1
|
Opozda MJ, Bonson J, Vigona J, Aanundsen D, Paradisis C, Anderson P, Stahl G, Watkins DC, Black O, Brickley B, Canuto KJ, Drummond MJN, Miller KF, Oth G, Petersen J, Prehn J, Raciti MM, Robinson M, Rodrigues D, Stokes C, Canuto K, Smith JA. Navigating the cultural adaptation of a US-based online mental health and social support program for use with young Aboriginal and Torres Strait Islander males in the Northern Territory, Australia: Processes, outcomes, and lessons. Int J Equity Health 2024; 23:165. [PMID: 39169369 PMCID: PMC11337567 DOI: 10.1186/s12939-024-02253-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 08/13/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Despite disproportionate rates of mental ill-health compared with non-Indigenous populations, few programs have been tailored to the unique health, social, and cultural needs and preferences of young Aboriginal and Torres Strait Islander males. This paper describes the process of culturally adapting the US-based Young Black Men, Masculinities, and Mental Health (YBMen) Project to suit the needs, preferences, culture, and circumstances of Aboriginal and Torres Strait Islander males aged 16-25 years in the Northern Territory, Australia. YBMen is an evidence-based social media-based education and support program designed to promote mental health, expand understandings of gender and cultural identities, and enhance social support in college-aged Black men. METHODS Our adaptation followed an Extended Stages of Cultural Adaptation model. First, we established a rationale for adaptation that included assessing the appropriateness of YBMen's core components for the target population. We then investigated important and appropriate models to underpin the adapted program and conducted a non-linear, iterative process of gathering information from key sources, including young Aboriginal and Torres Strait Islander males, to inform program curriculum and delivery. RESULTS To maintain program fidelity, we retained the core curriculum components of mental health, healthy masculinities, and social connection and kept the small cohort, private social media group delivery but developed two models: 'online only' (the original online delivery format) and 'hybrid in-person/online' (combining online delivery with weekly in-person group sessions). Adaptations made included using an overarching Aboriginal and Torres Strait Islander social and emotional wellbeing framework and socio-cultural strengths-based approach; inclusion of modules on health and wellbeing, positive Indigenous masculinities, and respectful relationships; use of Indigenous designs and colours; and prominent placement of images of Aboriginal and Torres Strait Islander male sportspeople, musicians, activists, and local role models. CONCLUSIONS This process resulted in a culturally responsive mental health, masculinities, and social support health promotion program for young Aboriginal and Torres Strait Islander males. Next steps will involve pilot testing to investigate the adapted program's acceptability and feasibility and inform further refinement.
Collapse
Affiliation(s)
- Melissa J Opozda
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Casuarina, NT, Australia
| | - Jason Bonson
- Rural and Remote Health NT, College of Medicine and Public Health, Flinders University, Casuarina, NT, Australia
- Healthy Male, Melbourne, VIC, Australia
| | - Jahdai Vigona
- Rural and Remote Health NT, College of Medicine and Public Health, Flinders University, Casuarina, NT, Australia
- One Percent Program, Karama, NT, Australia
| | - David Aanundsen
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Casuarina, NT, Australia
| | - Chris Paradisis
- Rural and Remote Health NT, College of Medicine and Public Health, Flinders University, Casuarina, NT, Australia
| | - Peter Anderson
- Indigenous Research Unit, Griffith University, Nathan, QLD, Australia
| | - Garth Stahl
- School of Education, University of Queensland, St. Lucia, QLD, Australia
| | - Daphne C Watkins
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Oliver Black
- The National Centre for Aboriginaland, National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Acton, ACT, Australia
| | - Bryce Brickley
- Rural and Remote Health NT, College of Medicine and Public Health, Flinders University, Casuarina, NT, Australia
| | - Karla J Canuto
- Rural and Remote Health NT, College of Medicine and Public Health, Flinders University, Casuarina, NT, Australia
| | - Murray J N Drummond
- College of Education, Psychology, and Social Work, Flinders University, Bedford Park, SA, Australia
| | - Keith F Miller
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Gabriel Oth
- Indigenous Allied Health Australia, Brinkin, NT, Australia
| | - Jasmine Petersen
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
| | - Jacob Prehn
- School of Social Sciences, University of Tasmania, Hobart, TAS, Australia
| | - Maria M Raciti
- Indigenous and Transcultural Research Centre, School of Business and Creative Industries, University of the Sunshine Coast, Sippy Downs, Indooroopilly, QLD, Australia
| | - Mark Robinson
- Institute for Social Science Research, University of Queensland, Indooroopilly, QLD, Australia
- School of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | | | - Cameron Stokes
- Rural and Remote Health NT, College of Medicine and Public Health, Flinders University, Casuarina, NT, Australia
| | - Kootsy Canuto
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Casuarina, NT, Australia.
