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Brimblecombe J, Ferguson M, McMahon E, Fredericks B, Turner N, Pollard C, Maple-Brown L, Batstone J, McCarthy L, Miles E, De Silva K, Barnes A, Chatfield M, Hill A, Christian M, van Burgel E, Fairweather M, Murison A, Lukose D, Gaikwad S, Lewis M, Clancy R, Santos C, Uhlmann K, Funston S, Baddeley L, Tsekouras S, Ananthapavan J, Sacks G, Lee A. Benchmarking for healthy food stores: protocol for a randomised controlled trial with remote Aboriginal and Torres Strait Islander communities in Australia to enhance adoption of health-enabling store policy and practice. BMC Public Health 2024; 24:1790. [PMID: 38970046 PMCID: PMC11229494 DOI: 10.1186/s12889-024-19277-0] [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: 08/30/2023] [Accepted: 06/25/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander communities in remote Australia have initiated bold policies for health-enabling stores. Benchmarking, a data-driven and facilitated 'audit and feedback' with action planning process, provides a potential strategy to strengthen and scale health-enabling best-practice adoption by remote community store directors/owners. We aim to co-design a benchmarking model with five partner organisations and test its effectiveness with Aboriginal and Torres Strait Islander community stores in remote Australia. METHODS Study design is a pragmatic randomised controlled trial with consenting eligible stores (located in very remote Northern Territory (NT) of Australia, primary grocery store for an Aboriginal community, and serviced by a Nutrition Practitioner with a study partner organisation). The Benchmarking model is informed by research evidence, purpose-built best-practice audit and feedback tools, and co-designed with partner organisation and community representatives. The intervention comprises two full benchmarking cycles (one per year, 2022/23 and 2023/24) of assessment, feedback, action planning and action implementation. Assessment of stores includes i adoption status of 21 evidence-and industry-informed health-enabling policies for remote stores, ii implementation of health-enabling best-practice using a purpose-built Store Scout App, iii price of a standardised healthy diet using the Aboriginal and Torres Strait Islander Healthy Diets ASAP protocol; and, iv healthiness of food purchasing using sales data indicators. Partner organisations feedback reports and co-design action plans with stores. Control stores receive assessments and continue with usual retail practice. All stores provide weekly electronic sales data to assess the primary outcome, change in free sugars (g) to energy (MJ) from all food and drinks purchased, baseline (July-December 2021) vs July-December 2023. DISCUSSION We hypothesise that the benchmarking intervention can improve the adoption of health-enabling store policy and practice and reduce sales of unhealthy foods and drinks in remote community stores of Australia. This innovative research with remote Aboriginal and Torres Strait Islander communities can inform effective implementation strategies for healthy food retail more broadly. TRIAL REGISTRATION ACTRN12622000596707, Protocol version 1.
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Affiliation(s)
- Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia.
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia.
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia.
| | - Megan Ferguson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Emma McMahon
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Bronwyn Fredericks
- Office of the Deputy Vice-Chancellor, The University of Queensland, Herston, QLD, 4006, Australia
| | - Nicole Turner
- Indigenous Allied Health Australia, Alia House, Napier Cl, 2600, Deakin, ACT, Australia
- Charles Perkins Centre, University of Sydney John Hopkins Dr, Camperdown, NSW, 2050, Australia
| | - Christina Pollard
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Louise Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Joanna Batstone
- Monash Data Futures Institute, Monash University, Melbourne, VIC, Australia
| | - Leisa McCarthy
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Eddie Miles
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
- Community First Development, 1/67 Townshend St, Phillip, ACT, 2606, Australia
| | - Khia De Silva
- Arnhem Land Progress Aboriginal Corporation, 70 O'Sullivan Cct, East Arm, NT, 0822, Australia
| | - Adam Barnes
- NT Health, Manunda Place, 38 Cavenagh Street, Darwin, NT, 0800, Australia
| | - Mark Chatfield
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
- Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital Campus, Darwin, NT, Australia
| | - Amanda Hill
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Meaghan Christian
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Emma van Burgel
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- Faculty of Health Sciences, Curtin School of Population Health, Curtin University, Perth, WA, Australia
| | - Molly Fairweather
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Anna Murison
- Outback Stores, 67 Pruen Rd, Berrimah, NT, 0828, Australia
| | - Dickson Lukose
- Monash Data Futures Institute, Monash University, Melbourne, VIC, Australia
| | - Surekha Gaikwad
- Monash Data Futures Institute, Monash University, Melbourne, VIC, Australia
| | - Meron Lewis
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
| | - Rebekah Clancy
- Miwatj Health Aboriginal Corporation, Lot 1425 Arnhem Road, Nhulunbuy, NT, Australia
| | - Claire Santos
- Population and Primary Health Care Outreach Team, NT Health, Casuarina Plaza, 258 Trower Road, Darwin, NT, 0810, Australia
| | - Kora Uhlmann
- Health and Wellbeing Queensland, 139 Coronation Drive, Milton, QLD, 4064, Australia
| | - Sarah Funston
- Arnhem Land Progress Aboriginal Corporation, 70 O'Sullivan Cct, East Arm, NT, 0822, Australia
| | - Laura Baddeley
- Arnhem Land Progress Aboriginal Corporation, 70 O'Sullivan Cct, East Arm, NT, 0822, Australia
| | - Sally Tsekouras
- Katherine West Health Board Aboriginal Corporation, 38 First St, Katherine, NT, 0850, Australia
| | - Jaithri Ananthapavan
- Deakin Health Economics, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, Australia
| | - Gary Sacks
- Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Institute for Health Transformation, Geelong, Australia
| | - Amanda Lee
- School of Public Health, The University of Queensland, Level 4 Public Health Building, Herston, Brisbane, QLD, 4072, Australia
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Chappell E, Chan E, Deen C, Brimblecombe J, Cadet-James Y, Hefler M, Stubbs E, Ferguson M. Using photovoice to generate solutions to improve food security among families living in remote Aboriginal and/or Torres Strait Islander communities in Australia. BMC Public Health 2024; 24:785. [PMID: 38481178 PMCID: PMC10935805 DOI: 10.1186/s12889-024-18200-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
The right to food security has been recognised internationally, and nationally in Australia by Aboriginal Community Controlled Health Organisations. This study aims to explore food (in)security and solutions for improvement of food security in remote Aboriginal and/or Torres Strait Islander communities in Australia, from the perspective of caregivers of children within the context of the family using photovoice. Participants took part in workshops discussing participant photographs of food (in)security, including solutions. Themes and sub-themes with associated solutions included traditional food use, sharing as a part of culture, the cost of healthy food, energy and transport, and housing and income. Community leaders used these data in setting priorities for advocacy to improve food security in their communities.
