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Young C, Burgess L, Falster K, Zoega H, Banks E, Clapham K, Woolfenden S, Cutmore M, Williamson A. Mental health-related service and medicine use among a cohort of urban Aboriginal children and young people: Data linkage study. Aust N Z J Psychiatry 2024; 58:787-799. [PMID: 38711323 DOI: 10.1177/00048674241248357] [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: 05/08/2024]
Abstract
OBJECTIVE The objective was to describe mental health service and psychotropic medicine use among a cohort of Aboriginal young people and quantify their relation to sociodemographic, family and health factors. METHODS In a prospective cohort study with data linkage, 892 Aboriginal children aged 0-17 years living in urban and regional areas of New South Wales, Australia, were included. We assessed mental health-related service use, paediatric service use and psychotropic medicine dispensing claims covered by the Australian Government Medicare Benefits Schedule and the Pharmaceutical Benefits Scheme from July 2012 to June 2017. RESULTS Most children (71%) did not have a record of mental health service or psychotropic medication use. 18.7% had ⩾1 mental health-related service claim; 26.7% had ⩾1 paediatric service claim; and 20.3% had ⩾1 psychotropic medicine dispensing claim. General practitioner services were the most accessed mental health-related service (17.4%) and 12.7% had been dispensed attention-deficit hyperactivity disorder medicines. Child characteristics associated with treatment included emotional and behavioural problems (prevalence ratio: 1.97, 95% confidence interval = [1.46, 2.64] for mental health services; prevalence ratio: 2.87, 95% confidence interval = [2.07, 3.96] for medicines) and risky behaviour (prevalence ratio: 1.56, 95% confidence interval = [1.12, 2.16] for mental health services; prevalence ratio: 2.28, 95% confidence interval = [1.54, 3.37] for medicines). Parent-related factors included chronic illness (prevalence ratio: 1.42, 95% confidence interval = [1.03, 1.95] for mental health services; prevalence ratio: 2.00, 95% confidence interval = [1.49, 2.69] for medicines) and functional limitations (prevalence ratio: 1.61, 95% confidence interval = [1.16, 2.24] for mental health services; prevalence ratio: 1.86, 95% confidence interval = [1.34, 2.59] for medicines). CONCLUSIONS Most Aboriginal children and young people did not have claims for mental health services or medicines. Aboriginal children with emotional and behavioural problems, or parents with health problems were more likely to have mental health service or medicine claims.
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Affiliation(s)
| | | | - Kathleen Falster
- School of Population Health, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Helga Zoega
- School of Population Health, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Emily Banks
- College of Health & Medicine, Australian National University, Canberra, ACT, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Sue Woolfenden
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, NSW, Australia
- School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
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Luke JN, Bessarab D, Smith K, LoGiudice D, Flicker L, Gilchrist L, Dow B, Temple J. Counting the Ways That Aboriginal and Torres Strait Islander Older People Participate in Their Communities and Culture. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae100. [PMID: 38818851 PMCID: PMC11234290 DOI: 10.1093/geronb/gbae100] [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: 08/13/2023] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVES This study aimed to determine the proportion of older Aboriginal and Torres Strait Islander peoples participating in cultural events and activities and determine the demographic and sociocultural characteristics associated with participation. METHODS The Australian Bureau of Statistics National Aboriginal and Torres Strait Islander Social Survey (2014-2015) was used to measure the prevalence of participation in cultural events and activities. Multivariate logistic regression models were used to measure associations. Sociocultural factors were selected by matching survey items to the 12 sociocultural factors described in the Good Spirit Good Life Framework, a culturally validated quality-of-life tool for older people. RESULTS The majority (62.0%) of survey respondents 45 years and older participated in cultural events (e.g., ceremonies, funerals/sorry business, NAIDOC week activities, sports carnivals, festivals/carnivals) or were involved in organizations. Many (58.5%) also participated in activities (e.g., fishing, hunting, gathering wild plants/berries, arts/crafts, music/dance/theater, writing/telling of stories). In regression models including demographic and cultural variables, participation in cultural events was highest among people living remotely (odds ratio [OR] = 2.71), reporting recognition of homelands (OR = 2.39), identifying with a cultural group (OR = 3.56), and those reporting having a say in their communities (OR = 1.57), with similar odds seen for participation in activities. Participation was inversely proportional to increasing age, with a greater proportion of females participating in events and males in activities. DISCUSSION The social lives of older Aboriginal and Torres Strait Islander people were characterized by widespread participation in cultural events and activities. These findings provide important insights into services as they support older people to live a good life.
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Affiliation(s)
- Joanne Nicole Luke
- Centre for Health Policy, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences,The University of Melbourne, Melbourne, Victoria, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Kate Smith
- Centre for Aboriginal Medical and Dental Health, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Dina LoGiudice
- Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Leon Flicker
- Western Australian Centre for Health and Ageing, Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Lianne Gilchrist
- Centre for Aboriginal Medical and Dental Health, Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Briony Dow
- Department of Medicine, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Jeromey Temple
- Centre for Health Policy, School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences,The University of Melbourne, Melbourne, Victoria, Australia
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Gomez Cardona L, Yang M, Seon Q, Karia M, Velupillai G, Noel V, Linnaranta O. The methods of improving cultural sensitivity of depression scales for use among global indigenous populations: a systematic scoping review. Glob Ment Health (Camb) 2023; 10:e83. [PMID: 38161748 PMCID: PMC10755398 DOI: 10.1017/gmh.2023.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 11/01/2023] [Accepted: 11/14/2023] [Indexed: 01/03/2024] Open
Abstract
Cultural adaptation of psychometric measures has become a process aimed at increasing acceptance, reliability, and validity among specific Indigenous populations. We present a systematic scoping review to: (1) identify the depression scales that have been culturally adapted for use among Indigenous populations worldwide, (2) globally report on the methods used in the cultural adaptation of those scales, and (3) describe the main features of those cultural adaptation methods. We included articles published from inception to April 2021, including 3 levels of search terms: Psychometrics, Indigenous, and Depression. The search was carried out in the Ovid Medline, PubMed, Embase, Global Health, PsycINFO, and CINAHL databases, following PRISMA guidelines. We identified 34 reports on processes of cultural adaptation that met the criteria. The scales were adapted for use among Indigenous populations from Africa, Australia, Asia, North America, and Latin America. The most common scales that underwent adaptation were the Patient Health Questionnaire (PHQ-9), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Edinburgh Postnatal Depression Scale (EPDS). Methods of adaptation involved a revision of the measures' cultural appropriateness, standard/transcultural translation, revision of the administration process, and inclusion of visual supports. Culturally safe administration of scales was reported in some studies. To come to a consensus on most appropriate methods of improving cultural safety of psychometric measurement, most studies utilized qualitative methods or mixed methods to understand the specific community's needs. Revision of linguistic equivalence and cultural relevance of content, culturally safe administration procedures, qualitative methods, and participatory research were key features of developing safe culturally adapted measures for depressive symptoms among Indigenous populations. While for comparability, uniform scales would be ideal as mental health evaluations, an understanding of the cultural impact of measurements and local depression expressions would benefit the process of developing culturally sensitive psychometric scales. PROSPERO registration ID: CRD42023391439.
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Affiliation(s)
- Liliana Gomez Cardona
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Michelle Yang
- École interdisciplinaire des sciences de la santé/Interdisciplinary School of Health Sciences, Université d’Ottawa/University of Ottawa, Ottawa, ON, Canada
| | - Quinta Seon
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Maharshee Karia
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | | | - Valérie Noel
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- ACCESS Open Minds, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Outi Linnaranta
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Equality Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
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Brown A, Haregu T, Gee G, Mensah F, Waters L, Brown SJ, Nicholson JM, Hegarty K, Smith D, D'Amico S, Ritte R, Paradies Y, Armstrong G. Social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples in Aboriginal controlled social housing. BMC Public Health 2023; 23:1935. [PMID: 37803360 PMCID: PMC10557265 DOI: 10.1186/s12889-023-16817-y] [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: 05/01/2023] [Accepted: 09/22/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Little is known about the wellbeing and aspirations of Aboriginal and Torres Strait Islander peoples living in social housing. Aboriginal and Torres Strait Islander peoples living in social housing face common social housing challenges of low income, higher incidence of mental health issues and poorer health along with specific challenges due to the impacts of colonisation and its ongoing manifestations in racism and inequity. A greater understanding of social and emotional wellbeing needs and aspirations is essential in informing the provision of appropriate support. METHODS Surveys of social and emotional wellbeing (SEWB) were completed by 95 Aboriginal people aged 16 years and older living in Aboriginal Housing Victoria social housing in 2021. The survey addressed a range of domains reflecting social and emotional wellbeing, as defined by Aboriginal and Torres Strait Islander peoples. RESULTS Most respondents demonstrated a strong sense of identity and connection to family however 26% reported having 6 or more health conditions. Ill health and disability were reported to be employment barriers for almost a third of people (32%). Improving health and wellbeing (78%) was the most cited aspiration. Experiences of racism and ill health influenced engagement with organisations and correspondingly education and employment. CONCLUSION Strong connections to identity, family and culture in Aboriginal peoples living in social housing coexist along with disrupted connections to mind, body and community. Culturally safe and appropriate pathways to community services and facilities can enhance these connections. Research aimed at evaluating the impact of strengths-based interventions that focus on existing strong connections will be important in understanding whether this approach is effective in improving SEWB in this population. TRIAL REGISTRATION This trial was retrospectively registered with the ISRCTN Register on the 12/7/21 with the study ID:ISRCTN33665735.
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Affiliation(s)
- Alison Brown
- The University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Tilahun Haregu
- The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Graham Gee
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
- School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Fiona Mensah
- The University of Melbourne, Parkville, VIC, 3010, Australia
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
| | - Lea Waters
- The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Stephanie J Brown
- The University of Melbourne, Parkville, VIC, 3010, Australia
- Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, VIC, 3052, Australia
| | | | - Kelsey Hegarty
- The University of Melbourne, Parkville, VIC, 3010, Australia
- The Royal Women's Hospital, Parkville, VIC, 3052, Australia
| | - Darren Smith
- Aboriginal Housing Victoria, Fitzroy North, VIC, 3068, Australia
| | - Sue D'Amico
- Aboriginal Housing Victoria, Fitzroy North, VIC, 3068, Australia
| | - Rebecca Ritte
- The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Yin Paradies
- Deakin University, Burwood, VIC, 3125, Australia
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Yang M, Seon Q, Gomez Cardona L, Karia M, Velupillai G, Noel V, Linnaranta O. Safe and valid? A systematic review of the psychometric properties of culturally adapted depression scales for use among Indigenous populations. Glob Ment Health (Camb) 2023; 10:e60. [PMID: 37854390 PMCID: PMC10579654 DOI: 10.1017/gmh.2023.52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/26/2023] [Accepted: 09/02/2023] [Indexed: 10/20/2023] Open
Abstract
Background Implementing culturally sensitive psychometric measures of depression may be an effective strategy to improve acceptance, response rate, and reliability of psychological assessment among Indigenous populations. However, the psychometric properties of depression scales after cultural adaptation remain unclear. Methods We screened the Ovid Medline, PubMed, Embase, Global Health, PsycInfo, and CINAHL databases through three levels of search terms: Depression, Psychometrics, and Indigenous, following the PRISMA guidelines. We assessed metrics for reliability (including Cronbach's alpha), validity (including fit indices), and clinical utility (including predictive value). Results Across 31 studies included the review, 13 different depression scales were adapted through language or content modification. Sample populations included Indigenous from the Americas, Asia, Africa, and Oceania. Most cultural adaptations had strong psychometric properties; however, few and inconsistent properties were reported. Where available, alphas, inter-rater and test-retest reliability, construct validity, and incremental validity often indicated increased cultural sensitivity of adapted scales. There were mixed results for clinical utility, criterion validity, cross-cultural validity, sensitivity, specificity, area under the receiver operating characteristic curve, predictive value, and likelihood ratio. Conclusions Modifications to increase cultural relevance have the potential to improve fit and acceptance of a scale by the Indigenous population, however, these changes may decrease specificity and negative predictive value. There is an urgent need for suitable tools that are useful and reliable for identifying Indigenous individuals for clinical treatment of depression. This awaits future work for optimal specificity and validated cut-off points that take into account the high prevalence of depression in these populations.
