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Healey Akearok GK, Chaliak AJ, Cueva K, Cook D, Larsen CVL, Jóhannsdóttir L, Nilsson LM, San Sebastián M, Peterson M, Timlin U, Broderstadt AR, Dagsvold I, Siri S, Olesen I, Stoor JPA, Rautio A, Rink E, Lavoie JG. Diverse methodological approaches to a Circumpolar multi-site case study which upholds and responds to local and Indigenous community research processes in the Arctic. Int J Circumpolar Health 2024; 83:2336284. [PMID: 38573784 PMCID: PMC10997363 DOI: 10.1080/22423982.2024.2336284] [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: 10/12/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024] Open
Abstract
This paper outlines the methodological approaches to a multi-site Circumpolar case study exploring the impacts of COVID-19 on Indigenous and remote communities in 7 of 8 Arctic countries. Researchers involved with the project implemented a three-phase multi-site case study to assess the positive and negative societal outcomes associated with the COVID-19 pandemic in Arctic communities from 2020 to 2023. The goal of the multi-site case study was to identify community-driven models and evidence-based promising practices and recommendations that can help inform cohesive and coordinated public health responses and protocols related to future public health emergencies in the Arctic. Research sites included a minimum of 1 one community each from Canada (Nunavut,) United States of America (Alaska), Greenland, Iceland, Norway, Sweden, Finland. The approaches used for our multi-site case study provide a comprehensive, evidence-based account of the complex health challenges facing Arctic communities, offering insights into the effectiveness of interventions, while also privileging Indigenous local knowledge and voices. The mixed method multi-site case study approach enriched the understanding of unique regional health disparities and strengths during the pandemic. These methodological approaches serve as a valuable resource for policymakers, researchers, and healthcare professionals, informing future strategies and interventions.
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Affiliation(s)
| | | | - Katie Cueva
- Department of Psychology, University of Alaska, Anchorage, AK, USA
| | - David Cook
- Environment and Natural Resources Programme, University of Iceland, Reykjavík, Iceland
| | - Christina VL Larsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Institute of Health and Nature, University of Greenland, Nuuk, Greenland
| | - Lára Jóhannsdóttir
- Environment and Natural Resources Programme, University of Iceland, Reykjavík, Iceland
| | - Lena Maria Nilsson
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
| | - Miguel San Sebastián
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
| | - Malory Peterson
- Department of Human Development and Community Health, Montana State University, Bozeman, MT, USA
| | - Ulla Timlin
- Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Ann Ragnhild Broderstadt
- Centre for Sámi Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Inger Dagsvold
- Centre for Sámi Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Susanna Siri
- Centre for Sámi Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Ingelise Olesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Institute of Health and Nature, University of Greenland, Nuuk, Greenland
| | - Jon Petter A. Stoor
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
- Centre for Sámi Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Arja Rautio
- Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Elizabeth Rink
- Department of Human Development and Community Health, Montana State University, Bozeman, MT, USA
| | - Josée G. Lavoie
- Ongomiizwin Research, University of Manitoba, Winnipeg, MB, Canada
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Erb T, Stelkia K. Best Practices to Support the Self-Determination of Indigenous Communities, Collectives, and Organizations in Health Research through a Provincial Health Research Network Environment in British Columbia, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6523. [PMID: 37569063 PMCID: PMC10418653 DOI: 10.3390/ijerph20156523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023]
Abstract
In Canada, the health research funding landscape limits the self-determination of Indigenous peoples in multiple ways, including institutional eligibility, priority setting, and institutional structures that deprioritize Indigenous knowledges. However, Indigenous-led research networks represent a promising approach to transforming the funding landscape to better support the self-determination of Indigenous peoples in health research. The British Columbia Network Environment for Indigenous Health Research (BC NEIHR) is one of nine Indigenous-led networks across Canada that supports research leadership among Indigenous (First Nations, Métis, and Inuit) communities, collectives, and organizations (ICCOs). In this paper, we share three best practices to support the self-determination of ICCOs in health research based on three years of operating the BC NEIHR: (1) creating capacity-bridging initiatives to overcome funding barriers; (2) building relational research relationships with ICCOs ("people on the ground"); and (3) establishing a network of partnerships and collaborations to support ICCO self-determination. Supporting the self-determination of ICCOs and enabling them to lead their own health research is a critical pathway toward transforming the way Indigenous health research is funded and conducted in Canada.
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Affiliation(s)
- Tara Erb
- School of Public Health and Social Policy, University of Victoria, Victoria, BC V8P 5C2, Canada
| | - Krista Stelkia
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada;
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Yarning about Diet: The Applicability of Dietary Assessment Methods in Aboriginal and Torres Strait Islander Australians-A Scoping Review. Nutrients 2023; 15:nu15030787. [PMID: 36771491 PMCID: PMC9919225 DOI: 10.3390/nu15030787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
Conventional dietary assessment methods are based predominately on Western models which lack Aboriginal and Torres Strait Islander knowledges, methodologies, and social and cultural contextualisation. This review considered dietary assessment methods used with Aboriginal and Torres Strait Islander populations and assessed their applicability. Four electronic databases and grey literature were searched with no time limit applied to the results. Screening, data extraction and quality appraisal were undertaken independently by two reviewers. Out of 22 studies, 20 were conducted in rural/remote settings, one in an urban setting, and one at the national population level. The most frequently used and applicable dietary assessment method involved store data. Weighed food records and food frequency questionnaires had low applicability. Modifications of conventional methods were commonly used to adapt to Indigenous practices, but few studies incorporated Indigenous research methodologies such as yarning. This highlights an opportunity for further investigation to validate the accuracy of methods that incorporate qualitative yarning-based approaches, or other Indigenous research methodologies, into quantitative data collection. The importance of developing validated dietary assessment methods that are appropriate for this population cannot be understated considering the high susceptibility to nutrition-related health conditions such as malnutrition, overweight or obesity, diabetes, and cardiovascular disease.
