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Crocetti AC, Walker T, Mitchell F, Sherriff S, Hill K, Paradies Y, Backholer K, Browne J. Making Big Business Everybody's Business: Aboriginal leaders' perspectives on commercial activities influencing aboriginal health in Victoria, Australia. Global Health 2024; 20:33. [PMID: 38637867 PMCID: PMC11025162 DOI: 10.1186/s12992-024-01038-8] [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: 12/06/2023] [Accepted: 04/02/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The commercial determinants of health is a rapidly expanding field of research; however Indigenous perspectives remain notably underrepresented. For Indigenous peoples the intersection of globalisation, colonialism and capitalism may amplify commercially-driven health inequities. This study aimed to explore the perspectives of Aboriginal leaders regarding the influence of commercial activities on Aboriginal health and wellbeing in Victoria, Australia. METHODS Semi-structured interviews with 23 Aboriginal leaders from across five sectors (n = 15 urban, n = 8 rural/regional) were analysed through reflexive thematic analysis. RESULTS Three overarching themes were identified encompassing (i) harmful commercial practices and processes, (ii) improving corporate engagement and (iii) opportunities for self-determination through business. Participants expressed concern over aggressive marketing by the gambling industry, commercial exploitation of Aboriginal culture, the privatisation of public services, and lack of oversignt of corporate social responsibility strategies. Simultaneously, Aboriginal-led businesses were viewed as opportunities for cultural connection, and financial empowerment and self-determination. CONCLUSION Numerous commercial entities and activities are perceived to influence Aboriginal health and wellbeing. This study highlights the need for stronger policy and regulation to mitigate harmful industry practices while incentivising the potential positive impacts of the commercial activities on Aboriginal health and wellbeing.
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Affiliation(s)
- Alessandro Connor Crocetti
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia.
| | - Troy Walker
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Fiona Mitchell
- Deakin Rural Health, Faculty of Health, Deakin University, Warrnambool, VIC, Australia
| | - Simone Sherriff
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Karen Hill
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC, Australia
| | - Kathryn Backholer
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Jennifer Browne
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
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MacLean S, Ritte R, Thorpe A, Ewen S, Arabena K. Health and wellbeing outcomes of programs for Indigenous Australians that include strategies to enable the expression of cultural identities: a systematic review. Aust J Prim Health 2019; 23:309-318. [PMID: 28619126 DOI: 10.1071/py16061] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 03/19/2017] [Indexed: 11/23/2022]
Abstract
Indigenous people have long maintained that strong cultural identities are critical to health and wellbeing. The purpose of this systematic review is to examine whether interventions that entail strategies to enable expression of cultural identities for Australian Indigenous peoples are associated with measurable improvements in health and wellbeing. Peer-reviewed articles that reported quantitatively expressed health and wellbeing outcomes involving Indigenous Australian participants only were included. The cultural intervention component was defined and assessed by Indigenous researchers on the team. A narrative analysis was conducted. The protocol was registered on PROSPERO (CRD42015027387). Thirteen articles describing eleven studies were identified, including one randomised control trial (RCT), one cluster RCT and two studies with non-randomised controls. Other studies reported on case series or cross-sectional studies. All except two studies described multiple intervention strategies. Eight studies showed significant improvement in at least one psychosocial, behavioural or clinical measure, with two showing a positive direction of effect and one showing no improvement. Publication bias may discourage researchers to report negative findings of these interventions. Although studies vary in quality, this review provides evidence that interventions that include opportunities for expression of cultural identities can have beneficial effects for Australian Indigenous peoples.
