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Lewis DA, Mitchell T, Kowal E. Precision medicine in Australia: indigenous health professionals are needed to improve equity for Aboriginal and Torres Strait Islanders. Int J Equity Health 2024; 23:134. [PMID: 38965527 PMCID: PMC11223270 DOI: 10.1186/s12939-024-02202-7] [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: 11/15/2022] [Accepted: 05/22/2024] [Indexed: 07/06/2024] Open
Abstract
Precision medicine, also known as "personalised medicine", seeks to identify strategies in the prevention and treatment of disease informed by a patient's genomic information. This allows a targeted approach to disease identification with the intention of reducing the burden of illness. Currently, both the emerging field of precision medicine and the established field of clinical genetics are highly reliant on genomic databases which are fraught with inbuilt biases, particularly from sample populations. The inequities of most concern here are those affecting Aboriginal and Torres Strait Islander (or Zenadth Kes) peoples of Australia (hereafter, respectfully, Indigenous Australians). It is with this perspective that the Summer internship forINdigenous peoples inGenomics Australia endeavours to support the development of culturally appropriate genomic research with Indigenous Australians. We argue here that Indigenous researchers are best placed to create the informed, culturally safe environment necessary for Indigenous Australians to participate in genomic research.
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Affiliation(s)
- Dawn Alison Lewis
- University of Adelaide, Adelaide, 5005, Australia
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood Campus, 3125, Melbourne, Australia
| | - Tala Mitchell
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood Campus, 3125, Melbourne, Australia
| | - Emma Kowal
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood Campus, 3125, Melbourne, Australia.
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Cullen T, Griffith M, Damodaran A, Lewis E, McMillan F, Sammel A, Honeysette R, Biles B, Beadman K, Nathan S. The First Nations experience of accessing rheumatology services in a metropolitan hospital: A qualitative study. Health Expect 2024; 27:e14049. [PMID: 38623822 PMCID: PMC11019439 DOI: 10.1111/hex.14049] [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: 01/18/2024] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVE First Nations Australians experience a higher burden and severity of Rheumatic Disease with poorer outcomes than the general population. Despite a widely acknowledged need to improve health outcomes, there has been minimal research assessing existing models of care from a First Nations perspective in Australia. The objective of this study was to describe First Nations experiences and barriers and enablers to accessing a hospital-based adult Rheumatology service in Sydney. METHODS A qualitative study using semi-structured interviews was undertaken. Patients who self-identified as First Nations attending the Prince of Wales Hospital Rheumatology Clinic in 2021 were invited to participate. Interviews were conducted face-to-face or by telephone using culturally-appropriate Yarning methods with an Aboriginal Health Worker (AHW) at the request of participants. Thematic analysis was done in consultation with an Aboriginal Reference Group (ARG). RESULTS Four categories, which encapsulated 11 themes were identified. Participants reported barriers to care such as logistics of the referral process, not feeling culturally safe because of uncomfortable clinic environments and health worker behaviours, inadequate cultural support and community perceptions of the specialty. Enabling factors included family member involvement, AHW support and telehealth consultation. CONCLUSION The current model of care perpetuates access challenges for First Nations Australians within rheumatology. Barriers to care include the delayed referral process, limited cultural responsivity in the clinic environment and poor cross-cultural communication. There is a need for models of care that are co-designed with First Nations Peoples to address these barriers. PATIENT AND PUBLIC CONTRIBUTION Participants were First Nations Australians with lived experience attending the rheumatology clinic. All interviewees were offered the opportunity to review their transcripts to ensure trustworthiness of the data. Preliminary thematic analysis was conducted in partnership with the AHW who has over 20 years experience. Following preliminary coding, a list of themes were presented to the ARG for iterative discussion and refinement. The ARG provided community representation and ensured that First Nations voices were privileged in the analysis. It's intended that the findings of this study will support the upcoming co-design of a First Nations health service for Rheumatology patients.
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Affiliation(s)
- Taylor Cullen
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
- Department of RheumatologyPrince of Wales HospitalSydneyAustralia
| | - Miki Griffith
- Aboriginal and Torres Strait Islander Community ServicesPrince of Wales HospitalSydneyAustralia
| | - Arvin Damodaran
- Department of RheumatologyPrince of Wales HospitalSydneyAustralia
- School of Clinical Medicine, Faculty of Medicine and Health, UNSWSydneyAustralia
| | - Ebony Lewis
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
| | - Faye McMillan
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
- School of Public HealthUniversity of TechnologySydneyAustralia
| | - Anthony Sammel
- Department of RheumatologyPrince of Wales HospitalSydneyAustralia
- School of Clinical Medicine, Faculty of Medicine and Health, UNSWSydneyAustralia
| | - Rhiana Honeysette
- Aboriginal and Torres Strait Islander Community ServicesPrince of Wales HospitalSydneyAustralia
| | - Brett Biles
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
| | | | - Sally Nathan
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
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Kerrigan V, McGrath SY, Doig C, Herdman RM, Daly S, Puruntatameri P, Lee B, Hefler M, Ralph AP. Evaluating the impact of 'Ask the Specialist Plus': a training program for improving cultural safety and communication in hospital-based healthcare. BMC Health Serv Res 2024; 24:119. [PMID: 38254093 PMCID: PMC10804863 DOI: 10.1186/s12913-024-10565-4] [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: 05/25/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND First Nations peoples in colonised countries often feel culturally unsafe in hospitals, leading to high self-discharge rates, psychological distress and premature death. To address racism in healthcare, institutions have promised to deliver cultural safety training but there is limited evidence on how to teach cultural safety. To that end, we created Ask the Specialist Plus: a training program that focuses on improving healthcare providers intercultural communication skills to improve cultural safety. Our aim is to describe training implementation and to evaluate the training according to participants. METHODS Inspired by cultural safety, Critical Race Theory and Freirean pedagogy, Ask the Specialist Plus was piloted at Royal Darwin Hospital in Australia's Northern Territory in 2021. The format combined listening to an episode of a podcast called Ask the Specialist with weekly, one-hour face-to-face discussions with First Nations Specialists outside the clinical environment over 7 to 8 weeks. Weekly surveys evaluated teaching domains using five-point Likert scales and via free text comments. Quantitative data were collated in Excel and comments were collated in NVivo12. Results were presented following Kirkpatrick's evaluation model. RESULTS Fifteen sessions of Ask the Specialist Plus training were delivered. 90% of participants found the training valuable. Attendees enjoyed the unique format including use of the podcast as a catalyst for discussions. Delivery over two months allowed for flexibility to accommodate clinical demands and shift work. Students through to senior staff learnt new skills, discussed institutionally racist systems and committed to behaviour change. Considering racism is commonly denied in healthcare, the receptiveness of staff to discussing racism was noteworthy. The pilot also contributed to evidence that cultural safety should be co-taught by educators who represent racial and gender differences. CONCLUSION The Ask the Specialist Plus training program provides an effective model for cultural safety training with high potential to achieve behaviour change among diverse healthcare providers. The training provided practical information on how to improve communication and fostered critical consciousness among healthcare providers. The program demonstrated that training delivered weekly over two months to clinical departments can lead to positive changes through cycles of learning, action, and reflection.
