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Understanding the Roles of Remoteness and Indigenous Status in Rural and Remote Road Trauma in North Queensland: Using a Mixed-Methods Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051467. [PMID: 32106471 PMCID: PMC7084541 DOI: 10.3390/ijerph17051467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 12/21/2022]
Abstract
Road trauma is a significant health problem in rural and remote regions of Australia, particularly for Indigenous communities. This study aims to identify and compare the circumstances leading to (proximal causation) and social determinants of (distal causation) crashes of Indigenous and non-Indigenous people in these regions and their relation to remoteness. This is a topic seriously under-researched in Australia. Modelled on an earlier study, 229 persons injured in crashes were recruited from local health facilities in rural and remote North Queensland and interviewed, mainly by telephone, according to a fixed protocol which included a detailed narrative of the circumstances of the crash. A qualitative analysis of these narratives identified several core themes, further explored statistically in this sample, supplemented by participants in the earlier study with compatible questionnaire data, designed to determine which factors were more closely associated with Indigenous status and which with remoteness. Indigenous participants were less often vehicle controllers, more likely to have recently been a drink driver or passenger thereof; to be unemployed, unlicensed, distracted or fatigued before the crash, alcohol dependent and have lower perceived social, but not personal, locus of control in a traffic crash than non-Indigenous persons. Differences between Indigenous and non-Indigenous participants are largely ascribable to hardship and transport disadvantage due to lack of access to licensing and associated limitations on employment opportunities. Based on these findings, a number of policy recommendations relating to educational, enforcement and engineering issues have been made.
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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: 4] [Impact Index Per Article: 0.8] [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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Cullen P, Hunter K, Clapham K, Senserrick T, Rogers K, Harrison JE, Ivers RQ. Road user behaviour, attitudes and crashes: a survey of Aboriginal and Torres Strait Islander people in Australia. Inj Prev 2019; 26:123-128. [PMID: 30837328 DOI: 10.1136/injuryprev-2018-043011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study aimed to describe road user behaviour, attitudes and crashes in Aboriginal and Torres Strait Islander people in four urban, regional and remote communities located in New South Wales (NSW) and South Australia (SA). METHODS Face-to-face surveys were administered to clients (n=625) in Aboriginal Community Controlled Health Services (ACCHS). All Aboriginal and Torres Strait Islander clients attending the ACCHS for any reason were approached to participate over a 2-week period. Surveys included questions on sociodemographic factors, crash involvement, road behaviours and road safety attitudes drawn from tools used in national surveys. RESULTS The participation rate was high (69%-75%). Seat belt wearing rates were very high, particularly in the front of a car, although rear seat belt wearing rates in SA (77%) were substantially lower than in NSW (93%). Among drivers, 11% reported always or mostly driving 10 km/hour over the speed limit, and this was higher among drivers in SA (13.4%). Drivers aged 55 years and over and/or women were more likely to report that they do not drink at any time or restricted what they drank when driving. These results enable comparison with the Community Attitude to Road Safety survey conducted Australia-wide in 2013. CONCLUSIONS This study confirms that Aboriginal and Torres Strait Islander people are inclined to report attitudes or road safety behaviours similar to the rest of the population; however, rear restraint use was lower and self-reported speeding was higher. These issues are likely attributable to transport options and geography in remote communities, which can contribute to overcrowding and unsafe driving practices.
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Affiliation(s)
- Patricia Cullen
- School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia.,The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
| | - Kate Hunter
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
| | - Kathleen Clapham
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, New South Wales, Australia
| | - Teresa Senserrick
- Centre for Accident Research and Road Safety-Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Transport and Road Safety Research, UNSW, Sydney, New South Wales, Australia
| | - Kris Rogers
- The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia.,Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - James E Harrison
- College of Medicine & Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Rebecca Q Ivers
- School of Public Health and Community Medicine, UNSW, Sydney, New South Wales, Australia .,The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia.,Southgate Institute, Flinders University, Adelaide, South Australia, Australia
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Senserrick T, Boufous S, Olivier J, Hatfield J. Associations between graduated driver licensing and road trauma reductions in a later licensing age jurisdiction: Queensland, Australia. PLoS One 2018; 13:e0204107. [PMID: 30252870 PMCID: PMC6155503 DOI: 10.1371/journal.pone.0204107] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 09/03/2018] [Indexed: 11/25/2022] Open
Abstract
The success of driver graduated licensing systems (GLS) is demonstrated primarily in jurisdictions that licence at young ages with requirements expiring at age 18. In Australia, GLS requirements typically apply for all applicants aged under 25. In 2007, the Queensland licensing system was strengthened, extending the learner and introducing a 100-hour supervised driving requirement, introducing restrictions on passenger carriage at night and high-powered vehicles for provisional drivers, and on phone use for all novice drivers (learner and provisional). The objective of the current research was to evaluate whether these changes were associated with reductions in crashes (all) and killed-and-serious-injury (KSI) crashes involving novice drivers, and respective casualties. Government licensing and police crash records were linked and interrupted time series analysis was used to examine potential shifts in crash trends by rates of licensed drivers per month. Substantial declines were found in novice driver crashes (13.1% per year; 95%CI -0.0130, -0.0096), crash casualties (13.9% per year; 95%CI -0.0137, -0.0101), KSI crashes (5.4% per year; 95%CI -0.0080, -0.0046) and associated casualties (5.2% per year; 95%CI -0.0075, -0.0039). Compared to the total licensed driver population, declines in crashes (3.0% per year; 95%CI -0.0027, -0.0007) and crash casualties (2.9% per year; 95%CI -0.0029, -0.0006) but not KSI outcomes were observed. More narrowly, declines were found for provisional-licensed driver crashes (9.3% per year; 95%CI -0.0096, -0.0063) and KSI crashes (3.6% per year; 95%CI -0.0004, -0.0128) that were approximately 2.6% and 1.2% greater than respective declines for 25-29-year-old open-licensed drivers. Substantial declines also were observed in novice driver single-vehicle, night, passenger and alcohol crashes. Overall, these results demonstrate that GLS can be effective in a later age licensing jurisdiction. However, KSI outcomes were limited. Modelling research is recommended on ways to further strengthen Queensland’s GLS to achieve greater trauma reductions.
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Affiliation(s)
- Teresa Senserrick
- Transport and Road Safety Research, School of Aviation, The University of New South Wales, Sydney, New South Wales, Australia
| | - Soufiane Boufous
- Transport and Road Safety Research, School of Aviation, The University of New South Wales, Sydney, New South Wales, Australia
| | - Jake Olivier
- Transport and Road Safety Research, School of Aviation, The University of New South Wales, Sydney, New South Wales, Australia.,School of Mathematics and Statistics, The University of New South Wales, Sydney, New South Wales, Australia
| | - Julie Hatfield
- Transport and Road Safety Research, School of Aviation, The University of New South Wales, Sydney, New South Wales, Australia
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