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Hodgkinson L, Bowman S, Blunden S. Reconnecting with the Warrior Within: Australian Indigenous perspectives on the development of a social and emotional wellbeing program. Health Promot J Austr 2024; 35:784-793. [PMID: 37812937 DOI: 10.1002/hpja.805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 05/10/2023] [Accepted: 08/28/2023] [Indexed: 10/11/2023] Open
Abstract
ISSUE ADDRESSED Australian Indigenous youth are at high risk of developing mental health problems. Historical determinants and socioeconomic disadvantage continue to impact their social and emotional wellbeing (SEWB) and sense of identity. Previous literature suggests connecting to culture significantly impacts SEWB in Indigenous youth. Given the diversity of Indigenous culture, collaboration and consultation with specific cultural groups is required to develop appropriate and relevant psychological treatments for SEWB. The Warrior Within Program was developed to improve SEWB in Indigenous youth by assisting them to better understand their identity through participation in group-based cultural activities. This research aimed to understand Central Queensland Indigenous Development staff perspectives around (1) the process of developing the program and (2) how group-based cultural activities contributed to staff perceived improvements in SEWB of program participants. METHODS In this qualitative study, semi-structured individual interviews of 60-90 min were conducted with four Warrior Within Program staff of Central Queensland Indigenous Development. Transcripts were thematically analysed and the subthemes identified were categorised into main themes. RESULTS The process of developing the Warrior Within Program, cultural and Indigenous identity, reconnecting and knowledge emerged as the four main themes. CONCLUSIONS This study makes a unique and important contribution to the Australian Indigenous literature regarding the role and nature of culture in group-based programs and the importance of collaborating with Indigenous groups to increase our understanding of their usefulness and efficacy. This study also helps to bridge the gap between Indigenous ways of knowing in program development and non-Indigenous methods of evaluation. SO WHAT?: Acknowledging Australian Indigenous methods and ways of knowing are essential to the development and delivery of culturally appropriate group problems for addressing the psychological needs of this population. The methods used in this study could be used by others seeking to legitimise cultural ways of knowing.
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Affiliation(s)
- Luke Hodgkinson
- College of Psychology, CQUniversity, Rockhampton, Queensland, Australia
| | - Sarah Bowman
- College of Psychology, CQUniversity, Rockhampton, Queensland, Australia
| | - Sarah Blunden
- College of Psychology, CQUniversity, Rockhampton, Queensland, Australia
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Fraser SL, Lyonnais MC, Riva M, Fletcher C, Beauregard N, Thompson J, Mickpegak R, Bouchard LA. Culturally and contextually adaptive indicators of organizational success: Nunavik, Quebec. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:44-55. [PMID: 36449222 PMCID: PMC10831023 DOI: 10.17269/s41997-022-00704-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 09/19/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE This study aimed to develop a preliminary guide to culturally and contextually relevant indicators to assess community resources in the 14 communities of the Inuit territory of Nunavik, Quebec. METHODS As part of the Community Component of Qanuilirpitaa? of the 2017 Nunavik Health Survey, data were collected from 354 organizations located across Nunavik. Data were collected via short structured interviews with representatives of the organization. An inductive qualitative analysis was conducted to identify emerging themes describing the contexts that influence organizations, how key informants conceptualized what is a successful resource, and the facilitators and needs to achieving these indicators of success. Inuit partners were involved throughout the project to offer insight and to ascertain its pertinence and validity. RESULTS Interviews revealed structural and community realities that influenced organizations. Three main indicators were used to describe successes: (1) team efficiency and dynamics; (2) accessibility of the resource; and (3) ability to impact clients and the community. The third indicator was by far the most discussed indicator of success. Participants and leaders offer suggestions as to how to achieve these indicators and advocate for the conditions necessary for organizational sustainability. CONCLUSION This data-driven framework suggests that the measures of success that are frequently used by funding agencies (e.g., number of people reached, number of activities) may not fully represent the potential of local services in a given community. Indeed, services may be creating job opportunities for Inuit, instilling pride, offering cultural opportunities, and increasing capital (human, economic, health) within the community, all of which are equally important indicators of success that may more adequately further improve the social determinants of health among communities.
