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Jones KA, Henderson H, Bright T, Segal L, Mauerhofer O, Lake KJ, Julian R, Duncan J, Raymond A, Jones A, Cameron D, Fergie D, Andrews S, Stewart S, Atkinson C, Elliot A, Crawford B, Mohammed J, Bundle G, Hirvonen T, Gnanamanickam E, Davis E, Gee G, Herrman H, Fisher J, Lovett R, Campbell S, Forster DA, Clark Y, Atkinson J, Marriott R, Chamberlain C. Healing the Past by Nurturing the Future: trauma-aware, healing-informed care to improve support for Aboriginal and Torres Strait Islander families - implementation and evaluation study protocol. BMJ Open 2024; 14:e085555. [PMID: 38960467 PMCID: PMC11227778 DOI: 10.1136/bmjopen-2024-085555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/11/2024] [Indexed: 07/05/2024] Open
Abstract
INTRODUCTION Complex trauma can have serious impacts on the health and well-being of Aboriginal and Torres Strait Islander families. The perinatal period represents a 'critical window' for recovery and transforming cycles of trauma into cycles of healing. The Healing the Past by Nurturing the Future (HPNF) project aims to implement and evaluate a programme of strategies to improve support for Aboriginal and Torres Strait islander families experiencing complex trauma. METHOD The HPNF programme was codesigned over 4 years to improve awareness, support, recognition and assessment of trauma. Components include (1) a trauma-aware, healing-informed training and resource package for service providers; (2) trauma-awareness resources for parents; (3) organisational readiness assessment; (4) a database for parents and service providers to identify accessible and appropriate additional support and (5) piloting safe recognition and assessment processes. The programme will be implemented in a large rural health service in Victoria, Australia, over 12 months. Evaluation using a mixed-methods approach will assess feasibility, acceptability, cost, effectiveness and sustainability. This will include service user and provider interviews; service usage and cost auditing; and an administrative linked data study of parent and infant outcomes. ANALYSIS Qualitative data will be analysed using reflexive thematic analysis. Quantitative and service usage outcomes will be described as counts and proportions. Evaluation of health outcomes will use interrupted time series analyses. Triangulation of data will be conducted and mapped to the Consolidated Framework for Implementation Research and Reach, Effectiveness, Adoption, Implementation and Maintenance frameworks to understand factors influencing feasibility, acceptability, effectiveness, cost and sustainability. ETHICS AND DISSEMINATION Approval granted from St Vincent's Melbourne Ethics Committee (approval no. 239/22). Data will be disseminated according to the strategy outlined in the codesign study protocol, in-line with the National Health and Medical Research Council Aboriginal and Torres Strait Islander Research Excellence criteria.
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Affiliation(s)
- Kimberley Ann Jones
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Henderson
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Tess Bright
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Leonie Segal
- Health Economics and Social Policy Group, University of South Australia, Adelaide, South Australia, Australia
| | - Olivia Mauerhofer
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine Jane Lake
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebakah Julian
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jhodie Duncan
- Latrobe Regional Hospital, Traralgon, Victoria, Australia
| | - Anita Raymond
- Latrobe Regional Hospital, Traralgon, Victoria, Australia
| | - Amanda Jones
- Victoria Aboriginal Child and Community Agency, Melbourne, Victoria, Australia
| | - Danielle Cameron
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Doseena Fergie
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Shawana Andrews
- Poche Centre for Indigenous Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Skye Stewart
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Caroline Atkinson
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alison Elliot
- The Bouverie Centre, La Trobe University, Melbourne, Victoria, Australia
| | | | | | - Gina Bundle
- Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Tanja Hirvonen
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Emmanuel Gnanamanickam
- Health Economics and Social Policy Group, University of South Australia, Adelaide, South Australia, Australia
- Adelaide EpiCentre, The University of Adelaide, Adelaide, South Australia, Australia
| | - Elise Davis
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Graham Gee
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Herrman
- Orygen Youth Health Research Centre and Centre for Youth Mental Health, Orygen Ltd, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Fisher
- Global and Women's Health, Monash University, Melbourne, Victoria, Australia
| | - Raymond Lovett
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Sandy Campbell
- Charles Darwin University, Darwin, Northern Territory, Australia
| | - Della Anne Forster
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- Maternity Services, Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Yvonne Clark
- South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
| | | | - Rhonda Marriott
- Ngangk Yira Institute for Change, Murdoch University, Perth, Western Australia, Australia
| | - Catherine Chamberlain
- Indigenous Health Equity Unit, Onemda, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Cormick A, Graham A, Stevenson T, Owen K, O'Donnell K, Kelly J. Co-designing a Health Journey Mapping resource for culturally safe health care with and for First Nations people. Aust J Prim Health 2024; 30:PY23172. [PMID: 38621019 DOI: 10.1071/py23172] [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: 09/12/2023] [Accepted: 03/13/2024] [Indexed: 04/17/2024]
Abstract
Background Many healthcare professionals and services strive to improve cultural safety of care for Australia's First Nations people. However, they work within established systems and structures that do not reliably meet diverse health care needs nor reflect culturally safe paradigms. Journey mapping approaches can improve understanding of patient/client healthcare priorities and care delivery challenges from healthcare professionals' perspectives leading to improved responses that address discriminatory practices and institutional racism. This project aimed to review accessibility and usability of the existing Managing Two Worlds Together (MTWT) patient journey mapping tools and resources, and develop new Health Journey Mapping (HJM) tools and resources. Method Four repeated cycles of collaborative participatory action research were undertaken using repeated cycles of look and listen, think and discuss, take action together. A literature search and survey were conducted to review accessibility and usability of MTWT tools and resources. First Nations patients and families, and First Nations and non-First Nations researchers, hospital and university educators and healthcare professionals (end users), reviewed and tested HJM prototypes, shaping design, format and focus. Results The MTWT tool and resources have been used across multiple health care, research and education settings. However, many users experienced initial difficulty engaging with the tool and offered suggested improvements in design and usability. End user feedback on HJM prototypes identified the need for three distinct mapping tools for three different purposes: clinical care, detailed care planning and strategic mapping, to be accompanied by comprehensive resource materials, instructional guides, videos and case study examples. These were linked to continuous quality improvement and accreditation standards to enhance uptake in healthcare settings. Conclusion The new HJM tools and resources effectively map diverse journeys and assist recognition and application of strengths-based, holistic and culturally safe approaches to health care.
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Affiliation(s)
- Alyssa Cormick
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
| | - Amy Graham
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
| | - Tahlee Stevenson
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
| | - Kelli Owen
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
| | - Kim O'Donnell
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia; and College of Medicine and Public Health, Flinders University, Kaurna Yarta, Bedford Park, SA 2100, Australia
| | - Janet Kelly
- Adelaide Nursing School, The University of Adelaide, Kaurna Yarta, North Terrace, Adelaide, SA 5000, Australia
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Kirkham R, Puszka S, Titmuss A, Freeman N, Weaver E, Morris J, Mack S, O'Donnell V, Boffa J, Dowler J, Ellis E, Corpus S, Graham S, Scott L, Sinha AK, Connors C, Shaw JE, Azzopardi P, Brown A, Davis E, Wicklow B, Maple-Brown L. Codesigning enhanced models of care for Northern Australian Aboriginal and Torres Strait Islander youth with type 2 diabetes: study protocol. BMJ Open 2024; 14:e080328. [PMID: 38453190 PMCID: PMC10921539 DOI: 10.1136/bmjopen-2023-080328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Premature onset of type 2 diabetes and excess mortality are critical issues internationally, particularly in Indigenous populations. There is an urgent need for developmentally appropriate and culturally safe models of care. We describe the methods for the codesign, implementation and evaluation of enhanced models of care with Aboriginal and Torres Strait Islander youth living with type 2 diabetes across Northern Australia. METHODS AND ANALYSIS Our mixed-methods approach is informed by the principles of codesign. Across eight sites in four regions, the project brings together the lived experience of Aboriginal and Torres Strait Islander young people (aged 10-25) with type 2 diabetes, their families and communities, and health professionals providing diabetes care through a structured yet flexible codesign process. Participants will help identify and collaborate in the development of a range of multifaceted improvements to current models of care. These may include addressing needs identified in our formative work such as the development of screening and management guidelines, referral pathways, peer support networks, diabetes information resources and training for health professionals in youth type 2 diabetes management. The codesign process will adopt a range of methods including qualitative interviews, focus group discussions, art-based methods and healthcare systems assessments. A developmental evaluation approach will be used to create and refine the components and principles of enhanced models of care. We anticipate that this codesign study will produce new theoretical insights and practice frameworks, resources and approaches for age-appropriate, culturally safe models of care. ETHICS AND DISSEMINATION The study design was developed in collaboration with Aboriginal and Torres Strait Islander and non-Indigenous researchers, health professionals and health service managers and has received ethical approval across all sites. A range of outputs will be produced to disseminate findings to participants, other stakeholders and the scholarly community using creative and traditional formats.
