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Naidu P, Paolucci Muran-Iwaidja O, Luta Kaurareg R, Hughes Wagadagam JT. Optimisation during transition to dialysis commencement. Med J Aust 2024; 221:18-24. [PMID: 38946647 DOI: 10.5694/mja2.52347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/07/2024] [Indexed: 07/02/2024]
Affiliation(s)
| | | | | | - Jaquelyne T Hughes Wagadagam
- Royal Darwin Hospital, Darwin, NT
- Flinders Health and Medical Research Institute, Flinders University, Darwin, NT
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Dias T, MacKay D, Canuto K, Boyle JA, D’Antoine H, Hampton D, Martin K, Phillips J, Bartlett N, Mcintyre HD, Graham S, Corpus S, Connors C, McCarthy L, Kirkham R, Maple-Brown LJ. Supporting healthy lifestyles for First Nations women and communities through co-design: lessons and early findings from remote Northern Australia. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 5:1356060. [PMID: 38863516 PMCID: PMC11165116 DOI: 10.3389/fcdhc.2024.1356060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/24/2024] [Indexed: 06/13/2024]
Abstract
Background The period before, during, and after pregnancy presents an opportunity to reduce diabetes-related risks, which in Australia disproportionately impact Aboriginal and Torres Strait Islander women. Collaboration with Aboriginal and Torres Strait Islander women/communities is essential to ensure acceptability and sustainability of lifestyle modifications. Using a novel co-design approach, we aimed to identify shared priorities and potential lifestyle strategies. We also reflected on learnings from this approach. Methods We conducted 11 workshops and 8 interviews at two sites in Australia's Northern Territory (Central Australia and Top End), using experience-based co-design (EBCD) and incorporating principles of First Nations participatory research. Workshops/interviews explored participant' experiences and understanding of diabetes in pregnancy, contextual issues, and potential lifestyle strategies. Participants included three groups: 1) Aboriginal and Torres Strait Islander women of reproductive age (defined as aged 16-45 years); 2) Aboriginal and Torres Strait Islander community members; and 3) health/community services professionals. The study methodology sought to amplify the voices of Aboriginal women. Findings Participants included 23 women between ages 16-45 years (9 with known lived experience of diabetes in pregnancy), 5 community members and 23 health professionals. Key findings related to identified priority issues, strategies to address priorities, and reflections on use of EBCD methodology. Priorities were largely consistent across study regions: access to healthy foods and physical activity; connection to traditional practices and culture; communication regarding diabetes and related risks; and the difficulty for women of prioritising their health among competing priorities. Strategies included implementation of a holistic women's program in Central Australia, while Top End participants expressed the desire to improve nutrition, peer support and community awareness of diabetes. EBCD provided a useful structure to explore participants' experiences and collectively determine priorities, while allowing for modifications to ensure co-design methods were contextually appropriate. Challenges included the resource-intensive nature of stakeholder engagement, and collaborating effectively with services and communities when researchers were "outsiders". Conclusions A hybrid methodology using EBCD and First Nations participatory research principles enabled collaboration between Aboriginal women, communities and health services to identify shared priorities and solutions to reduce diabetes-related health risks. Genuine co-design processes support self-determination and enhance acceptability and sustainability of health strategies.
