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Sangha KK, Dinku Y, Costanza R, Poelina A. A comprehensive analysis of well-being frameworks applied in Australia and their suitability for Indigenous peoples. Int J Qual Stud Health Well-being 2024; 19:2321646. [PMID: 38437516 PMCID: PMC10913715 DOI: 10.1080/17482631.2024.2321646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/18/2024] [Indexed: 03/06/2024] Open
Abstract
PURPOSE Well-being is a complex, multi-dimensional, dynamic, and evolving concept, covering social, economic, health, cultural and spiritual dimensions of human living, and often used synonymously with happiness, life satisfaction, prosperity, and quality of life. We review the existing key wellbeing frameworks applied in Australia both for the wider public and Indigenous peoples. The aim is to provide a comprehensive overview of various applied frameworks, along with a critical analysis of domains or dimensions comprising those frameworks, and to analyse the role of nature in those frameworks. METHODOLOGY We conducted a critical analysis of the main frameworks applied in Australia to date to measure the well-being of the mainstream (mainly non-Indigenous) and Indigenous populations. This study is particularly timely given the Australian Government's interest in revising the well-being frameworks as mentioned in the Government "Measuring What Matters" statement. RESULTS The existing well-being frameworks in Australia either overlook or hardly consider the role of nature and its services which are important to support human well-being. Likewise, for Indigenous peoples "Country" (Indigenous clan land) is vital for their well-being as their living is imbued with "Country". The role of nature/"Country" needs to be considered in revising the well-being frameworks, indicators and measures to inform and develop appropriate policies and programs in Australia. CONCLUSION To develop appropriate welfare policies and programs for achieving socio-economic and other wellbeing outcomes, it is essential to evolve and conceptualize wellbeing frameworks (and related indicators and measures) in line with people's contemporary values, particularly considering the role of nature and its services.
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Affiliation(s)
- Kamaljit K Sangha
- Research Institute for the Environment and Livelihoods, Charles Darwin University, Darwin, Australia
| | - Yonatan Dinku
- Centre for Centre for Aboriginal Economic Policy Research, The Australian National University, Canberra, Australia
| | - Robert Costanza
- Institute for Global Prosperity, University College London, London, UK
| | - Anne Poelina
- College of Indigenous Education Futures, Arts & Society, Charles Darwin University, Darwin, Australia
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2
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Meldrum K, Wallace V, Webb T, Ridgway L, Quigley R, Strivens E, Russell SG. A Delphi study and development of a social and emotional wellbeing screening tool for Australian First Nations Peoples living in the Torres Strait and Northern Peninsula Area of Australia. PLoS One 2024; 19:e0306316. [PMID: 38935759 PMCID: PMC11210860 DOI: 10.1371/journal.pone.0306316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 06/14/2024] [Indexed: 06/29/2024] Open
Abstract
Tools screening depression and anxiety developed using the Western biomedical paradigm are still used with First Nations Peoples globally, despite calls for cross-cultural adaption. Recent work by this research team found that tools used to screen for depression and anxiety were inappropriate for use with Australian First Nations Peoples living in the Torres Strait and Northern Peninsula Area of Australia. The objective of this Delphi study, the second phase of a broader four-phase project, was to gain consensus from an expert mental health and/or social and emotional wellbeing (SEWB) panel to inform the development of an appropriate screening tool. This Delphi study took place between March and May 2023. Three sequential rounds of anonymous online surveys delivered using QualtricsTM were planned, although only two were needed to reach 75% consensus. The first round sought consensus on whether a new screening tool needed to be developed or whether existing tools could be used. The second round achieved consensus. Twenty-eight experts (47% response rate) participated across the two Delphi rounds. In the second round, 83% of these experts agreed or strongly agreed that a new screening tool, using the holistic First Nations concept of social and emotional wellbeing, be developed. Ninety-four percent of them agreed that it should take a Yarning approach. These findings enabled the development of a new SEWB screening tool that adopted a Yarning (narrative) approach designed for use in primary care and geriatric settings in the region. The new tool has four different Yarning areas: Community engagement and behaviour; Stress worries; Risk; and Feeling strong. Guidelines for tool use are integrated as well as Summary and Recommendation sections. At a macro-level this project responds to the need for new screening tools that are underpinned by First Nations worldviews.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Lynne Ridgway
- North Coast Neuropsychology, East Ballina, New South Wales, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sarah G. Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
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3
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Howard K, Garvey G, Anderson K, Dickson M, Viney R, Ratcliffe J, Howell M, Gall A, Cunningham J, Whop LJ, Cass A, Jaure A, Mulhern B. Development of the What Matters 2 Adults (WM2A) wellbeing measure for Aboriginal and Torres Strait Islander adults. Soc Sci Med 2024; 347:116694. [PMID: 38569315 DOI: 10.1016/j.socscimed.2024.116694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 01/30/2024] [Accepted: 02/12/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE As wellbeing is culturally bound, wellbeing measures for Aboriginal and Torres Strait Islander peoples must be culturally relevant and grounded in Aboriginal and Torres Strait Islander values and preferences. We describe the development of a nationally-relevant and culturally grounded wellbeing measure for Aboriginal and Torres Strait Islander adults: the What Matters to Adults (WM2A) measure. METHODS We used a mixed methods approach to measure development, combining Indigenist methodologies and psychometric methods. Candidate items were derived through a large national qualitative study. Think-aloud interviews (n = 17) were conducted to assess comprehension, acceptability, and wording of candidate items. Two national surveys collected data on the item pool (n = 312, n = 354). Items were analysed using exploratory factor analysis (EFA), and item response theory (IRT) to test dimensionality, local dependence and item fit. A Collaborative Yarning approach ensured Aboriginal and Torres Strait Islander voices were privileged throughout. RESULTS Fifty candidate items were developed, refined, and tested. Using EFA, an eight factor model was developed. All items met pre-specified thresholds for maximum endorsement frequencies, and floor and ceiling effects; no item redundancy was identified. Ten items did not meet thresholds for aggregate adjacent endorsement frequencies. During Collaborative Yarning, six items were removed based on low factor loadings (<0.4) and twelve due to conceptual overlap, high correlations with other items, endorsement frequencies, and/or low IRT item level information. Several items were retained for content validity. The final measure includes 32 items across 10 domains (Balance & control; Hope & resilience; Caring for others; Culture & Country; Spirit & identity; Feeling valued; Connection with others; Access; Racism & worries; Pride & strength). CONCLUSIONS The unique combination of Indigenist and psychometric methodologies to develop WM2A ensures a culturally and psychometrically robust measure, relevant across a range of settings and applications.
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Affiliation(s)
- K Howard
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia.
| | - G Garvey
- The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia
| | - K Anderson
- The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia
| | - M Dickson
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; The Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia
| | - R Viney
- The Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - J Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, 5001, Australia
| | - M Howell
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia
| | - A Gall
- The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia
| | - J Cunningham
- Menzies School of Health Research, Charles Darwin University, Darwin NT, Australia
| | - L J Whop
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, 2600, Australia
| | - A Cass
- Menzies School of Health Research, Charles Darwin University, Darwin NT, Australia
| | - A Jaure
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia
| | - B Mulhern
- The Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Ultimo, NSW, 2007, Australia
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Meldrum K, Wallace V, Webb T, Ridgway L, Quigley R, Strivens E, Russell S. Developing an appropriate depression and anxiety screening tool for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area of Australia: Protocol for a Delphi study. PLoS One 2023; 18:e0292162. [PMID: 38060486 PMCID: PMC10703283 DOI: 10.1371/journal.pone.0292162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/13/2023] [Indexed: 12/18/2023] Open
Abstract
Tools that screen for depression and anxiety developed using the Western biomedical paradigm are still used with First Nations peoples globally, despite calls for cross-cultural adaption. Recent work by the research team found that tools used to screen for depression and anxiety were not appropriate for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area (NPA). of Australia. Consequently, the objective of this Delphi study is to gain consensus from an expert mental health panel to inform the development of an appropriate depression and anxiety screening tool(s). A Delphi study with Australian expert panellists will be used to reach consensus about whether an existing screening tool should be used or whether adaption or new tool development should take place. Three sequential rounds of anonymous online surveys will be used to reach consensus. The first round will seek consensus about the tool(s). Subsequent rounds will seek consensus on the development of the tool(s) identified in round one. Panellists will be identified using a combination of authorship of related publications, established national clinical or research profile in First Nations mental health, and/or by peer referral. Consensus will be reached when 75% of the panel agree. When agreement is not reached suggestions will be taken to the next round. If agreement is not achieved by the third round, the Steering Committee will make any outstanding decisions. Dissemination of the findings through continuing community engagement, conference presentations and publications will be led by Torres Strait Islander members of the research team.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Lynne Ridgway
- North Coast Neuropsychology, East Ballina, New South Wales, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
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Hedges J, Poirier B, Soares G, Haag D, Sethi S, Santiago PR, Cachagee M, Jamieson L. Journeying towards decolonising Aboriginal and Torres Strait Islander oral health re-search. Community Dent Oral Epidemiol 2023; 51:1232-1240. [PMID: 37294001 DOI: 10.1111/cdoe.12881] [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: 01/04/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Arguably, the deficit narrative of oral health inequities, perpetuated by colonial re-search agendas, media and sociopolitical discourse, contributes to oral disease burden and fatalism among Aboriginal and Torres Strait Islander Peoples. There remains a need to evolve the way oral health is understood, in a manner that reflects the lived experiences of Aboriginal and Torres Strait Islander Peoples. METHODS This paper proposes decolonising methodologies as a strategy to ensure oral health re-search creates more equitable oral health outcomes and realities for Aboriginal and Torres Strait Islander Communities. Anchored by a critical reflection of the failure of dominant oral health inequity re-search practices to address Indigenous oral health, both in Australia and internationally, we propose five explicit pathways for decolonising Aboriginal and Torres Strait Islander oral health re-search. RESULTS We argue the need for (1) positionality statements in all re-search endeavours, (2) studies that honour reciprocal relationships through the development of proposals that ask questions and follow models based on Traditional Knowledges, (3) the development of culturally secure and strengths-based data capturing tools, (4) frameworks that address the intersection of multiple axes of oppression in creating inequitable conditions and (5) decolonising knowledge translation techniques. CONCLUSION Importantly, we recognize that re-search will never be entirely 'decolonised' due to the colonial foundations upheld by academic institutions and society more broadly; however, as oral health re-searchers, we ascertain that there is an ethical compulsion to drive decolonising re-search pursuits that produce equitable oral health outcomes for Aboriginal and Torres Strait Islander Communities.
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Affiliation(s)
- Joanne Hedges
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Brianna Poirier
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Gustavo Soares
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Dandara Haag
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Sneha Sethi
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Pedro Ribeiro Santiago
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Madison Cachagee
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Lisa Jamieson
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
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Meldrum K, Andersson E, Wallace V, Webb T, Quigley R, Strivens E, Russell S. Approaches to the development of new screening tools that assess distress in Indigenous peoples: A systematic mixed studies review. PLoS One 2023; 18:e0291141. [PMID: 37682832 PMCID: PMC10490875 DOI: 10.1371/journal.pone.0291141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 08/08/2023] [Indexed: 09/10/2023] Open
Abstract
This mixed studies review assessed the extent of the literature related to approaches used to develop new tools that screen for distress in Indigenous adults globally. It answered the research question: What qualitative and quantitative approaches are used to develop new screening tools that assess distress in Indigenous peoples globally? CINAHL, Embase, Emcare, Medline, PsychInfo and Scopus databases were systematically searched to identify relevant articles published between January 2000 and February 2023. Articles describing the development of a new screening tool for Indigenous peoples, globally, published in English since 2000 and constituted a full publication of primary research, met the inclusion criteria. Studies underwent quality appraisal using the Mixed-Methods Appraisal Tool. A sequential exploratory design guided data analysis. Synthesis occurred using a two-phase sequential method. Nineteen articles constituted the data set. Articles described the use of qualitative, quantitative, or mixed methods in approximately equal numbers. Overall, qualitative methods were used in early stages of tool development, with mixed and quantitative methods used to pilot and validate them. However, most studies did not follow the theoretical guidelines for tool development, and while validation studies took place in over half of the data set, none adequately assessed construct validity. Sixty percent of the articles were located using citation searches, which suggests database searches were ineffective. Valid tools that screen for distress in Indigenous populations support equitable access to health care. This review found that most screening tools were developed in Australia. However, additional evidence of their validity is needed in addition to a valid diagnostic tool that supports the determination of criterion validity. These needs present important future research opportunities.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | | | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
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Meldrum K, Andersson E, Webb T, Quigley R, Strivens E, Russell S. Screening depression and anxiety in Indigenous peoples: A global scoping review. Transcult Psychiatry 2023:13634615231187257. [PMID: 37490720 DOI: 10.1177/13634615231187257] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Indigenous peoples' worldviews are intricately interconnected and interrelated with their communities and the environments in which they live. Their worldviews also manifest in a holistic view of health and well-being, which contrasts with those of the dominant western biomedical model. However, screening depression and/or anxiety in Indigenous peoples often occurs using standard western tools. Understandably, the cultural appropriateness of these tools has been questioned. The purpose of this scoping review was to map the literature that used any type of tool to screen depression or anxiety in Indigenous adults globally. A systematic scoping review method was used to search databases including, but not limited to, CINAHL, PubMed, Scopus and Google. Database-specific search terms associated with Indigenous peoples, depression and anxiety, and screening tools were used to identify literature. In addition, citation searches of related systematic reviews and relevant websites were conducted. The data set was limited to English language publications since database inception. Fifty-four publications met the review's inclusion criteria. Most studies were completed in community settings using standard western depression and anxiety screening tools. Thirty-three different tools were identified, with the Patient Health Questionnaire-9 being the most frequently used. The review's findings are concerning given repeated calls for culturally appropriate screening tools to be used with Indigenous peoples. Although there has been some work to cross-culturally adapt depression screening tools for specific Indigenous populations, clearly more clinicians and researchers need to be aware of, and use, culturally appropriate approaches to screening.