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Affiliation(s)
- Emma Chappell
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia.
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia.
| | - Ellie Chan
- Central Australian Aboriginal Congress, Alice Springs, NT, 0871, Australia
| | - Caroline Deen
- Apunipima Cape York Health Council, Bungalow, QLD, 4870, Australia
| | - Julie Brimblecombe
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
- Department of Nutrition, Dietetics and Food , Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Yvonne Cadet-James
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Apunipima Cape York Health Council, Bungalow, QLD, 4870, Australia
- Indigenous Education and Research Centre, James Cook University, Bungalow, QLD, 4870, Australia
| | - Marita Hefler
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
| | - Emma Stubbs
- Central Australian Aboriginal Congress, Alice Springs, NT, 0871, Australia
| | - Megan Ferguson
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
- Department of Nutrition, Dietetics and Food , Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
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van Burgel E, Fairweather M, Hill A, Christian M, Ferguson M, Lee A, Funston S, Fredericks B, McMahon E, Pollard C, Brimblecombe J. Development of a survey tool to assess the environmental determinants of health-enabling food retail practice in Aboriginal and Torres Strait Islander communities of remote Australia. BMC Public Health 2024; 24:442. [PMID: 38347471 PMCID: PMC10863203 DOI: 10.1186/s12889-024-17945-9] [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: 03/15/2023] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Environmental factors can impact the ability of food retail businesses to implement best practice health-enabling food retail. METHODS We co-designed a short-item survey on factors influencing food retail health-enabling practice in a remote Australian setting. Publicly available submissions to an Australian Parliamentary Inquiry into food pricing and food security in remote Indigenous communities were coded using an existing remote community food systems assessment tool and thematically analysed. Themes informed survey questions that were then prioritised, refined and pre-tested with expert stakeholder input. RESULTS One-hundred and eleven submissions were coded, and 100 themes identified. Supply chain related data produced the most themes (n = 25). The resulting 26-item survey comprised questions to assess the perceived impact of environmental factors on a store's health-enabling practice (n = 20) and frequency of occurrence (n = 6). CONCLUSIONS The application of this evidence-informed, co-designed survey will provide a first-time cross-sectional analysis and the potential for ongoing longitudinal data and advocacy on how environmental factors affect the operations of remote stores.
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Affiliation(s)
- Emma van Burgel
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia.
| | - Molly Fairweather
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Amanda Hill
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Meaghan Christian
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Megan Ferguson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Amanda Lee
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Sarah Funston
- Arnhem Land Progress Aboriginal Corporation, Darwin, NT, Australia
| | - Bronwyn Fredericks
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Emma McMahon
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Christina Pollard
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
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4
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Abdul M, Ingabire A, Lam CYN, Bennett B, Menzel K, MacKenzie-Shalders K, van Herwerden L. Indigenous food sovereignty assessment-A systematic literature review. Nutr Diet 2024; 81:12-27. [PMID: 37154011 DOI: 10.1111/1747-0080.12813] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/20/2023] [Accepted: 03/23/2023] [Indexed: 05/10/2023]
Abstract
AIMS The aims of this systematic review were to (1) identify assessment approaches of Indigenous food sovereignty using the core domains of community ownership, inclusion of traditional food knowledge, inclusion/promotion of cultural foods and environmental/intervention sustainability, (2) describe Indigenous research methodologies when assessing Indigenous food sovereignty. METHODS Guided by Indigenous members of the research team, a systematic review across four databases (Medline, Embase, CINAHL and PsycINFO) was performed. Studies in any language from 1996 to 2021, that used one or more of the core domains (identified from a recent scoping review) of community ownership, inclusion of traditional food knowledge, inclusion/promotion of cultural foods and environmental/intervention sustainability were included. RESULTS From 20 062 records, after exclusion criteria were applied, 34 studies were included. Indigenous food sovereignty assessment approaches were mostly qualitative (n = 17) or mixed methods (n = 16), with interviews the most utilised (n = 29), followed by focus groups and meetings (n = 23) and validated frameworks (n = 7) as assessment tools. Indigenous food sovereignty assessment approaches were mostly around inclusion of traditional food knowledge (n = 21), or environmental/intervention sustainability (n = 15). Community-Based Participatory Research approaches were utilised across many studies (n = 26), with one-third utilising Indigenous methods of inquiry. Acknowledgement of data sovereignty (n = 6) or collaboration with Indigenous researchers (n = 4) was limited. CONCLUSION This review highlights Indigenous food sovereignty assessment approaches in the literature worldwide. It emphasises the importance of using Indigenous research methodologies in research conducted by or with Indigenous Peoples and acknowledges Indigenous communities should lead future research in this area.
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Affiliation(s)
- Malika Abdul
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Ale Ingabire
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Chin Yu Nicole Lam
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Bindi Bennett
- National Centre for Reconciliation, Truth and Justice, Federation University, Brisbane, Australia
| | - Kelly Menzel
- Gnibi College of Indigenous Australian Peoples, Southern Cross University, Gold Coast, Australia
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Pamungkas DR, O'Sullivan B, McGrail M, Chater B. Tools, frameworks and resources to guide global action on strengthening rural health systems: a mapping review. Health Res Policy Syst 2023; 21:129. [PMID: 38049824 PMCID: PMC10694960 DOI: 10.1186/s12961-023-01078-3] [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: 01/11/2023] [Accepted: 11/22/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Inequities of health outcomes persist in rural populations globally. This is strongly associated with there being less health coverage in rural and underserviced areas. Increasing health care coverage in rural area requires rural health system strengthening, which subsequently necessitates having tools to guide action. OBJECTIVE This mapping review aimed to describe the range of tools, frameworks and resources (hereafter called tools) available globally for rural health system capacity building. METHODS This study collected peer-reviewed materials published in 15-year period (2005-2020). A systematic mapping review process identified 149 articles for inclusion, related to 144 tools that had been developed, implemented, and/or evaluated (some tools reported over multiple articles) which were mapped against the World Health Organization's (WHO's) six health system building blocks (agreed as the elements that need to be addressed to strengthen health systems). RESULTS The majority of tools were from high- and middle-income countries (n = 85, 59% and n = 43, 29%, respectively), and only 17 tools (12%) from low-income countries. Most tools related to the health service building block (n = 57, 39%), or workforce (n = 33, 23%). There were a few tools related to information and leadership and governance (n = 8, 5% each). Very few tools related to infrastructure (n = 3, 2%) and financing (n = 4, 3%). This mapping review also provided broad quality appraisal, showing that the majority of the tools had been evaluated or validated, or both (n = 106, 74%). CONCLUSION This mapping review provides evidence that there is a breadth of tools available for health system strengthening globally along with some gaps where no tools were identified for specific health system building blocks. Furthermore, most tools were developed and applied in HIC/MIC and it is important to consider factors that influence their utility in LMIC settings. It may be important to develop new tools related to infrastructure and financing. Tools that have been positively evaluated should be made available to all rural communities, to ensure comprehensive global action on rural health system strengthening.
