1
|
Dudgeon Bardi P, Chang EP, Chan J, Mascall C, King Noongar G, Collova JR, Ryder Noongar A. Evaluation of the Cultural, Social and Emotional Wellbeing Program with Aboriginal women in the Boronia Pre-Release Centre for Women: a mixed methods study. Med J Aust 2024; 221:55-60. [PMID: 38946642 DOI: 10.5694/mja2.52354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 05/07/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE To assess the effectiveness of the Cultural, Social and Emotional Wellbeing Program for reducing psychological distress and enhancing the social and emotional wellbeing of Aboriginal women preparing for release from prison. STUDY DESIGN Mixed methods; qualitative study (adapted reflexive thematic analysis of stories of most significant change) and assessment of psychological distress. SETTING, PARTICIPANTS Aboriginal and Torres Strait Islander women at the Boronia Pre-release Centre for Women, Perth, Western Australia, May and July 2021. INTERVENTION Cultural, Social and Emotional Wellbeing Program (two days per week for six weeks). The Program involves presentations, workshops, activities, group discussions, and self-reflections designed to enhance social and emotional wellbeing. MAIN OUTCOME MEASURES Themes and subthemes identified from reflexive thematic analysis of participants' stories of most significant change; change in mean psychological distress, as assessed with the 5-item Kessler Scale (K-5) before and after the Program. RESULTS Fourteen of 16 invited women completed the Program; ten participated in its evaluation. They reported improved social and emotional wellbeing, reflected as enhanced connections to culture, family, and community. Mean psychological distress was lower after the Program (mean K-5 score, 11.3; 95% confidence interval [CI], 9.0-13.6) than before the Program (9.0; 95% CI, 6.5-11.5; P = 0.047). CONCLUSION The women who participated in the Program reported personal growth, including acceptance of self and acceptance and pride in culture, reflecting enhanced social and emotional wellbeing through connections to culture and kinship. Our preliminary findings suggest that the Program could improve the resilience of Aboriginal and Torres Strait Islander in contact with the justice system.
Collapse
Affiliation(s)
- Pat Dudgeon Bardi
- Poche Centre for Indigenous Health, the University of Western Australia, Perth, WA
- Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, the University of Western Australia, Perth, WA
| | - Ee Pin Chang
- Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, the University of Western Australia, Perth, WA
- Suicide Prevention Australia, Sydney, NSW
| | - Joan Chan
- Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, the University of Western Australia, Perth, WA
| | - Carolyn Mascall
- Aboriginal Services Relationships Australia Western Australia, Perth, WA
- Langford Aboriginal Association, Perth, WA
| | | | - Jemma R Collova
- Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, the University of Western Australia, Perth, WA
| | - Angela Ryder Noongar
- Aboriginal Services Relationships Australia Western Australia, Perth, WA
- Langford Aboriginal Association, Perth, WA
| |
Collapse
|
2
|
Chaturvedi S, Ullah S, Hughes Wagadagam JT. Kidney transplantation access and outcomes for Aboriginal and Torres Strait Islander children and young adults, 1963-2020: an ANZDATA registry study. Med J Aust 2024; 221:47-54. [PMID: 38946656 DOI: 10.5694/mja2.52355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/08/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVES To assess differences between Aboriginal and Torres Strait Islander and non-Indigenous Australian children and young adults in access to and outcomes of kidney transplantation. STUDY DESIGN A cohort study based on prospectively collected data; analysis of Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) data. SETTING, PARTICIPANTS Children and young adults aged 0-24 years who commenced kidney replacement therapy in Australia during 1963-2020. MAIN OUTCOME MEASURES Proportions of children and young adults who received kidney transplants within five years of commencing dialysis; 5- and 10-year death-censored graft survival; and 5- and 10-year survival of children and young adults who received kidney transplants or who remained on dialysis. RESULTS During 1963-2020, 3736 children and young adults received kidney replacement therapy in Australia: 213 (5.8%) Aboriginal and Torres Strait Islander and 3523 (94.2%) non-Indigenous children and young adults. During follow-up (median, eight years; interquartile range [IQR], 2.6-15 years), 2762 children and young adults received kidney transplants: 93 Aboriginal and Torres Strait Islander (43.7% of those receiving kidney replacement therapy) and 2669 non-Indigenous children and young adults (75.8%). Smaller proportions of Aboriginal and Torres Strait Islander than of non-Indigenous children and young adults received transplants within five years of commencing dialysis (99, 46% v 2924, 83.0%), received living donor transplants (19, 20% v 1170, 43.9%), or underwent pre-emptive transplantation (one, 1.1% v 363, 13.6%). Five-year graft survival for Aboriginal and Torres Strait Islander recipients was similar to non-Indigenous recipients (61% v 75%; adjusted hazard ratio [aHR], 1.43; 95% confidence interval [CI], 0.02-2.05), but 10-year graft survival was lower (35% v 61%; aHR, 1.69; 95% CI, 1.25-2.28). Five- and 10-year survival after kidney transplantation was similar for Aboriginal and Torres Strait Islander and non-Indigenous people. Among those who remained on dialysis, 10-year survival was poorer for Aboriginal and Torres Strait Islander than non-Indigenous children and young adults (aHR, 1.50; 95% CI, 1.08-2.10). CONCLUSIONS Five-year graft and recipient survival were excellent for Aboriginal and Torres Strait Islander children and young adults who received kidney transplants; however, a lower proportion received transplants within five years of dialysis initiation, than non-Indigenous children and young adults. Improving transplant access within five years of dialysis commencement should be a priority.
Collapse
Affiliation(s)
- Swasti Chaturvedi
- Sydney Children's Hospital, Sydney, NSW
- College of Medicine and Public Health, Flinders University, Adelaide, SA
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Adelaide, SA
| | - Jaquelyne T Hughes Wagadagam
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Darwin, NT
- Royal Darwin Hospital, Darwin, NT
| |
Collapse
|
3
|
Harfield S, Elliott S, Barzi F, Minto K, Dean JA, Ward J. Sexual risk and testing for sexually transmissible infections in Aboriginal and Torres Strait Islander peoples and non-Indigenous young South Australians: results of an online survey. Sex Health 2024; 21:SH24041. [PMID: 38950143 DOI: 10.1071/sh24041] [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: 02/23/2024] [Accepted: 06/13/2024] [Indexed: 07/03/2024]
Abstract
Background Disproportionate rates of sexually transmissible infections (STIs) among Aboriginal and Torres Strait Islander young people are often attributed to risk-taking behaviours, but research rarely conducts direct comparison with their non-Indigenous peers to address this negative discourse. Methods 'Let's Talk About It 2019' was a cross-sectional online survey of South Australians (16-29 years). It prioritised recruitment of Aboriginal and Torres Strait Islander respondents to compare behaviours with non-Indigenous peers using multivariable Poisson regression models. Results Aboriginal and Torres Strait Islander (n =231) and non-Indigenous (n =2062) respondents reported similar condom use (40% vs 43%, P =0.477) and sexual debut median ages (16 years vs 17 years). Higher proportions of Aboriginal and/or Torres Strait Islander respondents reported a recent health check (48% vs 38%, P =0.002), STIs (60% vs 49%, P P =0.006) testing, STI diagnosis (29% vs 21%, P =0.042), and intoxication during last sex (30% vs 18%, P Conclusions Behaviours associated with STI transmission were mostly similar among Aboriginal and Torres Strait Islander and non-Indigenous respondents. Higher STI/HIV testing among Aboriginal and Torres Strait Islander respondents suggests effectiveness of targeted programs. Interventions targeting substance use and condom use among all young people are needed. Future interventions need to focus beyond behaviours and explore social determinants of health and sexual networks as contributors to disproportionate STI rates.
Collapse
Affiliation(s)
- Stephen Harfield
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia; and School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Salenna Elliott
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Federica Barzi
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Kiara Minto
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Judith A Dean
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia; and School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia
| | - James Ward
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
| |
Collapse
|
4
|
Kennedy Wiradjuri M, Ninomiya MM, Ninomiya MM, Brascoupé Anishinabeg/Haudenausanee S, Smylie Mѐtis J, Calma Kungarakan Iwaidja T, Mohamed Narrunga Kaurna J, Stewart Taungurung PJ, Maddox Bagumani Modewa R. Knowledge translation in Indigenous health research: voices from the field. Med J Aust 2024; 221:61-67. [PMID: 38946651 DOI: 10.5694/mja2.52357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 05/07/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVES To better understand what knowledge translation activities are effective and meaningful to Indigenous communities and what is required to advance knowledge translation in health research with, for, and by Indigenous communities. STUDY DESIGN Workshop and collaborative yarning. SETTING Lowitja Institute International Indigenous Health Conference, Cairns, June 2023. PARTICIPANTS About 70 conference delegates, predominantly Indigenous people involved in research and Indigenous health researchers who shared their knowledge, experiences, and recommendations for knowledge translation through yarning and knowledge sharing. RESULTS Four key themes were developed using thematic analysis: knowledge translation is fundamental to research and upholding community rights; knowledge translation approaches must be relevant to local community needs and ways of mobilising knowledge; researchers and research institutions must be accountable for ensuring knowledge translation is embedded, respected and implemented in ways that address community priorities; and knowledge translation must be planned and evaluated in ways that reflect Indigenous community measures of success. CONCLUSION Knowledge translation is fundamental to making research matter, and critical to ethical research. It must be embedded in all stages of research practice. Effective knowledge translation approaches are Indigenous-led and move beyond Euro-Western academic metrics. Institutions, funding bodies, and academics should embed structures required to uphold Indigenous knowledge translation. We join calls for reimaging health and medical research to embed Indigenous knowledge translation as a prerequisite for generative knowledge production that makes research matter.
Collapse
|
5
|
Dos Santos Gumbaynggirr Kwiamble A, Cheong E, Balabanski AH, Goldsmith K, Burchill Yorta Yorta Dja Dja Wurrung L, Burrow J, Brady S, Alam F, Parsons M, Katzenellenbogen JM, Thrift AG, Kleinig TJ, Brown Wadi Wadi A. First stroke incidence, causes, treatments, and outcomes for Aboriginal Peoples in South Australia and the Northern Territory: a pilot prospective study. Med J Aust 2024; 221:39-46. [PMID: 38946653 DOI: 10.5694/mja2.52356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/07/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE We performed a pilot stroke incidence study, focused on feasibility and inclusion of the CONSIDER reporting guidelines, to model the design of a future population-based study aiming to definitively determine stroke incidence, antecedents, treatment, and outcomes. STUDY DESIGN Prospective stroke incidence study (pilot study). SETTING, PARTICIPANTS All people aged 15 years or older who lived in postcode-defined areas of South Australia and Northern Territory (885 472 people, including 45 127 Aboriginal people [5.1%]) diagnosed with stroke for the first time during 1 October - 31 December 2015 and admitted to public hospitals or stroke and transient ischaemic attack clinics. MAIN OUTCOME MEASURES Feasibility of a prospective population-based stroke incidence study. RESULTS Of the 123 participants with first strokes, ten were Aboriginal (8%); the median age of Aboriginal people was 45 years (interquartile range [IQR], 33-55 years), of non-Indigenous people 73 years (IQR, 62-84 years). For Aboriginal people, the age-standardised incidence of stroke was 104 (95% confidence interval [CI], 84-124) per 100 000 person-years, for non-Indigenous people 33 (95% CI, 22-44) per 100 000 person-years. We found that a prospective population-based stroke incidence study in Aboriginal people was feasible, including with respect to establishing an adequate sample size, diagnostic confirmation, identification of incident stroke, confirming stroke subtypes, establishing a stable statistical population, standardising data reporting for comparison with other stroke incidence studies, and ethical research reporting that conforms to CONSIDER guidelines. CONCLUSIONS A larger, population-based study of the incidence of stroke in Aboriginal people is both feasible and needed to provide robust estimates of stroke incidence, antecedents, treatments and outcomes to help guide strategies for reducing the risk of and outcomes of stroke in Aboriginal people.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Ferdous Alam
- Whyalla Hospital and Health Services, Whyalla, SA
| | - Mark Parsons
- University of New South Wales, Sydney, NSW
- Liverpool Hospital, Sydney, NSW
| | | | | | - Timothy J Kleinig
- Royal Adelaide Hospital, Adelaide, SA
- The University of Adelaide, Adelaide, SA
| | - Alex Brown Wadi Wadi
- National Centre for Indigenous Genomics, Australian National University, Canberra, ACT
| |
Collapse
|
6
|
Saunders P. Fulfilling cultural safety expectations in specialist medical education and training: considerations for colleges to advance recognition and quality. Med J Aust 2024; 221:8-12. [PMID: 38946654 DOI: 10.5694/mja2.52317] [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: 10/19/2023] [Accepted: 04/18/2024] [Indexed: 07/02/2024]
|
7
|
Pearson Eastern Kuku-Yalanji And Torres Strait Islander O, Air T, Humphrey G, Bradley C, Tunny N, Brown Yuin Nation A, Wesselingh SL, Inacio MC, Caughey GE. Aged care service use by Aboriginal and Torres Strait Islander people after aged care eligibility assessments, 2017-2019: a population-based retrospective cohort study. Med J Aust 2024; 221:31-38. [PMID: 38946633 DOI: 10.5694/mja2.52353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 05/01/2024] [Indexed: 07/02/2024]
Abstract
OBJECTIVE To characterise the socio-demographic characteristics, aged and health care needs, and aged care services used by older Aboriginal and Torres Strait Islander people assessed for aged care service eligibility. STUDY DESIGN Population-based retrospective cohort study; analysis of Registry of Senior Australians (ROSA) National Historical Cohort data. SETTING, PARTICIPANTS Aboriginal and Torres Strait Islander people aged 50 years or older who were first assessed for aged care service eligibility (permanent residential aged care, home care package, respite care, or transition care) during 1 January 2017 - 31 December 2019. MAJOR OUTCOME MEASURES Socio-demographic and aged care assessment characteristics; health conditions and functional limitations recorded at the time of the assessment; subsequent aged care service use. RESULTS The median age of the 6209 people assessed for aged care service eligibility was 67 years (interquartile range [IQR], 60-75 years), 3626 were women (58.4%), and 4043 lived in regional to very remote areas of Australia (65.1%). Aboriginal health workers were involved in 655 eligibility assessments (10.5%). The median number of health conditions was six (IQR, 4-8); 6013 (96.9%) had two or more health conditions, and 2592 (41.8%) had seven or more. Comorbidity was most frequent among people with mental health conditions: 597 of 1136 people with anxiety (52.5%) and 1170 of 2416 people with depression (48.5%) had seven or more other medical conditions. Geriatric syndromes were recorded for 2265 people (36.5%); assistance with at least one functional activity was required by 6190 people (99.7%). A total of 6114 people (98.5%) were approved for at least one aged care service, 3218 of whom (52.6%) subsequently used these services; the first services used were most frequently home care packages (1660 people, 51.6%). CONCLUSION Despite the high care needs of older Aboriginal and Torres Strait Islander people, only 52% used aged care services for which they were eligible. It is likely that the health and aged care needs of older Aboriginal and Torres Strait Islander people are not being adequately met.