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Affiliation(s)
| | | | | | | | - Edward Strivens
- James Cook University
- Queensland Health, Cairns and Hinterland Hospital and Health Service
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Abstract
Prolonged grief disorder has recently been added to the International Classification of Diseases, 11th edition and the Diagnostic and Statistical Manual of Mental Disorders 5, Text Revision. This historical development is often presented as a linear process culminating in the inclusion of valid, clinically relevant prolonged grief disorder criteria in diagnostic handbooks. The present contribution provides an overview of work contradicting this dominant narrative. First, I show that the developmental history of prolonged grief disorder has been nonlinear and that this yields questions on generalizability and problems with measurement of the newest criteria sets. Second, I highlight an important gap in the validity evidence: the distinction of prolonged grief disorder from normal grief. Third, I discuss concerns relating to the societal effects of the inclusion of prolonged grief disorder in diagnostic handbooks, including the medicalization of grief, development and adverse effects of pharmacotherapy and stigmatization. A more realistic, balanced view on the history, validity and societal impact of prolonged grief disorder appears appropriate. I recommend stringent validation of assessment instruments for prolonged grief disorder, convergence of criteria-sets, closing gaps in validity evidence and developing strategies to mitigate the negative effects of grief diagnoses.
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Affiliation(s)
- Maarten C Eisma
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, the Netherlands
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Saunders V, McCalman J, Tsey S, Askew D, Campbell S, Jongen C, Angelo C, Spurling G, Cadet-James Y. Counting what counts: a systematic scoping review of instruments used in primary healthcare services to measure the wellbeing of Indigenous children and youth. BMC PRIMARY CARE 2023; 24:51. [PMID: 36803458 PMCID: PMC9936129 DOI: 10.1186/s12875-023-02001-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/02/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth. METHODS Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels. RESULTS Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains. CONCLUSION There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth.
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Affiliation(s)
- Vicki Saunders
- Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD, 4870, Australia.
| | - Janya McCalman
- grid.1023.00000 0001 2193 0854Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD 4870 Australia
| | - Sena Tsey
- grid.1023.00000 0001 2193 0854Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD 4870 Australia
| | - Deborah Askew
- grid.1003.20000 0000 9320 7537General Practice Clinical Unit and School of Public Health, Faculty of Medicine, University of Queensland, Level 2, Public Health Building, 288 Herston Road, Brisbane, QLD 4006 Australia
| | - Sandy Campbell
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Level 11, 410 Ann St, Brisbane, QLD 4000 Australia
| | - Crystal Jongen
- grid.1023.00000 0001 2193 0854Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD 4870 Australia
| | - Candace Angelo
- grid.1013.30000 0004 1936 834XAboriginal and Torres Strait Islander Public Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Edward Ford Building, Fisher Road, Sydney, NSW 2006 Australia
| | - Geoff Spurling
- grid.1003.20000 0000 9320 7537General Practice Clinical Unit and School of Public Health, Faculty of Medicine, University of Queensland, Level 2, Public Health Building, 288 Herston Road, Brisbane, QLD 4006 Australia
| | - Yvonne Cadet-James
- Yvonne Cadet-James, Apunipima Cape York Health Council, 186 McCoombe St, Cairns, QLD 4870 Australia
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Meldrum K, Andersson E, Sagigi B, Webb T, Wapau C, Quigley R, Strivens E, Russell S. How Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area of Australia describe and discuss social and emotional well-being: a qualitative study protocol. BMJ Open 2022; 12:e067052. [PMID: 36600438 PMCID: PMC9772669 DOI: 10.1136/bmjopen-2022-067052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Colonisation has, and continues to, negatively impact the mental well-being of Australia's First Nations peoples. However, the true magnitude of the impact is not known, partially because clinicians have low levels of confidence in using many existing screening tools with First Nations clients. In addition, many authors have critiqued the use of tools designed for Western populations with First Nations peoples, because their worldview of health and well-being is different. Therefore, the aim of the overarching study is to develop an appropriate mental well-being screening tool(s) for older adults (aged 45 and over) living in the Torres Strait that can be used across primary health and geriatric settings. This protocol describes the first phase designed to achieve the overarching aim-yarning about social and emotional well-being (inclusive of mental well-being) in First Nations peoples living in the Torres Strait and Northern Peninsula Area of Australia. METHOD AND ANALYSIS The study will be guided by decolonising and participatory action research methodologies. Yarning is an Australian First Nations relational method that relies on storytelling as a way of sharing knowledge. Yarning circles will be conducted with community members and health and aged care workers living on six different island communities of the Torres Strait. Participants will be recruited using purposive sampling. Thematic analysis of the data will be led by Torres Strait Islander members of the research team. ETHICS AND DISSEMINATION The Far North Queensland, Human Research Ethics Committee (HREC) (HREC/2021/QCH/73 638-1518) and James Cook University HREC (H8606) have approved this study. Dissemination of study findings will be led by Torres Strait members of the research team through conferences and peer-reviewed publications.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Ellaina Andersson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Betty Sagigi
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Torres and Cape Hospital and Health Service, Queensland Health, Thursday Island, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Chenoa Wapau
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Torres and Cape Hospital and Health Service, Queensland Health, Thursday Island, Queensland, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Queensland Health, Cairns, Queensland, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
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Lam J. Neighborhood Characteristics, Neighborhood Satisfaction, and Loneliness Differences Across Ethnic-Migrant Groups in Australia. J Gerontol B Psychol Sci Soc Sci 2022; 77:2113-2125. [PMID: 34888639 DOI: 10.1093/geronb/gbab219] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Loneliness is an important concern for older adults. Studies have linked demographic characteristics with loneliness, showing that it varies by ethnic and migrant statuses in countries in Europe and North America. Characteristics of the physical environment in which older adults are embedded have also received some attention, though prior studies have not fully investigated whether older adults from different ethnic-migrant backgrounds may report variation in loneliness because of characteristics of, or satisfaction with, their neighborhoods, which may shape their social interactions. METHODS Drawing on up to 4 waves of data from the Household, Income, and Labour Dynamics in Australia Surveys and random-effects models, I examine whether loneliness differs across ethnic/migrant groups in the Australian context. Furthermore, I examine whether neighborhood characteristics (its conditions and sociality) and satisfaction with the neighborhood (with its safety, with the neighborhood itself, and with "feeling part of the local community") may be mediators for the association between ethnic-migrant status and loneliness. RESULTS Findings show migrants from non-English-speaking countries report higher levels of loneliness, as compared with native-born, non-Indigenous Australians. More favorable neighborhood characteristics and higher levels of satisfaction with different aspects of the neighborhood are consistently associated with lower levels of loneliness. Neighborhood sociality and satisfaction with aspects of the neighborhood partially mediated the association between ethnicity status and loneliness for migrants from non-English-speaking countries. DISCUSSION This study showed loneliness differs across older Australians of different ethnic and migrant backgrounds. It also showed how loneliness differences are explained by different mechanisms.
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Affiliation(s)
- Jack Lam
- Institute for Social Science Research, University of Queensland, Indooroopilly, Queensland, Australia
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12
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McBride-Henry K, Roguski M, Miller C, Van Wissen K, Saravanakumar P. Re-orientating health and nursing care: a qualitative study on indigenous conceptualisations of wellbeing. BMC Nurs 2022; 21:294. [PMID: 36324117 PMCID: PMC9628117 DOI: 10.1186/s12912-022-01063-1] [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: 06/13/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Health systems often fail to address the wellbeing needs of older Indigenous populations; this is attributed to a lack of knowledge of Indigenous health systems arising from a privileging of dominant western biomedical epistemologies. In Aotearoa/New Zealand, there is a dearth of nursing knowledge relating to Māori, which negatively impacts on the provision of holistic nursing care. This research explores insights and perspectives of older Māori adult's (pakeke) perceptions of wellbeing so nurses can provide culturally responsive care and support the wellbeing of Indigenous New Zealanders. METHODS An Indigenous kaupapa Māori methodology underpinned and directed this research project. Audio-recorded interviews were conducted face to face in participants' homes, marae (meeting house) and workplaces. Pakeke over the age of 55 participated in in-depth interviews. A total of 10 pakeke were interviewed and narratives were thematically analysed in accordance with meanings derived from Māori worldviews. RESULTS Wellbeing was attributed to the holistic interconnection and balancing of whānau (wider family), whanaungatanga (social connectedness), hinengaro (mental and emotional wellbeing), taha tinana (physical wellbeing) and wairua (spirituality). CONCLUSION The findings offer unique insights into how wellbeing is constructed for pakeke; the results are unique but consistent with international accounts of older Indigenous peoples. Pakeke wellbeing can be supported by acknowledging existing cultural and spiritual beliefs and peer-support initiatives. Nursing models of care should prioritise Indigenous ways of knowing; this research offers nursing-focused recommendations to improve care.
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Affiliation(s)
- Karen McBride-Henry
- grid.267827.e0000 0001 2292 3111School of Nursing, Midwifery, and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | | | - Charissa Miller
- grid.267827.e0000 0001 2292 3111School of Nursing, Midwifery, and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Kim Van Wissen
- grid.267827.e0000 0001 2292 3111School of Nursing, Midwifery, and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Padmapriya Saravanakumar
- grid.117476.20000 0004 1936 7611School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, NSW Australia
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Ryder C, Stephens JH, Ullah S, Coombes J, Cominos N, Sharpe P, D’Angelo S, Cameron D, Hayes C, Bennett-Brook K, Mackean T. Community Engagement and Psychometric Methods in Aboriginal and Torres Strait Islander Patient-Reported Outcome Measures and Surveys-A Scoping Review and Critical Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10354. [PMID: 36011989 PMCID: PMC9407920 DOI: 10.3390/ijerph191610354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: In healthcare settings, patient-reported outcome measures (PROMs) and surveys are accepted, patient-centered measures that provide qualitative information on dimensions of health and wellbeing. The level of psychometric assessment and engagement with end users for their design can vary significantly. This scoping review describes the psychometric and community engagement processes for PROMs and surveys developed for Aboriginal and Torres Strait Islander communities. (2) Methods: The PRISMA ScR guidelines for scoping reviews were followed, aimed at those PROMs and surveys that underwent psychometric assessment. The Aboriginal and Torres Strait Islander Quality Appraisal Tool and a narrative synthesis approach were used. (3) Results: Of 1080 articles, 14 were eligible for review. Most articles focused on a validity assessment of PROMs and surveys, with reliability being less common. Face validity with Aboriginal and Torres Strait Islander communities was reported in most studies, with construct validity through exploratory factor analyses. Methodological design risks were identified in the majority of studies, notably the absence of explicit Indigenous knowledges. Variability existed in the development of PROMs and surveys for Aboriginal and Torres Strait Islander communities. (4) Conclusions: Improvement in inclusion of Indigenous knowledges and research approaches is needed to ensure relevance and appropriate PROM structures. We provide suggestions for research teams to assist in future design.