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Affiliation(s)
- Michelle Yang
- École interdisciplinaire des sciences de la santé/Interdisciplinary School of Health Sciences, Université d’Ottawa/University of Ottawa, Ottawa, ON, Canada
| | - Quinta Seon
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Liliana Gomez Cardona
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Maharshee Karia
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
| | | | - Valérie Noel
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- ACCESS Open Minds, Centre de recherche Douglas/Perry 3, Montreal, QC, Canada
| | - Outi Linnaranta
- Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Department of Equality, Finnish Institute for Health and Welfare, Helsinki, Finland
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Caruana T, Mao L, Gray RM, Bryant J. Engagement and outcomes of marginalised young people in an early intervention youth alcohol and other drug program: The Street Universities model. PLoS One 2023; 18:e0286025. [PMID: 37200391 DOI: 10.1371/journal.pone.0286025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 05/06/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Early intervention alcohol and drug (AOD) programs for disadvantaged young people have the potential to substantially decrease the need for future intervention, however there is little research about how young people use these programs or the substance use and other outcomes of such programs. This paper uses data from an Australian AOD early intervention program, The Street Universities, to: describe young people's participation; examine changes in substance use and wellbeing over 90 days; and assess which young people are most positively impacted. METHODS Data come from a prospective study of new attendees, measuring retention in and attendance patterns in an 'engagement' program focussed on arts and lifestyle activities (n = 95), and a routine service dataset collected from seven years of therapeutic intervention (n = 3,893), measuring substance dependence (SDS), psychological distress (K10) and quality of life (EQoL). RESULTS Analysis reveals that young people were retained in the program at high proportion (63% at six months) and more than half of these returned at a frequency of weekly or more often. Young people participating in the therapeutic component of the program reported significant improvements in all key wellbeing indicators with SDS, K10 and EQoL scores significantly improving (at p < .001). These improvements occurred rapidly, within the first 30 days, and were maintained over the 90 day study period. Moreover, young people with the highest SDS and K10 scores and lowest quality of life at baseline experienced the most positive changes. CONCLUSION Aligning engagement program with therapeutic intervention can provide comprehensive support to disadvantaged young people, producing substantial improvements in AOD use, distress and wellbeing.
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Affiliation(s)
- Theresa Caruana
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Limin Mao
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Rebecca M Gray
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
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Psychological Distress, Stressful Life Events and Social Disadvantage in Pregnant Indigenous Australian Women Residing in Rural and Remote NSW: a Longitudinal Cohort Study. J Racial Ethn Health Disparities 2022; 9:2197-2207. [PMID: 34595675 DOI: 10.1007/s40615-021-01159-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/13/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Pregnancy can be a stressful time for many women. Australian Indigenous women of childbearing age (18-44 years) have been found to experience high or very high rates of psychological distress. However, few studies have examined the burden of or any associations between stressful life events, social disadvantage and psychological distress for pregnant Indigenous women in Australia. METHODS Two hundred sixty-one rural and remote women, pregnant with an Indigenous infant, from New South Wales in Australia were invited to provide data regarding social disadvantage then complete the Kessler-10 and Stressful Life Events surveys via self-report during each trimester of their pregnancy. Descriptive statistics, Pearson's correlations, Mann-Whitney U and Kruskal-Wallis tests were performed to determine the burden of and any associations between the variables of interest. RESULTS High rates of psychological distress were reported by participants with 16.9% scoring severe distress levels during their pregnancy. Participants also reported high rates of stressful life events with almost 25% experiencing the death of a family member or friend, almost 14% living in overcrowded accommodation, 11% having someone close to them jailed and 8% experience separation from their partner, during their pregnancies. Distress was associated with numerous stressful life events (e.g. witnessing violence, a family member in jail and overcrowding) and one aspect of social disadvantage (smoking status). CONCLUSIONS Immediate attention needs to focus on the development of interventions to address the high levels of psychological distress and provide appropriate support services during periods of major life events for pregnant Australian Indigenous women.
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Santiago PHR, Soares GH, Smithers LG, Roberts R, Jamieson L. Psychological Network of Stress, Coping and Social Support in an Aboriginal Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15104. [PMID: 36429821 PMCID: PMC9690794 DOI: 10.3390/ijerph192215104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Over the past decades, increasing research interest has been directed towards the psychosocial factors that impact Aboriginal health, including stress, coping and social support. However, there has been no study that examined whether the behaviours, cognitions and emotions related to stress, coping and social support constitute a psychological network in an Aboriginal population and that examined its properties. To address this gap, the current study employed a new methodology, network psychometrics, to evaluate stress, coping and social support in an Aboriginal Australian population. This study conducted a secondary analysis of the South Australian Aboriginal Birth Cohort (SAABC) study, a randomised controlled trial in South Australia, which included 367 pregnant Aboriginal women at study baseline. The Gaussian Graphical Model was estimated with least absolute shrinkage and selection operator (LASSO). Node centrality was evaluated with eigencentrality, strength and bridge centrality. Network communities were investigated with the walktrap algorithm. The findings indicated that stress, coping and social support constituted a connected psychological network in an Aboriginal population. Furthermore, at the centre of the network were the troubles experienced by the Aboriginal pregnant women, bridging their perceptions of stress and coping and constituting a potential target for future interventions.
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Affiliation(s)
- Pedro Henrique Ribeiro Santiago
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
- School of Public Health, The University of Adelaide, Adelaide 5005, Australia
| | - Gustavo Hermes Soares
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
| | - Lisa Gaye Smithers
- School of Public Health, The University of Adelaide, Adelaide 5005, Australia
- School of Health and Society, University of Wollongong, Wollongong 2500, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide 5000, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
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Cultural adaptation of an appropriate tool for mental health among Kanien'kehá:ka: a participatory action project based on the Growth and Empowerment Measure. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2131-2145. [PMID: 34398264 DOI: 10.1007/s00127-021-02164-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
We present a cultural adaptation of the Growth and Empowerment Measure (GEM) from the Kanien'kehá:ka people of Quebec (Canada). Our aim was to develop a culturally competent and safe tool to assess and promote well-being among this population. We followed a qualitative, collaborative, and participatory method that sought to benefit Indigenous participants and communities, while honouring their culture and philosophies. Twelve adults from health and community services of Kahnawà:ke participated in total five focus group meetings. We carried out a thematic analysis of the data collected through an advisory group that led a revision of the cultural and conceptual relevance of the tool and its content. The group integrated socio-culturally relevant elements and restructured the tool so that it reflected local well-being factors and showed its versatility of being an assessment tool and therapeutic support. A narrative and empowerement-driven approach, culturally based intervention, cultural safety and flexibility when using the instrument were considered successful strategies to improve wellness. This project provides valuable information about the perspectives of local Indigenous communities regarding mental health and factors of empowerment. Mutual understanding and integration of psychological and traditional knowledge can create a beneficial program to improve emotional, mental, spiritual, and physical well-being for the local population. It remains to be tested whether the Kanien'kehá:ka Growth and Empowerment Measure (K-GEM) is clinically useful in psychological and psychiatric intervention, and social and community services.
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Estimating the difference in prevalence of common mental disorder diagnoses for Aboriginal and Torres Strait Islander peoples compared to the general Australian population. Epidemiol Psychiatr Sci 2022; 31:e44. [PMID: 35726614 PMCID: PMC9228582 DOI: 10.1017/s2045796022000233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIMS There is currently little nationally representative diagnostic data available to quantify how many Aboriginal and Torres Strait Islander people may need a mental health service in any given year. Without such information, health service planners must rely on less direct indicators of need such as service utilisation. The aim of this paper is to provide a starting point by estimating the prevalence ratio of 12-month common mental disorders (i.e. mood and anxiety disorders) for Indigenous peoples compared to the general Australian population. METHODS Analysis of the four most recent Australian Indigenous and corresponding general population surveys was undertaken. Kessler-5 summary scores by 10-year age group were computed as weighted percentages with corresponding 95% confidence intervals. A series of meta-analyses were conducted to pool prevalence ratios of Indigenous to general population significant psychological distress by 10-year age groups. The proportion of respondents with self-reported clinician diagnoses of mental disorders was also extracted from the most recent survey iterations. RESULTS Indigenous Australians are estimated to have between 1.6 and 3.3 times the national prevalence of anxiety and mood disorders. Sensitivity analyses found that the prevalence ratios did not vary across age group or survey wave. CONCLUSIONS To combat the current landscape of inequitable mental health in Australia, priority should be given to populations in need, such as Indigenous Australians. Having a clear idea of the current level of need for mental health services will allow planners to make informed decisions to ensure adequate services are available.
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LaGrappe D, Massey L, Kruavit A, Howarth T, Lalara G, Daniels B, Wunungmurra JG, Flavell K, Barker R, Flavell H, Heraganahally SS. Sleep disorders among Aboriginal Australians with Machado-Joseph Disease: Quantitative results from a multiple methods study to assess the experience of people living with the disease and their caregivers. Neurobiol Sleep Circadian Rhythms 2022; 12:100075. [PMID: 35516836 PMCID: PMC9062757 DOI: 10.1016/j.nbscr.2022.100075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 04/12/2022] [Accepted: 04/17/2022] [Indexed: 12/31/2022] Open
Abstract
Background Machado-Joseph Disease (MJD), or Spinocerebellar Ataxia Type 3 (SCA3), is a genetic disorder that causes progressive muscle weakness, loss of motor control, ataxia and permanent physical disability. Sleep disturbances are associated with MJD but remain poorly understood. Objective To investigate frequency and characteristics of sleep disorders and their association with health-related quality of life and psychosocial wellbeing for Aboriginal Australians living with MJD. Methods A convenience sample of MJD participants n = 24 participated in a semi-attended, ambulatory diagnostic sleep study to capture polysomnography, actigraphy and sleep diary data. Self-report measures collected were the Pittsburgh Sleep Quality Index (PSQI), STOP-BANG Questionnaire for Obstructive Sleep Apnoea (OSA), International Restless Legs Syndrome Study Group rating scale (IRLS), Kessler-5 (K5) and EuroQoL-5 Dimension (EQ5D). Caregivers (n = 22) reported EQ-5D, K5 and bed partners’ sleep behaviour (Mayo Sleep Questionnaire-Informant). Environmental factors were measured. Results We observed Nocturia, Sleep Related Leg Cramps, OSA, REM Behaviour Disorder, and RLS, respectively in 100%, 71%, 47%, 43%, and 33% of participants with a significant positive correlation between Body mass index (BMI) and Apnoea hypopnea index (AHI). The majority of sleep was spent in non-rapid eye movement sleep (NREM)-N2 stage (77.8% (67.7, 81.6)). Overcrowding (92%) and overnight care needs (42%) interrupted sleep. MJD participants and caregivers reported high psychological distress (K5 median 12.5 IQR 7, 16.5 & 8 IQR 6, 12 respectively). Conclusion Poor sleep quality and sleep disturbances are prevalent among this cohort. Disease manifestations and environmental factors are driving factors. Larger sample sizes are required to predict risk factors and confirm observed associations. Aboriginal People living with MJD in Australia experience numerous sleep disorders. Majority of sleep was spent in non-rapid eye movement sleep. Overcrowding and overnight care needs interrupt sleep. MJD participants and caregivers reported high psychological distress.