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Affiliation(s)
- Sarah MacLean
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Vic. 3010, Australia
| | - Rebecca Ritte
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Vic. 3010, Australia
| | - Alister Thorpe
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Vic. 3010, Australia
| | - Shaun Ewen
- Melbourne Poche Centre for Indigenous Health, University of Melbourne, Vic. 3010, Australia
| | - Kerry Arabena
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Vic. 3010, Australia
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Geia L, Broadfield K, Grainger D, Day A, Watkin-Lui F. Adolescent and young adult substance use in Australian Indigenous communities: a systematic review of demand control program outcomes. Aust N Z J Public Health 2018; 42:254-261. [PMID: 29697886 DOI: 10.1111/1753-6405.12789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 01/01/2018] [Accepted: 03/01/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Identifying preventative approaches to substance use in Indigenous communities is the foundation for developing evidence-based responses. This study reports the findings of a systematic review of the published literature evaluating the impact of substance use programs on Australian Indigenous youth. METHODS Evidence about the impact of substance use programs for Indigenous young people was identified from a systematic review of the literature conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. RESULTS Only four original studies that met the inclusion criteria were identified, although a further 19 papers that described characteristics of programs that may be associated with improved outcomes were reviewed. CONCLUSIONS Evidence relevant to the outcomes of demand control programs that target Australian Indigenous youth substance use is both weak and inconsistent. There is a need to support the type of evaluation activity required to better understand program effectiveness and build the Indigenous knowledge base. Implications for public health: These findings are discussed in relation to the development of evidence-based practice and the type of knowledge that is likely to be of most use to those seeking to address problems associated with youth substance use.
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Affiliation(s)
- Lynore Geia
- Indigenous Education and Research Centre, James Cook University, Queensland
| | - Kirstie Broadfield
- Indigenous Education and Research Centre, James Cook University, Queensland
| | - Daniel Grainger
- Indigenous Education and Research Centre, James Cook University, Queensland
| | - Andrew Day
- Indigenous Education and Research Centre, James Cook University, Queensland
| | - Felecia Watkin-Lui
- Indigenous Education and Research Centre, James Cook University, Queensland
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Pilgrim JL, Jenkins EL, Baber Y, Caldicott D, Drummer OH. Fatal acute poisonings in Australian children (2003-13). Addiction 2017; 112:627-639. [PMID: 27766705 DOI: 10.1111/add.13669] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/21/2016] [Accepted: 10/19/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Fatal poisonings in children comprise a small proportion of cases investigated by an Australian coroner; however, they present a major opportunity for death prevention. This study aimed to examine fatal child poisonings in Australia to (1) estimate the rate of acute poisoning deaths in children; (2) describe the key characteristics of the cohort; and (3) describe the outcomes of coronial recommendations made as a death prevention measure. DESIGN Retrospective case series. SETTING The National Coronial Information System (NCIS), a database of cases reported to an Australian coroner. PARTICIPANTS Ninety poisoning deaths reported to an Australian coroner between January 2003 and December 2013 involving children (≤ 16 years of age). MEASURES Logistic regression, Pearson's correlation coefficient and descriptive statistics were used to examine the significance of associations. The primary outcome measures were poisoning type and cause of death. Covariates included age and mental illness. FINDINGS There were marginally more males (52.2%) [confidence interval (CI) = 44.4-45.6] in the cohort and most occurred in the 13-16-year age group (58.9%) (CI = 7.5-12.5). Deaths were typically unintentional (61.1%) (CI = 17.9-27.1) and occurred in the home (68.9%) (CI = 6.8-15.7). The most common form of poisoning was due to opioids (24.4%), followed by carbon monoxide (20%) and volatile substances (18.9%) (CI = 18.5-19.6). Males had slightly higher odds of dying from prescription opioids compared with females [odds ratio (OR) = 1.9, CI = 0.7-5.1], but this was not statistically significant. A recommendation was made by a coroner in 12 cases, 10 of which related to poisons (including drugs). Of these, eight recommendations were implemented. CONCLUSIONS In Australia between 2003 and 2013 there were on average eight acute poisoning deaths in children each year, most commonly involving prescription opioids and adolescents. There has been a downward trend in mortality since 2003. These cases generated more than twice as many recommendations for public safety compared with other Australian coroners' cases.