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Affiliation(s)
- Renae Kirkham
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Stefanie Puszka
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Angela Titmuss
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- Department of Paediatrics, Royal Darwin Hospital, Casuarina, Northern Territory, Australia
| | - Natasha Freeman
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Emma Weaver
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Jade Morris
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Shiree Mack
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Vicki O'Donnell
- Kimberley Aboriginal Medical Services, Broome, Western Australia, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - James Dowler
- Department of Paediatrics, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Elna Ellis
- Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Sumaria Corpus
- Endocrine Department, Royal Darwin Hospital, Casuarina, Northern Territory, Australia
| | - Sian Graham
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Lydia Scott
- WA Country Health Service - Kimberley, Broome, Western Australia, Australia
| | - Ashim K Sinha
- Endocrinology Department, Cairns Hospital, Cairns, Queensland, Australia
| | - Christine Connors
- Northern Territory Department of Health, Darwin, Northern Territory, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Azzopardi
- Burnet Institute, Melbourne, Victoria, Australia
- National Centre for Indigenous Genomics, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alex Brown
- National Centre for Indigenous Genomics, Australian National University, Canberra, Australian Capital Territory, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth Davis
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Brandy Wicklow
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Pediatric Endocrinology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Louise Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- Endocrine Department, Royal Darwin Hospital, Casuarina, Northern Territory, Australia
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Thapa S, Gibbs P, Ross N, Newman J, Allan J, Dalton H, Mahmood S, Kalinna BH, Ross AG. Are adverse childhood experiences (ACEs) the root cause of the Aboriginal health gap in Australia? BMJ Glob Health 2024; 9:e014901. [PMID: 38442985 DOI: 10.1136/bmjgh-2023-014901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/04/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
- Subash Thapa
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Peter Gibbs
- Regional Enterprise Development Institute (REDI.E), Dubbo, New South Wales, Australia
| | - Nancy Ross
- School of Social Work, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jamie Newman
- Orange Aboriginal Medical Service, Orange, New South Wales, Australia
| | - Julaine Allan
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Hazel Dalton
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Shakeel Mahmood
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Bernd H Kalinna
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Allen G Ross
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
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Sholler GF, Selbie LA, Tallon M, Keating J, Ayer J, Burchill L, Cheung MMH, Cordina R, Culnane E, Donovan S, Eastaugh L, Elliott C, Fletcher J, Justo RN, Kasparian NA, Kelly A, Morsman D, Nicolae M, Orr Y, Pendrick E, Ramsay JM, Reményi B, Shipton S, Weintraub RG, Van Wijk E, Wheaton G, Venugopal P. Australian National Standards of Care for Childhood-onset Heart Disease (CoHD Standards). 1st Edition. Heart Lung Circ 2024; 33:153-196. [PMID: 38453293 DOI: 10.1016/j.hlc.2023.03.017] [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: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 03/09/2024]
Abstract
These first Australian National Standards of Care for Childhood-onset Heart Disease (CoHD Standards) have been developed to inform the healthcare requirements for CoHD services and enable all Australian patients, families and carers impacted by CoHD (paediatric CoHD and adult congenital heart disease [ACHD]) to live their best and healthiest lives. The CoHD Standards are designed to provide the clarity and certainty required for healthcare services to deliver excellent, comprehensive, inclusive, and equitable CoHD care across Australia for patients, families and carers, and offer an iterative roadmap to the future of these services. The CoHD Standards provide a framework for excellent CoHD care, encompassing key requirements and expectations for whole-of-life, holistic and connected healthcare service delivery. The CoHD Standards should be implemented in health services in conjunction with the National Safety and Quality Health Service Standards developed by the Australian Commission on Safety and Quality in Health Care. All healthcare services should comply with the CoHD Standards, as well as working to their organisation's or jurisdiction's agreed clinical governance framework, to guide the implementation of structures and processes that support safe care.
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Affiliation(s)
- Gary F Sholler
- Sydney Children's Hospitals Network, NSW, Australia; Heart Centre for Children, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia.
| | - Lisa A Selbie
- HeartKids Ltd, Parramatta, NSW, Australia; School of Biotechnology & Biomolecular Sciences University of NSW, Sydney, NSW, Australia and Johns Hopkins University, Baltimore, MD, USA
| | - Mary Tallon
- HeartKids Ltd, Parramatta, NSW, Australia; Perth Children's Hospital, Perth, WA, Australia; School of Nursing, Curtin University, Perth, WA, Australia
| | | | - Julian Ayer
- Sydney Children's Hospitals Network, NSW, Australia; Heart Centre for Children, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | - Luke Burchill
- The Royal Melbourne Hospital, Melbourne, Vic, Australia and Mayo Clinic, Rochester, New York, NY, USA
| | - Michael M H Cheung
- The University of Melbourne, Melbourne, Vic, Australia; The Royal Children's Hospital, Melbourne, Vic, Australia
| | - Rachael Cordina
- The University of Sydney, Sydney, NSW, Australia; Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Evelyn Culnane
- The Royal Children's Hospital, Melbourne, Vic, Australia
| | | | - Lucas Eastaugh
- The Royal Children's Hospital, Melbourne, Vic, Australia
| | | | - Jeffery Fletcher
- Queensland Paediatric Specialists, Southport, Qld, Australia; Department of Paediatrics, The Tweed Hospital, Tweed Heads, NSW, Australia and Griffith University, Brisbane, Qld, Australia
| | - Robert N Justo
- Queensland Children's Hospital, South Brisbane, Qld, Australia; The University of Queensland, Herston, Qld, Australia; Queensland Paediatric Cardiac Research, Children's Health Queensland, South Brisbane, Qld, Australia
| | - Nadine A Kasparian
- Sydney Children's Hospitals Network, NSW, Australia; Heart Centre for Children, Sydney, NSW, Australia; Heart Institute and Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital, Ohio, OH, USA
| | - Andrew Kelly
- Women's and Children's Hospital, North Adelaide, SA, Australia
| | | | - Mugur Nicolae
- The University of Queensland, Herston, Qld, Australia; Mater Hospital Services, Brisbane, Qld, Australia
| | - Yishay Orr
- Sydney Children's Hospitals Network, NSW, Australia; Heart Centre for Children, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | | | | | - Bo Reményi
- Menzies School of Health Research, Charles Darwin University, Darwin, NT and Royal Darwin Hospital, Darwin, NT, Australia
| | | | - Robert G Weintraub
- The University of Melbourne, Melbourne, Vic, Australia; The Royal Children's Hospital, Melbourne, Vic, Australia; Murdoch Children's Research Institute, Melbourne, Vic, Australia
| | - Elsa Van Wijk
- HeartKids Ltd, Parramatta, NSW, Australia; Australian Institute of Company Directors, NSW, Australia
| | - Gavin Wheaton
- Women's and Children's Hospital, North Adelaide, SA, Australia; University of Adelaide, Adelaide, SA, Australia
| | - Prem Venugopal
- Queensland Children's Hospital, South Brisbane, Qld, Australia; The University of Queensland, Herston, Qld, Australia
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Ricciardo BM, Kessaris HL, Nannup N, Tilbrook D, Farrant B, Michie C, Hansen L, Douglas R, Walton J, Poore A, Whelan A, Barnett TC, Kumarasinghe PS, Carapetis JR, Bowen AC. Describing skin health and disease in urban-living Aboriginal children: co-design, development and feasibility testing of the Koolungar Moorditj Healthy Skin pilot project. Pilot Feasibility Stud 2024; 10:6. [PMID: 38200545 PMCID: PMC10782716 DOI: 10.1186/s40814-023-01428-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Indigenous children in colonised nations experience high rates of health disparities linked to historical trauma resulting from displacement and dispossession, as well as ongoing systemic racism. Skin infections and their complications are one such health inequity, with the highest global burden described in remote-living Australian Aboriginal and/or Torres Strait Islander (hereafter respectfully referred to as Aboriginal) children. Yet despite increasing urbanisation, little is known about the skin infection burden for urban-living Aboriginal children. More knowledge is needed to inform service provision, treatment guidelines and community-wide healthy skin strategies. In this pilot study, we aimed to test the feasibility and design of larger multi-site observational studies, provide initial descriptions of skin disease frequency and generate preliminary hypotheses of association. METHODS This project has been co-designed with local (Noongar) Elders to provide an Australian-first description of skin health and disease in urban-living Aboriginal children. In collaboration with an urban Aboriginal Community Controlled Health Organisation (Derbarl Yerrigan Health Service), we conducted a week-long cross-sectional observational cohort study of Aboriginal children (0-18 years) recruited from the waiting room. Participants completed a questionnaire, skin examination, clinical photos, and swabs and received appropriate treatment. We assessed the feasibility and impact of the pilot study. RESULTS From 4 to 8 October 2021, we recruited 84 Aboriginal children of whom 80 (95%) were urban-living. With a trusted Aboriginal Health Practitioner leading recruitment, most parents (or caregivers) who were approached consented to participate. Among urban-living children, over half (45/80, 56%) of parents described a current concern with their child's skin, hair and/or nails; and one-third (26/80, 33%) reported current itchy skin. Using a research-service model, 27% (21/79) of examined urban-living participants received opportunistic same-day treatment and 18% (14/79) were referred for later review. CONCLUSIONS This co-designed pilot study to understand skin health in urban-living Aboriginal children was feasible and acceptable, with high study participation and subsequent engagement in clinical care observed. Co-design and the strong involvement of Aboriginal people to lead and deliver the project was crucial. The successful pilot has informed larger, multi-site observational studies to more accurately answer questions of disease burden and inform the development of healthy skin messages for urban-living Aboriginal children.
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Affiliation(s)
- Bernadette M Ricciardo
- University of Western Australia, Crawley, WA, Australia.
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia.
- Fiona Stanley Hospital, Murdoch, WA, Australia.
- Perth Children's Hospital, Nedlands, WA, Australia.
| | - Heather-Lynn Kessaris
- Fiona Stanley Hospital, Murdoch, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Noel Nannup
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Dale Tilbrook
- Telethon Kids Institute, Nedlands, WA, Australia
- Maalingup Aboriginal Gallery, Caversham, WA, Australia
| | - Brad Farrant
- University of Western Australia, Crawley, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Carol Michie
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Lorraine Hansen
- Derbarl Yerrigan Health Services Aboriginal Corporation, East Perth, WA, Australia
| | - Richelle Douglas
- Derbarl Yerrigan Health Services Aboriginal Corporation, East Perth, WA, Australia
| | - Jacinta Walton
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Ainslie Poore
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Alexandra Whelan
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Timothy C Barnett
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Marshall Centre for Infectious Diseases Research and Training, School of Biomedical Sciences, University of Western Australia, Nedlands, WA, Australia
| | | | - Jonathan R Carapetis
- University of Western Australia, Crawley, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
| | - Asha C Bowen
- University of Western Australia, Crawley, WA, Australia
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, WA, Australia
- Perth Children's Hospital, Nedlands, WA, Australia
- Telethon Kids Institute, Nedlands, WA, Australia
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7
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Gilbert S, Irvine R, D'or M, Adam MTP, Collins CE, Marriott R, Rollo ME, Walker R, Rae KM. Indigenous women and their nutrition during pregnancy: Study Protocol for co-designed m-health resource for the 'Mums and Bubs Deadly Diets' project. JMIR Res Protoc 2023. [PMID: 37147188 PMCID: PMC10360010 DOI: 10.2196/45983] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Nutrition in pregnancy is pivotal to optimising infant growth and maternal wellbeing. The factors affecting Indigenous people's food and nutrition intake are complex, with a history of colonisation impacting the disproportionate effect of social determinants to this day. Literature regarding the dietary intake or priorities of Indigenous women in Australia is scarce with supportive, culturally appropriate resources developing for and with this group rare. Research suggests mHealth tools are effective in supporting health knowledge of Indigenous people and positive health behaviour changes when designed and developed with the expertise of Indigenous communities. OBJECTIVE This study seeks to build the body of knowledge related to nutrition needs and priorities for Indigenous women in Australia during pregnancy. Further this project team and its participants will co-design an mHealth digital tool to support these nutrition needs. METHODS The Mums and Bubs Deadly Diets study recruits Indigenous women and healthcare professionals who support Indigenous women during pregnancy into two phases. Phase One (pre-design) utilises a mixed methods convergent design utilising a biographical questionnaire and social/focus groups to inform Phase Two (generative). Phase Two will use a participatory action research process during co-design workshops to iteratively develop the digital tool, the exact actions within a workshop will evolve according to the participant group decisions. RESULTS To date, this project has undertaken Phase One focus groups at all Queensland sites with New South Wales and Western Australia to begin in early to mid 2023. We have recruited 12 participants from Galangoor Duwalami, 18 participants from Carbal in Toowoomba and 18 participants from Carbal in Warwick. We are expecting similar numbers of recruits in Western Australia and New South Wales. Participants have been both community members and health care professionals. CONCLUSIONS This study is an iterative and adaptive research program that endeavours to develop real world, impactful resources to support the nutrition needs and priorities of pregnant Indigenous women in Australia. This comprehensive project requires a combination of methods and methodologies to ensure Indigenous voices are heard at each stage and in all aspects of research output. The development of an mHealth resource for this cohort will provide a necessary bridge where there is often a gap in access to nutrition resources for women in pregnancy in Indigenous communities. CLINICALTRIAL Not applicable.