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Affiliation(s)
- Dewi Retno Pamungkas
- Mayne Academy of Rural and Remote Medicine, Rural and Remote Medicine Clinical Unit, Medical School, Faculty of Medicine, The University of Queensland, Theodore, QLD, Australia.
| | - Belinda O'Sullivan
- Toowoomba Regional Clinical Unit, Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, QLD, Australia.
- Murray Primary Health Network, Bendigo, VIC, Australia.
| | - Matthew McGrail
- Rockhampton Regional Clinical Unit, Rural Clinical School, Faculty of Medicine, The University of Queensland, Rockhampton, QLD, Australia
| | - Bruce Chater
- Mayne Academy of Rural and Remote Medicine, Rural and Remote Medicine Clinical Unit, Medical School, Faculty of Medicine, The University of Queensland, Theodore, QLD, Australia
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Whelan J, Fraser P, Bolton KA, Love P, Strugnell C, Boelsen-Robinson T, Blake MR, Martin E, Allender S, Bell C. Combining systems thinking approaches and implementation science constructs within community-based prevention: a systematic review. Health Res Policy Syst 2023; 21:85. [PMID: 37641151 PMCID: PMC10463953 DOI: 10.1186/s12961-023-01023-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 06/22/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Systems science offers methods for designing population health interventions while implementation science provides specific guidance for successful implementation. Integrating systems and implementation science may strengthen implementation and enhance and sustain systemic change to achieve system-level outcomes. Little is known about the extent to which these two approaches have been integrated to date. This review aimed to identify and synthesise the peer-reviewed literature that has reported the combined use of systems thinking approaches and implementation science constructs (within the same study), to deliver population health interventions. METHODS A systematic literature search of peer-reviewed original research was conducted across six databases from 2009 to 2021. Journal manuscripts were included if they: (1) reported on a population health study conducted in a community, (2) reported the use of a systems method in the design of the intervention, and (3) used an implementation science theory, framework or model in the delivery of the intervention. Data extracted related to the specific systems methods and definitions and implementation science constructs used. The Mixed Methods Appraisal Tool (MMAT) was used to assess study quality. RESULTS Of the 9086 manuscripts returned, 320 manuscripts were included for full-text review. Of these, 17 manuscripts that reported on 14 studies were included in the final extraction. The most frequently reported systems methods were a 'whole of community systems approach' (n = 4/14) and 'community-based system dynamics' (n = 2/14). Nineteen different implementation science theories, frameworks and models were used for intervention delivery, with RE-AIM being the only framework used in more than one study. CONCLUSION There are few published peer-reviewed studies using systems thinking and implementation science for designing and delivering population health interventions. An exploration of synergies is worthwhile to operationalise alignment and improve implementation of systems thinking approaches. Review protocol registration PROSPERO CRD42021250419.
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Affiliation(s)
- Jillian Whelan
- School of Medicine, Deakin University, Geelong, Australia.
- Institute for Health Transformation, Geelong, Australia.
- Global Centre for Preventive Health and Nutrition, Geelong, Australia.
| | - Penny Fraser
- School of Health and Social Development, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
| | - Kristy A Bolton
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Institute for Physical Activity and Nutrition, Geelong, Australia
| | - Penelope Love
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Institute for Physical Activity and Nutrition, Geelong, Australia
| | - Claudia Strugnell
- School of Health and Social Development, Deakin University, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
- Institute for Physical Activity and Nutrition, Geelong, Australia
| | - Tara Boelsen-Robinson
- School of Health and Social Development, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
| | - Miranda R Blake
- School of Health and Social Development, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
| | - Erik Martin
- School of Medicine, Deakin University, Geelong, Australia
| | - Steven Allender
- School of Health and Social Development, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
| | - Colin Bell
- School of Medicine, Deakin University, Geelong, Australia
- Institute for Health Transformation, Geelong, Australia
- Global Centre for Preventive Health and Nutrition, Geelong, Australia
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van Burgel E, Holden S, Ferguson M, Cullerton K, McCartan J, Turner N, Cubillo B, Day G, Brimblecombe J. Food security in Aboriginal and Torres Strait Islander communities in remote Australia during the COVID-19 pandemic: An analysis of print news media and press releases. Aust N Z J Public Health 2023; 47:100058. [PMID: 37201415 DOI: 10.1016/j.anzjph.2023.100058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/27/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE This article aims to examine the framing of the issue of food security in very remote Aboriginal and Torres Strait Islander communities in print media and press releases during the beginning of the COVID-19 pandemic in 2020. METHODS Newspaper articles were identified following a systematic search of the Factiva database, and press releases were identified from manual search of key stakeholder websites from January to June 2020 and analysed using a combined adapted framework of the Bacchi's What's the Problem Represented to be? Framework and the Narrative Policy Framework. RESULTS A food delivery "problem" dominated representations in press releases, and food supply at store level had prominence in print media. Both presented the cause of food insecurity as a singular, identifiable point in time, framed the issue as one of helplessness and lack of control, and proposed policy action. CONCLUSIONS The issue of food security was represented in the media as a simple issue requiring an immediate fix, as opposed to a complex issue requiring a systems-level and sustained policy response. IMPLICATIONS FOR PUBLIC HEALTH This study will help to guide future media dialogue to impact on both immediate and longer-term solutions to food insecurity in very remote Aboriginal and Torres Strait Islander communities in Australia.
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Affiliation(s)
- Emma van Burgel
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Stacey Holden
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Megan Ferguson
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Katherine Cullerton
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Julia McCartan
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Nicole Turner
- Indigenous Allied Health Australia, Deakin, ACT, Australia; NSW Rural Doctors Network, Sydney, NSW, Australia.
| | - Beau Cubillo
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Georgia Day
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia.