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Saunders P, Doyle AK. Cultural Proficiency in First Nations Health Research: A Mixed-Methods, Cross-Cultural Evaluation of a Novel Resource. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:39. [PMID: 36612362 PMCID: PMC9819740 DOI: 10.3390/ijerph20010039] [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: 11/04/2022] [Revised: 12/14/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
Recent efforts have illustrated the efficacy of culturally proficient approaches to research, underpinned by robust partnerships between researchers and First Nations peoples and communities. This article seeks to determine differences in approaches to First Nations research engagement perceptions between First Nations and non-First Nations researchers, as well as whether participation in a cultural proficiency workshop improved the perceived cultural proficiency of non-First Nations health researchers. Also, whether a set of novel cultural proficiency resources, designed in the Sydney region could be applied broadly across First Nations contexts within Australia. The evaluation adopted a mixed-methods, cross-cultural (First Nations and non-First Nations) design to appraise the novel cultural proficiency resources, identifying participant perceptions to First Nations research engagement, as well as views regarding the feasibility of universal application of the resources. A quantitative pre- and post-workshop evaluation was also undertaken to measure differences in self-reported cultural proficiency. Qualitative data underwent thematic analysis and quantitative data were analysed applying t-tests. Both qualitative and quantitative evaluation showed minimal variation between the cultural groups regarding research engagement perceptions, based on viewing of the online resources. A statistically significant increase in self-reported cultural proficiency was found in non-First Nations workshop participants. Cultural proficiency education and training programs that promote an immersive, interactive, and ongoing framework can build the perceived cultural proficiency of non-First Nations health researchers, however First Nations expertise must validate this perceived cultural proficiency to be beneficial in practice. Based on the research findings, applying the underlying ethical principles of First Nations research with a local, context-centred approach allows for the broad application of cultural proficiency research education and training programs within Australia.
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Affiliation(s)
- Paul Saunders
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
| | - Aunty Kerrie Doyle
- School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW 2560, Australia
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Butler T, Gall A, Garvey G, Ngampromwongse K, Hector D, Turnbull S, Lucas K, Nehill C, Boltong A, Keefe D, Anderson K. A Comprehensive Review of Optimal Approaches to Co-Design in Health with First Nations Australians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192316166. [PMID: 36498237 PMCID: PMC9735487 DOI: 10.3390/ijerph192316166] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND Australia's social, structural, and political context, together with the continuing impact of colonisation, perpetuates health care and outcome disparities for First Nations Australians. A new approach led by First Nations Australians is required to address these disparities. Co-design is emerging as a valued method for First Nations Australian communities to drive change in health policy and practice to better meet their needs and priorities. However, it is critical that co-design processes and outcomes are culturally safe and effective. Aims: This project aimed to identify the current evidence around optimal approaches to co-design in health with First Nations Australians. METHODS First Nations Australian co-led team conducted a comprehensive review to identify peer-reviewed and grey literature reporting the application of co-design in health-related areas by and with First Nations Australians. A First Nations Co-Design Working Group (FNCDWG) was established to guide this work and team.A Collaborative Yarning Methodology (CYM) was used to conduct a thematic analysis of the included literature. RESULTS After full-text screening, 99 studies were included. Thematic analysis elicited the following six key themes, which included 28 practical sub-themes, relevant to co-design in health with First Nations Australians: First Nations Australians leadership; Culturally grounded approach; Respect; Benefit to First Nations communities; Inclusive partnerships; and Evidence-based decision making. CONCLUSION The findings of this review provide a valuable snapshot of the existing evidence to be used as a starting point to guide appropriate and effective applications of co-design in health with First Nations Australians.
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Affiliation(s)
- Tamara Butler
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | - Alana Gall
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore 2480, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | | | | | | | | | | | - Anna Boltong
- Cancer Australia, Sydney 2010, Australia
- Kirby Institute, UNSW Medicine, The University of New South Wales, Kensington 2052, Australia
| | | | - Kate Anderson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
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Black O, Wright CJC, Clifford S, Erwin M, Canuto K, Wakerman J, Rossingh B, Morgan J, Smith J. YArnhem: Co-designing a model of social and emotional wellbeing stepped care for young people of the north east Arnhem region: A development study protocol. Aust J Rural Health 2022; 30:730-737. [PMID: 36226980 DOI: 10.1111/ajr.12926] [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: 02/20/2022] [Revised: 08/25/2022] [Accepted: 09/11/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION More Aboriginal and Torres Strait Islander young people experience high or very high levels of psychological distress compared to their non-Indigenous counterparts. This may be partly attributed to systemic barriers resulting in lower rates of help-seeking, sub-optimal identification of psychological challenges, and undertreatment. Reducing these barriers within health systems is an important factor in reducing the Social and Emotional Wellbeing (SEWB) health burden on young Aboriginal and Torres Strait Islander people. OBJECTIVES In partnership with Miwatj Health Aboriginal Corporation (Miwatj), this project will co-design an integrated youth Social and Emotional Wellbeing (SEWB) and mental health stepped care model for remote Aboriginal communities in the north east Arnhem region of the Northern Territory. DESIGN A collaborative research approach using co-design methods will underpin a community-centric stepped care allocation method, to which culturally appropriate SEWB and mental health interventions and treatments are assigned. These components of the project will inform a digital platform which will facilitate access to SEWB care for young people in north east Arnhem land. This concept was co-developed in a partnership between researchers and Miwatj and builds on Miwatj's previous work to map the stepped needs of young people. The co-design of the content and features of these outputs will be facilitated through community participation and overseen by community, health, and cultural governance structures. This will ensure the solutions developed by the project are culturally responsive, fit for purpose, and will enhance self-determination while reducing systemic barriers to care.
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Affiliation(s)
- Oliver Black
- Flinders University, Darwin, Northern Territory, Australia
| | - Cassandra J C Wright
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
- Burnet Institute, Melbourne, Victoria, Australia
- Centre for Alcohol Policy Research, Melbourne, Victoria, Australia
| | - Sarah Clifford
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Michelle Erwin
- Miwatj Health Aboriginal Organisation, Darwin, Northern Territory, Australia
| | - Kootsy Canuto
- Flinders University, Darwin, Northern Territory, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - John Wakerman
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Bronwyn Rossingh
- Miwatj Health Aboriginal Organisation, Darwin, Northern Territory, Australia
| | - John Morgan
- Miwatj Health Aboriginal Organisation, Darwin, Northern Territory, Australia
| | - James Smith
- Flinders University, Darwin, Northern Territory, Australia
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Harper A, Pratt B. Combatting neo-Colonialism in Health Research: What can Aboriginal Health Research Ethics and Global Health Research Ethics Teach Each Other? J Empir Res Hum Res Ethics 2022; 17:431-454. [PMID: 34931853 DOI: 10.1177/15562646211058253] [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] [Indexed: 11/16/2022]
Abstract
The ethics of research involving Aboriginal populations and low and middle-income country populations each developed out of a long history of exploitative research projects and partnerships. Commonalities and differences between the two fields have not yet been examined. This study undertook two independent literature searches for Aboriginal health research ethics and global health research ethics. Content analysis identified shared and differently emphasised ethical principles and concepts between the two fields. Shared ethical concepts like "benefit" and "capacity development" have been developed to guide collaborations in both Aboriginal health research and global health research. However, Aboriginal health research ethics gives much greater prominence to ethical principles that assist in decolonising research practice such as "self-determination", "community-control", and "community ownership". The paper argues that global health research ethics would benefit from giving greater emphasis to these principles to guide research practice, while justice as approached in global health research ethics may inform Aboriginal health research practice. With increasing attention being drawn to the need to decolonise global health research, the lessons Aboriginal health research ethics can offer may be especially timely.
