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Williams J, McMillan F, Peden AE. Yarning about river safety: A qualitative study exploring water safety beliefs and practices for First Nations People. Health Promot J Austr 2023. [PMID: 37607553 DOI: 10.1002/hpja.792] [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: 03/27/2023] [Revised: 06/29/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023] Open
Abstract
ISSUE ADDRESSED Water is vital to Australian First Nations Peoples' connection to country and culture. Despite this cultural significance, and epidemiological studies identifying elevated drowning risk among Australian First Nations Peoples, extremely limited qualitative research explores water safety beliefs and practices of First Nations Peoples. This study addressed this knowledge gap via qualitative research with Wiradjuri people living in Wagga Wagga, New South Wales. METHODS Under Aboriginal Reference Group guidance, a local researcher recruited participants using purposive sampling for yarning circles across four groups: young people aged 18-30 years, parents of children under 5, parents of older children and adolescents and Elders. Yarning circles were audio recorded, transcribed and thematically coded using an inductive approach. RESULTS In total, 10 First Nations individuals participated. Yarning led to rich insights and yielded five themes: families as first educators; importance of storytelling, lived experience and respect for knowledge holders; the river as a place of connection; historical influence on preference for river over pool and river is unpredictable and needs to be respected. CONCLUSIONS This study demonstrates the importance of First Nations culture to water safety practices, particularly around the river. To reduce drowning risk among First Nations populations, knowledge holders need to be embedded in the design and delivery of community water safety education. SO WHAT?: Co-designing water safety initiatives with First Nations Peoples will have dual benefits; developing culturally appropriate and locally relevant water safety education, while also continuing First Nations culture across generations.
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Affiliation(s)
- Jasmine Williams
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Faye McMillan
- School of Public Health, University of Technology Sydney, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Amy E Peden
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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Smith S, Martin‐Khan M, Travers C. What constitutes a quality community aged care service-client perspectives: An international scoping study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3593-e3628. [PMID: 36083293 PMCID: PMC10087212 DOI: 10.1111/hsc.13998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/25/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Overwhelmingly, older Australians (people aged 65 years and older or 50 years and older for Aboriginal and Torres Strait Islander people) prefer to remain living in their own home rather than moving into residential care. To enable older Australians who require assistance to remain living at home, the Federal Government provides a wide range of community care services, the provision of which has increased substantially over the last 15 years. The importance of client preferences, prefaced by the introduction of consumer directed care across community aged care services, has gathered momentum in Australia following legislation in 2015. Older peoples' preferences differ in comparison to younger people with disability and those with mental health concerns. Older people focus more on the provision of services rather than the notion of independent living itself. This scoping review aimed to explore what aspects people aged 65 years and older consider to be important qualities of aged care services delivered in the community. A computerised search in MEDLINE, CINAHL, PubMed and PsychINFO and hand searches of the Cochrane database and Google Scholar were completed in May 2022. Sixty-two articles met the selection criteria and were included in the review. Data were extracted using a fit-for-purpose protocol and analysed using the Miles and Huberman Model for thematic analysis. Results identified five themes representing quality domains that describe features that are important to clients: staff knowledge, respect for clients, a person-centred approach, a collaborative partnership with clients and clear communication. When providers of community aged care services are planning to assess the quality of their services, these findings could be used to guide their evaluation. This will ensure that future services delivered accommodate the needs and preferences of clients who receive them.