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Affiliation(s)
- Desireé LaGrappe
- Centre for Disease Control, Public Health Unit, Northern Territory Government Department of Health, O'Keefe House, Katherine Hospital, George Rd, Katherine, Northern Territory, 0850, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Level 3, George Sinclair Building, Bundoora, Victoria, 3086, Australia
| | - Libby Massey
- MJD Foundation, PO Box 414, Alyangula, Northern Territory, 0885, Australia
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Bebegu Yumba, Douglas Campus, 1 James Cook Drive, QLD, 4814, Australia
- Corresponding author. MJD Foundation Ltd, PO Box 414, Alyangula, Northern Territory, 0885, Australia.
| | - Anuk Kruavit
- Adelaide Respiratory, Level 5, Calvary Adelaide Hospital, Adelaide, South Australia, 5000, Australia
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, 105 Rocklands Drive, Tiwi, Northern Territory, 0810, Australia
| | - Timothy Howarth
- College of Health and Human Sciences, Charles Darwin University, Ellengowan Drive, Casuarina, Northern Territory, 0810, Australia
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia
| | - Gayangwa Lalara
- MJD Foundation, PO Box 414, Alyangula, Northern Territory, 0885, Australia
| | - Bronwyn Daniels
- MJD Foundation, PO Box 414, Alyangula, Northern Territory, 0885, Australia
| | | | - Kimberley Flavell
- College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, Adelaide, South Australia, Australia
| | - Ruth Barker
- College of Healthcare Sciences, James Cook University, Box 6811, Cairns, 4870, Townsville, QLD, Australia
| | - Howard Flavell
- Department of Rehabilitation Medicine, Palmerston Regional Hospital, Linco Rd, Holtze, Northern Territory, 0829, Australia
| | - Subash S. Heraganahally
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, 105 Rocklands Drive, Tiwi, Northern Territory, 0810, Australia
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia
- College of Medicine and Public Health, Flinders University, Sturt Rd, Bedford Park, Adelaide, South Australia, Australia
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Kelly PJ, Coyte J, Robinson LD, Deane FP, Russell S, Clapham K, Dale E, Longbottom M, Solley R, Baker AL. Evaluating an Aboriginal community controlled residential alcohol and other drug services: Use of benchmarking to examine within treatment changes in wellbeing. Drug Alcohol Rev 2022; 41:953-962. [PMID: 35106858 DOI: 10.1111/dar.13432] [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: 02/13/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Aboriginal Community Controlled Organisations (ACCO) have an important role in the Australian health-care sector. However, there has been a lack of research evaluating ACCOs in the treatment of alcohol and other drug (AOD) use. Using a benchmarking approach, the present study examined within treatment changes on measures of wellbeing for people attending a residential AOD ACCO. METHODS The study focused on The Glen, an AOD residential treatment service that is managed by the Ngaimpe Aboriginal Corporation (n = 775). The Glen is a male-only service and provides treatment to both Indigenous and non-Indigenous men. The evaluation focused on measures of wellbeing (i.e. symptom distress and quality of life) collected at intake, 30 and 60 days during the person's stay. Comparative benchmarking was conducted with a cohort of men who were attending non-ACCO residential AOD treatment services (n = 4457). RESULTS The Glen participants demonstrated statistically significant improvements on measures of wellbeing. The Glen participants were more likely to complete treatment than participants attending non-ACCO services. Likewise, Indigenous people attending The Glen were more likely to complete treatment (compared to Indigenous people attending non-ACCO services). Rates of reliable and clinically significant change suggested that changes in quality of life were largely equivalent between The Glen and non-ACCO services, while participants attending The Glen tended to demonstrate larger reductions in symptom distress compared to the non-ACCO services. DISCUSSION AND CONCLUSION The study provides further support for the important role that ACCOs play in supporting Indigenous people in their recovery.
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Affiliation(s)
- Peter J Kelly
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Joe Coyte
- The Glen, Central Coast Alcohol and Drug Rehabilitation Centre, Ngaimpe Aboriginal Corporation, Chittaway Point, Australia
| | - Laura D Robinson
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Frank P Deane
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Sophie Russell
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Elizabeth Dale
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia.,Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Marlene Longbottom
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Ryan Solley
- School of Psychology, University of Wollongong, Wollongong, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
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Stapinski L, Routledge K, Snijder M, Doyle M, Champion K, Chapman C, Ward J, Baumgart A, Lee KSK, Teesson M, Newton N. A Web-Based Alcohol and Other Drug Prevention Program (Strong & Deadly Futures) for Aboriginal and Torres Strait Islander School Students: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34530. [PMID: 34994696 PMCID: PMC8783274 DOI: 10.2196/34530] [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: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 11/22/2022] Open
Abstract
Background There are no available school-based alcohol and drug prevention programs with evidence of effectiveness among Aboriginal and Torres Strait Islander youth. To address this, we codeveloped the Strong & Deadly Futures well-being and alcohol and drug prevention program in partnership with an Indigenous creative design agency and 4 Australian schools. Objective This paper presents the protocol to evaluate the effectiveness of Strong & Deadly Futures in reducing alcohol and other drug use and improving well-being among Aboriginal and Torres Strait Islander youth. Methods The target sample will be 960 year 7 and 8 students from 24 secondary schools in Australia, of which approximately 40% (384/960) will identify as Aboriginal or Torres Strait Islander. The study design is a 2-group, parallel cluster randomized controlled trial with allocation concealment. Recruited schools will be block randomized (ratio 1:1), stratified by geographical remoteness, by an independent statistician. Schools will be randomized to receive Strong & Deadly Futures, a web-based alcohol and drug prevention and social and emotional well-being program that delivers curriculum-aligned content over 6 lessons via an illustrated story, or health education as usual (control). Control schools will be supported to implement Strong & Deadly Futures following trial completion. Surveys will be administered at baseline, 6 weeks, 12 months, and 24 months (primary end point) post baseline. Primary outcomes are alcohol use (adapted from the National Drug Strategy Household Survey), tobacco use (Standard High School Youth Risk Behavior Survey), and psychological distress (Kessler-5 Psychological Distress Scale). Secondary outcomes are alcohol and drug knowledge and intentions, alcohol-related harms, binge drinking, cannabis use, well-being, empowerment, appreciation of cultural diversity, and truancy. Results The trial was funded by the National Health and Medical Research Council in January 2019, approved by the Human Research Ethics Committee of the University of Sydney (2020/039, April 2020), the Aboriginal Health and Medical Research Council of New South Wales (1620/19, February 2020), the Western Australian Aboriginal Health Ethics Committee (998, October 2021), and the ethics committees of each participating school, including the New South Wales Department of Education (2020170, June 2020), Catholic Education Western Australia (RP2020/39, November 2020), and the Queensland Department of Education (550/27/2390, August 2021). Projected dates of data collection are 2022-2024, and we expect to publish the results in 2025. A total of 24 schools have been recruited as of submission of the manuscript. Conclusions This will be the first cluster randomized controlled trial of a culturally inclusive, school-based alcohol and drug prevention program for Aboriginal and Torres Strait Islander youth; therefore, it has significant potential to address alcohol and other drug harms among Aboriginal and Torres Strait Islander youth. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620001038987; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380038&isReview=true International Registered Report Identifier (IRRID) PRR1-10.2196/34530
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Affiliation(s)
- Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Kylie Routledge
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Mieke Snijder
- Institute of Development Studies, The University of Sussex, Brighton, United Kingdom
| | - Michael Doyle
- National Health and Medical Research Council Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Camperdown, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - James Ward
- University of Queensland Poche Centre for Indigenous Health, University of Queensland, St Lucia, Australia
| | - Amanda Baumgart
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - K S Kylie Lee
- National Health and Medical Research Council Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Camperdown, Australia.,National Drug Research Institute, Curtin University, Bentley, Australia.,Burnet Institute, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
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Depression or resilience? A participatory study to identify an appropriate assessment tool with Kanien'kéha (Mohawk) and Inuit in Quebec. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1891-1902. [PMID: 33683413 DOI: 10.1007/s00127-021-02057-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/24/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE We present a study on selection of a psychometric scale to be clinically used among Indigenous people with depression. Our aim was to select a psychometric tool for cultural adaptation with Mohawk and Inuit in Quebec. METHODS We selected three depression scales and three protective factor scales based on: strong validity for psychometric properties, evidence for good psychometric qualities across translations, avoidance of cognitively complex sentences, brevity, and clarity. We submitted the scales for consultation, and followed qualitative participatory methods with Mohawks of Kahnawake and Inuit from Nunavik living in an urban environment. We collected data through ten focus groups with advisory committees, and carried out a thematic analysis of the information. RESULTS The advisory groups considered the measurement scales to be unsafe. The major components that hindered their acceptance were: numeric rating, self-evaluation (versus supportive interaction), and a focus on symptoms rather than supportive factors. The participants preferred the Growth and Empowerment Measure due to its empowering approach. They voiced that it is necessary to develop a culturally sensitive and safe tool which facilitates interactions between the person and the practitioner. CONCLUSION This project provides valuable information about the perspectives of local Indigenous peoples regarding mental health and factors of empowerment and resilience. The ideal tool should be flexible in terms of the content and its use as compared to the conventional psychometric strategies. A tool developed with the Indigenous perspective on wellbeing could be used in psychological and psychiatric intervention as well as in social and community services.
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15
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Luke JN, Thorpe A, Black C, Thorpe L, Thomas D, Eades S, Rowley K. Collaborative Social-Epidemiology: A Co-analysis of the Cultural and Structural Determinants of Health for Aboriginal Youth in Victorian Schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8674. [PMID: 34444421 PMCID: PMC8393666 DOI: 10.3390/ijerph18168674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022]
Abstract
Social-epidemiology that excludes Aboriginal voices often fails to capture the full and complex social worlds of Aboriginal people. Using data from an existing co-designed Victorian government Adolescent Health and Wellbeing Survey (2008/9), we worked with Aboriginal organizations to identify data priorities, select measures, interpret data, and contextualize findings. Using this participatory co-analysis approach, we selected "cultural" and "structural" determinants identified by Aboriginal organizations as important and modelled these using principal component analysis. Resulting components were then modelled using logistic regression to investigate associations with "likely being well" (Kessler-10 score < 20) for 88 Aboriginal adolescents aged 11-17 years. Principal component analysis grouped 11 structural variables into four components and 11 cultural variables into three components. Of these, "grew up in Aboriginal family/community and connected" associated with significantly higher odds of "likely being well" (OR = 2.26 (1.01-5.06), p = 0.046). Conversely, "institutionally imposed family displacement" had significantly lower odds (OR = 0.49 (0.24-0.97), p = 0.040) and "negative police contact and poverty" non-significantly lower odds (OR = 0.53 (0.26-1.06), p = 0.073) for "likely being well". Using a co-analysis participatory approach, the voices of Aboriginal researchers and Aboriginal organizations were able to construct a social world that aligned with their ways of knowing, doing, and being. Findings highlighted institutionally imposed family displacement, policing, and poverty as social sites for health intervention and emphasized the importance of strong Aboriginal families for adolescents.
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Affiliation(s)
- Joanne Nicole Luke
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
| | - Alister Thorpe
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
| | - Carlina Black
- The Victorian Aboriginal Child Care Agency, Preston 3072, Australia;
| | - Lisa Thorpe
- Bubup Wilam-Aboriginal Child and Family Centre, Thomastown 3074, Australia;
| | - David Thomas
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia;
| | - Sandra Eades
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
- Curtin Medical School, Curtin University, Bentley 6102, Australia
| | - Kevin Rowley
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
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16
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Núñez-Rocha GM, Esqueda-Eguía BM, Salinas-Martínez AM, Ávila-Ortiz MN, Castro-Sánchez AE, Zambrano-Moreno A, Hernández-Ruiz KJ. Differences in Social Determinants of Health between Urban Indigenous Migrants and Non-Indigenous People in North-Eastern Mexico: An Analysis to Prioritize. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168464. [PMID: 34444213 PMCID: PMC8392500 DOI: 10.3390/ijerph18168464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/25/2021] [Accepted: 08/06/2021] [Indexed: 11/20/2022]
Abstract
The degree to which social determinants of health differ between indigenous migrants and non-indigenous people born and raised locally is currently unknown. We compared social determinants of health between indigenous migrants and non-indigenous people from urban north-eastern Mexico. Additionally, we ranked priorities for addressing the negative social determinants of health. This was a population-based comparative cross-sectional study (n = 235 indigenous migrants and 168 non-indigenous people). A two-stage non-random sampling was carried out from June to August of 2019. Heads of households ≥18 years and those with the ability to communicate in Spanish were recruited house by house. Structural and intermediary determinants of health were identified according to the World Health Organization Conceptual Framework and priorities were ranked using Z-scores. Being a migrant indigenous increased 1.6 times the odds of low education (95% CI = 1.1, 2.4). In addition, the migrant indigenous status increased the odds of poor housing, unhealthy behaviour and low social cohesion (p < 0.05). Housing, behaviours and health service accessibility were top priorities for indigenous migrants and structural determinants for non-indigenous people. The findings show that the right to access the social determinants of health has not yet been guaranteed for indigenous communities.
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Affiliation(s)
- Georgina Mayela Núñez-Rocha
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
- Correspondence:
| | - Brenda Mayela Esqueda-Eguía
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
| | - Ana María Salinas-Martínez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Nuevo León 64360, Mexico
| | - María Natividad Ávila-Ortiz
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
| | - Ana Elisa Castro-Sánchez
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
| | - Adriana Zambrano-Moreno
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
| | - Karina Janett Hernández-Ruiz
- Facultad de Salud Pública y Nutrición, Universidad Autónoma de Nuevo León, Nuevo León 66455, Mexico; (B.M.E.-E.); (A.M.S.-M.); (M.N.Á.-O.); (A.E.C.-S.); (A.Z.-M.); (K.J.H.-R.)