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Affiliation(s)
- Adrian Harper
- School of Population and Global Health, University of Melbourne, Australia
| | - Bridget Pratt
- School of Population and Global Health, University of Melbourne, Australia
- Queensland Bioethics Centre, 1513Australian Catholic University, Australia
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Patel J, Durey A, Naoum S, Kruger E, Slack-Smith L. A scoping review to inform the use of continuous quality improvement in Australian Aboriginal oral health care. AUST HEALTH REV 2022; 46:478-484. [PMID: 35831033 DOI: 10.1071/ah21394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 06/17/2022] [Indexed: 11/23/2022]
Abstract
ObjectiveThe need to improve existing services to Aboriginal communities is prioritised by Australia's National Oral Health Plan. Although only an emerging area in dentistry, continuous quality improvement (CQI) approaches have positively impacted the delivery of primary health services to Aboriginal communities. This scoping review maps the applicability of CQI strategies to Aboriginal Australian oral healthcare services.MethodsA scoping review was conducted and studies that reported using CQI approaches to improve existing oral health services or quality of care deemed relevant to Aboriginal Australian communities were included.ResultsA total of 73 articles were retrieved and eight articles were included in the final synthesis. Several CQI tools were identified, including: plan-do-study-act cycles, dental quality alliance measures, prioritisation matrices, causal mapping and the use of collective impact methodology.ConclusionData exploring CQI in the context of Aboriginal oral health is scarce. The plan-do-study-act cycle and its variations show potential applicability to Aboriginal oral health care. However, for CQI approaches to be adequately implemented, the prevailing model of dental care requires a paradigm shift from quality assurance to quality improvement, acknowledging the impact of structural and process elements on care.
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Affiliation(s)
- Jilen Patel
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia; and Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Angela Durey
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
| | - Steven Naoum
- Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Estie Kruger
- School of Human Sciences, The University of Western Australia, WA, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Nedlands, WA, Australia
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O’Brien P, Conley B, Bunzli S, Bullen J, Coffin J, Persaud J, Gunatillake T, Dowsey MM, Choong PF, Lin I. Staying moving, staying strong: Protocol for developing culturally appropriate information for Aboriginal people with osteoarthritis, rheumatoid arthritis, lupus and gout. PLoS One 2021; 16:e0261670. [PMID: 34941954 PMCID: PMC8699613 DOI: 10.1371/journal.pone.0261670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Addressing disparities in arthritis care is an important yet unmet health need for Aboriginal and Torres Strait Islander people in Australia (respectfully Aboriginal people herewith). Despite the significant prevalence and burden of arthritis within Aboriginal communities, access to care for arthritis is low. One means to reduce existing disparities in health care is to address current challenges relating to the appropriateness and acceptability of health care information resources for Aboriginal people. Health information sources can help to empower patients and their families to have greater involvement in their care and to engage in self-management of their condition. Despite an extensive range of arthritis information resources being available, currently no resources have been culturally adapted and developed in collaboration with Aboriginal consumers with arthritis. This paper outlines the processes that will be undertaken within the Staying Moving, Staying Strong project. This project aims to develop culturally secure arthritis information for Aboriginal people with osteoarthritis, rheumatoid arthritis, lupus and gout. Methods and analysis The overarching principle guiding this project is cultural security, referring to the incorporation of processes such that the research will not compromise the cultural rights, values and expectations of Aboriginal people. This project will prioritise partnerships, community engagement, community benefit, sustainability, transferability, and capacity building and therefore uphold the cultural rights and values of Aboriginal people. In this six-phase project we will; 1) Establish a community reference group and advisory committee; 2) Explore the health information needs and preferences of Aboriginal people with arthritis; 3) Synthesise the existing key recommendations in high quality clinical practice guidelines on arthritis care; 4) Culturally adapt key clinical recommendations; 5) Develop culturally appropriate arthritis resources and; 6) Qualitatively evaluate the developed resources.
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Affiliation(s)
- Penny O’Brien
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Brooke Conley
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
- * E-mail:
| | - Samantha Bunzli
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Jonathan Bullen
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Juli Coffin
- Telethon Kids Institute, Broome, WA, Australia
| | - Jennifer Persaud
- Arthritis and Osteoporosis Western Australia, Perth, WA, Australia
- Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tilini Gunatillake
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Michelle M. Dowsey
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter F. Choong
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA, Australia
- Geraldton Regional Aboriginal Medical Service, Geraldton, WA, Australia
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10
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Working for the Welfare: Support and Supervision Needs of Indigenous Australian Child Protection Practitioners. SOCIAL SCIENCES 2021. [DOI: 10.3390/socsci10080277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Aboriginal and Torres Strait Islander children are disproportionately represented in all parts of the child protection system in Australia. The recruitment of Aboriginal and Torres Strait Islander practitioners into child protection systems to work with Indigenous families at risk underpins the government strategy to reduce this over-representation. However, little is known about the experiences of Indigenous people who undertake child protection work or what their support and supervision needs may be. This research is centered on Indigenous Australian child protection practitioners as experts in their own experiences and as such includes large excerpts of their own narratives throughout. Practitioner narratives were collected via qualitative semi-structured in-depth interviews. Critical theory and decolonising frameworks underpinned the research design. The study found that Indigenous child protection practitioners have a unique place in the families, communities and profession. Many viewed their work in the child protection field as an extension of their Indigeneity. This coupled with the historical experience of state-sanctioned removal of Indigenous children during colonisation and contemporarily, informs the need for child protection workplaces to re-think the support and supervision afforded to Indigenous practitioners.
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Chandanabhumma PP, Narasimhan S. Towards health equity and social justice: an applied framework of decolonization in health promotion. Health Promot Int 2021; 35:831-840. [PMID: 31236575 DOI: 10.1093/heapro/daz053] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The pursuit of health equity and social justice lie at the heart of community-empowered health promotion practice. However, there is a need to address the colonial legacy and its contributions to health inequities. The process of decolonization is essential to eliminating the mechanisms that contributed to such inequities. To this end, we propose an Applied Decolonial Framework for Health Promotion that integrates decolonial processes into health promotion practice. We present characteristics of the framework, its values for health promotion transformations and considerations for using the framework in health promotion practice. The framework will help health promotion stakeholders attend to colonizing structures within the field and engage with communities to achieve social justice and health equity.
