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Injecting drugs alone during an overdose crisis in Vancouver, Canada. Harm Reduct J 2022; 19:125. [PMID: 36397146 PMCID: PMC9670082 DOI: 10.1186/s12954-022-00701-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/12/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Settings throughout Canada and the USA continue to experience crises of overdose death due to the toxic unregulated drug supply. Injecting drugs alone limits the potential for intervention and has accounted for a significant proportion of overdose deaths, yet the practice remains understudied. We sought to examine the practice of injecting alone among people who inject drugs (PWID) in Vancouver, Canada. METHODS Data were derived from two prospective cohorts of people who use drugs between June 2016 and November 2018. This analysis was restricted to participants who, in the previous 6 months, reported any injection drug use. Rates of injecting alone were categorized as always, usually, sometimes, or occasionally. We fit a multivariable generalized linear mixed model to identify factors associated with injecting drugs alone. RESULTS Among 1070 PWID who contributed 3307 observations, 931 (87%) reported injecting alone at least once during the study period. In total, there were 729 (22%) reports of always injecting alone, 722 (21.8%) usually, 471 (14.2%) sometimes, 513 (15.5%) occasionally, and 872 (26.4%) never. In a multivariable model, factors positively associated with injecting drugs alone included male sex (adjusted odds ratio [AOR] 1.69; 95% confidence interval [CI] 1.20-2.37), residence in the Downtown Eastside neighbourhood (AOR 1.43; 95% CI 1.08-1.91), binge drug use (AOR 1.36; 95% CI 1.08-1.72), and experiencing physical or sexual violence or both (AOR 1.43; 95% CI 1.00-2.03). Protective factors included Indigenous ancestry (AOR 0.71; 95% CI 0.52-0.98) and being in a relationship (AOR 0.30; 95% CI 0.23-0.39). CONCLUSION We observed that injecting alone, a key risk for overdose mortality, was common among PWID in Vancouver. Our findings underline the need for additional overdose prevention measures that are gender-specific, culturally appropriate, violence- and trauma-informed, and available to those who inject alone.
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Santiago PHR, Soares GH, Smithers LG, Roberts R, Jamieson L. Psychological Network of Stress, Coping and Social Support in an Aboriginal Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15104. [PMID: 36429821 PMCID: PMC9690794 DOI: 10.3390/ijerph192215104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Over the past decades, increasing research interest has been directed towards the psychosocial factors that impact Aboriginal health, including stress, coping and social support. However, there has been no study that examined whether the behaviours, cognitions and emotions related to stress, coping and social support constitute a psychological network in an Aboriginal population and that examined its properties. To address this gap, the current study employed a new methodology, network psychometrics, to evaluate stress, coping and social support in an Aboriginal Australian population. This study conducted a secondary analysis of the South Australian Aboriginal Birth Cohort (SAABC) study, a randomised controlled trial in South Australia, which included 367 pregnant Aboriginal women at study baseline. The Gaussian Graphical Model was estimated with least absolute shrinkage and selection operator (LASSO). Node centrality was evaluated with eigencentrality, strength and bridge centrality. Network communities were investigated with the walktrap algorithm. The findings indicated that stress, coping and social support constituted a connected psychological network in an Aboriginal population. Furthermore, at the centre of the network were the troubles experienced by the Aboriginal pregnant women, bridging their perceptions of stress and coping and constituting a potential target for future interventions.