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Affiliation(s)
- Courtney Ryder
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
- The George Institute for Global Health Australia, University of New South Wales (UNSW), Missenden Rd., Sydney, NSW 2052, Australia
- School of Population Health, University of New South Wales (UNSW), Sydney, NSW 2052, Australia
| | - Jacqueline H. Stephens
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
| | - Julieann Coombes
- The George Institute for Global Health Australia, University of New South Wales (UNSW), Missenden Rd., Sydney, NSW 2052, Australia
| | - Nayia Cominos
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
| | - Patrick Sharpe
- Far West Community Partnerships, Ceduna, SA 5690, Australia
| | - Shane D’Angelo
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
| | - Darryl Cameron
- Moorundi Aboriginal Community Controlled Health Service, Lot 1 Wharf Road, Murray Bridge, SA 5253, Australia
| | - Colleen Hayes
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
| | - Keziah Bennett-Brook
- The George Institute for Global Health Australia, University of New South Wales (UNSW), Missenden Rd., Sydney, NSW 2052, Australia
| | - Tamara Mackean
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
- The George Institute for Global Health Australia, University of New South Wales (UNSW), Missenden Rd., Sydney, NSW 2052, Australia
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Meldrum K, Andersson E, Wallace V, Webb T, Quigley R, Strivens E, Russell S. Approaches to the development of new mental well-being screening tools for Indigenous peoples: a systematic mixed studies review protocol. BMJ Open 2022; 12:e063710. [PMID: 35973708 PMCID: PMC9386234 DOI: 10.1136/bmjopen-2022-063710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Indigenous peoples' world views are intricately interrelated and interconnected with those of their communities and the environments where they live. Consequently, Indigenous peoples have a holistic view of their health, which contrasts with the dominant Western biomedical paradigm. However, the mental well-being of Indigenous peoples is predominately screened using tools developed using the Western paradigm that may not be culturally appropriate. The objective of this systematic mixed studies review (SMSR) is to assess the extent of the literature related to approaches used to develop new tools to screen the mental well-being of Indigenous adults. METHODS AND ANALYSIS This SMSR will be conducted in accordance with the method proposed by Pluye et al. It will include studies that describe the development of any type of tool or approach to screen for mental well-being in Indigenous adults, globally. Searches will be limited to the English language and literature published since January 2000. Databases to be searched include: CINAHL, Medline, PsycINFO, PubMed and Scopus. Only published studies will be included in the SMSR. Data that answers the research questions will be extracted from the literature and recorded on the associated data charting form. A sequential synthesis method will be used to analyse data from qualitative, quantitative and mixed-method studies. Data will be presented graphically, diagrammatically or in tabular form depending on what approach best conveys its meaning. ETHICS AND DISSEMINATION The SMSR will describe the approach to developing new tools for screening the mental well-being of Indigenous peoples across the globe. It will support researchers, clinicians and practitioners to consider both their approach to new tool development or, if they are using a previously developed tool, how reliable and valid it is for the population that they intend to use it with. Peer-reviewed publications will be used to disseminate SMSR findings.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Ellaina Andersson
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
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15
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Browne J, Becker D, Orellana L, Ryan J, Walker T, Whelan J, Alston L, Egan M, Johnson B, Rossignoli A, Crooks N, Brown AD, Bolton KA, Fraser P, Le H, Bell C, Hayward J, Sanigorski A, Backholer K, Allender S, Strugnell C. Healthy weight, health behaviours and quality of life among Aboriginal children living in regional Victoria. Aust N Z J Public Health 2022; 46:595-603. [DOI: 10.1111/1753-6405.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/01/2022] [Accepted: 05/01/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jennifer Browne
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Denise Becker
- Biostatistics Unit, Faculty of Health Deakin University Geelong Victoria
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health Deakin University Geelong Victoria
| | - Joleen Ryan
- School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Troy Walker
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Jill Whelan
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- School of Medicine, Faculty of Health Deakin University Geelong Victoria
| | - Laura Alston
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Deakin Rural Health, Faculty of Health Deakin University Warrnambool Victoria
| | - Mikaela Egan
- Victorian Aboriginal Community Controlled Health Organisation Melbourne Victoria
| | - Brittney Johnson
- Victorian Aboriginal Community Controlled Health Organisation Melbourne Victoria
| | - Amy Rossignoli
- Victorian Aboriginal Community Controlled Health Organisation Melbourne Victoria
| | - Nicholas Crooks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Andrew D. Brown
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Kristy A. Bolton
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Faculty of Health Deakin University Geelong Victoria
| | - Penny Fraser
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- School of Medicine, Faculty of Health Deakin University Geelong Victoria
| | - Ha Le
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Deakin Health Economics, Faculty of Health Deakin University Geelong Victoria
| | - Colin Bell
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- School of Medicine, Faculty of Health Deakin University Geelong Victoria
| | - Josh Hayward
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Andrew Sanigorski
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Kathryn Backholer
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Steven Allender
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Deakin Rural Health, Faculty of Health Deakin University Warrnambool Victoria
| | - Claudia Strugnell
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
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16
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Gall A, Diaz A, Garvey G, Anderson K, Lindsay D, Howard K. Self-reported wellbeing and health-related quality of life of Aboriginal and Torres Strait Islander people pre and post the first wave of the COVID-19 2020 pandemic. Aust N Z J Public Health 2022; 46:170-176. [PMID: 34939687 PMCID: PMC9968567 DOI: 10.1111/1753-6405.13199] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/01/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Quantify change in wellbeing and health-related quality-of-life (HRQoL) in Aboriginal and Torres Strait Islander adults pre and post Australia's initial COVID-19 lockdown. METHODS Aboriginal and Torres Strait Islander adults completed an online survey at Time 1 (October-November 2019; before the initial Australian COVID-19 outbreak) and Time 2 (August-September 2020; after the first Australian lockdown). We assessed wellbeing using a visual analogue scale (VAS) and HRQoL using the Assessment of Quality of Life (AQoL-4D) instrument. Participants who completed both surveys (n=42) were included to quantify change in outcomes over time and by comorbidity and demographic factors. RESULTS Mean reduction in wellbeing over time was 6.4 points (95%CI -14.2 to 1.4) and was associated with age (18-54yo), financial instability and mental health comorbidity. Mean reduction in HRQoL over time was 0.06 (95%CI -0.12 to 0.01) and was associated with financial instability, high physical comorbidity level and mental health comorbidity. CONCLUSIONS Aboriginal and Torres Strait Islanders aged 18-54yo, who were financially unstable or had elevated comorbidity during COVID lockdowns experienced greater reductions in wellbeing and HRQoL. IMPLICATIONS FOR PUBLIC HEALTH As the COVID-19 pandemic continues in Australia, both urgent and forward planning is needed, especially for the priority groups identified.
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Affiliation(s)
- Alana Gall
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory,Correspondence to: Alana Gall, Menzies School of Health Research, PO Box 41096, Casuarina, Northern Territory, 0811
| | - Abbey Diaz
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory,School of Public Health, University of Queensland, Brisbane, Queensland
| | - Gail Garvey
- School of Public Health, University of Queensland, Brisbane, Queensland,School of Public Health, Faculty of Medicine & Health, University of Sydney, New South Wales
| | - Kate Anderson
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory,School of Public Health, University of Queensland, Brisbane, Queensland
| | - Daniel Lindsay
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory,School of Public Health, University of Queensland, Brisbane, Queensland
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine & Health, University of Sydney, New South Wales,Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, New South Wales
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Gardiner F, Middleton J, Perera S, Gunner M, Churilov L, Coleman M, Poole L. Cohort study comparison of Mental Health and Wellbeing Services delivered by The Royal Flying Doctor Service, across Far North and Central West Queensland. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 21:100385. [PMID: 35540562 PMCID: PMC9079348 DOI: 10.1016/j.lanwpc.2022.100385] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Understanding cultural differences between geographical regions is essential in delivering culturally appropriate healthcare. We aimed to describe the characteristics and outcomes of diverse clients using the Far North Mental Health and Wellbeing Service (FNS) and the Central West Health and Wellbeing Service (CWS). Methods We conducted a cohort study within Queensland, Australia, on all clients who received a mental health therapy session at either the FNS or the CWS. Patient data was prospective data collected form July 2019 to December 2020. Findings There were1202 clients, with a median number of individual contacts per-client of 3.0 (IQR 2.0-6.0). There was 428 (35.6% 95% CI 32.90-38.39) males and 772 (64.2% 95% CI 61.44-66.94) females with a median age across the genders of 38.0 (IQR 28.0-51.0). There was 505 (42.0% 95% CI 39.20-44.86) identifying as Indigenous and 697 (58.0% 95% CI 55.14-60.80) as non-Indigenous Australians. The FNS had a significantly higher proportion of Indigenous clients (n=484; 54.8% 95% CI 51.46-58.13) as compared to the CWS (n=21; 6.6% 95% CI 4.12-9.89). Of the 1202 clients, 946 (78.7% 95% CI 76.28-80.99) had a socio-economic classification of ‘most disadvantaged’, consisting of 740 (83.8%) clients from the FNS and 206 (64.6%) clients from the CWS. The majority of presentations were for neurotic, stress-related and somatoform disorders (n=568; 47.3%), followed by mood affective disorders (n=310; 25.8%). The overall number of treatments strategies employed was 10798, equalling a median of 6.0 (IQR 4.0-9.0) strategies per-client, with the leading strategies being counselling/psychosocial (n=1394; 12.9%), reflective listening (n=1191; 11.0%), and strengths based reasoning (n=1116; 10.3%). There were 511 (42.5%) clients who completed the Kessler Psychological Distress Scale (K10/K5), with 493 (41.0%) clients not offered as deemed not culturally appropriate by the treating team. The mean initial K10/K5 score was 23.7 (SD 9.4) which significantly decreased (p<0.001) to 18.0 (SD 10.0) at final consultation. Interpretation This study highlighted client socioeconomic differences between two geographically remote mental health services. It is essential that services are regionally co-designed to ensure cultural appropriateness. Funding No funding to declare.
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Dudgeon P, Derry KL, Mascall C, Ryder A. Understanding Aboriginal Models of Selfhood: The National Empowerment Project's Cultural, Social, and Emotional Wellbeing Program in Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4078. [PMID: 35409761 PMCID: PMC8997958 DOI: 10.3390/ijerph19074078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/13/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023]
Abstract
Culturally safe and responsive interventions that acknowledge Aboriginal models of selfhood are needed. Such interventions empower Aboriginal peoples and communities by increasing self-determination over individual and community social and emotional wellbeing (SEWB). In response to this need, the National Empowerment Project developed the Cultural, Social, and Emotional Wellbeing Program (CSEWB). The CSEWB aims to strengthen SEWB and cultural identity and subsequently reduce psychological distress in Aboriginal peoples. An Aboriginal Participatory Action Research approach ensured community ownership and engagement. Seven research questions and a culturally modified adaption of the Most Significant Change technique informed a thematic analysis of the evaluation content. Aboriginal adults (n = 49; 53% ≥50 years, 66% female, 34% male) from three Western Australian urban communities participated in the program evaluation workshops. Participants reported the benefits of enhanced SEWB and reduced psychological distress. This research reaffirms the need for culturally safe programs that acknowledge social determinants of health and are guided by the SEWB framework. Long-term commitment from the government is needed to support such programs.
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Affiliation(s)
- Pat Dudgeon
- Poche Centre for Indigenous Health, School of Indigenous Studies, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Kate L. Derry
- Poche Centre for Indigenous Health, School of Indigenous Studies, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Carolyn Mascall
- Relationships Australia WA, West Leederville, WA 6007, Australia; Langford Aboriginal Association, Langford, WA 6147, Australia; (C.M.); (A.R.)
| | - Angela Ryder
- Relationships Australia WA, West Leederville, WA 6007, Australia; Langford Aboriginal Association, Langford, WA 6147, Australia; (C.M.); (A.R.)
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19
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Elder-Robinson E, Diaz A, Howard K, Parikh DR, Kar G, Garvey G. Quality of Life in the First Year of Cancer Diagnosis among Aboriginal and Non-Aboriginal People Living in Regional and Remote Areas of Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:330. [PMID: 35010591 PMCID: PMC8751055 DOI: 10.3390/ijerph19010330] [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: 11/30/2021] [Revised: 12/17/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Little is known of the quality of life (QoL) of cancer patients in the Northern Territory (NT) of Australia, where healthcare delivery is geographically challenged. This exploratory study describes QoL among Aboriginal and non-Aboriginal cancer patients in the NT, in the first year of diagnosis. Participants were recruited from the only cancer care centre in the NT and completed the Assessment of Quality-of-Life questionnaire (AQoL-4D). The results were descriptively analysed. The participants' (n = 63; mean age 58.8 years) mean AQoL utility score was 0.72 (SD 0.26); patients scored lowest in the relationships and mental health dimensions of the questionnaire (mean 0.89, SD 0.19, and 0.89, SD 0.17, respectively). Participants living in remote and very remote areas (46%) reported higher QoL scores, compared with participants in the outer regional capital city of the NT in the overall (mean 0.76, SD 0.22 and 0.78, SD 0.20 vs. 0.67, SD 0.29, respectively), and mental health dimensions (mean 0.92, SD 0.09 and mean 0.94, SD 0.06 vs. 0.85, SD 0.22, respectively). The findings were suggestive of clinically meaningful differences across socioeconomic groups, cancer and treatment types, and comorbidity status. Mean QoL scores were consistent with previous reports in other Australian cancer cohorts. The findings suggest a need to support cancer patients' mental health and relationships during the diagnosis and treatment phase of their cancer journey.