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Affiliation(s)
- Tara Dias
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Diana MacKay
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Department of Endocrinology, Royal Darwin Hospital, Darwin, NT, Australia
| | - Karla Canuto
- College of Medicine and Public Health, Flinders University , Melbourne, VIC, Australia
| | - Jacqueline A. Boyle
- Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia
| | - Heather D’Antoine
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Denella Hampton
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
- Aboriginal and Torres Strait Islander Advisory Group, Diabetes Across the Lifecourse: Northern Australia Partnership, Darwin, NT, Australia
| | - Kim Martin
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Jessica Phillips
- Women’s Cultural Hub, Mala’la Community Wellness Centre, Mala’la Aboriginal Health Corporation, Maningrida, NT, Australia
| | - Norlisha Bartlett
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - H. David Mcintyre
- Mater Research, The University of Queensland, Brisbane, QLD, Australia
| | - Sian Graham
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Aboriginal and Torres Strait Islander Advisory Group, Diabetes Across the Lifecourse: Northern Australia Partnership, Darwin, NT, Australia
| | - Sumaria Corpus
- Aboriginal and Torres Strait Islander Advisory Group, Diabetes Across the Lifecourse: Northern Australia Partnership, Darwin, NT, Australia
- Northern Territory Department of Health, Darwin, NT, Australia
| | | | - Leisa McCarthy
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Anyinginyi Health Aboriginal Corporation, Tennant Creek, NT, Australia
| | - Renae Kirkham
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Louise J. Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Department of Endocrinology, Royal Darwin Hospital, Darwin, NT, Australia
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3
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Cormick A, Graham A, Stevenson T, Owen K, O'Donnell K, Kelly J. Co-designing a Health Journey Mapping resource for culturally safe health care with and for First Nations people. Aust J Prim Health 2024; 30:PY23172. [PMID: 38621019 DOI: 10.1071/py23172] [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: 09/12/2023] [Accepted: 03/13/2024] [Indexed: 04/17/2024]
Abstract
Background Many healthcare professionals and services strive to improve cultural safety of care for Australia's First Nations people. However, they work within established systems and structures that do not reliably meet diverse health care needs nor reflect culturally safe paradigms. Journey mapping approaches can improve understanding of patient/client healthcare priorities and care delivery challenges from healthcare professionals' perspectives leading to improved responses that address discriminatory practices and institutional racism. This project aimed to review accessibility and usability of the existing Managing Two Worlds Together (MTWT) patient journey mapping tools and resources, and develop new Health Journey Mapping (HJM) tools and resources. Method Four repeated cycles of collaborative participatory action research were undertaken using repeated cycles of look and listen, think and discuss, take action together. A literature search and survey were conducted to review accessibility and usability of MTWT tools and resources. First Nations patients and families, and First Nations and non-First Nations researchers, hospital and university educators and healthcare professionals (end users), reviewed and tested HJM prototypes, shaping design, format and focus. Results The MTWT tool and resources have been used across multiple health care, research and education settings. However, many users experienced initial difficulty engaging with the tool and offered suggested improvements in design and usability. End user feedback on HJM prototypes identified the need for three distinct mapping tools for three different purposes: clinical care, detailed care planning and strategic mapping, to be accompanied by comprehensive resource materials, instructional guides, videos and case study examples. These were linked to continuous quality improvement and accreditation standards to enhance uptake in healthcare settings. Conclusion The new HJM tools and resources effectively map diverse journeys and assist recognition and application of strengths-based, holistic and culturally safe approaches to health care.
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Affiliation(s)
- Alyssa Cormick
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
| | - Amy Graham
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
| | - Tahlee Stevenson
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
| | - Kelli Owen
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
| | - Kim O'Donnell
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia; and College of Medicine and Public Health, Flinders University, Kaurna Yarta, Bedford Park, SA 2100, Australia
| | - Janet Kelly
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
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Samuels I, Hamm LM, Silva JC, Tousignant B, Furtado JM, Goodman L, Watene R, Adams J, Ramke J, Harwood M. Use of the CONSIDER statement by eye health researchers when conducting and reporting research involving Indigenous peoples: an online survey. Eye (Lond) 2024:10.1038/s41433-023-02881-6. [PMID: 38195924 DOI: 10.1038/s41433-023-02881-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Indigenous peoples experience worse eye health compared to non-Indigenous peoples. Service providers and researchers must avoid perpetuating this inequity. To help achieve this, researchers can use the CONSolIDated critERia for strengthening the reporting of health research involving Indigenous peoples (CONSIDER) statement. This study aimed to identify the degree to which the CONSIDER statement has been used by eye health researchers when conducting and reporting research with an Indigenous component, and how they perceive its relevance in their future research. METHODS We used purposive sampling to recruit eye health researchers from any country who have undertaken research with an Indigenous component. The online survey collected quantitative and qualitative data and was analysed using descriptive statistics and reflexive thematic analysis. Responses were gathered on a four-point Likert scale (1 to 4), with four being the most positive statement. RESULTS Thirty-nine eye health researchers from nine countries completed the survey (Aotearoa New Zealand, Argentina, Australia, Brazil, Canada, Colombia, Guatemala, Panama, Peru); almost two-thirds (n = 24) undertake epidemiological research. On average, participants disclosed only 'sometimes' previously reporting CONSIDER items (2.26 ± 1.14), but they thought the items were relevant to eye health research and were motivated to use these guidelines in their future research. Some participants requested clarity about how CONSIDER aligned with existing guidelines, and when and how to apply the statement. Others shared rich experiences of the benefits to their research of Indigenous leadership and collaboration. CONCLUSIONS The CONSIDER statement is perceived as a valuable tool by these eye health researchers, and there are opportunities to maximise uptake and use, including increasing awareness of the statement, clarity about when it applies, and availability of institutional-level support.