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Affiliation(s)
- Pedro Henrique Ribeiro Santiago
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
- School of Public Health, The University of Adelaide, Adelaide 5005, Australia
| | - Gustavo Hermes Soares
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
| | - Lisa Gaye Smithers
- School of Public Health, The University of Adelaide, Adelaide 5005, Australia
- School of Health and Society, University of Wollongong, Wollongong 2500, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide 5000, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
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Wichmann B, Wichmann R. COVID-19 and Indigenous health in the Brazilian Amazon. ECONOMIC MODELLING 2022; 115:105962. [PMID: 35874451 PMCID: PMC9290384 DOI: 10.1016/j.econmod.2022.105962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 06/07/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
We test whether the COVID-19 pandemic has an ethnicity-differentiated (Indigenous vs non-Indigenous) effect on infant health in the Brazilian Amazon. Using vital statistics data we find that Indigenous infants born during the pandemic are 0.5% more likely to have very low birth weights. Access to health care contributes to health gaps. Thirteen percent of mothers travel to deliver their babies. For traveling mothers, having an Indigenous baby during the pandemic increases the probability of very low birth weight by 3%. Indigenous mothers are 7.5% less likely to receive adequate prenatal care. Mothers that travel long distances to deliver their babies and give birth during the pandemic are 35% less likely to receive proper prenatal care. We also find evidence that the pandemic shifts medical resources from rural to urban areas, which disproportionately benefits non-Indigenous mothers. These results highlight the need for policies to reduce health inequalities in the Amazon.
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Affiliation(s)
- Bruno Wichmann
- Department of Resource Economics & Environmental Sociology, College of Natural and Applied Sciences, University of Alberta, 503 General Services Building, Edmonton, AB T6G-2H1, Canada
| | - Roberta Wichmann
- Brazilian Institute of Education, Development and Research - IDP, Economics Graduate Program, SGAS Quadra 607, Modulo 49, Via L2 Sul, Brasilia, DF CEP 70.200-670, Brazil
- World Bank, SCES Trecho 03, Lote 05, Ed. Polo 8, S/N, Brasilia, DF CEP 70200-003, Brazil
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Experiences of People with Cancer from Rural and Remote Areas of Western Australia Using Supported Accommodation in Perth While Undergoing Treatment. Curr Oncol 2022; 29:1190-1200. [PMID: 35200600 PMCID: PMC8871240 DOI: 10.3390/curroncol29020101] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/26/2022] [Accepted: 02/07/2022] [Indexed: 02/08/2023] Open
Abstract
The aim of the study was to explore the lived experiences of people diagnosed with cancer from rural and remote areas of Western Australia, who utilise supported accommodation services whilst undergoing treatment in the capital city (Perth). Methods A qualitative phenomenological approach was used in this study. Ten participants were recruited using purposive sampling, who were aged between 35–65 years, were diagnosed with cancer within the previous three months and used accommodation services within the past 12 months. Semi-structured in-depth interviews were conducted with a duration of approximately 45–60 min via Zoom, FaceTime or phone call. Interview data was transcribed, thematically analysed and coded into relevant themes. Results: Three overarching themes were derived from the interviews–“It’s harder to have cancer when you have to relocate for treatment,” “The paradoxical experience of staying at the accommodation,” and “Feeling grateful for the support offered’. Conclusions: People diagnosed with cancer who have to relocate during treatment require emotional, logistical, and social supports. Cancer accommodation services are essential in enabling individuals to continue engaging in meaningful occupations and maintain their quality of life. Our study highlights the need for cancer accommodation services to consider the complex needs of individuals completing treatment for cancer in locations away from their usual homes.
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Rheault H, Coyer F, Bonner A. Chronic disease health literacy in First Nations people: A mixed methods study. J Clin Nurs 2021; 30:2683-2695. [PMID: 34180097 DOI: 10.1111/jocn.15757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/02/2021] [Accepted: 03/05/2021] [Indexed: 01/29/2023]
Abstract
AIM To explore chronic disease education, self-management and health literacy abilities from First Nations Australian adults with chronic disease through the integration of qualitative and quantitative findings. BACKGROUND Chronic disease management requires good health literacy abilities to manage long-term health needs. First Nations people have a higher burden of chronic disease although little is known regarding chronic disease health literacy of First Nations people. DESIGN A concurrent embedded mixed methods study reported using the Consolidated Criteria for Reporting Qualitative Research guidelines. METHODS Data were collected from First Nations people with one or more chronic diseases living in remote Australia between February-November 2017. Quantitative data (n = 200) were collected using the Health Literacy Questionnaire along with demographic and health data. Qualitative data (n = 20) were collected via face-to-face interviews to examine chronic disease education and self-management experiences. Data were analysed separately then integrated to develop meta-inferences. RESULTS Poor communication from healthcare providers coupled with low health literacy abilities is a major barrier to both active and successful management of chronic disease. Communicating in medical jargon resulted in individuals being placed in a power differential causing lack of trust and relationship breakdowns with healthcare providers affecting active chronic disease self-management. The perception of inevitability and ambivalence towards chronic disease and the notion of futility towards self-management were concurred with the low level of active engagement in health care. CONCLUSIONS Yarning is an important strategy used by First Nations people for communication. For nurses, understanding and developing skills in yarning will facilitate cultural safety, communication and understanding about chronic disease self-management in contexts where health literacy abilities are challenged. RELEVANCE TO CLINICAL PRACTICE Using yarning, and plain language visual aids, and teach-back will readdress the power differential experienced by First Nations people and may also improve understanding of chronic disease self-management.