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Affiliation(s)
- Stephanie Gilbert
- Faculty of Humanities and Social Sciences, University of Queensland, Brisbane, AU
- Aboriginal and Torres Strait Islander Studies Unit,, University of Queensland, St Lucia, Brisbane, AU
| | - Rachel Irvine
- Aboriginal and Torres Strait Islander Studies Unit,, University of Queensland, St Lucia, Brisbane, AU
| | - Melissa D'or
- Mater Research Institute, Aubigny Place, South Brisbane, Brisbane, AU
| | - Marc T P Adam
- School of Information and Physical Science,, The University of Newcastle, Callaghan, Newcastle, AU
| | - Clare E Collins
- School of Health Sciences, College of Health, Medicine and Wellbeing,, The University of Newcastle, Callaghan, Newcastle, AU
- Food and Nutrition Research Program,, Hunter Medical Research Institute, Rankin Park, Newcastle, AU
| | - Rhonda Marriott
- Ngangk Yira Institute for Change,, Murdoch University, Perth, AU
| | - Megan E Rollo
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Perth, AU
| | - Roz Walker
- Ngangk Yira Institute for Change,, Murdoch University, Perth, AU
- School of Indigenous Studies, University of Western Australia, Nedlands, Perth, AU
- School of Population and Global Health, University of Western Australia, Nedlands, Perth, AU
| | - Kym M Rae
- Mater Research Institute, Aubigny Place, Raymond Terrace, Brisbane, AU
- Faculty of Medicine,, The University of Queensland, Herston, AU
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Jones KA, Freijah I, Brennan SE, McKenzie JE, Bright TM, Fiolet R, Kamitsis I, Reid C, Davis E, Andrews S, Muzik M, Segal L, Herrman H, Chamberlain C. Interventions from pregnancy to two years after birth for parents experiencing complex post-traumatic stress disorder and/or with childhood experience of maltreatment. Cochrane Database Syst Rev 2023; 5:CD014874. [PMID: 37146219 PMCID: PMC10162699 DOI: 10.1002/14651858.cd014874.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Acceptable, effective and feasible support strategies (interventions) for parents experiencing complex post-traumatic stress disorder (CPTSD) symptoms or with a history of childhood maltreatment may offer an opportunity to support parental recovery, reduce the risk of intergenerational transmission of trauma and improve life-course trajectories for children and future generations. However, evidence relating to the effect of interventions has not been synthesised to provide a comprehensive review of available support strategies. This evidence synthesis is critical to inform further research, practice and policy approaches in this emerging area. OBJECTIVES To assess the effects of interventions provided to support parents who were experiencing CPTSD symptoms or who had experienced childhood maltreatment (or both), on parenting capacity and parental psychological or socio-emotional wellbeing. SEARCH METHODS In October 2021 we searched CENTRAL, MEDLINE, Embase, six other databases and two trials registers, together with checking references and contacting experts to identify additional studies. SELECTION CRITERIA All variants of randomised controlled trials (RCTs) comparing any intervention delivered in the perinatal period designed to support parents experiencing CPTSD symptoms or with a history of childhood maltreatment (or both), to any active or inactive control. Primary outcomes were parental psychological or socio-emotional wellbeing and parenting capacity between pregnancy and up to two years postpartum. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of trials for inclusion, extracted data using a pre-designed data extraction form, and assessed risk of bias and certainty of evidence. We contacted study authors for additional information as required. We analysed continuous data using mean difference (MD) for outcomes using a single measure, and standardised mean difference (SMD) for outcomes using multiple measures, and risk ratios (RR) for dichotomous data. All data are presented with 95% confidence intervals (CIs). We undertook meta-analyses using random-effects models. MAIN RESULTS We included evidence from 1925 participants in 15 RCTs that investigated the effect of 17 interventions. All included studies were published after 2005. Interventions included seven parenting interventions, eight psychological interventions and two service system approaches. The studies were funded by major research councils, government departments and philanthropic/charitable organisations. All evidence was of low or very low certainty. Parenting interventions Evidence was very uncertain from a study (33 participants) assessing the effects of a parenting intervention compared to attention control on trauma-related symptoms, and psychological wellbeing symptoms (postpartum depression), in mothers who had experienced childhood maltreatment and were experiencing current parenting risk factors. Evidence suggested that parenting interventions may improve parent-child relationships slightly compared to usual service provision (SMD 0.45, 95% CI -0.06 to 0.96; I2 = 60%; 2 studies, 153 participants; low-certainty evidence). There may be little or no difference between parenting interventions and usual perinatal service in parenting skills including nurturance, supportive presence and reciprocity (SMD 0.25, 95% CI -0.07 to 0.58; I2 = 0%; 4 studies, 149 participants; low-certainty evidence). No studies assessed the effects of parenting interventions on parents' substance use, relationship quality or self-harm. Psychological interventions Psychological interventions may result in little or no difference in trauma-related symptoms compared to usual care (SMD -0.05, 95% CI -0.40 to 0.31; I2 = 39%; 4 studies, 247 participants; low-certainty evidence). Psychological interventions may make little or no difference compared to usual care to depression symptom severity (8 studies, 507 participants, low-certainty evidence, SMD -0.34, 95% CI -0.66 to -0.03; I2 = 63%). An interpersonally focused cognitive behavioural analysis system of psychotherapy may slightly increase the number of pregnant women who quit smoking compared to usual smoking cessation therapy and prenatal care (189 participants, low-certainty evidence). A psychological intervention may slightly improve parents' relationship quality compared to usual care (1 study, 67 participants, low-certainty evidence). Benefits for parent-child relationships were very uncertain (26 participants, very low-certainty evidence), while there may be a slight improvement in parenting skills compared to usual care (66 participants, low-certainty evidence). No studies assessed the effects of psychological interventions on parents' self-harm. Service system approaches One service system approach assessed the effect of a financial empowerment education programme, with and without trauma-informed peer support, compared to usual care for parents with low incomes. The interventions increased depression slightly (52 participants, low-certainty evidence). No studies assessed the effects of service system interventions on parents' trauma-related symptoms, substance use, relationship quality, self-harm, parent-child relationships or parenting skills. AUTHORS' CONCLUSIONS There is currently a lack of high-quality evidence regarding the effectiveness of interventions to improve parenting capacity or parental psychological or socio-emotional wellbeing in parents experiencing CPTSD symptoms or who have experienced childhood maltreatment (or both). This lack of methodological rigour and high risk of bias made it difficult to interpret the findings of this review. Overall, results suggest that parenting interventions may slightly improve parent-child relationships but have a small, unimportant effect on parenting skills. Psychological interventions may help some women stop smoking in pregnancy, and may have small benefits on parents' relationships and parenting skills. A financial empowerment programme may slightly worsen depression symptoms. While potential beneficial effects were small, the importance of a positive effect in a small number of parents must be considered when making treatment and care decisions. There is a need for further high-quality research into effective strategies for this population.
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Affiliation(s)
- Kimberley A Jones
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Isabella Freijah
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Tess M Bright
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Renee Fiolet
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Ilias Kamitsis
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Carol Reid
- Judith Lumley Centre, La Trobe University, Bundoora, Australia
| | - Elise Davis
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Shawana Andrews
- Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Australia
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Leonie Segal
- Health Economics and Social Policy, Australian Centre for Precision Health, University of South Australia, North Terrace, Australia
| | - Helen Herrman
- Orygen, National Centre of Excellenece in Youth Mental Health, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Catherine Chamberlain
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
- Judith Lumley Centre, La Trobe University, Bundoora, Australia
- NGANGK YIRA Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, Australia
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Day A, Malvaso C. Researching Adverse Childhood Experiences in the Youth Justice System: Reflections on Methodology From a Members of a Non-Indigenous Research Team. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2023; 67:707-719. [PMID: 34784806 DOI: 10.1177/0306624x211058951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Understanding the impacts of Adverse Childhood Experiences (ACEs) has rapidly emerged as an important area of research that has implications for those who work in youth justice settings. This paper identifies a series of considerations facing those who work in jurisdictions where Indigenous or First Nations peoples have much higher levels of contact with both child protection and criminal justice systems than other population groups. It presents some reflections from members of a non-Indigenous research team about their efforts to engage with cultural perspectives on ACEs research in a way that facilitates further discussion within the research community about the methodological decisions that are made when investigating issues that are of importance to members of minority culture communities.