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Affiliation(s)
- Elaina Elder-Robinson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia; (A.D.); (G.G.)
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Abbey Diaz
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia; (A.D.); (G.G.)
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Kirsten Howard
- Menzies Centre for Health Policy and Economics, School of Public Health, University of Sydney, Sydney, NSW 2006, Australia;
| | - Darshit Rajeshkumar Parikh
- School of Psychological and Clinical Sciences, Charles Darwin University, Causarina, NT 0810, Australia;
| | - Giam Kar
- Alan Walker Cancer Care Centre, Royal Darwin Hospital, Casuarina, NT 0810, Australia;
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia; (A.D.); (G.G.)
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
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20
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Miller J, Berger E. Supporting First Nations Students with a Trauma Background in Schools. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09485-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Gall A, Diaz A, Garvey G, Anderson K, Lindsay D, Howard K. An exploration of the sociodemographic and health conditions associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults. BMC Res Notes 2021; 14:386. [PMID: 34600592 PMCID: PMC8487334 DOI: 10.1186/s13104-021-05794-3] [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: 08/25/2021] [Accepted: 09/20/2021] [Indexed: 11/21/2022] Open
Abstract
Objective To identify sociodemographic factors and health conditions associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults. Participants were recruited via investigator networks and an online panel provider with an established nationwide panel of Aboriginal and Torres Strait Islander adults. Those interested were invited to complete a survey that included an assessment of wellbeing using a visual analogue scale. Data was collected from October–November 2019 and August–September 2020. Exploratory analyses were conducted to ascertain factors associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults. Results Having more than enough money to last until next pay day, full-time employment, completion of grade 12, having a partner, and living with others were significantly associated with higher wellbeing among Aboriginal and Torres Strait Islander adults. A self-reported history of depression, anxiety, other mental health conditions, heart disease, or disability were associated with lower self-rated wellbeing scores. Our findings indicate a need for further investigation among these socioeconomic and patient groups to identify how to improve and support the wellbeing of Aboriginal and Torres Strait Islander adults. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05794-3.
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Affiliation(s)
- A Gall
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.
| | - A Diaz
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - G Garvey
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.,School of Public Health, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, 2006, Australia.,School of Public Health, University of Queensland, Brisbane, Australia
| | - K Anderson
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - D Lindsay
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - K Howard
- School of Public Health, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, 2006, Australia.,Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
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Butten K, Jones L, Newcombe PA, Chang AB, Sheffield JK, O'Grady KAF, Johnson NW, Bell AM, Ross G, Toombs M. Development and validation of a parent-proxy health-related quality of life survey for Australian First Nations children. BMJ Open 2021; 11:e046007. [PMID: 34400446 PMCID: PMC8370500 DOI: 10.1136/bmjopen-2020-046007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Within Australia, Aboriginal and Torres Strait Islander (First Nations) populations perceive health and well-being differently to non-Indigenous Australians. Existing health-related quality of life (HR-QoL) measurement tools do not account for these differences. The objective of this study was to develop and validate a culturally specific parent-proxy HR-QoL measurement tool for First Nations children. DESIGN Scale development was informed by parents/carers of children with a chronic illness and an expert panel. The preliminary 39-item survey was reviewed (n=12) and tested (n=163) with parents/carers of First Nations children aged 0-12 years at baseline with comparative scales: the Kessler Psychological Distress Scale, generic HR-QoL (Paediatric QoL Inventory 4.0, PedsQL4.0) and Spence Children's Anxiety Scale, and repeated (n=46) 4 weeks later. Exploratory Factor Analysis was used for scale reduction. Reliability and validity were assessed by internal consistency, test-retest, and correlations with comparison scales. RESULTS Items within our First Nations-Child Quality of Life (FirstNations-CQoL) were internally consistent with Cronbach's alpha coefficients of ≥0.7 (quality of life, 0.808; patient experience, 0.880; patient support, 0.768) and overall test-retest reliability was good (r=0.75; 95% CI 0.593 to 0.856). Convergent validity was observed with the PedsQL4.0 with Pearson's coefficients of r=0.681 (ages 2-4 years); r=0.651 (ages 5-12 years) and with the Kessler Psychological Distress scale (r=-0.513). Divergent validity against the Spence Anxiety Scale was not demonstrated. CONCLUSIONS The FirstNations-CQoL scale was accepted by the participants, reliable and demonstrated convergent validity with comparison measures. This tool requires further evaluation to determine responsiveness, its minimal important difference and clinical utility.
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Affiliation(s)
- Kaley Butten
- Institute of Health & Biomedical Innovation, Queensland University of Technology - QUT, Brisbane, Queensland, Australia
| | - Lee Jones
- Institute of Health & Biomedical Innovation, Queensland University of Technology - QUT, Brisbane, Queensland, Australia
| | - Peter A Newcombe
- School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Anne B Chang
- Department of Respiratory Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- Child Health Division, Menzies School of Health Research, Darwin, Queensland, Australia
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jeanie K Sheffield
- School of Psychology, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Kerry-Ann F O'Grady
- Institute of Health & Biomedical Innovation, Queensland University of Technology - QUT, Brisbane, Queensland, Australia
| | - Newell W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Gold Coast Campus - Griffith University, Gold Coast, Queensland, Australia
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Anna Maria Bell
- Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Greggory Ross
- Queensland Children's Hospital, South Brisbane, Queensland, Australia
| | - Maree Toombs
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
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Measuring Social and Emotional Wellbeing in Aboriginal Youth Using Strong Souls: A Rasch Measurement Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168425. [PMID: 34444174 PMCID: PMC8391716 DOI: 10.3390/ijerph18168425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/30/2021] [Accepted: 08/05/2021] [Indexed: 12/04/2022]
Abstract
Currently, there are few robustly evaluated social and emotional wellbeing (SEWB) measures available for use with Aboriginal youth in research, policy, and practice. As such, this study used a Rasch measurement approach to examine the psychometric properties of Strong Souls, a 25-item self-reported SEWB instrument, created for use with Aboriginal youth in the Northern Territory. Our sample (N = 154) included youth (15–25 years old) living on Whadjuk (metropolitan Western Australia; N = 91) and Kamilaroi countries (rural New South Wales; N = 63). Using Rasch modelling techniques, evidence for multidimensionality in the scale was observed, resulting in subsequent analyses conducted separately on two subscales: Psychological Distress and Resilience. The Resilience subscale did not meet the Rasch model assumptions, with poor person and item separation and reliability indexes suggesting the scale was not reliably differentiating between participants’ Resilience scores. The Psychological Distress subscale had mixed separation and reliability index results, with good construct validity implied but poorer ability to target the distress of participants. Our findings provide novel evidence demonstrating the functioning of Strong Souls in a contemporary sample of Aboriginal youth, suggesting further modifications of the instrument are required before it can be used with confidence as a reliable measure in this population group.
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24
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Pan L, Xu X, Lu L, Gursoy D. How cultural confidence affects local residents’ wellbeing. SERVICE INDUSTRIES JOURNAL 2021. [DOI: 10.1080/02642069.2018.1540595] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Li Pan
- College of Economics and Management, Zhejiang Normal University, Jinhua, People’s Republic of China
| | - Xing’an Xu
- School of Tourism, Hainan University, Haikou, People’s Republic of China
| | - Lu Lu
- School of Sport, Tourism and Hospitality Management, Temple University, Philadelphia, USA
| | - Dogan Gursoy
- School of Hospitality Business Management, Carson College of Business, Washington State University, Pullman, USA
- School of Tourism and Hospitality, University of Johannesburg, Auckland Park, South Africa
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25
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Ryder C, Mackean T, Coombes J, Hunter K, Ullad S, Rogers K, Essue B, Holland AJA, Ivers R. Developing economic measures for Aboriginal and Torres Strait Islander families on out-of-pocket healthcare expenditure. AUST HEALTH REV 2021; 45:265-273. [PMID: 34016253 DOI: 10.1071/ah20299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/08/2021] [Indexed: 11/23/2022]
Abstract
Objective Out-of-pocket healthcare expenditure (OOPHE) has a significant impact on marginalised households. The purpose of this study was to modify a pre-existing OOPHE survey for Aboriginal and Torres Strait Islander households with children. Methods The OOPHE survey was derived through a scoping review, face and content validity, including judgement quantification with content experts. Exploratory factor analyses determined factor numbers for construct validity. Repeatability through test-retest processes and reliability was assessed through internal consistency. Results The OOPHE survey had 168 items and was piloted on 67 Aboriginal and Torres Strait Islander parents. Construct validity assessment generated a 62-item correlation matrix with a three-factor model. Across these factors, item loadings varied, 10 items with high correlations (>0.70) and 20 with low correlations (<0.40). OOPHE survey retest was conducted with 47 families, where 43 items reached slight to fair levels of agreement. Conclusion The low level of item loadings to factors in the OOPHE survey indicates interconnectedness across the three-factor model, and reliability results suggest systemic differences. Impeding factors may include cohort homogeneity and survey length. It is unknown how cultural and social nuances specific to Aboriginal and Torres Strait Islander households impacts on results. Further work is warranted. What is known about the topic? Out-of-pocket healthcare expenditure (OOPHE) are expenses not covered by universal taxpayer-funded health insurance. In elderly Australians or those with chronic conditions, OOPHE can cause substantial burden and financial hardship and, in the most extreme cases, induce bankruptcy. Despite higher hospital admissions and disease burden, little is known about how OOPHE impacts Aboriginal and Torres Strait Islander families. Additionally, in Australia, no OOPHE survey tools have been appropriately assessed; this includes for use with Aboriginal and Torres Strait Islander families. What does this paper add? This pilot study modified a pre-existing Australian OOPHE survey for use with Aboriginal and Torres Strait Islander households with children. Knowledge interface methodology was used to bring together Indigenous knowledges with quantitative survey methods. This was critical to ensuring Indigenous knowledges were central to the overall pilot study across item creation, participant focus, outcome contextualisation, interpretation, and resetting dominant norms. Outcomes have demonstrated pertinent points for future work in this area, such as the complexities in developing robust, culturally safe and specific surveys, which reach ideal psychometric levels of validity and reliability for Aboriginal and Torres Strait Islander communities. Certainly, it raises questions for current and future research using surveys in Aboriginal and Torres Strait Islander communities, which are generic and not purpose-built. What are the implications for practitioners? We recommend that OOPHE surveys should be developed with Aboriginal and Torres Strait Islander families from the outset, so they can include important contextual factors for Aboriginal and Torres Strait Islander households.
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Affiliation(s)
- Courtney Ryder
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Road, NSW 2050, Australia. ; ; ; ; and Discipline of Public Health, College of Medicine Public Health, Flinders University, GPO Box 2100, SA 5001, Australia. ; ; and Corresponding author.
| | - Tamara Mackean
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Road, NSW 2050, Australia. ; ; ; ; and Discipline of Public Health, College of Medicine Public Health, Flinders University, GPO Box 2100, SA 5001, Australia. ;
| | - Julieann Coombes
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Road, NSW 2050, Australia. ; ; ; ; and The University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
| | - Kate Hunter
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Road, NSW 2050, Australia. ; ; ;
| | - Shahid Ullad
- Discipline of Public Health, College of Medicine Public Health, Flinders University, GPO Box 2100, SA 5001, Australia. ;
| | - Kris Rogers
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Road, NSW 2050, Australia. ; ; ; ; and The University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia
| | - Beverley Essue
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Road, NSW 2050, Australia. ; ; ; ; and Canadian Partnership Against Cancer Corporation, 145 King Street West, Toronto, ON M4H IJ8, Canada
| | - Andrew J A Holland
- The University of Sydney School of Medicine, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, Westmead, NSW 2145, Australia.
| | - Rebecca Ivers
- The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Road, NSW 2050, Australia. ; ; ; ; and Discipline of Public Health, College of Medicine Public Health, Flinders University, GPO Box 2100, SA 5001, Australia. ; ; and School of Public Health and Community Medicine, UNSW, Sydney, NSW 2052, Australia.