Collapse
Affiliation(s)
| | - Tracy Air
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA
| | - Greer Humphrey
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA
| | - Clare Bradley
- UQ Poche Centre for Indigenous Health, University of Queensland, Brisbane, QLD
| | - Noeleen Tunny
- SNAICC: National Voice for our Children, Victoria, Melbourne, VIC
| | | | - Steven L Wesselingh
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA
| | - Maria C Inacio
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA
| | - Gillian E Caughey
- Adelaide Medical School, the University of Adelaide, Adelaide, SA
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, SA
| |
Collapse
|
8
|
Llaneza AJ, Holt A, Seward J, Piatt J, Campbell JE. Assessment of Racial Misclassification Among American Indian and Alaska Native Identity in Cancer Surveillance Data in the United States and Considerations for Oral Health: A Systematic Review. Health Equity 2024; 8:376-390. [PMID: 39011076 PMCID: PMC11249132 DOI: 10.1089/heq.2023.0252] [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] [Accepted: 04/10/2024] [Indexed: 07/17/2024] Open
Abstract
Introduction Misclassification of American Indian and Alaska Native (AI/AN) peoples exists across various databases in research and clinical practice. Oral health is associated with cancer incidence and survival; however, misclassification adds another layer of complexity to understanding the impact of poor oral health. The objective of this literature review was to systematically evaluate and analyze publications focused on racial misclassification of AI/AN racial identities among cancer surveillance data. Methods The PRISMA Statement and the CONSIDER Statement were used for this systematic literature review. Studies involving the racial misclassification of AI/AN identity among cancer surveillance data were screened for eligibility. Data were analyzed in terms of the discussion of racial misclassification, methods to reduce this error, and the reporting of research involving Indigenous peoples. Results A total of 66 articles were included with publication years ranging from 1972 to 2022. A total of 55 (83%) of the 66 articles discussed racial misclassification. The most common method of addressing racial misclassification among these articles was linkage with the Indian Health Service or tribal clinic records (45 articles or 82%). The average number of CONSIDER checklist domains was three, with a range of zero to eight domains included. The domain most often identified was Prioritization (60), followed by Governance (47), Methodologies (31), Dissemination (27), Relationships (22), Participation (9), Capacity (9), and Analysis and Findings (8). Conclusion To ensure equitable representation of AI/AN communities, and thwart further oppression of minorities, specifically AI/AN peoples, is through accurate data collection and reporting processes.
Collapse
Affiliation(s)
- Amanda J Llaneza
- Southern Plains Tribal Health Board, Oklahoma City, Oklahoma, USA
| | - Alex Holt
- Southern Plains Tribal Health Board, Oklahoma City, Oklahoma, USA
| | - Julie Seward
- Southern Plains Tribal Health Board, Oklahoma City, Oklahoma, USA
| | - Jamie Piatt
- Southern Plains Tribal Health Board, Oklahoma City, Oklahoma, USA
| | - Janis E Campbell
- Department of Biostatistics & Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| |
Collapse
|
9
|
Pickering JW, Devlin G, Body R, Aldous S, Jaffe AS, Apple FS, Mills N, Troughton RW, Kavsak P, Peacock WF, Cullen L, Lord SJ, Müller C, Joyce L, Frampton C, Lacey CJ, Richards AM, Pitama S, Than M. Protocol for Improving Care by FAster risk-STratification through use of high sensitivity point-of-care troponin in patients presenting with possible acute coronary syndrome in the EmeRgency department (ICare-FASTER): a stepped-wedge cluster randomised quality improvement initiative. BMJ Open 2024; 14:e083752. [PMID: 38871661 DOI: 10.1136/bmjopen-2023-083752] [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: 06/15/2024] Open
Abstract
INTRODUCTION Clinical assessment in emergency departments (EDs) for possible acute myocardial infarction (AMI) requires at least one cardiac troponin (cTn) blood test. The turn-around time from blood draw to posting results in the clinical portal for central laboratory analysers is ~1-2 hours. New generation, high-sensitivity, point-of-care cardiac troponin I (POC-cTnI) assays use whole blood on a bedside (or near bedside) analyser that provides a rapid (8 min) result. This may expedite clinical decision-making and reduce length of stay. Our purpose is to determine if utilisation of a POC-cTnI testing reduces ED length of stay. We also aim to establish an optimised implementation process for the amended clinical pathway. METHODS AND ANALYSIS This quality improvement initiative has a pragmatic multihospital stepped-wedge cross-sectional cluster randomised design. Consecutive patients presenting to the ED with symptoms suggestive of possible AMI and having a cTn test will be included. Clusters (comprising one or two hospitals each) will change from their usual-care pathway to an amended pathway using POC-cTnI-the 'intervention'. The dates of change will be randomised. Changes occur at 1 month intervals, with a minimum 2 month 'run-in' period. The intervention pathway will use a POC-cTnI measurement as an alternate to the laboratory-based cTn measurement. Clinical decision-making steps and logic will otherwise remain unchanged. The POC-cTnI is the Siemens (Erlangen Germany) Atellica VTLi high-sensitivity cTnI assay. The primary outcome is ED length of stay. The safety outcome is cardiac death or AMI within 30 days for patients discharged directly from the ED. ETHICS AND DISSEMINATION Ethics approval has been granted by the New Zealand Southern Health and Disability Ethics Committee, reference 21/STH/9. Results will be published in a peer-reviewed journal. Lay and academic presentations will be made. Māori-specific results will be disseminated to Māori stakeholders. TRIAL REGISTRATION NUMBER ACTRN12619001189112.
Collapse
Affiliation(s)
- John W Pickering
- Medicine, University of Otago Christchurch, Christchurch, New Zealand
- Emergency, Christchurch Hospital, Christchurch, New Zealand
| | - Gerard Devlin
- Waikato District Health Board, Hamilton, New Zealand
- Heart Foundation of New Zealand, Auckland, New Zealand
| | - Richard Body
- Division of Cardiovascular Sciences, University of Manchester, The Victoria University of Manchester Campus, Manchester, UK
| | - Sally Aldous
- Cardiology, Christchurch Hospital, Christchurch, New Zealand
| | | | - Fred S Apple
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Nicholas Mills
- The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, UK
| | - Richard W Troughton
- Medicine, University of Otago Christchurch, Christchurch, New Zealand
- Cardiology, Christchurch Hospital, Christchurch, New Zealand
| | | | - W Frank Peacock
- Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Louise Cullen
- Institute of Health and Biomedical Innovation and School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Emergency and Trauma Centre, Royal Brisbane and Woman's Hospital Health Service District, Herston, Queensland, Australia
| | - Sarah J Lord
- The School of Medicine, University of Notre Dame Australia - Darlinghurst Campus, Darlinghurst, New South Wales, Australia
- NHMRC Clinical Trials Centre, Camperdown, New South Wales, Australia
| | - Christian Müller
- Division of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Laura Joyce
- Emergency, Christchurch Hospital, Christchurch, New Zealand
- Surgery and Critical Care, University of Otago Christchurch, Christchurch, New Zealand
| | - Chris Frampton
- Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Cameron James Lacey
- Māori Indigenous Health Institute, University of Otago Christchurch, Christchurch, New Zealand
| | - Arthur M Richards
- Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Suzanne Pitama
- Māori Indigenous Health Institute, University of Otago Christchurch, Christchurch, New Zealand
| | - Martin Than
- Medicine, University of Otago Christchurch, Christchurch, New Zealand
- Emergency, Christchurch Hospital, Christchurch, New Zealand
| |
Collapse
|
10
|
Binks P, Venkatesan S, Everitt A, Gurruwiwi GG, Dhurrkay RG, Bukulatjpi SM, Ross C, Alley T, Hosking K, Vintour-Cesar E, McKinnon M, Sullivan RP, Davis JS, Hefler M, Davies J. An evaluation and refinement of the "Hep B Story" app, tailored to meet the community's cultural needs. BMC Health Serv Res 2024; 24:710. [PMID: 38849881 PMCID: PMC11162029 DOI: 10.1186/s12913-024-11149-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/27/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Hepatitis B is endemic amongst the Australian Aboriginal population in the Northern Territory. A participatory action research project identified the lack of culturally appropriate education tools and led to the development of the "Hep B Story" app in the Aboriginal language Yolŋu Matha. This paper describes a formal evaluation of the app's first version, which informed improvements and translation into a further ten Aboriginal languages. METHODS The evaluation employed Participatory Action Research (PAR) principles to work within Indigenous research methodologies and prioritise Indigenous knowledge to improve the app iteratively. Semi-structured interviews and focus groups were conducted across the Northern Territory with 11 different language groups. Local Community Based Researchers and Aboriginal Research team members coordinated sessions. The recorded, translated conversations were transcribed verbatim and thematically analysed using an inductive and deductive approach. RESULTS Between November 2018 and September 2020, 94 individuals from 11 language groups participated in 25 semi-structured interviews and 10 focus groups. All participants identified as Aboriginal. Most participants felt the app would be culturally appropriate for Aboriginal communities in the Northern Territory and improve knowledge surrounding hepatitis B. The information gathered from these interviews allowed for identifying five main themes: support for app, relationships, concept versus language, shame, and perceptions of images, along with errors that required modification. CONCLUSIONS A "real-life" evaluation of the app was comprehensively completed using a PAR approach blended with Indigenous research methods. This evaluation allowed us to develop an updated and enhanced version of the app before creating the additional ten language versions. An iterative approach alongside strong community engagement was pivotal in ensuring the app's cultural safety and appropriateness. We recommend avoiding the use of knowledge-based evaluations in an Aboriginal setting to ensure relevant and culturally appropriate feedback is obtained.
Collapse
Affiliation(s)
- Paula Binks
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
| | - Sudharsan Venkatesan
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospitals, Northern Territory Health, Darwin, NT, Australia
| | - Anngie Everitt
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - George Garambaka Gurruwiwi
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Roslyn Gundjirryirr Dhurrkay
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Sarah Mariyalawuy Bukulatjpi
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Miwatj Health Aboriginal Corporation, Nhulunbuy, East Arnhem Land, NT, Australia
| | - Cheryl Ross
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Tiana Alley
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Kelly Hosking
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Darwin, NT, Australia
| | - Emily Vintour-Cesar
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Melita McKinnon
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Richard P Sullivan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Department of Infectious Diseases and Immunology, School of Clinical Medicine, St George and Sutherland Hospital, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Joshua S Davis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Marita Hefler
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Jane Davies
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospitals, Northern Territory Health, Darwin, NT, Australia
| |
Collapse
|
11
|
Brewer KM, Taueetia-Su'a T, Hanchard S, Vaka S, Ameratunga S, Tane T, Newport R, Selak V, Grey C, Harwood M. Māori and Pacific families' experiences and perspectives of cardiovascular care; A qualitative study. Aust N Z J Public Health 2024; 48:100149. [PMID: 38733861 DOI: 10.1016/j.anzjph.2024.100149] [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: 09/19/2023] [Revised: 02/18/2024] [Accepted: 04/02/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVE This study aimed to understand the reasons behind evidence-practice gaps and inequities in cardiovascular care for Māori and Pacific people, as evidenced by the experiences and perspectives of patients and their families. METHODS The research was guided by Māori and Pacific worldviews, incorporating Kaupapa Māori Theory and Pacific conceptual frameworks and research methodologies. Template analysis was used to analyse interview data from 61 Māori and Pacific people who had experienced a cardiovascular disease (CVD) risk assessment, acute coronary syndrome, and/or heart failure. RESULTS The range of experiences relating to participants' heart health journeys are presented in five main themes: Context, Mana (maintaining control and dignity), Condition, People and Journey. CONCLUSIONS Māori and Pacific people want to take charge of their heart health but face challenges. Participants described important obligations to family, community and tikanga (the culturally correct way of doing things). Participants described times when health care undermined existing responsibilities, their dignity and/or their mana, and they felt excluded from treatment as a result. IMPLICATIONS FOR PUBLIC HEALTH Good reciprocal communication, stemming from a high-quality relationship is essential for successful outcomes. A workforce that is representative of the population it serves and is culturally safe lays the foundation for excellence in care.
Collapse
Affiliation(s)
- Karen Marie Brewer
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
| | - Tua Taueetia-Su'a
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Sandra Hanchard
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Sione Vaka
- The University of Waikato Te Huataki Waiora School of Health Dean's Office, Hamilton, New Zealand
| | - Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; Te Whatu Ora | Health New Zealand - Counties Manukau, Auckland, New Zealand
| | - Taria Tane
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Rochelle Newport
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Vanessa Selak
- Section of Epidemiology and Biostatistics, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Corina Grey
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Matire Harwood
- Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
12
|
Ball N, Wyber R, Cornforth F. Descriptive epidemiology must not perpetuate deficit discourse and mask systemic racism. Intern Med J 2024; 54:1044-1045. [PMID: 38881455 DOI: 10.1111/imj.16410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/03/2024] [Indexed: 06/18/2024]
Affiliation(s)
- Nicola Ball
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rosemary Wyber
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
- Telethon Kids Institute, Perth, Western Australia, Australia
| | - Fiona Cornforth
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
13
|
Fisher C, Bird P, McCombie A, Huria T, Love R. Review of Māori equity in surgical trainee selection. ANZ J Surg 2024; 94:1039-1044. [PMID: 38366700 DOI: 10.1111/ans.18909] [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: 05/16/2023] [Revised: 01/24/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
BACKGROUND The Royal Australasian College of Surgeons (RACS) aims to achieve Māori health equity and cultural safety within the surgical workforce. The RACS Māori Health Strategy and Action Plans encourage Surgical Education and Training (SET) selection criteria that recognizes and credit applicants who identify as Māori or demonstrate competence in Māori health issues. This study investigates the current SET selection criteria for Māori entering surgical specialties. METHODS The selection criteria for each surgical speciality for the proposed 2024 intake were examined through a documentary analysis. Criteria were reviewed for applicability to Māori identification and/or cultural competency. RESULTS Criteria related to Māori identification and/or cultural competency make up 6%, 2%, and 1.5% of Otolaryngology and Head and Neck, General, and Vascular Surgery total SET selection score respectively. Criteria related to Māori identification and/or cultural competency make up 9% and 0.1% of Orthopaedic and Plastics and Reconstructive Surgery ranking scores for interview eligibility respectively. Cardiothoracic Surgery, Paediatric Surgery, Neurosurgery and Urology specialties do not incorporate any criteria appertaining to Māori. Allocation of research-related points determined by authorship may disincentivize Māori trainees. CONCLUSIONS Some surgical specialties fail to recognize or credit Māori identification and cultural competency in SET selection criteria. There is a need for regular auditing to ensure SET criteria align with the RACS aspirations for Māori health equity and cultural safety within the surgical workforce.
Collapse
Affiliation(s)
- Calum Fisher
- Department of Surgery, University of Otago, Christchurch, New Zealand
| | - Philip Bird
- Department of Surgery, University of Otago, Christchurch, New Zealand
- Department of Otolaryngology, Te Whatu Ora - Waitaha Canterbury, Christchurch, New Zealand
| | - Andrew McCombie
- Department of Surgery, Te Whatu Ora Waitaha, Christchurch, New Zealand
| | - Tania Huria
- Māori Indigenous Health Institute (MIHI), University of Otago, Christchurch, New Zealand
| | - Rachelle Love
- Department of Otolaryngology, Te Whatu Ora - Waitaha Canterbury, Christchurch, New Zealand
| |
Collapse
|
14
|
Chew M, Samuel D, Mullan Z, Kleinert S. The Lancet Group's new guidance to authors on reporting race and ethnicity. Lancet 2024; 403:2360-2361. [PMID: 38823979 DOI: 10.1016/s0140-6736(24)01081-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 05/22/2024] [Indexed: 06/03/2024]
Affiliation(s)
- Mabel Chew
- The Lancet, Sydney, NSW 2067, Australia.
| | | | | | | |
Collapse
|
15
|
Scholes-Robertson N, Guha C, Gutman T, Howell M, Yip A, Cashmore B, Roberts I, Lopez-Vargas P, Wong G, MacGinley R, Synnot A, Craig JC, Jauré A, Krishnasamy R, Tunnicliffe DJ. Consumer involvement in the development and dissemination of chronic kidney disease guidelines: a summary of a meaningful and sustainable approach developed by Caring for Australians and New ZealandeRs with kidney Impairment guidelines. J Clin Epidemiol 2024; 170:111330. [PMID: 38537911 DOI: 10.1016/j.jclinepi.2024.111330] [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: 09/22/2023] [Revised: 03/10/2024] [Accepted: 03/18/2024] [Indexed: 04/19/2024]
Abstract
OBJECTIVES The involvement of consumers (people with lived experience of disease) in guidelines is widely advocated to improve their relevance and uptake. However, the approaches to consumer involvement in guidelines vary and are not well documented. We describe the consumer involvement framework of Caring for Australians and New ZealandeRs with kidney Impairment Guidelines. STUDY DESIGN AND SETTING We used a descriptive document analysis to collate all relevant policies, documents, e-mails, and presentations on consumer involvement in our organizations. We performed a narrative synthesis of collated data to summarize our evolving consumer involvement approach in guidelines. RESULTS We involve consumers at all levels of Caring for Australians and New ZealandeRs with kidney Impairment guideline development and dissemination according to their capacity, from conducting consumer workshops to inform the scope of guidelines, to including consumers as members of the guideline Working Groups and overseeing operations and governance as members of the Steering Committee and staff. Our approach has resulted in tangible outcomes including high-priority topics on patient education, psychosocial care, and clinical care pathways, and focusing the literature reviews to assess patient-important outcomes. The ongoing partnership with consumers led to the generation of consumer version guidelines to improve guideline dissemination and translation to support shared decision-making. CONCLUSION Meaningful consumer involvement can be achieved through a comprehensive approach across the entire lifecycle of guidelines. However, it must be individualized by ensuring that the involvement of consumers is timely and flexible. Future work is needed to assess the impact of consumer involvement in guideline development.