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Janse van Rensburg E, Woolard A, Hill NTM, Reid C, Milroy H, Ohan JL, Lin A, Chamberlain C. The effect of childhood maltreatment on adult survivors' parental reflective function, and attachment of their children: A systematic review. Dev Psychopathol 2023:1-15. [PMID: 37052290 DOI: 10.1017/s0954579423000391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
BACKGROUND Parental reflective function (PRF) is a candidate mechanism in the transmission of intergenerational trauma. This systematic review examined (1) the association between parental history of childhood maltreatment and PRF, (2) how PRF relates to attachment in children of parent survivors, and (3) whether PRF moderates the association between parental maltreatment history and child attachment. METHODS Ten databases were searched (from inception to 10th November 2021). Inclusion criteria were primary study, quantitative, parent participants, measures of childhood maltreatment, and postnatal PRF. Exclusion criteria were qualitative, intervention follow-up, gray literature, or a review study. Risk of bias was assessed using recommended tools. Data were narratively synthesized. RESULTS One-thousand-and-two articles were retrieved, of which eleven met inclusion criteria (N = 974 participants). Four studies found a significant association between parental childhood maltreatment and disrupted PRF, six did not, one found mixed results. One study reported the association between childhood maltreatment and attachment (nonsignificant results). DISCUSSION There is no clear evidence PRF is routinely disrupted in parent survivors, though there is high heterogeneity in studies. Future research should standardize design to better understand whether PRF is a candidate mechanism in intergenerational trauma. OTHER PROSPERO CRD42020223594.
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Affiliation(s)
- Elmie Janse van Rensburg
- Embrace, Telethon Kids Institute, WA, Australia
- School of Psychological Science, The University of Western Australia, WA, Australia
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
| | - Alix Woolard
- Embrace, Telethon Kids Institute, WA, Australia
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
- Medical School, University of Western Australia, WA, Australia
| | - Nicole T M Hill
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
- Centre for Child Health Research, University of Western Australia, WA, Australia
| | - Carol Reid
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Helen Milroy
- Embrace, Telethon Kids Institute, WA, Australia
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
- Medical School, University of Western Australia, WA, Australia
| | - Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, WA, Australia
| | - Ashleigh Lin
- Youth Mental Health Team, Telethon Kids Institute, WA, Australia
- Centre for Child Health Research, University of Western Australia, WA, Australia
| | - Catherine Chamberlain
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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Fiolet R, Woods C, Moana AH, Reilly R, Herrman H, McLachlan H, Fisher J, Lynch J, Chamberlain C. Community perspectives on delivering trauma-aware and culturally safe perinatal care for Aboriginal and Torres Strait Islander parents. Women Birth 2023; 36:e254-e262. [PMID: 35934615 DOI: 10.1016/j.wombi.2022.07.174] [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: 05/23/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Since colonisation, Aboriginal and Torres Strait Islander peoples have experienced violence, loss of land, ongoing discrimination and increased exposure to traumatic events. These include adverse childhood experiences which can lead to complex trauma, and are associated with increased incidence of high-risk pregnancies, birth complications and emergence of post-traumatic symptoms during the perinatal period, potentially impacting parenting and leading to intergenerational trauma. The perinatal period offers unique opportunities for processing experiences of trauma and healing yet can also be a time when parents experience complex trauma-related distress. Therefore, it is essential that trauma-aware culturally safe perinatal care is accessible to Aboriginal and Torres Strait Islander parents. AIM This study aimed to understand community perspectives of what 'trauma-aware culturally safe perinatal care' would look like for Aboriginal and Torres Strait Islander parents. METHODS Data were collected during a workshop held with predominantly Aboriginal and Torres Strait Islander key stakeholders to co-design strategies to foster trauma-aware culturally safe perinatal care. Data were thematically analysed. FINDINGS Four overarching themes represent proposed goals for trauma-aware culturally safe care: Authentic partnerships that are nurtured and invested in to provide the foundations of care; a skilled workforce educated in trauma awareness; empowering and compassionate care for building trust; and safe and accessible environments to facilitate parent engagement. CONCLUSIONS Provision of trauma-aware culturally safe care achieving these goals is likely to enable parents experiencing complex trauma to access appropriate support and care to foster healing in the critical perinatal period.
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Affiliation(s)
- Renee Fiolet
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Victoria, Australia.
| | - Cindy Woods
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Anni Hine Moana
- Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Rachel Reilly
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Helen Herrman
- Orygen Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
| | - Jane Fisher
- School of Public Health and Preventative Medicine, Turning Point Monash University, Melbourne, Victoria, Australia
| | | | - Catherine Chamberlain
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Victoria, Australia; Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia; NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Murdoch, Western Australia, Australia,; The Lowitja Institute, Melbourne, Victoria, Australia
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Hine R, Krakouer J, Elston J, Fredericks B, Hunter SA, Taylor K, Stephens T, Couzens V, Manahan E, DeSouza R, Boyle J, Callander E, Cunningham H, Miller R, Willey S, Wilton K, Skouteris H. Identifying and dismantling racism in Australian perinatal settings: Reframing the narrative from a risk lens to intentionally prioritise connectedness and strengths in providing care to First Nations families. Women Birth 2023; 36:136-140. [PMID: 35487864 DOI: 10.1016/j.wombi.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The perinatal period is a time when provision of responsive care offers a life course opportunity for positive change to improve health outcomes for mothers, infants and families. Australian perinatal systems carry the legacy of settler-colonialism, manifesting in racist events and interactions that First Nations parents encounter daily. OBJECTIVE The dominance of a western risk lens, and conscious and unconscious bias in the child protection workforce, sustains disproportionately high numbers of First Nations infants being removed from their parents' care. Cascading medical interventions compound existing stressors and magnify health inequities for First Nations women. DESIGN Critical discourse was informed by Indigenous ways of knowing, being and doing via targeted dialogue with a group of First Nations and non-Indigenous experts in Australian perinatal care who are co-authors on this paper. Dynamic discussion evolved from a series of yarning circles, supplemented by written exchanges and individual yarns as themes were consolidated. RESULTS First Nations maternity services prioritise self-determination, partnership, strengths and communication and have demonstrated positive outcomes with, and high satisfaction from First Nations women. Mainstream perinatal settings could be significantly enhanced by embracing similar principles and models of care. CONCLUSIONS AND RELEVANCE The Australian Anti-racism in Perinatal Practice (AAPP) Alliance calls for urgent transformations to Australian perinatal models of care whereby non-Indigenous health policy makers, managers and clinicians take a proactive role in identifying and redressing ethnocentrism, judgemental and culturally blind practices, reframing the risk narrative, embedding strength-based approaches and intentionally prioritising engagement and connectedness within service delivery.
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Affiliation(s)
| | - Jacynta Krakouer
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University.
| | - Jacinta Elston
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University; William Cooper Institute, Monash University, Australia
| | | | | | | | | | | | | | - Ruth DeSouza
- College of Design and Social Context, RMIT University, Australia
| | | | - Emily Callander
- Public Health and Preventative Medicine, Monash University, Australia
| | | | | | - Sue Willey
- Nursing and Midwifery, Monash University, Australia
| | | | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University and Warwick Business School, University of Warwick, Coventry, UK
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Kennedy M, Bright T, Graham S, Heris C, Bennetts SK, Fiolet R, Davis E, Jones KA, Mohamed J, Atkinson C, Chamberlain C. "You Can't Replace That Feeling of Connection to Culture and Country": Aboriginal and Torres Strait Islander Parents' Experiences of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16724. [PMID: 36554604 PMCID: PMC9779697 DOI: 10.3390/ijerph192416724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
This Aboriginal-led study explores Aboriginal and Torres Strait Islander parents' experiences of COVID-19. 110 Aboriginal and Torres Strait Islander parents were interviewed between October 2020 and March 2022. Participants were recruited through community networks and partner health services in South Australia, Victoria, and Northern Territory, Australia. Participants were predominantly female (89%) and based in Victoria (47%) or South Australia (45%). Inductive thematic analysis identified three themes: (1) Changes to daily living; (2) Impact on social and emotional wellbeing; and (3) Disconnection from family, community, and culture. COVID-19 impacted Aboriginal and Torres Strait Islander families. Disruption to cultural practice, and disconnection from country, family, and community was detrimental to wellbeing. These impacts aggravated pre-existing inequalities and may continue to have greater impact on Aboriginal and Torres Strait Islander parents and communities due to intergenerational trauma, stemming from colonisation, violence and dispossession and ongoing systemic racism. We advocate for the development of a framework that ensures an equitable approach to future public health responses for Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Michelle Kennedy
- College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Hunter Medical Research Institute, Rankin Park, Newcastle, NSW 2287, Australia
| | - Tess Bright
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | - Simon Graham
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | - Christina Heris
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, ACT 2601, Australia
| | - Shannon K. Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Melbourne, VIC 3083, Australia
- Intergenerational Health Group, Murdoch Children’s Research Institute, Parkville, Melbourne, VIC 3052, Australia
| | - Renee Fiolet
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | - Elise Davis
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | - Kimberley A. Jones
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | | | | | - Catherine Chamberlain
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
- Intergenerational Health Group, Murdoch Children’s Research Institute, Parkville, Melbourne, VIC 3052, Australia
- Ngangk Yira Institute for Change, Murdoch University, Perth, WA 6150, Australia
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Heris CL, Kennedy M, Graham S, Bennetts SK, Atkinson C, Mohamed J, Woods C, Chennall R, Chamberlain C. Key features of a trauma-informed public health emergency approach: A rapid review. Front Public Health 2022; 10:1006513. [PMID: 36568798 PMCID: PMC9771594 DOI: 10.3389/fpubh.2022.1006513] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022] Open
Abstract
COVID-19 is a major threat to public safety, and emergency public health measures to protect lives (e.g., lockdown, social distancing) have caused widespread disruption. While these measures are necessary to prevent catastrophic trauma and grief, many people are experiencing heightened stress and fear. Public health measures, risks of COVID-19 and stress responses compound existing inequities in our community. First Nations communities are particularly at risk due to historical trauma, ongoing socio-economic deprivation, and lack of trust in government authorities as a result of colonization. The objective of this study was to review evidence for trauma-informed public health emergency responses to inform development of a culturally-responsive trauma-informed public health emergency framework for First Nations communities. We searched relevant databases from 1/1/2000 to 13/11/2020 inclusive, which identified 40 primary studies (and eight associated references) for inclusion in this review. Extracted data were subjected to framework and thematic synthesis. No studies reported evaluations of a trauma-informed public health emergency response. However, included studies highlighted key elements of a "trauma-informed lens," which may help to consider implications, reduce risks and foster a sense of security, wellbeing, self- and collective-efficacy, hope and resilience for First Nations communities during COVID-19. We identified key elements for minimizing the impact of compounding trauma on First Nations communities, including: a commitment to equity and human rights, cultural responsiveness, good communication, and positive leadership. The six principles guiding trauma-informed culturally-responsive public health emergency frameworks included: (i) safety, (ii) empowerment, (iii) holistic support, (iv) connectedness and collaboration, (v) compassion and caring, and (vi) trust and transparency in multi-level responses, well-functioning social systems, and provision of basic services. These findings will be discussed with First Nations public health experts, together with data on the experiences of First Nations families and communities during COVID-19, to develop a trauma-integrated public health emergency response framework or "lens" to minimize compounding trauma for First Nations communities.