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Affiliation(s)
- Sandra Smith
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
| | - Melinda Martin‐Khan
- Centre for Health Services ResearchThe University of QueenslandBrisbaneQueenslandAustralia
| | - Catherine Travers
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQueenslandAustralia
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Macniven R, Simon A, Wilson R, Howie A, Stewart G, Ma T, Turner NJ, Cairnduff S, Coombes J. Ironbark: Developing a healthy community program for older Aboriginal people. Health Promot J Austr 2022; 33 Suppl 1:128-133. [PMID: 35148452 PMCID: PMC9790301 DOI: 10.1002/hpja.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED Programs by, with and for Aboriginal older people must be culturally safe and relevant. Successful elements include being Aboriginal specific and group based. Co-design with Aboriginal people and stakeholders is essential. We describe the co-design process of developing the Ironbark: Healthy Community program. METHODS Aboriginal ways of knowing, being and doing and yarning conversational methods guided the development process, during 2018. A desktop review provided details of current group characteristics and key community stakeholders. Stakeholder engagement regarding views about group operations, participants and benefits also occurred. Aboriginal Elders views of their groups were gathered through yarning circles in New South Wales (NSW). Grounded theory approach was used to ascertain key themes. RESULTS Initial engagement occurred with 13 different community stakeholders and organisations in three Australian states (NSW, South Australia (SA), Western Australia (WA)). Three yarning circles occurred with Elders from urban (N = 10), regional coastal (N = 10) and regional country (N = 4) groups. Six key themes were organised in three groups according to an Aboriginal ontology. 1. Knowing: groups provide opportunities to share knowledge and connect socially. Adequate program resourcing and sustainability are valued. 2. Being: groups strengthen culture, providing important social, emotional and other forms of support to age well. 3. Doing: previous program experiences inform perceptions for new program operations. Group venues and operational aspects should be culturally safe, acknowledging diversity among Elders, their preferences and community control. Themes were used to develop the program and its resource manual that were finalised with stakeholders, including steering committee approval. CONCLUSIONS Stakeholder feedback at multiple stages and Aboriginal Elders' perspectives resulted in a new co-designed community program involving weekly yarning circles and social activities. So what?: Co-design, guided by Aboriginal ways of knowing, being and doing, can develop programs relevant for Aboriginal people.
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Affiliation(s)
- Rona Macniven
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,Faculty of Health, Medicine and Human SciencesMacquarie UniversityNew South WalesAustralia
| | | | - Roland Wilson
- Southgate Institute for Health, Society, and EquityFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Adam Howie
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Georgia Stewart
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research InstituteThe University of WollongongWollongongNew South WalesAustralia
| | - Tracey Ma
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,The George Institute for Global HealthSydneyNew South WalesAustralia
| | - Norma Jean Turner
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Sallie Cairnduff
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,The George Institute for Global HealthSydneyNew South WalesAustralia
| | - Julieann Coombes
- The George Institute for Global HealthSydneyNew South WalesAustralia
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Kennedy M, Maddox R, Booth K, Maidment S, Chamberlain C, Bessarab D. Decolonising qualitative research with respectful, reciprocal, and responsible research practice: a narrative review of the application of Yarning method in qualitative Aboriginal and Torres Strait Islander health research. Int J Equity Health 2022; 21:134. [PMID: 36100899 PMCID: PMC9472448 DOI: 10.1186/s12939-022-01738-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/22/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Indigenous academics have advocated for the use and validity of Indigenous methodologies and methods to centre Indigenous ways of knowing, being and doing in research. Yarning is the most reported Indigenous method used in Aboriginal and Torres Strait Islander qualitative health research. Despite this, there has been no critical analysis of how Yarning methods are applied to research conduct and particularly how they privilege Indigenous peoples. OBJECTIVE To investigate how researchers are applying Yarning method to health research and examine the role of Aboriginal and Torres Strait Islander researchers in the Yarning process as reported in health publications. DESIGN Narrative review of qualitative studies. DATA SOURCES Lowitja Institute LitSearch January 2008 to December 2021 to access all literature reporting on Aboriginal and Torres Strait Islander health research in the PubMed database. A subset of extracted data was used for this review to focus on qualitative publications that reported using Yarning methods. METHODS Thematic analysis was conducted using hybrid of inductive and deductive coding. Initial analysis involved independent coding by two authors, with checking by a third member. Once codes were developed and agreed, the remaining publications were coded and checked by a third team member. RESULTS Forty-six publications were included for review. Yarning was considered a culturally safe data collection process that privileges Indigenous knowledge systems. Details of the Yarning processes and team positioning were vague. Some publications offered a more comprehensive description of the research team, positioning and demonstrated reflexive practice. Training and experience in both qualitative and Indigenous methods were often not reported. Only 11 publications reported being Aboriginal and/or Torres Strait Islander led. Half the publications reported Aboriginal and Torres Strait Islander involvement in data collection, and 24 reported involvement in analysis. Details regarding the role and involvement of study reference or advisory groups were limited. CONCLUSION Aboriginal and Torres Strait Islander people should be at the forefront of Indigenous research. While Yarning method has been identified as a legitimate research method to decolonising research practice, it must be followed and reported accurately. Researcher reflexivity and positioning, and Aboriginal and Torres Strait Islander ownership, stewardship and custodianship of data collected were significantly under detailed in the publications included in our review. Journals and other establishments should review their processes to ensure necessary details are reported in publications and engage Indigenous Editors and peer reviewers to uphold respectful, reciprocal, responsible and ethical research practice.