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia; Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia.
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Zou T, Dawodu A, Mangi E, Cheshmehzangi A. General limitations of the current approach in developing sustainable food system frameworks. GLOBAL FOOD SECURITY 2022. [DOI: 10.1016/j.gfs.2022.100624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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McKay FH, Godrich SL. Interventions to address food insecurity among Aboriginal and Torres Strait Islander people: a rapid review. Appl Physiol Nutr Metab 2021; 46:1448-1458. [PMID: 34637657 DOI: 10.1139/apnm-2020-1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Food insecurity disproportionately impacts Aboriginal and Torres Strait Islander Australians. This review sought to investigate research and evaluations of programs and interventions implemented to address food insecurity among Aboriginal and Torres Strait Islander communities. A rapid review was conducted to collate the available research from 6 databases. The search was conducted in May 2020. Search constructs related to food insecurity, Aboriginal and Torres Strait Islander people, and Australia. Twenty-five publications were included in this review, 24 reported on an intervention, while 9 were evaluations of an intervention. Interventions included behaviour change projects, including projects that sought to change purchasing and cooking behaviours, school-based education programs, and gardening programs. In general, the studies included in this sample were small and lacked a systematic consideration of the factors that shape the experience of food insecurity among Aboriginal and Torres Strait Islander people specifically. Based on the findings of this review, authors suggest greater consideration to the systematic determinants of food insecurity among Aboriginal and Torres Strait Islander communities to have lasting and sustainable impact on food insecurity. This review has been registered with the international prospective register of systematic reviews (PROSPERO: CRD42020183709). Novelty: Food insecurity among Aboriginal and Torres Strait Islander people poses significant risk to health and wellbeing. Small-scale food security interventions may not provide ongoing and sustained impact. Any intervention to promote food security will need to involve Aboriginal and Torres Strait Islander people and be sustained once external parties have left.
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Affiliation(s)
- Fiona H McKay
- School of Health and Social Development, Faculty of Health, Deakin University, Melbourne Burwood Campus, Burwood, VIC 3125, Australia
| | - Stephanie L Godrich
- School of Medical and Health Sciences, Edith Cowan University, South West Campus, Bunbury, WA 6230, Australia
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Wood AJ, Graham S, Boyle JA, Marcusson-Rababi B, Anderson S, Connors C, McIntyre HD, Maple-Brown L, Kirkham R. Incorporating Aboriginal women's voices in improving care and reducing risk for women with diabetes in pregnancy - A phenomenological study. BMC Pregnancy Childbirth 2021; 21:624. [PMID: 34530749 PMCID: PMC8445012 DOI: 10.1186/s12884-021-04055-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 08/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a high burden of gestational diabetes (GDM) and type 2 diabetes in pregnancy for Aboriginal and Torres Strait Islander women. Postpartum diabetes programs have the potential to prevent recurrent GDM and improve management of type 2 diabetes. However, data on such programs are limited, particularly in the Indigenous context. We aimed to explore Aboriginal Australian women's and health providers' preferences for a program to prevent and improve diabetes after pregnancy. METHODS A phenomenological methodology underpinned semi-structured in-depth interviews with eleven Aboriginal women and seven health professionals across the Northern Territory from October 2019- February 2020. Interviews were analysed using an inductive analysis framework to address the barriers and enablers of proposed diabetes prevention programs identified by participants. RESULTS Identified structural barriers to lifestyle change included: food insecurity, persuasive marketing of unhealthy food options, lack of facilities and cultural inappropriateness of previous programs. Enablers to lifestyle change included: a strong link between a healthy lifestyle and connection with Country, family and community. Suggested strategies to improve lifestyle included: co-designed cooking classes or a community kitchen, team sports and structural change (targeting the social determinants of health). Lifestyle change was preferred over metformin to prevent and manage diabetes after pregnancy by participants and health care providers. CONCLUSIONS We recommend individual level programs be designed alongside policies that address systemic inequalities. A postpartum lifestyle program should be co-designed with community members and grounded in Aboriginal conceptions of health to adequality address the health disparities experienced by Aboriginal people in remote communities.
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Affiliation(s)
- Anna J Wood
- Menzies School of Health Research, Charles Darwin University, NT, Darwin, Australia. .,Department of Endocrinology, Royal Darwin Hospital, NT, 0810, Darwin, Australia.
| | - Sian Graham
- Menzies School of Health Research, Charles Darwin University, NT, Darwin, Australia.,Aboriginal and Torres Strait Islander Advisory Group, Menzies School of Health Research, Charles Darwin University, NT, Darwin, Australia
| | - Jacqueline A Boyle
- Menzies School of Health Research, Charles Darwin University, NT, Darwin, Australia.,Monash Centre for Health Research and Implementation, Monash University, Vic, Melbourne, Australia
| | | | - Shonada Anderson
- Menzies School of Health Research, Charles Darwin University, NT, Darwin, Australia
| | - Christine Connors
- Top End Health Service, Northern Territory Department of Health, NT, Darwin, Australia
| | - Harold D McIntyre
- Mater Research, The University of Queensland, QLD, South Brisbane, Australia
| | - Louise Maple-Brown
- Menzies School of Health Research, Charles Darwin University, NT, Darwin, Australia.,Department of Endocrinology, Royal Darwin Hospital, NT, 0810, Darwin, Australia
| | - Renae Kirkham
- Menzies School of Health Research, Charles Darwin University, NT, Darwin, Australia
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11
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Robidoux MA, Winnepetonga D, Santosa S, Haman F. Assessing the Contribution of Traditional Foods to Food Security for the Wapekeka First Nation of Canada. Appl Physiol Nutr Metab 2021; 46:1170-1178. [PMID: 34310881 DOI: 10.1139/apnm-2020-0951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The food security crisis and disproportionately high burden of dietary related disease amongst northern Indigenous populations in Canada continues to be a troubling reality with little sign of improvement. The Government of Canada is responding by developing programs to support local food initiatives for northern isolated communities. While such investments appear commendable, the impact of local food harvesting to improve food security has yet to be determined. While there are clear nutritional and cultural benefits to traditional food sources, communities face considerable barriers acquiring it in sufficient amounts because of historically imposed lifestyle changes that have increased food insecurity rates. This study responds by providing a novel multidisciplinary approach that draws from firsthand experiences working with First Nations community members in a remote subarctic region in northwestern, Ontario to estimate their community's total food requirement and the amount of wild animal food sources needed to sustain yearly food intake. This transferrable energy demand approach will be critical for policy makers to put into perspective the amount of wild food needed to have an impact on food security rates and ultimately improve dietary related diseases. Novelty: • It will provide government policy makers information about current harvest yields in a remote northern First Nation to understand the potential contribution of traditional food to improve local food security • Provides Indigenous communities a means to assess local food resources to measure the caloric contributions of traditional foods toward household food security.