Collapse
Affiliation(s)
- Nicole Scholes-Robertson
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Chandana Guha
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Talia Gutman
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Adela Yip
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Brydee Cashmore
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Ieyesha Roberts
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Pamela Lopez-Vargas
- Child Protection Unit, The Sydney Children's Hospital Network, Sydney, New South Wales, Australia
| | - Germaine Wong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Robert MacGinley
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Anneliese Synnot
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Centre for Health Communication and Participation, Department of Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Allison Jauré
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Rathika Krishnasamy
- Centre for Kidney Disease Research, The University of Queensland, Brisbane, Australia; Department of Nephrology, Sunshine Coast University Hospital, Birtinya, Australia
| | - David J Tunnicliffe
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
| |
Collapse
|
16
|
Hikaka J, McCreedy EM, Jutkowitz E, McCarthy EP, Baier RR. Modifications of the readiness assessment for pragmatic trials tool for appropriate use with Indigenous populations. BMC Med Res Methodol 2024; 24:121. [PMID: 38822242 PMCID: PMC11140978 DOI: 10.1186/s12874-024-02244-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Inequities in health access and outcomes exist between Indigenous and non-Indigenous populations. Embedded pragmatic randomized, controlled trials (ePCTs) can test the real-world effectiveness of health care interventions. Assessing readiness for ePCT, with tools such as the Readiness Assessment for Pragmatic Trials (RAPT) model, is an important component. Although equity must be explicitly incorporated in the design, testing, and widespread implementation of any health care intervention to achieve equity, RAPT does not explicitly consider equity. This study aimed to identify adaptions necessary for the application of the 'Readiness Assessment for Pragmatic Trials' (RAPT) tool in embedded pragmatic randomized, controlled trials (ePCTs) with Indigenous communities. METHODS We surveyed and interviewed participants (researchers with experience in research involving Indigenous communities) over three phases (July-December 2022) in this mixed-methods study to explore the appropriateness and recommended adaptions of current RAPT domains and to identify new domains that would be appropriate to include. We thematically analyzed responses and used an iterative process to modify RAPT. RESULTS The 21 participants identified that RAPT needed to be modified to strengthen readiness assessment in Indigenous research. In addition, five new domains were proposed to support Indigenous communities' power within the research processes: Indigenous Data Sovereignty; Acceptability - Indigenous Communities; Risk of Research; Research Team Experience; Established Partnership). We propose a modified tool, RAPT-Indigenous (RAPT-I) for use in research with Indigenous communities to increase the robustness and cultural appropriateness of readiness assessment for ePCT. In addition to producing a tool for use, it outlines a methodological approach to adopting research tools for use in and with Indigenous communities by drawing on the experience of researchers who are part of, and/or working with, Indigenous communities to undertake interventional research, as well as those with expertise in health equity, implementation science, and public health. CONCLUSION RAPT-I has the potential to provide a useful framework for readiness assessment prior to ePCT in Indigenous communities. RAPT-I also has potential use by bodies charged with critically reviewing proposed pragmatic research including funding and ethics review boards.
Collapse
Affiliation(s)
- Joanna Hikaka
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.
| | - Ellen M McCreedy
- Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI, USA
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA
| | - Eric Jutkowitz
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA
- Providence Veterans Affairs Medical Center, Providence VA, RI, USA
| | - Ellen P McCarthy
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Rosa R Baier
- Center for Long-Term Care Quality & Innovation, Brown University School of Public Health, Providence, RI, USA
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
17
|
Lin J, Selkirk EK, Siqueira I, Beaucage M, Carriere C, Dart A, De Angelis M, Erickson RL, Ghent E, Goldberg A, Hartell D, Henderson R, Matsuda-Abedini M, McKay A, Prestidge C, Toulouse C, Urschel S, Weiss MJ, Anthony SJ. Access to and Health Outcomes of Pediatric Solid Organ Transplantation for Indigenous Children in 4 Settler-colonial Countries: A Scoping Review. Transplantation 2024:00007890-990000000-00777. [PMID: 38776228 DOI: 10.1097/tp.0000000000005071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
Solid organ transplantation (SOT) is considered the optimal treatment for children with end-stage organ failure; however, increased efforts are needed to understand the gap surrounding equitable access to and health outcomes of SOT for Indigenous children. This scoping review summarizes the literature on the characteristics of access to and health outcomes of pediatric SOT among Indigenous children in the settler-colonial states of Canada, Aotearoa New Zealand, Australia, and the United States. A search was performed on MEDLINE, EMBASE, PsycINFO, and CINAHL for studies matching preestablished eligibility criteria from inception to November 2021. A preliminary gray literature search was also conducted. Twenty-four studies published between 1996 and 2021 were included. Studies addressed Indigenous pediatric populations within the United States (n = 7), Canada (n = 6), Aotearoa New Zealand (n = 5), Australia (n = 5), and Aotearoa New Zealand and Australia combined (n = 1). Findings showed that Indigenous children experienced longer time on dialysis, lower rates of preemptive and living donor kidney transplantation, and disparities in patient and graft outcomes after kidney transplantation. There were mixed findings about access to liver transplantation for Indigenous children and comparable findings for graft and patient outcomes after liver transplantation. Social determinants of health, such as geographic remoteness, lack of living donors, and traditional spiritual beliefs, may affect SOT access and outcomes for Indigenous children. Evidence gaps emphasize the need for action-based initiatives within SOT that prioritize research with and for Indigenous pediatric populations. Future research should include community-engaged methodologies, situated within local community contexts, to inform culturally safe care for Indigenous children.
Collapse
Affiliation(s)
- Jia Lin
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
| | - Enid K Selkirk
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
| | - Izabelle Siqueira
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
| | - Mary Beaucage
- Patient, Family and Donor Partnership Platform, Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada
- Indigenous Peoples' Engagement and Research Council, Can-SOLVE CKD Network, Vancouver, BC, Canada
| | - Carmen Carriere
- Patient, Family and Donor Partnership Platform, Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada
| | - Allison Dart
- Section of Pediatric Nephrology, Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Maria De Angelis
- Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | - Robin L Erickson
- Paediatric Kidney Service, Starship Children's Hospital, Auckland, New Zealand
| | - Emily Ghent
- Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Social Work, The Hospital for Sick Children, Toronto, ON, Canada
| | - Aviva Goldberg
- Section of Pediatric Nephrology, Department of Pediatrics and Child Health, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Randi Henderson
- Patient, Family and Donor Partnership Platform, Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada
| | - Mina Matsuda-Abedini
- Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Division of Nephrology, BC Children's Hospital, Vancouver, BC, Canada
| | - Ashlene McKay
- Division of Nephrology, Department of Paediatrics, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Chanel Prestidge
- Paediatric Kidney Service, Starship Children's Hospital, Auckland, New Zealand
| | - Crystal Toulouse
- Patient, Family and Donor Partnership Platform, Canadian Donation and Transplantation Research Program, Edmonton, AB, Canada
| | - Simon Urschel
- Department of Pediatrics, University of Alberta/Stollery Children's Hospital, Edmonton, AB, Canada
| | - Matthew J Weiss
- Division of Critical Care, Department of Pediatrics, Faculty of Medicine, Université Laval, Quebec City, QC, Canada
| | - Samantha J Anthony
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, ON, Canada
- Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Social Work, The Hospital for Sick Children, Toronto, ON, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
18
|
Dong L, Brown RA, Palimaru AI, D'Amico EJ, Dickerson DL, Klein DJ, Johnson CL, Troxel WM. Enhancing sleep health in urban American Indian/Alaska Native adolescents: Implications for culturally tailored interventions. J Adolesc 2024. [PMID: 38757459 DOI: 10.1002/jad.12350] [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: 03/04/2024] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Urban American Indian/Alaska Native (AI/AN) adolescents are vulnerable to sleep and other health-related disparities due to numerous social drivers, including historical trauma and relocation to urban areas. This study aims to identify strategies to increase protective factors and culturally tailor sleep health interventions for this population. METHODS Using community-based participatory research, the NAYSHAW study conducted in-depth interviews with urban AI/AN adolescents aged 12-19 years to understand critical components needed for developing a culturally sensitive sleep health intervention. Data from two qualitative subsamples (N = 46) and parent surveys (N = 110) were analyzed, focusing on factors that affect sleep health behaviors, including parental involvement, technology, and traditional practices. RESULTS Key findings include the detrimental impact of electronics use at night and protective effects of traditional practices on sleep. Parental involvement in sleep routines varied by adolescent's age. Adolescents desired sleep health education in interactive formats, whereas parents preferred workshops and digital applications for sleep health strategies. Findings suggest that interventions need to address electronics use and should also be culturally tailored to address the unique experiences of urban AI/AN adolescents. CONCLUSIONS Results underscore the importance of utilizing community-based strategies to develop culturally tailored sleep interventions for underserved populations, specifically urban AI/AN adolescents. Integrating traditional practices with evidence-based sleep health strategies can provide a holistic approach to improving sleep and overall well-being. Parental education and involvement will be critical to the success of such interventions.
Collapse
Affiliation(s)
- Lu Dong
- RAND Corporation, Santa Monica, California, USA
| | | | | | | | - Daniel L Dickerson
- UCLA Integrated Substance Abuse Programs (ISAP), Semel Institute for Neuroscience and Human Behavior, Los Angeles, California, USA
| | | | - Carrie L Johnson
- Sacred Path Indigenous Wellness Center, Los Angeles, California, USA
| | | |
Collapse
|
19
|
Kjerland TM, Schroeder S, Tofaeono V. Increased community engagement of Indigenous Peoples in dementia research leads to higher context relevance of results. DEMENTIA 2024; 23:643-668. [PMID: 38445447 PMCID: PMC11059836 DOI: 10.1177/14713012241233651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Health research that focuses on Indigenous Peoples must ensure that the community in question is actively engaged, and that the results have context relevance for Indigenous Peoples. Context relevance is "the benefits, usability, and respectful conduct of research from the perspective of Indigenous communities." The purpose of this study was to apply two tools within an already-published scoping review of 76 articles featuring research on cognitive impairment and dementia among Indigenous Peoples worldwide. One tool assessed levels of community engagement reported in the corpus, and the other tool assessed the context relevance of recommendations in the corpus. We hypothesized that research with higher levels of reported community engagement would produce recommendations with greater context relevance for Indigenous Peoples. METHODS We employed semi-structured deductive coding using two novel tools assessing levels of reported community engagement and context relevance of recommendations based on studies included in the existing scoping review. RESULTS Application of the two tools revealed a positive relationship between increasing community engagement and greater context relevance. Community engagement primarily occurred in studies conducted with First Nations, Inuit, and Métis populations in Canada and with Australian Aboriginal and/or Torres Strait Islander Peoples. Research with Alaska Native, American Indian, and Native Hawaiian Peoples in the USA stood out for its comparative lack of meaningful community engagement. DISCUSSION There is opportunity to utilize these tools, and the results of this assessment, to enhance training and mentorship for researchers who work with Indigenous populations. There is a need to increase investigator capacity to involve communities throughout all phases of research, particularly in the pre-research stages.
Collapse
Affiliation(s)
- Tonya M Kjerland
- Department of Indigenous Health, University of North Dakota, USA
| | | | | |
Collapse
|
20
|
Walker RC, Walker C, Reynolds A, Haselden R, Hay S, Palmer SC. Consumer values, perspectives and experiences of psychological health when living with dialysis at home: An in-depth interview study. Perit Dial Int 2024; 44:185-193. [PMID: 37822201 DOI: 10.1177/08968608231202899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND People treated with home dialysis report social and emotional isolation, fear of catastrophic events and concern about being a burden. There is a paucity of research exploring psychological well-being among consumers dialysing at home. We aimed to explore the psychological health issues related to home dialysis, and how these issues may impact on sustaining home-based treatment. METHODS We conducted a qualitative interview study with 36 consumers. We included patients with experience of home dialysis and caregivers. Thirteen participants had experienced peritoneal dialysis, seven home haemodialysis, seven had experienced both and nine caregivers. Data were analysed inductively to generate themes and a conceptual framework. RESULTS We identified four themes and subthemes: overwhelming isolation and disconnection (devastating isolation of home dialysis; abandoned from support; escalating anxiety; compounding impact of feeling like a burden); importance of support systems (impact on relationships; need for emotional support; reassurance through shared experiences; valuing trustworthy and committed clinicians); burden of distress (individualised feelings of low mood; grappling with stigma surrounding diagnosis; contemplating treatment withdrawal and suicide); seeking mental health support (normalising mental health support as a distinct entity in dialysis care; overcoming barriers to seeking mental health support; additional tools for mental health support and connection). CONCLUSION Consumers may experience intense psychological distress during home-based dialysis care. Increasing clinician and health services literacy about the management of psychological impacts of home-based dialysis may improve consumer safety, quality of life and sustainability of home treatment.
Collapse
Affiliation(s)
- Rachael C Walker
- Faculty of Medicine and Health Science, School of Nursing, University of Auckland, New Zealand
| | - Curtis Walker
- Department of Medicine, Te Whatu Ora, Palmerston North, New Zealand
| | - Annie Reynolds
- Department of Medicine, Te Whatu Ora, Hastings, New Zealand
| | - Rachel Haselden
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Sandra Hay
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Suetonia C Palmer
- Department of Medicine, University of Otago, Christchurch, New Zealand
- Department of Nephrology, Te Whatu Ora Waitaha, Christchurch, New Zealand
| |
Collapse
|
21
|
Harfield S, Purcell T, Schioldann E, Ward J, Pearson O, Azzopardi P. Enablers and barriers to primary health care access for Indigenous adolescents: a systematic review and meta-aggregation of studies across Australia, Canada, New Zealand, and USA. BMC Health Serv Res 2024; 24:553. [PMID: 38693527 PMCID: PMC11062015 DOI: 10.1186/s12913-024-10796-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/28/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Indigenous adolescents access primary health care services at lower rates, despite their greater health needs and experience of disadvantage. This systematic review identifies the enablers and barriers to primary health care access for Indigenous adolescents to inform service and policy improvements. METHODS We systematically searched databases for publications reporting enablers or barriers to primary health care access for Indigenous adolescents from the perspective of adolescents, their parents and health care providers, and included studies focused on Indigenous adolescents aged 10-24 years from Australia, Canada, New Zealand, and United States of America. Results were analyzed against the WHO Global standards for quality health-care services for adolescents. An additional ninth standard was added which focused on cultural safety. RESULTS A total of 41 studies were included. More barriers were identified than enablers, and against the WHO Global standards most enablers and barriers related to supply factors - providers' competencies, appropriate package of services, and cultural safety. Providers who built trust, respect, and relationships; appropriate package of service; and culturally safe environments and care were enablers to care reported by adolescents, and health care providers and parents. Embarrassment, shame, or fear; a lack of culturally appropriate services; and privacy and confidentiality were common barriers identified by both adolescent and health care providers and parents. Cultural safety was identified as a key issue among Indigenous adolescents. Enablers and barriers related to cultural safety included culturally appropriate services, culturally safe environment and care, traditional and cultural practices, cultural protocols, Indigenous health care providers, cultural training for health care providers, and colonization, intergenerational trauma, and racism. Nine recommendations were identified which aim to address the enablers and barriers associated with primary health care access for Indigenous adolescents. CONCLUSION This review provides important evidence to inform how services, organizations and governments can create accessible primary health care services that specifically meet the needs of Indigenous adolescents. We identify nine recommendations for improving the accessibility of primary health care services for Indigenous adolescents.