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Affiliation(s)
- Haunnah Rheault
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Advanced Heart Failure and Transplant Unit, The Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Fiona Coyer
- School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia.,Intensive Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Ann Bonner
- School of Nursing and Midwifery, Griffith University, Southport, Queensland, Australia.,NHMRC Chronic Kidney Disease Centre of Research Excellence, University of Queensland, Herston, Queensland, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Herston, Queensland, Australia
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6
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Askew DA, Togni SJ, Egert S, Rogers L, Potter N, Hayman NE, Cass A, Brown ADH, Schluter PJ. Quantitative evaluation of an outreach case management model of care for urban Aboriginal and Torres Strait Islander adults living with complex chronic disease: a longitudinal study. BMC Health Serv Res 2020; 20:917. [PMID: 33023589 PMCID: PMC7539491 DOI: 10.1186/s12913-020-05749-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 09/21/2020] [Indexed: 11/27/2022] Open
Abstract
Background Chronic diseases are the leading contributor to the excess morbidity and mortality burden experienced by Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) people, compared to their non-Indigenous counterparts. The Home-based Outreach case Management of chronic disease Exploratory (HOME) Study provided person-centred, multidisciplinary care for Indigenous people with chronic disease. This model of care, aligned to Indigenous peoples’ conceptions of health and wellbeing, was integrated within an urban Indigenous primary health care service. We aimed to determine the impact of this model of care on participants’ health and wellbeing at 12 months. Methods HOME Study participants were Indigenous, regular patients of the primary health care service, with a diagnosis of at least one chronic disease, and complex health and social care needs. Data were collected directly from participants and from their medical records at baseline, and 3, 6 and 12 months thereafter. Variables included self-rated health status, depression, utilisation of health services, and key clinical outcomes. Participants’ baseline characteristics were described using frequencies and percentages. Generalized estimating equation (GEE) models were employed to evaluate participant attrition and changes in outcome measures over time. Results 60 participants were enrolled into the study and 37 (62%) completed the 12-month assessment. After receiving outreach case management for 12 months, 73% of participants had good, very good or excellent self-rated health status compared with 33% at baseline (p < 0.001) and 19% of participants had depression compared with 44% at baseline (p = 0.03). Significant increases in appointments with allied health professionals (p < 0.001) and medical specialists other than general practitioners (p = 0.001) were observed at 12-months compared with baseline rates. Mean systolic blood pressure decreased over time (p = 0.02), but there were no significant changes in mean HbA1c, body mass index, or diastolic blood pressure. Conclusions The HOME Study model of care was predicated on a holistic conception of health and aimed to address participants’ health and social care needs. The positive changes in self-rated health and rates of depression evinced that this aim was met, and that participants received the necessary care to support and improve their health and wellbeing.
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Affiliation(s)
- Deborah A Askew
- The University of Queensland, Primary Care Clinical Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia. .,Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, Wirraway Pde, Inala, Queensland, 4077, Australia.