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Affiliation(s)
- Jennifer L Pilgrim
- Department of Forensic Medicine, Monash University, Australia.,Deaths from Emergencies and Accidents Data Set (DEADSet) Project, Australia
| | - Elizabeth L Jenkins
- Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia.,Deaths from Emergencies and Accidents Data Set (DEADSet) Project, Australia
| | - Yeliena Baber
- Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia
| | - David Caldicott
- Deaths from Emergencies and Accidents Data Set (DEADSet) Project, Australia.,Calvary Health Care, Australian National University, Australian Capital Territory, Australia
| | - Olaf H Drummer
- Department of Forensic Medicine, Monash University, Australia.,Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia
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MacLean S, Harney A, Arabena K. Primary health-care responses to methamphetamine use in Australian Indigenous communities. Aust J Prim Health 2016; 21:384-90. [PMID: 25704260 DOI: 10.1071/py14126] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 11/22/2014] [Indexed: 11/23/2022]
Abstract
Crystal methamphetamine (commonly known as 'ice') use is currently a deeply concerning problem for some Australian Indigenous peoples and can cause serious harms to individual, families and communities. This paper is intended to support best practice responses by primary health-care staff working with Australian Indigenous people who use methamphetamine. It draws on a systematic search of relevant databases to identify literature from January 1999 to February 2014, providing an overview of prevalence, treatment, education and harm reduction, and community responses. The prevalence of methamphetamine use is higher in Indigenous than non-Indigenous communities, particularly in urban and regional settings. No evidence was identified that specifically related to effective treatment and treatment outcomes for Indigenous Australians experiencing methamphetamine dependence or problematic use. While studies involving methamphetamine users in the mainstream population suggest that psychological and residential treatments show short-term promise, longer-term outcomes are less clear. Community-driven interventions involving Indigenous populations in Australia and internationally appear to have a high level of community acceptability; however, outcomes in terms of methamphetamine use are rarely evaluated. Improved national data on prevalence of methamphetamine use among Indigenous people and levels of treatment access would support service planning. We argue for the importance of a strength-based approach to addressing methamphetamine use, to counteract the stigma and despair that frequently accompanies it.
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Rowan M, Poole N, Shea B, Gone JP, Mykota D, Farag M, Hopkins C, Hall L, Mushquash C, Dell C. Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2014; 9:34. [PMID: 25179797 PMCID: PMC4158387 DOI: 10.1186/1747-597x-9-34] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2014] [Accepted: 08/26/2014] [Indexed: 01/06/2023]
Abstract
Background Cultural interventions offer the hope and promise of healing from addictions for Indigenous people.a However, there are few published studies specifically examining the type and impact of these interventions. Positioned within the Honouring Our Strengths: Culture as Intervention project, a scoping study was conducted to describe what is known about the characteristics of culture-based programs and to examine the outcomes collected and effects of these interventions on wellness. Methods This review followed established methods for scoping studies, including a final stage of consultation with stakeholders. The data search and extraction were also guided by the “PICO” (Patient/population, Intervention, Comparison, and Outcome) method, for which we defined each element, but did not require direct comparisons between treatment and control groups. Twelve databases from the scientific literature and 13 databases from the grey literature were searched up to October 26, 2012. Results The search strategy yielded 4,518 articles. Nineteen studies were included from the United States (58%) and Canada (42%), that involved residential programs (58%), and all (100%) integrated Western and culture-based treatment services. Seventeen types of cultural interventions were found, with sweat lodge ceremonies the most commonly (68%) enacted. Study samples ranged from 11 to 2,685 clients. Just over half of studies involved quasi-experimental designs (53%). Most articles (90%) measured physical wellness, with fewer (37%) examining spiritual health. Results show benefits in all areas of wellness, particularly by reducing or eliminating substance use problems in 74% of studies. Conclusions Evidence from this scoping study suggests that the culture-based interventions used in addictions treatment for Indigenous people are beneficial to help improve client functioning in all areas of wellness. There is a need for well-designed studies to address the question of best relational or contextual fit of cultural practices given a particular place, time, and population group. Addiction researchers and treatment providers are encouraged to work together to make further inroads into expanding the study of culture-based interventions from multiple perspectives and locations.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Colleen Dell
- Department of Sociology, University of Saskatchewan, 1109 - 9 Campus Drive, Saskatoon, SK S7N 5A5, Canada.