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Affiliation(s)
- Christina L. Heris
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Michelle Kennedy
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Simon Graham
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC, Australia
| | - Shannon K. Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Murdoch Children's Research Institute, Parkville, VIC, Australia
| | | | | | - Cindy Woods
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Richard Chennall
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, Australia,Lowitja Institute, Collingwood, VIC, Australia,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia,Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, WA, Australia,*Correspondence: Catherine Chamberlain
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Graham S, Kamitsis I, Kennedy M, Heris C, Bright T, Bennetts SK, Jones KA, Fiolet R, Mohamed J, Atkinson C, Chamberlain C. A Culturally Responsive Trauma-Informed Public Health Emergency Framework for Aboriginal and Torres Strait Islander Communities in Australia, Developed during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15626. [PMID: 36497699 PMCID: PMC9738974 DOI: 10.3390/ijerph192315626] [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: 11/03/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic impacted peoples' livelihoods and mental wellbeing. Aboriginal and Torres Strait Islander peoples in Australia continue to experience intergenerational trauma associated with colonization and may experience trauma-related distress in response to government responses to public health emergencies. We aimed to develop a culturally responsive trauma-informed public health emergency response framework for Aboriginal and Torres Strait Islander peoples. This Aboriginal and Torres Strait Islander-led study involved: (i) a review of trauma-informed public health emergency responses to develop a draft framework (ii) interviews with 110 Aboriginal and Torres Strait Islander parents about how COVID-19 impacted their lives, and (iii) a workshop with 36 stakeholders about pandemic experiences using framework analysis to refine a culturally responsive trauma-informed framework. The framework included: an overarching philosophy (cultural humility, safety and responsiveness); key enablers (local leadership and Eldership); supporting strategies (provision of basic needs and resources, well-functioning social systems, human rights, dignity, choice, justice and ethics, mutuality and collective responsibility, and strengthening of existing systems); interdependent core concepts (safety, transparency, and empowerment, holistic support, connectedness and collaboration, and compassion, protection and caring); and central goals (a sense of security, resilience, wellbeing, self- and collective-efficacy, hope, trust, resilience, and healing from grief and loss).
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Affiliation(s)
- Simon Graham
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC 3000, Australia
| | - Ilias Kamitsis
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Michelle Kennedy
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Christina Heris
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia
| | - Tess Bright
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Shannon K. Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
- Intergenerational Health Group, Murdoch Children’s Research Institute, Parkville, VIC 3000, Australia
| | - Kimberley A Jones
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Renee Fiolet
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | | | | | - Catherine Chamberlain
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
- The Lowitja Institute, Collingwood, VIC 3066, Australia
- NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, WA 6150, Australia
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Macniven R, Simon A, Wilson R, Howie A, Stewart G, Ma T, Turner NJ, Cairnduff S, Coombes J. Ironbark: Developing a healthy community program for older Aboriginal people. Health Promot J Austr 2022; 33 Suppl 1:128-133. [PMID: 35148452 PMCID: PMC9790301 DOI: 10.1002/hpja.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED Programs by, with and for Aboriginal older people must be culturally safe and relevant. Successful elements include being Aboriginal specific and group based. Co-design with Aboriginal people and stakeholders is essential. We describe the co-design process of developing the Ironbark: Healthy Community program. METHODS Aboriginal ways of knowing, being and doing and yarning conversational methods guided the development process, during 2018. A desktop review provided details of current group characteristics and key community stakeholders. Stakeholder engagement regarding views about group operations, participants and benefits also occurred. Aboriginal Elders views of their groups were gathered through yarning circles in New South Wales (NSW). Grounded theory approach was used to ascertain key themes. RESULTS Initial engagement occurred with 13 different community stakeholders and organisations in three Australian states (NSW, South Australia (SA), Western Australia (WA)). Three yarning circles occurred with Elders from urban (N = 10), regional coastal (N = 10) and regional country (N = 4) groups. Six key themes were organised in three groups according to an Aboriginal ontology. 1. Knowing: groups provide opportunities to share knowledge and connect socially. Adequate program resourcing and sustainability are valued. 2. Being: groups strengthen culture, providing important social, emotional and other forms of support to age well. 3. Doing: previous program experiences inform perceptions for new program operations. Group venues and operational aspects should be culturally safe, acknowledging diversity among Elders, their preferences and community control. Themes were used to develop the program and its resource manual that were finalised with stakeholders, including steering committee approval. CONCLUSIONS Stakeholder feedback at multiple stages and Aboriginal Elders' perspectives resulted in a new co-designed community program involving weekly yarning circles and social activities. So what?: Co-design, guided by Aboriginal ways of knowing, being and doing, can develop programs relevant for Aboriginal people.
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Affiliation(s)
- Rona Macniven
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,Faculty of Health, Medicine and Human SciencesMacquarie UniversityNew South WalesAustralia
| | | | - Roland Wilson
- Southgate Institute for Health, Society, and EquityFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Adam Howie
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Georgia Stewart
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research InstituteThe University of WollongongWollongongNew South WalesAustralia
| | - Tracey Ma
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,The George Institute for Global HealthSydneyNew South WalesAustralia
| | - Norma Jean Turner
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Sallie Cairnduff
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,The George Institute for Global HealthSydneyNew South WalesAustralia
| | - Julieann Coombes
- The George Institute for Global HealthSydneyNew South WalesAustralia
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17
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Leinweber J, Fontein-Kuipers Y, Karlsdottir SI, Ekström-Bergström A, Nilsson C, Stramrood C, Thomson G. Developing a woman-centered, inclusive definition of positive childbirth experiences: A discussion paper. Birth 2022; 50:362-383. [PMID: 35790019 DOI: 10.1111/birt.12666] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION A positive childbirth experience promotes women's health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high-quality maternity care. Currently, there is no clear, inclusive, woman-centered definition of a positive childbirth experience to guide practice, education, and research. AIM To formulate an inclusive woman-centered definition of a positive childbirth experience. METHODS A six-step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women's feedback (n = 42). RESULTS The following definition was formulated: "A positive childbirth experience refers to a woman's experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long-term positive impacts on a woman's psychosocial well-being." CONCLUSIONS This inclusive, woman-centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy-making.
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Affiliation(s)
- Julia Leinweber
- Institute of Midwifery, Charité-University Medicine Berlin, Berlin, Germany
| | - Yvonne Fontein-Kuipers
- School of Midwifery, Health and Social Work, University College Antwerp, Antwerp, Belgium.,Edinburgh Napier University, School of Health and Social Care, Edinburgh, UK
| | | | - Anette Ekström-Bergström
- Department of Health Sciences, University West, Trollhättan, Sweden.,Department of Nursing and Reproductive, Perinatal and Sexual Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Christina Nilsson
- Munkebäck Antenatal Clinic, Region Västra Götaland, Gothenburg, Sweden
| | - Claire Stramrood
- Department of Obstetrics and Gynaecology, OLVG Hospital, Amsterdam, The Netherlands
| | - Gill Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
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18
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Chamberlain C, Gray P, Bennet D, Elliott A, Jackomos M, Krakouer J, Marriott R, O'Dea B, Andrews J, Andrews S, Atkinson C, Atkinson J, Bhathal A, Bundle G, Davies S, Herrman H, Hunter S, Jones‐Terare G, Leane C, Mares S, McConachy J, Mensah F, Mills C, Mohammed J, Hetti Mudiyanselage L, O'Donnell M, Orr E, Priest N, Roe Y, Smith K, Waldby C, Milroy H, Langton M. Supporting Aboriginal and Torres Strait Islander Families to Stay Together from the Start (SAFeST Start): Urgent call to action to address crisis in infant removals. THE AUSTRALIAN JOURNAL OF SOCIAL ISSUES 2022; 57:252-273. [PMID: 35910416 PMCID: PMC9304314 DOI: 10.1002/ajs4.200] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/29/2021] [Accepted: 01/01/2022] [Indexed: 05/22/2023]
Abstract
Reducing the rate of over-representation of Aboriginal and Torres Strait Islander children in out-of-home care (OOHC) is a key Closing the Gap target committed to by all Australian governments. Current strategies are failing. The "gap" is widening, with the rate of Aboriginal and Torres Strait Islander children in OOHC at 30 June 2020 being 11 times that of non-Indigenous children. Approximately, one in five Aboriginal and Torres Strait Islander children entering OOHC each year are younger than one year. These figures represent compounding intergenerational trauma and institutional harm to Aboriginal and Torres Strait Islander families and communities. This article outlines systemic failures to address the needs of Aboriginal and Torres Strait Islander parents during pregnancy and following birth, causing cumulative harm and trauma to families, communities and cultures. Major reform to child and family notification and service systems, and significant investment to address this crisis, is urgently needed. The Family Matters Building Blocks and five elements of the Aboriginal and Torres Strait Islander Child Placement Principle (Prevention, Participation, Partnership, Placement and Connection) provide a transformative foundation to address historical, institutional, well-being and socioeconomic drivers of current catastrophic trajectories. The time for action is now.