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Affiliation(s)
| | - Subasri Narasimhan
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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12
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O'Brien P, Bunzli S, Lin I, Bessarab D, Coffin J, Dowsey MM, Choong PFM. Addressing surgical inequity for Aboriginal and Torres Strait Islander people in Australia's universal health care system: a call to action. ANZ J Surg 2021; 91:238-244. [PMID: 33506978 DOI: 10.1111/ans.16557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 11/29/2022]
Abstract
Aboriginal and Torres Strait Islander people continue to experience health inequity within the Australian health care system. Little research has examined how disparities in surgical care access and outcomes contribute to Aboriginal health. In this narrative review and call to action, we discuss five care points along the journey to high-quality surgical care: health care seeking, primary health care services, specialist services, surgery and surgical outcomes. We highlight barriers and disparities that exist along this journey, drawing examples from the field of joint replacement surgery. Finally, we present opportunities for change at the health system, health service and clinician level, calling upon researchers, clinicians and policy makers to confront the surgical disparities experienced by Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Penny O'Brien
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Samantha Bunzli
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Juli Coffin
- Social and Emotional Wellbeing of Aboriginal Young People, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Michelle M Dowsey
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter F M Choong
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
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13
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Bell S, Aggleton P, Lockyer A, Ferguson T, Murray W, Silver B, Kaldor J, Maher L, Ward J. Working with Aboriginal young people in sexual health research: a peer research methodology in remote Australia. QUALITATIVE HEALTH RESEARCH 2021; 31:16-28. [PMID: 33012220 PMCID: PMC7750674 DOI: 10.1177/1049732320961348] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In a context of ongoing colonization and dispossession in Australia, many Aboriginal people live with experiences of health research that is done "on" rather than "with" or "by" them. Recognizing the agency of young people and contributing to Aboriginal self-determination and community control of research, we used a peer research methodology involving Aboriginal young people as researchers, advisors, and participants in a qualitative sexual health study in one remote setting in the Northern Territory, Australia. We document the methodology, while critically reflecting on its benefits and limitations as a decolonizing method. Findings confirm the importance of enabling Aboriginal young people to play a central role in research with other young people about their own sexual health. Future priorities include developing more enduring forms of coinvestigation with Aboriginal young people beyond data collection during single studies, and support for young researchers to gain formal qualifications to enhance future employability.
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Affiliation(s)
| | - Peter Aggleton
- UNSW Sydney, Sydney, New South
Wales, Australia
- The Australian National
University, Canberra, Australia
- University College London, London,
United Kingdom
| | - Andrew Lockyer
- Central Australian Aboriginal
Congress Aboriginal Corporation, Alice Springs, Australia
| | - Tellisa Ferguson
- Central Australian Aboriginal
Congress Aboriginal Corporation, Alice Springs, Australia
| | - Walbira Murray
- Central Australian Aboriginal
Congress Aboriginal Corporation, Alice Springs, Australia
| | - Bronwyn Silver
- Central Australian Aboriginal
Congress Aboriginal Corporation, Alice Springs, Australia
| | - John Kaldor
- UNSW Sydney, Sydney, New South
Wales, Australia
| | - Lisa Maher
- UNSW Sydney, Sydney, New South
Wales, Australia
- Burnet Institute, Melbourne,
Australia
| | - James Ward
- University of Queensland,
Brisbane, Queensland, Australia
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14
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Oates F. Racism as trauma: Experiences of Aboriginal and Torres Strait Islander Australian child protection practitioners. CHILD ABUSE & NEGLECT 2020; 110:104262. [PMID: 31733938 DOI: 10.1016/j.chiabu.2019.104262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 10/12/2019] [Accepted: 11/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Aboriginal and Torres Strait Islander children are disproportionately represented in the statutory child protection system across Australia. A strategy gaining traction to address this disproportionate representation is to recruit more Indigenous practitioners into statutory child protection work. However, the experiences of Indigenous people who undertake child protection work have not been explored thoroughly, particularly in an Australian research context. OBJECTIVE While it has been established in contemporary literature that exposure to trauma is an expected occupational hazard of undertaking statutory child protection work, the experience of racism as a potential source of traumatic stress for practitioners has not been explicitly explored. PARTICIPANTS AND SETTING This paper reports on results from a recent doctoral study which explored the experiences of Indigenous child protection practitioners based in Queensland, Australia. METHOD This research relied on the stories of participants, shared through qualitative in-depth semi-structured interviews, to answer the primary research question: what are the experiences of Indigenous child protection workers? The findings emerged from a research design that was underpinned by critical theory and decolonisation frameworks, which placed the participants as experts of their own experiences. RESULTS The experiences of the research participants tell the story of a deficiency within the statutory child protection system to meet the wellbeing needs of Indigenous workers and provide a workplace environment that is culturally safe. Participants described recurrent experiences of racist behaviour displayed by non-Indigenous colleagues and a lack of support that acknowledges the distinctive experience of Indigenous people who undertake child protection work.
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Affiliation(s)
- Fiona Oates
- James Cook University, Cairns, Queensland, Australia.
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15
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Dawes G, Davidson A, Walden E, Isaacs S. Keeping on Country: Understanding and Responding to Crime and Recidivism in Remote Indigenous Communities. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12296] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Glenn Dawes
- College of Arts Social Sciences and Education, James Cook University,
| | | | - Edward Walden
- Woolbubinya Doomadgee Wellbeing Centre, North and West Remote Health,
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16
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Rieger KL, Gazan S, Bennett M, Buss M, Chudyk AM, Cook L, Copenace S, Garson C, Hack TF, Hornan B, Horrill T, Horton M, Howard S, Linton J, Martin D, McPherson K, Rattray JM, Phillips-Beck W, Sinclair R, Schultz ASH. Elevating the uses of storytelling approaches within Indigenous health research: a critical and participatory scoping review protocol involving Indigenous people and settlers. Syst Rev 2020; 9:257. [PMID: 33148328 PMCID: PMC7640994 DOI: 10.1186/s13643-020-01503-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is a complicated and exploitative history of research with Indigenous peoples and accompanying calls to meaningfully and respectfully include Indigenous knowledge in healthcare. Storytelling approaches that privilege Indigenous voices can be a useful tool to break the hold that Western worldviews have within the research. Our collaborative team of Indigenous and non-Indigenous researchers, and Indigenous patients, Elders, healthcare providers, and administrators, will conduct a critical participatory, scoping review to identify and examine how storytelling has been used as a method in Indigenous health research. METHODS Guided by two-eyed seeing, we will use Bassett and McGibbon's adaption of Arksey and O'Malley's scoping review methodology. Relevant articles will be identified through a systematic search of the gray literature, core Indigenous health journals, and online databases including Scopus, MEDLINE, Embase, CINAHL, AgeLine, Academic Search Complete, Bibliography of Native North Americans, Canadian Reference Centre, and PsycINFO. Qualitative and mixed-methods research articles will be included if the researchers involved Indigenous participants or their healthcare professionals living in Turtle Island (i.e., Canada and the USA), Australia, or Aotearoa (New Zealand); use storytelling as a research method; focus on healthcare phenomena; and are written in English. Two reviewers will independently screen titles/abstracts and full-text articles. We will extract data, identify the array of storytelling approaches, and critically examine how storytelling was valued and used. An intensive collaboration will be woven throughout all review stages as academic researchers co-create this work with Indigenous patients, Elders, healthcare professionals, and administrators. Participatory strategies will include four relational gatherings throughout the project. Based on our findings, we will co-create a framework to guide the respectful use of storytelling as a method in Indigenous health research involving Indigenous and non-Indigenous peoples. DISCUSSION This work will enable us to elucidate the extent, range, and nature of storytelling within Indigenous health research, to critically reflect on how it has been and could be used, and to develop guidance for the respectful use of this method within research that involves Indigenous peoples and settlers. Our findings will enable the advancement of storytelling methods which meaningfully include Indigenous perspectives, practices, and priorities to benefit the health and wellbeing of Indigenous communities. SYSTEMATIC REVIEW PROTOCOL REGISTRATION Open Science Framework ( https://osf.io/rvf7q ).
