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Dostie R, Dunn H, Marks WN, Camden C, Lovo S. Use of telehealth for paediatric rehabilitation needs of Indigenous children - a scoping review. Int J Circumpolar Health 2024; 83:2308944. [PMID: 38320112 PMCID: PMC10848996 DOI: 10.1080/22423982.2024.2308944] [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: 12/04/2023] [Accepted: 01/18/2024] [Indexed: 02/08/2024] Open
Abstract
Telerehabilitation is proposed as a promising avenue to enhance service accessibility for Indigenous communities, yet its application for Indigenous children remains relatively unexplored. This scoping review followed the PRISMA-ScR framework to explore current knowledge on the use of telerehabilitation for Indigenous children. Ten scholarly databases, seven grey literature databases, reference searches, and expert consultations were utilised to identify relevant studies. Included articles discussed the use of telerehabilitation provided by rehabilitation professionals (e.g. occupational therapist (OT), physical therapist (PT), speech and language pathologist (SLP) to Indigenous children and/or caregivers. Seven studies were included. Telerehabilitation was explored in different ways, the most common being real-time videoconferencing by SLPs. While some studies explicitly acknowledged cultural responsiveness within both the research process and the intervention, most were not designed for Indigenous children and their caregivers; rather, these participants were included with non-Indigenous participants. Successful implementation and sustainability of telerehabilitation services requires addressing technological limitations, understanding, and respecting diverse worldviews, and co-developing services to meet the unique needs of Indigenous families. Telerehabilitation has been rarely used with Indigenous children and when it was, little attention was given to cultural considerations. These findings emphasise that future telerehabilitation interventions should be truly community-led to ensure cultural relevance.
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Affiliation(s)
- Rosalie Dostie
- School of rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Qc, Canada
| | - Hailey Dunn
- School of rehabilitation sciences, College of Medicine, Saskatchewan University, Saskatoon, SK, Canada
| | | | - Chantal Camden
- School of rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Qc, Canada
| | - Stacey Lovo
- School of rehabilitation sciences, College of Medicine, Saskatchewan University, Saskatoon, SK, Canada
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2
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James MH, Prokopiv V, Barbagallo MS, Porter JE, Johnson N, Jones J, Smitherson T. Indigenous experiences and underutilisation of disability support services in Australia: a qualitative meta-synthesis. Disabil Rehabil 2024; 46:1438-1449. [PMID: 37029626 DOI: 10.1080/09638288.2023.2194681] [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: 08/17/2022] [Accepted: 03/18/2023] [Indexed: 04/09/2023]
Abstract
Purpose: Aboriginal and Torres Strait Islander People with a disability continue to experience barriers to service engagement such as mistrust of government services, lack of culturally appropriate support, marginalisation and disempowerment. This meta-synthesis reviews current literature regarding these experiences to explain why services are underutilised.Methods: The meta-synthesis was conducted using a meta-ethnographic approach to synthesise existing studies into new interpretive knowledge. The approach was supported by a search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).Results: Ten original research papers utilising a qualitative methodology were extracted. Synthesis of the articles revealed four concepts that were developed into a conceptual model. These include:1) History Matters; 2) Cultural Understanding of Disability Care; 3) Limitations to Current Service Provision; and 4) Delivery of Effective Services.Conclusions: Disability services do not adequately consider the cultural needs of Aboriginal and Torres Strait Islander People or communicate in a culturally appropriate manner. There are expectations that Aboriginal and Torres Strait Islander People acknowledge their disability in alignment with western definitions of disability in order to access services. More work is needed to align disability services with culturally appropriate support to provide better health outcomes.Implications for RehabilitationAboriginal and Torres Strait Islander people with a disability continue to experience barriers to service engagement which must be addressed.An essential gap that must be filled in providing disability services to Aboriginal and Torres Strait Islander people is the acknowledgment of culture as a resolute influence on all client interactions with providers.A cultural model of disability may better align with the experiences of Aboriginal and Torres Strait Islander people than current medical and social models used in healthcare.Disability services need to align better with culturally appropriate support to provide better health outcomes for Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Michelle H James
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Valerie Prokopiv
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Michael S Barbagallo
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Joanne E Porter
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Nicholas Johnson
- Aboriginal Student Success Officer, Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Jan Jones
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Tanisha Smitherson
- Business Manager, Gippsland Aboriginal Advocacy Support Service, Morwell, Australia
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3
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Gilroy J, Henningham M, Meehan D, Nila F, McGlone J, McAtamney A, Whittaker K, Brown B, Varlow M, Buchanan T. Systematic review of Aboriginal and Torres Strait Islander peoples' experiences and supportive care needs associated with cancer. BMC Public Health 2024; 24:523. [PMID: 38378574 PMCID: PMC10877816 DOI: 10.1186/s12889-024-18070-3] [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: 08/21/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Persistent disparities exist between Aboriginal and Torres Strait Islander peoples (the Indigenous peoples of Australia) and non-Indigenous Australians associated with cancer, with Aboriginal and Torres Strait Islander peoples experiencing a longer time to treatment, higher morbidity rates, and higher mortality rates. This systematic review aimed to investigate findings and recommendations in the literature about the experiences and supportive care needs of Aboriginal and Torres Strait Islander peoples with cancer in Australia. METHODS A qualitative systematic review was conducted using thematic analysis. Database searches were conducted in CINAHL, Informit, MEDLINE, ProQuest, Scopus, and Web of Science for articles published between January 2000 and December 2021. There were 91 included studies which were appraised using the Mixed Methods Appraisal Tool. The included studies reported on the experiences of cancer and supportive care needs in Aboriginal and Torres Strait Islander populations. RESULTS Six key themes were determined: Culture, family, and community; cancer outcomes; psychological distress; access to health care; cancer education and awareness; and lack of appropriate data. Culture was seen as a potential facilitator to achieving optimal cancer care, with included studies highlighting the need for culturally safe cancer services and the routine collection of Aboriginal and Torres Strait Islander status in healthcare settings. CONCLUSION Future work should capitalize on these findings by encouraging the integration of culture in healthcare settings to increase treatment completion and provide a positive experience for Aboriginal and Torres Strait Islander peoples with cancer.