| | - Samantha J Togni
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Sonya Egert
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, Wirraway Pde, Inala, Queensland, 4077, Australia
| | - Lynne Rogers
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, Wirraway Pde, Inala, Queensland, 4077, Australia
| | - Nichola Potter
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, Wirraway Pde, Inala, Queensland, 4077, Australia
| | - Noel E Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, Wirraway Pde, Inala, Queensland, 4077, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Alex D H Brown
- South Australian Health and Medical Research Institute, North Terrace, Adelaide, Australia.,University of Adelaide, North Terrace, Adelaide, Australia
| | - Philip J Schluter
- The University of Queensland, Primary Care Clinical Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, 4029, Australia.,University of Canterbury - Te Whare Wānanga o Waitaha, School of Health Sciences, Christchurch, New Zealand
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Soares GH, Santiago PHR, Michel-Crosato E, Jamieson L. The utility of network analysis in the context of Indigenous Australian oral health literacy. PLoS One 2020; 15:e0233972. [PMID: 32492049 PMCID: PMC7269264 DOI: 10.1371/journal.pone.0233972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/17/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The study of oral health literacy (OHL) is likely to gain new and interesting insights with the use of network analysis, a powerful analytical tool that allows the investigation of complex systems of relationships. Our aim was to investigate the relationships between oral health literacy and oral health-related factors in a sample of Indigenous Australian adults using a network analysis approach. METHODS Data from 400 Indigenous Australian adults was used to estimate four regularised partial correlation networks. Initially, a network with the 14 items of the Health Literacy in Dentistry scale (HeLD-14) was estimated. In a second step, psychosocial, sociodemographic and oral health-related factors were included in the network. Finally, two networks were estimated for participants with high and low oral health literacy. Participants were categorised into 'high' or 'low' OHL networks based on a median split. Centrality measures, clustering coefficients, network stability, and edge accuracy were evaluated. A permutation-based test was used to test differences between networks. RESULTS Solid connections among HeLD-14 items followed the structure of theoretical domains across all networks. Oral health-related self-efficacy, sporting activities, and self-rated oral health status were the strongest positively associated nodes with items of the HeLD-14 scale. HeLD-14 items were the four most central nodes in both HeLD-14 + covariates network and high OHL network, but not in the low OHL network. Differences between high and low OHL models were observed in terms of overall network structure, edge weight, and clustering coefficient. CONCLUSION Network models captured the dynamic relationships between oral health literacy and psychosocial, sociodemographic and oral health-related factors. Discussion on the implications of these findings for informing the development of targeted interventions to improve oral health literacy is presented.
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Affiliation(s)
| | | | | | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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Graham R, Masters-Awatere B. Experiences of Māori of Aotearoa New Zealand's public health system: a systematic review of two decades of published qualitative research. Aust N Z J Public Health 2020; 44:193-200. [PMID: 32311187 DOI: 10.1111/1753-6405.12971] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/01/2019] [Accepted: 12/01/2019] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This paper aims to synthesise the broader perspectives of Māori patients and their whānau (extended family, family group) of their treatment within the public health system. Our research question was 'What are the experiences of Māori in the public health and/or hospital system in Aotearoa New Zealand?' METHODS A systematic search using PRISMA protocols and reflexive typology organised around the categories of Māori, public healthcare and qualitative research identified 14 papers that covered all three categories. We undertook a qualitative metasynthesis on these papers using a critical community psychology approach. RESULTS Māori patients and whānau from the included papers mention both barriers and facilitators to health. We categorised barriers as organisational structures, staff interactions and practical considerations. Facilitators were categorised as the provision of whānau support in the form of practical assistance, emotional care and health system navigation. CONCLUSIONS For many Māori, the existing public health system is experienced as hostile and alienating. Whānau members provide support to mitigate this, but it comes as a cost to whānau. Implications for public health: Public health providers must find ways to ensure that Māori consistently experience positive, high-quality healthcare interactions that support Māori ways of being.