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Affiliation(s)
- Vicki Kerrigan
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia.
| | - Stuart Yiwarr McGrath
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Cassandra Doig
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Rarrtjiwuy Melanie Herdman
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Shannon Daly
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Pirrawayingi Puruntatameri
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Bilawara Lee
- Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Anna P Ralph
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
- Royal Darwin Hospital, Darwin, NT, 0811, Australia
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Abu-Saad K, Accos M, Ziv A, Collins F, Shepherd C, Eades S, Kalter-Leibovici O. Development and Functionality of a Parsimonious Digital Food Frequency Questionnaire for a Clinical Intervention among an Indigenous Population. Nutrients 2023; 15:5012. [PMID: 38068870 PMCID: PMC10707983 DOI: 10.3390/nu15235012] [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: 10/19/2023] [Revised: 11/21/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
Nutrition-related chronic diseases are a major problem among Indigenous populations. Appropriate dietary intake assessment tools are needed for nutritional surveillance and intervention; however, tools designed to measure the habitual dietary intake of Indigenous persons are largely lacking. We developed a digital food frequency questionnaire (FFQ) to measure habitual consumption among Australian Aboriginal adults and support personalized nutrition counseling. The primary contributors to energy, select nutrients, and inter-person variation (83 food groups) were identified from nationally representative 24 h recall (24HR) data, and they accounted for >80% of the total intake and inter-person variation of the nutrients of interest. Based on community input, a meal-based FFQ format was adopted, with a main food/beverage list of 81 items and the capacity to report on >300 additional items via the digital platform. The nutrient database was based on the Australian Food and Nutrient Database. Data for the first 60 study participants (70% female; median age: 48 years) were used to assess the FFQ's utility. The participants' median [IQR] reported energy intake (10,042 [6968-12,175] kJ/day) was similar to their median [IQR] estimated energy expenditure (10,197 [8636-11,551] kJ/day). Foods/beverages on the main FFQ list accounted for between 66% and 90% of the participants' reported energy and nutrient intakes; the remainder came from participant-selected extra items. The digital FFQ platform provides a potentially valuable resource for monitoring habitual dietary intake among Aboriginal adults and supporting chronic disease prevention and management interventions.
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Affiliation(s)
- Kathleen Abu-Saad
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Moran Accos
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Arnona Ziv
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
| | - Fiona Collins
- South West Aboriginal Medical Service, Bunbury, WA 6230, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Carrington Shepherd
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia;
| | - Sandra Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Ofra Kalter-Leibovici
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan 52126, Israel
- Epidemiology & Preventive Medicine Department, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
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Massi L, Hickey S, Maidment SJ, Roe Y, Kildea S, Kruske S. "This has changed me to be a better mum": A qualitative study exploring how the Australian Nurse-Family Partnership Program contributes to the development of First Nations women's self-efficacy. Women Birth 2023; 36:e613-e622. [PMID: 37302902 DOI: 10.1016/j.wombi.2023.05.010] [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: 02/10/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND The Australian Nurse-Family Partnership Program is based on the Nurse-Family Partnership program from the United States, which was designed to support first-time mothers experiencing social and economic disadvantage from early in pregnancy until their child's second birthday. International trials have demonstrated this program measurably improves family environment, maternal competencies, and child development. The Australian program has been tailored for mothers having a First Nations baby. AIM This study aimed to understand how the program impacts self-efficacy using a qualitative interpretive approach. METHODS The study took place in two sites within one Aboriginal Community Controlled Health Service in Meanjin (Brisbane), Australia. Twenty-nine participants were interviewed: first-time mothers having a First Nations baby who had accessed the program (n = 26), their family members (n = 1), and First Nations Elders (n = 2). Interviews were conducted either face-to-face or by telephone, using a yarning tool and method, to explore women's experiences and perceptions. Yarns were analysed using reflexive thematic analysis. FINDINGS Three main themes were generated: 1) sustaining connections and relationships; 2) developing self-belief and personal skills; and 3) achieving transformation and growth. We interpret that when the program facilitates the development of culturally safe relationships with staff and peers, it enables behaviour change, skill development, personal goal setting and achievement, leading to self-efficacy. DISCUSSION Located within a community-controlled health service, the program can foster cultural connection, peer support and access to health and social services; all contributing to self-efficacy. CONCLUSION We recommend the program indicators are strengthened to reflect these findings and enable monitoring and reporting of activities that facilitate self-efficacy, growth, and empowerment.
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Affiliation(s)
- Luciana Massi
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Sarah-Jade Maidment
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia.
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Ciccia D, Doyle AK, Ng CHM, Armour M. Indigenous Peoples' Experience and Understanding of Menstrual and Gynecological Health in Australia, Canada and New Zealand: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6321. [PMID: 37444168 PMCID: PMC10341312 DOI: 10.3390/ijerph20136321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/13/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
There are a variety of cultural and religious beliefs and customs worldwide related to menstruation, and these often frame discussing periods and any gynecological issues as taboo. While there has been previous research on the impact of these beliefs on menstrual health literacy, this has almost entirely been confined to low- and middle-income countries, with very little information on high-income countries. This project used the Joanna Briggs Institute (JBI) scoping review methodology to systematically map the extent and range of evidence of health literacy of menstruation and gynecological disorders in Indigenous people in the colonized, higher-income countries of Australia, Canada, and New Zealand. PubMed, CINHAL, PsycInfo databases, and the grey literature were searched in March 2022. Five studies from Australia and New Zealand met the inclusion criteria. Only one of the five included studies focused exclusively on menstrual health literacy among the Indigenous population. Despite considerable research on menstrual health globally, studies focusing on understanding the menstrual health practices of the Indigenous populations of Australia, New Zealand, and Canada are severely lacking, and there is little to no information on how Indigenous beliefs of colonized people may differ from the broader society in which they live.