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Johnston L, Doyle J, Morgan B, Atkinson-Briggs S, Firebrace B, Marika M, Reilly R, Cargo M, Riley T, Rowley K. A review of programs that targeted environmental determinants of Aboriginal and Torres Strait Islander health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3518-42. [PMID: 23939388 PMCID: PMC3774452 DOI: 10.3390/ijerph10083518] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 08/02/2013] [Accepted: 08/05/2013] [Indexed: 11/15/2022]
Abstract
Objective: Effective interventions to improve population and individual health require environmental change as well as strategies that target individual behaviours and clinical factors. This is the basis of implementing an ecological approach to health programs and health promotion. For Aboriginal People and Torres Strait Islanders, colonisation has made the physical and social environment particularly detrimental for health. Methods and Results: We conducted a literature review to identify Aboriginal health interventions that targeted environmental determinants of health, identifying 21 different health programs. Program activities that targeted environmental determinants of health included: Caring for Country; changes to food supply and/or policy; infrastructure for physical activity; housing construction and maintenance; anti-smoking policies; increased workforce capacity; continuous quality improvement of clinical systems; petrol substitution; and income management. Targets were categorised according to Miller’s Living Systems Theory. Researchers using an Indigenous community based perspective more often identified interpersonal and community-level targets than were identified using a Western academic perspective. Conclusions: Although there are relatively few papers describing interventions that target environmental determinants of health, many of these addressed such determinants at multiple levels, consistent to some degree with an ecological approach. Interpretation of program targets sometimes differed between academic and community-based perspectives, and was limited by the type of data reported in the journal articles, highlighting the need for local Indigenous knowledge for accurate program evaluation. Implications: While an ecological approach to Indigenous health is increasingly evident in the health research literature, the design and evaluation of such programs requires a wide breadth of expertise, including local Indigenous knowledge.
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Affiliation(s)
- Leah Johnston
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Joyce Doyle
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Bec Morgan
- Centre of Excellence in Intervention and Prevention Science, Carlton, VIC 3053, Australia; E-Mail:
| | | | - Bradley Firebrace
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Mayatili Marika
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
| | - Rachel Reilly
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Margaret Cargo
- School of Population Health, University of South Australia, Adelaide, SA 5000, Australia; E-Mail:
| | - Therese Riley
- Centre of Excellence in Intervention and Prevention Science, Carlton, VIC 3053, Australia; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +61-03-8344-0814
| | - Kevin Rowley
- Onemda VicHealth Koori Health Unit, Centre for Health and Society, Melbourne School of Population & Global Health, The University of Melbourne, Carlton, VIC 3010, Australia; E-Mails: (L.J.); (J.D.); (B.F.); (M.M.); (R.R.); (K.R.)
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Embleton L, Ayuku D, Atwoli L, Vreeman R, Braitstein P. Knowledge, attitudes, and substance use practices among street children in Western Kenya. Subst Use Misuse 2012; 47:1234-47. [PMID: 22780841 PMCID: PMC3749375 DOI: 10.3109/10826084.2012.700678] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The study describes the knowledge of and attitudes toward substance use among street-involved youth in Kenya, and how they relate to their substance use practices. In 2011, 146 children and youth ages 10-19 years, classified as either children on the street or children of the street were recruited to participate in a cross-sectional survey in Eldoret, Kenya. Bivariate analysis using χ² or Fisher's Exact Test was used to test the associations between variables, and multiple logistic regression analysis was used to identify independent covariates associated with lifetime and current drug use. The study's limitations and source of funding are noted.