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Affiliation(s)
- Catherine Chamberlain
- Centre for Health EquityThe University of MelbourneMelbourneVic.Australia
- Judith Lumley CentreLa Trobe UniversityMelbourneVic.Australia
- The Lowitja InstituteCarltonVicAustralia
- NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social EquityMurdochWAAustralia
| | - Paul Gray
- SNAICC ‐ National Voice for our ChildrenCollingwoodVic.Australia
- Jumbunna Institute for Indigenous Education and ResearchUniversity of Technology SydneySydneyNSWAustralia
| | - Debra Bennet
- SNAICC ‐ National Voice for our ChildrenCollingwoodVic.Australia
- Relationships AustraliaEight Mile PlainsQLDAustralia
| | - Alison Elliott
- Bouverie CentreLa Trobe UniversityMelbourneVic.Australia
| | | | - Jacynta Krakouer
- SNAICC ‐ National Voice for our ChildrenCollingwoodVic.Australia
- Health and Social Care UnitMonash UniversityClaytonVic.Australia
| | - Rhonda Marriott
- NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social EquityMurdochWAAustralia
| | - Birri O'Dea
- Molly Wardaguga Research CentreCharles Darwin UniversityCasuarinaNTAustralia
| | - Julie Andrews
- Aboriginal StudiesLa Trobe UniversityMelbourneVic.Australia
| | - Shawana Andrews
- Melbourne Poche Centre for Indigenous HealthThe University of MelbourneMelbourneVic.Australia
- School of PsychiatryUniversity of NSWSydneyNSWAustralia
| | | | | | - Alex Bhathal
- Social Work and Social PolicyLa Trobe UniversityMelbourneVic.Australia
| | - Gina Bundle
- The Royal Women's Hospital, MelbourneParkvilleVic.Australia
| | - Shanamae Davies
- Women's and Children's Health Network South AustraliaAdelaideSAAustralia
| | - Helen Herrman
- Orygen and Centre for Youth Mental HealthThe University of MelbourneMelbourneVic.Australia
| | | | | | - Cathy Leane
- Women's and Children's Health Network South AustraliaAdelaideSAAustralia
| | - Sarah Mares
- School of PsychiatryUniversity of NSWSydneyNSWAustralia
| | - Jennifer McConachy
- Department of Social WorkThe University of MelbourneMelbourneVic.Australia
| | - Fiona Mensah
- Murdoch Children's Research InstituteMelbourneVic.Australia
- Royal Children's HospitalMelbourneVic.Australia
- Department of PaediatricsThe University of MelbourneMelbourneVic.Australia
| | - Catherine Mills
- Monash Bioethics CentreMonash UniversityClaytonVic.Australia
| | | | | | | | - Elizabeth Orr
- School of PsychiatryUniversity of NSWSydneyNSWAustralia
| | - Naomi Priest
- Murdoch Children's Research InstituteMelbourneVic.Australia
- Centre for Social Research and MethodsAustralian National UniversityCanberraACTAustralia
- Melbourne School of Population and Global HealthUniversity of MelbourneMelbourneVic.Australia
| | - Yvette Roe
- Molly Wardaguga Research CentreCharles Darwin UniversityCasuarinaNTAustralia
| | - Kristen Smith
- Centre for Health EquityThe University of MelbourneMelbourneVic.Australia
| | - Catherine Waldby
- Research School of Social SciencesThe Australian National UniversityCanberraACTAustralia
| | - Helen Milroy
- Perth Children's HospitalNedlandsWAAustralia
- Division of PsychiatryUniversity of Western AustraliaCrawleyWAAustralia
| | - Marcia Langton
- Centre for Health EquityThe University of MelbourneMelbourneVic.Australia
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19
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King PT, Cormack D, Edwards R, Harris R, Paine SJ. Co-design for indigenous and other children and young people from priority social groups: A systematic review. SSM Popul Health 2022; 18:101077. [PMID: 35402683 PMCID: PMC8983433 DOI: 10.1016/j.ssmph.2022.101077] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 11/28/2022] Open
Abstract
Background Co-design has increasingly been posited as a useful approach for Indigenous peoples and other social groups that experience inequities. However, the relatively rapid rise in co-design rhetoric has not necessarily been accompanied by increased understanding of whether co-design works for these social groups, and how equity is addressed. Methods We conducted a systematic review to identify the current state of co-design as theory and praxis within the context of health and/or disability related interventions or services, with a specific focus on equity considerations for Indigenous and other children and young people from priority social groups. Six electronic databases were searched systematically to identify peer-reviewed papers and grey literature (dissertation and theses) published between January 1, 2000 to December 31, 2020, and a hand-search of reference lists for selected full texts was undertaken. Results Fifteen studies met the inclusion criteria. Although all studies used the term ‘co-design’, only three provided a definition of what they meant by use of the term. Nine studies described one or more theory-based frameworks and a total of 26 methods, techniques and tools were reported, with only one study describing a formal evaluation. The key mechanism by which equity was addressed appeared to be the inclusion of participants from a social group experiencing inequities within an area of interest. Conclusion A dearth of information limits the extent to which the literature can be definitive as to whether co-design works for Indigenous and other children and young people from priority social groups, or whether co-design reduces health inequities. It is critical for quality reporting to occur regarding co-design definitions, theory, and praxis. There is an urgent requirement for evaluation research that focuses on co-design impacts and assesses the contribution of co-design to achieving equity. We also recommend culturally safe ethical processes be implemented whenever undertaking co-design. Limited studies report co-design contribution to positive outcomes. Evaluatin Evaluation of co-design impacts and contribution to equity is urgently required. Culturally safe ethical processes must be implemented in co-design.
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Affiliation(s)
- Paula Toko King
- Te Rōpū Rangahau Hauora a Eru Pōmare (Eru Pōmare Māori Health Research Unit), University of Otago, Wellington, New Zealand
- Corresponding author. Department of Public Health, University of Otago. 23A Mein Street, Newtown. Wellington, 6021, New Zealand.
| | - Donna Cormack
- Te Rōpū Rangahau Hauora a Eru Pōmare (Eru Pōmare Māori Health Research Unit), University of Otago, Wellington, New Zealand
- Te Kupenga Hauora Māori (Department of Māori Health), The University of Auckland, Auckland, New Zealand
| | - Richard Edwards
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ricci Harris
- Te Rōpū Rangahau Hauora a Eru Pōmare (Eru Pōmare Māori Health Research Unit), University of Otago, Wellington, New Zealand
| | - Sarah-Jane Paine
- Te Kupenga Hauora Māori (Department of Māori Health), The University of Auckland, Auckland, New Zealand
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20
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Flemington T, Fraser J, Gibbs C, Shipp J, Bryant J, Ryan A, Wijetilaka D, Marks S, Scarcella M, Tzioumi D, Ramanathan S, Clague L, Hartz D, Lonne B, Lock (Ngiyampaa) M. The Daalbirrwirr Gamambigu (Safe Children) Model: Embedding Cultural Safety in Child Protection Responses for Australian Aboriginal Children in Hospital Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5381. [PMID: 35564775 PMCID: PMC9102959 DOI: 10.3390/ijerph19095381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 02/01/2023]
Abstract
The aim of this paper is to describe the development of a model of care to embed cultural safety for Aboriginal children into paediatric hospital settings. The Daalbirrwirr Gamambigu (pronounced "Dahl-beer-weer gum-um-be-goo" in the Gumbaynggirr language means 'safe children') model encompasses child protection responses at clinical, managerial and organisational levels of health services. A review of scholarly articles and grey literature followed by qualitative interviews with Aboriginal health professionals formed the evidence base for the model, which then underwent rounds of consultation for cultural suitability and clinical utility. Culturally appropriate communication with children and their families using clinical yarning and a culturally adapted version of ISBAR (a mnemonic for Identify, Situation, Background, Assessment and Recommendation) for interprofessional communication is recommended. The model guides the development of a critical consciousness about cultural safety in health care settings, and privileges the cultural voices of many diverse Aboriginal peoples. When adapted appropriately for local clinical and cultural contexts, it will contribute to a patient journey experience of respect, dignity and empowerment.
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Affiliation(s)
- Tara Flemington
- Nursing, Midwifery and Service Reform, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
- Faculty of Medicine and Health, Susan Wakil School of Nusing and Midwifery, University of Sydney, Camperdown, NSW 2006, Australia
| | - Jennifer Fraser
- Faculty of Medicine and Health, Susan Wakil School of Nusing and Midwifery, University of Sydney, Camperdown, NSW 2006, Australia
- Nursing, Midwifery and Education, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia
| | - Clinton Gibbs
- Health Reform, Opportunities and Transition, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Joanne Shipp
- Integrated Child, Youth and Family Wellbeing, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Joe Bryant
- Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
| | - Amanda Ryan
- Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Devika Wijetilaka
- Paediatrics, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
| | - Susan Marks
- Child Protection Unit, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia;
| | - Mick Scarcella
- Aboriginal Health, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia;
| | - Dimitra Tzioumi
- Child Protection Unit, The Sydney Children’s Hospitals Network, Randwick, NSW 2031, Australia;
- Child Protection and Wellbeing, Ministry of Health, St Leonards, NSW 2065, Australia
- Faculty of Medicine, School of Women’s and Children’s Health, University of New South Wales, Kensington, NSW 2052, Australia
| | - Shanthi Ramanathan
- Health Research Economics, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Liesa Clague
- School of Nursing, Midwifery, Health Science and Physiotherapy, The University of Notre Dame, Darlinghurst, NSW 2010, Australia;
| | - Donna Hartz
- School of Nursing and Midwifery, College of Medicine Health & Wellbeing, University of Newcastle, Gosford, NSW 2250, Australia;
| | - Bob Lonne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia;
| | - Mark Lock (Ngiyampaa)
- Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW 2007, Australia;
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21
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Using participatory action research to co-design perinatal support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. Women Birth 2021; 35:e494-e501. [PMID: 34961730 DOI: 10.1016/j.wombi.2021.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/07/2021] [Accepted: 12/17/2021] [Indexed: 11/20/2022]
Abstract
PROBLEM & BACKGROUND Support is important for all parents but critical for those experiencing complex trauma. The The Healing the Past by Nurturing the Future project uses participatory action research to co-design effective perinatal support for Aboriginal and Torres Strait Islander parents. AIM This research aims to identify and refine culturally appropriate support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. DESIGN We presented our synthesised eight parent support goals and 60 strategies, collated from Elder and parent focus groups, previous participatory workshops, and evidence reviews, for discussion at a stakeholder workshop. Stakeholder perspectives were captured using a three-point agreement activity and, self- and scribe-recorded comments. Aboriginal and non-Aboriginal researchers analysised the qualitative data, to identify core factors which might facilitate or help enact the parenting related goals. FINDINGS Overall, stakeholders (n = 37) strongly endorsed all eight goals. Workshop attendees (57% Aboriginal) represented multiple stakeholder roles including Elder, parent and service provider. Four core factors were identified as crucial for supporting parents to heal from complex trauma: Culture (cultural traditions, practices and strengths), Relationality (family, individual, community and services), Safety (frameworks, choice and control) and Timing (the right time socio-emotionally and stage of parenting). DISCUSSION Context-specific support tailored to the Culture, Relationality, Safety, and Timing needs of parents is essential. These four factors are important elements to help enact or facilitate parenting support strategies. CONCLUSION Further work is now required to develop practical resources for parents, and to implement and evaluate these strategies in perinatal care to address cumulative and compounding cycles of intergenerational trauma.