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Affiliation(s)
- Kendra L Rieger
- School of Nursing, Trinity Western University, Langley, Canada.
| | - Sarah Gazan
- Lakota First Nation; Professional and French Language Services, Manitoba Teachers Society, Winnipeg, Canada
| | - Marlyn Bennett
- Faculty of Social Work, University of Manitoba, Winnipeg, Canada
| | - Mandy Buss
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Northern Connections Medical Center, Winnipeg, Canada
| | - Anna M Chudyk
- Department of Family Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | | | - Cindy Garson
- Interlake Reserves Tribal Council, Headingley, Canada
| | - Thomas F Hack
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | - Tara Horrill
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | | | - Janice Linton
- Neil John Maclean Health Sciences Library, Bannatyne Campus, University of Manitoba, Winnipeg, Canada
| | - Donna Martin
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | | | - Wanda Phillips-Beck
- First Nation Health and Social Secretariat of Manitoba, Indigenous Research Chair in Nursing, University of Manitoba, Winnipeg, Canada
| | | | - Annette S H Schultz
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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17
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Kong AC, Sousa MS, Ramjan L, Dickson M, Goulding J, Gwynne K, Talbot F, Jones N, Srinivas R, George A. "Got to build that trust": the perspectives and experiences of Aboriginal health staff on maternal oral health. Int J Equity Health 2020; 19:187. [PMID: 33097061 PMCID: PMC7585174 DOI: 10.1186/s12939-020-01301-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 10/14/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the cultural needs of Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal health staff towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally safe model of oral health care for Aboriginal women during pregnancy. METHODS A descriptive qualitative methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia. RESULTS A total of 14 people participated in the focus groups. There were four themes that were constructed. These focused on Aboriginal Health Workers and Family Partnership Workers identifying their role in promoting maternal oral health, where adequate training is provided and where trust has been developed with clients. Yet, because the Aboriginal health staff work in a system fundamentally driven by the legacy of colonisation, it has significantly contributed to the systemic barriers Aboriginal pregnant women continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care. CONCLUSIONS The Aboriginal health staff identified the potential role of Aboriginal Health Workers and Family Partnership Workers promoting oral health among Aboriginal pregnant women. To develop an effective oral health model of care among Aboriginal women during pregnancy, there is the need for training of Aboriginal Health Workers and Family Partnership Workers in oral health. Including Aboriginal staff at every stage of a dental referral pathway could reduce the fear of accessing mainstream health institutions and also promote continuity of care. Although broader oral health policies still need to be changed, this model could mitigate some of the barriers between Aboriginal women and both dental care providers and healthcare systems.
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Affiliation(s)
- Ariana C. Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
| | - Mariana S. Sousa
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, 2007 NSW Australia
| | - Lucie Ramjan
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
- Translational Health Research Institute, Campbelltown, 2560 NSW Australia
| | - Michelle Dickson
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
| | - Joanne Goulding
- Primary and Community Services, South Western Sydney Local Health District, Liverpool, 2170 NSW Australia
| | - Kylie Gwynne
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, 2109 NSW Australia
| | - Folau Talbot
- Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
| | - Nathan Jones
- Aboriginal Health Unit, South Western Sydney Local Health District, Liverpool, 2170 NSW Australia
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
- Oral Health Services, South Western Sydney Local Health District, Liverpool, 2170 NSW Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
- Translational Health Research Institute, Campbelltown, 2560 NSW Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
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18
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Purcell-Khodr GC, Lee KSK, Conigrave JH, Webster E, Conigrave KM. What can primary care services do to help First Nations people with unhealthy alcohol use? A systematic review: Australia, New Zealand, USA and Canada. Addict Sci Clin Pract 2020; 15:31. [PMID: 32811549 PMCID: PMC7437002 DOI: 10.1186/s13722-020-00204-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 08/07/2020] [Indexed: 11/24/2022] Open
Abstract
Background First Nations peoples of Australia, New Zealand, the United States of America (USA) and Canada are more likely to be non-drinkers than other people in these countries. However, those who do drink may be at greater risk of alcohol-related harms (at a population level) due to the ongoing impacts from colonisation and associated oppression. Addressing unhealthy drinking (drinking above recommended limits including alcohol use disorders) in primary care settings is one important way to increase accessibility of treatment. Methods This systematic review identifies peer-reviewed studies of alcohol treatments delivered in primary care or other non-residential settings for First Nations peoples of Australia, New Zealand, USA and Canada. Literature searches were conducted in seven academic databases from their inception until March, 2020. We assessed evidence of treatment or implementation effectiveness, perceived acceptability or accessibility, and the study quality as assessed by the AXIS tool and by a measure of community participation in the research process. Results Twenty-eight studies were included, published between 1968 and 2018. Studies reported on a range of alcohol treatments, from brief intervention to ambulatory withdrawal management, relapse prevention medicines, and cultural therapies. Brief intervention was the most studied approach. Cultural healing practices and bicultural approaches were a key theme amongst several studies. Four studies measured treatment effectiveness, including one randomised controlled trial (naltrexone vs naltrexone plus sertraline vs placebo) and two uncontrolled trials of disulfiram. Of the six implementation studies, three were (hybrid) effectiveness-implementation designs. Most of the remaining studies (n = 21) focused on treatment accessibility or acceptability. Community participation in the research process was poorly reported in most studies. Conclusions Research evidence on how best to care for First Nations peoples with unhealthy alcohol use is limited. Trials of naltrexone and disulfiram presented promising results. Cultural and bicultural care were perceived as highly important to clinical staff and clients in several studies. More effectiveness studies on the full scope of alcohol treatments are needed. Greater community participation in research and more transparent reporting of this in study methods will be key to producing quality research that combines scientific rigour with cultural appropriateness.