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Brown A, Mensah F, Gee G, Paradies Y, French S, Waters L, Arabena K, Armstrong G, Nicholson J, Brown SJ, Hegarty K, Ritte R, Meiselbach K, Kelaher M. Evaluation of an Aboriginal and Torres Strait Islander strengths based coaching program: a study protocol. BMC Public Health 2021; 21:1451. [PMID: 34301227 PMCID: PMC8301731 DOI: 10.1186/s12889-021-11503-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/16/2021] [Indexed: 11/10/2022] Open
Abstract
Background Increasingly, strength-based approaches to health and wellbeing interventions with Aboriginal and Torres Strait Islander Australians are being explored. This is a welcome counter to deficit-based initiatives which can represent a non-Indigenous view of outcomes of interest. However, the evidence base is not well developed. This paper presents the protocol for evaluating a strengths-based initiative which provides life coaching services to Aboriginal and Torres Strait Islander community housing tenants. The study aims to evaluate the effect of life coaching on social and emotional wellbeing (SEWB) of tenants in three Victorian regions. Methods The More Than a Landlord (MTAL) study is a prospective cohort study of Aboriginal Housing Victoria tenants aged 16 years and over that embeds the evaluation of a life coaching program. All tenant holders in one metropolitan and two regional areas of Victoria are invited to participate in a survey of SEWB, containing items consistent with key categories of SEWB as understood and defined by Aboriginal and Torres Strait Islander peoples, and key demographics, administered by Aboriginal and Torres Strait Islander peer researchers at baseline, 6 and 18 months. Survey participants are then invited to participate in strengths based life coaching, using the GROW model, for a duration of up to 18 months. Indigenous life coaches provide tenants with structured support in identifying and making progress towards their goals and aspirations, rather than needs. The study aims to recruit a minimum of 200 survey participants of which it is anticipated that approximately 73% will agree to life coaching. Discussion The MTAL study is a response to Aboriginal and Torres Strait Islander community and organisational requests to build the evidence base for an initiative originally developed and piloted within an Aboriginal controlled organisation. The study design aligns with key principles for research in Indigenous communities in promoting control, decision making and capacity building. The MTAL study will provide essential evidence to evaluate the effectiveness of strengths-based initiatives in promoting SEWB in these communities and provide new evidence about the relationship between strengths, resilience, self-determination and wellbeing outcomes. Trial registration This trial was retrospectively registered with the ISRCTN Register on the 12/7/21 with the study ID:ISRCTN33665735.
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Affiliation(s)
| | - Fiona Mensah
- Murdoch Children's Research Institute and University of Melbourne, Melbourne, Australia
| | - Graham Gee
- Murdoch Children's Research Institute, Melbourne, Australia
| | | | | | - Lea Waters
- University of Melbourne, Melbourne, Australia
| | | | | | | | - Stephanie J Brown
- Murdoch Children's Research Institute and University of Melbourne, Melbourne, Australia
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Garvey G, Anderson K, Gall A, Butler TL, Whop LJ, Arley B, Cunningham J, Dickson M, Cass A, Ratcliffe J, Tong A, Howard K. The Fabric of Aboriginal and Torres Strait Islander Wellbeing: A Conceptual Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157745. [PMID: 34360037 PMCID: PMC8345714 DOI: 10.3390/ijerph18157745] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/16/2022]
Abstract
Wellbeing is culturally bound and is shaped by many aspects of life, including experiences, beliefs and values. As such, in order to accurately measure wellbeing for a specific cultural group, it is necessary to understand the experiences, beliefs and values that influence the conception and experience of wellbeing of that group. This paper presents a conceptual model of wellbeing for Aboriginal and Torres Strait Islander people, which was developed from a large national qualitative study that explored the views of 359 Aboriginal and Torres Strait Islander adults. An Aboriginal- and Torres Strait Islander-led research team used an Indigenist research approach to iteratively develop this conceptual model, called the Fabric of Aboriginal and Torres Strait Islander Wellbeing model, which takes inspiration from Aboriginal and Torres Strait Islander weaving traditions whereby individual strands are twined to create fabrics that are both beautiful and strong. This reflects our findings that the parts of life that are most important to wellbeing for many Aboriginal and Torres Strait Islander people are interwoven with their families, communities and culture.
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Affiliation(s)
- Gail Garvey
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (G.G.); (A.G.); (T.L.B.); (L.J.W.); (B.A.); (J.C.); (A.C.); (K.H.)
- School of Public Health, University of Queensland, Brisbane 4000, Australia
- Sydney School of Public Health, The University of Sydney, Sydney 2006, Australia; (M.D.); (A.T.)
| | - Kate Anderson
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (G.G.); (A.G.); (T.L.B.); (L.J.W.); (B.A.); (J.C.); (A.C.); (K.H.)
- Correspondence:
| | - Alana Gall
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (G.G.); (A.G.); (T.L.B.); (L.J.W.); (B.A.); (J.C.); (A.C.); (K.H.)
| | - Tamara L. Butler
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (G.G.); (A.G.); (T.L.B.); (L.J.W.); (B.A.); (J.C.); (A.C.); (K.H.)
| | - Lisa J. Whop
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (G.G.); (A.G.); (T.L.B.); (L.J.W.); (B.A.); (J.C.); (A.C.); (K.H.)
- National Centre for Epidemiology and Population Health, Australian National University, Canberra 2601, Australia
| | - Brian Arley
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (G.G.); (A.G.); (T.L.B.); (L.J.W.); (B.A.); (J.C.); (A.C.); (K.H.)
| | - Joan Cunningham
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (G.G.); (A.G.); (T.L.B.); (L.J.W.); (B.A.); (J.C.); (A.C.); (K.H.)
| | - Michelle Dickson
- Sydney School of Public Health, The University of Sydney, Sydney 2006, Australia; (M.D.); (A.T.)
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (G.G.); (A.G.); (T.L.B.); (L.J.W.); (B.A.); (J.C.); (A.C.); (K.H.)
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University, Adelaide 5042, Australia;
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney 2006, Australia; (M.D.); (A.T.)
| | - Kirsten Howard
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia; (G.G.); (A.G.); (T.L.B.); (L.J.W.); (B.A.); (J.C.); (A.C.); (K.H.)
- Sydney School of Public Health, The University of Sydney, Sydney 2006, Australia; (M.D.); (A.T.)
- Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney 2006, Australia
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19
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Brinckley MM, Calabria B, Walker J, Thurber KA, Lovett R. Reliability, validity, and clinical utility of a culturally modified Kessler scale (MK-K5) in the Aboriginal and Torres Strait Islander population. BMC Public Health 2021; 21:1111. [PMID: 34112127 PMCID: PMC8194217 DOI: 10.1186/s12889-021-11138-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Aboriginal and Torres Strait Islander peoples are the first people of Australia. Consequences of historic and contemporary settler-colonialism including racism, trauma, grief and loss (of land, culture, spirituality, and freedoms) have led to substantial negative health and wellbeing impacts. The Kessler Psychological Distress Scales are population and individual-level tools designed to measure general psychological health status. There has been limited assessment of the psychometric properties and validity of the Kessler Psychological Distress Scale for use with the Aboriginal and Torres Strait Islander population in Australia, despite its widespread use. Methods A national sample of Aboriginal and Torres Strait Islander adults (n = 6988 ≥ 16 years) was used in the psychometric assessment of the MK-K5, which involved face validity, acceptability, internal consistency/reliability, construct validity, and convergent and divergent validity testing. Receiver Operator Characteristics (ROC) curves were produced to assess clinical utility for depression and anxiety screening. Results The MK-K5 demonstrated face validity for psychological distress in two focus groups, and had good acceptability, good internal consistency/reliability (α = 0.89), good construct validity (uni-dimensional; one underlying component explaining 70.1% of variance), and demonstrated convergent and divergent validity in the sample. The MK-K5 had good clinical utility at a cut-off score of 11 for detecting ever being diagnosed with depression or anxiety. Conclusions The MK-K5 is a valid measure of psychological distress and has clinical utility in the Aboriginal and Torres Strait Islander population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11138-4.
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Affiliation(s)
- Makayla-May Brinckley
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, 54 Mills Road, Acton, ACT, 2601, Australia.
| | - Bianca Calabria
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, 54 Mills Road, Acton, ACT, 2601, Australia
| | - Jennie Walker
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, 54 Mills Road, Acton, ACT, 2601, Australia
| | - Katherine A Thurber
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, 54 Mills Road, Acton, ACT, 2601, Australia
| | - Raymond Lovett
- National Centre for Epidemiology & Population Health, Research School of Population Health, Australian National University, 54 Mills Road, Acton, ACT, 2601, Australia
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20
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Rahman MA, Salehin M, Islam SMS, Alif SM, Sultana F, Sharif A, Hoque N, Nazim NB, Cross WM. Reliability of the tools used to examine psychological distress, fear of COVID-19 and coping amongst migrants and non-migrants in Australia. Int J Ment Health Nurs 2021; 30:747-758. [PMID: 33555128 PMCID: PMC8013171 DOI: 10.1111/inm.12845] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 01/13/2021] [Accepted: 01/21/2021] [Indexed: 12/19/2022]
Abstract
Study tools examining psychological distress, fear of COVID-19 and coping amongst migrants and non-migrants in Australia are very limited. The aim of this research was to assess the psychometric properties and correlation of the English version of Kessler Psychological Distress Scale (K-10), Fear of COVID-19 Scale (FCSV-19S), and Brief Resilient Coping Scale (BRCS) tools during the COVID-19 pandemic situation in Australia. Data from a cross-sectional survey (n = 516) were utilized to examine reliability; 299 (57.9%) were migrants. High internal consistency, as evidenced by Cronbach's alpha, was found for the K-10 (0.92), FCV-19S (0.87) and BRCS (0.66) tools. The corresponding values for migrants and non-migrants were (0.92, 0.87, 0.67) and (0.92, 0.86, 0.63), respectively. Item-total correlations ranged 0.57-0.78 for K-10, 0.62-0.69 for FCV-19S, and 0.39-0.50 for BRCS tools. EFA retained a single factor for each tool with adequate factor loadings. The scoring of K-10 was significantly predicted by the scoring of FCV-19S (r = 0.284, P < 0.001) and BRCS tool (r = 0.132, P < 0.01). Therefore, these tools can be used reliably amongst both migrant and non-migrant population in Australia.
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Affiliation(s)
- Muhammad Aziz Rahman
- School of HealthFederation University AustraliaBerwickVictoriaAustralia
- Australian Institute of Primary Care and Ageing, La Trobe UniversityMelbourneVictoriaAustralia
- Bangladesh Medical Society of Victoria (BMSV)MelbourneVictoriaAustralia
| | - Masudus Salehin
- School of HealthFederation University AustraliaBerwickVictoriaAustralia
| | | | - Sheikh M. Alif
- Bangladesh Medical Society of Victoria (BMSV)MelbourneVictoriaAustralia
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | | | - Ahmed Sharif
- Bangladesh Medical Society of Victoria (BMSV)MelbourneVictoriaAustralia
- Station Street ClinicPakenhamVictoriaAustralia
- Bangladesh Institute of Family Medicine and ResearchUniversity of Science & Technology ChittagongChittagongBangladesh
| | - Nazmul Hoque
- Bangladesh Medical Society of Victoria (BMSV)MelbourneVictoriaAustralia
- Emerald Medical CentreEmeraldVictoriaAustralia
| | - Nashrin Binte Nazim
- Bangladesh Medical Society of Victoria (BMSV)MelbourneVictoriaAustralia
- Greenvale Medical CentreGreenvaleVictoriaAustralia
| | - Wendy M. Cross
- School of HealthFederation University AustraliaBerwickVictoriaAustralia
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21
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Wright A, Yap M, Jones R, Richardson A, Davis V, Lovett R. Examining the Associations between Indigenous Rangers, Culture and Wellbeing in Australia, 2018-2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3053. [PMID: 33809609 PMCID: PMC8002247 DOI: 10.3390/ijerph18063053] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 11/23/2022]
Abstract
The centrality of culture to Indigenous peoples' health and wellbeing is becoming increasingly acknowledged in government policy. In Australia, the Indigenous Ranger program is a leading example of employment that supports increased cultural participation. In 2017, we demonstrated higher life satisfaction and family wellbeing among Indigenous Rangers compared to non-Rangers in Central Australia. Using an expanded national dataset, this present study aimed to: examine if associations between Ranger status and wellbeing continued to be observed in Central Australia; assess if these associations were observed among non-Central Australian Rangers; and, quantify the effect of mediating variables (Rangers status, cultural factors) on wellbeing outcomes. We analyzed Mayi Kuwayu baseline data (n = 9691 Aboriginal and Torres Strait Islander people) and compared participants who identified as past or currently employed Rangers compared to non-Rangers across two geographic locations (Central Australia, non-Central Australia). Ranger participation was significantly associated with very high life satisfaction and family wellbeing in Central Australia (high life satisfaction PR 1.31, 95% CI 1.09-1.57, and family wellbeing (PR 1.17, 95% CI 1.01-1.36) and non-Central Australia (high life satisfaction PR 1.29, 95% CI 1.06-1.57), family wellbeing (PR 1.37, 95% CI 1.14-1.65). These findings concord with those observed in the 2017 proof-of-concept study. Additionally, we found that Ranger status partially mediated the relationships between existing cultural practices (first language as your Indigenous language and living on your country) and the two wellbeing outcomes. Current cultural practices, spending time on country and speaking your Aboriginal language, also partially mediated the associations between Ranger status and high life satisfaction, and between Ranger status and high family wellbeing. This analysis supports evidence that both Ranger employment and cultural participation are contributors to wellbeing. Ranger work is not only good for land, but it is good for people. As such, determining policies that mutually acknowledge and enhance culture, health and wellbeing will likely have additional benefits for the broader Aboriginal and Torres Strait Islander population.