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Affiliation(s)
- Rebekah Graham
- School of Psychology, University of Waikato, Hamilton, Aotearoa New Zealand
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9
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Rheault H, Coyer F, Jones L, Bonner A. Health literacy in Indigenous people with chronic disease living in remote Australia. BMC Health Serv Res 2019; 19:523. [PMID: 31349842 PMCID: PMC6659262 DOI: 10.1186/s12913-019-4335-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/08/2019] [Indexed: 11/16/2022] Open
Abstract
Background Health literacy is strongly associated with health outcomes and is important for health policy and service delivery. Low health literacy was reported in 59% of Australian adults, however, there is no national data on the health literacy of Aboriginal and Torres Strait Islander (ATSI) peoples. The ATSI population in Australia experience a notable gap in health outcomes compared with non-Indigenous Australians which is due, in part to a higher prevalence of chronic diseases. The health outcome gap is more pronounced in rural and remote locations. This study aims to establish the health literacy profile of ATSI adults with chronic disease living in remote North-West Queensland Australia, and to investigate associations between the Health Literacy Questionnaire (HLQ) domains and self-reported chronic disease and demographic characteristics. Methods Using a cross-sectional design, 200 ATSI adults with a diagnosis of chronic disease/s (cardiovascular disease, diabetes, respiratory disease and/or chronic kidney disease) were recruited from two sites with the assistance of Aboriginal Health Workers. Data were collected using the HLQ, a multidimensional 44 item instrument to assess nine domains of health literacy. Demographic and health data were also collected. Analysis of variance using backwards modelling was used to determine predictors of health literacy. Results Participants were mostly male (53.5%) and aged between 19 and 89 years. The most prevalent chronic disease was cardiovascular disease (74%) followed by diabetes (67.5%). More than half (62%) had two or more chronic diseases. There was at least one independent predicator for each of the nine health literacy domains. Age, number of chronic diseases, gender, and level of education were all highly significant predictors of health literacy. Conclusion Improved health literacy will enable individuals to take an active role in their health. Understanding the health literacy of ATSI adults is a crucial first step. Our findings can assist Australian healthcare organisations to review their health literacy responsiveness and examine ways to improve patients’ needs and health capabilities to better support people to engage in effective self-management for chronic diseases. Electronic supplementary material The online version of this article (10.1186/s12913-019-4335-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Haunnah Rheault
- School of Nursing, Queensland University of Technology, Brisbane, Australia. .,Advanced Heart Failure and Transplant Unit, The Prince Charles Hospital, Rode Road, Chermside, Brisbane, QLD, 4032, Australia.
| | - Fiona Coyer
- School of Nursing, Queensland University of Technology, Brisbane, Australia.,Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Lee Jones
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Ann Bonner
- School of Nursing, Queensland University of Technology, Brisbane, Australia.,Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.,Kidney Health Service, Metro North Hospital and Health Service, Brisbane, Australia.,NHMRC Chronic Kidney Disease Centre of Research Excellence, University of Queensland, Brisbane, Australia
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Santiago PHR, Roberts R, Smithers LG, Jamieson L. Stress beyond coping? A Rasch analysis of the Perceived Stress Scale (PSS-14) in an Aboriginal population. PLoS One 2019; 14:e0216333. [PMID: 31050685 PMCID: PMC6499425 DOI: 10.1371/journal.pone.0216333] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 04/18/2019] [Indexed: 11/23/2022] Open
Abstract
The history of colonization contributed to Aboriginal and Torres Strait Islanders becoming one of the most disadvantaged groups in Australia. The multiple social inequalities, and therefore the constant insecurities for many about low income, poor living conditions, unemployment, and discrimination, generate chronic stress in this population. In the Baby Teeth Talk Study, an oral-health randomized controlled trial, the Perceived Stress Scale (PSS-14) was administered to 367 pregnant Aboriginal women at baseline. The aim of the present study was to evaluate the validity and reliability of the PSS-14 in an Aboriginal population. The study analysed: (a) model fit; (b) dimensionality; (c) local dependence; (d) differential item functioning; (e) threshold ordering and item fit; (f) targeting; (g) reliability; and (h) criterion validity. The dimensionality analysis indicated a two-factor structure, with negatively and positively worded items clustering together and 21.7% (95% Agresti-Coull C.I. [17.8%, 26.2%]) statistically significant t-tests between the persons' estimates. After the creation of composite items, the revised Perceived Distress (χ2 (21) = 11.74, p = 0.946) and Perceived Coping (χ2 (28) = 17.63, p = 0.935) subscales fitted the Rasch model. Reliability was modest (PersonSeparationIndexdistress = 0.72; PersonSeparationIndexcoping = 0.76). The latent correlation between the Perceived Distress and Perceived Coping subscales was r = 0.14. It is hypothesized that the social inequalities experienced by the Aboriginal population are so pronounced that even Aboriginal pregnant women that perceived themselves as coping well with life challenges ended up endorsing items regarding high levels of stress. The present research showed that a revised PSS-14 is a culturally valid and modestly reliable psychological instrument to measure stress in a population of pregnant Aboriginal women in Australia.