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Molloy L, Guha MD, Scott MP, Beckett P, Merrick TT, Patton D. Mental health nursing practice and Aboriginal and Torres Strait Islander people: an integrative review. Contemp Nurse 2021; 57:140-156. [PMID: 33989117 DOI: 10.1080/10376178.2021.1927773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: For nearly thirty years, significant concerns have been raised about the public-provided mental health services for Aboriginal and Torres Strait Islander peoples. Staff have been identified as having little understanding of Indigenous culture, and this had resulted in inappropriate treatment. In attempting to understand what specialist knowledge exists to guide mental health nursing practice with Aboriginal and Torres Strait Islander peoples, the authors have turned to published peer-reviewed literature.Methods: The approach chosen to explore this area was an integrative review. This provided a method to identify, analyse, and synthesise a wide range of literature.Results: The available evidence points to the need that treatment planning must be focused on the promotion of social and emotional wellbeing and not simply the treatment of symptoms. It also emphasises the importance of cultural safety informed by awareness and understanding of social, cultural and historical factors that can impact the health and treatment of Aboriginal and Torres Strait Islander peoples. Within the literature, staff reported difficulty in understanding how knowledge about social and emotional wellbeing could translate into practice. Nurses working in mental health contexts reported not feeling adequately prepared for, or confident in this area of practice.Conclusions: There is a paucity of current literature on mental health nursing practice for Aboriginal and Torres Strait Islander peoples, with the literature available not providing clear guidance for effective and meaningful practice.
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Affiliation(s)
- Luke Molloy
- School of Nursing, University of Wollongong, Wollongong, Australia.,School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Monica D Guha
- Western New South Wales Local Health District, Bloomfield, Orange, NSW, Australia
| | - Matthew P Scott
- Wiradjuri Nation, Clinical Nurse Specialist- Aboriginal Mental Health, Western New South Wales Local Health District, Bloomfield, Orange, NSW, Australia
| | - Paul Beckett
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Camperdown, NSW, Australia
| | | | - Declan Patton
- School of Nursing and Midwifery. Royal College of Surgeons in Ireland, Dublin, Ireland.,Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia.,University of Wollongong, Wollongong NSW, Australia
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27
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Green M, Cunningham J, Anderson K, Griffiths K, Garvey G. Measuring health care experiences that matter to Indigenous people in Australia with cancer: identifying critical gaps in existing tools. Int J Equity Health 2021; 20:100. [PMID: 33845852 PMCID: PMC8042987 DOI: 10.1186/s12939-021-01433-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 03/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measurement of patients' healthcare experiences is increasingly used as an indicator of quality of care, but there are concerns that existing measures omit information that is meaningful to patients and that results may not be used systematically to inform service improvement. Further, current approaches may be inadequate for some population groups, such as Indigenous people in Australia, whose healthcare experience is impacted by the context of colonisation and discordance between Indigenous understandings of health and the Western biomedical health system. This study aimed to assess the extent to which existing patient experience measures used in Australia collect information about critical aspects of cancer care, as previously identified by Indigenous people affected by cancer and their health care providers. METHODS A two-stage process was used to examine the adequacy of existing patient experience measures for Indigenous people in Australia: (1) relevant tools and measures were identified and assessed, and four measures selected as suitable comparators; (2) comparators were examined in detail and mapped against topics identified in earlier research as important to Indigenous people with cancer. Gaps in topic coverage in comparators were identified. RESULTS No comparators completely captured the critical aspects of cancer care identified by Indigenous people affected by cancer and their health care providers. The number of topics 'partially' captured by the four comparators ranged from 4 to 7 out of 9. While most topics were partially covered, the lack of questions around culture and cultural safety was notable. CONCLUSIONS Existing tools are likely to miss key aspects of Indigenous peoples' experiences of cancer care in Australia. Failure to adequately assess care experiences related to cultural safety may compromise efforts to improve health outcomes. Addressing gaps requires development of experience measures that are strengths-based, reflect an Indigenous worldview and measure aspects of experience relevant to Indigenous people.
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Affiliation(s)
- Monica Green
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Level 10, East Tower, 410 Ann Street, Brisbane, QLD, 4000, Australia.
| | - Joan Cunningham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Level 10, East Tower, 410 Ann Street, Brisbane, QLD, 4000, Australia
| | - Kate Anderson
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Level 10, East Tower, 410 Ann Street, Brisbane, QLD, 4000, Australia
| | - Kalinda Griffiths
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Level 10, East Tower, 410 Ann Street, Brisbane, QLD, 4000, Australia
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Gail Garvey
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Level 10, East Tower, 410 Ann Street, Brisbane, QLD, 4000, Australia
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Wright A, Yap M, Jones R, Richardson A, Davis V, Lovett R. Examining the Associations between Indigenous Rangers, Culture and Wellbeing in Australia, 2018-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3053. [PMID: 33809609 PMCID: PMC8002247 DOI: 10.3390/ijerph18063053] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 11/23/2022]
Abstract
The centrality of culture to Indigenous peoples' health and wellbeing is becoming increasingly acknowledged in government policy. In Australia, the Indigenous Ranger program is a leading example of employment that supports increased cultural participation. In 2017, we demonstrated higher life satisfaction and family wellbeing among Indigenous Rangers compared to non-Rangers in Central Australia. Using an expanded national dataset, this present study aimed to: examine if associations between Ranger status and wellbeing continued to be observed in Central Australia; assess if these associations were observed among non-Central Australian Rangers; and, quantify the effect of mediating variables (Rangers status, cultural factors) on wellbeing outcomes. We analyzed Mayi Kuwayu baseline data (n = 9691 Aboriginal and Torres Strait Islander people) and compared participants who identified as past or currently employed Rangers compared to non-Rangers across two geographic locations (Central Australia, non-Central Australia). Ranger participation was significantly associated with very high life satisfaction and family wellbeing in Central Australia (high life satisfaction PR 1.31, 95% CI 1.09-1.57, and family wellbeing (PR 1.17, 95% CI 1.01-1.36) and non-Central Australia (high life satisfaction PR 1.29, 95% CI 1.06-1.57), family wellbeing (PR 1.37, 95% CI 1.14-1.65). These findings concord with those observed in the 2017 proof-of-concept study. Additionally, we found that Ranger status partially mediated the relationships between existing cultural practices (first language as your Indigenous language and living on your country) and the two wellbeing outcomes. Current cultural practices, spending time on country and speaking your Aboriginal language, also partially mediated the associations between Ranger status and high life satisfaction, and between Ranger status and high family wellbeing. This analysis supports evidence that both Ranger employment and cultural participation are contributors to wellbeing. Ranger work is not only good for land, but it is good for people. As such, determining policies that mutually acknowledge and enhance culture, health and wellbeing will likely have additional benefits for the broader Aboriginal and Torres Strait Islander population.
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Affiliation(s)
- Alyson Wright
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 64 Mills Road, Acton 2600, Australia; (R.J.); (R.L.)
| | - Mandy Yap
- Centre for Aboriginal Economic and Policy Research, The Australian National University, Acton 2600, Australia;
| | - Roxanne Jones
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 64 Mills Road, Acton 2600, Australia; (R.J.); (R.L.)
| | - Alice Richardson
- Statistical Consulting Unit, The Australian National University, Acton 2600, Australia;
| | - Vanessa Davis
- Tangentyere Council, 1 Elders St, Alice Springs 0870, Australia;
| | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 64 Mills Road, Acton 2600, Australia; (R.J.); (R.L.)
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29
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Racism, stress, and sense of personal control among Aboriginal Australian pregnant women. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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30
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Robinson GW, Lee E, Silburn SR, Nagel P, Leckning B, Midford R. School-Based Prevention in Very Remote Settings: A Feasibility Trial of Methods and Measures for the Evaluation of a Social Emotional Learning Program for Indigenous Students in Remote Northern Australia. Front Public Health 2020; 8:552878. [PMID: 33282808 PMCID: PMC7706087 DOI: 10.3389/fpubh.2020.552878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose: Skills for Life (SFL) is a social-emotional curriculum for Indigenous middle school students that was co-developed with educators and community members in a remote community of northern Australia. This preliminary study aimed to test the feasibility of processes and methods of data-gathering, the reliability of youth self-report measures, and to identify the direction of effects for an evaluation of a longer-term pilot of the curriculum. Design/Methodology/Approach: Indigenous Students in years 7–9 of a remote school participated in SFL over 2 years. The Strengths and Difficulties Questionnaire (SDQ), Kessler 6 (K6), and a purpose-designed Connected Self Scale (CSS) were administered to 63 students pre- and post-program. Findings: Only the K6, Prosocial behavior (SDQ), and two CSS subscales showed sufficient internal consistency for analysis. Change was positive but non-significant for SDQ and CSS. There was evidence of a dosage effect: students receiving the intervention over 2 years showed greater reduction in psychological distress than other students. There was no evidence of iatrogenic effects. Conclusions: The feasibility pilot is a critically important phase in the development of evaluation design and cjhoice of evaluation measures for challenging remote settings. This study found that evaluation of SFL with culturally and linguistically distinct Indigenous middle school students using self-report measures is feasible. However, the SDQ may not be suitable for this project. High levels of psychological distress suggest the need to investigate sources of life stress and potential supports for adolescent resilience in this context. This preliminary pilot aimed to trial methods and measures for evaluation of a social-emotional curriculum developed specifically for remote Australian Indigenous students who are at risk of poor psychosocial outcomes. No studies have examined the appropriateness of standardized self-report measures for evaluation of SEL with this student population in remote school settings.
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Affiliation(s)
| | - Eunro Lee
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Sven Robert Silburn
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Patricia Nagel
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Bernard Leckning
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Richard Midford
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,National Drug Research Institute, Curtin University, Perth, WA, Australia
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31
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Luke JN, Ferdinand AS, Paradies Y, Chamravi D, Kelaher M. Walking the talk: evaluating the alignment between Australian governments' stated principles for working in Aboriginal and Torres Strait Islander health contexts and health evaluation practice. BMC Public Health 2020; 20:1856. [PMID: 33272249 PMCID: PMC7713017 DOI: 10.1186/s12889-020-09983-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 11/26/2020] [Indexed: 12/04/2022] Open
Abstract
Background Stated principles in government policy documents serve as a set of values outlining how governments intend to work. As such, health planning principles should be reflected in health policy across the cycle of planning, implementation and evaluation. Such principles should be reflected in the process of governments commissioning and funding evaluation, and in the work of those commissioned to do evaluation on behalf of governments. Methods We reviewed health planning policy documents to identify principles Australian State and Territory and National governments stated as being important to the work they do within Aboriginal and Torres Strait Islander health contexts. Evaluation tenders and reports relating to Aboriginal and Torres Strait Islander health policy, programs and service for the period 1-Jan-2007 to 1-Jan-2017 were retrieved and assessed as to whether they embedded principles governments state as important. Results In Aboriginal and Torres Strait Islander health planning policy contexts, Australian governments outline shared responsibility, cultural competence, engagement, partnership, capacity building, equity, a holistic concept of health, accountability, and evidence-based as fundamental principles that will underpin the work they will do. In total, we identified 390 publicly advertised evaluation tenders, but were only able to retrieve 18 tenders and 97 reports. Despite strong rhetoric placing importance on the abovementioned principles, these were not consistently embedded in tenders released by government commissioners, nor in reports largely commissioned by governments. Principles most widely incorporated in documents were those corresponding to Closing the Gap - accountability, evidence-based and equity. Principles of holistic concept of health, capacity building, cultural competence and partnership do not appear well applied in evaluation practice. Conclusion Notwithstanding the tensions and criticism of current practice that sees dominant governments policing Aboriginal and Torres Strait Islander populations and defining what principles should inform health policy and evaluation practice, this paper reveals shortcomings in current evaluation practice. Firstly, this paper reveals a lack of transparency about current practice, with only 2% of tenders and 25% of reports in the public domain. Secondly, this paper reveals that governments do not ‘walk the talk’, particularly when it comes to principles relating to Aboriginal participation in health.