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Affiliation(s)
- Michael A Robidoux
- University of Ottawa Faculty of Health Sciences, 70363, Human Kinetics, 125 University St., School of Human Kinetics, Ottawa, Ottawa, Ontario, Canada, K1N6N5;
| | | | - Sylvia Santosa
- Concordia University, 5618, Health Sciences, Montreal, Quebec, Canada, H3G 1M8;
| | - François Haman
- University of Ottawa, Faculty of Health Sciences, Ottawa, United States, K1N 6N5;
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12
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Browne J, Walker T, Brown A, Sherriff S, Christidis R, Egan M, Versace V, Allender S, Backholer K. Systems thinking for Aboriginal Health: Understanding the value and acceptability of group model building approaches. SSM Popul Health 2021; 15:100874. [PMID: 34355056 PMCID: PMC8325093 DOI: 10.1016/j.ssmph.2021.100874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/08/2021] [Accepted: 07/13/2021] [Indexed: 12/25/2022] Open
Abstract
Systems thinking is increasingly applied to understand and address systemic drivers of complex health problems. In Australia, group model building, a participatory method from systems science, has been applied in various locations to engage communities in systems-based health promotion projects. To date there is limited evidence regarding GMB use with Australian Aboriginal communities. This study aimed to determine the value and acceptability of group model building (GMB) as a methodological approach in research with Aboriginal communities and identify any adaptations required to optimise its utility. Semi-structured interviews were undertaken with 18 Aboriginal health and university staff who had prior experience with a GMB research project. Interview transcripts were inductively analysed using thematic analysis and key themes were organised using an Indigenous research framework. Participants reported that GMB methods generally aligned well with Aboriginal ways of knowing, being, and doing. Participants valued the holistic, visual and collaborative nature of the method and its emphasis on sharing stories and collective decision-making. Group model building was viewed as a useful tool for identifying Aboriginal-led actions to address priority issues and advancing self-determination. Our findings suggest that by bringing together Aboriginal and non-Aboriginal knowledge, GMB is a promising tool, which Aboriginal communities could utilise to explore and address complex problems in a manner that is consistent with their worldviews. In adapting group model building methods, non-Aboriginal researchers should aspire to move beyond co-design processes and enable Aboriginal health research to be entirely led by Aboriginal people. Group model building is a promising method for research with Aboriginal communities that is generally consistent with Aboriginal worldviews. Group Model Building may be a useful tool for identifying actions to address priority issues and advancing Aboriginal self-determination. Capacity building is required so that Group Model Building workshops, and ideally entire research projects, can be led by Aboriginal people.
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Affiliation(s)
- Jennifer Browne
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag, 20000, Geelong Victoria, Australia
| | - Troy Walker
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag, 20000, Geelong Victoria, Australia
| | - Andrew Brown
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag, 20000, Geelong Victoria, Australia
| | - Simone Sherriff
- Sax Institute, Level 3/30C Wentworth St, Glebe, NSW, Australia
| | - Rebecca Christidis
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag, 20000, Geelong Victoria, Australia
| | - Mikaela Egan
- Victorian Aboriginal Community Controlled Health Organisation, 17-23, Sackville St Collingwood, Victoria, Australia
| | - Vincent Versace
- Deakin Rural Health, School of Medicine, Deakin University, PO Box 423, Warrnambool Victoria, Australia
| | - Steven Allender
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag, 20000, Geelong Victoria, Australia
| | - Kathryn Backholer
- Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Locked Bag, 20000, Geelong Victoria, Australia
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13
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Jaenke R, van den Boogaard C, McMahon E, Brimblecombe J. Development and pilot of a tool to measure the healthiness of the in-store food environment. Public Health Nutr 2021; 24:243-252. [PMID: 32787988 PMCID: PMC7808860 DOI: 10.1017/s1368980020002025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 04/23/2020] [Accepted: 06/01/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To rigorously develop a tool which enables rapid yet comprehensive appraisal of the consumer food retail environment and provision of real-time feedback to store managers and owners, based on the '4Ps' principles of marketing. DESIGN Multi-stage iterative approach including (1) Systematic literature review; (2) Stakeholder consultation; (3) Assessment of existing tools against identified needs; (4) Tool development; (5) Pilot testing and (6) Transition of tool to mobile application (the Store Scout app). SETTING Northern Territory, Australia. PARTICIPANTS Nine remote Aboriginal community food stores; public health nutritionists, retailers, store board directors, Aboriginal community members, government representatives. RESULTS Forty-seven existing tools and thirty-four stakeholder interviews informed the development of the current instrument, which comprised: (1) seven product categories (Fruit & Vegetables, Drinks, Snack Foods, Meals & Convenience Foods, Meat & Seafood, Dairy & Eggs, Breads & Cereals) across the '4Ps' (Product, Placement, Price, Promotion); (2) Store manager questions about context and perceived importance of key principles about the store environment and (3) a scoring and feedback component. The tool was considered feasible and acceptable by all testers. CONCLUSIONS The developed tool addresses an unmet need to measure the consumer food retail environment across all 4Ps whilst also incorporating manager perspectives and immediate feedback. Our objectives of developing a comprehensive, feasible and acceptable instrument were achieved during pilot testing. The tool will support implementation of best practice within stores to encourage healthy food choices and has potential for broad application in retail settings locally and internationally, as well as for research purposes.