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Affiliation(s)
- Michelle Kennedy
- College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia.
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
| | - Raglan Maddox
- National Centre for Epidemiology and Public Health, The Australian National University, Canberra ACT, Australia
| | - Kade Booth
- College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Sian Maidment
- College of Health Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Catherine Chamberlain
- School of Population and Global Health, Centre for Health Equity, University of Melbourne, Melbourne, VIC, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, WA, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, UWA Medical School, Crawley, WA, Australia
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Gidgup MJR, Kickett M, Jacques A, Weselman T, Hill KD, Coombes J, Ivers R, Bowser N, Palacios V, Hill AM. Translating and Evaluating a Physical Activity Program for Aboriginal Elders on Noongar Boodjar (Country) — A Longitudinal Study. Front Public Health 2022; 10:904158. [PMID: 35937226 PMCID: PMC9355611 DOI: 10.3389/fpubh.2022.904158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/09/2022] [Indexed: 11/24/2022] Open
Abstract
Objective The primary aim of the study was to translate and evaluate the impact of a Physical Activity (PA) program on the physical function of older Aboriginal Elders on Noongar Boodjar (Country). Methods A longitudinal design framed within an Indigenous methodology. Two groups, one metropolitan and one regional, of Aboriginal Elders, aged ≥45 years, participated in the Ironbark PA program. This comprised weekly strength and balance exercises followed by yarning circles. Physical function (primary outcome) and functional ability, cardiovascular risk factors (weight, waist circumference), falls efficacy and health-related quality of life were measured at baseline 6, 12 and 24 months. Data were analyzed using generalized linear mixed effects modeling. Results Fifty-two Elders initially enrolled and of those, n = 23 (44.2%) Elders participated regularly for 24 months. There was a 6-month gap in program delivery due to the COVID-19 pandemic. Participants made significant improvement in physical function at 12 months compared to baseline: [short physical performance battery (SPPB) at baseline, 8.85 points (95% CI 8.10, 9.61); 12 months 10.28 (95% CI 9.44, 11.13), p = 0.001: gait speed at baseline 0.81 ms−1 (95% CI 0.60, 0.93); 12 months 1.14 (95% CI 1.01, 1.27), p < 0.001]. Some sustained improvement compared to baseline was still evident at 24 months after the 6-month gap in attendance [SPPB 9.60 (8.59, 10.60) p = 0.14, gait speed 1.11 (0.95, 1.26) p < 0.001]. Cardiovascular risk factors showed a non-significant improvement at 12 and 24 months compared to baseline. All participants reported that they enjoyed the program, found it culturally appropriate and would recommend it to others. Conclusion Older Aboriginal people showed sustained improvements in physical function after engaging in a culturally appropriate PA program. Culturally appropriate PA programs provide safety, security and choice for older Aboriginal people to engage in evidence-based PA.