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Affiliation(s)
- Joanne N Luke
- Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population & Global Health, The University of Melbourne, 4/207 Bouverie Street, South Carlton, VIC, 3053, Australia.
| | - Angeline S Ferdinand
- Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population & Global Health, The University of Melbourne, 4/207 Bouverie Street, South Carlton, VIC, 3053, Australia
| | - Yin Paradies
- School of Humanities and Social Sciences, Deakin University, Burwood, VIC, 3125, Australia
| | - Daniel Chamravi
- Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population & Global Health, The University of Melbourne, 4/207 Bouverie Street, South Carlton, VIC, 3053, Australia
| | - Margaret Kelaher
- Evaluation and Implementation Science Unit, Centre for Health Policy, Melbourne School of Population & Global Health, The University of Melbourne, 4/207 Bouverie Street, South Carlton, VIC, 3053, Australia
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Davies K, Read DMY, Booth A, Turner N, Gottschall K, Perkins D. Connecting with social and emotional well-being in rural Australia: An evaluation of 'We-Yarn', an Aboriginal gatekeeper suicide prevention workshop. Aust J Rural Health 2020; 28:579-587. [PMID: 33245192 DOI: 10.1111/ajr.12671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This evaluation considered the potential of We-Yarn, a suicide prevention gatekeeper training workshop, to contribute to Aboriginal suicide prevention in rural New South Wales. DESIGN A mixed methods approach included surveys, in-depth interviews and workshop observations. SETTING Aboriginal suicide prevention training in rural New South Wales, Australia. PARTICIPANTS Attendees at We-Yarn training. INTERVENTION We-Yarn provided culturally safe suicide prevention skills training for Aboriginal people and for those who work with Aboriginal communities and persons in rural New South Wales. Training workshops were delivered across multiple locations for 6 hours in one day. Workshops were facilitated by two facilitators with lived and professional experience; one Aboriginal and one non-Aboriginal facilitator. We-Yarn content was developed by staff from the Centre for Rural and Remote Mental Health, and in consultation with Aboriginal Elders and representatives of Aboriginal Medical Services to ensure relevance and cultural appropriateness. MAIN OUTCOME MEASURES Pre and post-workshop surveys captured capacity and participants' confidence in identifying and responding to a person at risk of suicide. Interviews explored participants' experiences of workshops, implementation of learning, and attitudes regarding social and emotional wellbeing and suicide. Observations detailed the workshop environment, participants' engagement, and participants' responses to facilitators and content. RESULTS We-Yarn was considered culturally appropriate. Participants responded to facilitators' lived experiences. Participants reported significant improvements in understanding the links between cultural strengths, social and emotional wellbeing and suicide prevention. However, health professionals with existing knowledge wanted a stronger focus on clinical training. CONCLUSION We-Yarn promoted discussion of suicide prevention within a holistic health framework, building on participants' pre-existing knowledge about social and emotional wellbeing. Importantly, skilful facilitators with lived experience were vital to the success of the workshops. Consideration should be given to attracting people with low suicide prevention knowledge to the workshops, developing tailored workshops for health professionals and ensuring prolonged engagement with communities. Multifaceted and long term responses in addition to this type of training are important.
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Affiliation(s)
- Kate Davies
- Centre for Rural and Remote Mental Health, University of Newcastle, NSW, Australia
| | - Donna M Y Read
- Centre for Rural and Remote Mental Health, University of Newcastle, NSW, Australia
| | - Angela Booth
- Centre for Rural and Remote Mental Health, University of Newcastle, NSW, Australia
| | - Nicole Turner
- Centre for Rural and Remote Mental Health, University of Newcastle, NSW, Australia
| | - Kristina Gottschall
- Centre for Rural and Remote Mental Health, University of Newcastle, NSW, Australia
| | - David Perkins
- Centre for Rural and Remote Mental Health, University of Newcastle, NSW, Australia
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Thurber KA, Thandrayen J, Banks E, Doery K, Sedgwick M, Lovett R. Strengths-based approaches for quantitative data analysis: A case study using the australian Longitudinal Study of Indigenous Children. SSM Popul Health 2020; 12:100637. [PMID: 32923575 PMCID: PMC7475116 DOI: 10.1016/j.ssmph.2020.100637] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/27/2020] [Accepted: 07/28/2020] [Indexed: 10/26/2022] Open
Abstract
In Australia and internationally, there are increasing calls for the use of strengths-based methodologies, to counter the dominant deficit discourse that pervades research, policy, and media relating to Indigenous health and wellbeing. However, there is an absence of literature on the practical application of strengths-based approaches to quantitative research. This paper describes and empirically evaluates a set of strategies to support strengths-based quantitative analysis. A case study about Aboriginal and Torres Strait Islander child wellbeing was used to demonstrate approaches to support strengths-based quantitative analysis, in comparison to the dominant deficit approach of identifying risk factors associated with a negative outcome. Data from Wave 8 (2015) of the Australian Longitudinal Study of Indigenous Children were analysed. The Protective Factors Approach is intended to enable identification of factors protective against a negative outcome, and the Positive Outcome Approach is intended to enable identification of factors associated with a positive health outcome. We compared exposure-outcome associations (prevalence ratios and 95% confidence intervals (CIs), calculated using Poisson regression with robust variance) between the strengths-based and deficit approaches. In this case study, application of the strengths-based approaches retains the identification of statistically significant exposure-outcome associations seen with the standard deficit approach. Strengths-based approaches can enable a more positive story to be told, without altering statistical rigour. For Indigenous research, a strengths-based approach better reflects community values and principles, and it is more likely to support positive change than standard pathogenic models. Further research is required to explore the generalisability of these findings.
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Affiliation(s)
- Katherine A. Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, 2602, Australia
| | - Joanne Thandrayen
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, 2602, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, 2602, Australia
- Sax Institute, Sydney, NSW, Australia
| | - Kate Doery
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, 2602, Australia
- Centre for Social Research and Methods, College of Arts and Social Sciences, Australian National University, Acton, ACT, 2602, Australia
| | - Mikala Sedgwick
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, 2602, Australia
| | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, 2602, Australia
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A review of school trauma-informed practice for Aboriginal and Torres Strait Islander children and youth. THE EDUCATIONAL AND DEVELOPMENTAL PSYCHOLOGIST 2020. [DOI: 10.1017/edp.2020.2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Leckning B, Hirvonen T, Armstrong G, Carey TA, Westby M, Ringbauer A, Robinson G. Developing best practice guidelines for the psychosocial assessment of Aboriginal and Torres Strait Islander people presenting to hospital with self-harm and suicidal thoughts. Aust N Z J Psychiatry 2020; 54:874-882. [PMID: 32456445 PMCID: PMC7469712 DOI: 10.1177/0004867420924082] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To develop guidelines for the culturally responsive psychosocial assessment of Aboriginal and Torres Strait Islander people presenting to hospital with self-harm and suicidal thoughts. METHOD The Delphi method was used to establish expert consensus. A systematic search and review of relevant research literature, existing guidelines and grey literature was undertaken to develop a 286-item questionnaire. The questionnaire contained best practice statements to guide clinicians undertaking psychosocial assessment of Aboriginal and Torres Strait Islander people presenting to hospital with self-harm and suicidal thoughts. An expert panel comprising 28 individuals with clinical, community-based and lived experience in Aboriginal and Torres Strait Islander mental health and/or suicide prevention were recruited and independently rated the items over three rounds. Statements endorsed as essential or important by 90% or more of the expert panel were then synthesised into recommendations for the best practice guideline document. RESULTS A total of 226 statements across all relevant areas of clinical practice were endorsed. No statements covering the use of structured assessment tools were endorsed. The endorsed statements informed the development of a set of underlying principles of culturally competent practice and recommendations for processes of effective and appropriate engagement; risks, needs and strengths to be assessed; formulation of psychosocial assessment; and recommendations specific to children and young people. CONCLUSION The guidelines are based on recommendations endorsed across a range of expertise to address an important gap in the evidence-base for clinically effective and culturally responsive assessment of self-harm and suicidal thoughts by Aboriginal and Torres Strait Islander people in hospital settings. Further work is needed to develop an implementation strategy and evaluate the recommendations in practice.
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Affiliation(s)
- Bernard Leckning
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia,Bernard Leckning, Menzies School of Health Research, Charles Darwin University, Building Red 9, Casuarina Campus, Casuarina, NT 0811, Australia.
| | - Tanja Hirvonen
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Timothy A Carey
- Centre for Remote Health, Flinders University, Alice Springs, NT, Australia
| | - Mark Westby
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - Alix Ringbauer
- Department of Psychology, College of Health & Human Sciences, Charles Darwin University, Casuarina, NT, Australia
| | - Gary Robinson
- Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
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Carlin E, Spry E, Atkinson D, Marley JV. Why validation is not enough: Setting the scene for the implementation of the Kimberley Mum's Mood Scale. PLoS One 2020; 15:e0234346. [PMID: 32530934 PMCID: PMC7292413 DOI: 10.1371/journal.pone.0234346] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/22/2020] [Indexed: 01/15/2023] Open
Abstract
Background The two part Kimberley Mum’s Mood Scale (KMMS) has been developed and validated as a culturally appropriate perinatal depression and anxiety screening tool for Aboriginal women living in the sparsely populated Kimberley region of North West Australia. As part of implementation aspects of user acceptability were explored to improve clinical utilisation of the KMMS. Methods Eighteen health professionals involved in perinatal care participated in an online survey or a qualitative semi-structured interview. Ten Aboriginal women (who held administrative, professional or executive roles) were subsequently interviewed in depth to further explore aspects of KMMS user acceptability. Results Many of the health professionals were not using the second part of the KMMS (the psychosocial discussion tool). Time constraints and a perception that the KMMS is only appropriate for women with literacy issues were identified by health professionals as significant barriers to KMMS uptake. In contrast the Aboriginal women interviewed considered the KMMS to be important for literate Aboriginal women and placed high value on having the time and space to ‘yarn’ with health professionals about issues that are important to them. Conclusion Implementing the KMMS across the Kimberley region requires health professionals to be trained. It also requires strategic engagement with health services to ensure health professionals and mangers understand the rationale and significance of the KMMS and are engaged in its successful implementation.
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Affiliation(s)
- Emma Carlin
- The Rural Clinical School of Western Australia, The University of Western Australia, Broome, Western Australia, Australia
- Kimberley Aboriginal Medical Services, Broome, Western Australia, Australia
- * E-mail:
| | - Erica Spry
- Kimberley Aboriginal Medical Services, Broome, Western Australia, Australia
| | - David Atkinson
- The Rural Clinical School of Western Australia, The University of Western Australia, Broome, Western Australia, Australia
| | - Julia V. Marley
- The Rural Clinical School of Western Australia, The University of Western Australia, Broome, Western Australia, Australia
- Kimberley Aboriginal Medical Services, Broome, Western Australia, Australia
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McCalman J, Langham E, Benveniste T, Wenitong M, Rutherford K, Britton A, Stewart R, Bainbridge R. Integrating Healthcare Services for Indigenous Australian Students at Boarding Schools: A Mixed-Methods Sequential Explanatory Study. Int J Integr Care 2020; 20:8. [PMID: 32194357 PMCID: PMC7068848 DOI: 10.5334/ijic.4669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Accepted: 02/19/2020] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Many Aboriginal and Torres Strait Islander Australian adolescents from remote communities attend boarding schools, requiring integrated healthcare between home and schools. This study explored students' health status, healthcare service use and satisfaction. METHODOLOGY A two-phased mixed-methods explanatory design was implemented. 32 Indigenous primary and 188 secondary boarding school students were asked their health status, psychological distress, use of healthcare services in community and boarding school, and service satisfaction. Results were fed back to students, parents and community members, and education and healthcare staff to elicit further explanation and interpretation. RESULTS In the previous year, 75% of primary and 81% of secondary boarding school students had visited a doctor. More than 90% were satisfied with healthcare services used. Despite 27.1% reporting high psychological distress, students did not perceive distress as reducing their overall health, nor was distress associated with mental healthcare service use. DISCUSSION Despite high levels of service use and satisfaction, this study highlighted the need for improved healthcare integration for Indigenous adolescents between school-based and remote community services. Further research is needed to identify students' expectations and models for healthcare integration. CONCLUSION With resourcing, schools could play a greater role in facilitating access to healthcare.
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Davison B, Liddle R, Fitz J, Singh GR. Computerised emotional well-being and substance use questionnaires in young Indigenous and non-Indigenous Australian adults. SAGE Open Med 2020; 8:2050312120906042. [PMID: 32095239 PMCID: PMC7011318 DOI: 10.1177/2050312120906042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 12/27/2019] [Indexed: 11/15/2022] Open
Abstract
Background: Mental health disorders rank among the most substantial causes of morbidity
and mortality worldwide. Almost half of Australian adults experience mental
illness at some point in their lifetime, with Indigenous Australians
disproportionally affected. Thus, it is imperative that effective,
acceptable screening tools are used, which are tailored to the target
population. Objectives: This research investigates the methodology of computerised questionnaires in
assessing the emotional well-being and substance use in Indigenous and
non-Indigenous young adults. Methods: Cross-sectional data from young adults (21–28 years) in the Life Course
Program, Northern Territory, Australia, are presented. Through an extensive
consultation process, validated questionnaires were adapted to a
computerised format suitable for both remote and urban residing Indigenous
and non-Indigenous adults. Results: Of the 576 participants (459 Indigenous, 117 non-Indigenous) available for
assessment, high consent rates were seen, with completion rates >86%. One
in three young adults in this cohort were highlighted as ‘at risk’ of
psychological distress, and one in five as ‘at risk’ of suicidal ideation or
self-harm. Conclusion: The target population of this study were at a critical age with high levels
of psychological distress and suicidal ideation reported, particularly in
Indigenous young adults. This simple, user-friendly, pictorial programme
allowed assessment of a sensitive topic anonymously, while simultaneously
collating data and identifying those at high risk, irrespective of literacy
level or cultural background.