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Affiliation(s)
- Isaac Samuels
- Department of Ophthalmology, University of Auckland, Auckland, 1142, New Zealand
| | - Lisa M Hamm
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand
| | | | - Benoit Tousignant
- School of Optometry, Université de Montréal, Montreal, H3T 1P1, QC, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, H3C 3T4, QC, Canada
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Lucy Goodman
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand
| | - Renata Watene
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand
| | - Jaki Adams
- The Fred Hollows Foundation, Darwin, Australia
| | - Jacqueline Ramke
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand.
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
| | - Matire Harwood
- School of Population Health, University of Auckland, Auckland, 1142, New Zealand
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Yashadhana A, Zwi AB, Brady B, De Leeuw E, Kingsley J, O'Leary M, Raven M, Serova N, Topp SM, Fields T, Foster W, Jopson W, Biles B. Gaawaadhi Gadudha: understanding how cultural camps impact health, well-being and resilience among Aboriginal adults in New South Wales, Australia-a collaborative study protocol. BMJ Open 2023; 13:e073551. [PMID: 38135326 DOI: 10.1136/bmjopen-2023-073551] [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] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION The health and well-being of Aboriginal Australians is inextricably linked to culture and Country. Our study challenges deficit approaches to health inequities by seeking to examine how cultural connection, practice and resilience among Aboriginal peoples through participation in 'cultural camps' held on sites of cultural significance promotes health and well-being. METHODS AND ANALYSIS The study will be undertaken in close collaboration and under the governance of traditional cultural knowledge holders from Yuwaalaraay, Gamilaraay and Yuin nation groups in New South Wales, Australia. Three cultural camps will be facilitated, where participants (n=105) will engage in activities that foster a connection to culture and cultural landscapes. A survey assessing connection to culture, access to cultural resources, resilience, self-rated health and quality of life will be administered to participants pre-camp and post-camp participation, and to a comparative group of Aboriginal adults who do not attend the camp (n=105). Twenty participants at each camp (n=60) will be invited to participate in a yarning circle to explore cultural health, well-being and resilience. Quantitative analysis will use independent samples' t-tests or χ2 analyses to compare camp and non-camp groups, and linear regression models to determine the impact of camp attendance. Qualitative analysis will apply inductive coding to data, which will be used to identify connections between coded concepts across the whole data set, and explore phenomenological aspects. Results will be used to collaboratively develop a 'Model of Cultural Health' that will be refined through a Delphi process with experts, stakeholders and policymakers. ETHICS AND DISSEMINATION The study has ethics approval from the Aboriginal Health and Medical Research Council (#1851/21). Findings will be disseminated through a combination of peer-reviewed articles, media communication, policy briefs, presentations and summary documents to stakeholders.
