1
|
Palafu T, Carreira Ching DL, Acosta VM, Okamoto SK, Okamura KH. Native Hawaiian and Pacific Islanders' Identity and Housing Status: The Impact on Historical Trauma and Perceived Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1249. [PMID: 39338132 PMCID: PMC11431825 DOI: 10.3390/ijerph21091249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 08/31/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024]
Abstract
Native Hawaiian and Pacific Islanders (NHPIs) are overrepresented in Hawai'i's houseless population. Indigenous populations, such as NHPIs, may encounter experiences of historical trauma that impact their well-being. This original research project examines how NHPI identity and houselessness compound to affect the perceived stress and historical trauma of transition-aged youth. Fifty-one participants aged 18 to 24 (M = 21.37, SD = 1.93) completed a survey that included the historical traumatic events scale, historical loss scale, perceived stress scale, and a demographic questionnaire. Over half (n = 26, 51.0%) of the participants identified as NHPI. A two-way ANOVA indicated a non-significant effect of NHPI identity and housing status on perceived stress. However, housed participants scored significantly higher than participants experiencing houselessness on the historical traumatic events scale (p = 0.006). Our findings elucidate the role of knowledge in the experience of historical trauma. Further results, limitations, and future directions are offered.
Collapse
Affiliation(s)
- Tessa Palafu
- The Baker Center for Children and Families, Harvard Medical School, Boston, MA 02120, USA
- Department of Psychology, Hawai'i Pacific University, Honolulu, HI 96813, USA
| | - Danielle L Carreira Ching
- The Baker Center for Children and Families, Harvard Medical School, Boston, MA 02120, USA
- Department of Psychology, Hawai'i Pacific University, Honolulu, HI 96813, USA
| | - Veronica M Acosta
- Department of Psychology, Hawai'i Pacific University, Honolulu, HI 96813, USA
| | - Scott K Okamoto
- Population Sciences in the Pacific Program, University of Hawai'i Cancer Center, Honolulu, HI 96813, USA
| | - Kelsie H Okamura
- The Baker Center for Children and Families, Harvard Medical School, Boston, MA 02120, USA
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI 96822, USA
| |
Collapse
|
2
|
Barton KS, Porter KM, Mai T, Claw KG, Hiratsuka VY, Carroll SR, Burke W, Garrison NA. Genetic research within Indigenous communities: Engagement opportunities and pathways forward. Genet Med 2024; 26:101158. [PMID: 38699966 DOI: 10.1016/j.gim.2024.101158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
PURPOSE Against a historical backdrop of researchers who violated trust through lack of benefit sharing, transparency, and engagement, efforts are underway to develop better approaches for genetic and genomic research with Indigenous communities. To increase engagement, there is a need to understand factors that affect researcher and community collaborations. This study aimed to understand the barriers, challenges, and facilitators of Indigenous Peoples in the United States participating in genetic research. METHODS We conducted 42 semistructured interviews with Tribal leaders, clinicians, researchers, policy makers, and Tribal research review board members across the United States to explore perceived risks, benefits, barriers, and facilitators of genetic research participation. RESULTS Participants, identifying as Indigenous (88%) or non-Indigenous allies (12%), described their concerns, hesitancy, and fears about genetic research, as well as the roles of trust, transparency, and respect for culture in facilitating partnerships. Previous harms-such as sample and data misuse, stigmatization, or misrepresentation by researchers-revealed strategies for building trust to create more equitable and reciprocal research partnerships. CONCLUSION Participants in this study offered strategies for increasing genetic research engagement. The pathway forward should foster transparent research policies and practices to facilitate informed research that supports the needs and priorities of participants, communities, and researchers.