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Affiliation(s)
- Gemma C Purcell-Khodr
- Faculty of Medicine and Health, Sydney School of Medicine; NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, University of Sydney, Camperdown, NSW, Australia.
| | - K S Kylie Lee
- Faculty of Medicine and Health, Sydney School of Medicine; NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, University of Sydney, Camperdown, NSW, Australia.,Centre for Alcohol Policy Research, La Trobe University, Bundoora, VIC, Australia
| | - James H Conigrave
- Faculty of Medicine and Health, Sydney School of Medicine; NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, University of Sydney, Camperdown, NSW, Australia
| | - Emma Webster
- Faculty of Medicine and Health, School of Rural Health, The University of Sydney, Dubbo, NSW, Australia
| | - Katherine M Conigrave
- Faculty of Medicine and Health, Sydney School of Medicine; NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, University of Sydney, Camperdown, NSW, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
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19
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Miller HM, Young C, Nixon J, Talbot-McDonnell M, Cutmore M, Tong A, Craig JC, Woolfenden S. Parents' and carers' views on factors contributing to the health and wellbeing of urban Aboriginal children. Aust N Z J Public Health 2020; 44:265-270. [PMID: 32510750 DOI: 10.1111/1753-6405.12992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/01/2020] [Accepted: 03/01/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To identify and describe caregiver perspectives on factors important for the health and wellbeing of urban Aboriginal children. METHODS Caregivers of Aboriginal children participating in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH) were asked to describe the single most important factor that would help their children to be healthy and well. Responses were analysed using thematic and content analysis. RESULTS Of the 626 carers in SEARCH, 425 (68%) provided a response. We identified 13 factors related to: loving family relationships, culturally competent healthcare, food security, active living, community services, education, social and emotional connectedness, safety, breaking cycles of disadvantage, housing availability and affordability, positive Aboriginal role models, strong culture, and carer wellbeing. CONCLUSIONS Aligning with holistic concepts of health, caregivers believe that a broad range of child, family and environmental-level factors are needed to ensure the health and wellbeing of Aboriginal children. Implications for public health: This study highlights the importance of providing public health initiatives that enable equal access to the social determinants of health for carers of Aboriginal children. Affordable and adequate housing, food security, culturally appropriate healthcare, and family and community connectedness remain critical areas for targeted initiatives.
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Affiliation(s)
- Hilary M Miller
- Sydney School of Public Health, The University of Sydney, New South Wales.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales
| | - Christian Young
- Sydney School of Public Health, The University of Sydney, New South Wales.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales
| | | | | | | | - Allison Tong
- Sydney School of Public Health, The University of Sydney, New South Wales.,Centre for Kidney Research, The Children's Hospital at Westmead, New South Wales
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, South Australia
| | - Susan Woolfenden
- School of Women's and Children's Health, University of New South Wales
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20
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"Our culture, how it is to be us" - Listening to Aboriginal women about on Country urban birthing. Women Birth 2019; 32:391-403. [PMID: 31345660 DOI: 10.1016/j.wombi.2019.06.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Birth on Country is often assumed as relevant to Aboriginal women in rural/remote locations and not usually associated with urban environments. In Western Australia, one third of the Aboriginal population live in the greater metropolitan area. We wanted to know Aboriginal women's experiences of on Country urban births. METHODS Indigenous qualitative data collection and analysis methods were used to learn about Aboriginal women's stories of contemporary and past experiences of maternity care and cultural practices associated with Birth on Country. RESULTS Aboriginal Birthing, Senior and Elder women consistently reported ongoing cultural practices associated with childbirth including knowledge sharing across generations and family support, observance of extended family present at the time of or shortly after birth, and how their cultural security was improved when Aboriginal staff were present. Also noted, were the inflexibility of health systems to meet their needs and midwives lack of cultural awareness and understanding of the importance of Aboriginal kinship. CONCLUSION The Birthing on Noongar Boodjar project Aboriginal women's data represents four generations of women's stories, experiences and expressions of childbearing, which highlighted that maternity care changes across time have failed to acknowledge and support Aboriginal women's cultural needs during childbearing. In terms of on Country urban birth, the women collectively expressed a strong desire to maintain cultural practices associated with childbirth, including birthing close to home (on Country); having family acknowledged and included throughout the perinatal period; and, having access to Aboriginal midwives, nurses, doctors, and other health care workers to support their cultural security.
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21
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Exploring the Term “Resilience” in Arctic Health and Well-Being Using a Sharing Circle as a Community-Centered Approach: Insights from a Conference Workshop. SOCIAL SCIENCES 2019. [DOI: 10.3390/socsci8020045] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In the field of Arctic health, “resilience” is a term and concept used to describe capacity to recover from difficulties. While the term is widely used in Arctic policy contexts, there is debate at the community level on whether “resilience” is an appropriate term to describe the human dimensions of health and wellness in the Arctic. Further, research methods used to investigate resilience have largely been limited to Western science research methodologies, which emphasize empirical quantitative studies and may not mirror the perspective of the Arctic communities under study. To explore conceptions of resilience in Arctic communities, a Sharing Circle was facilitated at the International Congress on Circumpolar Health in 2018. With participants engaging from seven of the eight Arctic countries, participants shared critiques of the term “resilience,” and their perspectives on key components of thriving communities. Upon reflection, this use of a Sharing Circle suggests that it may be a useful tool for deeper investigations into health-related issues affecting Arctic Peoples. The Sharing Circle may serve as a meaningful methodology for engaging communities using resonant research strategies to decolonize concepts of resilience and highlight new dimensions for promoting thriving communities in Arctic populations.
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22
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Horrill T, McMillan DE, Schultz ASH, Thompson G. Understanding access to healthcare among Indigenous peoples: A comparative analysis of biomedical and postcolonial perspectives. Nurs Inq 2018; 25:e12237. [PMID: 29575412 PMCID: PMC6055798 DOI: 10.1111/nin.12237] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2018] [Indexed: 12/30/2022]
Abstract
As nursing professionals, we believe access to healthcare is fundamental to health and that it is a determinant of health. Therefore, evidence suggesting access to healthcare is problematic for many Indigenous peoples is concerning. While biomedical perspectives underlie our current understanding of access, considering alternate perspectives could expand our awareness of and ability to address this issue. In this paper, we critique how access to healthcare is understood through a biomedical lens, how a postcolonial theoretical lens can extend that understanding, and the subsequent implications this alternative view raises for the nursing profession. Drawing on peer-reviewed published and gray literature concerning healthcare access and Indigenous peoples to inform this critique, we focus on the underlying theoretical lens shaping our current understanding of access. A postcolonial analysis provides a way of understanding healthcare as a social space and social relationship, presenting a unique perspective on access to healthcare. The novelty of this finding is of particular importance for the profession of nursing, as we are well situated to influence these social aspects, improving access to healthcare services broadly, and among Indigenous peoples specifically.