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Affiliation(s)
- Donna Ciccia
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia
| | - Aunty Kerrie Doyle
- School of Medicine, Western Sydney University, Campbelltown 2560, Australia
| | - Cecilia H. M. Ng
- School of Clinical Medicine, Health and Medicine, Division of Obstetrics and Gynaecology, University of New South Wales, Sydney 2052, Australia
- Gynaecological Research and Clinical Evaluation (GRACE) Unit, Royal Hospital for Women and University of New South Wales, Randwick 2031, Australia
- Jean Hailes for Women’s Health, Melbourne 3002, Australia
- Global Women’s Health, The George Institute for Global Health, Sydney 2042, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington 6021, New Zealand
- Translational Health Research Institute (THRI), Western Sydney University, Sydney 2145, Australia
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Jennings W, Egert S, Fisher C, Renouf S, Bryce V, Grugan S, Wang W, Askew D. Better cardiac care - the patient experience - a qualitative study. Int J Equity Health 2023; 22:122. [PMID: 37380998 DOI: 10.1186/s12939-023-01931-5] [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: 03/16/2023] [Accepted: 06/05/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND In 2015, a Brisbane tertiary hospital's cardiac unit implemented a new model of multidisciplinary care (Better Cardiac Care (BCC)) for Aboriginal and Torres Strait Islander patients. Since then, clinical indicators for Aboriginal and Torres Strait Islander cardiac patients have improved, but the recipients' voices have not been heard. This research aimed to determine the acceptability and appropriateness, features of value, and opportunities for improvements in this model of care, from the perspective of patients and their family members. METHODS This descriptive qualitative study employed a narrative methodology. BCC Health Workers contacted prospective participants; with consent, interested individuals were then contacted by the Aboriginal Research Officer (RO) who arranged yarning sessions and consent. Family members were also invited to share their stories of their loved ones' hospitalisation. Two researchers conducted the interviews, using a yarning approach. Inductive narrative analysis, informed by Aboriginal and Torres Strait Islander ways of Being, Knowing, and Doing, focused on enabling participants' stories to be heard and understood from their perspectives. RESULTS Relationality was at the heart of the BCC model of care, particularly between patients and Aboriginal and Torres Strait Islander staff. The relationality included a responsibility for holistic care, extending beyond hospital discharge, although support and handover for family members required improvement. The Aboriginal and Torres Strait Islander staff understood the contextual and structural challenges faced by participants, including the disempowerment and racism experienced in healthcare. This understanding was shared with the BCC team who, in turn, protected, advocated for, and holistically supported participants through their cardiac health journeys. CONCLUSIONS Empowering (and employing) Aboriginal and Torres Strait Islander staff, and relating to patients as people, enabled BCC to meet Aboriginal and Torres Strait Islander patient's needs and improve outcomes. The wider health system and health academia could benefit from exploring and valuing Aboriginal and Torres Strait Islander discourses of relationality.
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Affiliation(s)
- Warren Jennings
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Hospital and Health Service, 37 Wirraway Parade, Inala, Qld, 4077, Australia.
- General Practice Clinical Unit, The University of Queensland, Women's Hospital, Level 8, Health Sciences Building, Royal Brisbane, Brisbane, Qld, 4029, Australia.
| | - Sonya Egert
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Metro South Hospital and Health Service, 37 Wirraway Parade, Inala, Qld, 4077, Australia
| | - Celestine Fisher
- Princess Alexandra Hospital, Queensland Health, 199 Ipswich Road, Woolloongabba, Qld, 4102, Australia
| | - Sonia Renouf
- Princess Alexandra Hospital, Queensland Health, 199 Ipswich Road, Woolloongabba, Qld, 4102, Australia
| | - Vivian Bryce
- Princess Alexandra Hospital, Queensland Health, 199 Ipswich Road, Woolloongabba, Qld, 4102, Australia
| | - Sean Grugan
- Princess Alexandra Hospital, Queensland Health, 199 Ipswich Road, Woolloongabba, Qld, 4102, Australia
| | - William Wang
- Princess Alexandra Hospital, Queensland Health, 199 Ipswich Road, Woolloongabba, Qld, 4102, Australia
- Faculty of Medicine, The University of Queensland, 199 Ipswich Road, Woolloongabba, Qld, 4102, Australia
| | - Deborah Askew
- General Practice Clinical Unit, The University of Queensland, Women's Hospital, Level 8, Health Sciences Building, Royal Brisbane, Brisbane, Qld, 4029, Australia
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Culbong H, Ramirez-Watkins A, Anderson S, Culbong T, Crisp N, Pearson G, Lin A, Wright M. "Ngany Kamam, I Speak Truly": First-Person Accounts of Aboriginal Youth Voices in Mental Health Service Reform. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6019. [PMID: 37297622 PMCID: PMC10253012 DOI: 10.3390/ijerph20116019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
Aboriginal young people are experts in their own experience and are best placed to identify the solutions to their mental health and wellbeing needs. Given that Aboriginal young people experience high rates of mental health concerns and are less likely than non-Indigenous young people to access mental health services, co-design and evaluation of appropriate mental health care is a priority. Increasing Aboriginal young people's participation in mental health service reform is key to ensuring services are culturally secure, relevant and accessible. This paper presents first-person accounts from three Aboriginal young people who worked alongside their Elders and in a positive and constructive partnership with mainstream mental health services on a three-year participatory action research project in Perth, Western Australia, in Whadjuk Nyoongar boodja (Country). The young people recount their experiences as participants and co-researchers on a systems change mental health research project and share their views on the importance of privileging Aboriginal youth voices. Their accounts highlight that Aboriginal young people's participation and leadership must be understood through a decolonising lens and that working in genuine partnership with the community is key to increasing their contact and engagement with mental health care and improving mental health and wellbeing outcomes.
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Affiliation(s)
- Hunter Culbong
- College of Arts and Social Sciences, Australian National University, Canberra 2601, Australia;
| | | | - Shae Anderson
- Kulbardi Aboriginal Centre, Murdoch University, Perth 6150, Australia;
| | - Tiana Culbong
- School of Nursing and Midwifery, The University of Technology, Sydney 2000, Australia;
| | - Nikayla Crisp
- Design Participation and Inclusion, Neami National, Perth 6000, Australia;
| | - Glenn Pearson
- Telethon Kids Institute, University of Western Australia, Perth 6000, Australia; (G.P.); (A.L.)