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Affiliation(s)
- John Gilroy
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Mandy Henningham
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Drew Meehan
- Cancer Council Australia, Sydney, NSW, 2000, Australia.
| | - Farhana Nila
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | | | | | - Bena Brown
- Inala Indigenous Health Service, Metro South Health, Inala, QLD, 4077, Australia
| | - Megan Varlow
- Cancer Council Australia, Sydney, NSW, 2000, Australia
| | - Tanya Buchanan
- Cancer Council Australia, Sydney, NSW, 2000, Australia
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
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4
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Luke CR, Benfer K, Mick-Ramsamy L, Ware RS, Reid N, Bos AF, Bosanquet M, Boyd RN. Early detection of Australian Aboriginal and Torres Strait Islander infants at high risk of adverse neurodevelopmental outcomes at 12 months corrected age: LEAP-CP prospective cohort study protocol. BMJ Open 2022; 12:e053646. [PMID: 34996793 PMCID: PMC8744123 DOI: 10.1136/bmjopen-2021-053646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 12/10/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Neurodevelopmental disorders (NDD), including cerebral palsy (CP), autism spectrum disorder (ASD) and foetal alcohol spectrum disorder (FASD), are characterised by impaired development of the early central nervous system, impacting cognitive and/or physical function. Early detection of NDD enables infants to be fast-tracked to early intervention services, optimising outcomes. Aboriginal and Torres Strait Islander infants may experience early life factors increasing their risk of neurodevelopmental vulnerability, which persist into later childhood, further compounding the health inequities experienced by First Nations peoples in Australia. The LEAP-CP prospective cohort study will investigate the efficacy of early screening programmes, implemented in Queensland, Australia to earlier identify Aboriginal and Torres Strait Islander infants who are 'at risk' of adverse neurodevelopmental outcomes (NDO) or NDD. Diagnostic accuracy and feasibility of early detection tools for identifying infants 'at risk' of a later diagnosis of adverse NDO or NDD will be determined. METHODS AND ANALYSIS Aboriginal and/or Torres Strait Islander infants born in Queensland, Australia (birth years 2020-2022) will be invited to participate. Infants aged <9 months corrected age (CA) will undergo screening using the (1) General Movements Assessment (GMA); (2) Hammersmith Infant Neurological Examination (HINE); (3) Rapid Neurodevelopmental Assessment (RNDA) and (4) Ages and Stages Questionnaire-Aboriginal adaptation (ASQ-TRAK). Developmental outcomes at 12 months CA will be determined for: (1) neurological (HINE); (2) motor (Peabody Developmental Motor Scales 2); (3) cognitive and communication (Bayley Scales of Infant Development III); (4) functional capabilities (Paediatric Evaluation of Disability Inventory-Computer Adaptive Test) and (5) behaviour (Infant Toddler Social and Emotional Assessment). Infants will be classified as typically developing or 'at risk' of an adverse NDO and/or specific NDD based on symptomology using developmental and diagnostic outcomes for (1) CP (2) ASD and (3) FASD. The effects of perinatal, social and environmental factors, caregiver mental health and clinical neuroimaging on NDOs will be investigated. ETHICS AND DISSEMINATION Ethics approval has been granted by appropriate Queensland ethics committees; Far North Queensland Health Research Ethics Committee (HREC/2019/QCH/50533 (Sep ver 2)-1370), the Townsville HHS Human Research Ethics Committee (HREC/QTHS/56008), the University of Queensland Medical Research Ethics Committee (2020000185/HREC/2019/QCH/50533) and the Children's Health Queensland HHS Human Research Ethics Committee (HREC/20/QCHQ/63906) with governance and support from local First Nations communities. Findings from this study will be disseminated via peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER ACTRN12619000969167.