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Affiliation(s)
- Alyson Wright
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 64 Mills Road, Acton 2600, Australia; (R.J.); (R.L.)
| | - Mandy Yap
- Centre for Aboriginal Economic and Policy Research, The Australian National University, Acton 2600, Australia;
| | - Roxanne Jones
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 64 Mills Road, Acton 2600, Australia; (R.J.); (R.L.)
| | - Alice Richardson
- Statistical Consulting Unit, The Australian National University, Acton 2600, Australia;
| | - Vanessa Davis
- Tangentyere Council, 1 Elders St, Alice Springs 0870, Australia;
| | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, 64 Mills Road, Acton 2600, Australia; (R.J.); (R.L.)
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22
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Jiao C, Leng A, Nicholas S, Maitland E, Wang J, Zhao Q, Xu L, Gong C. Multimorbidity and Mental Health: The Role of Gender among Disease-Causing Poverty, Rural, Aged Households in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238855. [PMID: 33260787 PMCID: PMC7734588 DOI: 10.3390/ijerph17238855] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/20/2020] [Accepted: 11/20/2020] [Indexed: 12/15/2022]
Abstract
(1) Background: The association between multimorbidity and mental health is well established. However, the role of gender in different populations remains unclear. Currently, China is facing an increased prevalence of multimorbidity, especially in its disease-causing poverty population. The present study explores the gender-based differences in the relationship between multimorbidity and mental health using data from the rural, disease-causing poverty, older-age population in Shandong province, China, as a case study. (2) Methods: The data were obtained from the survey on the health and welfare of disease-causing poverty households in rural Shandong province. We identified 936 rural participants who were over 60 years old from disease-causing poverty households. The mental health status was measured using the Kessler Psychological Distress Scale (K10) instrument. Using a multivariable linear regression model, including the interaction of gender and multimorbidity, gender differences in the association between multimorbidity and mental health were explored. (3) Results: Multimorbidity was a serious health problem in rural, disease-causing poverty, older-age households, with the prevalence of multimorbidity estimated as 40% for women and 35.4% for men. There was a strong association between multimorbidity and mental health, which was moderated by gender. Women had higher K10 scores than men, and the mean K10 score was highest in women with three or more chronic diseases. Compared with men, women with multimorbidity had a higher risk of mental health problems. (4) Conclusions: The prevalence of multimorbidity in older-age rural disease-causing poverty subpopulations is a severe public health problem in China. The association between multimorbidity and mental health differed by gender, where multimorbid women suffered an increased mental health risk compared with men. Gender differences should be addressed when delivering effective physical and mental healthcare support to disease-causing poverty, older-age, rural households.
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Affiliation(s)
- Chen Jiao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (C.J.); (Q.Z.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Anli Leng
- School of Political Science and Public Administration, Institute of Governance, Shandong University, 72 Binhai Rd, Qingdao 266237, Shandong, China;
| | - Stephen Nicholas
- Australian National Institute of Management and Commerce, 1 Central Avenue, Australian Technology Park, Sydney, NSW 2015, Australia;
- Guangdong Institute for International Strategies, Guangdong University of Foreign Studies, 2 Baiyun North Avenue, Guangzhou 510420, Guangdong, China
- School of Economics and School of Management, Tianjin Normal University, No. 339 Binshui West Avenue, Tianjin 300387, China
- Newcastle Business School, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Elizabeth Maitland
- School of Management, University of Liverpool, Chatham Building, Chatham Street, Liverpool L697ZH, UK;
| | - Jian Wang
- Dong Fureng Institute of Economics and Social Development, Wuhan University, No. 54 Dongsi Lishi Hutong, Dongcheng District, Beijing 100010, China;
- Center for Health Economics and Management, Economics and Management School, Wuhan University, Luojia Hill, Wuhan 430072, China
| | - Qinfeng Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; (C.J.); (Q.Z.)
- NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Lizheng Xu
- The George Institute for Global Health, Sydney, NSW 2052, Australia;
- UNSW Medicine, UNSW Sydney, Sydney, NSW 2052, Australia
| | - Chaofan Gong
- Center for Digital Health, School of Medicine, Stanford University, Palo Alto, CA 94305, USA
- Correspondence:
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23
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Davison B, Singh GR, Oguoma VM, McFarlane J. Fingernail cortisol as a marker of chronic stress exposure in Indigenous and non-Indigenous young adults. Stress 2020; 23:298-307. [PMID: 31651211 DOI: 10.1080/10253890.2019.1683159] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Cumulative exposure to stress over a long period can negatively impact an individual's health. Significant advancements in biomarkers of chronic stress have been made, with the use of fingernails recently explored. Cross sectional data from the Australian Aboriginal Birth Cohort (Indigenous) and Top End Cohort (non-Indigenous) were used to investigate the associations (sociodemographic and emotional) of fingernail cortisol in Indigenous and non-Indigenous young adults. Details on sociodemographic (age, gender, and Indigenous identification), smoking and alcohol use, emotional wellbeing, and emotional stress (perceived stress and stressful events), and fingernail samples were obtained face-to-face. Fingernail samples were analyzed for 179 Indigenous and 66 non-Indigenous participants (21-28 years). Indigenous participants were subjected to higher rates of stressful events compared to non-Indigenous (Median 6.0; interquartile range (IQR) 4, 9 vs. 1.0; IQR 0, 2; p < .001). Median cortisol levels were similar between Indigenous and non-Indigenous participants (4.36 pg/mg; IQR 2.2, 10.0 vs. 3.87 pg/mg: IQR 2.0, 9.7; p = .68). However, Indigenous participants had a higher cortisol level on adjustment for emotional distress and exposure to stressful events (Geometric Mean 1.82; 95CI: 1.07-3.09), with a negative association with increasing number of stressful events (Geometric Mean 0.94; 95CI 0.90, 0.99). Collection of fingernails was an easily conducted, well-tolerated method to measure stress markers in this multicultural cohort. Indigenous young adults experienced a high number of stressful events which was associated with a lowering of fingernail cortisol levels.Lay abstractChronic stress can impact negatively on health and emotional wellbeing. A fingernail sample provided a culturally acceptable, noninvasive method of measuring chronic stress in Indigenous and non-Indigenous young adults. Cortisol levels, a marker of chronic stress, were different between Indigenous and non-Indigenous young adults and were influenced by emotional status and occurrence of multiple stressful events.
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Affiliation(s)
- Belinda Davison
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Gurmeet R Singh
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Northern Territory Medical Program, Flinders University, Darwin, Australia
| | - Victor M Oguoma
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - James McFarlane
- Centre for Bioactive Discovery in Health & Ageing, University of New England, Armidale, Australia
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24
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Davison B, Liddle R, Fitz J, Singh GR. Computerised emotional well-being and substance use questionnaires in young Indigenous and non-Indigenous Australian adults. SAGE Open Med 2020; 8:2050312120906042. [PMID: 32095239 PMCID: PMC7011318 DOI: 10.1177/2050312120906042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 12/27/2019] [Indexed: 11/15/2022] Open
Abstract
Background: Mental health disorders rank among the most substantial causes of morbidity
and mortality worldwide. Almost half of Australian adults experience mental
illness at some point in their lifetime, with Indigenous Australians
disproportionally affected. Thus, it is imperative that effective,
acceptable screening tools are used, which are tailored to the target
population. Objectives: This research investigates the methodology of computerised questionnaires in
assessing the emotional well-being and substance use in Indigenous and
non-Indigenous young adults. Methods: Cross-sectional data from young adults (21–28 years) in the Life Course
Program, Northern Territory, Australia, are presented. Through an extensive
consultation process, validated questionnaires were adapted to a
computerised format suitable for both remote and urban residing Indigenous
and non-Indigenous adults. Results: Of the 576 participants (459 Indigenous, 117 non-Indigenous) available for
assessment, high consent rates were seen, with completion rates >86%. One
in three young adults in this cohort were highlighted as ‘at risk’ of
psychological distress, and one in five as ‘at risk’ of suicidal ideation or
self-harm. Conclusion: The target population of this study were at a critical age with high levels
of psychological distress and suicidal ideation reported, particularly in
Indigenous young adults. This simple, user-friendly, pictorial programme
allowed assessment of a sensitive topic anonymously, while simultaneously
collating data and identifying those at high risk, irrespective of literacy
level or cultural background.
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Affiliation(s)
- Belinda Davison
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Robyn Liddle
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Joseph Fitz
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Gurmeet R Singh
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.,Northern Territory Medical Program, Flinders University, Darwin, NT, Australia
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25
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Chando S, Craig JC, Burgess L, Sherriff S, Purcell A, Gunasekera H, Banks S, Smith N, Banks E, Woolfenden S. Developmental risk among Aboriginal children living in urban areas in Australia: the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMC Pediatr 2020; 20:13. [PMID: 31931753 PMCID: PMC6956483 DOI: 10.1186/s12887-019-1902-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 12/23/2019] [Indexed: 12/05/2022] Open
Abstract
Background Most Australian Aboriginal children are on track with their development, however, the prevalence of children at risk of or with a developmental or behavioural problem is higher than in other children. Aboriginal child development data mostly comes from remote communities, whereas most Aboriginal children live in urban settings. We quantified the proportion of participating children at moderate and high developmental risk as identified by caregivers’ concerns, and determined the factors associated with developmental risk among urban Aboriginal communities. Methods Study methods were co-designed and implemented with four participating urban Aboriginal Community Controlled Health Services in New South Wales, Australia, between 2008 and 2012. Caregiver-reported data on children < 8 years old enrolled in a longitudinal cohort study (Study of Environment on Aboriginal Resilience and Child Health: SEARCH) were collected by interview. The Parents’ Evaluation of Developmental Status (PEDS) was used to assess developmental risk through report of caregiver concerns. Odds ratios (OR) were calculated using multinomial logistic regression to investigate risk factors and develop a risk prediction model. Results Of 725 children in SEARCH with PEDS data (69% of eligible), 405 (56%) were male, and 336 (46%) were aged between 4.5 and 8 years. Using PEDS, 32% were at high, 28% moderate, and 40% low/no developmental risk. Compared with low/no risk, factors associated with high developmental risk in a mutually-adjusted model, with additional adjustment for study site, were male sex (OR 2.42, 95% confidence intervals 1.62–3.61), being older (4.5 to < 8 years versus < 3 years old, 3.80, 2.21–6.54), prior history of ear infection (1.95, 1.21–3.15), having lived in 4 or more houses versus one house (4.13, 2.04–8.35), foster care versus living with a parent (5.45, 2.32–12.78), and having a caregiver with psychological distress (2.40, 1.37–4.20). Conclusion In SEARCH, 40% of urban Aboriginal children younger than 8 years were at no or low developmental risk. Several factors associated with higher developmental risk were modifiable. Aboriginal community-driven programs to improve detection of developmental problems and facilitate early intervention are needed.
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Affiliation(s)
| | - Jonathan C Craig
- University of Sydney, Sydney, Australia.,Flinders University, Adelaide, Australia
| | - Leonie Burgess
- Sax Institute, Sydney, Australia.,Australian National University, Canberra, Australia
| | - Simone Sherriff
- University of Sydney, Sydney, Australia.,Sax Institute, Sydney, Australia
| | | | - Hasantha Gunasekera
- University of Sydney, Sydney, Australia.,Sydney Children's Hospitals Network, Sydney, Australia
| | - Sandra Banks
- Tharawal Aboriginal Medical Service, Campbelltown, Australia
| | - Natalie Smith
- Riverina Medical and Dental Corporation, Wagga Wagga, Australia
| | - Emily Banks
- Australian National University, Canberra, Australia
| | - Sue Woolfenden
- Sydney Children's Hospitals Network, Sydney, Australia. .,University of New South Wales, School of Women and Children's Health, Sydney, Australia.