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Affiliation(s)
- Belinda Davison
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Robyn Liddle
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Joseph Fitz
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Gurmeet R Singh
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Northern Territory Medical Program, Flinders University, Darwin, NT, Australia
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Kularatna S, Lalloo R, Kroon J, Tadakamadla SKK, Scuffham PA, Johnson NW. Demonstration of high value care to improve oral health of a remote Indigenous community in Australia. Health Qual Life Outcomes 2020; 18:43. [PMID: 32093749 PMCID: PMC7041200 DOI: 10.1186/s12955-020-01300-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 02/17/2020] [Indexed: 12/12/2022] Open
Abstract
Background The oral health of Indigenous children in remote communities is much worse than other population groups in Australia. Providing and maintaining an oral health service is challenging due to the remoteness of communities, the associated high cost, and the low retention of clinical staff. An annual preventive intervention delivered by fly-in clinicians may be a more cost-effective way to manage this problem. In this analysis we estimate the cost-effectiveness of an annual professional intervention for the prevention of dental caries in children of a remote Indigenous community in Far North Queensland. Methods A cost-effectiveness analysis was conducted based on an annual preventive intervention protocol. This included treating all dental decay in those with disease, applying fissure sealants, a disinfectant swab, fluoride varnish and providing oral hygiene instructions and dietary advice to all participating school children. This study included an intervention group and a natural comparison group and both groups were followed-up for 2 years after the initial preventive intervention. A Markov model was built to assess the cost-effectiveness of the intervention compared with the usual care. Costs of treatment from the Queensland Department of Health were used and effectiveness was measured as quality-adjusted life years (QALYs) with the CHU-9D. One-way and probabilistic sensitivity analyses were conducted to identify key drivers and quantify uncertainty. Results The preventive intervention was found to be highly cost-effective. The incremental cost per QALY gained was AU$3747. Probability of new caries and seeking treatment were identified as the main drivers of the model. In probabilistic sensitivity analysis intervention was cost effective in 100% of simulations. Conclusion An annual preventive intervention for remote Indigenous communities in Australia is a highly cost-effective strategy to prevent dental caries and improve the quality of life of children.
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Affiliation(s)
- Sanjeewa Kularatna
- Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | - Jeroen Kroon
- School of Dentistry and Oral Health, Giffith University, Gold Coast, Australia
| | | | - Paul A Scuffham
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Newell W Johnson
- School of Dentistry and Oral Health, Giffith University, Gold Coast, Australia.,Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.,Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, England
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My experiences with kidney care: A qualitative study of adults in the Northern Territory of Australia living with chronic kidney disease, dialysis and transplantation. PLoS One 2019; 14:e0225722. [PMID: 31856215 PMCID: PMC6922340 DOI: 10.1371/journal.pone.0225722] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/10/2019] [Indexed: 12/26/2022] Open
Abstract
Background Australian healthcare quality and safety accreditation standards recommend health services partner with health care users, to ensure the highest quality of care. Aboriginal Australians with chronic and end stage kidney disease have high health care access needs. Aim To describe the experiences of health care users of a large government kidney healthcare service provider. Methods Within a government renal health service in the Top-End of the Northern Territory, we undertook a qualitative study involving in-depth interviews with 26 adult clients from urban, regional and remote settings who were living with kidney health conditions. Results Client characteristics included a mean age of 55 years, 55% female and 81% identifying as Aboriginal. The kidney related conditions of client participants included CKD (11, 42.3%), haemodialysis (12, 46.2%), peritoneal dialysis (1, 3.9%), and transplant (2, 7.7%). Key themes emerging from patient interviews related to perceived gaps for clients and carers including: 1) knowledge gaps about the health condition, 2) the impact of relocation in order to access centrally-based renal care, 3) healthcare staff professionalism and qualities and 4) service environments. Overall, the experiences centred on a greater need for client-centred, respectful and culturally based healthcare support. Clients recommended the need for patient-led collective care, including sustaining an Indigenous Patient Reference Group to support ongoing healthcare service decision processes. Participants included in almost equal proportion, clients with CKD (without dialysis) and clients utilising renal replacement therapy, which adds significant weight to the client-identified recommendations for highest quality of kidney care across a wide spectrum of kidney function. Conclusion Four major themes identified by clients related to their experience with renal care provided by this major regional health care provider: knowledge gaps of their own condition, the lived impacts of relocating to access health care, service environments, and Health Care Provider Quality. An Indigenous Patient Reference Group was one mechanism recommended to support the co-design of preferred care models.
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Farnbach S, Gee G, Eades AM, Evans JR, Fernando J, Hammond B, Simms M, DeMasi K, Hackett ML. 'We're here to listen and help them as well': a qualitative study of staff and Indigenous patient perceptions about participating in social and emotional wellbeing research at primary healthcare services. BMC Psychiatry 2019; 19:294. [PMID: 31590642 PMCID: PMC6781305 DOI: 10.1186/s12888-019-2263-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/29/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Research can inform culturally-appropriate care to strengthen social and emotional wellbeing (SEWB) among Aboriginal and Torres Strait Islander (hereafter, the term 'Indigenous Peoples' is respectfully used and refers to all Aboriginal and/or Torres Strait Islander Peoples of Australia). We acknowledge the cultural diversity of Australia's Indigenous First Peoples and they do not represent a homogenous group.) (hereafter Indigenous) Peoples. We explore the perspectives of primary healthcare staff and Indigenous patients about their willingness to and experiences participating in SEWB research. METHOD Process evaluation using grounded theory approaches of Getting it Right: The validation study, a national validation designed Indigenous SEWB research project (N = 500). Primary healthcare staff (n = 36) and community members (n = 4) from nine of ten primary healthcare services involved with the research project completed qualitative semi-structured interviews. Interview data were triangulated with participant feedback (responses to structured questions and free-text feedback collected during Getting it Right), study administrative data (participant screening logs, communication logs, study protocol, deviation logs and ethics correspondence) and interviewer field notes. RESULTS Three themes about staff, patient and community perspectives concerning research participation developed: (1) considering the needs, risk, preferences and impact of participation in research for staff, patients and community; (2) building staff confidence speaking to patients about research and SEWB problems and (3) patients speaking openly about their SEWB. Some staff described pressure to ensure patients had a positive experience with the research, to respond appropriately if patients became upset or SEWB problems were identified during interviews, or due to their dual role as community member and researcher. Patients and staff reported that patients were more likely to participate if they knew the staff outside of the service, especially staff with a shared cultural background, and they perceived SEWB as a community priority. Staff reported their skills speaking to patients about the research and SEWB improved during the research, which built their confidence. Contrary to staff preconceptions, staff and patients reported that many patients appreciated the opportunity to speak about their SEWB and contributing to research that may eventually enhance SEWB in their community. CONCLUSION Our research project was considered acceptable by most staff and patients. The positive outcomes reported by staff and feedback from patients highlights the importance of providing opportunities for people to speak about their SEWB and for research-informed SEWB PHC care. TRIAL REGISTRATION Getting it Right is registered on ANZCTR12614000705684 .
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Affiliation(s)
- Sara Farnbach
- The George Institute for Global Health, PO Box M201, Missenden Road, Camperdown, NSW, 2050, Australia. .,University of New South Wales, Sydney, 2052, Australia. .,The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Graham Gee
- grid.439127.aVictorian Aboriginal Health Service, 186 Nicholson St, 3065, Fitzroy, VIC 3072 Australia ,0000 0001 2179 088Xgrid.1008.9University of Melbourne, Melbourne, VIC 3000 Australia
| | - Anne-Marie Eades
- 0000 0001 1964 6010grid.415508.dThe George Institute for Global Health, PO Box M201, Missenden Road, Camperdown, NSW 2050 Australia ,0000 0004 4902 0432grid.1005.4University of New South Wales, Sydney, 2052 Australia ,0000 0004 1936 834Xgrid.1013.3The University of Sydney, Sydney, NSW 2006 Australia
| | - John Robert Evans
- 0000 0004 1936 834Xgrid.1013.3The University of Sydney, Sydney, NSW 2006 Australia ,0000 0004 1936 7611grid.117476.2The University of Technology, 15 Broadway, Ultimo, NSW 2007 Australia
| | - Jamie Fernando
- The Glen Centre (Ngampie), 50 Church Rd, Chittaway, NSW 2261 Australia
| | - Belinda Hammond
- Nunkuwarrin Yunti of South Australia, Adelaide, South Australia 5000 Australia
| | - Matty Simms
- The Glen Centre (Ngampie), 50 Church Rd, Chittaway, NSW 2261 Australia
| | - Karrina DeMasi
- Aboriginal Medical Services Alliance Northern Territory, Moonta House 43 Mitchell Street, Darwin City, Northern Territory 0801 Australia
| | - Maree L. Hackett
- 0000 0001 1964 6010grid.415508.dThe George Institute for Global Health, PO Box M201, Missenden Road, Camperdown, NSW 2050 Australia ,0000 0004 4902 0432grid.1005.4University of New South Wales, Sydney, 2052 Australia ,0000 0001 2167 3843grid.7943.9The University of Central Lancashire, Preston, PR1 2HE UK
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Macniven R, Canuto K, Wilson R, Bauman A, Evans J. The impact of physical activity and sport on social outcomes among Aboriginal and Torres Strait Islander people: A systematic scoping review. J Sci Med Sport 2019; 22:1232-1242. [PMID: 31281075 DOI: 10.1016/j.jsams.2019.06.017] [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: 04/13/2019] [Revised: 06/21/2019] [Accepted: 06/26/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To identify and describe existing evidence of the impact of sport and physical activity programs on social outcomes among Aboriginal and Torres Strait Islander people. DESIGN Systematic scoping review. METHODS Nine scientific databases (MEDLINE, Scopus, SPORTSDiscus, PsycINFO, Informit, Database of Abstracts of Reviews of Effects (DARE), The Cochrane Library, The Campbell Library, ProQuest Dissertations and Theses) and grey literature were systematically searched for programs or activities that target Aboriginal and Torres Strait Islander people and use physical activity and sport participation to improve one or more of six social and community outcomes of: (i) education; (ii) employment; (iii) culture; (iv) social and emotional wellbeing; (v) life skills; (vi) crime reduction. RESULTS Of the 1160 studies identified, 20 met the inclusion criteria and were published between 2003 and 2018. Most studies reported positive findings across multiple, broad outcomes of education (N = 11), employment (N = 1), culture (N = 9), social and emotional wellbeing (N = 12), life skills (N = 5) and crime reduction (N = 5). Some evidence was found for increased school attendance and improved self-esteem resulting from physical activity and sport participation as well as enhanced aspects of culture, such as cultural connections, connectedness, values and identity. CONCLUSIONS There is some evidence of benefit across the six social outcomes from physical activity and sport programs. This promotes their continuation and development, although critical appraisal of their methods is needed to better quantify benefits, as well as the generation of new evidence across indicators where gaps currently exist, particularly for employment and crime reduction outcomes.