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Affiliation(s)
- Carly R Luke
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
- Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Katherine Benfer
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Leeann Mick-Ramsamy
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - Arend F Bos
- Department of Neonatology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Margot Bosanquet
- Townsville Hospital and Health Service, Townsville, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia
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5
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Lilley R, Sedgwick M, Pellicano E. Inclusion, acceptance, shame and isolation: Attitudes to autism in Aboriginal and Torres Strait Islander communities in Australia. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 24:1860-1873. [PMID: 32529835 DOI: 10.1177/1362361320928830] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
LAY ABSTRACT There has been almost no research done about autism in Aboriginal and Torres Strait Islander communities in Australia. This article is the first detailed report on attitudes to autism in these communities. Understanding attitudes to autism is important because they influence whether or not children are diagnosed, as well as the kinds of support autistic people are getting. Twelve families who lived in different parts of Australia were interviewed. They told us that there is a range of attitudes to autism in Aboriginal and Torres Strait Islander communities. These include negative ideas such as sometimes feeling shame associated with children's unusual behaviour, as well as feeling stigmatised and socially isolated. The negative attitudes reported may mean that some children are missing out on an autism diagnosis or being wrongly diagnosed with a different condition in these communities. They also included positive ideas such as the importance of looking after each other and of accepting autistic people and their differences. We can all learn from these positive attitudes. It will be interesting to know in future projects whether these accepting attitudes lead to better outcomes for autistic children and adults in these communities. This research helps us to understand how autism is thought about in different cultures and how attitudes impact diagnosis and support. It will also help people to plan supports that reflect what Aboriginal and Torres Strait Islander families actually want and need.
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Affiliation(s)
| | - Mikala Sedgwick
- Macquarie University, Australia.,Australian National University, Australia
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Green A, Abbott P, Luckett T, Davidson PM, Delaney J, Delaney P, Gunasekera H, DiGiacomo M. Collaborating across sectors to provide early intervention for Aboriginal and Torres Strait Islander children with disability and their families: a qualitative study of provider perspectives. J Interprof Care 2019; 34:388-399. [PMID: 31821054 DOI: 10.1080/13561820.2019.1692798] [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: 10/25/2022]
Abstract
Aboriginal and Torres Strait Islander children experience a higher prevalence of disability than other Australian children. Early intervention from across the health, education, and social service sectors is vital for improving outcomes, but families face lack of coordination between services. This study aimed to inform improvements in service access for families of urban-dwelling Aboriginal children with disability through exploring providers' perceptions of factors that influenced working together across sectors. Semi-structured interviews were conducted. Data analysis was informed by the general inductive approach and the Collaborative Practice to Enhance Patient Care Outcomes framework. Twenty-four providers participated. Interprofessional collaborative practice was influenced by interdependent interactional and organizational factors. Interactional factors fit within one of two dimensions: the ability of providers to share common goals and vision within a complex cross-sector service landscape, and influence of interpersonal relationships on their sense of belonging working in a cross-cultural space. Organizational factors also fit within one of two dimensions: the influence of governance in relation to its role in coordination and unlocking the strength of schools as service settings, and the need to formalize processes for effective interprofessional communication. Interprofessional collaborative practice was managed within the context of systemic factors relating to policy and funding. These findings demonstrate the complex interplay of factors related to the cross-sector involvement of providers in early intervention service provision. Consideration of these factors is required to facilitate collaborative cross-sector responses to improve service access for Aboriginal families.Abbreviations: WHO: world health organization; ACCHS: aboriginal community controlled health service; GP: general practitioner; NDIS: national disability insurance scheme.
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Affiliation(s)
- Anna Green
- Faculty of Health, IMPACCT, University of Technology Sydney, Sydney, Australia
| | - Penelope Abbott
- School of Medicine, Western Sydney University, Richmond, Australia
| | - Tim Luckett
- Faculty of Health, IMPACCT, University of Technology Sydney, Sydney, Australia
| | - Patricia Mary Davidson
- Faculty of Health, IMPACCT, University of Technology Sydney, Sydney, Australia.,School of Nursing, Johns Hopkins University, Baltimore, USA
| | - John Delaney
- Faculty of Health, IMPACCT, University of Technology Sydney, Sydney, Australia
| | - Patricia Delaney
- Faculty of Health, IMPACCT, University of Technology Sydney, Sydney, Australia
| | | | - Michelle DiGiacomo
- Faculty of Health, IMPACCT, University of Technology Sydney, Sydney, Australia
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Dias Junior CS, Verona AP. [Visual, hearing, and motor impairments in the indigenous population in Brazil]. CAD SAUDE PUBLICA 2018; 34:e00131717. [PMID: 30328998 DOI: 10.1590/0102-311x00131717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 05/14/2018] [Indexed: 11/22/2022] Open
Abstract
This study aimed to describe the prevalence of visual, hearing, and motor impairments in the indigenous population in Brazil and to estimate the odds of presenting one of the three disabilities, separately, according to degree of severity. The data were obtained from the 2010 Population Census conducted by the Brazilian Institute of Geography and Statistics (IBGE). The methods included direct standardization for calculation of the prevalence rates and multinomial logistic regression models. According to the standardized results, indigenous men and women showed the highest prevalence in each of the three disabilities, except for mild visual impairment in women. The results of the multinomial regression models revealed a relative disadvantage for indigenous peoples in nearly all the types of disability.