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Affiliation(s)
- Margaret J. R. Gidgup
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- *Correspondence: Margaret J. R. Gidgup
| | | | - Angela Jacques
- Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
| | - Tammy Weselman
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, WA, Australia
| | - Keith D. Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, VIC, Australia
| | - Julieann Coombes
- Aboriginal and Torres Strait Islander Health Program, The George Institute for Global Health, Sydney, NSW, Australia
| | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Nicole Bowser
- South West Aboriginal Medical Service Aboriginal Corporation, Bunbury, WA, Australia
| | - Vilma Palacios
- North Metropolitan Public Health Unit, WA North Metropolitan Health Service, Perth, WA, Australia
| | - Anne-Marie Hill
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, WA, Australia
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Stapinski L, Routledge K, Snijder M, Doyle M, Champion K, Chapman C, Ward J, Baumgart A, Lee KSK, Teesson M, Newton N. A Web-Based Alcohol and Other Drug Prevention Program (Strong & Deadly Futures) for Aboriginal and Torres Strait Islander School Students: Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34530. [PMID: 34994696 PMCID: PMC8783274 DOI: 10.2196/34530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 11/22/2022] Open
Abstract
Background There are no available school-based alcohol and drug prevention programs with evidence of effectiveness among Aboriginal and Torres Strait Islander youth. To address this, we codeveloped the Strong & Deadly Futures well-being and alcohol and drug prevention program in partnership with an Indigenous creative design agency and 4 Australian schools. Objective This paper presents the protocol to evaluate the effectiveness of Strong & Deadly Futures in reducing alcohol and other drug use and improving well-being among Aboriginal and Torres Strait Islander youth. Methods The target sample will be 960 year 7 and 8 students from 24 secondary schools in Australia, of which approximately 40% (384/960) will identify as Aboriginal or Torres Strait Islander. The study design is a 2-group, parallel cluster randomized controlled trial with allocation concealment. Recruited schools will be block randomized (ratio 1:1), stratified by geographical remoteness, by an independent statistician. Schools will be randomized to receive Strong & Deadly Futures, a web-based alcohol and drug prevention and social and emotional well-being program that delivers curriculum-aligned content over 6 lessons via an illustrated story, or health education as usual (control). Control schools will be supported to implement Strong & Deadly Futures following trial completion. Surveys will be administered at baseline, 6 weeks, 12 months, and 24 months (primary end point) post baseline. Primary outcomes are alcohol use (adapted from the National Drug Strategy Household Survey), tobacco use (Standard High School Youth Risk Behavior Survey), and psychological distress (Kessler-5 Psychological Distress Scale). Secondary outcomes are alcohol and drug knowledge and intentions, alcohol-related harms, binge drinking, cannabis use, well-being, empowerment, appreciation of cultural diversity, and truancy. Results The trial was funded by the National Health and Medical Research Council in January 2019, approved by the Human Research Ethics Committee of the University of Sydney (2020/039, April 2020), the Aboriginal Health and Medical Research Council of New South Wales (1620/19, February 2020), the Western Australian Aboriginal Health Ethics Committee (998, October 2021), and the ethics committees of each participating school, including the New South Wales Department of Education (2020170, June 2020), Catholic Education Western Australia (RP2020/39, November 2020), and the Queensland Department of Education (550/27/2390, August 2021). Projected dates of data collection are 2022-2024, and we expect to publish the results in 2025. A total of 24 schools have been recruited as of submission of the manuscript. Conclusions This will be the first cluster randomized controlled trial of a culturally inclusive, school-based alcohol and drug prevention program for Aboriginal and Torres Strait Islander youth; therefore, it has significant potential to address alcohol and other drug harms among Aboriginal and Torres Strait Islander youth. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620001038987; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380038&isReview=true International Registered Report Identifier (IRRID) PRR1-10.2196/34530
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Affiliation(s)
- Lexine Stapinski
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Kylie Routledge
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Mieke Snijder
- Institute of Development Studies, The University of Sussex, Brighton, United Kingdom
| | - Michael Doyle
- National Health and Medical Research Council Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Camperdown, Australia
| | - Katrina Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Cath Chapman
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - James Ward
- University of Queensland Poche Centre for Indigenous Health, University of Queensland, St Lucia, Australia
| | - Amanda Baumgart
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - K S Kylie Lee
- National Health and Medical Research Council Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Camperdown, Australia.,National Drug Research Institute, Curtin University, Bentley, Australia.,Burnet Institute, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Darlington, Australia
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Sivertsen N, Harrington A, Hamiduzzaman M. ‘Two-eyed seeing’: the integration of spiritual care in Aboriginal residential aged care in South Australia. JOURNAL OF RELIGION, SPIRITUALITY & AGING 2019. [DOI: 10.1080/15528030.2019.1669515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Angell B, Laba T, Lukaszyk C, Coombes J, Eades S, Keay L, Ivers R, Jan S. Participant preferences for an Aboriginal-specific fall prevention program: Measuring the value of culturally-appropriate care. PLoS One 2018; 13:e0203264. [PMID: 30169525 PMCID: PMC6118364 DOI: 10.1371/journal.pone.0203264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 08/17/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Culturally-specific services are central to efforts to improve the health of Aboriginal Australians. Few empirical studies have demonstrated the value of such services relative to mainstream alternatives. OBJECTIVE To assess the preferences and willingness to pay (WTP) of participants for attending a class and the relative importance of transport, cost and cultural-appropriateness in the choices made by participants. DESIGN A discrete choice experiment (DCE) was conducted alongside a study of a culturally-specific fall-prevention service. Attributes that were assessed were out-of-pocket costs, whether transport was provided and whether the class was Aboriginal-specific. Choices of participants were modelled using panel-mixed logit methods. RESULTS 60 patients completed the DCE. Attending a service was strongly preferred over no service (selected 99% of the time). Assuming equivalent efficacy of fall-prevention programs, participants indicated a preference for services that were culturally-specific (OR 1.25 95% CI: 1.00-1.55) and incurred lower out-of-pocket participant costs (OR 1.19 95% CI 1.11-1.27). The provision of transport did not have a statistically significant influence on service choice (p = 0.57). DISCUSSION AND CONCLUSIONS This represents the first published DCE in the health field examining preferences amongst an Aboriginal population. The results empirically demonstrate the value of the culturally-specific element of a program has to this cohort and the potential that stated-preference methods can have in incorporating the preferences of Aboriginal Australians and valuing cultural components of health services. NOTE ON TERMINOLOGY As the majority of the NSW Aboriginal and Torres Strait Islander population is Aboriginal (97.2%), this population will be referred to as 'Aboriginal' in this manuscript.