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Affiliation(s)
- Aryati Yashadhana
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Anthony B Zwi
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Brooke Brady
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Evelyne De Leeuw
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- École de Santé Publique, l'Université de Montréal, Montréal, Quebec, Canada
| | - Jonathan Kingsley
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Michelle O'Leary
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Miri Raven
- Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Nina Serova
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephanie M Topp
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Ted Fields
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Warren Foster
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Wendy Jopson
- Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Brett Biles
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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6
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Nykiforuk CIJ, Belon AP, de Leeuw E, Harris P, Allen-Scott L, Atkey K, Glenn NM, Hyshka E, Jaques K, Kongats K, Montesanti S, Nieuwendyk LM, Pabayo R, Springett J, Yashadhana A. An action-oriented public health framework to reduce financial strain and promote financial wellbeing in high-income countries. Int J Equity Health 2023; 22:66. [PMID: 37055742 PMCID: PMC10099014 DOI: 10.1186/s12939-023-01877-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 03/28/2023] [Indexed: 04/15/2023] Open
Abstract
BACKGROUND Perceived financial security impacts physical, mental, and social health and overall wellbeing at community and population levels. Public health action on this dynamic is even more critical now that the COVID-19 pandemic has exacerbated financial strain and reduced financial wellbeing. Yet, public health literature on this topic is limited. Initiatives targeting financial strain and financial wellbeing and their deterministic effects on equity in health and living conditions are missing. Our research-practice collaborative project addresses this gap in knowledge and intervention through an action-oriented public health framework for initiatives targeting financial strain and wellbeing. METHODS The Framework was developed using a multi-step methodology that involved review of theoretical and empirical evidence alongside input from a panel of experts from Australia and Canada. In an integrated knowledge translation approach, academics (n = 14) and a diverse group of experts from government and non-profit sectors (n = 22) were engaged throughout the project via workshops, one-on-one dialogues, and questionnaires. RESULTS The validated Framework provides organizations and governments with guidance for the design, implementation, and assessment of diverse financial wellbeing- and financial strain-related initiatives. It presents 17 priority actionable areas (i.e., entry points for action) likely to have long-lasting, positive effects on people's financial circumstances, contributing to improved financial wellbeing and health. The 17 entry points relate to five domains: Government (All Levels), Organizational & Political Culture, Socioeconomic & Political Context, Social & Cultural Circumstances, and Life Circumstances. CONCLUSIONS The Framework reveals the intersectionality of root causes and consequences of financial strain and poor financial wellbeing, while also reinforcing the need for tailored actions to promote socioeconomic and health equity for all people. The dynamic, systemic interplay of the entry points illustrated in the Framework suggest opportunities for multi-sectoral, collaborative action across government and organizations towards systems change and the prevention of unintended negative impacts of initiatives.
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Affiliation(s)
- Candace I. J. Nykiforuk
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Ana Paula Belon
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Evelyne de Leeuw
- Centre for Primary Health Care & Equity, University of New South Wales, Level 3, AGSM, UNSW, Sydney, NSW 2052 Australia
| | - Patrick Harris
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Sydney Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, NSW, Liverpool, BC 1871 Australia
| | - Lisa Allen-Scott
- Provincial Population and Public Health, Alberta Health Services, 2210, 2nd Street SW, Calgary, AB T2S 3C3 Canada
| | - Kayla Atkey
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Nicole M. Glenn
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Elaine Hyshka
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Karla Jaques
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Sydney Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, NSW, Liverpool, BC 1871 Australia
| | - Krystyna Kongats
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Stephanie Montesanti
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Laura M. Nieuwendyk
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Roman Pabayo
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Jane Springett
- Centre for Healthy Communities, School of Public Health, University of Alberta, ECHA 3-300, 11405-87 Ave, Edmonton, AB T6G 1C9 Canada
| | - Aryati Yashadhana
- Centre for Primary Health Care & Equity, University of New South Wales, Level 3, AGSM, UNSW, Sydney, NSW 2052 Australia