Collapse
Affiliation(s)
- Krysta S Barton
- Biostatistics Epidemiology and Analytics for Research (BEAR) Core, Seattle Children's Research Institute, Seattle, WA
| | - Kathryn M Porter
- Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, Seattle, WA
| | - Thyvu Mai
- Institute for Public Health Genetics, University of Washington School of Medicine, Seattle, WA
| | - Katrina G Claw
- Department of Biomedical Informatics, Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Vanessa Y Hiratsuka
- Center for Human Development, College of Health, University of Alaska Anchorage, Anchorage, AK; Southcentral Foundation, Anchorage, AK
| | - Stephanie Russo Carroll
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ; Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ
| | - Wylie Burke
- Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA
| | - Nanibaa' A Garrison
- Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA; Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA; Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
| |
Collapse
|
3
|
O’Brien JM, Blais N, Butler C, White N, Bustead A, Figler C, Wells M, Anderson G, Yuhas A, Ernakovich JG. Ten "simple" rules for non-Indigenous researchers engaging Indigenous communities in Arctic research. PLoS Comput Biol 2024; 20:e1012093. [PMID: 38935596 PMCID: PMC11210771 DOI: 10.1371/journal.pcbi.1012093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2024] Open
Affiliation(s)
- Joy M. O’Brien
- Department of Biology, Indiana University, Bloomington, Indiana, United States of America
| | - Nathan Blais
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, United States of America
- Center of Soil Biogeochemistry and Microbial Ecology (Soil BioME), University of New Hampshire, Durham, New Hampshire, United States of America
| | - Carmen Butler
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, United States of America
| | - Natalie White
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, United States of America
| | - Ash Bustead
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, United States of America
| | - Collin Figler
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, United States of America
| | - McKenna Wells
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, United States of America
| | - George Anderson
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, United States of America
| | - Anna Yuhas
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, United States of America
| | - Jessica Gilman Ernakovich
- Department of Natural Resources and the Environment, University of New Hampshire, Durham, New Hampshire, United States of America
- Center of Soil Biogeochemistry and Microbial Ecology (Soil BioME), University of New Hampshire, Durham, New Hampshire, United States of America
| |
Collapse
|
4
|
Chappell E, Arbour L, Laksman Z. The Inclusion of Underrepresented Populations in Cardiovascular Genetics and Epidemiology. J Cardiovasc Dev Dis 2024; 11:56. [PMID: 38392270 PMCID: PMC10888590 DOI: 10.3390/jcdd11020056] [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: 12/24/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
Novel genetic risk markers have helped us to advance the field of cardiovascular epidemiology and refine our current understanding and risk stratification paradigms. The discovery and analysis of variants can help us to tailor prognostication and management. However, populations underrepresented in cardiovascular epidemiology and cardiogenetics research may experience inequities in care if prediction tools are not applicable to them clinically. Therefore, the purpose of this article is to outline the barriers that underrepresented populations can face in participating in genetics research, to describe the current efforts to diversify cardiogenetics research, and to outline strategies that researchers in cardiovascular epidemiology can implement to include underrepresented populations. Mistrust, a lack of diverse research teams, the improper use of sensitive biodata, and the constraints of genetic analyses are all barriers for including diverse populations in genetics studies. The current work is beginning to address the paucity of ethnically diverse genetics research and has already begun to shed light on the potential benefits of including underrepresented and diverse populations. Reducing barriers for individuals, utilizing community-driven research processes, adopting novel recruitment strategies, and pushing for organizational support for diverse genetics research are key steps that clinicians and researchers can take to develop equitable risk stratification tools and improve patient care.
Collapse
Affiliation(s)
- Elias Chappell
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Laura Arbour
- Department of Medical Genetics, University of British Columbia, Vancouver, BC V6H 3N1, Canada
| | - Zachary Laksman
- Department of Medicine and the School of Biomedical Engineering, Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| |
Collapse
|
5
|
Huynh ALH, Wang Y, Ma L, Low YLC, Chen W, Fowler C, Tan ECK, Masters CL, Jin L, Pan Y. A Comparison of an Australian Observational Longitudinal Alzheimer's Disease Cohort to Community-Based Australian Data. J Alzheimers Dis 2024; 101:737-749. [PMID: 39213065 DOI: 10.3233/jad-240241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
Background Observational Alzheimer's disease (AD) cohorts including the Australian, Biomarkers, Imaging and Lifestyle (AIBL) Study have enhanced our understanding of AD. The generalizability of findings from AIBL to the general population has yet to be studied. Objective We aimed to compare characteristics of people with AD dementia in AIBL to 1) the general population of older Australians using pharmacological treatment for AD dementia, and to 2) the general population of older Australians who self-reported a diagnosis of dementia. Methods Descriptive study comparing people aged 65 years of over (1) in AIBL that had a diagnosis of AD dementia, (2) dispensed with pharmacological treatment for AD in Australia in 2021 linked to the Australian census in 2021 (refer to as PBS/census), (3) self-reported a diagnosis of dementia in the 2021 Australian census (refer to as dementia/census). Baseline characteristics included age, sex, highest education attainment, primary language, and medical co-morbidities. Results Participants in AIBL were younger, had more years of education, and had a lower culturally and linguistically diverse (CALD) population compared to the PBS/census cohort and dementia/census cohort (mean age±standard deviation - AIBL 79±7 years, PBS/census 81±7, p < 0.001, dementia/census 83±8, p < 0.001; greater than 12 years of education AIBL 40%, PBS/census 35%, p = 0.020, dementia/census 29%, p < 0.001; CALD - AIBL 3%, PBS/census 20%, p < 0.001, dementia/census 22%, p < 0.001). Conclusions Our findings suggest that care should be taken regarding the generalizability of AIBL in CALD populations and the interpretation of results on the natural history of AD.