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Affiliation(s)
- Rachael Jaenke
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Christel van den Boogaard
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Emma McMahon
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Julie Brimblecombe
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
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Kenny TA, Little M, Lemieux T, Griffin PJ, Wesche SD, Ota Y, Batal M, Chan HM, Lemire M. The Retail Food Sector and Indigenous Peoples in High-Income Countries: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238818. [PMID: 33261090 PMCID: PMC7730644 DOI: 10.3390/ijerph17238818] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Indigenous Peoples in high-income countries experience higher burdens of food insecurity, obesity, and diet-related health conditions compared to national averages. The objective of this systematic scoping review is to synthesize information from the published literature on the methods/approaches, findings, and scope for research and interventions on the retail food sector servicing Indigenous Peoples in high-income countries. A structured literature search in two major international databases yielded 139 relevant peer-reviewed articles from nine countries. Most research was conducted in Oceania and North America, and in rural and remote regions. Several convergent issues were identified across global regions including limited grocery store availability/access, heightened exposure to unhealthy food environments, inadequate market food supplies (i.e., high prices, limited availability, and poor quality), and common underlying structural factors including socio-economic inequality and colonialism. A list of actions that can modify the nature and structure of retailing systems to enhance the availability, accessibility, and quality of healthful foods is identified. While continuing to (re)align research with community priorities, international collaboration may foster enhanced opportunities to strengthen the evidence base for policy and practice and contribute to the amelioration of diet quality and health at the population level.
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Affiliation(s)
- Tiff-Annie Kenny
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Correspondence: or
| | - Matthew Little
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Tad Lemieux
- Department of English Language and Literature, Carleton University, Ottawa, ON K1S 5B6, Canada;
| | - P. Joshua Griffin
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Department of American Indian Studies, University of Washington, Seattle, WA 98195, USA
| | - Sonia D. Wesche
- Department of Geography, Environment and Geomatics, Faculty of Arts, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Yoshitaka Ota
- School of Marine and Environmental Affairs, University of Washington, Seattle, WA 98105, USA; (P.J.G.); (Y.O.)
- Nippon Foundation Ocean Nexus Center, EarthLab, University of Washington; Seattle, WA 98195, USA
| | - Malek Batal
- Département de nutrition, Faculté de médecine, Université de Montréal, Montreal, QC H3T 1J4, Canada;
- Centre de recherche en santé publique (CReSP), Montreal, Quebec, QC H3N 1X9, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Ottawa, ON K1N 9A7, Canada;
| | - Melanie Lemire
- Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Quebec, QC G1V 0A6, Canada;
- Centre de recherche du CHU de Québec, Université Laval, Axe santé des populations et pratiques optimales en santé, Quebec, QC G1E 6W2, Canada
- Institut de biologie intégrative et des systèmes (IBIS), Université Laval, Quebec, QC G1V 0A6, Canada
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15
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McCalman J, Bainbridge R, James YC, Bailie R, Tsey K, Matthews V, Ungar M, Askew D, Fagan R, Visser H, Spurling G, Percival N, Blignault I, Doran C. Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children: protocol for a community-driven continuous quality improvement approach. BMC Public Health 2020; 20:1810. [PMID: 33246445 PMCID: PMC7694265 DOI: 10.1186/s12889-020-09885-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Systems integration to promote the mental health of Aboriginal and Torres Strait Islander children works towards developing a spectrum of effective, community-based services and supports. These services and supports are organised into a coordinated network, build meaningful partnerships with families and address their cultural and linguistic needs, to help children to function better at home, in school, in the community, and throughout life. This study is conducted in partnership with primary healthcare (PHC) and other services in three diverse Indigenous Australian communities. It entails conceptualising, co-designing, implementing, and evaluating the effectiveness of systems integration to promote the mental health and wellbeing of Indigenous school-aged children (4-17 years). This paper outlines a protocol for implementing such complex community-driven research. METHODS/DESIGN Using continuous quality improvement processes, community co-designed strategies for improved systems integration will be informed by narratives from yarning circles with Indigenous children and service providers, and quantitative data from surveys of service providers and audits of PHC client records and intersectoral systems. Agreed strategies to improve the integration of community-based services and supports will be modelled using microsimulation software, with a preferred model implemented in each community. The evaluation will investigate changes in the: 1) availability of services that are community-driven, youth-informed and culturally competent; 2) extent of collaborative service networks; 3) identification by PHC services of children's social and emotional wellbeing concerns; and 4) ratio of children receiving services to identified need. Costs and benefits of improvements to systems integration will also be calculated. DISCUSSION The study will provide evidence-informed, community-driven, and tested models that can be used for implementing systems integration to promote the mental health and wellbeing of Indigenous children. It will identify the situational enablers and barriers that impact systems integration and determine the extent to which systems integration improves service availability, systems and child outcomes. Evidence for the cost effectiveness of systems-level integration will contribute to national mental health policy reform.
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Affiliation(s)
- Janya McCalman
- Centre for Indigenous Health Equity Research, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia.
- School of Health, Medical and Applied Sciences, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia.
| | - Roxanne Bainbridge
- School of Health, Medical and Applied Sciences, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia
| | - Yvonne Cadet James
- Apunipima Cape York Health Council, 186 McCoombe St, Cairns, QLD, 4870, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, 61 Uralba St, Lismore, NSW, 2480, Australia
| | - Komla Tsey
- The Cairns Institute, James Cook University, McGregor Rd, Cairns, QLD, 4878, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, 61 Uralba St, Lismore, NSW, 2480, Australia
| | - Michael Ungar
- Resilience Research Centre, Dalhousie University, 6420 Coburg Rd, Halifax, NS, B3H 4R2, Canada
| | - Deborah Askew
- Primary Care Clinical Unit, The University of Queensland, Brisbane, Qld, 4072, Australia
- Southern Queensland Health Centre of Excellence in Aboriginal and Torres Strait Islander Primary Healthcare, Building 2/37 Wirraway Parade, Inala, QLD, 4077, Australia
| | - Ruth Fagan
- Gurriny Yealamucka Health Service, Bukki Rd, Yarrabah, QLD, 4871, Australia
| | - Hannah Visser
- Bulgarr Ngaru Medical Aboriginal Corporation, 153 Canterbury St, Casino, NSW, 2470, Australia
| | - Geoffrey Spurling
- Primary Care Clinical Unit, The University of Queensland, Brisbane, Qld, 4072, Australia
- Southern Queensland Health Centre of Excellence in Aboriginal and Torres Strait Islander Primary Healthcare, Building 2/37 Wirraway Parade, Inala, QLD, 4077, Australia
| | - Nikki Percival
- Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, 235 Jones St, Ultimo, NSW, 2007, Australia
| | - Ilse Blignault
- Translational Health Research Institute, University of Western Sydney, School of Medicine, Campbelltown Campus, NSW, 2560, Australia
| | - Chris Doran
- Centre for Indigenous Health Equity Research, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia
- School of Health, Medical and Applied Sciences, Central Queensland University, cnr Abbott and Shield St, Cairns, QLD, 4870, Australia
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16
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Maitjara Wangkanyi: Insights from an Ethnographic Study of Food Practices of Households in Remote Australian Aboriginal Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218109. [PMID: 33153133 PMCID: PMC7663776 DOI: 10.3390/ijerph17218109] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/30/2020] [Accepted: 10/30/2020] [Indexed: 02/07/2023]
Abstract
Many historical, environmental, socioeconomic, political, commercial, and geographic factors underscore the food insecurity and poor diet-related health experienced by Aboriginal people in Australia. Yet, there has been little exploration of Aboriginal food practices or perspectives on food choice recently. This study, with 13 households in remote communities on the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands, fills this gap using ethnographic and Indigenist methods. Results highlight Anangu resourcefulness, securing food despite poverty and adversity, and provide unique insights into factors influencing the three major types and range of dietary patterns identified. These factors include household economic cycles and budgeting challenges; overcrowding and family structures, mobility and ‘organization’; available food storage, preparation and cooking infrastructure; and familiarity and convenience. Structural and systemic reform, respecting Aboriginal leadership, is required to improve food security.
