and emotional support to first-time mothers having Aboriginal and/or Torres Strait Islander (First Nations) babies. The community-controlled sector identified the need for specialised support for first time mothers due to the inequalities in birthing and early childhood outcomes between First Nations’ and other babies in Australia. The program is based on the United States’ Nurse Family Partnership program which has improved long-term health outcomes and life trajectories for mothers and children. International implementation of the Nurse Family Partnership program has identified interagency service integration as key to program recruitment, retention, and efficacy. How the ANFPP integrates with other services in an Australian urban setting and how to improve this is not yet known. Our research explores the barriers and enablers to interagency service integration for the Australian Nurse Family Partnership Program ANFPP in an urban setting. Methods A qualitative study using individual and group interviews. Purposive and snowball sampling was used to recruit clients, staff (internal and external to the program), Elders and family members. Interviews were conducted using a culturally appropriate ‘yarning’ method with clients, families and Elders and semi-structured interview guide for staff. Interviews were audio-recorded and transcribed prior to reflexive thematic analysis. Results Seventy-six participants were interviewed: 26 clients, 47 staff and 3 Elders/family members. Three themes were identified as barriers and three as enablers. Barriers: 1) confusion around program scope, 2) duplication of care, and 3) tensions over ‘ownership’ of clients. Enablers (existing and potential): 1) knowledge and promotion of the program; 2) cultural safety; and 3) case coordination, co-location and partnership forums. Conclusion Effective service integration is essential to maximise access and acceptability of the ANFPP; we provide practical recommendations to improve service integration in this context.
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Affiliation(s)
- Luciana Massi
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia.
| | - Sarah-Jade Maidment
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Carmel Nelson
- Institute of Urban Indigenous Health, Brisbane, QLD, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
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Hickey S, Roe Y, Harvey C, Kruske S, Clifford-Motopi A, Fisher I, Bernardino B, Kildea S. Community-Based Sexual and Reproductive Health Promotion and Services for First Nations People in Urban Australia. Int J Womens Health 2021; 13:467-478. [PMID: 34040455 PMCID: PMC8140890 DOI: 10.2147/ijwh.s297479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/29/2021] [Indexed: 11/23/2022] Open
Abstract
Context Little is known about sexual and reproductive health (SRH) access and health promotion for First Nations peoples in Australia. This study aimed to better understand community preferences, knowledge and access to contraception and SRH services, and use this understanding to make recommendations which support approaches led by local Aboriginal community-controlled health organisations (ACCHOs). Methods Qualitative First Nations-led yarning circles were conducted with 55 community members and health service providers using and/or working at ACCHOs in urban South East Queensland. Cultural protocols ensured women’s and men’s interviews were separately collected and analysed. Thematic analysis was conducted by multiple coders, privileging interpretations by First Nations researchers. Results Family, kin and friends were described as key knowledge holders and ACCHOs as knowledge spaces for sharing information about maintaining positive SRH and wellbeing for First Nations people. Interviewees wanted accurate and timely information in an accessible, culturally appropriate way. Making informed choices about family planning was described as an important process of agency and self-determination for First Nations people, and contextualized within broader aspirations for growing strong families and healthy relationships. Conclusion Understanding SRH through the concept of “knowledge spaces” and “knowledge holders” highlights the collective importance of community relationality to support individual agency and informed SRH decision-making. ACCHOs appear to be acceptable knowledge spaces for SRH information; and evidence-based recommendations may increase their reach. Health services should consider upskilling community SRH knowledge holders to share consistent, accurate and accessible SRH information.