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Affiliation(s)
| | - Ana Paula Verona
- Centro de Desenvolvimento e Planejamento Regional, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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8
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Green A, Abbott P, Davidson PM, Delaney P, Delaney J, Patradoon-Ho P, DiGiacomo M. Interacting With Providers: An Intersectional Exploration of the Experiences of Carers of Aboriginal Children With a Disability. QUALITATIVE HEALTH RESEARCH 2018; 28:1923-1932. [PMID: 30101663 DOI: 10.1177/1049732318793416] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Intersectionality has potential to create new ways to describe disparities and craft meaningful solutions. This study aimed to explore Aboriginal carers' experiences of interactions with health, social, and education providers in accessing services and support for their child. Carers of Aboriginal children with a disability were recruited from an Australian metropolitan Aboriginal community-controlled health service. In-depth, semistructured interviews were conducted with 19 female carers. Intersectionality was applied as an analytical framework due to the inherent power differentials for Aboriginal Australians and carers for people with a disability. Marginalization and a lack of empowerment were evident in the experiences of interactions with providers due to cultural stereotypes and racism, lack of cultural awareness and sensitivity, and poverty and homelessness. Community-led models of care can help overcome the intersectional effects of these identities and forms of oppression in carers' interactions with providers and enhance access to care.
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Affiliation(s)
- Anna Green
- 1 University of Technology Sydney, Sydney, New South Wales, Australia
| | - Penelope Abbott
- 2 Western Sydney University, Penrith, New South Wales, Australia
| | - Patricia Mary Davidson
- 1 University of Technology Sydney, Sydney, New South Wales, Australia
- 3 Johns Hopkins University, Baltimore, Maryland, USA
| | - Patricia Delaney
- 1 University of Technology Sydney, Sydney, New South Wales, Australia
| | - John Delaney
- 1 University of Technology Sydney, Sydney, New South Wales, Australia
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Jones C, Sharma M, Harkus S, McMahon C, Taumoepeau M, Demuth K, Mattock K, Rosas L, Wing R, Pawar S, Hampshire A. A program to respond to otitis media in remote Australian Aboriginal communities: a qualitative investigation of parent perspectives. BMC Pediatr 2018; 18:99. [PMID: 29510680 PMCID: PMC5840719 DOI: 10.1186/s12887-018-1081-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 02/22/2018] [Indexed: 11/15/2022] Open
Abstract
Background Indigenous infants and children in Australia, especially in remote communities, experience early and chronic otitis media (OM) which is difficult to treat and has lifelong impacts in health and education. The LiTTLe Program (Learning to Talk, Talking to Learn) aimed to increase infants’ access to spoken language input, teach parents to manage health and hearing problems, and support children’s school readiness. This paper aimed to explore caregivers’ views about this inclusive, parent-implemented early childhood program for 0–3 years in an Aboriginal community health context. Methods Data from in-depth, semi-structured interviews with 9 caregivers of 12 children who had participated in the program from one remote Aboriginal community in the Northern Territory are presented. Data were analysed thematically. Caregivers provided overall views on the program. In addition, three key areas of focus in the program are also presented here: speech and language, hearing health, and school readiness. Results Caregivers were positive about the interactive speech and language strategies in the program, except for some strategies which some parents found alien or difficult: such as talking slowly, following along with the child’s topic, using parallel talk, or baby talk. Children’s hearing was considered by caregivers to be important for understanding people, enjoying music, and detecting environmental sounds including signs of danger. Caregivers provided perspectives on the utility of sign language and its benefits for communicating with infants and young children with hearing loss, and the difficulty of getting young community children to wear a conventional hearing aid. Caregivers were strongly of the opinion that the program had helped prepare children for school through familiarising their child with early literacy activities and resources, as well as school routines. But caregivers differed as to whether they thought the program should have been located at the school itself. Conclusions The caregivers generally reported positive views about the LiTTLe Program, and also drew attention to areas for improvement. The perspectives gathered may serve to guide other cross-sector collaborations across health and education to respond to OM among children at risk for OM-related disability in speech and language development. Electronic supplementary material The online version of this article (10.1186/s12887-018-1081-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Caroline Jones
- MARCS Institute, ARC Centre of Excellence for the Dynamics of Language, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,ARC Centre of Excellence for Cognition and its Disorders, Macquarie University, Sydney, Australia.