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Mathew S, Fitts MS, Liddle Z, Bourke L, Campbell N, Murakami-Gold L, Russell DJ, Humphreys JS, Mullholand E, Zhao Y, Jones MP, Boffa J, Ramjan M, Tangey A, Schultz R, Wakerman J. Telehealth in remote Australia: a supplementary tool or an alternative model of care replacing face-to-face consultations? BMC Health Serv Res 2023; 23:341. [PMID: 37020234 PMCID: PMC10074370 DOI: 10.1186/s12913-023-09265-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/08/2023] [Indexed: 04/07/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic increased the use of telehealth consultations by telephone and video around the world. While telehealth can improve access to primary health care, there are significant gaps in our understanding about how, when and to what extent telehealth should be used. This paper explores the perspectives of health care staff on the key elements relating to the effective use of telehealth for patients living in remote Australia. METHODS Between February 2020 and October 2021, interviews and discussion groups were conducted with 248 clinic staff from 20 different remote communities across northern Australia. Interview coding followed an inductive approach. Thematic analysis was used to group codes into common themes. RESULTS Reduced need to travel for telehealth consultations was perceived to benefit both health providers and patients. Telehealth functioned best when there was a pre-established relationship between the patient and the health care provider and with patients who had good knowledge of their personal health, spoke English and had access to and familiarity with digital technology. On the other hand, telehealth was thought to be resource intensive, increasing remote clinic staff workload as most patients needed clinic staff to facilitate the telehealth session and complete background administrative work to support the consultation and an interpreter for translation services. Clinic staff universally emphasised that telehealth is a useful supplementary tool, and not a stand-alone service model replacing face-to-face interactions. CONCLUSION Telehealth has the potential to improve access to healthcare in remote areas if complemented with adequate face-to-face services. Careful workforce planning is required while introducing telehealth into clinics that already face high staff shortages. Digital infrastructure with reliable internet connections with sufficient speed and latency need to be available at affordable prices in remote communities to make full use of telehealth consultations. Training and employment of local Aboriginal staff as digital navigators could ensure a culturally safe clinical environment for telehealth consultations and promote the effective use of telehealth services among community members.
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Affiliation(s)
- Supriya Mathew
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia.
| | - Michelle S Fitts
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia
- Institute for Culture and Society, Western Sydney University, Parramatta, NSW, Australia
| | - Zania Liddle
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia
| | - Lisa Bourke
- Department of Rural Health, The University of Melbourne, Shepparton, VIC, Australia
| | - Narelle Campbell
- Flinders Rural and Remote Health Northern Territory, College of Medicine and Public Health, Flinders University, Darwin, NT, Australia
| | | | - Deborah J Russell
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia
| | - John S Humphreys
- School of Rural Health, Monash University, Bendigo, VIC, Australia
| | | | - Yuejen Zhao
- Northern Territory Department of Health, Darwin, NT, Australia
| | - Michael P Jones
- School of Psychological Sciences, Macquarie University, North Ryde, NSW, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - Mark Ramjan
- Top End Population and Primary Health Care, Northern Territory Government, Casuarina, NT, Australia
| | - Annie Tangey
- Ngaanyatjarra Health Service, Alice Springs, NT, Australia
| | | | - John Wakerman
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT, Australia
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8
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Anstice NS, Alam K, Armitage JA, Biles B, Black JM, Boon MY, Carlson T, Chinnery HR, Collins AV, Cochrane A, Duthie D, Hopkins S, Fitzpatrick G, Keay L, Watene R, Yashadhana A, Bentley SA. Developing culturally safe education practices in optometry schools across Australia and Aotearoa New Zealand. Clin Exp Optom 2023; 106:110-118. [PMID: 36336833 DOI: 10.1080/08164622.2022.2136514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Access to culturally safe health services is a basic human right, however through the lasting effects of colonisation, oppression, and systemic racism, the individual and community health of Indigenous peoples in Australia and Aotearoa New Zealand have been severely impacted. The Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy of the Australian Health Practitioners Regulation Agency, and the Standards of Cultural Competence and Cultural Safety of the Optometrists and Dispensing Opticians Board of New Zealand, recognise the importance of access to safe health care for Aboriginal, Torres Strait Islander and Māori patients, which encompasses both clinical competency and cultural safety. Universities have an ongoing responsibility to ensure their learning and teaching activities result in graduates being able to provide culturally safe practice. This article highlights the emergence of culturally safe practices in the Australian and Aotearoa New Zealand optometry curricula over the last five years incorporating Indigenous ways of knowing, being and doing into the curricula, understanding the local Indigenous histories and contexts, the adoption of online cultural education modules, and clinical placement partnerships with local Indigenous communities. Whilst there is still much work to do to achieve the goal of graduating culturally safe optometrists, this paper focuses on features that enable or impede progress in the development of culturally safe practices within the optometry programmes to improve eye health equity for Indigenous recognise the diversity of Indigenous cultures across Australia and NZ.