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Affiliation(s)
- Sarah Louise Fraser
- Centre de Recherche en Santé Publique (CReSP), University of Montreal and CIUSSS du centre Sud-de-l'Île de Montréal, Montreal, Quebec, Canada.
- School of Psychoeducation, University of Montreal, Montreal, Quebec, Canada.
| | | | - Mylene Riva
- Department of Geography, McGill University, Montreal, Quebec, Canada
| | - Christopher Fletcher
- Centre de Recherche CHU de Québec, Université Laval, Quebec City, Quebec, Canada
| | - Nancy Beauregard
- Centre de Recherche en Santé Publique (CReSP), University of Montreal and CIUSSS du centre Sud-de-l'Île de Montréal, Montreal, Quebec, Canada
- École de Relations Industrielles, Université de Montréal, Montreal, Quebec, Canada
| | - Jennifer Thompson
- Centre de Recherche en Santé Publique (CReSP), University of Montreal and CIUSSS du centre Sud-de-l'Île de Montréal, Montreal, Quebec, Canada
| | | | - Laury-Ann Bouchard
- School of Psychoeducation, University of Montreal, Montreal, Quebec, Canada
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Cultural adaptation of an appropriate tool for mental health among Kanien'kehá:ka: a participatory action project based on the Growth and Empowerment Measure. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2131-2145. [PMID: 34398264 DOI: 10.1007/s00127-021-02164-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
We present a cultural adaptation of the Growth and Empowerment Measure (GEM) from the Kanien'kehá:ka people of Quebec (Canada). Our aim was to develop a culturally competent and safe tool to assess and promote well-being among this population. We followed a qualitative, collaborative, and participatory method that sought to benefit Indigenous participants and communities, while honouring their culture and philosophies. Twelve adults from health and community services of Kahnawà:ke participated in total five focus group meetings. We carried out a thematic analysis of the data collected through an advisory group that led a revision of the cultural and conceptual relevance of the tool and its content. The group integrated socio-culturally relevant elements and restructured the tool so that it reflected local well-being factors and showed its versatility of being an assessment tool and therapeutic support. A narrative and empowerement-driven approach, culturally based intervention, cultural safety and flexibility when using the instrument were considered successful strategies to improve wellness. This project provides valuable information about the perspectives of local Indigenous communities regarding mental health and factors of empowerment. Mutual understanding and integration of psychological and traditional knowledge can create a beneficial program to improve emotional, mental, spiritual, and physical well-being for the local population. It remains to be tested whether the Kanien'kehá:ka Growth and Empowerment Measure (K-GEM) is clinically useful in psychological and psychiatric intervention, and social and community services.
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Depression or resilience? A participatory study to identify an appropriate assessment tool with Kanien'kéha (Mohawk) and Inuit in Quebec. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1891-1902. [PMID: 33683413 DOI: 10.1007/s00127-021-02057-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/24/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE We present a study on selection of a psychometric scale to be clinically used among Indigenous people with depression. Our aim was to select a psychometric tool for cultural adaptation with Mohawk and Inuit in Quebec. METHODS We selected three depression scales and three protective factor scales based on: strong validity for psychometric properties, evidence for good psychometric qualities across translations, avoidance of cognitively complex sentences, brevity, and clarity. We submitted the scales for consultation, and followed qualitative participatory methods with Mohawks of Kahnawake and Inuit from Nunavik living in an urban environment. We collected data through ten focus groups with advisory committees, and carried out a thematic analysis of the information. RESULTS The advisory groups considered the measurement scales to be unsafe. The major components that hindered their acceptance were: numeric rating, self-evaluation (versus supportive interaction), and a focus on symptoms rather than supportive factors. The participants preferred the Growth and Empowerment Measure due to its empowering approach. They voiced that it is necessary to develop a culturally sensitive and safe tool which facilitates interactions between the person and the practitioner. CONCLUSION This project provides valuable information about the perspectives of local Indigenous peoples regarding mental health and factors of empowerment and resilience. The ideal tool should be flexible in terms of the content and its use as compared to the conventional psychometric strategies. A tool developed with the Indigenous perspective on wellbeing could be used in psychological and psychiatric intervention as well as in social and community services.