| | - Mridula Sharma
- Audiology Program, Department of Linguistics, Macquarie University, HEARing CRC, Sydney, Australia
| | | | - Catherine McMahon
- Audiology Program, Department of Linguistics, Macquarie University, HEARing CRC, Sydney, Australia
| | - Mele Taumoepeau
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Katherine Demuth
- ARC Centre of Excellence for Cognition and its Disorders, Macquarie University, Sydney, Australia.,Department of Linguistics, Macquarie University, Sydney, Australia
| | - Karen Mattock
- MARCS Institute, ARC Centre of Excellence for the Dynamics of Language, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Lee Rosas
- MARCS Institute, ARC Centre of Excellence for the Dynamics of Language, Western Sydney University, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Raelene Wing
- Sunrise Health Service, Katherine, Northern Territory, Australia
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10
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DiGiacomo M, Green A, Delaney P, Delaney J, Patradoon-Ho P, Davidson PM, Abbott P. Experiences and needs of carers of Aboriginal children with a disability: a qualitative study. BMC FAMILY PRACTICE 2017; 18:96. [PMID: 29187141 PMCID: PMC5707922 DOI: 10.1186/s12875-017-0668-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 11/16/2017] [Indexed: 11/15/2022]
Abstract
Background Australian parents/carers of a person with a disability experience higher rates of depression, more financial stress, and are twice as likely to be in poor physical health than the general population. Aboriginal and Torres Strait Islander peoples experience worse health, social and economic outcomes than other Australians, and those with a disability face ‘double disadvantage’. This study aimed to better understand the experiences and needs of parents/carers/families of Aboriginal children with a disability. Methods Semi-structured in-depth interviews were conducted with parents or primary carers of Aboriginal children aged zero-eight with disability. Interviews were analysed using thematic analysis. Results Nineteen women (sixteen mothers and three grandmothers) were interviewed. More than half were lone carers (without a partner or spouse). Participants described their experiences, including challenges and facilitators, to providing and accessing care, impacts on their health and wellbeing, and associated economic and non-economic costs of caregiving. Financial strain and social isolation was particularly prominent for lone carers. Conclusions Tailoring services to the needs of carers of Aboriginal children with a disability means supporting kinship caregiving, facilitating engagement with other Aboriginal families, and streamlining services and systems to mitigate costs. The experiences described by our participants depict an intersection of race, socio-economic status, gender, disability, and caregiving. Services and funding initiatives should incorporate such intersecting determinants in planning and delivery of holistic care.
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Affiliation(s)
- Michelle DiGiacomo
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Anna Green
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Patricia Delaney
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - John Delaney
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Patrick Patradoon-Ho
- Blacktown and Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown Road, Blacktown, NSW, 2148, Australia.,Western Sydney University, Locked Bag 1797, Penrith, NSW, 1797, Australia
| | - Patricia Mary Davidson
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia.,Johns Hopkins University, School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Penelope Abbott
- Western Sydney University, Locked Bag 1797, Penrith, NSW, 1797, Australia.
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11
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Raman S, Ruston S, Irwin S, Tran P, Hotton P, Thorne S. Taking culture seriously: Can we improve the developmental health and well-being of Australian Aboriginal children in out-of-home care? Child Care Health Dev 2017; 43:899-905. [PMID: 28736897 DOI: 10.1111/cch.12488] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 06/19/2017] [Accepted: 06/22/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children in out-of-home care have well-documented health and developmental needs. Research suggests that Aboriginal children in care have unmet health and intervention needs. In metropolitan Sydney, Kari Aboriginal Resources Inc. (KARI), an Aboriginal organization, provides support to indigenous children in care, including clinical assessment and intervention. We wanted to determine the health and developmental needs of a subset of children in out-of-home care with KARI, who had been in stable care for at least a year. We wanted to identify child, carer, and intervention characteristics that contributed to children doing well. We also wanted to identify enablers and barriers to providing culturally competent intervention. METHODS We used mixed methods. From the KARI clinic database over the past 3 years, we identified children who had been in stable care with KARI for >12 months. We compared clinical measures and outcomes for these children with results from previous audits. We carried out a group discussion and key informant interviews with therapists and caseworkers to identify risk and resilience factors for each child, as well as enablers and barriers to culturally competent intervention. RESULTS The health and developmental profile of the 26 children identified as being in stable care was similar to that of previous audits. Most (88%) were getting speech pathology intervention; one third were getting occupational therapy and psychological intervention; most children and their carers attended cultural programmes. The majority of children (25/26) improved in their developmental health. Caseworkers and therapists identified risk and resilience factors related to child, carer, and home characteristics. They also identified elements of good practice; systemic issues prevented some interventions from being carried out. CONCLUSIONS There are challenges delivering a trauma-informed, culturally respectful service to Aboriginal children in out-of-home care in an urban setting, but it can be done if attention is paid to culture and the enablers and barriers are identified.