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Affiliation(s)
- Tara Horrill
- Rady Faculty of Health SciencesCollege of NursingUniversity of ManitobaWinnipegMBCanada
| | - Diana E McMillan
- Rady Faculty of Health SciencesCollege of NursingUniversity of ManitobaWinnipegMBCanada
- Health Sciences CentreWinnipegMBCanada
| | - Annette S H Schultz
- Rady Faculty of Health SciencesCollege of NursingUniversity of ManitobaWinnipegMBCanada
| | - Genevieve Thompson
- Rady Faculty of Health SciencesCollege of NursingUniversity of ManitobaWinnipegMBCanada
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Coombes J, Lukaszyk C, Sherrington C, Keay L, Tiedemann A, Moore R, Ivers R. First Nation Elders’ perspectives on healthy ageing in NSW, Australia. Aust N Z J Public Health 2018; 42:361-364. [DOI: 10.1111/1753-6405.12796] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/01/2018] [Accepted: 04/01/2018] [Indexed: 11/28/2022] Open
Affiliation(s)
| | - Caroline Lukaszyk
- The George Institute for Global Health; New South Wales
- Faculty of Medicine; The University of New South Wales
- Sydney School of Public Health; University of Sydney; New South Wales
| | | | - Lisa Keay
- The George Institute for Global Health; New South Wales
- Faculty of Medicine; The University of New South Wales
- Sydney School of Public Health; University of Sydney; New South Wales
| | - Anne Tiedemann
- Sydney School of Public Health; University of Sydney; New South Wales
| | - Robyn Moore
- Yerin Aboriginal Health Services Inc; New South Wales
| | - Rebecca Ivers
- The George Institute for Global Health; New South Wales
- Faculty of Medicine; The University of New South Wales
- Sydney School of Public Health; University of Sydney; New South Wales
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24
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Hovey RB, Delormier T, McComber AM, Lévesque L, Martin D. Enhancing Indigenous Health Promotion Research Through Two-Eyed Seeing: A Hermeneutic Relational Process. QUALITATIVE HEALTH RESEARCH 2017; 27:1278-1287. [PMID: 28682710 DOI: 10.1177/1049732317697948] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The intention of this article is to demonstrate how Indigenous and allied health promotion researchers learned to work together through a process of Two-Eyed Seeing. This process was first introduced as a philosophical hermeneutic research project on diabetes prevention within an Indigenous community in Quebec Canada. We, as a research team, became aware that hermeneutics and the principles of Haudenosaunee decision making were characteristic of Two-Eyed Seeing. This article describes our experiences while working with each other. Our learning from these interactions emphasized the relational aspects needed to ensure that we became a highly functional research team while working together and becoming Two-Eyed Seeing partners.
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Affiliation(s)
- Richard B Hovey
- 1 McGill University, Montreal, Quebec, Canada
- 2 Kahnawake Schools Diabetes Prevention Project, Kahnawake Mohawk Territory, Quebec, Canada
| | - Treena Delormier
- 2 Kahnawake Schools Diabetes Prevention Project, Kahnawake Mohawk Territory, Quebec, Canada
- 3 University of Hawaii at Mānoa, Honolulu, Hawaii, USA
| | - Alex M McComber
- 2 Kahnawake Schools Diabetes Prevention Project, Kahnawake Mohawk Territory, Quebec, Canada
| | - Lucie Lévesque
- 2 Kahnawake Schools Diabetes Prevention Project, Kahnawake Mohawk Territory, Quebec, Canada
- 4 Queen's University, Kingston, Ontario, Canada
| | - Debbie Martin
- 5 Dalhousie University, Halifax, Nova Scotia, Canada
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An Australian model of the First 1000 Days: an Indigenous-led process to turn an international initiative into an early-life strategy benefiting indigenous families. GLOBAL HEALTH EPIDEMIOLOGY AND GENOMICS 2016; 1:e11. [PMID: 29868203 PMCID: PMC5870429 DOI: 10.1017/gheg.2016.7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 05/09/2016] [Accepted: 05/20/2016] [Indexed: 11/13/2022]
Abstract
Internationally, the 1000 days movement calls for action and investment in improving nutrition for the period from a child's conception to their second birthday, thereby providing an organising framework for early-life interventions. To ensure Australian Indigenous families benefit from this 1000 days framework, an Indigenous-led year-long engagement process was undertaken linking early-life researchers, research institutions, policy-makers, professional associations and human rights activists with Australian Indigenous organisations and families. The resultant model, First 1000 Days Australia, broadened the international concept beyond improving nutrition. The First 1000 Days Australia model was built by adhering to Indigenous methodologies, a recognition of the centrality of culture that reinforces and strengthens families, and uses a holistic view of health and wellbeing. The First 1000 Days Australia was developed under the auspice of Indigenous people's leadership using a collective impact framework. As such, the model emphasises Indigenous leadership, mutual trust and solidarity to achieve early-life equity.
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Griffiths K, Coleman C, Lee V, Madden R. How colonisation determines social justice and Indigenous health—a review of the literature. JOURNAL OF POPULATION RESEARCH 2016. [DOI: 10.1007/s12546-016-9164-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Ashcroft R, Van Katwyk T. An Examination of the Biomedical Paradigm: A View of Social Work. SOCIAL WORK IN PUBLIC HEALTH 2016; 31:140-152. [PMID: 26959864 DOI: 10.1080/19371918.2015.1087918] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The biomedical paradigm provides foundational assumptions that shape the context within which social workers in health care settings practice. By providing social workers with a greater understanding of the history, epistemology, and key assumptions, this article aims to promote critical awareness and critical reflection on how the biomedical paradigm may be influencing health care environments. The analysis of this article raises important questions for social workers within health care environments, questions about how social workers are able to retain their disciplinary identity as agents of change in the pursuit of social justice.
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Affiliation(s)
- Rachelle Ashcroft
- a School of Social Work, Renison University College, University of Waterloo , Waterloo , Ontario , Canada
| | - Trish Van Katwyk
- a School of Social Work, Renison University College, University of Waterloo , Waterloo , Ontario , Canada
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28
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Gould GS, Munn J, Avuri S, Hoff S, Cadet-James Y, McEwen A, Clough AR. “Nobody smokes in the house if there's a new baby in it”: Aboriginal perspectives on tobacco smoking in pregnancy and in the household in regional NSW Australia. Women Birth 2013; 26:246-53. [DOI: 10.1016/j.wombi.2013.08.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 08/12/2013] [Indexed: 11/28/2022]
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Walker M, Fredericks B, Mills K, Anderson D. "Yarning" as a method for community-based health research with Indigenous women: the Indigenous Women's Wellness Research Program. Health Care Women Int 2013; 35:1216-26. [PMID: 23980668 DOI: 10.1080/07399332.2013.815754] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This project explores yarning as a methodology for understanding health and wellness from an indigenous woman's perspective. Previous research exploring indigenous Australian women's perspectives have used traditional Western methodologies and have often been felt by the women themselves to be inappropriate and ineffective in gathering information and promoting discussion. This research arose from the indigenous women themselves, and resulted in the exploration of using yarning as a methodology. Yarning is a conversational process that involves the sharing of stories and the development of knowledge. It prioritizes indigenous ways of communicating, in that it is culturally prescribed, cooperative, and respectful. The authors identify different types of yarning that are relevant throughout their research, and explain two types of yarning-family yarning and cross-cultural yarning-which have not been previously identified in research literature. This project found that yarning as a research method is appropriate for community-based health research with indigenous Australian women. This may be an important finding for health professionals and researchers to consider when working and researching with indigenous women from other countries.