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Affiliation(s)
- Blake Angell
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- The Poche Centre for Indigenous Health, Sydney Medical School, the University of Sydney, Sydney, Australia
| | - Tracey Laba
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- The University of Sydney, Menzies Centre for Health Policy, School of Public Health, Sydney Medical School, Sydney, New South Wales, Australia
| | - Caroline Lukaszyk
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Julieann Coombes
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | | | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- School of Public Health & Community Medicine, University of New South Wales, Sydney, Australia
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Lukaszyk C, Coombes J, Sherrington C, Tiedemann A, Keay L, Mackean T, Clemson L, Cumming R, Broe T, Ivers R. The Ironbark program: Implementation and impact of a community-based fall prevention pilot program for older Aboriginal and Torres Strait Islander people. Health Promot J Austr 2017; 29:189-198. [PMID: 30159986 DOI: 10.1002/hpja.25] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 11/17/2017] [Indexed: 11/10/2022] Open
Abstract
AIM To document the implementation and investigate within-group impact of The Ironbark Program: a community-based, Aboriginal-specific fall prevention program, in New South Wales, Australia. METHODS The Ironbark Program was trialled in six Aboriginal communities over a three- to six-month period. A mixed methods approach was used for program evaluation: strength, balance and gait were assessed to measure participant physical function and BMI was monitored. Semi-structured participant interviews investigated program suitability, relevance and impact. RESULTS Ninety-eight Aboriginal people aged 40+ years registered for the pilot program, 77 (79%) of whom were present at all assessment time points. There were significant improvements in participant leg strength (average time to complete five repetition sit-to-stand: 14 seconds to 11 seconds), balance (timed single-leg stance: 5.6 seconds to 7.8 seconds), gait (timed 4 m walk: 0.51 m/s to 0.94 m/s) and a significant decrease in BMI (32.0 to 31.6) was observed. Participants reported enjoying the program and stated they would recommend it to others. CONCLUSION The evaluation of the Ironbark Program demonstrated acceptability, and showed significant improvements in physical function. If proven to be effective in a definitive trial, this program could be used widely to prevent falls in older Aboriginal people. IMPLICATIONS Key features of the Ironbark Program were local Aboriginal management, culturally relevant resources, ongoing availability and enabling program use for people aged less than 65 years. These features should be retained on the program's upscale, and may be incorporated into other healthy ageing programs developed for the Aboriginal population.
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Affiliation(s)
- Caroline Lukaszyk
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Julieann Coombes
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | | | - Anne Tiedemann
- Faculty of Health Sciences, University of Sydney, Camperdown, NSW, Australia
| | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
| | - Tamara Mackean
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Southgate Institute for Health, Society and Equity, Flinders University, North Ridge Precinct, Adelaide, SA, Australia
| | - Lindy Clemson
- Faculty of Health Sciences, University of Sydney, Camperdown, NSW, Australia.,Centre of Excellence in Population Ageing Research, University of Sydney, Lidcombe, NSW, Australia
| | - Robert Cumming
- Sydney School of Public Health, University of Sydney, Camperdown, NSW, Australia
| | - Tony Broe
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
| | - Rebecca Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Camperdown, NSW, Australia.,School of Nursing and Midwifery, Flinders University, Adelaide, SA, Australia
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