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26
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Farnbach S, Gee G, Eades AM, Evans JR, Fernando J, Hammond B, Simms M, DeMasi K, Glozier N, Brown A, Hackett ML. Process evaluation of the Getting it Right study and acceptability and feasibility of screening for depression with the aPHQ-9. BMC Public Health 2019; 19:1270. [PMID: 31533670 PMCID: PMC6749631 DOI: 10.1186/s12889-019-7569-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/29/2019] [Indexed: 11/30/2022] Open
Abstract
Background The Getting it Right study determined the validity, sensitivity, specificity and acceptability of the culturally adapted 9-item Patient Health Questionnaire (aPHQ-9) as a screening tool for depression in Aboriginal and Torres Strait Islander (hereafter referred to as Indigenous) people. In this process evaluation we aimed to explore staff perceptions about whether Getting it Right was conducted per protocol, and if the aPHQ-9 was considered an acceptable and feasible screening tool for depression in primary healthcare. This process evaluation will provide information for clinicians and policy makers about the experiences of staff and patients with Getting it Right and what they thought about using the aPHQ-9. Methods Process evaluation using grounded theory approaches. Semi-structured interviews with primary healthcare staff from services participating in Getting it Right were triangulated with feedback (free-text and elicited) from participants collected during the validation study and field notes. Data were thematically analysed according to the Getting it Right study protocol to identify the acceptability and feasibility of the aPHQ-9. Results Primary healthcare staff (n = 36) and community members (n = 4) from nine of the ten participating Getting it Right services and Indigenous participants (n = 500) from the ten services that took part. Most staff reported that the research was conducted according to the study protocol. Staff from two services reported sometimes recruiting opportunistically (rather than recruiting consecutive patients attending the service as outlined in the main study protocol), when they spoke to patients who they knew from previous interactions, because they perceived their previous relationship may increase the likelihood of patients participating. All Getting it Right participants responded to at least six of the seven feedback questions and 20% provided free-text feedback. Most staff said they would use the aPHQ-9 and most participants said that the questions were easy to understand (87%), the response categories made sense (89%) and that they felt comfortable answering the questions (91%). Conclusion Getting it Right was predominantly conducted according to the study protocol. The aPHQ-9, the first culturally adapted, nationally validated, freely available depression screening tool for use by Indigenous people, appears to be acceptable and feasible to use. Trial registration Australian New Zealand Clinical Trial Registry ANZCTR12614000705684, 03/07/2014.
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Affiliation(s)
- Sara Farnbach
- The George Institute for Global Health, The University of New South Wales, PO Box M201, Missenden Road, Sydney, New South Wales, 2050, Australia. .,University of New South Wales, Sydney, New South Wales, 2052, Australia. .,University of Sydney, Sydney, New South Wales, 2006, Australia.
| | - Graham Gee
- Victorian Aboriginal Health Service, Melbourne, Victoria, 3065, Australia.,University of Melbourne, Melbourne, Victoria, 3000, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, 3052, Australia
| | - Anne-Marie Eades
- The George Institute for Global Health, The University of New South Wales, PO Box M201, Missenden Road, Sydney, New South Wales, 2050, Australia.,University of New South Wales, Sydney, New South Wales, 2052, Australia.,University of Sydney, Sydney, New South Wales, 2006, Australia
| | - John Robert Evans
- The University of Technology, Sydney, New South Wales, 2006, Australia.,The University of Sydney, Sydney, New South Wales, 2006, Australia
| | - Jamie Fernando
- The Glen Centre (Ngampie), Chittaway Point, New South Wales, 2261, Australia.,The University of Newcastle, Newcastle, New South Wales, 2308, Australia
| | - Belinda Hammond
- Nunkuwarrin Yunti of South Australia, Adelaide, South Australia, 5000, Australia
| | - Matty Simms
- The University of Sydney, Sydney, New South Wales, 2006, Australia
| | - Karrina DeMasi
- Aboriginal Medical Services Alliance Northern Territory, Darwin, 0801, Australia
| | - Nick Glozier
- Brain and Mind Centre and Central Clinical School University of Sydney, Sydney, New South Wales, 2052, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - Maree L Hackett
- The George Institute for Global Health, The University of New South Wales, PO Box M201, Missenden Road, Sydney, New South Wales, 2050, Australia.,University of New South Wales, Sydney, New South Wales, 2052, Australia.,University of Sydney, Sydney, New South Wales, 2006, Australia.,The University of Central Lancashire, Preston, PR1 2HE, UK
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27
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Sullivan EA, Kendall S, Chang S, Baldry E, Zeki R, Gilles M, Wilson M, Butler T, Levy M, Wayland S, Cullen P, Jones J, Sherwood J. Aboriginal mothers in prison in Australia: a study of social, emotional and physical wellbeing. Aust N Z J Public Health 2019; 43:241-247. [PMID: 30994971 DOI: 10.1111/1753-6405.12892] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/01/2018] [Accepted: 02/01/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE To describe the social, emotional and physical wellbeing of Aboriginal mothers in prison. METHODS Cross-sectional survey, including a Short Form Health Survey (SF-12) and Kessler Psychological Distress Scale (5-item version) administered to Aboriginal women who self-identified as mothers. RESULTS Seventy-seven Aboriginal mothers in New South Wales (NSW) and 84 in Western Australia (WA) participated in the study. Eighty-three per cent (n=59) of mothers in NSW were in prison for drug-related offences, 64.8% (n=46) of mothers in WA were in prison for offences committed under the influence of alcohol. Sixty-eight per cent (n=52) of mothers in NSW and 35% (n=28) of mothers in WA reported mental health problems. Physical (PCS) and Mental (MCS) component scores of SF-12 varied for mothers in NSW and WA. Mothers in NSW experienced poorer health and functioning than mothers in WA (NSW: PCS 49.5, MCS 40.6; WA: PCS 54.4, MCS 48.3) and high levels of psychological distress (NSW: 13.1; WA 10.1). CONCLUSIONS Aboriginal mothers in prison have significant health needs associated with physical and mental health, and psychological distress. Implications for public health: Adoption of social and emotional wellbeing as an explanatory framework for culturally secure healthcare in prison is essential to improving health outcomes of Aboriginal mothers in prison in Australia.
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Affiliation(s)
- Elizabeth A Sullivan
- Faculty of Health and Medicine, University of Newcastle, New South Wales.,The Australian Centre for Public and Population Health Research, University of Technology Sydney, New South Wales
| | - Sacha Kendall
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, New South Wales
| | - Sungwon Chang
- IMPACCT, Faculty of Health, University of Technology Sydney, New South Wales
| | - Eileen Baldry
- School of Social Sciences, UNSW Sydney, New South Wales
| | - Reem Zeki
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, New South Wales
| | - Marisa Gilles
- WA Country Health Service - Midwest, Western Australia
| | - Mandy Wilson
- National Drug Research Institute, Curtin University, Western Australia
| | - Tony Butler
- The Kirby Institute, UNSW Sydney, New South Wales
| | - Michael Levy
- Medical School, Australian National University, Canberra
| | - Sarah Wayland
- Faculty of Health Sciences, The University of Sydney, New South Wales
| | - Patricia Cullen
- School of Public Health and Community Medicine, UNSW Sydney, New South Wales
| | - Jocelyn Jones
- Faculty of Health and Medical Sciences, The University of Western Australia, Western Australia
| | - Juanita Sherwood
- Faculty of Medicine and Health, The University of Sydney, New South Wales
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Gubhaju L, Banks E, Ward J, D’Este C, Ivers R, Roseby R, Azzopardi P, Williamson A, Chamberlain C, Liu B, Hotu C, Boyle J, McNamara B, Eades SJ. 'Next Generation Youth Well-being Study:' understanding the health and social well-being trajectories of Australian Aboriginal adolescents aged 10-24 years: study protocol. BMJ Open 2019; 9:e028734. [PMID: 30862639 PMCID: PMC6429910 DOI: 10.1136/bmjopen-2018-028734] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Australian Aboriginal and/or Torres Strait Islander (hereafter referred to as 'Aboriginal') adolescents (10-24 years) experience multiple challenges to their health and well-being. However, limited evidence is available on factors influencing their health trajectories. Given the needs of this group, the young age profile of the Aboriginal population and the long-term implications of issues during adolescence, reliable longitudinal data are needed. METHODS AND ANALYSIS The 'Next Generation: Youth Well-being Study' is a mixed-methods cohort study aiming to recruit 2250 Aboriginal adolescents aged 10-24 years from rural, remote and urban communities in Central Australia, Western Australia and New South Wales. The study assesses overall health and well-being and consists of two phases. During phase 1, we qualitatively explored the meaning of health and well-being for adolescents and accessibility of health services. During phase 2, participants are being recruited into a longitudinal cohort. Recruitment is occurring mainly through community networks and connections. At baseline, participants complete a comprehensive survey and undertake an extensive age relevant clinical assessment. Survey and clinical data will be linked to various databases including those relating to health services; medication; immunisation; hospitalisations and emergency department presentations; death registrations; education; child protection and corrective services. Participants will receive follow-up surveys approximately 2 years after their baseline visit. The 'Next Generation' study will fill important evidence gaps by providing longitudinal data on the health and social well-being of Aboriginal adolescents supplemented with narratives from participants to provide context. ETHICS AND DISSEMINATION Ethics approvals have been sought and granted. Along with peer-reviewed publications and policy briefs, research findings will be disseminated via reports, booklets and other formats that will be most useful and informative to the participants and community organisations.
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Affiliation(s)
- Lina Gubhaju
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Emily Banks
- ANU College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - James Ward
- Infection and Immunity, South Australia Health and Medical Research Centre, Adelaide, South Australia, Australia
- Flinders University Faculty of Medicine Nursing and Health Sciences, Adelaide, South Australia, Australia
| | - Catherine D’Este
- National Centre for Epidemiology and Population Health (NCEPH), ANU College of Medicine, Biology and Environment, The Australian National University, Callaghan, Western Australia, Australia
| | - Rebecca Ivers
- Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Robert Roseby
- Monash Children’s Hospital, Monash Health, Clayton, Victoria, Australia
| | - Peter Azzopardi
- Infection and Immunity, South Australia Health and Medical Research Centre, Adelaide, South Australia, Australia
- Burnet Institute, Melbourne, Victoria, Australia
| | | | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Bette Liu
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Cheri Hotu
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jacqueline Boyle
- Monash Children’s Hospital, Monash Health, Clayton, Victoria, Australia
| | - Bridgette McNamara
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sandra J Eades
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Davison B, Singh GR, McFarlane J. Hair cortisol and cortisone as markers of stress in Indigenous and non-Indigenous young adults. Stress 2019; 22:210-220. [PMID: 30663480 DOI: 10.1080/10253890.2018.1543395] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Chronic, ongoing stress can impact negatively on health and wellbeing. Indigenous Australians are at an increased risk of experiencing multiple stressors. Hair glucocorticoids have been used as a marker for chronic stress. This study aimed to assess the associations of hair cortisol and cortisone with sociodemographic (age, gender, Indigenous Identification), substance use, emotional wellbeing, and emotional stress, in a cohort at increased risk of stressful events and psychological distress. Cross-sectional data (age 21-28 years) are presented from two Australian longitudinal studies; the Aboriginal Birth Cohort (n = 253) and non-Indigenous Top End Cohort (n = 72). A third of the cohort reported psychological distress, with Indigenous participants reporting higher rates of stressful events compared to non-Indigenous (6 vs. 1; p < .001). Significantly higher levels of cortisone were seen in Indigenous women compared to non-Indigenous women (β 0.21; p = .003). A positive association with age was present in hair cortisol and cortisone in Indigenous young adults (β 0.29 and β 0.41; p < .001, respectively). No association with substance use, emotional wellbeing or emotional stress was seen. Sub-analysis in women suggested a possible curvilinear relationship between hair cortisone and the number of stressful events. In this culturally diverse cohort, hair sampling provides a noninvasive, easily conducted and generally well tolerated mechanism to measure stress markers. The association with age, even in this narrow age range, likely represents the manifold changes in circumstances (financial independence, becoming parents, increased risk of substance use and mental illness) that occur during this transitional period of life, particularly for young Indigenous women. LAY ABSTRACT Chronic stress can impact negatively on health and emotional wellbeing. A hair sample is an easy way to measure chronic stress in Indigenous and non-Indigenous young people. The markers of chronic stress, cortisol and cortisone, were different between Indigenous and non-Indigenous, men and women and increased with age in Indigenous young adults.