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Affiliation(s)
- Lonnie Embleton
- Department of Medicine, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
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DINGWALL KYLIEM, MARUFF PAUL, CLOUGH ALANR, CAIRNEY SHEREE. Factors associated with continued solvent use in Indigenous petrol sniffers following treatment. Drug Alcohol Rev 2011; 31:40-6. [DOI: 10.1111/j.1465-3362.2010.00279.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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d'Abbs P, MacLean S. Petrol sniffing interventions among Australian indigenous communities through product substitution: from skunk juice to opal. Subst Use Misuse 2011; 46 Suppl 1:99-106. [PMID: 21609153 DOI: 10.3109/10826084.2011.580223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Inhalation of petrol (gasoline) fumes has been prevalent in some Australian Indigenous communities since World War II, and has led to a continuing quest for an effective method of preventing the practice either by modifying the substance or by substituting nonharmful alternatives. This article traces the results of this search, beginning with the addition of ethyl mercaptan, then describing the substitution of aviation fuel for conventional vehicle fuel, and concluding with the staged introduction of Opal--a vehicle fuel containing low levels of aromatic hydrocarbons--throughout many communities from 2005. The article assesses the benefits and limitations of supply reduction methods.
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Affiliation(s)
- Peter d'Abbs
- Healing and Resiliance Division, Menzies School of Health Research, Darwin, Northern Territory, Australia
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Hart LM, Bourchier SJ, Jorm AF, Kanowski LG, Kingston AH, Stanley D, Lubman DI. Development of mental health first aid guidelines for Aboriginal and Torres Strait Islander people experiencing problems with substance use: a Delphi study. BMC Psychiatry 2010; 10:78. [PMID: 20932326 PMCID: PMC2964528 DOI: 10.1186/1471-244x-10-78] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 10/08/2010] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Problems with substance use are common in some Aboriginal communities. Although problems with substance use are associated with significant mortality and morbidity, many people who experience them do not seek help. Training in mental health first aid has been shown to be effective in increasing knowledge of symptoms and behaviours associated with seeking help. The current study aimed to develop culturally appropriate guidelines for providing mental health first aid to an Aboriginal or Torres Strait Islander person who is experiencing problem drinking or problem drug use (e.g. abuse or dependence). METHODS Twenty-eight Aboriginal health experts participated in two independent Delphi studies (n = 22 problem drinking study, n = 21 problem drug use; 15 participated in both). Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the content. Statements were accepted for inclusion in the guidelines if they were endorsed by ≥ 90% of panellists as either 'Essential' or 'Important'. At the end of the two Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. RESULTS From a total of 735 statements presented over two studies, 429 were endorsed (223 problem drinking, 206 problem drug use). Statements were grouped into sections based on common themes (n = 7 problem drinking, n = 8 problem drug use), then written into guideline documents. Participants evaluated the Delphi method employed, and the guidelines developed, as useful and appropriate for Aboriginal and Torres Strait Islander people. CONCLUSIONS Aboriginal health experts were able to reach consensus about culturally appropriate first aid for problems with substance use. Many first aid actions endorsed in the current studies were not endorsed in previous international Delphi studies, conducted on problem drinking and problem drug use in non-Indigenous people, highlighting the need for culturally specific first aid strategies to be employed when assisting Aboriginal or Torres Strait Islander people.
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Affiliation(s)
- Laura M Hart
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Sarah J Bourchier
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Leonard G Kanowski
- Aboriginal Mental Health and Drug & Alcohol, Greater Western Area Health Service, New South Wales Department of Health, Orange, New South Wales, Australia
| | - Anna H Kingston
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Donna Stanley
- Aboriginal Mental Health and Drug & Alcohol, Greater Western Area Health Service, New South Wales Department of Health, Orange, New South Wales, Australia
| | - Dan I Lubman
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia,Turning Point Alcohol and Drug Centre, Eastern Health and Monash University, Fitzroy, Victoria, Australia
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Maclean SJ, D'Abbs PHN. Five challenges for volatile substance misuse policy and intervention in Australia. Drug Alcohol Rev 2010; 30:223-7. [DOI: 10.1111/j.1465-3362.2010.00232.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
The practice of petrol sniffing is a unique and poorly understood phenomenon that is associated with substantial morbidity, mortality and social devastation in affected remote Indigenous communities. For these groups and for the wider community, much mystery has surrounded the practice and its effects. Here we introduce the epidemiology of petrol sniffing among Indigenous groups internationally, review its impact on the brain, behaviour and social functions and summarise related interventions.