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Affiliation(s)
- Nicola S Anstice
- Optometry and Vision Science, Flinders University, Adelaide, Australia
| | - Khyber Alam
- Division of Optometry, University of Western Australia, Perth, Australia
| | - James A Armitage
- School of Medicine (Optometry), Deakin University, Geelong, Australia
| | - Brett Biles
- Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Joanna M Black
- School of Optometry and Vision Science, The University of Auckland, Aotearoa New Zealand
| | - Mei Ying Boon
- Optometry and Vision Science, University of Canberra, Bruce, Australia
| | - Teah Carlson
- College of Health, Massey University, Aotearoa, New Zealand
| | - Holly R Chinnery
- Department of Optometry and Vision Science, The University of Melbourne, Melbourne, Australia
| | - Andrew V Collins
- School of Optometry and Vision Science, The University of Auckland, Aotearoa New Zealand
| | - Anthea Cochrane
- Department of Optometry and Vision Science, The University of Melbourne, Melbourne, Australia
| | - Debbie Duthie
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Shelley Hopkins
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Australia
| | - Gary Fitzpatrick
- Division of Optometry, University of Western Australia, Perth, Australia
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Renata Watene
- School of Optometry and Vision Science, The University of Auckland, Aotearoa New Zealand
| | - Aryati Yashadhana
- Office of Medical Education, University of New South Wales, Sydney, Australia
| | - Sharon A Bentley
- School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Australia
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9
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Estevez JJ, Hamlyn BR, Anjou Am MD, Nicholls S, Hutchinson L, Cappuccio S. Lessons learnt during the COVID-19 pandemic: supporting Aboriginal and Torres Strait Islander eye health care. Clin Exp Optom 2023; 106:215-217. [PMID: 36062385 DOI: 10.1080/08164622.2022.2114820] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Jose J Estevez
- Wardliparingga Aboriginal Health Equity Theme, South Australia Health and Medical Research Institute, Adelaide, Australia.,Optometry and Vision Science, Flinders University, Adelaide, Australia
| | - Ben R Hamlyn
- Optometry Australia, South Melbourne, Australia.,Private Practitioner, Community Eyecare, Australia
| | - Mitchell D Anjou Am
- Indigenous Eye Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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10
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Topp SM, Tully J, Cummins R, Graham V, Yashadhana A, Elliott L, Taylor S. Rhetoric, Reality and Racism: The Governance of Aboriginal and Torres Strait Islander Health Workers in a State Government Health Service in Australia. Int J Health Policy Manag 2022; 11:2951-2963. [PMID: 35569001 PMCID: PMC10105169 DOI: 10.34172/ijhpm.2022.6750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 04/22/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND In northern Australia, Aboriginal and Torres Strait Islander Health Workers (A&TSIHWs) are unique members of nominally integrated teams of primary care professionals. Spurred by research documenting ongoing structural violence experienced by Indigenous health providers and more recent challenges to recruitment and retention of A&TSIHWs, this study aimed to explore whether the governance of the A&TSIHW role supports full and meaningful participation. METHODS The qualitative study was co-designed by a team of Aboriginal, Torres Strait Islander and non-Indigenous collaborators. Data collection comprised document review and interviews with A&TSIHWs (n=51), clinicians (n=19) community members (n=8) and administrators (n=5) in a north Queensland health district. We analysed governance at multiple levels (regulatory, organisational, and socio-cultural) and used critical race theory to deepen exploration of the role of race and racism in shaping it. RESULTS Governance of the A&TSIHW role occurs within a health system where racism is built into, and amplified by, formal and informal rules at all levels. Racially discriminatory structures such as the previous but long-standing relegation of A&TSIHW into the same career stream as cleaners were mirrored in discriminatory rules and managerial practices such as an absence of career-specific corporate support and limited opportunities to participate in, or represent to, key leadership groups. These interacted with and helped perpetuate workplace norms permissive of disrespect and abuse by non-Indigenous professionals. Ongoing resistance to the structural violence required of, and demonstrated by A&TSIHWs speaks to the gap between rhetoric and reality of governance for A&TSIHWs. CONCLUSION Strengthening governance to support A&TSIHWs requires critical attention be given to the role of race and racism in regulatory structures, organisational practice, and inter-professional relationships. Addressing all domains will be essential to achieve systemic change that recognises, supports and embeds the unique knowledge, skills and functions of the A&TSIHW role.