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Perth 6000, Australia; (G.P.); (A.L.)
| | - Michael Wright
- School of Allied Health, Faculty of Health Sciences, Curtin University, Bentley 6102, Australia
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D'Aprano A, Lloyd-Johnsen C, Cameron D, Wunungmurra A, Hull C, Boyle C, Naylon M, Brunette R, Campbell J, Matthews V. Trusting relationships and learning together: A rapid review of Indigenous reference groups in Australian Indigenous health research. Aust N Z J Public Health 2023; 47:100051. [PMID: 37182503 DOI: 10.1016/j.anzjph.2023.100051] [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: 07/28/2022] [Accepted: 03/14/2023] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVE This rapid review aims to identify how Indigenous research governance is conceptualised, implemented and documented within Australian Indigenous health research studies. METHODS We searched for peer-reviewed English-language articles in two databases and for web-based grey literature published from database inception to November 2021. Reference lists were searched to identify additional articles. Data relating to research governance were extracted and analysed thematically. RESULTS A total of 1120 records were screened, and 27 articles were included. Most articles providing detailed description of Indigenous research governance activities were qualitative studies (n=15, 55.6%). Key themes included members are experts; respectful relationships; flexibility; and key logistic considerations (nuts 'n' bolts). CONCLUSIONS Although Indigenous research governance is recognised as an essential part of ethical research, activities and contributions made by Indigenous reference group (IRG) members are underreported. This important work needs greater visibility in the published literature to share best practice in Indigenous research governance that foregrounds Indigenous expert knowledge, perspectives, and experiences. IMPLICATIONS FOR PUBLIC HEALTH The study provides a synthesis of factors to consider when establishing and facilitating an IRG for research with Indigenous communities. This has implications for researchers who can adapt and apply the findings to their practice.
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Affiliation(s)
- Anita D'Aprano
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia.
| | - Catherine Lloyd-Johnsen
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Daniele Cameron
- University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
| | | | - Charmaine Hull
- South Australian Department of Health, Port Augusta, SA, Australia
| | - Cassie Boyle
- Northern Territory Department of Education, Alice Springs, NT, Australia
| | - Marjorie Naylon
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - Raelene Brunette
- Sunrise Health Service Aboriginal Corporation, Katherine, NT, Australia
| | - Jeannie Campbell
- Northern Territory Central Australia Health Service, Tri Tree, NT, Australia
| | - Veronica Matthews
- University Centre for Rural Health, University of Sydney, Lismore, NSW, Australia
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McBride K, Franks C, Wade V, King V, Rigney J, Burton N, Dowling A, Mitchell JA, Van Kessel G, Howard N, Paquet C, Hillier S, Nicholls SJ, Brown A. Getting to the heart of the matter: a research partnership with Aboriginal women in South and Central Australia. CRITICAL PUBLIC HEALTH 2022. [DOI: 10.1080/09581596.2022.2147417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Katharine McBride
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Christine Franks
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- Aboriginal Women’s Advisory Group, Adelaide, Australia
| | - Vicki Wade
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- Menzies School of Health Research, Darwin, Australia
| | - Veronica King
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- Central Australian Aboriginal Congress, Alice Springs, Australia
| | - Janice Rigney
- Aboriginal Women’s Advisory Group, Adelaide, Australia
| | - Nyunmiti Burton
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- Ngaanyatjarra, Pitjantjatjara, Yankunytjatjara Women’s Council, Alice Springs, Australia
| | - Anna Dowling
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Julie Anne Mitchell
- Aboriginal Women’s Advisory Group, Adelaide, Australia
- The Heart Foundation of Australia, Sydney, Australia
| | - Gisela Van Kessel
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | - Natasha Howard
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- Indigenous Genomics, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Catherine Paquet
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
- Faculté des Sciences de l’Administration, Université Laval, Québec, Canada
| | - Susan Hillier
- Allied Health & Human Performance, University of South Australia, Adelaide, Australia
| | | | - Alex Brown
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- Telethon Kids Institute and Australian National University, Adelaide, Australia
- Indigenous Genomics, Australian National University, Adelaide, Australia
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Kerrigan V, McGrath SY, Herdman RM, Puruntatameri P, Lee B, Cass A, Ralph AP, Hefler M. Evaluation of 'Ask the Specialist': a cultural education podcast to inspire improved healthcare for Aboriginal peoples in Northern Australia. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2022; 31:139-157. [PMID: 35373706 DOI: 10.1080/14461242.2022.2055484] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
In Australia's Northern Territory (NT) most people who access health services are Aboriginal and most healthcare providers are non-Indigenous; many providers struggle to deliver culturally competent care. Cultural awareness training is offered however, dissatisfaction exists with the limited scope of training and the face-to-face or online delivery format. Therefore, we developed and evaluated Ask the Specialist: Larrakia, Tiwi and Yolŋu stories to inspire better healthcare, a cultural education podcast in which Aboriginal leaders of Larrakia, Tiwi and Yolŋu nations, known as the Specialists, answer doctors' questions about working with Aboriginal patients. The Specialists offer 'counterstories' which encourage the development of critical consciousness thereby challenging racist narratives in healthcare. After listening to the podcast, doctors reported attitudinal and behavioural changes which led to stereotypes being overturned and more culturally competent care delivery. While the podcast was purposefully local, issues raised had applicability beyond the NT and outside of healthcare. Our approach was shaped by cultural safety, critical race theory and Freirean pedagogy. This pilot is embedded in a Participatory Action Research study which explores strategies to improve culturally safe communication at the main NT hospital Royal Darwin Hospital.