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Affiliation(s)
- S Raman
- Department of Community Paediatrics, South Western Sydney Local Health District, Liverpool, NSW, Australia.,School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - S Ruston
- Kari Aboriginal Resources Inc., Liverpool, NSW, Australia.,Allied Health Department, Liverpool Hospital, Liverpool, NSW, Australia
| | - S Irwin
- Kari Aboriginal Resources Inc., Liverpool, NSW, Australia
| | - P Tran
- Kari Aboriginal Resources Inc., Liverpool, NSW, Australia.,Allied Health Department, Liverpool Hospital, Liverpool, NSW, Australia
| | - P Hotton
- Child Protection Unit, Sydney Children's Hospital, Randwick, NSW, Australia
| | - S Thorne
- Kari Aboriginal Resources Inc., Liverpool, NSW, Australia
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Jacups SP, Newman D, Dean D, Richards A, McConnon KM. An innovative approach to improve ear, nose and throat surgical access for remote living Cape York Indigenous children. Int J Pediatr Otorhinolaryngol 2017; 100:225-231. [PMID: 28802377 DOI: 10.1016/j.ijporl.2017.07.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 07/11/2017] [Accepted: 07/12/2017] [Indexed: 01/18/2023]
Abstract
INTRODUCTION On a background of high rates of severe otitis media (OM) with associated hearing loss, children from the Torres Strait and Cape York region requiring ear, nose and throat (ENT) surgery, faced waiting times exceeding three years. After numerous clinical safety incidents were raised, indicating a failure of the current system to deliver appropriate care, the governing Hospital and Health service opted to deliver surgical care through an alternate process. ENT surgeries were performed on 16 consented children from two remote locations via the private health care system, funded by a health provider partnership. METHODS We examined the collaboration processes alongside clinical findings from this ENT surgery. Collated patient data, included patient demographics, clinical and audiometry presentation features were reviewed and compared pre and post-operatively. Cost savings associated with the use of TeleHealth post-operatively were briefly examined. RESULTS Surgeries were successfully completed in all 16 children. The reported mean waitlist time for ENT surgery was 1.2 years. Pre-surgery pure-tone average hearing thresholds were reported at left: 30.9 dB, right: 38.2 dB. The majority of presentations were for bilateral OM with Effusion (69%). Post-surgical follow up indicated successful clinical outcomes in 80% of patients and successful hearing outcomes in 88% of patients. Mean difference pure-tone average hearing thresholds, left: 8.4 dB and right: 11.2 dB. Furthermore, the majority of patients reported improved hearing and breathing. The use of TeleHealth for post-operative review enabled a minimum cost saving of AUD$21,664 for these 16 children. Overall, a high level of staffing resources was required to successfully coordinate this intense surgical activity. CONCLUSION This innovative approach to a health system crisis enabled successful ENT surgical and hearing outcomes in 16 children, whose waitlisted time grossly exceeded state health recommendations. Using private health facilities funded by a health partnership, while unlikely to be a suitable model of care for routine service delivery; may be applied as an adjunct service model when blockages and delays lead to sub-standard service provision. This approach may be applicable to other health care facilities when facing extended elective surgery wait times in ENT or other specialty areas.
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Affiliation(s)
- Susan P Jacups
- Medical Services, Torres and Cape York Hospital and Health Service (TCHHS), Citi Building Level 9 46-48 Sheridan Street, Cairns, QLD 4870, Australia; The Cairns Institute, James Cook University (JCU), Australia.
| | - Denise Newman
- Medical Services, Torres and Cape York Hospital and Health Service (TCHHS), Citi Building Level 9 46-48 Sheridan Street, Cairns, QLD 4870, Australia.
| | - Deborah Dean
- Medical Services, Torres and Cape York Hospital and Health Service (TCHHS), Citi Building Level 9 46-48 Sheridan Street, Cairns, QLD 4870, Australia.
| | - Ann Richards
- Medical Services, Torres and Cape York Hospital and Health Service (TCHHS), Citi Building Level 9 46-48 Sheridan Street, Cairns, QLD 4870, Australia.
| | - Kate M McConnon
- Medical Services, Torres and Cape York Hospital and Health Service (TCHHS), Citi Building Level 9 46-48 Sheridan Street, Cairns, QLD 4870, Australia; Institute of Health Innovation, Macquarie University, Australia.