Collapse
Affiliation(s)
- Stephen Harfield
- UQ Poche Centre for Indigenous Health, University of Queensland, St Lucia, Australia.
- School of Public Health, University of Queensland, Herston, Australia.
- Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, Australia.
- School of Public Health, The University of Adelaide, Adelaide, Australia.
| | - Tara Purcell
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Eliza Schioldann
- Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, Australia
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - James Ward
- UQ Poche Centre for Indigenous Health, University of Queensland, St Lucia, Australia
| | - Odette Pearson
- Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, Australia
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Peter Azzopardi
- Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, Australia
- Global Adolescent Health Group, Maternal Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
- Centre for Adolescent Health, Department of Paediatrics, University of Melbourne, Melbourne, Australia
| |
Collapse
|
22
|
Crocetti AC, Walker T, Mitchell F, Sherriff S, Hill K, Paradies Y, Backholer K, Browne J. Making Big Business Everybody's Business: Aboriginal leaders' perspectives on commercial activities influencing aboriginal health in Victoria, Australia. Global Health 2024; 20:33. [PMID: 38637867 PMCID: PMC11025162 DOI: 10.1186/s12992-024-01038-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/02/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The commercial determinants of health is a rapidly expanding field of research; however Indigenous perspectives remain notably underrepresented. For Indigenous peoples the intersection of globalisation, colonialism and capitalism may amplify commercially-driven health inequities. This study aimed to explore the perspectives of Aboriginal leaders regarding the influence of commercial activities on Aboriginal health and wellbeing in Victoria, Australia. METHODS Semi-structured interviews with 23 Aboriginal leaders from across five sectors (n = 15 urban, n = 8 rural/regional) were analysed through reflexive thematic analysis. RESULTS Three overarching themes were identified encompassing (i) harmful commercial practices and processes, (ii) improving corporate engagement and (iii) opportunities for self-determination through business. Participants expressed concern over aggressive marketing by the gambling industry, commercial exploitation of Aboriginal culture, the privatisation of public services, and lack of oversignt of corporate social responsibility strategies. Simultaneously, Aboriginal-led businesses were viewed as opportunities for cultural connection, and financial empowerment and self-determination. CONCLUSION Numerous commercial entities and activities are perceived to influence Aboriginal health and wellbeing. This study highlights the need for stronger policy and regulation to mitigate harmful industry practices while incentivising the potential positive impacts of the commercial activities on Aboriginal health and wellbeing.
Collapse
Affiliation(s)
- Alessandro Connor Crocetti
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia.
| | - Troy Walker
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Fiona Mitchell
- Deakin Rural Health, Faculty of Health, Deakin University, Warrnambool, VIC, Australia
| | - Simone Sherriff
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Karen Hill
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC, Australia
| | - Kathryn Backholer
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Jennifer Browne
- Deakin University, Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| |
Collapse
|
23
|
Probst Y, McKnight A, O'Flynn G, Tillott S, Stanley RM. Describing the food choices of Aboriginal children attending an afterschool cultural program from two different knowledge systems: The importance of Country, community, and kinship. Nutr Diet 2024. [PMID: 38637156 DOI: 10.1111/1747-0080.12873] [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: 10/06/2023] [Revised: 01/31/2024] [Accepted: 03/04/2024] [Indexed: 04/20/2024]
Abstract
AIMS This study describes a program co-created with Aboriginal communities to strengthen cultural ties with the children. Food data are reported from two knowledge systems (lenses): Western and Aboriginal relational, focused on Country, community, and kinship. METHODS A cultural program was undertaken with primary school children of Aboriginal heritage, on Yuin nation, over 10 weeks including culturally appropriate practices (painting, bushtucker, and dance). We report mixed method food outcomes framed by Western (quantitative) 24-h recall and Aboriginal relational methods (qualitative) captured by cultural images, yarning and continuous consultation methods to expose lessons from community and Country, to extend kinship. RESULTS In total, 111 children (79 providing food data) across three regional communities commenced the program. A storying approach to food data collection and interpretation was preferred. The number of serves of seafood products, such as fish increased, vegetable consumption improved, intakes of dairy improved in quality and energy intakes from discretionary foods decreased across the programs. Qualitative data exposed six themes: Eating with family, competing agendas, food as medicine, applying cultural practices, food choices driven by 'post-invasion tradition' and community events, which deepened our understanding of the food data. Teaching the importance of the ocean and water saw participants engage with family in practices such as fishing to improve overall awareness of culture through food. CONCLUSION The kinship system in a cultural context supported positive shifts towards accessible food choices driven by messages from Country. While the changes cannot be isolated to the program, cultural immersion drove change and strength-based reporting.
Collapse
Affiliation(s)
- Yasmine Probst
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Anthony McKnight
- Woolyungah Indigenous Centre, University of Wollongong, Wollongong, New South Wales, Australia
| | - Gabrielle O'Flynn
- School of Education, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sarah Tillott
- School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Faculty of Health, Southern Cross University, Gold Coast, Australia
| | - Rebecca M Stanley
- School of Education, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia
| |
Collapse
|
24
|
Waddell O, Pearson J, McCombie A, Marshall H, Purcell R, Keenan J, Glyn T, Frizelle F. The incidence of early onset colorectal cancer in Aotearoa New Zealand: 2000-2020. BMC Cancer 2024; 24:456. [PMID: 38609870 PMCID: PMC11010297 DOI: 10.1186/s12885-024-12122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 03/14/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The incidence of early-onset colorectal cancer (EOCRC), diagnosed before age 50, has been rising in many countries in the past few decades. This study aims to evaluate this trend in Aotearoa New Zealand and assess its impact on Māori. METHODS Crude incidence and age-standardized incidence of colorectal cancer (CRC) was analyzed from all new cases from the Aotearoa New Zealand national cancer registry for the period 2000-2020. Trends were estimated by sex, ethnicity, age group and location of cancer and projections made to 2040. RESULTS Between 2000 and 2020, there were a total of 56,761 cases of CRC diagnosed in Aotearoa New Zealand, 3,702 of these being EOCRC, with age-standardized incidence decreasing significantly (P = 8.2 × 10- 80) from 61.0 to 47.3 cases per 100,000. EOCRC incidence increased on average by 26% per decade (incidence rate ratio (IRR) 1.26, p = < 0.0001) at all sites (proximal colon, distal colon and rectum), while the incidence in those aged 50-79 years decreased on average by 18% per decade (IRR 0.82, p = < 0.0005), again across all sites. There was no significant average change in CRC incidence in those over 80 years. In Māori, there was no significant change in age-standardized incidence. There was however a significant increase in crude incidence rates (IRR 1.28, p = < 0.0005) driven by significant increases in EOCRC (IRR1.36, p = < 0.0005). By 2040, we predict the incidence of EOCRC will have risen from 8.00 to 14.9 per 100,000 (6.33 to 10.00 per 100,000 in Māori). However, due to the aging population an estimated 43.0% of all CRC cases will be diagnosed in those over 80 years of age (45.9% over 70 years of age in Māori). CONCLUSION The age-standardized incidence of CRC from 2000 to 2020 decreased in Aotearoa New Zealand, but not for Māori. The incidence of EOCRC over the same period continues to rise, and at a faster rate in Māori. However, with the ageing of the population in Aotearoa New Zealand, and for Māori, CRC in the elderly will continue to dominate case numbers.
Collapse
Affiliation(s)
- Oliver Waddell
- Department of Surgery and Critical Care, University of Otago Christchurch, 36 Cashel St, Christchurch central, Christchurch, New Zealand.
| | - John Pearson
- Biostatistics and Computational Biology Unit, University of Otago Christchurch, Christchurch, New Zealand
| | - Andrew McCombie
- Department of Surgery and Critical Care, University of Otago Christchurch, 36 Cashel St, Christchurch central, Christchurch, New Zealand
- Department of General Surgery, Te Whatu Ora Health New Zealand, Christchurch, New Zealand
| | - Harriet Marshall
- Department of General Surgery, Te Whatu Ora Health New Zealand, Christchurch, New Zealand
| | - Rachel Purcell
- Department of Surgery and Critical Care, University of Otago Christchurch, 36 Cashel St, Christchurch central, Christchurch, New Zealand
| | - Jacqueline Keenan
- Department of Surgery and Critical Care, University of Otago Christchurch, 36 Cashel St, Christchurch central, Christchurch, New Zealand
| | - Tamara Glyn
- Department of Surgery and Critical Care, University of Otago Christchurch, 36 Cashel St, Christchurch central, Christchurch, New Zealand
- Department of General Surgery, Te Whatu Ora Health New Zealand, Christchurch, New Zealand
| | - Frank Frizelle
- Department of Surgery and Critical Care, University of Otago Christchurch, 36 Cashel St, Christchurch central, Christchurch, New Zealand
- Department of General Surgery, Te Whatu Ora Health New Zealand, Christchurch, New Zealand
| |
Collapse
|
25
|
Haitana T, Clark MTR, Crowe M, Cunningham R, Porter R, Pitama S, Mulder R, Lacey C. The Right to Equal Health: Best Practice Priorities for Māori with Bipolar Disorder from Staff Focus Groups. Healthcare (Basel) 2024; 12:793. [PMID: 38610215 PMCID: PMC11011462 DOI: 10.3390/healthcare12070793] [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: 02/13/2024] [Revised: 03/23/2024] [Accepted: 03/31/2024] [Indexed: 04/14/2024] Open
Abstract
Bipolar disorder (BD) is a serious mental health condition that is clinically complex to monitor and manage. While best practice guidelines exist, they vary internationally lacking consensus. Indigenous peoples, including Māori in New Zealand, experience higher community rates of BD. While New Zealand practice guidelines recommend providing culturally responsive care to Māori, studies show that Māori do not receive best practice. This qualitative study aimed to share the evidence about patterns of health service use and Māori patient experiences with focus group participants involved in the design and delivery of BD services, to discuss and develop guidelines for best practice for Māori with BD and address areas of unmet need. Three focus groups were conducted with 22 participants involved in the delivery of services to Māori with BD across three sites. Willing participants were sent background information and three focus group questions framed to elicit priority solutions to improve clinical, structural and organisational features of mental health service delivery for Māori patients with BD and their whānau (family). The nominal group technique was used to synthesise responses, and then develop a prioritised list of proposed solutions. Results identified system-level changes required at the clinical, structural and organisational levels of healthcare. Findings further evidence the need for healthcare reform in New Zealand, to be responsive to Māori with BD.
Collapse
Affiliation(s)
- Tracy Haitana
- Department of MIHI, University of Otago, Christchurch 8011, New Zealand
| | | | - Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch 8011, New Zealand
| | - Ruth Cunningham
- Department of Public Health, University of Otago, Wellington 6021, New Zealand
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch 8011, New Zealand
| | - Suzanne Pitama
- Department of MIHI, University of Otago, Christchurch 8011, New Zealand
| | - Roger Mulder
- Department of Psychological Medicine, University of Otago, Christchurch 8011, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch 8011, New Zealand
| |
Collapse
|
26
|
Veenstra N, Kewene F, Morgaine K, Crengle S. What we do matters: Supporting anti-racism and decolonisation of public health teaching and practice through the development of Māori public health competencies. Aust N Z J Public Health 2024; 48:100132. [PMID: 38422582 DOI: 10.1016/j.anzjph.2024.100132] [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: 06/26/2023] [Revised: 11/14/2023] [Accepted: 01/14/2024] [Indexed: 03/02/2024] Open
Abstract
OBJECTIVE This research sought to expand on a set of core Māori hauora ā-iwi/public health competencies initially designed for teaching and to enable their use in workplaces. METHODS The research used a kaupapa Māori methodology in four stages including the development of draft levels of competence for all core competencies, consultation hui (meetings), analysis of feedback and redrafting, and respondent validation. RESULTS Key themes elicited in relation to the content of the competencies included increasing language expectations, the importance of strength-based approaches and self-determination, and the need for individual responsibility to address structural racism. Reflective practice was identified as a fundamental cross-cutting competency. Participants suggested planetary health and political ideologies be included as additional socio-political determinants of health with equity impacts. Key concerns related to the application of the competency document included the need for cultural safety and ensuring that all public health practitioners are 'seen'. CONCLUSIONS The Māori hauora ā-iwi/public health competencies have been published under a Creative Commons licence. IMPLICATIONS FOR PUBLIC HEALTH The process of drafting a set of Māori public health competencies elicited key themes potentially relevant for public health practice in other countries and resulted in a competency document for use by universities and workplaces.
Collapse
Affiliation(s)
- Nina Veenstra
- Ngāi Tahu Māori Health Research Unit/ Te Roopū Rakahau Hauora Māori o Kāi Tahu, University of Otago/Te Whare Wānanga o Ōtago, Dunedin, New Zealand
| | - Fran Kewene
- School of Health/Te Kura Tātai Hauora, Victoria University Wellington/Te Herenga Waka, Wellington, New Zealand
| | - Kate Morgaine
- Department of Preventive and Social Medicine/Te Tari Hauora Tūmatanui, University of Otago/ Te Whare Wānanga o Ōtago, Dunedin, New Zealand
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit/ Te Roopū Rakahau Hauora Māori o Kāi Tahu, University of Otago/Te Whare Wānanga o Ōtago, Dunedin, New Zealand.
| |
Collapse
|
27
|
Martinez SA, Anderson AS, Burkhart M, Gopalani SV, Janitz AE, Campbell JE, White AH, Comiford AL. Perception of Barriers to and Factors Associated with HPV Vaccination Among Parents of American Indian Adolescents in the Cherokee Nation. J Racial Ethn Health Disparities 2024; 11:958-967. [PMID: 36964480 PMCID: PMC10038366 DOI: 10.1007/s40615-023-01576-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/15/2023] [Accepted: 03/19/2023] [Indexed: 03/26/2023]
Abstract
The purpose of this study was to understand the perceptions of HPV vaccination barriers and factors among parents or guardians of American Indian adolescents in the Cherokee Nation. Fifty-four parents of American Indian adolescents in the Cherokee Nation participated in one of eleven focus group discussions from June to August 2019. Discussions were recorded, transcribed, coded, and analyzed for themes. Protection against cancer was the primary parent-reported reason for vaccinating their children against HPV. The lack of information and safety concerns about the HPV vaccine were the main reasons for non-vaccination. To increase HPV vaccine uptake, parents strongly supported offering vaccinations in school. Furthermore, increased healthcare provider-initiated discussion can ease parental concerns about HPV vaccine safety and improve coverage.