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Bovill M, Chamberlain C, Bar-Zeev Y, Gruppetta M, Gould GS. Ngu-ng-gi-la-nha (to exchange) knowledge. How is Aboriginal and Torres Strait Islander people's empowerment being upheld and reported in smoking cessation interventions during pregnancy: a systematic review. Aust J Prim Health 2020; 25:395-401. [PMID: 31586502 DOI: 10.1071/py18186] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 08/01/2019] [Indexed: 11/23/2022]
Abstract
Smoking during pregnancy is a national priority to improve Aboriginal health. Empowerment approaches underpin the priorities set by the government to improve Aboriginal health and wellbeing; however, empowerment is seldom evaluated within interventions for Aboriginal people. Literature was searched to April 2018 and data was extracted using an assessment tool with domains of individual and community empowerment in smoking cessation during pregnancy studies with Aboriginal women. Three interventions were found in published and grey literature. Elements of individual empowerment were embedded in all interventions. Interventions considered barriers for Aboriginal women to quit smoking and areas for capacity building. Interventions used health education resources. There was limited reporting of community empowerment domains. Aboriginal ethics and capacity building was the only criterium addressed by all studies. Interventions are incorporating individual empowerment, but seldom report community empowerment. The development of reporting guidelines or extensions of current guidelines would be beneficial to set a consistently high standard reporting across Aboriginal health interventions, similar to the work conducted to develop the extension of Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity (PRISMA-E) for health equity in systematic review reporting. Reporting empowerment domains would reflect the government priority of empowerment to improve Aboriginal health, as well as enhancing knowledge translation into practice.
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Affiliation(s)
- Michelle Bovill
- The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; and Corresponding author.
| | - Catherine Chamberlain
- Judith Lumley Centre, La Trobe University, Level 3, George Singer Building, Bundoora, Vic. 3086, Australia; and Murdoch Children's Research Institute, Flemington Road, Parkville, Vic. 3052, Australia; and School of Public Health and Preventive Medicine, Monash University, 99 Commercial Road, Melbourne, Vic. 3004, Australia
| | - Yael Bar-Zeev
- The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Maree Gruppetta
- The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Gillian S Gould
- The University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
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Peake RM, Jackson D, Lea J, Usher K. Investigating the processes used to develop and evaluate the effectiveness of health education resources for adult Indigenous people: A literature review. Contemp Nurse 2019; 55:421-449. [DOI: 10.1080/10376178.2019.1633939] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Rachel M. Peake
- Stroke Care Coordinator, Peel & Mehi Sector, Tamworth, NSW 2348 Australia
- Hunter New England Local Health District, Tamworth, NSW 2348 Australia
| | - Debra Jackson
- Faculty of Health, University of Technology, Sydney (UTS), Australia
| | - Jackie Lea
- School of Nursing & Midwifery, Faculty of Health, Engineering & Sciences, University of Southern Queensland, Toowoomba, QLD, Australia 4350
| | - Kim Usher
- School of Health Faculty of Medicine & Health, University of New England, Armidale, NSW 2351 Australia
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Haynes E, Marawili M, Marika BM, Mitchell AG, Phillips J, Bessarab D, Walker R, Cook J, Ralph AP. Community-based participatory action research on rheumatic heart disease in an Australian Aboriginal homeland: Evaluation of the 'On track watch' project. EVALUATION AND PROGRAM PLANNING 2019; 74:38-53. [PMID: 30849711 DOI: 10.1016/j.evalprogplan.2019.02.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 06/09/2023]
Abstract