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Green A, Abbott P, Delaney P, Patradoon-Ho P, Delaney J, Davidson PM, DiGiacomo M. Navigating the journey of Aboriginal childhood disability: a qualitative study of carers' interface with services. BMC Health Serv Res 2016; 16:680. [PMID: 27905923 PMCID: PMC5134075 DOI: 10.1186/s12913-016-1926-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Accepted: 11/25/2016] [Indexed: 12/31/2022] Open
Abstract
Background The disadvantage experienced by Aboriginal and Torres Strait Islander children with a disability is well recognized. The long term consequences of failing to address disability on health, education and employment underlies the importance of early intervention. Caregivers experience a disproportionate burden and have challenges accessing services. The aim of this study was to describe the carer journey of accessing support and services. Methods We conducted in-depth semi-structured interviews with nineteen parents and carers of Aboriginal children aged 0–8 years. The children were patients at a child developmental clinic at a metropolitan area Aboriginal health service in Eastern Australia. Interpretive phenomenological analysis was applied to transcribed verbatim accounts. Results Four themes were developed using the ‘journey’ metaphor to describe the carer pathway of accessing support and services at the community, service and policy levels. Themes included 1) the need for increased signage within communities via community education, information and awareness, 2) wrong way signs, roundabouts and roadblocks encountered when accessing services, 3) alternate routes can facilitate the journey, and 4) incompatibility of inflexible bureaucratic road rules and lived realities. Conclusions The challenges of caring for a child with a disability are indisputable and these can be compounded for people experiencing socio-economic disadvantage and marginalisation. Overcoming challenges to service access faced by carers of Aboriginal children with a disability will require investment in community, services and policy to tailor culturally appropriate models of care. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1926-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Green
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Penelope Abbott
- Western Sydney University, Locked Bag 1797, Penrith, NSW, 1797, Australia.
| | - Patricia Delaney
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Patrick Patradoon-Ho
- Western Sydney University, Blacktown Mt Druitt Hospital, Western Sydney Local Health District, Blacktown Road, Blacktown, NSW, 2148, Australia
| | - John Delaney
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Patricia Mary Davidson
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, Johns Hopkins University, School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Michelle DiGiacomo
- University of Technology Sydney, Center for Cardiovascular and Chronic Care, Faculty of Health, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
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Greenstein C, Lowell A, Thomas DP. Improving physiotherapy services to Indigenous children with physical disability: Are client perspectives missed in the continuous quality improvement approach? Aust J Rural Health 2015; 24:176-81. [PMID: 26692226 DOI: 10.1111/ajr.12258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2015] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To compare the outcomes of two cycles of continuous quality improvement (CQI) at a paediatric physiotherapy service with findings from interviews with clients and their carers using the service. DESIGN Case study based at one paediatric physiotherapy service SETTING Community-based paediatric allied health service in Northern Australia. PARTICIPANTS Forty-nine clinical records and four staff at physiotherapy service, five Indigenous children with physical disability aged 8-21 years, and nine carers of Indigenous children aged 0-21 years (current or previous clients). INTERVENTIONS The CQI process based on the Audit and Best Practice for Chronic Disease involved a clinical audit; a workshop where clinicians assessed their health care systems, identified weaknesses and strengths, and developed goals and strategies for improvement; and reassessment through a second audit and workshop. Twelve open-ended, in-depth interviews were conducted with previous or current clients selected through purposive and theoretical sampling. CQI and interview results were then compared. MAIN OUTCOME MEASURE Comparison of findings from the two studies RESULTS Both CQI and interview results highlighted service delivery flexibility and therapists' knowledge, support and advocacy as service strengths, and lack of resources and a child-friendly office environment as weaknesses. However, the CQI results reported better communication and client input into the service than the interview results. CONCLUSION The CQI process, while demonstrating improvements in clinical and organisational aspects of the service, did not always reflect or address the primary concerns of Indigenous clients and underlined the importance of including clients in the CQI process.
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Affiliation(s)
- Caroline Greenstein
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Anne Lowell
- Research Centre for Health and Wellbeing, Charles Darwin University, Darwin, Northern Territory, Australia
| | - David Piers Thomas
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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Green A, DiGiacomo M, Luckett T, Abbott P, Davidson PM, Delaney J, Delaney P. Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis. Int J Equity Health 2014; 13:126. [PMID: 25519053 PMCID: PMC4307173 DOI: 10.1186/s12939-014-0126-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 12/09/2014] [Indexed: 01/08/2023] Open
Abstract
Introduction Aboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice. Methods A systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework. Results Thirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level. Conclusions The policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local needs and sustainable.
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Affiliation(s)
- Anna Green
- Center for Cardiovascular and Chronic Care, Faculty of Health, University of Technology, Sydney, PO Box 123, Broadway, NSW, 2007, Australia.
| | - Michelle DiGiacomo
- Center for Cardiovascular and Chronic Care, Faculty of Health, University of Technology, Sydney, PO Box 123, Broadway, NSW, 2007, Australia.
| | - Tim Luckett
- Center for Cardiovascular and Chronic Care, Faculty of Health, University of Technology, Sydney, PO Box 123, Broadway, NSW, 2007, Australia.
| | - Penelope Abbott
- University of Western Sydney, Locked Bag 1797, Penrith, NSW, 1797, Australia.
| | - Patricia Mary Davidson
- School of Nursing, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Joanne Delaney
- Aboriginal Medical Service Western Sydney, PO Box 3160, Mt Druitt, NSW, 2770, Australia.
| | - Patricia Delaney
- Aboriginal Medical Service Western Sydney, PO Box 3160, Mt Druitt, NSW, 2770, Australia.