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Affiliation(s)
- Pedro Henrique Ribeiro Santiago
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Gaye Smithers
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Bernardes CM, Langbecker D, Beesley V, Garvey G, Valery PC. Does social support reduce distress and worry among Aboriginal and Torres Strait Islander people with cancer? Cancer Rep (Hoboken) 2019; 2:e1178. [PMCID: PMC7941438 DOI: 10.1002/cnr2.1178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/05/2019] [Accepted: 03/27/2019] [Indexed: 08/20/2024] Open
Abstract
Background Connections to people and place are particularly important for Indigenous Australians. It is currently unknown what role social support plays in helping this population cope with a diagnosis of cancer. Aims This study describes components of social support available for Indigenous Australians with cancer and investigates its association with distress and/or worry. Methods and results Secondary data of a cross‐sectional study involving 248 Aboriginal and Torres Strait Islander cancer patients was used to map out social support dimensions (structural, functional, and appraisal) using Cheng et al's27 social support framework. Distress was measured by the distress thermometer and worry by the worry chart. Overall, 67% of participants reported significant distress, and 49% worry about their cancer. In the functional dimension of social support, participants who had someone caring for them during diagnosis and treatment had increased odds of reporting worry. In the appraisal dimension, participants with unmet social support needs had significantly increased odds of reporting distress and worry compared with participants who were satisfied with the support received. Components in the structural dimension were not associated with distress or worry. Conclusion While many aspects of social support did not appear to affect cancer distress or worry, having a carer or having unmet social support needs had a negative impact on these outcomes. Health professionals should consider the worries of the bonded relationship and monitor patients' needs and their satisfaction with the support provided as an integral part of cancer care.
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Affiliation(s)
| | - Danette Langbecker
- Centre for Online Health—Centre for Health Services ResearchThe University of QueenslandBrisbaneQLDAustralia
| | - Vanessa Beesley
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
| | - Gail Garvey
- Menzies School of Health ResearchCharles Darwin UniversityDarwinNTAustralia
| | - Patricia Casarolli Valery
- QIMR Berghofer Medical Research InstituteBrisbaneQLDAustralia
- Menzies School of Health ResearchCharles Darwin UniversityDarwinNTAustralia
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Goodman A, Snyder M, Wilson K, Whitford J. Healthy spaces: Exploring urban Indigenous youth perspectives of social support and health using photovoice. Health Place 2019; 56:34-42. [PMID: 30690280 DOI: 10.1016/j.healthplace.2019.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/26/2018] [Accepted: 01/07/2019] [Indexed: 11/19/2022]
Abstract
Ongoing injustices perpetrated by colonization and racism have resulted in a disproportionate burden of health disparities among Indigenous peoples, with youth being particularly vulnerable. However, very little is known about the health experiences of Indigenous youth, particularly how they understand and interpret such experiences. In collaboration with an Indigenous-led youth program, this research explored the relationship between social support and health among a unique group of Indigenous youth living in Winnipeg, Canada. Through Photovoice, youth revealed how residential mobility and racism negatively influenced the types of social support and relationships formed, and called for improved access to health-promoting social programs.
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Affiliation(s)
- Ashley Goodman
- Department of Geography, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, Ontario, Canada L5L 1C6.
| | - Marcie Snyder
- Department of Geography, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, Ontario, Canada L5L 1C6.
| | - Kathi Wilson
- Department of Geography, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, Ontario, Canada L5L 1C6.
| | - Jason Whitford
- Program Manager, Eagle Urban Transition Centre, 275 Portage Avenue, Winnipeg, Manitoba, Canada, R3B 2B3.