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Affiliation(s)
- Melissa Walker
- a School of Nursing , Queensland University of Technology , Brisbane , Queensland , Australia
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Redman-MacLaren M, MacLaren DJ, Harrington H, Asugeni R, Timothy-Harrington R, Kekeubata E, Speare R. Mutual research capacity strengthening: a qualitative study of two-way partnerships in public health research. Int J Equity Health 2012; 11:79. [PMID: 23249439 PMCID: PMC3552762 DOI: 10.1186/1475-9276-11-79] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 11/22/2012] [Indexed: 11/10/2022] Open
Abstract
Introduction Capacity building has been employed in international health and development sectors to describe the process of ‘experts’ from more resourced countries training people in less resourced countries. Hence the concept has an implicit power imbalance based on ‘expert’ knowledge. In 2011, a health research strengthening workshop was undertaken at Atoifi Adventist Hospital, Solomon Islands to further strengthen research skills of the Hospital and College of Nursing staff and East Kwaio community leaders through partnering in practical research projects. The workshop was based on participatory research frameworks underpinned by decolonising methodologies, which sought to challenge historical power imbalances and inequities. Our research question was, “Is research capacity strengthening a two-way process?” Methods In this qualitative study, five Solomon Islanders and five Australians each responded to four open-ended questions about their experience of the research capacity strengthening workshop and activities: five chose face to face interview, five chose to provide written responses. Written responses and interview transcripts were inductively analysed in NVivo 9. Results Six major themes emerged. These were: Respectful relationships; Increased knowledge and experience with research process; Participation at all stages in the research process; Contribution to public health action; Support and sustain research opportunities; and Managing challenges of capacity strengthening. All researchers identified benefits for themselves, their institution and/or community, regardless of their role or country of origin, indicating that the capacity strengthening had been a two-way process. Conclusions The flexible and responsive process we used to strengthen research capacity was identified as mutually beneficial. Using community-based participatory frameworks underpinned by decolonising methodologies is assisting to redress historical power imbalances and inequities and is helping to sustain the initial steps taken to establish a local research agenda at Atoifi Hospital. It is our experience that embedding mutuality throughout the research capacity strengthening process has had great benefit and may also benefit researchers from more resourced and less resourced countries wanting to partner in research capacity strengthening activities.
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Abstract
The current paper discusses the historical evolvement of ethnography, identifies the various genres that have developed and argues that the development of ethnographic genres has been informed by a variety of epistemologies that have different aims, methods of data collection and analysis, and styles of presentation. The different genres of ethnography are systematised and categorised into three broad categories, namely classical ethnography, critical ethnography and interpretive ethnography. Each one of these genres are analysed and linked to the unique aims, methods of data collection and analysis, and styles of presentation that are congruent with the epistemology that informs it. Furthermore, it is asserted that different ethnographic genres require different criteria for judging their validity and these criteria should be contextualised and related to the epistemology that informed the specific genre, rather than using a set of unifying criteria for judging all ethnographic studies. Finally, this paper develops a series of steps that coherently link the epistemology, the aims, the data collection, the data analysis, the researcher’s representation in the study, and the presentation of the study for each genre so as to enable researchers and readers of ethnographic studies to accordingly assess the validity of each ethnographic genre.
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Affiliation(s)
- Stefanos Mantzoukas
- Assistant Professor in Nursing, Technological Educational Institution (University) of Epirus, Greece
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Nelson AL, Macdonald D, Abbott RA. A risky business? Health and physical activity from the perspectives of urban Australian Indigenous young people. HEALTH RISK & SOCIETY 2012. [DOI: 10.1080/13698575.2012.680949] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Williams L, Mumtaz Z. Being alive well? Power-Knowledge as a Countervailing Force to the Realization of Mental Well-being for Canada's Aboriginal Young People. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2012. [DOI: 10.1080/14623730.2008.9721773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Cultural safety is a familiar concept used in nursing education, research, and practice. It is also an important concept in nursing research and is one way of providing safety for indigenous participants and researchers, but it raises several questions, for one, who is the most appropriate person or persons to work in partnership with indigenous participants in research? Furthermore, who is the most appropriate person to critique the academic research of an indigenous researcher? These questions are usually not considered when ethic committees review a researcher’s application for research approval or funding. This article defines cultural safety and the concern that indigenous students put aside their culture when they commit to study within an education steeped in Westernized thinking. It discusses the decolonization of research and the part that nonindigenous researchers play within an indigenous research project. This article also outlines the application of an indigenous methodology and method in a project that enabled participants and the researcher to develop a culturally safe process in the form of a metaphorical whanau (family). This was also reflected in the findings of the project when Maori students within a bachelor of nursing program formed whanau groups, which enabled them to succeed in their study.
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Affiliation(s)
- Ann McCleland
- Eastern Institute of Technology, Napier, New Zealand
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Wilkin A, Liamputtong P. The photovoice method: researching the experiences of Aboriginal health workers through photographs. Aust J Prim Health 2010; 16:231-9. [DOI: 10.1071/py09071] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This paper discusses the methodological framework and perspectives that were used in a larger study aiming at examining the experience of working life among female Aboriginal health care workers. Currently, the voice of Aboriginal women who work in the Australian health system has not received much attention. In comparison to other occupations and backgrounds, there is virtually no literature on Aboriginal woman health care workers despite 15% of health care and social service industry employees in Australia being Aboriginal. In this study, we selected female participants because of the fact that of these 15% of health workers in the Victorian health system, 76% of them are women. This paper outlines some of the barriers in researching Indigenous communities. These barriers were overcome in this study by framing the research in feminist theory, decolonising theory, empowerment and by employing the photovoice method. The photovoice method was used because it is relatively unobtrusive and has the capacity to be empowering. All data was extrapolated from the participants’ own narratives that were prompted by the photographs they had taken. The data produced were rich descriptions and narratives that were oral as well as visual. Finally, the article discusses the experience of using the photovoice method from the researcher and participants’ perspective.
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Nagel T, Robinson G, Condon J, Trauer T. Approach to treatment of mental illness and substance dependence in remote Indigenous communities: Results of a mixed methods study. Aust J Rural Health 2009; 17:174-82. [DOI: 10.1111/j.1440-1584.2009.01060.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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