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Affiliation(s)
- Vicki Kerrigan
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | | | | | | | - Bilawara Lee
- Indigenous leadership, Charles Darwin University, Darwin, Australia
| | - Alan Cass
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Anna P Ralph
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Royal Darwin Hospital, Darwin, Australia
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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12
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Mills BW, Hill MG, Miles AK, Smith EC, Afrifa-Yamoah E, Reid DN, Rogers SL, Sim MGB. Ability of the Australian general public to identify common emergency medical situations: Results of an online survey of a nationally representative sample. Australas Emerg Care 2022; 25:327-333. [PMID: 35525724 DOI: 10.1016/j.auec.2022.04.002] [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: 02/14/2022] [Revised: 04/20/2022] [Accepted: 04/26/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the Australian general public's ability to identify common medical emergencies as requiring an emergency response. METHODS An online survey asked participants to identify likely medical treatment pathways they would take for 17 hypothetical medical scenarios (eight emergency and nine non-emergency). The number and type of emergency scenarios participants correctly suggested warranted an emergency medical response was examined. Participants included Australian residents (aged >18 years; n = 5264) who had never worked as an Australian registered medical doctor, nurse or paramedic. RESULTS Most emergencies were predominately correctly classified as requiring emergency responses (e.g. Severe chest pain, 95% correct). However, non-emergency medical responses were often chosen for some emergency scenarios, such as a child suffering from a scalp haematoma (67%), potential meningococcal disease (57%), a box jellyfish sting (40%), a paracetamol overdose (37%), and mild chest pain (26%). Participants identifying as Aboriginal or Torres Strait Islander suggested a non-emergency response to emergency scenarios 40% more often compared with non-indigenous participants. CONCLUSIONS Educational interventions targeting specific medical symptoms may work to alleviate delayed emergency medical intervention. This research highlights a particular need for improving symptom identification and healthcare system confidence amongst Aboriginal and Torres Strait Islander populations.
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Affiliation(s)
- Brennen W Mills
- School of Medical and Health Sciences, Edith Cowan University, Australia.
| | - Michella G Hill
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Alecka K Miles
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Erin C Smith
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | | | - David N Reid
- School of Medical and Health Sciences, Edith Cowan University, Australia
| | - Shane L Rogers
- School of Arts and Humanities, Edith Cowan University, Australia
| | - Moira G B Sim
- School of Medical and Health Sciences, Edith Cowan University, Australia
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13
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West M, Sadler S, Charles J, Hawke F, Lanting S, Munteanu SE, Chuter V. Yarning about foot care: evaluation of a foot care service for Aboriginal and Torres Strait Islander Peoples. J Foot Ankle Res 2022; 15:25. [PMID: 35369890 PMCID: PMC8978452 DOI: 10.1186/s13047-022-00524-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/16/2022] [Indexed: 12/02/2022] Open
Abstract
Background Aboriginal and Torres Strait Islander Peoples have high rates of diabetes-related foot disease including foot ulcer and amputation. There has been limited evaluation of foot care services for Aboriginal and Torres Strait Islander Peoples. This project aimed to evaluate an Aboriginal and Torres Strait Islander foot care service (the Buridja Clinic) for prevention and management of diabetes-related foot disease embedded in a university podiatry program from a Community perspective using culturally appropriate methods. Methods This mixed-methods study took place from March 2018 to April 2021 in the Buridja Clinic on the Central Coast of New South Wales, Australia, and included an audit of occasions of service (March 2018 to March 2020), and review of the Buridja Clinic via research yarns with Aboriginal and Torres Strait Islander clients of the clinic and a written 10-item customised clinic feedback survey. Research yarns were transcribed and analysed thematically. Descriptive analysis of quantitative occasions of use and survey data was undertaken, with the open-ended survey responses thematically analysed. Results Total occasions of service across the review period was 548, with a total of 199 individual clients treated. Most common service types were general treatments (nail and skin care) and diabetes assessments. Nine participants who attended the Buridja Clinic were recruited to the two research yarns. An additional 52 participants who attended the clinic completed the customised clinic feedback survey. Specific clinic design elements, including yarning circles and group booking as well as student placement, were identified as strengths of the clinic. Participants reported difficulty with transport and restricted opening hours and encouraged increased Community engagement by clinic staff. Conclusion Evaluation of a foot care service for Aboriginal and Torres Strait Islander Peoples embedded in a university-based podiatry program demonstrated that the incorporation of specific service design elements, including yarning circles and group appointments as well as student placements, encouraged ongoing Community engagement with the service. Participants reported improved foot health, greater foot and self-care knowledge, and overall better general health and management as a result of attendance to the clinic. Consideration needs to be given to addressing limited access to transport and flexible operating hours when establishing similar services. Graphical abstract ![]()
Artist Jenni McEwen (Bundjalung) lives on Darkinjung Country. The story of her art shows people sitting in yarning circles sharing knowledges but looking outwards to connect with Country too, the Ochre of Wiradjuri Country around Wellington, and the Blue of Darkinjung Country around Central Coast. These are locations where podiatry service provision takes place. These are locations where everyone is sharing and learning. Students, teachers, patients, non-Indigenous people, and First Nations people, learning from each other, and learning from Country. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-022-00524-9.
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14
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Hill B, Dodd J, Uink B, Bonson D, Bennett S, Eades AM. Aboriginal and Queer Identity/ies in Western Australia: When There is a Need to Know in Therapeutic Settings. QUALITATIVE HEALTH RESEARCH 2022; 32:755-770. [PMID: 35201901 DOI: 10.1177/10497323211069682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A central question for the exploratory Aboriginal and LGBTQ+ researcher led project 'Breaking the Silence: Being Indigenous and identifying LGBTQ+' (Breaking the Silence) is how provision of genuinely inclusive service responses for Aboriginal and Torres Strait Islander people identifying as LGBTQ+ can be developed. This article presents the qualitative findings of this mixed-methods research project to show how organizational staff working in health, education and social support services in Western Australia consider the Aboriginal LGBTQ+ identity/experience. Analysis of the written, interview and focus group responses to a question about the relevance of LGBTQ+ identity show that these questions need to be considered and evaluated within diverse service cultures and philosophies of services. Staff views are diverse and organizational consensus on the relevance (or not) of LGBTQ+ identity needs to be the precursor before the development or consideration of changes to service delivery and models.