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22
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Healing the Past by Nurturing the Future: Aboriginal parents' views of what helps support recovery from complex trauma. Prim Health Care Res Dev 2021; 22:e47. [PMID: 34588088 PMCID: PMC8506449 DOI: 10.1017/s1463423621000463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
We aimed to understand support needs for Aboriginal and Torres Strait Islander parents experiencing complex trauma.Becoming a parent is an exciting yet challenging transition, particularly for parents who have experienced past hurt in their own childhood which can have long lasting effects, including complex trauma. Complex trauma-related distress can make it harder to care for a baby, but the parenting transition offers unique opportunities for recovery. This formative research is part of a community-based participatory action research project which aims to co-design perinatal awareness, recognition, assessment and support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. We used an Indigenist approach and grounded theory methods. Aboriginal and Torres Strait Islander parents who were pregnant and/or have children up to two years old were recruited through perinatal care services and community networks in three Australian sites (Alice Springs, Adelaide and Melbourne). Parents were offered a group discussion or individual interview, facilitated by Aboriginal researchers. Third-person scenarios and visual tools were used to facilitate reflections about the impact of past experiences, what keeps parents strong, hopes and dreams, and what is needed to achieve those dreams. Parents were also shown themes from a previous systematic review of parents’ experiences as a prompt to identify any additional key issues. Seventeen Aboriginal and Torres Strait Islander parents participated in August to September 2019. Most were mothers (n = 15). The study’s grounded theory methods provided the foundation of a theoretical supposition that positions the transformation of the compounding cycle of trauma, to a reinforcing cycle of nurturing at the intersection of: 1) parents’ connectedness; 2) social and emotional wellbeing; and 3) the transition to parenting. Unique opportunities and challenges situated at the interface are bound to the compounding or reinforcing nature of the intersecting factors. Findings reveal complexity, differing experiences by gender and age, as well as within and between communities.
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Co-Designing Health Service Evaluation Tools That Foreground First Nation Worldviews for Better Mental Health and Wellbeing Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168555. [PMID: 34444319 PMCID: PMC8394671 DOI: 10.3390/ijerph18168555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/03/2021] [Accepted: 08/08/2021] [Indexed: 11/29/2022]
Abstract
It is critical that health service evaluation frameworks include Aboriginal people and their cultural worldviews from design to implementation. During a large participatory action research study, Elders, service leaders and Aboriginal and non-Aboriginal researchers co-designed evaluation tools to test the efficacy of a previously co-designed engagement framework. Through a series of co-design workshops, tools were built using innovative collaborative processes that foregrounded Aboriginal worldviews. The workshops resulted in the development of a three-way survey that records the service experiences related to cultural safety from the perspective of Aboriginal clients, their carer/s, and the service staff with whom they work. The surveys centralise the role of relationships in client-service interactions, which strongly reflect their design from an Aboriginal worldview. This paper provides new insights into the reciprocal benefits of engaging community Elders and service leaders to work together to develop new and more meaningful ways of servicing Aboriginal families. Foregrounding relationships in service evaluations reinstates the value of human connection and people-centred engagement in service delivery which are central to rebuilding historically fractured relationships between mainstream services and Aboriginal communities. This benefits not only Aboriginal communities, but also other marginalised populations expanding the remit of mainstream services to be accessed by many.
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Jefferson K, Stanhope KK, Jones-Harrell C, Vester A, Tyano E, Hall CDX. A scoping review of recommendations in the English language on conducting research with trauma-exposed populations since publication of the Belmont report; thematic review of existing recommendations on research with trauma-exposed populations. PLoS One 2021; 16:e0254003. [PMID: 34324528 PMCID: PMC8321367 DOI: 10.1371/journal.pone.0254003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 06/17/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To identify recommendations for conducting public health research with trauma-exposed populations. METHODS Researchers searched Embase, PubMed, Scopus, Web of Science, Open Grey, and Google Scholar for recommendations. Trauma that causes psychological impact was our exposure of interest and we excluded clinical articles on treating physical trauma. We reviewed titles and abstracts of 8,070 articles and full text of 300 articles. We analyzed recommendations with thematic analysis, generated questions from the existing pool of recommendations, and then summarized select gaps. RESULTS We abstracted recommendations from 145 articles in five categories: community benefit, participant benefit, safety, researcher well-being, and recommendations for conduct of trauma research. CONCLUSIONS Gold standards to guide the conduct of trauma-informed public health research do not yet exist. The literature suggests participation in trauma research is not inherently harmful, and current recommendations concern using research to benefit communities and participants, protecting participants and researchers from harm, and improving professional practice. As public health researchers increasingly analyze trauma as a determinant of health, gold standards for the conduct of trauma-informed public health research would be appropriate and timely.
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Affiliation(s)
- Kevin Jefferson
- Independent Researcher, Atlanta, Georgia, United States of America
| | - Kaitlyn K. Stanhope
- Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Carla Jones-Harrell
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Aimée Vester
- Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Emma Tyano
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States of America
| | - Casey D. Xavier Hall
- Institute for Sexual and Gender Minority Health and Well-being, Northwestern University, Evanston, Illinois, United States of America
- Medical Social Sciences, Feinberg School of Medicine, Northwestern University Chicago, Chicago, Illinois, United States of America
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25
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Reid C, McKenzie JE, Brennan SE, Bennetts SK, Clark Y, Mensah F, Hokke S, Ralph N, Brown SJ, Gee G, Nicholson JM, Chamberlain C. Interventions during pregnancy or up to two years after birth for parents who are experiencing complex trauma or have experienced maltreatment in their childhood (or both) to improve parenting capacity or socio-emotional well-being. Hippokratia 2021. [DOI: 10.1002/14651858.cd014874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Carol Reid
- Judith Lumley Centre; La Trobe University; Bundoora Australia
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine; Monash University; Melbourne Australia
| | - Sue E Brennan
- School of Public Health and Preventive Medicine; Monash University; Melbourne Australia
| | - Shannon K Bennetts
- Judith Lumley Centre; La Trobe University; Bundoora Australia
- Murdoch Children's Research Institute; Parkville Australia
| | - Yvonne Clark
- South Australian Health and Medical Research Institute; Adelaide Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute; Parkville Australia
- Department of Paediatrics; University of Melbourne; Parkville Australia
| | - Stacey Hokke
- Judith Lumley Centre; La Trobe University; Bundoora Australia
| | - Naomi Ralph
- Judith Lumley Centre; La Trobe University; Bundoora Australia
- Central Queensland University; Townsville Australia
| | - Stephanie J Brown
- Murdoch Children's Research Institute; Parkville Australia
- Department of Paediatrics; University of Melbourne; Parkville Australia
- South Australian Health and Medical Research Council; Adelaide Australia
| | - Graham Gee
- Murdoch Children's Research Institute; Parkville Australia
- Melbourne School of Psychological Sciences; University of Melbourne; Melbourne Australia
| | - Jan M Nicholson
- Judith Lumley Centre; La Trobe University; Bundoora Australia
| | - Catherine Chamberlain
- Judith Lumley Centre; La Trobe University; Bundoora Australia
- NGANGK YIRA Murdoch University Research Centre for Aboriginal Health and Social Equity; Murdoch University; Perth Australia
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Racism, stress, and sense of personal control among Aboriginal Australian pregnant women. AUSTRALIAN PSYCHOLOGIST 2021. [DOI: 10.1111/ap.12435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Staying Strong Toolbox: Co-design of a physical activity and lifestyle program for Aboriginal families with Machado-Joseph disease in the Top End of Australia. PLoS One 2021; 16:e0244311. [PMID: 33544709 PMCID: PMC7864457 DOI: 10.1371/journal.pone.0244311] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022] Open
Abstract
Physical activity has positive health implications for individuals living with neurodegenerative diseases. The success of physical activity programs, particularly in culturally and linguistically diverse populations, is typically dependent on their alignment with the culture, lifestyle and environmental context of those involved. Aboriginal families living in remote communities in the Top End of Australia invited researchers to collaborate with them to co-design a physical activity and lifestyle program to keep individuals with Machado-Joseph disease (MJD) walking and moving around. The knowledge of Aboriginal families living with MJD, combined with findings from worldwide MJD research, formed the foundation for the co-design. An experience-based co-design (EBCD) approach, drawing from Indigenous and Participatory methodologies, was used. An expert panel of individuals with lived experience of MJD participated in a series of co-design phases. Prearranged and spontaneous co-design meetings were led by local community researchers within each phase. Data was collected using a culturally responsive ethnographic approach and analysed thematically. Sixteen panel members worked to develop the ‘Staying Strong Toolbox’ to cater for individuals with MJD who are ‘walking strong’; or ‘wobbly’; or ‘in a wheelchair’. Based on the ‘Staying Strong Framework’, the Toolbox was developed as a spiral bound A3 book designed to guide the user to select from a range of activities to keep them walking and moving around and to identify those activities most important to them to work on. The ‘Staying Strong Toolbox’ is a community driven, evidence based resource for a physical activity and lifestyle program for Aboriginal families with MJD. The Toolbox provides a guide for health professionals and support workers to deliver person-centred support to Aboriginal families with MJD, and that can be modified for use by other families with MJD or people with other forms of ataxia around the world.