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Affiliation(s)
- Rona Macniven
- University of New South Wales, School of Public Health and Community Medicine, Australia; The University of Sydney, Faculty of Medicine and Health, Poche Centre for Indigenous Health, Australia.
| | - Karla Canuto
- South Australian Health & Medical Research Institute, Wardliparingga Aboriginal Health Unit, Australia
| | - Rachel Wilson
- The University of Sydney, Sydney School of Education & Social Work, Australia
| | - Adrian Bauman
- The University of Sydney, Prevention Research Collaboration, The Charles Perkins Centre, Sydney School of Public Health, Australia
| | - John Evans
- The University of Sydney, Sydney School of Education & Social Work, Australia; University of Technology Sydney, Faculty of Health, Australia
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Balaratnasingam S, Janca A. Depression in Indigenous Australians: getting it right. Med J Aust 2019; 211:16-17. [DOI: 10.5694/mja2.50230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Sivasankaran Balaratnasingam
- Kimberley Mental Health and Drug Service Broome WA
- Aboriginal and Torres Strait Islander Mental Health CommitteeRoyal Australian and New Zealand College of Psychiatrists Melbourne VIC
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Hackett ML, Teixeira‐Pinto A, Farnbach S, Glozier N, Skinner T, Askew DA, Gee G, Cass A, Brown A. Getting it Right: validating a culturally specific screening tool for depression (
aPHQ
‐9) in Aboriginal and Torres Strait Islander Australians. Med J Aust 2019; 211:24-30. [DOI: 10.5694/mja2.50212] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 02/28/2019] [Indexed: 01/25/2023]
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Aboriginal and Torres Strait Islander people's domains of wellbeing: A comprehensive literature review. Soc Sci Med 2019; 233:138-157. [PMID: 31200269 DOI: 10.1016/j.socscimed.2019.06.004] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/03/2019] [Accepted: 06/03/2019] [Indexed: 11/20/2022]
Abstract
There are significant health and social disparities between the world's Indigenous and non-Indigenous people on factors likely to influence quality of life (QOL) and wellbeing. However, these disparities in wellbeing are not captured in conventional QOL instruments, as they often do not include dimensions that are likely to be relevant to Indigenous people. The objective of this comprehensive literature review was to identify these wellbeing domains for Aboriginal and Torres Strait Islander people in Australia (hereafter, respectfully referred to collectively as Indigenous Australians). We searched PsycINFO, MEDLINE, Econlit, CINAHL, and Embase (from inception to June 2017, and updated in March 2019), and grey literature sources using keywords relating to adult Indigenous Australians' QOL and wellbeing. From 278 full-text articles assessed for eligibility, 95 were included in a thematic analysis. This synthesis revealed nine broad interconnected wellbeing dimensions: autonomy, empowerment and recognition; family and community; culture, spirituality and identity; Country; basic needs; work, roles and responsibilities; education; physical health; and mental health. The findings suggest domains of wellbeing relevant to and valued by Indigenous Australians that may not be included in existing QOL and wellbeing instruments, domains that may be shared with Indigenous populations globally. This indicates the need for a tailored wellbeing instrument that includes factors relevant to Indigenous Australians. Developing such an instrument will ensure meaningful, culturally-relevant measurement of Indigenous Australians' wellbeing.
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Chamberlain C, Gee G, Harfield S, Campbell S, Brennan S, Clark Y, Mensah F, Arabena K, Herrman H, Brown S. Parenting after a history of childhood maltreatment: A scoping review and map of evidence in the perinatal period. PLoS One 2019; 14:e0213460. [PMID: 30865679 PMCID: PMC6415835 DOI: 10.1371/journal.pone.0213460] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/21/2019] [Indexed: 01/08/2023] Open
Abstract
Background and aims Child maltreatment is a global health priority affecting up to half of all children worldwide, with profound and ongoing impacts on physical, social and emotional wellbeing. The perinatal period (pregnancy to two years postpartum) is critical for parents with a history of childhood maltreatment. Parents may experience ‘triggering’ of trauma responses during perinatal care or caring for their distressed infant. The long-lasting relational effects may impede the capacity of parents to nurture their children and lead to intergenerational cycles of trauma. Conversely, the perinatal period offers a unique life-course opportunity for parental healing and prevention of child maltreatment. This scoping review aims to map perinatal evidence regarding theories, intergenerational pathways, parents’ views, interventions and measurement tools involving parents with a history of maltreatment in their own childhoods. Methods and results We searched Medline, Psychinfo, Cinahl and Embase to 30/11/2016. We screened 6701 articles and included 55 studies (74 articles) involving more than 20,000 parents. Most studies were conducted in the United States (42/55) and involved mothers only (43/55). Theoretical constructs include: attachment, social learning, relational-developmental systems, family-systems and anger theories; ‘hidden trauma’, resilience, post-traumatic growth; and ‘Child Sexual Assault Healing’ and socioecological models. Observational studies illustrate sociodemographic and mental health protective and risk factors that mediate/moderate intergenerational pathways to parental and child wellbeing. Qualitative studies provide rich descriptions of parental experiences and views about healing strategies and support. We found no specific perinatal interventions for parents with childhood maltreatment histories. However, several parenting interventions included elements which address parental history, and these reported positive effects on parent wellbeing. We found twenty-two assessment tools for identifying parental childhood maltreatment history or impact. Conclusions Perinatal evidence is available to inform development of strategies to support parents with a history of child maltreatment. However, there is a paucity of applied evidence and evidence involving fathers and Indigenous parents.
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Affiliation(s)
- Catherine Chamberlain
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- * E-mail:
| | - Graham Gee
- Victorian Aboriginal Health Service, Melbourne, Victoria, Australia
| | - Stephen Harfield
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
- Sansom Institute for Health Research, The University of South Australia, Adelaide, South Australia, Australia
| | - Sandra Campbell
- Centre for Chronic Disease Prevention, James Cook University, Cairns, Queensland, Australia
- Centre for Indigenous Health Equity Research, Central Queensland University, Cairns, Queensland, Australia
| | - Sue Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Yvonne Clark
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- School of Psychology, University of Adelaide, Hughes, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Fiona Mensah
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Royal Children’s Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Kerry Arabena
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Herrman
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
| | - Stephanie Brown
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
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Banham D, Karnon J, Lynch J. Health related quality of life (HRQoL) among Aboriginal South Australians: a perspective using survey-based health utility estimates. Health Qual Life Outcomes 2019; 17:39. [PMID: 30777065 PMCID: PMC6378737 DOI: 10.1186/s12955-019-1107-z] [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: 08/17/2018] [Accepted: 02/07/2019] [Indexed: 11/10/2022] Open
Abstract
Background Australian health surveys occasionally include health utility measures in describing health related quality of life (HRQoL) across the general population. However, the HRQoL of specific population groups, such as Aboriginal and Torres Strait Islander (respectfully referred to as Aboriginal), are poorly understood. Our analysis describes HRQoL utility among Aboriginal South Australians by examining the characteristics of respondents completing HRQoL questioning, the relationship between HRQoL and respondent characteristics, then considers reported HRQoL utility in the wider population context. Methods Population weighted and self-reported HRQoL was measured using SF-6D, as derived from the SF-12 version 2, in the South Australian Aboriginal Health Survey’s face to face interviews with 399 respondents aged 15 or more in 2010/11. Results Mean HRQoL utility was 0.77 (95% CIs 0.76–0.79) with marked variations by gender (females 0.03, 95% CIs 0.00–0.06 lower than males), age (with ages 55 or more 0.08, 95% CIs 0.02–0.14 lower than 15–35 years) and number of chronic health conditions (3 or more conditions 0.14, 95% CIs 0.09–0.19 lower than those with 0 conditions). A pattern of response to HRQoL questions was also evident. Response was less likely among respondents speaking Aboriginal languages at home, living in non-urban settings, and experiencing multiple chronic health conditions. Conclusions The SF-6D provides useful information on the HRQoL of Aboriginal South Australians. However, non-completion was pronounced among respondents speaking traditional languages and experiencing more chronic health conditions. Improved participation of vulnerable and health compromised respondents through culturally safe and relevant self-reporting HRQoL utility instruments is needed.
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Affiliation(s)
- David Banham
- School of Public Health, University of Adelaide, North Terrace, Adelaide, South Australia, 5000. .,Wardliparingga Aboriginal Health Research, South Australian Health and Medical Research Institute, North Terrace, Adelaide, South Australia, 5000. .,Division of Health Sciences, University of South Australia, North Terrace, Adelaide, South Australia, 5000.
| | - Jonathan Karnon
- School of Public Health, University of Adelaide, North Terrace, Adelaide, South Australia, 5000
| | - John Lynch
- School of Public Health, University of Adelaide, North Terrace, Adelaide, South Australia, 5000
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"Here we are part of a living culture": Understanding the cultural determinants of health in Aboriginal gathering places in Victoria, Australia. Health Place 2018; 54:210-220. [PMID: 30368099 DOI: 10.1016/j.healthplace.2018.10.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 02/03/2023]
Abstract
This article provides an exploration of the cultural determinants of health, based on a research evaluation investigating a number of Aboriginal gathering places in Victoria (Australia). Gathering places are recognised as settings in which people practice and learn about local Aboriginal culture, history and place. Academic literature on gathering places is sparse. Thirteen gathering places were evaluated in this research. Each site is unique and has a specific story that connects it to the history and geography of the place in which it is located. Sixty-nine gathering place members participated in qualitative semi-structured interviews or focus groups. Using thematic analysis, the findings were divided into four key themes associated with cultural determinants of health (social networks; inclusiveness; empowerment; connections). These elements create a safe place to learn about culture and Country, and support an environment for strengthening identity, improving health and building resilience. The findings from this study highlight the benefits of using gathering places to explore the cultural determinants of health.
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Langham E, McCalman J, Redman-MacLaren M, Hunter E, Wenitong M, Britton A, Rutherford K, Saunders V, Ungar M, Bainbridge R. Validation and Factor Analysis of the Child and Youth Resilience Measure for Indigenous Australian Boarding School Students. Front Public Health 2018; 6:299. [PMID: 30406069 PMCID: PMC6206896 DOI: 10.3389/fpubh.2018.00299] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 09/28/2018] [Indexed: 12/27/2022] Open
Abstract
Introduction: Resilience is a strengths-based construct that is useful for understanding differences in health and wellbeing among youth. There are a range of validated survey instruments available to measure resilience for Aboriginal and Torres Strait Islander (hereafter respectfully Indigenous1) youth. However, standard international instruments should only be used if they have been subjected to a rigorous cross-cultural adaptation process and psychometric evaluation in the target population to ensure their validity. The aim of the study was to validate an adapted Child and Youth Resilience Measure (CYRM-28) within a sample of Indigenous Australian boarding school students. Method: The CYRM-28, augmented with an additional 11 site specific items was administered to a purposive sample of Australian Indigenous boarding school students (n = 233) as part of the broader T4S survey instrument that captures demographic information and measures resilience, psychological distress and risk, and service usage. Confirmatory factor analysis was undertaken to verify the relationship between the observed variables with the theoretical constructs of the CYRM-28 and previous findings on the factor structure. Cronbach alpha was also calculated to assess the internal consistency of the CYRM-28 within this sample. Results: Survey data were not a good fit for any previously identified models of the CYRM-28, although the inclusion of a site-specific variable improved the overall fit statistics. Two separate scales were confirmed that capture the sources and expressions of resilience for Indigenous Australian boarding school students. This structure is different to previous findings in relation to the CYRM-28, but consistent with conceptualizations of resilience as a dynamic process. Conclusions: The findings are useful in guiding the future use of the CYRM-28 instrument, explorations of Indigenous youth resilience, and for services working with Indigenous youth in out of home care situations. They highlight contextual differences in the measurement of resilience and the importance of validating standard instruments that have been subjected to rigorous cross-cultural adaptation processes. The two scales offer practical guidance to human services working with Indigenous youth on strategies to build and monitor resilience in Indigenous Australian youth and contribute to the emergent understanding of their resilience.
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Affiliation(s)
- Erika Langham
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Science, Central Queensland University, Cairns, QLD, Australia
| | - Janya McCalman
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Science, Central Queensland University, Cairns, QLD, Australia.,Cairns Institute, James Cook University, Cairns, QLD, Australia
| | - Michelle Redman-MacLaren
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Science, Central Queensland University, Cairns, QLD, Australia.,College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
| | - Ernest Hunter
- Cairns Institute, James Cook University, Cairns, QLD, Australia.,School of Population Health, University of Queensland, Brisbane, QLD, Australia
| | - Mark Wenitong
- Apunipima Cape York Health Council, Cairns, QLD, Australia
| | - Amelia Britton
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Science, Central Queensland University, Cairns, QLD, Australia
| | - Katrina Rutherford
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Science, Central Queensland University, Cairns, QLD, Australia
| | - Vicki Saunders
- Aboriginal & Torres Strait Islander Child and Youth Outcomes Project, Australian Research Alliance for Children & Youth, Canberra, ACT, Australia.,Griffith Criminology Institute, Griffith University, Brisbane, QLD, Australia
| | - Michael Ungar
- Resilience Research Centre, Dalhousie University, Halifax, NS, Canada
| | - Roxanne Bainbridge
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Science, Central Queensland University, Cairns, QLD, Australia.,Cairns Institute, James Cook University, Cairns, QLD, Australia.,College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
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Evans JR, Wilson R, Coleman C, Man WYN, Olds T. Physical activity among indigenous Australian children and youth in remote and non-remote areas. Soc Sci Med 2018; 206:93-99. [DOI: 10.1016/j.socscimed.2018.04.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/12/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
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