Collapse
Affiliation(s)
- Sydney A Martinez
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Amber S Anderson
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | | | - Sameer V Gopalani
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Amanda E Janitz
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Janis E Campbell
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Ashley H White
- Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
| | | |
Collapse
|
28
|
Sobhy MM, Brand M, Henshall K, MacCormick AD. Investigating major trauma in Māori youth at Te Whatu Ora Counties Manukau. ANZ J Surg 2024; 94:580-584. [PMID: 38486439 DOI: 10.1111/ans.18948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/25/2024] [Accepted: 03/06/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The Ninth Perioperative Mortality Review Committee (POMRC) report found the likelihood of death was over three times higher in Māori youth compared to non-Māori (age: 15-18 years) in the 30-days following major trauma. The aim of our study is to investigate variations in care provided to Māori youth presenting to Te Whatu Ora Counties Manukau (TWO-CM) with major trauma, to inform policies and improve care. METHODS This was a retrospective, observational study of 15-18-year-olds admitted to Middlemore Hospital from January 2018 to December 2021 following major trauma (Injury Severity Score (ISS) >12 or with (ISS) <12 who died). Data were obtained from the New Zealand Trauma Registry (NZTR). Six key performance indicators were studied against hospital guidelines/international consensus: Deaths, Cause-of-death, trauma call, RedBlanket activations, time-to-computed tomography (CT), and time-to-operating theatre (OT). RESULTS Of 77 patients, five deaths occurred, four non-Māori, and one Māori (P = 0.645). Five trauma calls were not activated (P = 0.642). There was no statistically significant difference for both median time to CT (P = 0.917) and time to CT for patients with GCS >13 (P = 0.778) between Māori and non-Māori. Five patients did not meet guidelines for time-to-OT (three non-Māori and two Māori) (P = 0.377). CONCLUSION No statistically significant variations in care were present for Māori youth presenting with major trauma, these findings did not match the national trend.
Collapse
Affiliation(s)
- Mira M Sobhy
- Department of Surgery, Te Waipapa Taumata Rau (University of Auckland), Tāmaki Makaurau, Aotearoa, New Zealand
- Dunedin School of Medicine, Ōtākou Whakaihu Waka (University of Otago), Dunedin, Aotearoa, New Zealand
| | - Maria Brand
- Department of Surgery, Te Waipapa Taumata Rau (University of Auckland), Tāmaki Makaurau, Aotearoa, New Zealand
- Department of Surgery, Te Whatu Ora Counties Manukau, Auckland, Aotearoa, New Zealand
| | - Kevin Henshall
- Department of Surgery, Te Whatu Ora Counties Manukau, Auckland, Aotearoa, New Zealand
| | - Andrew D MacCormick
- Department of Surgery, Te Waipapa Taumata Rau (University of Auckland), Tāmaki Makaurau, Aotearoa, New Zealand
- Department of Surgery, Te Whatu Ora Counties Manukau, Auckland, Aotearoa, New Zealand
| |
Collapse
|
29
|
Dewidar O, McHale G, Al Zubaidi A, Bondok M, Abdelrazeq L, Huang J, Jearvis A, Aliyeva K, Alghamyan A, Jahel F, Greer-Smith R, Tufte J, Barker LC, Elmestekawy N, Sharp MK, Horsley T, Prats CJ, Jull J, Wolfenden L, Cuervo LG, Hardy BJ, Roberts JH, Ghogomu E, Obuku E, Owusu-Addo E, Nicholls SG, Mbuagbaw L, Funnell S, Shea B, Rizvi A, Tugwell P, Bhutta Z, Welch V, Melendez-Torres GJ. Motivations for investigating health inequities in observational epidemiology: a content analysis of 320 studies. J Clin Epidemiol 2024; 168:111283. [PMID: 38369078 DOI: 10.1016/j.jclinepi.2024.111283] [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: 11/01/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES To enhance equity in clinical and epidemiological research, it is crucial to understand researcher motivations for conducting equity-relevant studies. Therefore, we evaluated author motivations in a randomly selected sample of equity-relevant observational studies published during the COVID-19 pandemic. STUDY DESIGN AND SETTING We searched MEDLINE for studies from 2020 to 2022, resulting in 16,828 references. We randomly selected 320 studies purposefully sampled across income setting (high vs low-middle-income), COVID-19 topic (vs non-COVID-19), and focus on populations experiencing inequities. Of those, 206 explicitly mentioned motivations which we analyzed thematically. We used discourse analysis to investigate the reasons behind emerging motivations. RESULTS We identified the following motivations: (1) examining health disparities, (2) tackling social determinants to improve access, and (3) addressing knowledge gaps in health equity. Discourse analysis showed motivations stem from commitments to social justice and recognizing the importance of highlighting it in research. Other discourses included aspiring to improve health-care efficiency, wanting to understand cause-effect relationships, and seeking to contribute to an equitable evidence base. CONCLUSION Understanding researchers' motivations for assessing health equity can aid in developing guidance that tailors to their needs. We will consider these motivations in developing and sharing equity guidance to better meet researchers' needs.
Collapse
Affiliation(s)
- Omar Dewidar
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Bruyère Research Institute, University of Ottawa, Ottawa, Canada.
| | - Georgia McHale
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Ali Al Zubaidi
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; School of Medicine, University College Cork, Cork, Ireland
| | - Mostafa Bondok
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Leenah Abdelrazeq
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; Department of Health Sciences, Carelton University, Ottawa, Canada
| | - Jimmy Huang
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Alyssa Jearvis
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Khadija Aliyeva
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Amjad Alghamyan
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Fatima Jahel
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | | | | | - Lucy C Barker
- Department of Psychiatry, University of Toronto, Toronto, Canada; Women's College Hospital, Toronto, Canada
| | - Nour Elmestekawy
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Melissa K Sharp
- Department of General Practice, Health Research Board Centre for Primary Care Research, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Tanya Horsley
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
| | - Clara Juandro Prats
- Applied Health Research Center, St. Michael's Hospital, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Janet Jull
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Canada
| | - Luke Wolfenden
- Cochrane Public Health, School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia
| | - Luis Gabriel Cuervo
- Department of Evidence and Intelligence for Action in Health, Pan American Health Organization (PAHO/WHO), Washington, DC, USA; Department of Paediatrics, Obstetrics & Gynaecology, and Preventive Medicine, Doctoral School, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Billie-Jo Hardy
- Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Janet Hatchet Roberts
- WHO Collaborating Centre for Knowledge Translation and Health Technology Assessment in Health Equity, Ottawa, Canada
| | | | - Ekwaro Obuku
- Africa Centre for Systematic Reviews & Knowledge Translation, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ebenezer Owusu-Addo
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Stuart G Nicholls
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sarah Funnell
- Department of Family Medicine, Queen's University, Kingston, Canada; Department of Family Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Bev Shea
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Anita Rizvi
- School of Psychology, University of Ottawa, Ottawa, Canada
| | - Peter Tugwell
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Zulfiqar Bhutta
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada; Centre for Excellence in Women and Child Health and Institute of Global Health and Development, The Aga Khan University, Karachi, Pakistan
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | | |
Collapse
|
30
|
Parko K, Stitzer M, Trimble B, Christensen L. Neurological Care within the Indian Health Service. Semin Neurol 2024; 44:205-216. [PMID: 38499194 DOI: 10.1055/s-0044-1782517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
American Indians and Alaska Natives (AI/AN) are the Indigenous peoples of the United States. According to the U.S. Census Bureau, approximately 9.7 million people self-identified as AI/AN (alone or in combination with other races), representing 2.9% of the total U.S. population. These people represent diverse groups of discrete Tribes, each with their language, culture, and geographic home. As part of the conquest and settlement of North America, some Indigenous peoples signed treaties with the U.S. government, surrendering their lands in return for various government commitments, including health care. The Indian Health Service (IHS) was born out of these agreements. The IHS is an agency in the U.S. Department of Health and Human Services under the U.S. Public Health Service. The IHS provides a comprehensive health service delivery system for approximately 2.7 million AI/AN who belong to 574 federally recognized Tribes/nations in 37 states. The aim of this paper is to make recommendations regarding the initiation of sustainable neurology care in marginalized or underserved populations by reviewing 40 years of neurology care provision within the IHS. We will discuss (1) the IHS, (2) neurological care provided within the IHS, including midlevel provider extension of neurology care and traditional medical care, and (3) select neurological diagnoses within AI/AN populations. Marginalized populations, including those in the United States that are rural, remote, or low socioeconomic status, lack access to specialty neurology care. This includes many AI/AN. The IHS has developed novel solutions to promote specialty care, including neurology. Notably, initial IHS investments in full-time neurology providers have led to more robust neurology care, often receiving attention from university programs. This suggests that an initial investment in stable on-site full-time neurology services provides a path to potential sustainable care for marginalized populations.
Collapse
Affiliation(s)
- Karen Parko
- Department of Neurology, University of California at San Francisco, San Francisco, California
| | - Michael Stitzer
- Winslow Indian Health Care Center, Navajo Area Indian Health Service, Winslow, Arizona
- Department of Neurology, Mayo Clinic, Phoenix, Arizoana
| | - Brian Trimble
- Division of Neurology, Department of Internal Medicine, Alaska Native Tribal Health Consortium, Anchorage, Alaska
| | | |
Collapse
|
31
|
Garvey G, Howard K, Garvey D, Dickson M, Howell M, Butler TL, Cadet-James Y, Cunningham J, Bainbridge R, McGorry P, Williamson A, Anderson KM. What Matters to Aboriginal and Torres Strait Islander Youth (WM2Y): a study protocol to develop a national youth well-being measure. BMJ Open 2024; 14:e076119. [PMID: 38508611 PMCID: PMC10952880 DOI: 10.1136/bmjopen-2023-076119] [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: 05/30/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Adolescents face challenges associated with unprecedented environmental, social and technological changes. The impacts of colonisation, intergenerational trauma, racism and socioeconomic disadvantage intensify these challenges for many Aboriginal and Torres Strait Islander adolescents. However, Aboriginal and Torres Strait Islander adolescents also have cultural, spiritual, family and community capital that fosters their well-being.To date, little research has focused on understanding and appropriately measuring the well-being of Aboriginal and Torres Strait Islander adolescents, a pivotal factor in informing and guiding programmes and interventions that support them. This study will identify the domains of well-being and develop a new preference-based well-being measure based on the values and preferences of Aboriginal and Torres Strait Islander youth (aged 12-17 years). METHODS AND ANALYSIS This project will be conducted across three research phases: (1) qualitative exploration of well-being using PhotoYarning and yarns with adult mentors to develop candidate items; (2) Think Aloud study, quantitative survey, psychometric analysis, validity testing of candidate items and finalisation of the descriptive system; and (3) scoring development using a quantitative preference-based approach. A multinomial (conditional) logit framework will be used to analyse responses and generate a scoring algorithm for the new preference-based well-being measure. ETHICS AND DISSEMINATION Ethics approvals have been obtained from: the Human Research Ethics Committees for each state and territory where data are being collected, the institutions where the research is being conducted and from the relevant Departments of Education. The new well-being measure will have wide applicability and can be used in assessing the effectiveness of programmes and services. This new national measure will ensure benefit and positive impact through the ability to identify and measure the aspects of well-being important to and valued by Aboriginal and Torres Strait Islander youth. Results will be published in international peer-reviewed journals and presented at conferences, and summaries will be provided to the study partner organisations and other relevant organisations.
Collapse
Affiliation(s)
- Gail Garvey
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Kirsten Howard
- The University of Sydney, Sydney, New South Wales, Australia
| | - Darren Garvey
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | | | - M Howell
- The University of Sydney, Sydney, New South Wales, Australia
| | - Tamara L Butler
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | | | - Joan Cunningham
- Charles Darwin University, Casuarina, Northern Territory, Australia
| | | | | | | | | |
Collapse
|
32
|
Balabanski AH, Dos Santos A, Woods JA, Mutimer CA, Thrift AG, Kleinig TJ, Suchy-Dicey AM, Siri SRA, Boden-Albala B, Krishnamurthi RV, Feigin VL, Buchwald D, Ranta A, Mienna CS, Zavaleta-Cortijo C, Churilov L, Burchill L, Zion D, Longstreth WT, Tirschwell DL, Anand SS, Parsons MW, Brown A, Warne DK, Harwood M, Barber PA, Katzenellenbogen JM. Incidence of Stroke in Indigenous Populations of Countries With a Very High Human Development Index: A Systematic Review. Neurology 2024; 102:e209138. [PMID: 38354325 DOI: 10.1212/wnl.0000000000209138] [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: 06/02/2023] [Accepted: 12/01/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Cardiovascular disease contributes significantly to disease burden among many Indigenous populations. However, data on stroke incidence in Indigenous populations are sparse. We aimed to investigate what is known of stroke incidence in Indigenous populations of countries with a very high Human Development Index (HDI), locating the research in the broader context of Indigenous health. METHODS We identified population-based stroke incidence studies published between 1990 and 2022 among Indigenous adult populations of developed countries using PubMed, Embase, and Global Health databases, without language restriction. We excluded non-peer-reviewed sources, studies with fewer than 10 Indigenous people, or not covering a 35- to 64-year minimum age range. Two reviewers independently screened titles, abstracts, and full-text articles and extracted data. We assessed quality using "gold standard" criteria for population-based stroke incidence studies, the Newcastle-Ottawa Scale for risk of bias, and CONSIDER criteria for reporting of Indigenous health research. An Indigenous Advisory Board provided oversight for the study. RESULTS From 13,041 publications screened, 24 studies (19 full-text articles, 5 abstracts) from 7 countries met the inclusion criteria. Age-standardized stroke incidence rate ratios were greater in Aboriginal and Torres Strait Islander Australians (1.7-3.2), American Indians (1.2), Sámi of Sweden/Norway (1.08-2.14), and Singaporean Malay (1.7-1.9), compared with respective non-Indigenous populations. Studies had substantial heterogeneity in design and risk of bias. Attack rates, male-female rate ratios, and time trends are reported where available. Few investigators reported Indigenous stakeholder involvement, with few studies meeting any of the CONSIDER criteria for research among Indigenous populations. DISCUSSION In countries with a very high HDI, there are notable, albeit varying, disparities in stroke incidence between Indigenous and non-Indigenous populations, although there are gaps in data availability and quality. A greater understanding of stroke incidence is imperative for informing effective societal responses to socioeconomic and health disparities in these populations. Future studies into stroke incidence in Indigenous populations should be designed and conducted with Indigenous oversight and governance to facilitate improved outcomes and capacity building. REGISTRATION INFORMATION PROSPERO registration: CRD42021242367.