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Affiliation(s)
- Stephanie M. Topp
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Josslyn Tully
- Torres and Cape Hospital and Health Services (TCHSS), Cairns, QLD, Australia
| | - Rachel Cummins
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Veronica Graham
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
| | - Aryati Yashadhana
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, UNSW, Sydney, NSW, Australia
- School of Social Sciences, UNSW, Sydney, NSW, Australia
| | - Lana Elliott
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- School of Public Health and Social Work, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - Sean Taylor
- College of Public Health Medical and Veterinary Sciences, James Cook University, Townsville, QLD, Australia
- NT Health, Darwin, NT, Australia
- Menzies School of Health Research, Darwin, NT, Australia
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11
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Khan A, Green K, Medlin L, Khandaker G, Lawler S, Gartner C. Impact of the '10,000 lives' program on Quitline referrals, use and outcomes by demography and Indigenous status. Drug Alcohol Rev 2022; 41:1499-1509. [PMID: 35830355 PMCID: PMC9796440 DOI: 10.1111/dar.13499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/12/2022] [Accepted: 05/04/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION In November 2017, Central Queensland Public Health Unit launched the '10,000 Lives' initiative to reduce smoking prevalence in Central Queensland. The program partnered with local champions and other programs (e.g. 'Deadly Choices') to promote the use of smoking cessation services (e.g. Quitline) in Central Queensland. This study assesses the program's impact on Quitline use by participant demographics and Indigenous status. METHODS We compared the number of referred individuals who participated in and completed the Quitline program, and quit smoking during 26-months before (July 2015 to August 2017) and after (November 2017 to December 2019) the '10,000 Lives' launch. We conducted an interrupted time series analysis of monthly referrals to and use of Quitline for Aboriginal and Torres Strait Islander peoples. RESULTS Overall, 3207 individuals were referred to Quitline during the 26-months-post-launch compared to 1594 during 26-months-pre-launch period of '10,000 Lives'. The number of referred individuals who completed Quitline program increased by 330.7% and quit smoking by 308.3% in post-launch period. The increase was substantially higher among aged 45+ years, females and Aboriginal and Torres Strait Islander peoples. The result for referrals and use of Quitline was validated by interrupted time series analysis for Aboriginal and Torres Strait Islander peoples. DISCUSSION AND CONCLUSIONS The '10,000 Lives' collaborative approach to partner with local champions and targeted smoking cessation programs was effective in increasing the use of Quitline and smoking cessation among all demographic groups, including Aboriginal and Torres Strait Islander peoples. This approach can be used in other regions to address higher smoking prevalence.