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Hall KK, Chang AB, Anderson J, Arnold D, Otim M, O'Grady KAF. Health service utilisation amongst urban Aboriginal and Torres Strait Islander children aged younger than 5 years registered with a primary health-care service in South-East Queensland. J Paediatr Child Health 2018; 54:671-676. [PMID: 29341387 DOI: 10.1111/jpc.13812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 09/26/2017] [Accepted: 10/18/2017] [Indexed: 11/28/2022]
Abstract
AIM The majority of Australia's Aboriginal and/or Torres Strait Islander children live in urban areas; however, little is known about their health service use. We aimed to describe health service utilisation amongst a cohort of urban Aboriginal and/or Torres Strait Islander children aged <5 years. METHODS We analysed health service utilisation data collected in an ongoing prospective cohort study of children aged <5 years registered with an Aboriginal-owned and operated primary health-care service. Enrolled children were followed monthly for 12 months, with data on health service utilisation collected at baseline and at each monthly follow-up. Health service utilisation rates, overall and by service provider and reason for presentation, were calculated and reported as incidence rates per 100 child-months with the corresponding 95% confidence intervals (CIs). RESULTS Between February 2013 and November 2015, 180 children were enrolled, and 1541 child-months of observation were available for analysis. The overall incidence of health service utilisation was 52.5 per 100 child-months (95% CI 48.7-56.5); 81% of encounters were with general practitioners. Presentation rates were the highest for acute respiratory illnesses (30.7/100 child-months, 95% CI 27.8-33.9). CONCLUSIONS In this community, acute respiratory illnesses are predominant causes of health service utilisation in young children. The health-care utilisation profile of these children presents important opportunities for health promotion and intervention.
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Affiliation(s)
- Kerry K Hall
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Anne B Chang
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.,Department of Respiratory Medicine, Lady Cilento Children's Hospital, Brisbane, Queensland, Australia
| | - Jennie Anderson
- Caboolture Community Medical, Brisbane, Queensland, Australia
| | - Daniel Arnold
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael Otim
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia.,Department of Health Services Administration, University of Sharjah, Sharjah, United Arab Emirates
| | - Kerry-Ann F O'Grady
- Centre for Children's Health Research, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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Coe K, Benitez T, Tasevska N, Arriola A, Keller C. The Use of Family Rituals in Eating Behaviors in Hispanic Mothers. FAMILY & COMMUNITY HEALTH 2018; 41:28-36. [PMID: 29135792 PMCID: PMC5718173 DOI: 10.1097/fch.0000000000000170] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Food rituals often abruptly change when Hispanic families migrate to the United States. This report describes changes in rituals of food procurement, preparation, and presentation (food-PPP) in Hispanic women following migration to the United States. Focus groups and face-to-face interviews were conducted with 13 low-income, overweight/obese Hispanic women 27 to 40 years of age. Content analysis was used to analyze cultural and contextual sources for food-PPP. Changes in rituals and traditions in food-PPP occurred, including materials and ingredients for traditional meals. Food rituals may play a role in healthful eating and could, therefore, serve as leverage points for interventions designed to promote healthy eating behaviors.
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Affiliation(s)
- Kathryn Coe
- School of Medicine, Department of Public Health, Indiana University-Purdue University, Indianapolis, IN, USA.
| | - Tanya Benitez
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA, USA.
| | - Natasha Tasevska
- School of Nutrition and Health Promotion, College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
| | - Anel Arriola
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
| | - Colleen Keller
- Regents Professor, Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation at Arizona State University, Phoenix, AZ, USA.
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Ribeiro AA, Aciole GG, Arantes CIS, Reading J, Kurtz DL, Rossi LA. The work process and care production in a Brazilian indigenous health service. ESCOLA ANNA NERY 2017. [DOI: 10.1590/2177-9465-ean-2017-0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To understand the constitutive elements of the work process and care production in an Indigenous Health Support Service. Methods: Case study. Systematic observation and semi-structured interviews were conducted in January and February of 2012. The participants were 10 nursing professionals of an Indigenous Health Support Center, located in Mato Grosso do Sul state, Brazil. The work process was used as a conceptual and analytical category. Results: Through interpretative analysis, the data were organized into three categories. The results showed that care production was focused on procedures and guided by rigid institutional rules and bureaucracy. The prioritization of institutional rules and procedures was detrimental to the provision of person-centered care. Conclusion: The temporary employment contracts and rigid bureaucratic organization generated a tense work environment. These aspects do not maximize the efforts of the nursing staff to provide person-centered care.