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Affiliation(s)
- Braden Hill
- Kurongkurl Katitjin Aboriginal Centre, 95980Edith Cowan University, Perth, WA, Australia
| | - Jennifer Dodd
- Kurongkurl Katitjin Aboriginal Centre, 95980Edith Cowan University, Perth, WA, Australia
| | - Bep Uink
- Kulbardi Aboriginal Centre, 5673Murdoch University, Perth, WA, Australia
| | | | - Sian Bennett
- Kurongkurl Katitjin Aboriginal Centre, 95980Edith Cowan University, Perth, WA, Australia
| | - Anne-Marie Eades
- Looking Forward Research Team, Faculty of Health Sciences, 1649Curtin University, Perth, WA, Australia
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15
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Enhancing Cultural Capabilities Amongst Health Professions Students: A Pilot Study of Interprofessional Tag Team Simulation. Clin Simul Nurs 2022. [DOI: 10.1016/j.ecns.2021.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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16
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O’Brien P, Conley B, Bunzli S, Bullen J, Coffin J, Persaud J, Gunatillake T, Dowsey MM, Choong PF, Lin I. Staying moving, staying strong: Protocol for developing culturally appropriate information for Aboriginal people with osteoarthritis, rheumatoid arthritis, lupus and gout. PLoS One 2021; 16:e0261670. [PMID: 34941954 PMCID: PMC8699613 DOI: 10.1371/journal.pone.0261670] [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: 03/23/2021] [Accepted: 12/07/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Addressing disparities in arthritis care is an important yet unmet health need for Aboriginal and Torres Strait Islander people in Australia (respectfully Aboriginal people herewith). Despite the significant prevalence and burden of arthritis within Aboriginal communities, access to care for arthritis is low. One means to reduce existing disparities in health care is to address current challenges relating to the appropriateness and acceptability of health care information resources for Aboriginal people. Health information sources can help to empower patients and their families to have greater involvement in their care and to engage in self-management of their condition. Despite an extensive range of arthritis information resources being available, currently no resources have been culturally adapted and developed in collaboration with Aboriginal consumers with arthritis. This paper outlines the processes that will be undertaken within the Staying Moving, Staying Strong project. This project aims to develop culturally secure arthritis information for Aboriginal people with osteoarthritis, rheumatoid arthritis, lupus and gout. Methods and analysis The overarching principle guiding this project is cultural security, referring to the incorporation of processes such that the research will not compromise the cultural rights, values and expectations of Aboriginal people. This project will prioritise partnerships, community engagement, community benefit, sustainability, transferability, and capacity building and therefore uphold the cultural rights and values of Aboriginal people. In this six-phase project we will; 1) Establish a community reference group and advisory committee; 2) Explore the health information needs and preferences of Aboriginal people with arthritis; 3) Synthesise the existing key recommendations in high quality clinical practice guidelines on arthritis care; 4) Culturally adapt key clinical recommendations; 5) Develop culturally appropriate arthritis resources and; 6) Qualitatively evaluate the developed resources.
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Affiliation(s)
- Penny O’Brien
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Brooke Conley
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
- * E-mail:
| | - Samantha Bunzli
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Jonathan Bullen
- Curtin Medical School, Curtin University, Perth, WA, Australia
| | - Juli Coffin
- Telethon Kids Institute, Broome, WA, Australia
| | - Jennifer Persaud
- Arthritis and Osteoporosis Western Australia, Perth, WA, Australia
- Physiotherapy Department, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Tilini Gunatillake
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Michelle M. Dowsey
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Peter F. Choong
- Department of Surgery, St Vincent’s Hospital Melbourne, The University of Melbourne, Melbourne, VIC, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA, Australia
- Geraldton Regional Aboriginal Medical Service, Geraldton, WA, Australia
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Abu-Saad K, Daoud N, Kaplan G, Ziv A, Cohen AD, Pollack D, Olmer L, Kalter-Leibovici O. A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study. PLoS One 2021; 16:e0261030. [PMID: 34890440 PMCID: PMC8664199 DOI: 10.1371/journal.pone.0261030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022] Open
Abstract
Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a 'deficit-based' discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants' knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men's, 5 women's) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants' communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09-4.63), people with disabilities (OR: 2.43; 95% CI: 1.28-4.64), and unemployed people (OR: 2.64; 95% CI: 1.28-5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25-4.09), unemployment (OR: 4.07; 95% CI: 1.64-10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03-1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants' knowledge, experience, and strengths has the potential to improve individuals' diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths.
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Affiliation(s)
- Kathleen Abu-Saad
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
- * E-mail:
| | - Nihaya Daoud
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Giora Kaplan
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Arnona Ziv
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Arnon D. Cohen
- Clalit Health Services, Tel Aviv, Israel
- Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Daphna Pollack
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Liraz Olmer
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
| | - Ofra Kalter-Leibovici
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Mills K, Creedy DK, Sunderland N, Allen J, Corporal S. A critique of measures of emotion and empathy in First Peoples' cultural safety in nursing education: A systematic literature review. Contemp Nurse 2021; 57:338-355. [PMID: 34693881 DOI: 10.1080/10376178.2021.1991413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND In Australia, undertaking cultural safety education often evokes strong emotional responses by health students. Despite the potential for emotion to drive transformative learning in this space, measures of emotion are uncommon. AIM To review existing tools that intend to measure emotional components of learning in relation to cultural safety education. METHODS Articles published in English from January 2005 to January 2020; reported studies from Australia, New Zealand, Canada and United States of America; and measured an emotional construct/s after an education intervention offered to university students enrolled in a health programme were included. Studies were assessed for quality according to the Critical Appraisals Skills Programme criteria. RESULTS Eight articles were reviewed; five conducted in the United States of America, and three in Australia. Intervention type, measures, methodological rigour and outcomes varied. Studies predominately measured empathy, guilt and/or fear. CONCLUSIONS Although students' emotional responses were measured, processes for students to reflect upon these reactions were not incorporated in the classroom. The review has implications for future research and curricula through developments in measuring and acting upon emotion in cultural safety education for nursing students in Australia.
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Affiliation(s)
- Kyly Mills
- School of Health Services and Social Work, Griffith University, Meadowbrook, Australia
| | - D K Creedy
- School of Nursing and Midwifery, Griffith University, Meadowbrook, Australia
| | - N Sunderland
- School of Health Services and Social Work, Griffith University, Meadowbrook, Australia
| | - J Allen
- School of Nursing and Midwifery, Griffith University, Meadowbrook, Australia
| | - S Corporal
- School of Health Services and Social Work, Griffith University, Meadowbrook, Australia
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19
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Massi L, Hickey S, Maidment SJ, Roe Y, Kildea S, Nelson C, Kruske S. Improving interagency service integration of the Australian Nurse Family Partnership Program for First Nations women and babies: a qualitative study. Int J Equity Health 2021; 20:212. [PMID: 34563171 PMCID: PMC8465693 DOI: 10.1186/s12939-021-01519-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/17/2021] [Indexed: 11/10/2022] Open
Abstract
Background The Australian Nurse Family Partnership Program (ANFPP) is an evidence-based, home visiting program that offers health education, guidance, social and emotional support to first-time mothers having Aboriginal and/or Torres Strait Islander (First Nations) babies. The community-controlled sector identified the need for specialised support for first time mothers due to the inequalities in birthing and early childhood outcomes between First Nations’ and other babies in Australia. The program is based on the United States’ Nurse Family Partnership program which has improved long-term health outcomes and life trajectories for mothers and children. International implementation of the Nurse Family Partnership program has identified interagency service integration as key to program recruitment, retention, and efficacy. How the ANFPP integrates with other services in an Australian urban setting and how to improve this is not yet known. Our research explores the barriers and enablers to interagency service integration for the Australian Nurse Family Partnership Program ANFPP in an urban setting. Methods A qualitative study using individual and group interviews. Purposive and snowball sampling was used to recruit clients, staff (internal and external to the program), Elders and family members. Interviews were conducted using a culturally appropriate ‘yarning’ method with clients, families and Elders and semi-structured interview guide for staff. Interviews were audio-recorded and transcribed prior to reflexive thematic analysis. Results Seventy-six participants were interviewed: 26 clients, 47 staff and 3 Elders/family members. Three themes were identified as barriers and three as enablers. Barriers: 1) confusion around program scope, 2) duplication of care, and 3) tensions over ‘ownership’ of clients. Enablers (existing and potential): 1) knowledge and promotion of the program; 2) cultural safety; and 3) case coordination, co-location and partnership forums. Conclusion Effective service integration is essential to maximise access and acceptability of the ANFPP; we provide practical recommendations to improve service integration in this context.