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17
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Yii V, Palermo C, Kleve S. Population-based interventions addressing food insecurity in Australia: A systematic scoping review. Nutr Diet 2019; 77:6-18. [PMID: 31593624 DOI: 10.1111/1747-0080.12580] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/09/2019] [Accepted: 07/19/2019] [Indexed: 01/07/2023]
Abstract
AIM Food insecurity (FI) is a critical public health issue in Australia. Population-based interventions aiming to address the socio-ecological determinants of FI are critical for relieving and preventing it. This review aimed to map and summarise the characteristics of population-based interventions addressing household and/or community FI in Australia. METHODS A systematic scoping review was undertaken. Five databases, selected for range and relevance to FI in Australia ("CINAHL plus", "Ovid MEDLINE", "Sociological Abstracts", "Australian Public Affairs Information Service", and "Rural and Remote Health") were searched in May 2018 using the terms and relevant synonyms "FI" and "interventions". In addition a systematic grey literature search using multiple Google searches was undertaken. Data synthesis included categorisation and counting intervention type. Interventions were defined and charted by influence of at least one dimension of food security and impact on the socioeconomic, cultural and environmental conditions. RESULTS A total of 3565 published and grey literature records were identified, with the final 60 records describing 98 interventions. Few national interventions were identified, with approaches predominantly in Victoria, Northern Territory and Tasmania. Determinants related to living and working environments, food availability and food utilisation were most frequently addressed. Interventions addressing the key determinant of FI economic access were limited. A number of interventions did not appear to be associated with rigorous evaluation. CONCLUSIONS While there is evidence of population responses to FI in Australia, the effectiveness of these remains limited. Importantly there is a lack of coordinated and coherent national responses that address the range of FI determinants.
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Affiliation(s)
- Vivien Yii
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
| | - Sue Kleve
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Notting Hill, Victoria, Australia
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18
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Laycock A, Bailie J, Matthews V, Bailie R. Using developmental evaluation to support knowledge translation: reflections from a large-scale quality improvement project in Indigenous primary healthcare. Health Res Policy Syst 2019; 17:70. [PMID: 31324251 PMCID: PMC6642555 DOI: 10.1186/s12961-019-0474-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 07/02/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Developmental evaluation is a growing area of evaluation practice, advocated for informing the adaptive development of change initiatives in complex social environments. The utilisation focus, complexity perspective and systems thinking of developmental evaluation suggest suitability for evaluating knowledge translation initiatives in primary healthcare. However, there are few examples in the literature to guide its use in these contexts and in Indigenous settings. In this paper, we reflect on our experience of using developmental evaluation to implement a large-scale knowledge translation research project in Australian Aboriginal and Torres Strait Islander primary healthcare. Drawing on principles of knowledge translation and key features of developmental evaluation, we debate the key benefits and challenges of applying this approach to engage diverse stakeholders in using aggregated quality improvement data to identify and address persistent gaps in care delivery. DISCUSSION The developmental evaluation enabled the team to respond to stakeholder feedback and apply learning in real-time to successfully refine theory-informed research and engagement processes, tailor the presentation of findings to stakeholders and context, and support the project's dissemination and knowledge co-production aim. It thereby contributed to the production of robust, useable research findings for informing policy and system change. The use of developmental evaluation appeared to positively influence stakeholders' use of the project reports and their responses to the findings. Challenges included managing a high volume of evaluation data and multiple evaluation purposes, balancing facilitative sense-making processes and change with task-focused project management, and lack of experience in using this evaluation approach. Use of an embedded evaluator with facilitation skills and background knowledge of the project helped to overcome these challenges, as did similarities observed between features of developmental evaluation and continuous quality improvement. CONCLUSION Our experience of developmental evaluation confirmed our expectations of the potential value of this approach for strengthening improvement interventions and implementation research, and particularly for adapting healthcare innovations in Indigenous settings. In our project, developmental evaluation successfully encompassed evaluation, project adaptation, capacity development and knowledge translation. Further work is warranted to apply this approach more widely to improve primary healthcare initiatives and outcomes, and to evaluate implementation research.
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Affiliation(s)
- Alison Laycock
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, 0811, Australia. .,The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia.
| | - Jodie Bailie
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - Veronica Matthews
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - Ross Bailie
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia
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19
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McCalman J, Bailie R, Bainbridge R, McPhail-Bell K, Percival N, Askew D, Fagan R, Tsey K. Continuous Quality Improvement and Comprehensive Primary Health Care: A Systems Framework to Improve Service Quality and Health Outcomes. Front Public Health 2018; 6:76. [PMID: 29623271 PMCID: PMC5874897 DOI: 10.3389/fpubh.2018.00076] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 02/27/2018] [Indexed: 11/30/2022] Open
Abstract
Continuous quality improvement (CQI) processes for improving clinical care and health outcomes have been implemented by primary health-care services, with resultant health-care impacts. But only 10–20% of gain in health outcomes is contributed by health-care services; a much larger share is determined by social and cultural factors. This perspective paper argues that health care and health outcomes can be enhanced through applying CQI as a systems approach to comprehensive primary health care. Referring to the Aboriginal and Torres Strait Islander Australian context as an example, the authors provide a systems framework that includes strategies and conditions to facilitate evidence-based and local decision making by primary health-care services. The framework describes the integration of CQI vertically to improve linkages with governments and community members and horizontally with other sectors to influence the social and cultural determinants of health. Further, government and primary health-care service investment is required to support and extend integration and evaluation of CQI efforts vertically and horizontally.