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Woolfenden S, Posada N, Krchnakova R, Crawford J, Gilbert J, Jursik B, Sarkozy V, Perkins D, Kemp L. Equitable access to developmental surveillance and early intervention--understanding the barriers for children from culturally and linguistically diverse (CALD) backgrounds. Health Expect 2014; 18:3286-301. [PMID: 25510182 DOI: 10.1111/hex.12318] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Children from culturally and linguistically diverse (CALD) backgrounds are at risk of having developmental problems go undetected prior to starting school, and missing out on early intervention. Our aim was to explore the family and service characteristics, beliefs and experiences that influence the journey of families from CALD backgrounds in accessing developmental surveillance (DS) and early intervention services in south-eastern Sydney, Australia. DESIGN, SETTING AND PARTICIPANTS This qualitative study used in-depth interviews conducted with 13 parents from CALD backgrounds and 27 health and early childhood professionals in Sydney. The Andersen Behavioural Model of Health Service Use (BM) was the underlying theoretical framework for thematic analysis. RESULTS AND DISCUSSION Family and service knowledge about early childhood development (ECD), community attitudes, social isolation and English language proficiency were dominant themes that impacted on the probability of families accessing services in the first place. Those that impeded or facilitated access were resources, extended family and social support, information availability, competing needs, complex service pathways and community engagement. There were variable practices of early detection through DS. Children from CALD backgrounds with developmental problems were perceived to miss out on DS and early intervention despite language delay being a key issue identified by participants. CONCLUSION This study highlights the importance of increased community and family awareness and professional training in ECD; better coordination of health and early childhood services, with simpler referral pathways to early intervention to prevent children from CALD backgrounds 'slipping through the net'.
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Affiliation(s)
| | | | | | | | - John Gilbert
- South East Neighbourhood Centre, Sydney, NSW, Australia
| | | | | | | | - Lynn Kemp
- School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia
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DiGiacomo M, Delaney P, Abbott P, Davidson PM, Delaney J, Vincent F. 'Doing the hard yards': carer and provider focus group perspectives of accessing Aboriginal childhood disability services. BMC Health Serv Res 2013; 13:326. [PMID: 23958272 PMCID: PMC3765087 DOI: 10.1186/1472-6963-13-326] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 08/15/2013] [Indexed: 11/10/2022] Open
Abstract
Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of considerations to address provision of disability services in an urban Australian Aboriginal community including building expertise and specialist capacity within Aboriginal Health Worker positions and services. Increasing awareness of services, facilitating linkages and referrals, eliminating complexities to accessing support, and working with families and Aboriginal community organisations within a framework of resilience and empowerment to ensure a relevant and acceptable model are necessary steps to improving support and care for Aboriginal children with a disability.
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Affiliation(s)
- Michelle DiGiacomo
- Centre for Cardiovascular and Chronic Care, Faculty of Health, University of Technology Sydney, Broadway, P,O, Box 123, Broadway, Australia 2007.
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Ziviani J, Darlington Y, Feeney R, Rodger S, Watter P. Early intervention services of children with physical disabilities: complexity of child and family needs. Aust Occup Ther J 2013; 61:67-75. [PMID: 24689917 DOI: 10.1111/1440-1630.12059] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND/AIM To gain insight into the special issues confronting parents when accessing early intervention for children with physical disabilities where child and/or family characteristics indicate complex needs within the unique Australian context. METHODS Qualitative interviews with families receiving early intervention for their children with physical disabilities (N=10). Families with complex circumstances such as having children with high support needs, those from culturally and linguistically diverse backgrounds, and single-parent families were recruited to the study. Families where parents had mental or health issues, parents/other family members had an identified disability, and/or where families lived in regional or rural locations were also purposively sampled. RESULTS Participants highlighted issues around (i) the nature of early intervention services provided; (ii) the ways in which services were structured; and (ii) managing their child's needs/planning into the future. Parents stressed the importance of having access to a variety of early intervention services aside from therapy. They also emphasised the need for greater clarity about what to expect from services, the intensity of therapy, other services they could access and how long they would be able to receive these. CONCLUSIONS Despite their complex circumstances and needs, participants' experiences of accessing early intervention services were largely consistent with the broader research literature. Of the parents interviewed, those with health problems and single mothers expressed most apprehension about managing their child's needs and planning for the future.
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Affiliation(s)
- Jenny Ziviani
- Children's Allied Health Research, Queensland Health, Brisbane, Queensland, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
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