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Affiliation(s)
- Luciana Massi
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia.
| | - Sarah-Jade Maidment
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
| | - Carmel Nelson
- Institute of Urban Indigenous Health, Brisbane, QLD, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, College of Nursing and Midwifery, Charles Darwin University, Brisbane, QLD, Australia
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20
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Co-Designing Health Service Evaluation Tools That Foreground First Nation Worldviews for Better Mental Health and Wellbeing Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168555. [PMID: 34444319 PMCID: PMC8394671 DOI: 10.3390/ijerph18168555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/03/2021] [Accepted: 08/08/2021] [Indexed: 11/29/2022]
Abstract
It is critical that health service evaluation frameworks include Aboriginal people and their cultural worldviews from design to implementation. During a large participatory action research study, Elders, service leaders and Aboriginal and non-Aboriginal researchers co-designed evaluation tools to test the efficacy of a previously co-designed engagement framework. Through a series of co-design workshops, tools were built using innovative collaborative processes that foregrounded Aboriginal worldviews. The workshops resulted in the development of a three-way survey that records the service experiences related to cultural safety from the perspective of Aboriginal clients, their carer/s, and the service staff with whom they work. The surveys centralise the role of relationships in client-service interactions, which strongly reflect their design from an Aboriginal worldview. This paper provides new insights into the reciprocal benefits of engaging community Elders and service leaders to work together to develop new and more meaningful ways of servicing Aboriginal families. Foregrounding relationships in service evaluations reinstates the value of human connection and people-centred engagement in service delivery which are central to rebuilding historically fractured relationships between mainstream services and Aboriginal communities. This benefits not only Aboriginal communities, but also other marginalised populations expanding the remit of mainstream services to be accessed by many.
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21
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Murrup-Stewart C, Whyman T, Jobson L, Adams K. "Connection to Culture Is Like a Massive Lifeline": Yarning With Aboriginal Young People About Culture and Social and Emotional Wellbeing. QUALITATIVE HEALTH RESEARCH 2021; 31:1833-1846. [PMID: 33938295 DOI: 10.1177/10497323211009475] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Culture is an important social and emotional wellbeing factor for Aboriginal peoples in Australia, particularly regarding recovery from colonization. However, little is understood about how culture and wellbeing interact for young urban Aboriginal people. This study used Yarning methods to explore experiences and perceptions of culture and wellbeing for young urban Aboriginal people in Narrm, Australia. Findings indicate that culture is experienced as connection, and that perceived connection or disconnection has an essential influence on the wellbeing of young people. Through sharing young people stories, a range of factors, including colonization, relationships, cultural knowledge, community support, and agency, were identified as affecting perceptions of connectedness, and therefore on wellbeing. Youth were able to develop strategies to increase connection and provided illuminating advice and suggestions for improving connection for future generations. This study thus contributes to efforts to improved understanding of Aboriginal perspectives about social and emotional wellbeing and culture.
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Affiliation(s)
| | | | - Laura Jobson
- Monash University, Melbourne, Victoria, Australia
| | - Karen Adams
- Monash University, Melbourne, Victoria, Australia
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22
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Haynes E, Walker R, Mitchell AG, Katzenellenbogen J, D'Antoine H, Bessarab D. Decolonizing Indigenous health: Generating a productive dialogue to eliminate Rheumatic Heart Disease in Australia. Soc Sci Med 2021; 277:113829. [PMID: 33895707 DOI: 10.1016/j.socscimed.2021.113829] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/02/2021] [Accepted: 03/05/2021] [Indexed: 11/25/2022]
Abstract
In common with colonized Indigenous people worldwide, many Australian Aboriginal people experience inequitable health outcomes. While the commitment and advocacy of researchers and health practitioners has resulted in many notable improvements in policy and practice, systemic and structural impediments continue to restrain widespread gains in addressing Indigenous health injustices. We take Rheumatic Heart Disease (RHD), a potent marker of extreme health inequity, as a case study, and critically examine RHD practitioners' perspectives regarding the factors that need to be addressed to improve RHD prevention and care. This study is an important explanatory component of a broader study to inform new clinical practices, and health system strategies and policies to reduce RHD. A decolonising, critical medical anthropology (CMA) analysis of findings from 22 RHD practitioner in-depth interviews conducted in May 2016 revealed both practitioners' perceptions of health system shortcomings and a sense of hopelessness and powerlessness to transform existing health system inequities, the negative impacts of which were subsequently confirmed in a separate study of RHD patients' lived realities. We reveal how biomedical dominance, normalized deficit discourses and systemic racism influence the current policy and practice landscape, narrowing the intercultural space for productive dialogue and reinforcing the conditions that cause disease. To counter biomedical approaches that contribute to existing health inequities in health care, we recommend localized, strength-based, community-led research projects focused on actions that use critical decolonizing social science approaches to achieve system change. We demonstrate the importance of integrating biological and social sciences approaches in research, education/training, and practice to: 1) be guided by Indigenous strengths, knowledges and worldview, and 2) adopt a critical reflexive stance to examine systems, structures and practices. Such an approach facilitates productive cross-cultural dialogue and social transformation; providing direction and hope to practitioners, enhancing their knowledge, skills and capacity and improving Aboriginal health outcomes.