Strategies to date have been ineffective in reducing high rates of rheumatic heart disease (RHD) in Australian Aboriginal people; a disease caused by streptococcal infections. A remote Aboriginal community initiated a collaboration to work towards elimination of RHD. Based in 'both-way learning' (reciprocal knowledge co-creation), the aim of this study was to co-design, implement and evaluate community-based participatory action research (CBPAR) to achieve this vision. Activities related to understanding and addressing RHD social determinants were delivered through an accredited course adapted to meet learner and project needs. Theory-driven evaluation linking CBPAR to empowerment was applied. Data collection comprised focus groups, interviews, observation, and co-development and use of measurement tools such as surveys. Data analysis utilised process indicators from national guidelines for Aboriginal health research, and outcome indicators derived from the Wallerstein framework. Findings include the importance of valuing traditional knowledges and ways of learning such as locally-meaningful metaphors to explore unfamiliar concepts; empowerment through critical thinking and community ownership of knowledge about RHD and research; providing practical guidance in implementing empowering and decolonising principles / theories. Lessons learned are applicable to next stages of the RHD elimination strategy which must include scale-up of community leadership in research agenda-setting and implementation.
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Affiliation(s)
- Emma Haynes
- University of Western Australia, Perth, Western Australia, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia; Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia.
| | - Minitja Marawili
- Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia
| | | | - Alice G Mitchell
- Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia
| | - Jodi Phillips
- Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia
| | - Dawn Bessarab
- University of Western Australia, Perth, Western Australia, Australia
| | - Roz Walker
- University of Western Australia, Perth, Western Australia, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Jeff Cook
- Laynhapuy Homelands Health Service, Yirrkala, Northern Territory, Australia
| | - Anna P Ralph
- Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia; Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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Reilly L, Rees S. Fatherhood in Australian Aboriginal and Torres Strait Islander communities: An Examination of Barriers and Opportunities to Strengthen the Male Parenting Role. Am J Mens Health 2018; 12:420-430. [PMID: 29025357 PMCID: PMC5818118 DOI: 10.1177/1557988317735928] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 08/11/2017] [Accepted: 09/05/2017] [Indexed: 11/24/2022] Open
Abstract
Traditional Australian Aboriginal and Torres Strait Islander societies value men's role as parents; however, the importance of promoting fatherhood as a key social determinant of men's well-being has not been fully appreciated in Western medicine. To strengthen the Aboriginal and Torres Strait Islander male parenting role, it is vital to examine current barriers and opportunities. The first author (a male Aboriginal health project officer) conducted yarning sessions in three remote Australian communities, two being Aboriginal, the other having a high Aboriginal population. An expert sample of 25 Aboriginal and 6 non-Aboriginal stakeholders, including maternal and child health workers and men's group facilitators, considered barriers and opportunities to improve men's parenting knowledge and role, with an aim to inform services and practices intended to support men's parenting. A specific aim was to shape an existing men's group program known as Strong Fathers, Strong Families. A thematic analysis of data from the project identified barriers and opportunities to support men's role as parents. Challenges included the transition from traditional to contemporary parenting practices and low level of cultural and male gender sensitivity in maternal and child health services. Services need to better understand and focus on men's psychological empowerment and to address shame and lack of confidence around parenting. Poor literacy and numeracy are viewed as contributing to disempowerment. Communities need to champion Aboriginal and Torres Strait Islander male father role models. Biases and barriers should be addressed to improve service delivery and better enable men to become empowered and confident fathers.
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Affiliation(s)
- Lyndon Reilly
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Royal Flying Doctor Service (Queensland), Cairns, Australia
| | - Susan Rees
- Psychiatry Research and Teaching Unit, School of Psychiatry University of New South Wales,. Academic Mental Health Unit, Liverpool Hospital, New South Wales, Australia
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