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Affiliation(s)
- Belinda Davison
- a Menzies School of Health Research , Charles Darwin University , Darwin , NT , Australia
| | - Gurmeet R Singh
- a Menzies School of Health Research , Charles Darwin University , Darwin , NT , Australia
- b Northern Territory Medical Program , Flinders University , Darwin , NT , Australia
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Pregnancy stress, healthy pregnancy and birth outcomes - the need for early preventative approaches in pregnant Australian Indigenous women: a prospective longitudinal cohort study. J Dev Orig Health Dis 2019; 10:31-38. [PMID: 30651154 DOI: 10.1017/s204017441800079x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Adverse pregnancy outcomes including prematurity and low birth weight (LBW) have been associated with life-long chronic disease risk for the infant. Stress during pregnancy increases the risk of adverse pregnancy outcomes. Many studies have reported the incidence of adverse pregnancy outcomes in Indigenous populations and a smaller number of studies have measured rates of stress and depression in these populations. This study sought to examine the potential association between stress during pregnancy and the rate of adverse pregnancy outcomes in Australian Indigenous women residing in rural and remote communities in New South Wales. This study found a higher rate of post-traumatic stress disorder, depression and anxiety symptoms during pregnancy than the general population. There was also a higher incidence of prematurity and LBW deliveries. Unfortunately, missing post-traumatic stress disorder and depressive symptomatology data impeded the examination of associations of interest. This was largely due to the highly sensitive nature of the issues under investigation, and the need to ensure adequate levels of trust between Indigenous women and research staff before disclosure and recording of sensitive research data. We were unable to demonstrate a significant association between the level of stress and the incidence of adverse pregnancy outcomes at this stage. We recommend this longitudinal study continue until complete data sets are available. Future research in this area should ensure prioritization of building trust in participants and overestimating sample size to ensure no undue pressure is placed upon an already stressed participant.
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Associations between Participation in a Ranger Program and Health and Wellbeing Outcomes among Aboriginal and Torres Strait Islander People in Central Australia: A Proof of Concept Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15071478. [PMID: 30002356 PMCID: PMC6068952 DOI: 10.3390/ijerph15071478] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/09/2018] [Accepted: 07/10/2018] [Indexed: 11/17/2022]
Abstract
Culture can be viewed as an integral part of Aboriginal and Torres Strait Islander health and wellbeing. This study explores the association between caring for country, through participation in a Ranger program, and wellbeing. We analyzed cross-sectional data collected in Central Australia in 2017, comparing health and wellbeing (life satisfaction, general health, psychological wellbeing and family wellbeing) among Aboriginal and Torres Strait Islander peoples employed as Rangers (n = 43) versus not employed as Rangers (n = 160). We tested if any differences in outcomes were explained by differences in key demographic or health factors. Ranger participation was significantly associated with very high life satisfaction (PR = 1.69, 95% CI: 1.29, 2.20) and high family wellbeing (PR = 1.47, 95% CI: 1.13, 1.90); associations remained significant after individual adjustment for education, income, employment, health risk factors and health conditions. The magnitude and direction of associations were similar for very good general health, but results were not significant. We did not identify an association between Ranger participation and psychological wellbeing. While based on a small sample, these findings support the assertion that participation in the Ranger program is associated with positive health and wellbeing outcomes. This supports the continuation of cultural participation and practice through the Ranger program and has implications for funding, program and policy development.
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Young C, Craig JC, Clapham K, Williams S, Williamson A. Stressful life events and resilience among carers of Aboriginal children in urban New South Wales: cross-sectional findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMJ Open 2018; 8:e021687. [PMID: 29880570 PMCID: PMC6009629 DOI: 10.1136/bmjopen-2018-021687] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/19/2018] [Accepted: 04/19/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE In caregivers of urban Aboriginal children, to determine the frequency of major stressful life events, the proportion who meet criteria for resilience, and factors that are associated with resilience. DESIGN Cross-sectional survey. SETTING Four Aboriginal Community Controlled Health Services located in urban or regional areas in New South Wales, Australia. PARTICIPANTS 574 caregivers of Aboriginal children participating in the Study of Environment on Aboriginal Resilience and Child Health. PRIMARY OUTCOME MEASURE Resilience, defined as having experienced three or more stressful life events in the last 12 months, and having scores of ≤21 on the Kessler 10 Psychological Distress scale. RESULTS Over half (315, 55%) of the caregivers reported three or more stressful life events-the most common being a close family member who was hospitalised with a serious medical problem (259, 45%). Of the participants who experienced three or more stressful life events, almost three-quarters (227, 72%) met the criteria for resilience. Using multivariable analysis, two factors were independently associated with resilience: not having a physical health problem that limited normal activities (adjusted OR (aOR) 4.3; 95% CI 2.0 to 9.0), and not having problems caused by alcohol within the home (aOR 5.3; 95% CI 2.2 to 12.8). Having a child whose behaviour placed a great deal of burden on the family was associated with less resilience (aOR 0.25; 95% CI 0.09 to 0.68). CONCLUSIONS Caregivers of urban Aboriginal children experienced a large number of stressful events, the most common being the poor health of close family members, but most exhibited resilience. Resilience was associated with stable family environments and good physical health. The high number of stressful life events that caregivers experience is reflective of broader inequalities that Aboriginal communities face. The availability of easily accessible and long-term health and support services may go some way to reducing this inequality and improving social and emotional well-being for Aboriginal families.
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Affiliation(s)
- Christian Young
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia
| | - Jonathan C Craig
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital, Westmead, New South Wales, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute, The University of Wollongong, Wollongong, New South Wales, Australia
| | - Sandra Williams
- Tharawal Aboriginal Corporation, Sydney, New South Wales, Australia
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Thurber KA, Joshy G, Korda R, Eades SJ, Wade V, Bambrick H, Liu B, Banks E. Obesity and its association with sociodemographic factors, health behaviours and health status among Aboriginal and non-Aboriginal adults in New South Wales, Australia. J Epidemiol Community Health 2018. [PMID: 29514925 PMCID: PMC5969392 DOI: 10.1136/jech-2017-210064] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND High body mass index (BMI) is the second leading contributor to Australia's burden of disease and is particularly prevalent among Aboriginal peoples. This paper aims to provide insight into factors relating to obesity among Aboriginal adults and Aboriginal-non-Aboriginal differences. METHODS Cross-sectional analysis of data from the 45 and Up Study, comparing obesity (BMI ≥30 kg/m2) prevalence and risk factors among 1515 Aboriginal and 213 301 non-Aboriginal adults in New South Wales. Age-sex-adjusted prevalence ratios (PRs) for obesity by sociodemographic factors, health behaviours and health status were estimated (multivariable log-binomial regression) for Aboriginal and non-Aboriginal participants separately. We quantified the extent to which key factors (physical activity, screen time, education, remoteness, area-level disadvantage) accounted for any excess Aboriginal obesity prevalence. RESULTS Obesity prevalence was 39% among Aboriginal and 22% among non-Aboriginal participants (PR=1.65, 95% CI 1.55 to 1.76). Risk factors for obesity were generally similar for Aboriginal and non-Aboriginal participants and included individual-level and area-level disadvantage, physical inactivity, and poor physical and mental health, with steeper gradients observed among non-Aboriginal participants for some factors (Pinteraction <0.05). Many risk factors were more common among Aboriginal versus non-Aboriginal participants; key factors accounted for >40% of the excess Aboriginal obesity prevalence. CONCLUSION A substantial proportion of the excess obesity prevalence among Aboriginal versus non-Aboriginal participants was explained by physical activity, screen time, education, remoteness and area-level disadvantage. Socioeconomic and health behaviour factors are potential targets for promoting healthy BMI, but these must be considered within the context of upstream social and cultural factors. Adults with health needs and disability require particular attention.
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Affiliation(s)
- Katherine Ann Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Rosemary Korda
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Sandra J Eades
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Vicki Wade
- Djurupin Health in Our Hands, Sydney, New South Wales, Australia
| | - Hilary Bambrick
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bette Liu
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, Australia.,The Sax Institute, Sydney, New South Wales, Australia
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Does Walkability Contribute to Geographic Variation in Psychosocial Distress? A Spatial Analysis of 91,142 Members of the 45 and Up Study in Sydney, Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020275. [PMID: 29415461 PMCID: PMC5858344 DOI: 10.3390/ijerph15020275] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 01/31/2018] [Accepted: 02/01/2018] [Indexed: 01/03/2023]
Abstract
Walkability describes the capacity of the built environment to promote walking, and has been proposed as a potential focus for community-level mental health planning. We evaluated this possibility by examining the contribution of area-level walkability to variation in psychosocial distress in a population cohort at spatial scales comparable to those used for regional planning in Sydney, Australia. Data on psychosocial distress were analysed for 91,142 respondents to the 45 and Up Study baseline survey between January 2006 and April 2009. We fit conditional auto regression models at the postal area level to obtain smoothed “disease maps” for psychosocial distress, and assess its association with area-level walkability after adjusting for individual- and area-level factors. Prevalence of psychosocial distress was 7.8%; similar for low (7.9%), low-medium (7.9%), medium-high (8.0%), and high (7.4%) walkability areas; and decreased with reducing postal area socioeconomic disadvantage: 12.2% (most), 9.3%, 7.5%, 5.9%, and 4.7% (least). Unadjusted disease maps indicated strong geographic clustering of psychosocial distress with 99.0% of excess prevalence due to unobserved and spatially structured factors, which was reduced to 55.3% in fully adjusted maps. Spatial and unstructured variance decreased by 97.3% and 39.8% after adjusting for individual-level factors, and another 2.3% and 4.2% with the inclusions of area-level factors. Excess prevalence of psychosocial distress in postal areas was attenuated in adjusted models but remained spatially structured. Postal area prevalence of high psychosocial distress is geographically clustered in Sydney, but is unrelated to postal area walkability. Area-level socioeconomic disadvantage makes a small contribution to this spatial structure; however, community-level mental health planning will likely deliver greatest benefits by focusing on individual-level contributors to disease burden and inequality associated with psychosocial distress.
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McNamara BJ, Banks E, Gubhaju L, Joshy G, Williamson A, Raphael B, Eades S. Factors relating to high psychological distress in Indigenous Australians and their contribution to Indigenous-non-Indigenous disparities. Aust N Z J Public Health 2018; 42:145-152. [DOI: 10.1111/1753-6405.12766] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 09/01/2017] [Accepted: 11/01/2017] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Emily Banks
- The Sax Institute; New South Wales
- National Centre for Epidemiology and Population Health; The Australian National University; Australian Capital Territory
| | - Lina Gubhaju
- Aboriginal Health; Baker Heart and Diabetes Institute; Victoria
| | - Grace Joshy
- National Centre for Epidemiology and Population Health; The Australian National University; Australian Capital Territory
| | | | - Beverley Raphael
- Psychological and Addiction Medicine; The Australian National University; Australian Capital Territory
| | - Sandra Eades
- Aboriginal Health; Baker Heart and Diabetes Institute; Victoria
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Thurber K, Burgess L, Falster K, Banks E, Möller H, Ivers R, Cowell C, Isaac V, Kalucy D, Fernando P, Woodall C, Clapham K. Relation of child, caregiver, and environmental characteristics to childhood injury in an urban Aboriginal cohort in New South Wales, Australia. Aust N Z J Public Health 2017; 42:157-165. [DOI: 10.1111/1753-6405.12747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 08/01/2017] [Accepted: 10/01/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Katherine Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health; The Australian National University; Australian Capital Territory
| | - Leonie Burgess
- National Centre for Epidemiology and Population Health, Research School of Population Health; The Australian National University; Australian Capital Territory
- The Sax Institute; New South Wales
| | - Kathleen Falster
- National Centre for Epidemiology and Population Health, Research School of Population Health; The Australian National University; Australian Capital Territory
- The Sax Institute; New South Wales
- Centre for Big Data Research in Health; New South Wales
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health; The Australian National University; Australian Capital Territory
- The Sax Institute; New South Wales
| | - Holger Möller
- Centre for Big Data Research in Health; New South Wales
| | - Rebecca Ivers
- The George Institute for Global Health; UNSW Sydney; New South Wales
| | | | - Vivian Isaac
- Sydney Children's Health Network; New South Wales
| | | | | | | | - Kathleen Clapham
- Australian Health Services Research Institute; University of Wollongong; New South Wales
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Life, lifestyle and location: examining the complexities of psychological distress in young adult Indigenous and non-Indigenous Australians. J Dev Orig Health Dis 2017; 8:541-549. [DOI: 10.1017/s2040174417000162] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Mental health is fundamental to an individual’s health and well-being. Mental health disorders affect a substantial portion of the Australian population, with the most vulnerable time in adolescence and young adulthood. Indigenous Australians fare worse than other Australians on almost every measure of physical and mental health. Cross-sectional data from young adults (21–27 years) participating in the Life Course Program, Northern Territory, Australia, is presented. Rates of psychological distress were high in remote and urban residing Indigenous and urban non-Indigenous young adults. This rate was more pronounced in young women, particularly in Indigenous remote and urban residing women. Young adults with high psychological distress also had lower levels of positive well-being, higher perceived stress levels, experienced a higher number of major life events and were at an increased risk of suicidal ideation and/or self-harm. This study supports the need for a continued focus on early screening and treatment at this vulnerable age. The significant association seen between psychological distress and other markers of emotional well-being, particularly risk of suicidal ideation and/or self-harm, highlights the need for a holistic approach to mental health assessment and treatment. A concerted focus on improving the environs of young adults by lowering levels of stress, improving access to adequate housing, educational and employment opportunity, will assist in improving the emotional health of young adults.