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Affiliation(s)
- Janya McCalman
- Centre for Indigenous Health Equity research, Central Queensland University, Cairns, Australia.,The Cairns Institute, James Cook University, Townsville, QLD, Australia
| | - Ross Bailie
- Centre for Research Excellence in Integrated Quality Improvement, University Centre for Rural Health, University of Sydney, Sydney, NSW, Australia
| | - Roxanne Bainbridge
- Centre for Indigenous Health Equity research, Central Queensland University, Cairns, Australia.,The Cairns Institute, James Cook University, Townsville, QLD, Australia
| | - Karen McPhail-Bell
- Poche Centre for Indigenous Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | | | - Deborah Askew
- The University of Queensland, Brisbane, QLD, Australia.,Inala Indigenous Health Service, Queensland Health, Inala, QLD, Australia
| | - Ruth Fagan
- Gurriny Yealamucka Health Service, Yarrabah, QLD, Australia
| | - Komla Tsey
- The Cairns Institute, James Cook University, Townsville, QLD, Australia.,College of Arts, Social Science and Education, James Cook University, Townsville, QLD, Australia
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Bailie R, Bailie J, Larkins S, Broughton E. Editorial: Continuous Quality Improvement (CQI)-Advancing Understanding of Design, Application, Impact, and Evaluation of CQI Approaches. Front Public Health 2017; 5:306. [PMID: 29218305 PMCID: PMC5703697 DOI: 10.3389/fpubh.2017.00306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 11/03/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ross Bailie
- The University of Sydney, The University Centre for Rural Health, Lismore, NSW, Australia
| | - Jodie Bailie
- The University of Sydney, The University Centre for Rural Health, Lismore, NSW, Australia
| | - Sarah Larkins
- James Cook University, College of Medicine and Dentistry, Townsville, QLD, Australia
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Ashman AM, Brown LJ, Collins CE, Rollo ME, Rae KM. Factors Associated with Effective Nutrition Interventions for Pregnant Indigenous Women: A Systematic Review. J Acad Nutr Diet 2017; 117:1222-1253.e2. [DOI: 10.1016/j.jand.2017.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 03/13/2017] [Indexed: 11/25/2022]
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Feasibility of a novel participatory multi-sector continuous improvement approach to enhance food security in remote Indigenous Australian communities. SSM Popul Health 2017; 3:566-576. [PMID: 29349246 PMCID: PMC5769043 DOI: 10.1016/j.ssmph.2017.06.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 06/18/2017] [Accepted: 06/18/2017] [Indexed: 11/27/2022] Open
Abstract
Background Food insecurity underlies and compounds many of the development issues faced by remote Indigenous communities in Australia. Multi-sector approaches offer promise to improve food security. We assessed the feasibility of a novel multi-sector approach to enhance community food security in remote Indigenous Australia. Method A longitudinal comparative multi-site case study, the Good Food Systems Good Food for All Project, was conducted (2009–2013) with four Aboriginal communities. Continuous improvement meetings were held in each community. Data from project documents and store sales were used to assess feasibility according to engagement, uptake and sustainability of action, and impact on community diet, as well as identifying conditions facilitating or hindering these. Results Engagement was established where: the community perceived a need for the approach; where trust was developed between the community and facilitators; where there was community stability; and where flexibility was applied in the timing of meetings. The approach enabled stakeholders in each community to collectively appraise the community food system and plan action. Actions that could be directly implemented within available resources resulted from developing collaborative capacity. Actions requiring advocacy, multi-sectoral involvement, commitment or further resources were less frequently used. Positive shifts in community diet were associated with key areas where actions were implemented. Conclusion A multi-sector participatory approach seeking continuous improvement engaged committed Aboriginal and non-Aboriginal stakeholders and was shown to have potential to shift community diet. Provision of clear mechanisms to link this approach with higher level policy and decision-making structures, clarity of roles and responsibilities, and processes to prioritise and communicate actions across sectors should further strengthen capacity for food security improvement. Integrating this approach enabling local decision-making into community governance structures with adequate resourcing is an imperative. A diverse group of stakeholders engaged in a continuous improvement process of community-led action to strengthen food security. Stakeholders collectively appraised the whole local food system and prioritised strategies to improve food security. Actions able to be directly implemented within available resources resulted from developing collaborative capacity. Positive shifts in community diet were associated with key areas where actions were implemented. Integrating the approach with higher level decision-making structures could further strengthen capacity for food system improvement.
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Dalmau M. Not just a 'burden of developing countries'. J Paediatr Child Health 2017; 53:203-204. [PMID: 28194900 DOI: 10.1111/jpc.13404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 09/20/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Marguerite Dalmau
- Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Dietary intakes and anthropometric measures of Indigenous Australian women and their infants in the Gomeroi gaaynggal cohort. J Dev Orig Health Dis 2016; 7:481-497. [DOI: 10.1017/s2040174416000325] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Indigenous Australians continue to experience disparities in chronic diseases, many of which have nutrition-related trajectories. Optimal nutrition throughout the lifespan is protective for a number of adverse health outcomes, however little is known about current dietary intakes and related anthropometric outcomes of Indigenous women and their infants. Research is required to identify nutrition issues to target for health promotion activities. The Gomeroi gaaynggal programme is an ongoing, prospective cohort of pregnant Indigenous Australian women and their children. A cross-sectional examination of postnatal dietary intakes and anthropometric outcomes of mothers and children are reported. To date, 73 mother–child dyads have participatedpostpartum. Breastfeeding initiation was 85.9% and median (interquartile range) duration of any breastfeeding was 1.4 (0.5–4.0) months. Infants were introduced to solid foods at 5.0 months (4.0–6.0) and cow’s milk at 12.0 (10.0–13.0) months. At 12 monthspostpartum, 66.7% of women were overweight or obese, 63.7% at 2 years. Compared with recommendations, reported median maternal nutrient intakes from 24-h recall were low in fibre, folate, iodine, calcium, potassium and vitamin D and high in proportions of energy from total and saturated fat. Limitations of this study include a small sample size and incomplete data for the cohort at each time point. Preliminary data from this ongoing cohort of Indigenous Australian women and children suggest that women may need support to optimize nutrient intakes and to attain a healthy body weight for themselves and their children.
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