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Affiliation(s)
- Sheree Cairney
- Menzies School of Health Research, Institute of Advanced Studies, Charles Darwin University, Darwin, Northern Territory, Australia.
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Jamieson LM, Gunthorpe W, Cairney SJ, Sayers SM, Roberts-Thomson KF, Slade GD. Substance use and periodontal disease among Australian Aboriginal young adults. Addiction 2010; 105:719-26. [PMID: 20148786 DOI: 10.1111/j.1360-0443.2009.02851.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To investigate the effects of tobacco, marijuana, alcohol and petrol sniffing on periodontal disease among Australian Aboriginal young adults. DESIGN Cross-sectional nested within a long-standing prospective longitudinal study. Setting Aboriginal communities in Australia's Northern Territory. PARTICIPANTS Members of the Aboriginal Birth Cohort study who were recruited from birth between January 1987 and March 1990 at the Royal Darwin Hospital, Northern Territory, Australia. Data were from wave III, when the mean age of participants was 18 years. MEASUREMENTS Clinical dental examination and self-report questionnaire. FINDINGS Of 425 participants with complete data, 26.6% had moderate/severe periodontal disease. There was elevated risk of periodontal disease associated with tobacco [prevalence ratio (PR) = 1.59, 95% CI = 1.06-2.40], marijuana (PR = 1.44, 95% CI = 1.05-1.97) and petrol sniffing (PR = 1.83, 95% CI = 1.08-3.11), but not alcohol (PR = 0.92, 95% CI = 0.67-1.27). Stratified analysis showed that the effect of marijuana persisted among tobacco users (PR = 1.47, 95% CI 1.03-2.11). It was not possible to isolate an independent effect of petrol sniffing because all petrol sniffers used both marijuana and tobacco, although among smokers of both substances, petrol sniffing was associated with an 11.8% increased prevalence of periodontal disease. CONCLUSIONS This is the first time that substance use has been linked with periodontal disease in a young Australian Aboriginal adult population, and the first time that petrol sniffing has been linked with periodontal disease in any population. The role of substance use in periodontal disease among this, and other, marginalized groups warrants further investigation.
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Affiliation(s)
- Lisa M Jamieson
- Australian Research Center for Population Oral Health, The University of Adelaide, South Australia, Australia.
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MacLean S, D’abbs PH. Will modifying inhalants reduce volatile substance misuse? A review. DRUGS-EDUCATION PREVENTION AND POLICY 2009. [DOI: 10.1080/09687630600762202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Gray D, Pulver LJ, Saggers S, Waldon J. Addressing indigenous substance misuse and related harms. Drug Alcohol Rev 2007; 25:183-8. [PMID: 16753639 DOI: 10.1080/09595230600644616] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Johnson K, Holder H, Ogilvie K, Collins D, Ogilvie D, Saylor B, Courser M, Miller B, Moore R, Saltz B. A community prevention intervention to reduce youth from inhaling and ingesting harmful legal products. JOURNAL OF DRUG EDUCATION 2007; 37:227-47. [PMID: 18047181 PMCID: PMC2443954 DOI: 10.2190/de.37.3.b] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Youth use of harmful legal products, including inhaling or ingesting everyday household products, prescription drugs, and over-the-counter drugs, constitutes a growing health problem for American society. As such, a single targeted approach to preventing such a drug problem in a community is unlikely to be sufficient to reduce use and abuse at the youth population level. Therefore, the primary focus of this article is on an innovative, comprehensive, community-based prevention intervention. The intervention described here is based upon prior research that has a potential of preventing youth use of alcohol and other legal products. It builds upon three evidence-based prevention interventions from the substance abuse field: community mobilization, environmental strategies, and school-based prevention education intervention. The results of a feasibility project are presented and the description of a planned efficacy trial is discussed.