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Affiliation(s)
- Sophie Hickey
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia
| | - Caroline Harvey
- Institute for Urban Indigenous Health, Brisbane, Queensland, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia.,Institute for Urban Indigenous Health, Brisbane, Queensland, Australia
| | | | - Ike Fisher
- Institute for Urban Indigenous Health, Brisbane, Queensland, Australia
| | - Brenna Bernardino
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia.,Poche Centre for Indigenous Health, University of Queensland, Brisbane, Queensland, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia
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Kildea S, Gao Y, Hickey S, Nelson C, Kruske S, Carson A, Currie J, Reynolds M, Wilson K, Watego K, Costello J, Roe Y. Effect of a Birthing on Country service redesign on maternal and neonatal health outcomes for First Nations Australians: a prospective, non-randomised, interventional trial. LANCET GLOBAL HEALTH 2021; 9:e651-e659. [PMID: 33743199 DOI: 10.1016/s2214-109x(21)00061-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 12/16/2020] [Accepted: 02/02/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND There is an urgency to redress unacceptable maternal and infant health outcomes for First Nations families in Australia. A multi-agency partnership between two Aboriginal Community-controlled health services and a tertiary hospital in urban Australia designed, implemented, and evaluated the new Birthing in Our Community (BiOC) service. In this study, we aimed to assess and report the clinical effectiveness of the BiOC service on key maternal and infant health outcomes compared with that of standard care. METHODS Pregnant women attending the Mater Mothers Public Hospital (Brisbane, QLD, Australia) who were having a First Nations baby were invited to receive the BiOC service. In this prospective, non-randomised, interventional trial of the service, we specifically enrolled women who intended to birth at the study hospital, and had a referral from a family doctor or Aboriginal Medical Service. Participants were offered either standard care services or the BiOC service. Prespecified primary outcomes to test the effectiveness of the BiOC service versus standard care were the proportion of women attending five or more antenatal visits, smoking after 20 weeks of gestation, who had a preterm birth (<37 weeks), and who were exclusively breastfeeding at discharge from hospital. We used inverse probability of treatment weighting to balance confounders and calculate treatment effect. This trial is registered with the Australian New Zealand Clinical Trial Registry, ACTRN12618001365257. FINDINGS Between Jan 1, 2013, and June 30, 2019, 1867 First Nations babies were born at the Mater Mothers Public Hospital. After exclusions, 1422 women received either standard care (656 participants) or the BiOC service (766 participants) and were included in the analyses. Women receiving the BiOC service were more likely to attend five or more antenatal visits (adjusted odds ratio 1·54, 95% CI 1·13-2·09; p=0·0064), less likely to have an infant born preterm (0·62, 0·42-0·93; p=0·019), and more likely to exclusively breastfeed on discharge from hospital (1·34, 1·06-1·70; p=0·014). No difference was found between the two groups for smoking after 20 weeks of gestation, with both showing a reduction compared with smoking levels reported at their hospital booking visit. INTERPRETATION This study has shown the clinical effectiveness of the BiOC service, which was co-designed by stakeholders and underpinned by Birthing on Country principles. The widespread scale-up of this new service should be prioritised. Dedicated funding, knowledge translation, and implementation science are needed to ensure all First Nations families can access Birthing on Country services that are adapted for their specific contexts. FUNDING Australian National Health and Medical Research Council.
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Affiliation(s)
- Sue Kildea
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia; Mater Research Institute and School of Nursing and Midwifery, University of Queensland, Brisbane, QLD, Australia.
| | - Yu Gao
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia; Mater Research Institute and School of Nursing and Midwifery, University of Queensland, Brisbane, QLD, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia; Mater Research Institute and School of Nursing and Midwifery, University of Queensland, Brisbane, QLD, Australia
| | - Carmel Nelson
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD, Australia; Institute for Urban Indigenous Health, Windsor, QLD, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Adrian Carson
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD, Australia; Institute for Urban Indigenous Health, Windsor, QLD, Australia
| | - Jody Currie
- Aboriginal and Torres Strait Islander Community Health Service Brisbane, Woolloongabba, QLD, Australia
| | - Maree Reynolds
- Department of Mother's, Babies and Women's Health, Mater Hospital, Brisbane, QLD, Australia
| | - Kay Wilson
- Department of Mother's, Babies and Women's Health, Mater Hospital, Brisbane, QLD, Australia
| | - Kristie Watego
- Institute for Urban Indigenous Health, Windsor, QLD, Australia
| | - Jo Costello
- Department of Mother's, Babies and Women's Health, Mater Hospital, Brisbane, QLD, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia; Mater Research Institute and School of Nursing and Midwifery, University of Queensland, Brisbane, QLD, Australia
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