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Affiliation(s)
- Arifuzzaman Khan
- School of Public HealthThe University of QueenslandBrisbaneAustralia,Central Queensland Public Health UnitCentral Queensland Hospital and Health ServiceRockhamptonAustralia
| | - Kalie Green
- Central Queensland Public Health UnitCentral Queensland Hospital and Health ServiceRockhamptonAustralia
| | - Linda Medlin
- Aboriginal and Torres Strait Islander Health and WellbeingCentral Queensland Hospital and Health ServiceRockhamptonAustralia
| | - Gulam Khandaker
- School of Public HealthThe University of QueenslandBrisbaneAustralia,Central Queensland Public Health UnitCentral Queensland Hospital and Health ServiceRockhamptonAustralia
| | - Sheleigh Lawler
- School of Public HealthThe University of QueenslandBrisbaneAustralia
| | - Coral Gartner
- School of Public HealthThe University of QueenslandBrisbaneAustralia
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12
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Poirier B, Sethi S, Haag D, Hedges J, Jamieson L. The impact of neoliberal generative mechanisms on Indigenous health: a critical realist scoping review. Global Health 2022; 18:61. [PMID: 35705995 PMCID: PMC9199313 DOI: 10.1186/s12992-022-00852-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022] Open
Abstract
The pervasive nature and colonial foundations of neoliberalism has significant ramifications for Indigenous health, globally. Not only does neoliberalism undermine Indigenous collectivist values by emphasising personal autonomy, but the exploitation of natural resources has unique implications for Indigenous wellbeing. Therefore, this scoping review aims to synthesise evidence that articulates the impacts of neoliberalism on global Indigenous health inequities. Two reviewers searched PubMed, Embase, Scopus, Web of Science, and ProQuest Central to identify records eligible for inclusion. The search was not restricted by geographic location or language. Using principles of qualitative meta-aggregation, generative mechanism summaries and illustrations were extracted from each of the included articles, synthesised into broader categories, then considered in the context of neoliberal ideologies. The systematic search identified 9952 unique records, of which 38 fully satisfied the inclusion criteria. Findings represented 23 Indigenous communities across 12 countries and considered the impacts of neoliberalism across 16 health outcomes. Eighty-eight generative mechanisms of neoliberalism and 12 generative mechanisms of resistance were extracted from the included articles and mapped against four core principles of neoliberalism: competitive and private markets, reduced public expenditure on infrastructure, personal autonomy, and deregulation that facilitates economic activity. Overwhelmingly, neoliberalism has manifest impacts, through various pathways, on poor health outcomes and experiences for Indigenous communities included in this review. Importantly, Indigenous communities continue to resist the impacts of neoliberalism through advocacy, reclamation of traditional practices, and opposition to industrial development. Consideration and investigation of neoliberal structures and ideologies must become common practice in health equity scholarship. Actors within neoliberal societies must resist dominant epistemological, ontological, and praxiological stances that reinforce the supremacy of colonial values and subalternation of Indigenous ways of knowing, being, and doing to begin effectively addressing Indigenous health inequities.
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Affiliation(s)
- Brianna Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Dandara Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, 5005, Australia
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13
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Yashadhana A, Howie A, Veber M, Cullen P, Withall A, Lewis E, McCausland R, Macniven R, Andersen M. Experiences and perceptions of ageing among older First Nations Australians: A rapid review. Australas J Ageing 2021; 41:8-19. [PMID: 34905642 DOI: 10.1111/ajag.13031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 11/04/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To identify and describe articles reporting the experiences and perceptions of ageing among older First Nations Australians. METHODS Following rapid review and PRISMA guidelines, we searched five databases for peer-reviewed articles published prior to October 2019 that reported qualitative accounts of ageing among older (≥ 45 years) First Nations Australians. Data were extracted and synthesised thematically. RESULTS Twenty-one articles were included in the final synthesis. Priorities in ageing highlighted the role of Elders, family, community, culture and connection to ancestral lands. Experiences and perceptions of ageing reflected cultural marginalisation in aged and health care services, and highlighted the importance of cultural identity, resilience and survival as key to ageing well. CONCLUSIONS Our review suggests that mainstream ageing frameworks do not fully reflect the priorities of older First Nations Australians. This has important implications for ageing policy and the design and delivery of culturally safe aged and health care services.
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Affiliation(s)
- Aryati Yashadhana
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,Centre for Health Equity Training Research & Evaluation (CHETRE), University of New South Wales, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Adam Howie
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Madelene Veber
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Patricia Cullen
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, Sydney, New South Wales, Australia.,Ngarruwan Ngadju, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Adrienne Withall
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ebony Lewis
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Ruth McCausland
- School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia.,Institute for Global Development, University of New South Wales, Sydney, New South Wales, Australia
| | - Rona Macniven
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,Faculty of Medicine and Health, Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Melanie Andersen
- University of New South Wales Ageing Futures Institute, Sydney, New South Wales, Australia.,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, Sydney, New South Wales, Australia
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