Collapse
Affiliation(s)
- Anna H Balabanski
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Angela Dos Santos
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - John A Woods
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Chloe A Mutimer
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Amanda G Thrift
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Timothy J Kleinig
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Astrid M Suchy-Dicey
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Susanna Ragnhild A Siri
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Bernadette Boden-Albala
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Rita V Krishnamurthi
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Valery L Feigin
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Dedra Buchwald
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Annemarei Ranta
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Christina S Mienna
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Carol Zavaleta-Cortijo
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Leonid Churilov
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Luke Burchill
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Deborah Zion
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - W T Longstreth
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - David L Tirschwell
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Sonia S Anand
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Mark W Parsons
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Alex Brown
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Donald K Warne
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Matire Harwood
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - P Alan Barber
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| | - Judith M Katzenellenbogen
- From the Department of Medicine (A.H.B., A.G.T.), Monash University; Department of Medicine and Neurology (A.H.B., L.C.), University of Melbourne; Department of Stroke Medicine (A.H.B., C.A.M.), Alfred Health, Melbourne; South West Sydney Clinical School (A.D.S.), University of New South Wales, Liverpool; School of Allied Health (J.A.W.), The University of Western Australia, Perth; Department of Neurology (T.J.K.), Royal Adelaide Hospital, Australia; Elson S. Floyd College of Medicine (A.M.S.-D.); Institute for Research and Education to Advance Community Health (A.M.S.-D., D.B.), Washington State University, Spokane; Department of Community Medicine (S.R.A.S.), UiT The Arctic University of Norway, Tromso; Department of Health Society and Behavior (B.B.-A.); Department of Epidemiology and Biostatistics (B.B.-A.); Department of Neurology School of Medicine (B.B.-A.), University of California, Irvine; National Institute for Stroke and Applied Neurosciences (R.V.K., V.L.F.), Auckland University of Technology; Department of Medicine (A.R.), University of Otago, Wellington, New Zealand; Department of Odontology (C.S.M.); Várdduo - Centre for Sámi research (C.S.M.), Umeå University, Sweden; Unidad de Ciudadanía Intercultural y Salud Indígena (C.Z.-C.), Universidad Peruana Cayetano Heredia, Lima, Peru; Department of Medicine (L.B.), Royal Melbourne Hospital; Human Research Ethics Committee (D.Z.), Victoria University, Melbourne, Australia; Department of Neurology (W.T.L., D.L.T.); Department of Epidemiology (W.T.L.), University of Washington, Seattle; Department of Medicine (S.S.A.), McMaster University, Hamilton; Canada and Population Health Research Institute (S.S.A.), Hamilton Health Sciences; Department of Neurology (M.W.P.), Liverpool Hospital, Australia; Ingham Institute of Applied Medical Research (M.W.P.); National Centre for Indigenous Genomics (A.B.), Telethon Kids Institute and The Australian National University, Canberra; Bloomberg School of Public Health (D.K.W.), Johns Hopkins University, Baltimore, MD; Faculty of Medical and Health Sciences (M.H., P.A.B.), University of Auckland, New Zealand; and Cardiovascular Epidemiology Research Centre (J.M.K.), School of Population and Global Health, The University of Western Australia, Perth
| |
Collapse
|
33
|
Hill-Wall T, McCausland K, Thomas E, Norman R, Bullen J, Cowen G. Awareness and understanding of concussion among Aboriginal Australians with high health literacy. Concussion 2024; 9:CNC113. [PMID: 38939826 PMCID: PMC11204175 DOI: 10.2217/cnc-2023-0012] [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: 09/17/2023] [Accepted: 03/04/2024] [Indexed: 06/29/2024] Open
Abstract
Aim Indigenous Australians have higher rates of traumatic brain injury, with 74-90% of such injuries being concussion. This study explores concussion awareness and knowledge in Aboriginal Western Australians with high health literacy. Materials & methods Participants, aged 18-65 years, engaged in research topic yarning, and thematic analysis of the qualitative data then undertaken. Results There was awareness that direct head trauma can result in concussion, but a lack of differentiation between concussion and other head injuries. Knowledge was gained from sport, media or lived-experience. Symptom minimization and diversity of concussion symptoms prevented participants from seeking medical treatment. This was exacerbated by a mistrust of the medical system. Conclusion Research findings highlight knowledge and service gaps where co-designed strategies can be targeted.
Collapse
Affiliation(s)
- Trish Hill-Wall
- Moorditj Yorga Scholarship Program, Curtin University, Bentley, 6102, Australia
- Curtin Medical School, Curtin University, Bentley, 6102, Australia
| | - Kahlia McCausland
- Curtin School of Population Health, Curtin University, Bentley, 6102, Australia
| | - Elizabeth Thomas
- Centre for Clinical Research Excellence, Curtin University, Bentley, 6102, Australia
- Division of Surgery, Faculty of Health & Medical Sciences, The University of Western Australia, Perth, 6009, Australia
| | - Richard Norman
- Curtin School of Population Health, Curtin University, Bentley, 6102, Australia
- Curtin enABle Institute, Curtin University, Bentley, 6102, Australia
| | - Jonathan Bullen
- Curtin enABle Institute, Curtin University, Bentley, 6102, Australia
| | - Gill Cowen
- Curtin Medical School, Curtin University, Bentley, 6102, Australia
- Curtin Health Innovation Research Institute, Curtin University, Bentley, 6102, Australia
| |
Collapse
|
34
|
Lloyd-Johnsen C, Hampton A, Stubbs E, Moore S, Eades S, D'Aprano A, Goldfeld S. "I want to see them thrive!": exploring health service research priorities for young Aboriginal children growing up in Alice Springs - a qualitative study. BMC Health Serv Res 2024; 24:205. [PMID: 38355508 PMCID: PMC10868103 DOI: 10.1186/s12913-024-10642-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
To better understand the specific influences of early life on the long-term health and well-being of local Aboriginal children in Alice Springs, high-quality local longitudinal data is required. The Central Australian Aboriginal Congress and the Murdoch Children's Research Institute are exploring the feasibility of establishing a cohort study to fill this gap. A nested qualitative study was conducted to identify priority issues that can be translated into research questions answerable through the proposed cohort study. Semi-structured interviews and focus group discussions (FGDs) were conducted with a range of key community stakeholders, parents and caregivers of young Aboriginal children from Alice Springs in the Northern Territory between 2020 and 2021. Two Aboriginal and two non-Aboriginal researchers conducted 27 interviews and 3 FGDs with 42 participants. Three broad themes were constructed through reflexive thematic analysis representing the areas of focus community stakeholders and parents want future research to prioritise: (1) social determinants of health (2) building positive connections, and (3) making sure kids grow up strong and healthy. Priority setting for future research should be driven by Aboriginal and Torres Strait Islander peoples in order to be of practical benefit to their community. This qualitative study found that housing, transport and positive connections through nurturing and engaged parents were some of the most important issues raised. Participants also wanted future research to focus on issues specific to children such as nutrition, hearing loss, language development and capacity to learn. These findings will guide future work led by local Aboriginal researchers to co-design the proposed cohort study.
Collapse
Affiliation(s)
- C Lloyd-Johnsen
- Centre for Community Child Health, Murdoch Children's Research Institute, Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
| | - A Hampton
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - E Stubbs
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - S Moore
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
- Menzies School of Health Research, Darwin, NT, Australia
- Flinders University, Adelaide, SA, Australia
| | - S Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - A D'Aprano
- Centre for Community Child Health, Murdoch Children's Research Institute, Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Royal Children's Hospital, Melbourne, VIC, Australia
| | - S Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Royal Children's Hospital, Melbourne, VIC, Australia
| |
Collapse
|
35
|
Biles B, Christian B, Marshall C, McMillan F, Sara G, Anderson J, Davies N, Fealy S, Biles J. 'DANMM that's good!': evaluating the feasibility and acceptability of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) Programme across rural, regional and metropolitan NSW-a collaborative study protocol. BMJ Open 2024; 14:e079416. [PMID: 38341205 PMCID: PMC10862277 DOI: 10.1136/bmjopen-2023-079416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION This paper will describe the research protocol for the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) Project, which will determine the feasibility and acceptability of a cultural mentoring programme designed for Aboriginal and Torres Strait Islander nurses and midwives across five diverse local health districts in New South Wales, Australia. Government and health agencies highlight the importance of culturally appropriate and safe environments for Aboriginal people. Specifically, New South Wales Health prioritises workforce strategies that support Aboriginal people to enter and stay in the health workforce. However, retaining Aboriginal nurses and midwives remains challenging. The DANMM Project aligns with these local and state-wide health plans and strategies, addressing critical issues of workforce cultural safety and retention. METHODS AND ANALYSIS A mixed-methods study design will be employed to assess feasibility, acceptability and preliminary efficacy of the DANMM Programme across five publicly funded local health districts in New South Wales, Australia. Adhering to cultural safety, a project cultural governance group will be formed. Quantitative outcome measures include the use of questionnaires (Nursing Workplace Satisfaction Questionnaire, Ganngaleh nga Yagaleh Cultural Safety assessment tool). Resource implications will be measured using the Organisational Commitment and Health Professional Program Readiness Assessment Compass. These will be triangulated with individual and group yarning circles to provide a holistic evaluation of the programme. ETHICS AND DISSEMINATION The study has ethics approval: Aboriginal Health and Medical Research Council (#2054/23); New South Wales Health Human Research Committees (Greater Western Human Research Committee #2022/ETH01971, Murrumbidgee-site-specific approval, Sydney Local Health District-site-specific approval, Western Sydney Local Health District-site-specific approval and Mid North Coast-site-specific approval); and Charles Sturt University Human Research Committee (#2054/23). Findings will be disseminated through peer-reviewed articles, conferences and through roundtable discussions with key stakeholders.
Collapse
Affiliation(s)
- Brett Biles
- University of New South Wales, Sydney, New South Wales, Australia
| | - Bradley Christian
- Population Oral Health, The University of Sydney School of Dentistry, Surry Hills, New South Wales, Australia
| | - Charmaine Marshall
- New South Wales Health Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
| | - Faye McMillan
- School of Public Health, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Grant Sara
- InforMH, System Information and Analytics Branch, NSW Ministry of Health, North Ryde, New South Wales, Australia
| | - Judith Anderson
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Nicolle Davies
- Charles Sturt University, Albury, New South Wales, Australia
| | - Shanna Fealy
- Charles Sturt University, Port Macquarie, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Jessica Biles
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University-Albury-Wodonga Campus, Albury, New South Wales, Australia
| |
Collapse
|
36
|
Hollis JL, Deroover K, Licata M, Tully B, Farragher E, Lecathelinais C, Bennett N, Foster M, Pennell CE, Wiggers J, Daly J, Kingsland M. Antenatal care addressing gestational weight gain (GWG): a cross sectional study of pregnant women's reported receipt and acceptability of recommended GWG care and associated characteristics. BMC Pregnancy Childbirth 2024; 24:111. [PMID: 38321389 PMCID: PMC10845753 DOI: 10.1186/s12884-023-06158-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 11/25/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The Australian Clinical Practice Guidelines for Pregnancy Care recommend that during the first and subsequent antenatal visits all pregnant women are weighed; advised of recommended gestational weight gain (GWG), dietary intake and physical activity; and offered referrals for additional support if needed. The extent to which these recommendations are implemented and women's acceptability of recommended care is unknown. This study examines women's reported receipt and acceptability of guideline care for GWG, and characteristics associated with receipt of such care and its acceptability. METHODS From September 2018 to February 2019 a telephone survey was undertaken with women who had recently had a baby and received antenatal care from five public maternity services within a health district in Australia. Women self-reported their demographic characteristics, and receipt and acceptability of recommended GWG care. Receipt and acceptability of such care, and their association with the characteristics of women and the maternity service they attended, were examined using descriptive statistics and multivariable logistic regression analyses. RESULTS Of 514 women, 13.1% (95%CI:10.3-16.5) reported that they received an assessment of weight at both their first and a subsequent antenatal visit, and less than one third (30.0%; 95%CI:26.0-33.9) received advice on their recommended GWG range, dietary intake and physical activity. Just 6.6% (95%CI:4.8-9.1) of women reported receiving all assessment and advice components of recommended antenatal care, and 9.9% (95%CI:7.6-12.8) of women reported being referred for extra support. Women who were younger (OR = 1.13;95%CI:1.05-1.21), identifying as Aboriginal and Torres Strait Islander (OR = 24.54;95%CI:4.98-120.94), had a higher pre-pregnancy BMI (OR = 1.13;95%CI:1.05-1.21), were experiencing their first pregnancy (OR = 3.36;95%CI:1.27-8.86), and lived in a least disadvantaged area (compared to mid-disadvantaged area (OR = 18.5;95%CI:2.6-130.5) and most disadvantaged area (OR = 13.1;95%CI:2.09-82.4)) were more likely to receive recommended assessment and advice. Most Aboriginal (92%) and non-Aboriginal (93%) women agreed that recommended GWG care is acceptable. CONCLUSION Most women perceive antenatal care for GWG as recommended by the Clinical Practice Guidelines as acceptable, but did not receive it. When provided, such care is not delivered consistently to all women regardless of their characteristics or those of the maternity service they attend. There is a need for service-wide practice change to increase routine GWG care in pregnancy for all women.
Collapse
Affiliation(s)
- Jenna L Hollis
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia.
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia.
| | - Kristine Deroover
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Milly Licata
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Belinda Tully
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Gomeroi Nation, New England North West, NSW, Australia
| | - Eva Farragher
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Christophe Lecathelinais
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Nicole Bennett
- Hunter New England Local Health District Nursing and Midwifery Services, Newcastle, NSW, 2305, Australia
| | - Michelle Foster
- Hunter New England Local Health District Nursing and Midwifery Services, Newcastle, NSW, 2305, Australia
| | - Craig E Pennell
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - John Wiggers
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Justine Daly
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Longworth Avenue, Locked Bag 10, Wallsend, NSW, 2287, Australia
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| |
Collapse
|
37
|
Han E(F, Srinivasa S, Gurney J, Koea J. Cancer Screening Services: What Do Indigenous Communities Want? A Systematic Review. JCO Glob Oncol 2024; 10:e2300035. [PMID: 38359371 PMCID: PMC10881110 DOI: 10.1200/go.23.00035] [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: 03/06/2023] [Revised: 11/04/2023] [Accepted: 11/14/2023] [Indexed: 02/17/2024] Open
Abstract
PURPOSE Indigenous communities experience worse cancer outcomes compared with the general population partly because of lower cancer screening access. One-size-fits-all screening programs are unsuitable for reaching Indigenous communities. In this review, we summarize available evidence on the perspectives of these communities; with a view to informing the improvement of cancer screening services to achieve equitable access. METHODS We undertook a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using the databases MEDLINE, Scopus, PubMed, and Google Scholar. The search terms used were "Indigenous community or Indigenous communities," "cancer screening," and "facilitators, enablers, desires, or needs." Qualitative studies published up to the August 30, 2022 investigating the perspectives of Indigenous communities on factors encouraging screening participation were included in the study. The included studies were reviewed and analyzed inductively by two independent reviewers, and key themes regarding indigenous access to cancer screening were then extracted. RESULTS A total of 204 unique articles were identified from the search. The title and abstracts of these studies were screened, and 164 were excluded on the basis of the exclusion and inclusion criteria. The full texts of the remaining 40 studies were examined and 18 were included in the review. Four key themes were identified pertaining to culturally tailored education and information dissemination, community involvement, positive relationships with health care providers, and individual empowerment and autonomy. CONCLUSION Improvements, on the basis of the key themes identified from this review, must be made at all levels of the health care system to achieve equitable screening participation in Indigenous communities. However, we recommend an investigation into the perspectives of the local Indigenous communities before the initiation of cancer screening programs.
Collapse
Affiliation(s)
| | - Sanket Srinivasa
- Department of Surgery, North Shore Hospital, Auckland, New Zealand
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - Jason Gurney
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jonathan Koea
- Department of Surgery, North Shore Hospital, Auckland, New Zealand
- Department of Surgery, The University of Auckland, Auckland, New Zealand
- Te Kupenga Hauora Māori, University of Auckland, Auckland, New Zealand
| |
Collapse
|
38
|
Kerr M, Jaure A, Stephens JH, Kim S, Cutler R, Cashmore B, Dickson M, Evangelidis N, Hughes JT, Roberts I, Scholes-Robertson N, Sinka V, Craig JC. Experiences of Indigenous Patients Receiving Dialysis: Systematic Review of Qualitative Studies. Am J Kidney Dis 2024; 83:139-150.e1. [PMID: 37730171 DOI: 10.1053/j.ajkd.2023.07.014] [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: 04/03/2023] [Revised: 06/30/2023] [Accepted: 07/09/2023] [Indexed: 09/22/2023]
Abstract
RATIONALE & OBJECTIVE Indigenous People suffer a high burden of kidney disease. Those receiving maintenance dialysis have worse outcomes compared with similarly treated non-Indigenous patients. We characterized the experiences of Indigenous patients receiving dialysis in British-colonized countries to gain insights into which aspects of kidney care may benefit from improvement. STUDY DESIGN A systematic review of published qualitative interview studies. SETTING & STUDY POPULATIONS Indigenous Peoples aged 18 years and over, receiving hemodialysis or peritoneal dialysis in British-colonized countries. SELECTION CRITERIA FOR STUDIES Search terms for Indigenous Peoples, dialysis, and qualitative research were entered into Medline, Embase, PsycINFO, and CINAHL and searched from inception to January 5, 2023. DATA EXTRACTION Characteristics of each study were extracted into Microsoft Excel for quality assessment. ANALYTICAL APPROACH Data were analyzed using thematic synthesis. RESULTS The analysis included 28 studies involving 471 participants from Australia, New Zealand, Canada, and the United States. We identified four themes: centrality of family and culture (continuing dialysis for family, gaining autonomy through shared involvement, balancing primary responsibility to care for family); marginalization due to structural and social inequities (falling through gaps in primary care intensifying shock, discriminated against and judged by specialists, alienated and fearful of hospitals, overwhelmed by travel, financial and regimental burdens); vulnerability in accessing health care (need for culturally responsive care, lack of language interpreters, without agency in decision-making, comorbidities compounding complexity of self-management); and distress from separation from community (disenfranchisement and sorrow when away for dialysis, inability to perpetuate cultural continuity, seeking a kidney transplant). LIMITATIONS We only included articles published in English. CONCLUSIONS Indigenous patients receiving dialysis experience inequities in health care that compound existing accessibility issues caused by colonization. Improving the accessibility and cultural responsiveness of dialysis and kidney transplant services in collaboration with Indigenous stakeholders holds promise to enhance the experience of Indigenous patients receiving dialysis. PLAIN-LANGUAGE SUMMARY Worldwide Indigenous populations suffer a high incidence of chronic disease leading to lower life expectancy, particularly for kidney disease, an insidious condition requiring long-term dialysis treatment. By listening to Indigenous dialysis patients' stories, we hoped to understand how to improve their experience. We gathered 28 qualitative research studies from four countries reporting Indigenous adults' experiences of dialysis. They described lacking awareness of kidney disease, poor access to health services, systemic racism, inadequate cultural safety, and being dislocated from family, community, and culture. These findings indicate that respectful collaboration with Indigenous Peoples to craft and implement policy changes holds promise to improve prevention, integrate culturally responsive health care practices, and provide better access to local dialysis services and opportunities for kidney transplants.