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Affiliation(s)
- Knowlton Johnson
- Pacific Institute for Research and Evaluation, Louisville, Kentucky 40208, USA.
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Lubman DI, Hides L, Yücel M. Inhalant misuse in youth: time for a coordinated response. Med J Aust 2006; 185:327-30. [PMID: 16999675 DOI: 10.5694/j.1326-5377.2006.tb00588.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2005] [Accepted: 06/20/2006] [Indexed: 11/17/2022]
Abstract
Early adolescence is associated with high rates of experimental inhalant misuse, but only a minority continue to inhale on a regular basis. Inhalant misuse is associated with a range of adverse outcomes, including reports of increased morbidity and mortality. Research into inhalant use among adolescents is lacking, with limited data available on long-term outcomes or evidence-based approaches to treatment. Legislative and supply-reduction strategies have been introduced by a number of states and territories over recent years, but direct funding for specific targeted interventions is lacking. Investment and commitment to a national research framework, as well as coordination of local services, is urgently required.
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Affiliation(s)
- Dan I Lubman
- ORYGEN Research Centre, Department of Psychiatry, University of Melbourne, VIC, Australia.
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Abstract
Drug use and abuse carries risk in people of all ages. However, adolescents are particularly vulnerable to substance misuse. Adolescent drug use continues to be an area of concern with a number of adolescents developing problems associated with the use of various drugs. Negative sequelae associated with adolescent drug use include areas such as schooling, health, and family relationships. Difficulties with the legal system, schooling, or within the family are commonly the triggers for recognition of substance misuse problems in a young person. However, problems are usually well-established before they are recognized. The challenge of dealing with these problems will fall on families, particularly parents. This is a crisis for families, and ongoing support is needed if they are to overcome the challenges. Health workers (including nurses) are well-positioned to support families who are dealing with adolescent drug problems. In this paper we propose the adoption of a strengths approach as a strategy for developing resilience in families.
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Affiliation(s)
- Kim Usher
- School of Nursing Sciences, James Cook University, Townsville, Queensland, Australia.
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d'Abbs P, Brady M. Other people, other drugs: the policy response to petrol sniffing among indigenous Australians. Drug Alcohol Rev 2004; 23:253-60. [PMID: 15370004 DOI: 10.1080/09595230412331289400] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This paper examines the policy response of Australian governments to petrol sniffing in Indigenous communities from the 1980s until the present. During this period, despite the formation of numerous inquiries, working parties and intergovernmental committees, there has been little accumulation of knowledge about the nature and causes of sniffing, or about the effectiveness of interventions. Policies are fragmentary; programmes are rarely evaluated, and most rely on short-term funding. The paper sets out to explain why this should be so. It draws upon a conceptual framework known as 'analytics of government' to examine the ways in which petrol sniffing comes to the attention of government agencies and is perceived as an issue; the mechanisms deployed by governments to address petrol sniffing; ways in which knowledge about sniffing is generated; and the underlying assumptions about people that inform policy-making. Drawing upon case studies of policy responses, the paper argues that a number of structural factors combine to marginalize petrol sniffing as an issue, and to encourage reliance on short-term, one-off interventions in place of a sustained policy commitment. Four recommendations are advanced to help overcome these factors: (1) agreements should be reached within and between levels of government on steps to be taken to reduce risk factors before the eruption of petrol-sniffing crises; (2) the evidence base relevant to petrol sniffing (and other inhalants) should be improved by funding and directing one or more existing national drug research centres to collate data on inhalant-caused mortality and morbidity, and to conduct or commission research into prevalence patterns, effectiveness of interventions and other gaps in knowledge; (3) the current pattern of short-term, pilot and project funding should be replaced with longer-term, evidence-based interventions that address the multiple risk and protective factors present in communities; and (4) insistence by governments that communities must take 'ownership' of the problem should be replaced by a commitment to genuine partnerships involving governments, non-government and community sectors.
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Affiliation(s)
- Peter d'Abbs
- School of Public Health and Tropical Medicine, James Cook University, Cairns, Queensland, Australia.
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