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Affiliation(s)
- Emma Haynes
- School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton St, Nedlands, Perth, Western Australia, 6009, Australia.
| | - Roz Walker
- School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton St, Nedlands, Perth, Western Australia, 6009, Australia.
| | - Alice G Mitchell
- Menzies School of Health Research, Charles Darwin University, PO Box 41096 Casuarina, Northern Territory, 0811, Australia.
| | - Judy Katzenellenbogen
- School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton St, Nedlands, Perth, Western Australia, 6009, Australia.
| | - Heather D'Antoine
- Menzies School of Health Research, Charles Darwin University, PO Box 41096 Casuarina, Northern Territory, 0811, Australia.
| | - Dawn Bessarab
- School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton St, Nedlands, Perth, Western Australia, 6009, Australia.
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O'Brien P, Bunzli S, Lin I, Bessarab D, Coffin J, Dowsey MM, Choong PFM. Addressing surgical inequity for Aboriginal and Torres Strait Islander people in Australia's universal health care system: a call to action. ANZ J Surg 2021; 91:238-244. [PMID: 33506978 DOI: 10.1111/ans.16557] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 11/29/2022]
Abstract
Aboriginal and Torres Strait Islander people continue to experience health inequity within the Australian health care system. Little research has examined how disparities in surgical care access and outcomes contribute to Aboriginal health. In this narrative review and call to action, we discuss five care points along the journey to high-quality surgical care: health care seeking, primary health care services, specialist services, surgery and surgical outcomes. We highlight barriers and disparities that exist along this journey, drawing examples from the field of joint replacement surgery. Finally, we present opportunities for change at the health system, health service and clinician level, calling upon researchers, clinicians and policy makers to confront the surgical disparities experienced by Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Penny O'Brien
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Samantha Bunzli
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ivan Lin
- Western Australian Centre for Rural Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Juli Coffin
- Social and Emotional Wellbeing of Aboriginal Young People, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Michelle M Dowsey
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
| | - Peter F M Choong
- Department of Surgery, St Vincent's Hospital Melbourne, The University of Melbourne, Melbourne, Victoria, Australia
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Smith RL, Devine S, Preston R. Recommended methodologies to determine Australian Indigenous community members' perceptions of their health needs: a literature review. Aust J Prim Health 2021; 26:95-103. [PMID: 32061267 DOI: 10.1071/py19078] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/28/2019] [Indexed: 11/23/2022]
Abstract
When addressing disparities in health status of Indigenous Australians, it is necessary to consult with Indigenous people to explore their health needs. The process of improving health outcomes is complex; it requires acknowledgement of underlying cultural and social determinants of health and active engagement of Indigenous people to define the issues and identify solutions. The aim of this study is to explore the most appropriate research methodologies to determine Australian Indigenous community members' perceptions of their health needs. A scoping review was conducted in BioMed Central, CINAHL, Informit Health, MEDLINE Ovid, ProQuest and Scopus databases and Google Scholar for all relevant literature published between 2009 and 2018. Extensive manual searches of reference lists were also undertaken. The limited number of articles relating to needs assessment with Indigenous community members prescribed broadening the scope of the review to include articles that describe methodologies to enhance Indigenous people's engagement in the research process. Twelve papers met the inclusion criteria. Three major themes emerged: (1) the imperative to develop and implement Indigenist research methodologies; (2) participatory action research (PAR) and community-based participatory research (CBPR) as appropriate methodologies to conduct research with Indigenous community members; and (3) yarning or storytelling as a culturally appropriate Indigenous method of data collection.
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Affiliation(s)
- Rosetta Lillian Smith
- College of Public Health, Medicine and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, 1 James Cook Drive, Townsville, Qld 4811, Australia; and Corresponding author.
| | - Sue Devine
- College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Qld 4811, Australia
| | - Robyn Preston
- College of Medicine and Dentistry, James Cook University, Townsville, Qld 4811, Australia; and School of Health, Medical and Applied Sciences, Central Queensland University, Townsville, Qld 4811, Australia
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Haynes E, Marawili M, Marika BM, Mitchell AG, Phillips J, Bessarab D, Walker R, Cook J, Ralph AP. Community-based participatory action research on rheumatic heart disease in an Australian Aboriginal homeland: Evaluation of the 'On track watch' project. EVALUATION AND PROGRAM PLANNING 2019; 74:38-53. [PMID: 30849711 DOI: 10.1016/j.evalprogplan.2019.02.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 06/09/2023]
Abstract
Strategies to date have been ineffective in reducing high rates of rheumatic heart disease (RHD) in Australian Aboriginal people; a disease caused by streptococcal infections. A remote Aboriginal community initiated a collaboration to work towards elimination of RHD. Based in 'both-way learning' (reciprocal knowledge co-creation), the aim of this study was to co-design, implement and evaluate community-based participatory action research (CBPAR) to achieve this vision. Activities related to understanding and addressing RHD social determinants were delivered through an accredited course adapted to meet learner and project needs. Theory-driven evaluation linking CBPAR to empowerment was applied. Data collection comprised focus groups, interviews, observation, and co-development and use of measurement tools such as surveys. Data analysis utilised process indicators from national guidelines for Aboriginal health research, and outcome indicators derived from the Wallerstein framework. Findings include the importance of valuing traditional knowledges and ways of learning such as locally-meaningful metaphors to explore unfamiliar concepts; empowerment through critical thinking and community ownership of knowledge about RHD and research; providing practical guidance in implementing empowering and decolonising principles / theories. Lessons learned are applicable to next stages of the RHD elimination strategy which must include scale-up of community leadership in research agenda-setting and implementation.
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Affiliation(s)
- Emma Haynes
- University of Western Australia, Perth, Western Australia, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia; Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia.
| | - Minitja Marawili
- Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia
| | | | - Alice G Mitchell
- Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia
| | - Jodi Phillips
- Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia
| | - Dawn Bessarab
- University of Western Australia, Perth, Western Australia, Australia
| | - Roz Walker
- University of Western Australia, Perth, Western Australia, Australia; Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Jeff Cook
- Laynhapuy Homelands Health Service, Yirrkala, Northern Territory, Australia
| | - Anna P Ralph
- Menzies School of Health Research, Darwin, Northern Territory, Australia; Charles Darwin University (CDU), Darwin, Northern Territory, Australia; Division of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
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Gauld S, Kendall M. Exploring the impact of sharing personal narratives of brain injury through film in Australian Indigenous communities. ACTA ACUST UNITED AC 2018. [DOI: 10.5348/100037d05sg2018oa] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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