Collapse
Affiliation(s)
- Marianne Kerr
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Allison Jaure
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jacqueline H Stephens
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; College of Medicine and Public Health, Flinders University, Adelaide, Australia.
| | - Siah Kim
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Richard Cutler
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Brydee Cashmore
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Michelle Dickson
- Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Nicole Evangelidis
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jaquelyne T Hughes
- College of Medicine and Public Health, Rural and Remote Health, Flinders University, Adelaide, Australia
| | - Ieyesha Roberts
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia
| | - Nicole Scholes-Robertson
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Victoria Sinka
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| |
Collapse
|
39
|
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.
Collapse
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
| |
Collapse
|
40
|
Morisano D, Robinson M, Rush B, Linklater R. Conducting research with Indigenous Peoples in Canada: ethical and policy considerations. Front Psychol 2024; 14:1214121. [PMID: 38356990 PMCID: PMC10866143 DOI: 10.3389/fpsyg.2023.1214121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 12/13/2023] [Indexed: 02/16/2024] Open
Abstract
The international context of Indigenous mental health and wellbeing has been shaped by a number of key works recognizing Indigenous rights. Despite international recognitions, the mental health and wellness of Indigenous Peoples continues to be negatively affected by policies that ignore Indigenous rights, that frame colonization as historical rather than ongoing, or that minimize the impact of assimilation. Research institutions have a responsibility to conduct ethical research; yet institutional guidelines, principles, and policies often serve Indigenous Peoples poorly by enveloping them into Western knowledge production. To counter epistemological domination, Indigenous Peoples assert their research sovereignty, which for the purposes of this paper we define as autonomous control over research conducted on Indigenous territory or involving Indigenous Peoples. Indigenous sovereignty might also be applied to research impacting the landscape and the web of animal and spiritual lives evoked in a phrase such as "all my relations." This narrative review of material developed in the Canadian context examines the alignment with similar work in the international context to offer suggestions and a practice-based implementation tool to support Indigenous sovereignty in research related to wellness, mental health, and substance use. The compilation of key guidelines and principles in this article is only a start; addressing deeper issues requires a research paradigm shift.
Collapse
Affiliation(s)
- Dominique Morisano
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Ottawa, Ottawa, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Margaret Robinson
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Departments of English and Sociology & Social Anthropology, Dalhousie University, Halifax, NS, Canada
| | - Brian Rush
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Renee Linklater
- Shkaabe Makwa, Centre for Addiction and Mental Health, Toronto, ON, Canada
| |
Collapse
|
41
|
Samuels I, Hamm LM, Silva JC, Tousignant B, Furtado JM, Goodman L, Watene R, Adams J, Ramke J, Harwood M. Use of the CONSIDER statement by eye health researchers when conducting and reporting research involving Indigenous peoples: an online survey. Eye (Lond) 2024:10.1038/s41433-023-02881-6. [PMID: 38195924 DOI: 10.1038/s41433-023-02881-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Indigenous peoples experience worse eye health compared to non-Indigenous peoples. Service providers and researchers must avoid perpetuating this inequity. To help achieve this, researchers can use the CONSolIDated critERia for strengthening the reporting of health research involving Indigenous peoples (CONSIDER) statement. This study aimed to identify the degree to which the CONSIDER statement has been used by eye health researchers when conducting and reporting research with an Indigenous component, and how they perceive its relevance in their future research. METHODS We used purposive sampling to recruit eye health researchers from any country who have undertaken research with an Indigenous component. The online survey collected quantitative and qualitative data and was analysed using descriptive statistics and reflexive thematic analysis. Responses were gathered on a four-point Likert scale (1 to 4), with four being the most positive statement. RESULTS Thirty-nine eye health researchers from nine countries completed the survey (Aotearoa New Zealand, Argentina, Australia, Brazil, Canada, Colombia, Guatemala, Panama, Peru); almost two-thirds (n = 24) undertake epidemiological research. On average, participants disclosed only 'sometimes' previously reporting CONSIDER items (2.26 ± 1.14), but they thought the items were relevant to eye health research and were motivated to use these guidelines in their future research. Some participants requested clarity about how CONSIDER aligned with existing guidelines, and when and how to apply the statement. Others shared rich experiences of the benefits to their research of Indigenous leadership and collaboration. CONCLUSIONS The CONSIDER statement is perceived as a valuable tool by these eye health researchers, and there are opportunities to maximise uptake and use, including increasing awareness of the statement, clarity about when it applies, and availability of institutional-level support.
Collapse
Affiliation(s)
- Isaac Samuels
- Department of Ophthalmology, University of Auckland, Auckland, 1142, New Zealand
| | - Lisa M Hamm
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand
| | | | - Benoit Tousignant
- School of Optometry, Université de Montréal, Montreal, H3T 1P1, QC, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, H3C 3T4, QC, Canada
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049900, Brazil
| | - Lucy Goodman
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand
| | - Renata Watene
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand
| | - Jaki Adams
- The Fred Hollows Foundation, Darwin, Australia
| | - Jacqueline Ramke
- School of Optometry and Vision Science, University of Auckland, Auckland, 1142, New Zealand.
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
| | - Matire Harwood
- School of Population Health, University of Auckland, Auckland, 1142, New Zealand
| |
Collapse
|
42
|
Nguyen HXT, Bradley K, McNamara BJ, Watson R, Malay R, LoGiudice D. Risk, protective, and biomarkers of dementia in Indigenous peoples: A systematic review. Alzheimers Dement 2024; 20:563-592. [PMID: 37746888 PMCID: PMC10917055 DOI: 10.1002/alz.13458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION Dementia is an emergent health priority for Indigenous peoples worldwide, yet little is known about disease drivers and protective factors. METHODS Database searches were conducted in March 2022 to identify original publications on risk, protective, genetic, neuroradiological, and biological factors related to dementia and cognitive impairment involving Indigenous peoples. RESULTS Modifiable risk factors featured across multiple studies include childhood adversity, hearing loss, low education attainment, unskilled work history, stroke, head injury, epilepsy, diabetes, hypertension, hyperlipidemia, depression, low BMI, poor mobility, and continence issues. Non-modifiable risk factors included increasing age, sex, and genetic polymorphisms. Education, ex-smoking, physical and social activity, and engagement with cultural or religious practices were highlighted as potential protective factors. There is a paucity of research on dementia biomarkers involving Indigenous peoples. DISCUSSION Greater understanding of modifiable factors and biomarkers of dementia can assist in strength-based models to promote healthy ageing and cognition for Indigenous peoples.
Collapse
Affiliation(s)
- Huong X. T. Nguyen
- Department of MedicineRoyal Melbourne HospitalMelbourneVictoriaAustralia
- Department of Population Health and ImmunityWalter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
| | - Kate Bradley
- Department of MedicineRoyal Melbourne HospitalMelbourneVictoriaAustralia
| | - Bridgette J. McNamara
- Centre for Epidemiology and BiostatisticsUniversity of MelbourneVictoriaAustralia
- Barwon South‐West Public Health UnitBarwon HealthGeelongVictoriaAustralia
| | - Rosie Watson
- Department of MedicineRoyal Melbourne HospitalMelbourneVictoriaAustralia
- Department of Population Health and ImmunityWalter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
| | - Roslyn Malay
- Western Australian Centre for Health and AgeingUniversity of Western AustraliaPerthWAAustralia
| | - Dina LoGiudice
- Department of MedicineRoyal Melbourne HospitalMelbourneVictoriaAustralia
| |
Collapse
|
43
|
Welch S, Moles R, Viardot A, Deweerd P, Daly S, Lee K. Connecting the Dots of Care: A pilot study linking Aboriginal and/or Torres Strait Islander peoples with diabetes care in hospital, using hospital pharmacists. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100351. [PMID: 37965249 PMCID: PMC10641541 DOI: 10.1016/j.rcsop.2023.100351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/12/2023] [Accepted: 10/12/2023] [Indexed: 11/16/2023] Open
Abstract
Background Diabetes is common among Aboriginal and/or Torres Strait Islander peoples, yet often undetected in hospital. Objective To identify how urban hospital pharmacists can detect if Aboriginal and/or Torres Strait Islander patients have diabetes or a higher chance of getting diabetes. Methods A multi-methods study used data from patients, and researcher field notes. Aboriginal and/or Torres Strait Islander peoples admitted to hospital over 12-weeks (July-October 2021) were prospectively identified from admissions lists. A hospital pharmacist-researcher visited eligible patients. Consenting participants had their blood glucose and HbA1c checked. Participants with HbA1c > 6.5% (no known diabetes) or 7% (known diabetes) were referred for endocrinology review during their stay. Test results and resultant diabetes plan were shared with their general practitioner. Two days after discharge, participants were called to gauge views on their hospital-based diabetes care. Barcode technology recorded pharmacist time. Voice-recorded field notes were thematically analysed. Ethics approval was obtained. Results Seventy-two patients were eligible for inclusion, 67/72 (93%) consented to take part. Sixty-one (91%) patients returned a HbA1c < 6.5, of which, 4/61 (6.5%) returned a HbA1c, 6-6.4. They were contacted to yarn about diabetes prevention. Six of the 67 (9%) qualified for endocrine review, 5 had known diabetes, one newly diagnosed. None were known to endocrinology. All participants telephoned were satisfied with their hospital-based diabetes care. Pharmacist time for initial introductory yarn, consenting process, organisation of HbA1c and results discussion was 20 min or 40 min if referred for endocrine review. Field notes guided understanding of service implementation. Conclusion This novel pharmacist-led diabetes screening service for Aboriginal and/or Torres Strait Islander peoples appeared to provide a unique opportunity for screening and referral links in a holistic way. Future research is required to test this model by upscaling to include more pharmacists and other chronic disease screening and referral pathways.
Collapse
Affiliation(s)
- Susan Welch
- St. Vincent's Hospital, 390 Victoria St., Darlinghurst 2010, Australia
- University of Sydney, School of Pharmacy, Faculty of Medicine and Health, Camperdown, Sydney, N.S.W 2006, Australia
| | - Rebekah Moles
- University of Sydney, School of Pharmacy, Faculty of Medicine and Health, Camperdown, Sydney, N.S.W 2006, Australia
| | - Alexander Viardot
- St. Vincent's Hospital, 390 Victoria St., Darlinghurst 2010, Australia
- Garvan Institute, University of New South Wales, Randwick, Sydney, N.S.W. 2010, Australia
| | - Pauline Deweerd
- St. Vincent's Hospital, 390 Victoria St., Darlinghurst 2010, Australia
| | - Scott Daly
- St. Vincent's Hospital, 390 Victoria St., Darlinghurst 2010, Australia
| | - Kylie Lee
- University of Sydney, Addiction Medicine, Faculty of Medicine and Health, Camperdown, Sydney 2006, Australia
- The Edith Collins Centre, Camperdown, Sydney, 2006, Australia
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Vic 3083, Australia
- Burnet Institute, Melbourne, Vic 3004, Australia
- National Drug Research Institute, Curtin University, Perth, WA, 6045, Australia
| |
Collapse
|
44
|
Beks H, Mc Namara KP, Mitchell Mununjali F, Charles Kaurna JA, Versace VL. Responsiveness of a rural Aboriginal community controlled health organisation: A qualitative study. Aust J Rural Health 2023; 31:1214-1228. [PMID: 37800385 DOI: 10.1111/ajr.13048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 09/04/2023] [Accepted: 09/15/2023] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION Responsiveness of health care systems is a global concept defined as the ability of systems to function in a manner that meets the expectations of individuals, and is under-studied. In Australia, Aboriginal Community Controlled Health Organisations (ACCHOs) are valued by Aboriginal and Torres Strait Islander Peoples for the provision of holistic culturally safe primary health care and are well positioned to be responsive to community needs. OBJECTIVE To develop a conceptual framework examining the responsiveness of a rural ACCHO to the health care needs of Aboriginal and Torres Strait Islander Peoples in their service region. DESIGN A qualitative interview study using abductive reasoning was conducted. Interviews conducted with Aboriginal clients, key informants, and ACCHO health personnel from two evaluations undertaken in partnership with a rural ACCHO located in Victoria, Australia, were analysed through an iterative process of identifying key concepts from the data and evidence. Key concepts were used to develop a conceptual framework. FINDINGS Across the two evaluations, 22 participants were involved in data collection and 28 interviews were undertaken. A conceptual framework examining the responsiveness of a rural ACCHO to the health care needs of Aboriginal Peoples within their service region was developed and encompassed three concepts: operating within a complex adaptive system, mechanisms of responsiveness used by the ACCHO, and challenges experienced by the ACCHO when being responsive. DISCUSSION The developed conceptual framework expands on research supporting the value of ACCHOs in providing holistic culturally safe health care to their communities, particularly in rural settings. A key finding is the importance for ACCHOs to meet the health care needs of their community whilst navigating needs in the context of the broader health care system. When dissonance is encountered between external system components and community needs, challenges can be experienced such as adequately resourcing models of service delivery and maintaining the provision of services. CONCLUSION Conceptualising the health care system as a complex adaptive system in which an ACCHO operates and is responsive, highlights the competing demands experienced. Findings expand on mechanisms of responsiveness used at the service-user interface. Future research should examine how the broader health care system can support the role and functions of ACCHOs in being responsive to the health care needs of their communities.
Collapse
Affiliation(s)
- Hannah Beks
- Deakin Rural Health, Deakin University, Warrnambool, Victoria, Australia
| | - Kevin P Mc Namara
- Deakin Rural Health, Deakin University, Warrnambool, Victoria, Australia
| | | | | | - Vincent L Versace
- Deakin Rural Health, Deakin University, Warrnambool, Victoria, Australia
| |
Collapse
|
45
|
Williams LT, Somerville M, Wright F, Atkins H, Rogany A, Bell KL, Vincze L. How Can We Find Out What Indigenous Children and Their Families Need to Manage Weight? Lessons from Formative Nutrition Intervention Research with First Australians. Nutrients 2023; 15:4982. [PMID: 38068840 PMCID: PMC10708399 DOI: 10.3390/nu15234982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
In Australia, Indigenous children have rates of overweight and obesity 1.5 times those of non-Indigenous children. Culturally safe and effective nutrition interventions are needed for this group. This paper aims to describe a Community-based Participatory Action Research (CPAR) approach to designing formative nutrition intervention research with First Australian children and their families and to reflect on the challenges arising from this process. After obtaining ethical approvals, a Steering Committee (SC), including nine Aboriginal and Torres Strait Islander people experienced in delivering or receiving health care, was established as a project governance body to develop culturally safe project materials and methods. The Indigenous research method of yarning circles was chosen by the SC for the community consultation, and the First Australian SC members were trained to collect the data. They liaised with community organizations to recruit yarning circle participants. Individual interviews conducted by an Aboriginal research assistant replaced yarning circles due to the COVID-19 pandemic lockdowns. While the CPAR approach to formative research was successful, the pandemic and other factors tripled the study duration. To authentically, ethically and safely engage First Australians in research, researchers need to decolonize their methodological approach, and funding bodies need to allow adequate time and resources for the process.