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Nash S, Arora A. Interventions to improve health literacy among Aboriginal and Torres Strait Islander Peoples: a systematic review. BMC Public Health 2021; 21:248. [PMID: 33516186 PMCID: PMC7847024 DOI: 10.1186/s12889-021-10278-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/19/2021] [Indexed: 12/28/2022] Open
Abstract
Background Aboriginal and Torres Strait Islander peoples continue to experience poorer health outcomes than other population groups. While data specific to Indigenous Australians are scarce, a known social health literacy gradient exists linking low health literacy and poor health outcomes within many minority populations. Improving health literacy among Indigenous Australians is an important way to support self-determination and autonomy in both individuals and communities, by enhancing knowledge and improving health outcomes. This review aims to rigorously examine the effectiveness of health literacy interventions targeting Aboriginal and Torres Strait Islander peoples. Methods A systematic review across six databases (The Cochrane Library, PubMed, Embase, SCOPUS, ProQuest Dissertation and Thesis and Web of Science) was performed for publications evaluating interventions to improve health literacy among Indigenous Australian adults using search terms identifying a range of related outcomes. Results Of 824 articles retrieved, a total of five studies met the eligibility criteria and were included in this review. The included studies evaluated the implementation of workshops, structured exercise classes and the provision of discounted fruit and vegetables to improve nutrition, modify risk factors for chronic diseases, and improve oral health literacy. All interventions reported statistically significant improvement in at least one measured outcome. However, there was limited involvement of the Aboriginal and Torres Strait Islander community members in the research process and participant retention rates were sub-optimal. Conclusion There is limited evidence on interventions to improve health literacy in Indigenous Australian adults. Participation in interventions was often suboptimal and loss to follow-up was high. Future studies co-designed with Aboriginal and Torres Strait Islander community members are needed to improve health literacy in this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10278-x.
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Affiliation(s)
- Simone Nash
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, Westmead, NSW, 2145, Australia. .,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Surry Hills, NSW, 2010, Australia.
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Chamberlain C, Gee G, Gartland D, Mensah FK, Mares S, Clark Y, Ralph N, Atkinson C, Hirvonen T, McLachlan H, Edwards T, Herrman H, Brown SJ, Nicholson AJM. Community Perspectives of Complex Trauma Assessment for Aboriginal Parents: 'Its Important, but How These Discussions Are Held Is Critical'. Front Psychol 2020; 11:2014. [PMID: 33041880 PMCID: PMC7522325 DOI: 10.3389/fpsyg.2020.02014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/20/2020] [Indexed: 11/30/2022] Open
Abstract
Background and Purpose Becoming a parent can be an exciting and also challenging transition, particularly for parents who have experienced significant hurt in their own childhoods, and may be experiencing ‘complex trauma.’ Aboriginal and Torres Strait Islander (Aboriginal) people also experience historical trauma. While the parenting transition is an important time to offer support for parents, it is essential to ensure that the benefits of identifying parents experiencing complex trauma outweigh any risks (e.g., stigmatization). This paper describes views of predominantly Aboriginal stakeholders regarding (1) the relative importance of domains proposed for complex trauma assessment, and (2) how to conduct these sensitive discussions with Aboriginal parents. Setting and Methods A co-design workshop was held in Alice Springs (Central Australia) as part of an Aboriginal-led community-based participatory action research project. Workshop participants were 57 predominantly Aboriginal stakeholders with expertise in community, clinical, policy and academic settings. Twelve domains of complex trauma-related distress had been identified in existing assessment tools and through community consultation. Using story-telling and strategies to create safety for discussing complex and sensitive issues, and delphi-style methods, stakeholders rated the level of importance of the 12 domains; and discussed why, by whom, where and how experiences of complex trauma should be explored. Main Findings The majority of stakeholders supported the importance of assessing each of the proposed complex trauma domains with Aboriginal parents. However, strong concerns were expressed regarding where, by whom and how this should occur. There was greater emphasis and consistency regarding ‘qualities’ (e.g., caring), rather than specific ‘attributes’ (e.g., clinician). Six critical overarching themes emerged: ensuring emotional and cultural safety; establishing relationships and trust; having capacity to respond appropriately and access support; incorporating less direct cultural communication methods (e.g., yarning, dadirri); using strengths-based approaches and offering choices to empower parents; and showing respect, caring and compassion. Conclusion Assessments to identify Aboriginal parents experiencing complex trauma should only be considered when the prerequisites of safety, trusting relationships, respect, compassion, adequate care, and capacity to respond are assured. Offering choices and cultural and strengths-based approaches are also critical. Without this assurance, there are serious concerns that harms may outweigh any benefits for Aboriginal parents.
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Affiliation(s)
- Catherine Chamberlain
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia.,NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Perth, WA, Australia
| | - Graham Gee
- Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,School of Psychology, The University of Melbourne, Melbourne, VIC, Australia
| | - Deirdre Gartland
- Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Pediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Fiona K Mensah
- Department of Pediatrics, The University of Melbourne, Melbourne, VIC, Australia.,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sarah Mares
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,College of Medicine and Public Health, Flinders University, Darwin, NT, Australia
| | - Yvonne Clark
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia.,SAHMRI Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Naomi Ralph
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
| | | | - Tanja Hirvonen
- College of Medicine and Public Health, Flinders University, Darwin, NT, Australia
| | - Helen McLachlan
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia
| | - Tahnia Edwards
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - Helen Herrman
- Orygen, National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Stephanie J Brown
- Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Pediatrics, The University of Melbourne, Melbourne, VIC, Australia.,SAHMRI Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - And Jan M Nicholson
- Judith Lumley Centre, La Trobe University, Melbourne, VIC, Australia.,Population Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Perkes S, Bonevski B, Mattes J, Hall K, Gould GS. Respiratory, birth and health economic measures for use with Indigenous Australian infants in a research trial: a modified Delphi with an Indigenous panel. BMC Pediatr 2020; 20:368. [PMID: 32758202 PMCID: PMC7409441 DOI: 10.1186/s12887-020-02255-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/23/2020] [Indexed: 01/26/2023] Open
Abstract
Background There is significant disparity between the respiratory health of Indigenous and non-Indigenous Australian infants. There is no culturally accepted measure to collect respiratory health outcomes in Indigenous infants. The aim of this study was to gain end user and expert consensus on the most relevant and acceptable respiratory and birth measures for Indigenous infants at birth, between birth and 6 months, and at 6 months of age follow-up for use in a research trial. Methods A three round modified Delphi process was conducted from February 2018 to April 2019. Eight Indigenous panel members, and 18 Indigenous women participated. Items reached consensus if 7/8 (≥80%) panel members indicated the item was ‘very essential’. Qualitative responses by Indigenous women and the panel were used to modify the 6 months of age surveys. Results In total, 15 items for birth, 48 items from 1 to 6 months, and five potential questionnaires for use at 6 months of age were considered. Of those, 15 measures for birth were accepted, i.e., gestational age, birth weight, Neonatal Intensive Care Unit (NICU) admissions, length, head circumference, sex, Apgar score, substance use, cord blood gas values, labour, birth type, health of the mother, number people living in the home, education of mother and place of residence. Seventeen measures from 1-to 6 months of age were accepted, i.e., acute respiratory symptoms (7), general health items (2), health care utilisation (6), exposure to tobacco smoke (1), and breastfeeding status (1). Three questionnaires for use at 6 months of age were accepted, i.e., a shortened 33-item respiratory questionnaire, a clinical history survey and a developmental questionnaire. Conclusions In a modified Delphi process with an Indigenous panel, measures and items were proposed for use to assess respiratory, birth and health economic outcomes in Indigenous Australian infants between birth and 6 months of age. This initial step can be used to develop a set of relevant and acceptable measures to report respiratory illness and birth outcomes in community based Indigenous infants.
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Affiliation(s)
- Sarah Perkes
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia.
| | - Billie Bonevski
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
| | - Joerg Mattes
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
| | - Kerry Hall
- First Peoples Health Unit, (FPHU) Griffith University, Southport, Queensland, 4215, Australia
| | - Gillian S Gould
- Hunter Medical Research Institute and School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
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Chamberlain C, Ralph N, Hokke S, Clark Y, Gee G, Stansfield C, Sutcliffe K, Brown SJ, Brennan S. Healing The Past By Nurturing The Future: A qualitative systematic review and meta-synthesis of pregnancy, birth and early postpartum experiences and views of parents with a history of childhood maltreatment. PLoS One 2019; 14:e0225441. [PMID: 31834894 PMCID: PMC6910698 DOI: 10.1371/journal.pone.0225441] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/05/2019] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Child maltreatment can have serious effects on development and physical, social and emotional wellbeing. Any long-lasting relational effects can impede the capacity to nurture children, potentially leading to 'intergenerational trauma'. Conversely, the transition to parenthood during pregnancy, birth and the early postpartum period offers a unique life-course opportunity for healing. This systematic review aims to understand the pregnancy, birth and early postpartum experiences of parents who reported maltreatment in their own childhood. METHODS A protocol, based on the ENTREQ statement, was registered with PROSPERO. We searched Medline, PsycINFO, CINAHL, EMBASE, NHS Evidence and key Web of Science databases from date of inception to June 2018 to identify qualitative studies exploring perinatal experiences of parents who were maltreated in their own childhood. Two reviewers independently screened articles for inclusion and extracted data. Data were synthesised using grounded theory and thematic analysis approaches. FINDINGS The search yielded 18329 articles, 568 full text articles were reviewed, and 50 studies (60 articles) met inclusion criteria for this review. Due to the large number of studies across the whole perinatal period (pregnancy to two years postpartum), this paper reports findings for experiences during pregnancy, birth and early postpartum (27 studies). Parents described positive experiences and strategies to help them achieve their hopes and dreams of providing safe, loving and nurturing care for their children. However, many parents experienced serious challenges. Seven core analytic themes encapsulated these diverse and dynamic experiences: New beginnings; Changing roles and identities; Feeling connected; Compassionate care; Empowerment; Creating safety; and Reweaving a future. CONCLUSIONS Pregnancy birth and the early postpartum period is a unique life-course healing opportunity for parents with a history of maltreatment. Understanding parent's experiences and views of perinatal care and early parenting is critical for informing the development of acceptable and effective support strategies.
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Affiliation(s)
- Catherine Chamberlain
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- * E-mail:
| | - Naomi Ralph
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Stacey Hokke
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Yvonne Clark
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Graham Gee
- Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Claire Stansfield
- Evidence for Policy and Practice Co-ordinating Centre, Social Science Research Unit, UCL Institute of Education, University College London, London, United Kingdom
| | - Katy Sutcliffe
- Evidence for Policy and Practice Co-ordinating Centre, Social Science Research Unit, UCL Institute of Education, University College London, London, United Kingdom
| | - Stephanie J. Brown
- Intergenerational Health Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Department of Paediatrics, Royal Children’s Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sue Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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