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Understanding barriers to fruit and vegetable intake in the Australian Longitudinal Study of Indigenous Children: a mixed-methods approach. Public Health Nutr 2016; 20:832-847. [PMID: 27894381 PMCID: PMC5426329 DOI: 10.1017/s1368980016003013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective To identify barriers to fruit and vegetable intake for Indigenous Australian children
and quantify factors related to these barriers, to help understand why children do not
meet recommendations for fruit and vegetable intake. Design We examined factors related to carer-reported barriers using multilevel Poisson models
(robust variance); a key informant focus group guided our interpretation of
findings. Setting Eleven diverse sites across Australia. Subjects Australian Indigenous children and their carers (N 1230) participating
in the Longitudinal Study of Indigenous Children. Results Almost half (45 %; n 555/1230) of carers reported barriers to their
children’s fruit and vegetable intake. Dislike of fruit and vegetables was the most
common barrier, reported by 32·9 % of carers; however, we identified few factors
associated with dislike. Carers were more than ten times less likely to report barriers
to accessing fruit and vegetables if they lived large cities v. very
remote areas. Within urban and inner regional areas, child and carer well-being,
financial security, suitable housing and community cohesion promoted access to fruit and
vegetables. Conclusions In this national Indigenous Australian sample, almost half of carers faced barriers to
providing their children with a healthy diet. Both remote/outer regional carers and
disadvantaged urban/inner regional carers faced problems accessing fruit and vegetables
for their children. Where vegetables were accessible, children’s dislike was a
substantial barrier. Nutrition promotion must address the broader family, community,
environmental and cultural contexts that impact nutrition, and should draw on the
strengths of Indigenous families and communities.
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Ghosh M, Holman CDJ, Preen DB. Use of prescription stimulant for Attention Deficit Hyperactivity Disorder in Aboriginal children and adolescents: a linked data cohort study. BMC Pharmacol Toxicol 2015; 16:35. [PMID: 26646429 PMCID: PMC4673717 DOI: 10.1186/s40360-015-0035-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 11/18/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing recognition of Attention Deficit Hyperactivity Disorder (ADHD) among Aboriginal children, adolescents and young adults is a public health challenge. We investigated the pattern of prescription stimulants for ADHD among Aboriginal individuals in Western Australia (WA). METHODS Using a whole-population-based linked data we followed a cohort of individuals born in WA from 1980-2005, and their parents were born in Australia, to identify stimulant prescription for ADHD derived from statutory WA stimulant prescription dispensing between 2003 and 2007. Parental link was ascertained through WA Family Connections Genealogical Linkage System. Cox proportional hazards regression (HR) models were performed to determine the association between stimulant use and Aboriginal and non-Aboriginal status. RESULTS Of the total cohort of 186,468, around 2% (n = 3677) had prescription stimulants for ADHD. Individuals with both Aboriginal parents were two-thirds (HR 0.33, 95 % CI 0.26-0.42), and with only Aboriginal mother were one-third (HR 0.69, 95% CI 0.53-0.90) less likely to have stimulants, compared to individuals with non-Aboriginal parents. HR in Aboriginals was 62% lower (HR 0.35, 95% CI 0.25-0.49) in metropolitan areas, and 72% lower (HR 0.28, 95% CI 0.20-0.38) in non-metropolitan areas, than non-Aboriginals. The risk for simulant use was four times higher among Aboriginal boys than Aboriginal girls (HR 4.08, 95% CI, 2.92-5.69). CONCLUSION Aboriginal cultural understanding of ADHD and attitude towards stimulant medication serve as a determinant of their access to health services. Any ADHD intervention and policy framework must take into account a holistic approach to Aboriginal culture, beliefs and individual experience to provide optimal care they need.
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Affiliation(s)
- Manonita Ghosh
- Centre for Health Services Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - C D'Arcy J Holman
- Centre for Health Services Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - David B Preen
- Centre for Health Services Research, School of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
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