Collapse
Affiliation(s)
- Lauren T. Williams
- Menzies Health Institute of Queensland, Griffith University, Gold Coast, QLD 4222, Australia;
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD 4222, Australia; (M.S.); (F.W.)
| | - Mari Somerville
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD 4222, Australia; (M.S.); (F.W.)
| | - Fiona Wright
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD 4222, Australia; (M.S.); (F.W.)
- GUMURRII Student Success Unit, Griffith University, Gold Coast, QLD 4222, Australia
| | - Heidi Atkins
- Queensland Child and Youth Clinical Network, Clinical Excellence Queensland, Queensland Government, Brisbane, QLD 4006, Australia;
- Reform Office, Strategy, Policy and Reform Division, Queensland Government, Brisbane, QLD 4000, Australia
| | - Ayala Rogany
- Dietetics and Food Services, Children’s Health Queensland Hospital and Health Service, South Brisbane, QLD 4001, Australia; (A.R.); (K.L.B.)
| | - Kristie L. Bell
- Dietetics and Food Services, Children’s Health Queensland Hospital and Health Service, South Brisbane, QLD 4001, Australia; (A.R.); (K.L.B.)
| | - Lisa Vincze
- Menzies Health Institute of Queensland, Griffith University, Gold Coast, QLD 4222, Australia;
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD 4222, Australia; (M.S.); (F.W.)
| |
Collapse
|
46
|
Voaklander B, Sanni O, Serrano-Lomelin J, James A, Cordingley C, Bartel R, Eurich T, Ospina MB. Diabetes during pregnancy among Métis people in Alberta: a retrospective cohort study. CMAJ 2023; 195:E1533-E1542. [PMID: 37984935 PMCID: PMC10662493 DOI: 10.1503/cmaj.230175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Diabetes in pregnancy is an important public health concern for Indigenous populations. We sought to evaluate the prevalence and outcomes of pre-existing and gestational diabetes among Métis pregnancies compared with other pregnancies in Alberta, Canada. METHODS We conducted a retrospective cohort study using administrative health data from 2006 to 2016 and the Métis Nation of Alberta Identification Registry to compare the prevalence of pre-existing and gestational diabetes among all singleton Métis births with non-Métis births. We compared 10 maternal and neonatal outcomes using adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in multivariable analyses. RESULTS The study population included 7902 Métis and 471 886 non-Métis births. The age-standardized prevalence of pre-existing diabetes was 1.7% (95% CI 1.4%-2.1%) for Métis and 1.1% (95% CI 1.1%-1.2%) for non-Métis pregnancies. For gestational diabetes, the age-standardized prevalence was 6.3% (95% CI 5.6%-6.9%) for Métis and 5.4% (95% CI 5.3%-5.4%) for non-Métis pregnancies. After adjusting for parity, maternal weight, age, smoking during pregnancy and material and social deprivation, Métis pregnancies had 1.72 times higher prevalence of preexisting diabetes (adjusted OR 1.72, 95% CI 1.15-2.56) and 1.30 times higher prevalence of gestational diabetes (adjusted OR 1.30, 95% CI 1.08-1.57) than non-Métis pregnancies. Métis pregnancies with pre-existing diabetes had nearly 3 times the odds of developing preeclampsia (adjusted OR 2.96, 95% CI 1.27-6.90), while those with gestational diabetes had 48% higher odds of large-for-gestational-age infants (adjusted OR 1.48, 95% CI 1.00-2.19). INTERPRETATION Métis pregnancies have an increased prevalence of pre-existing and gestational diabetes than non-Métis pregnancies and an elevated risk of some perinatal outcomes. Interventions to tackle these health inequities should address both physiologic and cultural dimensions of health, informed by Métis perspectives.
Collapse
Affiliation(s)
- Britt Voaklander
- School of Public Health (Voaklander, Eurich), and Department of Obstetrics and Gynecology (Sanni, Serrano-Lomelin, Ospina), University of Alberta; Métis Nation of Alberta (James, Cordingley, Bartel), Edmonton, Alta.; Department of Public Health Sciences (Ospina), Queen's University, Kingston, Ont
| | - Omolara Sanni
- School of Public Health (Voaklander, Eurich), and Department of Obstetrics and Gynecology (Sanni, Serrano-Lomelin, Ospina), University of Alberta; Métis Nation of Alberta (James, Cordingley, Bartel), Edmonton, Alta.; Department of Public Health Sciences (Ospina), Queen's University, Kingston, Ont
| | - Jesus Serrano-Lomelin
- School of Public Health (Voaklander, Eurich), and Department of Obstetrics and Gynecology (Sanni, Serrano-Lomelin, Ospina), University of Alberta; Métis Nation of Alberta (James, Cordingley, Bartel), Edmonton, Alta.; Department of Public Health Sciences (Ospina), Queen's University, Kingston, Ont
| | - Ashton James
- School of Public Health (Voaklander, Eurich), and Department of Obstetrics and Gynecology (Sanni, Serrano-Lomelin, Ospina), University of Alberta; Métis Nation of Alberta (James, Cordingley, Bartel), Edmonton, Alta.; Department of Public Health Sciences (Ospina), Queen's University, Kingston, Ont
| | - Claire Cordingley
- School of Public Health (Voaklander, Eurich), and Department of Obstetrics and Gynecology (Sanni, Serrano-Lomelin, Ospina), University of Alberta; Métis Nation of Alberta (James, Cordingley, Bartel), Edmonton, Alta.; Department of Public Health Sciences (Ospina), Queen's University, Kingston, Ont
| | - Reagan Bartel
- School of Public Health (Voaklander, Eurich), and Department of Obstetrics and Gynecology (Sanni, Serrano-Lomelin, Ospina), University of Alberta; Métis Nation of Alberta (James, Cordingley, Bartel), Edmonton, Alta.; Department of Public Health Sciences (Ospina), Queen's University, Kingston, Ont
| | - T Eurich
- School of Public Health (Voaklander, Eurich), and Department of Obstetrics and Gynecology (Sanni, Serrano-Lomelin, Ospina), University of Alberta; Métis Nation of Alberta (James, Cordingley, Bartel), Edmonton, Alta.; Department of Public Health Sciences (Ospina), Queen's University, Kingston, Ont
| | - Maria B Ospina
- School of Public Health (Voaklander, Eurich), and Department of Obstetrics and Gynecology (Sanni, Serrano-Lomelin, Ospina), University of Alberta; Métis Nation of Alberta (James, Cordingley, Bartel), Edmonton, Alta.; Department of Public Health Sciences (Ospina), Queen's University, Kingston, Ont.
| |
Collapse
|
47
|
Lloyd-Johnsen C, Hampton A, Stubbs E, Moore S, Eades S, D'Aprano A, Goldfeld S. "It's gotta be done right way": a qualitative study exploring the acceptability of a proposed longitudinal cohort study of young Aboriginal children in Alice Springs. BMC Health Serv Res 2023; 23:1210. [PMID: 37932724 PMCID: PMC10626690 DOI: 10.1186/s12913-023-10148-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/15/2023] [Indexed: 11/08/2023] Open
Abstract
There is a need for quality longitudinal data on the health and well-being of young Aboriginal and Torres Strait Islander children (hereafter Aboriginal) in Alice Springs that can be used for research, planning and evaluation. The primary aim of this descriptive qualitative study was to determine whether or not a proposed cohort study would be acceptable to the local community. The proposed cohort study will prospectively examine various factors, events and exposures in early life that give Aboriginal children the best chance to grow up strong and lead a healthy happy life. Decisions on specific priority issues to be addressed and study procedures will be determined by local Aboriginal researchers and community members during a future co-design phase. 27 semi-structured interviews and 3 focus group discussions (FGD) were conducted with a range of community stakeholders and parents/caregivers of young Aboriginal children from Alice Springs in the Northern Territory (NT) of Australia. Audio recorded data were transcribed and imported into NVivo12 qualitative software for reflexive thematic analysis. Three major themes concerning acceptability of the concept were constructed from the analysis: (1) Have to be mindful, (2) Duplication of data, and (3) "It's gotta be done right way". There was general support for the concept, however, many participants felt that a cautious and slow approach was necessary. Recommendations included focusing on building trust, taking it slow, and ensuring the study is conducted by local Aboriginal researchers. Barriers to feasibility noted included the high mobility of families, competing demands, and privacy concerns. Findings from this qualitative study support the feasibility and acceptability of a future cohort study of young Aboriginal children in Alice Springs. Leadership from respected local Aboriginal researchers and key stakeholders will be critical to its success.
Collapse
Affiliation(s)
- Catherine Lloyd-Johnsen
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
| | - Angela Hampton
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - Emma Stubbs
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - Sam Moore
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
- Menzies School of Health Research, Darwin, NT, Australia
- Flinders University, Adelaide, SA, Australia
| | - Sandra Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Anita D'Aprano
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Royal Children's Hospital, Melbourne, VIC, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Royal Children's Hospital, Melbourne, VIC, Australia
| |
Collapse
|
48
|
Johnson B. Five award-winning researchers share their tips for inclusive health research. Nat Med 2023; 29:2704-2706. [PMID: 37968373 DOI: 10.1038/s41591-023-02683-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
|
49
|
Day S. Frameworks for cultural adaptation of psychosocial interventions: A systematic review with narrative synthesis. DEMENTIA 2023; 22:1921-1949. [PMID: 37515347 PMCID: PMC10644683 DOI: 10.1177/14713012231192360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Psychosocial dementia interventions may be less effective when used with populations for whom they were not initially intended. Cultural adaptation of interventions aims to increase effectiveness of interventions by enhancing cultural relevance. Use of theoretical frameworks may promote more systematic cultural adaptation. The aim of this review was to provide a comprehensive synthesis of published cultural adaptation frameworks for psychosocial interventions to understand important elements of cultural adaptation and guide framework selection. METHOD Five scientific databases, grey literature and reference lists were searched to January 2023 to identify cultural adaptation frameworks for psychosocial interventions. Papers were included that presented cultural adaptation frameworks for psychosocial interventions. Data were mapped to the framework for reporting adaptations and modifications to evidence-based interventions, then analysed using thematic synthesis. RESULTS Twelve cultural adaptation frameworks met inclusion criteria. They were mostly developed in the United States and for adaptation of psychological interventions. The main elements of cultural adaptation for psychosocial interventions were modifying intervention content, changing context (where, by whom an intervention is delivered) and consideration of fidelity to the original intervention. Most frameworks suggested that key intervention components must be retained to ensure fidelity, however guidance was not provided on how to identify or retain these key components. Engagement (ways to reach and involve recipients) and cultural competence of therapists were found to be important elements for cultural adaptation. CONCLUSIONS Comprehensive frameworks are available to guide cultural adaptation of psychosocial dementia interventions. More work is required to articulate how to ensure fidelity during adaptation, including how to identify and retain key intervention components.
Collapse
Affiliation(s)
- Sally Day
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
50
|
Tunnicliffe DJ, Bateman S, Arnold‐Chamney M, Dwyer KM, Howell M, Gebadi A, Jesudason S, Kelly J, Lambert K, Majoni SW, Oliva D, Owen KJ, Pearson O, Rix E, Roberts I, Stirling‐Kelly R, Taylor K, Wittert GA, Widders K, Yip A, Craig J, Phoon RK. Recommendations for culturally safe clinical kidney care for First Nations Australians: a guideline summary. Med J Aust 2023; 219:374-385. [PMID: 37838977 PMCID: PMC10952490 DOI: 10.5694/mja2.52114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 08/23/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION First Nations Australians display remarkable strength and resilience despite the intergenerational impacts of ongoing colonisation. The continuing disadvantage is evident in the higher incidence, prevalence, morbidity and mortality of chronic kidney disease (CKD) among First Nations Australians. Nationwide community consultation (Kidney Health Australia, Yarning Kidneys, and Lowitja Institute, Catching Some Air) identified priority issues for guideline development. These guidelines uniquely prioritised the knowledge of the community, alongside relevant evidence using an adapted GRADE Evidence to Decision framework to develop specific recommendations for the management of CKD among First Nations Australians. MAIN RECOMMENDATIONS These guidelines explicitly state that health systems have to measure, monitor and evaluate institutional racism and link it to cultural safety training, as well as increase community and family involvement in clinical care and equitable transport and accommodation. The guidelines recommend earlier CKD screening criteria (age ≥ 18 years) and referral to specialists services with earlier criteria of kidney function (eg, estimated glomerular filtration rate [eGFR], ≤ 45 mL/min/1.73 m2 , and a sustained decrease in eGFR, > 10 mL/min/1.73 m2 per year) compared with the general population. CHANGES IN MANAGEMENT AS RESULT OF THE GUIDELINES Our recommendations prioritise health care service delivery changes to address institutional racism and ensure meaningful cultural safety training. Earlier detection of CKD and referral to nephrologists for First Nations Australians has been recommended to ensure timely implementation to preserve kidney function given the excess burden of disease. Finally, the importance of community with the recognition of involvement in all aspects and stages of treatment together with increased access to care on Country, particularly in rural and remote locations, including dialysis services.
Collapse
Affiliation(s)
- David J Tunnicliffe
- University of SydneySydneyNSW
- Centre for Kidney ResearchChildren's Hospital at WestmeadSydneyNSW
| | - Samantha Bateman
- University of AdelaideAdelaideSA
- Central and Northern Adelaide Renal and Transplantation Services, Central Adelaide Local Health NetworkAdelaideSA
| | | | | | - Martin Howell
- University of SydneySydneyNSW
- Centre for Kidney ResearchChildren's Hospital at WestmeadSydneyNSW
| | - Azaria Gebadi
- University of SydneySydneyNSW
- Centre for Kidney ResearchChildren's Hospital at WestmeadSydneyNSW
| | | | | | - Kelly Lambert
- University of WollongongWollongongNSW
- Illawarra Health and Medical Research InstituteUniversity of WollongongWollongongNSW
| | | | - Dora Oliva
- Drug and Alcohol Services, South Australia HealthAdelaideSA
| | - Kelli J Owen
- University of AdelaideAdelaideSA
- Central and Northern Adelaide Renal and TransplantationRoyal Adelaide HospitalAdelaideSA
| | - Odette Pearson
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research InstituteAdelaideSA
- Cancer Research InstituteUniversity of South AustraliaAdelaideSA
| | - Elizabeth Rix
- University of AdelaideAdelaideSA
- Southern Cross UniversityLismoreNSW
| | - Ieyesha Roberts
- University of SydneySydneyNSW
- Centre for Kidney ResearchChildren's Hospital at WestmeadSydneyNSW
| | - Ro‐Anne Stirling‐Kelly
- University of SydneySydneyNSW
- Centre for Kidney ResearchChildren's Hospital at WestmeadSydneyNSW
- NSW Health Mid‐North Coast Local Health DistrictSydneyNSW
| | - Kimberly Taylor
- Aboriginal Communities and Families Health Research Alliance, South Australian Health and Medical Research InstituteAdelaideSA
| | - Gary A Wittert
- University of AdelaideAdelaideSA
- Royal Adelaide HospitalAdelaideSA
| | - Katherine Widders
- University of SydneySydneyNSW
- Centre for Kidney ResearchChildren's Hospital at WestmeadSydneyNSW
| | - Adela Yip
- University of SydneySydneyNSW
- Centre for Kidney ResearchChildren's Hospital at WestmeadSydneyNSW
| | | | | |
Collapse
|