| | - James A Smith
- Rural and Remote Health NT, College of Medicine and Public Health, Flinders University, Casuarina, NT, Australia.
| |
Collapse
|
2
|
Ghamrawi W, Benson J, Kennedy E. Communicating medical information with Aboriginal patients: lessons learned from GPs and GP registrars in Aboriginal primary health care. Aust J Prim Health 2024; 30:NULL. [PMID: 37710389 DOI: 10.1071/py23128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 08/21/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Aboriginal culture stands as the oldest continuous culture in the world. It gives paramount importance to a harmonious balance between personal connections to the body, spirit, and mind, as well as collective relationships with family, land, and community, integral to the wellbeing of Aboriginal people. However, obstacles can emerge for patients due to language barriers, cultural differences, or a historical lack of trust in the healthcare system. The establishment of Aboriginal Community Controlled Health Organisations (ACCHOs) has undoubtedly improved the healthcare experience for Aboriginal patients, yet there is limited research on the specific approaches utilised by general practitioners (GPs) working in these clinics. METHODS Twelve semi-structured interviews were conducted with two groups of GPs working in Aboriginal health. Each GP was presented with three scenarios and asked questions related to each scenario. Braun and Clarke's method of thematic analysis was applied to transcribed interviews. RESULTS Patient-doctor relationship, health literacy, and engagement with the health system emerged as key factors influencing communication with Aboriginal patients. Experienced GPs, despite differing clinical backgrounds, shared concise yet similar ideas to their less experienced counterparts. Notably, experienced GPs prioritised non-medical conversations and mindful body language, emphasising the importance of building strong patient relationships over other consultation aspects. CONCLUSIONS This research provides initial insights for GPs in Aboriginal health, comparing experienced GPs with more than 10years experience to novices. However, further research involving Aboriginal patients is needed to validate GP strategies and understand their significance from the patients' perspective.
Collapse
Affiliation(s)
- Wissam Ghamrawi
- Flinders University, College of Medicine and Public Health, Bedford Park, NT 41326, Australia; and GPEx, Research Department, Unley, SA 5061, Australia
| | - Jill Benson
- Flinders University, College of Medicine and Public Health, Bedford Park, NT 41326, Australia; and GPEx, Research Department, Unley, SA 5061, Australia
| | - Emma Kennedy
- Flinders University, College of Medicine and Public Health, Bedford Park, NT 41326, Australia
| |
Collapse
|
5
|
Sherriff S, Kalucy D, Tong A, Naqvi N, Nixon J, Eades S, Ingram T, Slater K, Dickson M, Lee A, Muthayya S. Murradambirra Dhangaang (make food secure): Aboriginal community and stakeholder perspectives on food insecurity in urban and regional Australia. BMC Public Health 2022; 22:1066. [PMID: 35643511 PMCID: PMC9146813 DOI: 10.1186/s12889-022-13202-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background It is widely acknowledged that the invasion by colonial powers of the Australian continent had profound and detrimental impacts on Aboriginal Communities, including food security. Policies of successive governments since European arrival have since further exacerbated the situation, with food insecurity now affecting 20–25% of Aboriginal and Torres Strait Islander people. Food insecurity contributes to long-term impacts on health, in particular diet-sensitive chronic diseases. This study aimed to describe Aboriginal community and stakeholder perspectives on food insecurity to get a better understanding of the key contributing factors and recommendations for potential strategies to address this issue in Aboriginal communities in urban and regional Australia. Methods Semi-structured interviews were conducted with 44 participants who were purposively selected. This included Aboriginal people in two communities and both Aboriginal and non-Aboriginal stakeholders from local food relief agencies, food suppliers, schools, and government in an urban and regional location in NSW. A conceptual framework was developed from literature on food security, and sensitizing concepts of availability, affordability, accessibility and acceptability or the lack thereof of healthy food were used to elicit responses from the participants. Interview transcripts were analysed thematically. Results All participants felt strongly that food insecurity was a major problem experienced in their local Aboriginal communities. Five core areas impacting on food security were identified: trapped in financial disadvantage; gaps in the local food system; limitations of non-Aboriginal food relief services; on-going impacts of colonization; and maintaining family, cultural and community commitments and responsibilities. Participants suggested a number of actions that could help ease food insecurity and emphasized that Aboriginal values and culture must be strongly embedded in potential programs. Conclusions This study found Aboriginal families in urban and regional Australia are experiencing food insecurity on a regular basis, which is impacted by a range of socio-economic, environmental, systemic and cultural factors, as reported by the participants. Study findings highlight the need to address system level changes in the food environment and acknowledge Aboriginal history, culture and food preferences when considering the development of programs to alleviate food insecurity among Aboriginal people. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13202-z.
Collapse
|