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Drake MM, Morris DM, Davis TJ. Neuroticism's susceptibility to distress: Moderated with mindfulness. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.10.060] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Williamson A, D'Este C, Clapham K, Redman S, Manton T, Eades S, Schuster L, Raphael B. What are the factors associated with good mental health among Aboriginal children in urban New South Wales, Australia? Phase I findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). BMJ Open 2016; 6:e011182. [PMID: 27381207 PMCID: PMC4947800 DOI: 10.1136/bmjopen-2016-011182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify the factors associated with 'good' mental health among Aboriginal children living in urban communities in New South Wales, Australia. DESIGN Cross-sectional survey (phase I of a longitudinal study). SETTING 4 Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban communities in New South Wales, Australia. PARTICIPANTS 1005 Aboriginal children aged 4-17 years who participated in phase I of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). PRIMARY OUTCOME MEASURE Carer report version of the Strengths and Difficulties Questionnaire. Scores <17 were considered to indicate 'good' mental health for the purposes of this article. RESULTS The majority (72%) of SEARCH participants were not at high risk for emotional or behavioural problems. After adjusting for the relative contributions of significant demographic, child and carer health factors, the factors associated with good mental health among SEARCH children were having a carer who was not highly psychologically distressed (OR=2.8, 95% CI 1.6 to 5.1); not suffering from frequent chest, gastrointestinal or skin infections (OR=2.8, 95% CI 1.8 to 4.3); and eating two or more servings of vegetables per day (OR=2.1, 95% CI 1.2 to 3.8). Being raised by a foster carer (OR=0.2, 95% CI 0.01 to 0.71) and having lived in 4 or more homes since birth (OR=0.62, 95% CI 0.39 to 1.0) were associated with significantly lower odds of good mental health. Slightly different patterns of results were noted for adolescents than younger children. CONCLUSIONS Most children who participated in SEARCH were not at high risk for emotional or behavioural problems. Promising targets for efforts to promote mental health among urban Aboriginal children may include the timely provision of medical care for children and provision of additional support for parents and carers experiencing mental or physical health problems, for adolescent boys and for young people in the foster care system.
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Affiliation(s)
- Anna Williamson
- School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia
- The Sax Institute, Haymarket, New South Wales, Australia
| | - Catherine D'Este
- National Centre for Epidemiology and Community Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Sally Redman
- The Sax Institute, Haymarket, New South Wales, Australia
| | - Toni Manton
- Awabakal Aboriginal Medical Service, Hamilton, New South Wales, Australia
| | - Sandra Eades
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Leanne Schuster
- Aboriginal Medical Service Western Sydney, Mount Druitt Village, New South Wales, Australia
| | - Beverley Raphael
- School of Medicine, University of Western Sydney, Penrith South, New South Wales, Australia
- Medical School, Australian National University, Canberra, Australian Capital Territory, Australia
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Williamson AB, D'Este CA, Clapham KF, Eades SJ, Redman S, Raphael B. Psychological distress in carers of Aboriginal children in urban New South Wales: findings from SEARCH (phase one). Med J Aust 2016; 205:27-32. [DOI: 10.5694/mja16.00111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/16/2016] [Indexed: 11/17/2022]
Affiliation(s)
| | - Catherine A D'Este
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
- Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW
| | - Kathleen F Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW
- George Institute for Global Health, Sydney, ACT
| | - Sandra J Eades
- Sax Institute, Sydney, NSW
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC
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Weetra D, Glover K, Buckskin M, Kit JA, Leane C, Mitchell A, Stuart-Butler D, Turner M, Yelland J, Gartland D, Brown SJ. Stressful events, social health issues and psychological distress in Aboriginal women having a baby in South Australia: implications for antenatal care. BMC Pregnancy Childbirth 2016; 16:88. [PMID: 27118001 PMCID: PMC4845352 DOI: 10.1186/s12884-016-0867-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 04/08/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Around 6% of births in Australia are to Aboriginal and Torres Strait Islander families. Aboriginal and Torres Strait Islander women are 2-3 times more likely to experience adverse maternal and perinatal outcomes than non-Aboriginal women in Australia. METHODS Population-based study of mothers of Aboriginal babies born in South Australia, July 2011 to June 2013. Mothers completed a structured questionnaire at a mean of 7 months postpartum. The questionnaire included measures of stressful events and social health issues during pregnancy and maternal psychological distress assessed using the Kessler-5 scale. RESULTS Three hundred forty-four women took part in the study, with a mean age of 25 years (range 15-43). Over half (56.1%) experienced three or more social health issues during pregnancy; one in four (27%) experienced 5-12 issues. The six most commonly reported issues were: being upset by family arguments (55%), housing problems (43%), family member/friend passing away (41%), being scared by others people's behavior (31%), being pestered for money (31%) and having to leave home because of family arguments (27%). More than a third of women reporting three or more social health issues in pregnancy experienced high/very high postpartum psychological distress (35.6% versus 11.1% of women reporting no issues in pregnancy, Adjusted Odds Ratio = 5.4, 95% confidence interval 1.9-14.9). CONCLUSIONS The findings highlight unacceptably high rates of social health issues affecting Aboriginal women and families during pregnancy and high levels of associated postpartum psychological distress. In order to improve Aboriginal maternal and child health outcomes, there is an urgent need to combine high quality clinical care with a public health approach that gives priority to addressing modifiable social risk factors for poor health outcomes.
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Affiliation(s)
- Donna Weetra
- />Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, VIC 3052 Australia
| | - Karen Glover
- />South Australian Health and Medical Research Institute, North Terrace, Adelaide, 5000 Australia
| | - Mary Buckskin
- />Aboriginal Health Council of South Australia Inc, 220 Franklin Street, Adelaide, South Australia 5000 Australia
| | - Jackie Ah Kit
- />Women’s and Children’s Health Network, 295 South Terrace, Adelaide, South Australia 5000 Australia
| | - Cathy Leane
- />Women’s and Children’s Health Network, 295 South Terrace, Adelaide, South Australia 5000 Australia
| | - Amanda Mitchell
- />Aboriginal Health Council of South Australia Inc, 220 Franklin Street, Adelaide, South Australia 5000 Australia
| | - Deanna Stuart-Butler
- />Women’s and Children’s Health Network, 295 South Terrace, Adelaide, South Australia 5000 Australia
| | - May Turner
- />Council of Aboriginal Elders Inc, 50-60 Sussex St, North Adelaide, South Australia 5006 Australia
| | - Jane Yelland
- />Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, VIC 3052 Australia
- />General Practice and Primary Health Care Academic Centre, The University of Melbourne, Parkville, VIC 3052 Australia
| | - Deirdre Gartland
- />Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, VIC 3052 Australia
| | - Stephanie J Brown
- />Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, VIC 3052 Australia
- />South Australian Health and Medical Research Institute, North Terrace, Adelaide, 5000 Australia
- />School of Population and Global Health, General Practice and Primary Health Care Academic Centre, The University of Melbourne, Parkville, VIC 3052 Australia
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A cohort of Indigenous Australian women and their children through pregnancy and beyond: the Gomeroi gaaynggal study. J Dev Orig Health Dis 2016; 7:357-68. [PMID: 27080434 DOI: 10.1017/s204017441600009x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Indigenous Australians have high rates of chronic diseases, the causes of which are complex and include social and environmental determinants. Early experiences in utero may also predispose to later-life disease development. The Gomeroi gaaynggal study was established to explore intrauterine origins of renal disease, diabetes and growth in order to inform the development of health programmes for Indigenous Australian women and children. Pregnant women are recruited from antenatal clinics in Tamworth, Newcastle and Walgett, New South Wales, Australia, by Indigenous research assistants. Measures are collected at three time points in pregnancy and from women and their children at up to eight time points in the child's first 5 years. Measures of fetal renal development and function include ultrasound and biochemical biomarkers. Dietary intake, infant feeding and anthropometric measurements are collected. Standardized procedures and validated tools are used where available. Since 2010 the study has recruited over 230 women, and retained 66 postpartum. Recruitment is ongoing, and Gomeroi gaaynggal is currently the largest Indigenous pregnancy-through-early-childhood cohort internationally. Baseline median gestational age was 39.1 weeks (31.5-43.2, n=110), median birth weight was 3180 g (910-5430 g, n=110). Over one third (39.3%) of infants were admitted to special care or neonatal nursery. Nearly half of mothers (47.5%) reported tobacco smoking during pregnancy. Results of the study will contribute to knowledge about origins of chronic disease in Indigenous Australians and nutrition and growth of women and their offspring during pregnancy and postpartum. Study strengths include employment and capacity-building of Indigenous staff and the complementary ArtsHealth programme.
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Physical Functional Limitations among Aboriginal and Non-Aboriginal Older Adults: Associations with Socio-Demographic Factors and Health. PLoS One 2015; 10:e0139364. [PMID: 26422239 PMCID: PMC4589378 DOI: 10.1371/journal.pone.0139364] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 09/11/2015] [Indexed: 11/19/2022] Open
Abstract
Background Australian Aboriginal people are disproportionately affected by physical disability; the reasons for this are unclear. This study aimed to quantify associations between severe physical functional limitations and socio-demographic and health-related factors among older Aboriginal and non-Aboriginal adults. Methods Questionnaire data from 1,563 Aboriginal and 226,802 non-Aboriginal participants aged ≥45 years from the Sax Institute’s 45 and Up Study (New South Wales, Australia) were used to calculate age- and sex-adjusted prevalence ratios (aPRs) for severe limitation [MOS-PF score <60] according to socio-demographic and health-related factors. Results Overall, 26% (410/1563) of Aboriginal participants and 13% (29,569/226,802) of non-Aboriginal participants had severe limitations (aPR 2.8, 95%CI 2.5–3.0). In both Aboriginal and non-Aboriginal participants, severe limitation was significantly associated with: being ≥70 vs <70 years old (aPRs 1.8, 1.3–2.4 and 5.3, 5.0–5.5, within Aboriginal and non-Aboriginal participants, respectively), none vs tertiary educational qualifications (aPRs 2.4, 1.7–3.3 and 3.1, 3.0–3.2), lower vs higher income (aPRs 6.6, 4.2–10.5 and 5.5, 5.2–5.8), current vs never-smoking (aPRs 2.0, 1.6–2.5 and 2.2, 2.1–2.3), obese vs normal weight (aPRs 1.7, 1.3–2.2 and 2.7, 2.7–2.8) and sitting for ≥7 vs <7 hours/day (aPRs 1.6, 1.2–2.0 and 1.6, 1.6–1.7). Severe limitations increased with increasing ill-health, with aPRs rising to 5–6 for ≥5 versus no chronic conditions. It was significantly higher in those with few vs many social contacts (aPRs 1.7, 1.4–2.0 and 1.4, 1.4–1.4) and with very high vs low psychological distress (aPRs 4.4, 3.6–5.4 and 5.7, 5.5–5.9). Conclusions Although the prevalence of severe physical limitation among Aboriginal people in this study is around three-fold that of non-Aboriginal people, the factors related to it are similar, indicating that Aboriginal people have higher levels of risk factors for and consequences of severe limitations. Effective management of chronic disease and reducing the prevalence of obesity and smoking are important areas for attention.
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