Collapse
Affiliation(s)
- Andrew Liem Hieu Huynh
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Aged Care, Austin Health, Heidelberg, VIC, Australia
- Department of Medicine, Austin Health, University of Melbourne, Heidelberg, VIC, Australia
| | - Yihan Wang
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Liwei Ma
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Yi Ling Clare Low
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Weisi Chen
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Christopher Fowler
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Edwin C K Tan
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
| | - Liang Jin
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Yijun Pan
- The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|
6
|
Buchwald DS, Bassett DR, Van Dyke ER, Harris RM, Hanson JD, Tu SP. "Sorry for laughing, but it's scary": humor and silence in discussions of Colorectal Cancer with Urban American Indians. BMC Cancer 2023; 23:1036. [PMID: 37884866 PMCID: PMC10601143 DOI: 10.1186/s12885-023-11245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/01/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Given high rates of cancer mortality in Native communities, we examined how urban American Indian and Alaska Native elders talk about colorectal cancer (CRC) and CRC screening. METHODS We conducted seven focus groups with a total of 46 participants in two urban clinics in the Pacific Northwest to assess participant awareness, perceptions, and concerns about CRC and CRC screening. Using speech codes theory, we identified norms that govern when and how to talk about CRC in this population. RESULTS Our analyses revealed that male participants often avoided screening because they perceived it as emasculating, whereas women often avoided screening because of embarrassment and past trauma resulting from sexual abuse. Both men and women used humor to mitigate the threatening nature of discussions about CRC and CRC screening. CONCLUSIONS We offer our analytic results to assist others in developing culturally appropriate interventions to promote CRC screening among American Indians and Alaska Natives.
Collapse
Affiliation(s)
- Dedra S. Buchwald
- Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Seattle, WA 98101 USA
| | - Deborah R. Bassett
- Department of Communication, University of West Florida, 11000 University Parkway, Pensacola, FL 32514 USA
| | | | - Raymond M. Harris
- Institute for Research and Education to Advance Community Health, Washington State University, 1100 Olive Way, Seattle, WA 98101 USA
| | - Jessica D. Hanson
- Department of Applied Human Sciences, University of Minnesota Duluth, 1216 Ordean Court, Duluth, MN 55812 USA
| | - Shin-Ping Tu
- Division of General Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VG 23298 USA
| |
Collapse
|
7
|
Al P, Hey S, Weijer C, Gillies K, McCleary N, Yee ML, Inglis J, Presseau J, Brehaut J. Changing patient preferences toward better trial recruitment: an ethical analysis. Trials 2023; 24:233. [PMID: 36973759 PMCID: PMC10044713 DOI: 10.1186/s13063-023-07258-4] [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: 10/04/2022] [Accepted: 03/14/2023] [Indexed: 03/29/2023] Open
Abstract
While randomized controlled trials are essential to health research, many of these trials fail to recruit enough participants. Approaching recruitment through the lens of behavioral science can help trialists to understand influences on the decision to participate and use them to increase recruitment. Although this approach is promising, the use of behavioral influences during recruitment is in tension with the ethical principle of respect for persons, as at least some of these influences could be used to manipulate potential participants. In this paper, we examine this tension by discussing two types of behavioral influences: one example involves physician recommendations, and the other involves framing of information to exploit cognitive biases. We argue that despite the apparent tension with ethical principles, influencing trial participants through behavior change strategies can be ethically acceptable. However, we argue that trialists have a positive obligation to analyze their recruitment strategies for behavioral influences and disclose these upfront to the research ethics committee. But we also acknowledge that since neither trialists nor ethics committees are presently well equipped to perform these analyses, additional resources and guidance are needed. We close by outlining a path toward the development of such guidance.
Collapse
Affiliation(s)
- Pepijn Al
- Rotman Institute of Philosophy, Western University, London, ON, Canada.
| | - Spencer Hey
- Prism Analytic Technologies, Cambridge, MA, USA
| | - Charles Weijer
- Departments of Medicine, Epidemiology & Biostatistics, and Philosophy, Western University, London, ON, Canada
| | - Katie Gillies
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Nicola McCleary
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Juliette Inglis
- Patient partner, Montreal, QC, Canada
- Patient partner, Edmonton, AB, Canada
| | - Justin Presseau
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jamie Brehaut
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
8
|
Passos-Castilho AM, Udhesister STP, Fontaine G, Jeong D, Dickie M, Lund C, Russell R, Kronfli N. The 11th Canadian Symposium on Hepatitis C Virus: 'Getting back on track towards hepatitis C elimination'. CANADIAN LIVER JOURNAL 2023; 6:56-69. [PMID: 36908576 PMCID: PMC9997521 DOI: 10.3138/canlivj-2022-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 08/20/2022] [Indexed: 11/05/2022]
Abstract
Hepatitis C virus (HCV) affects approximately 204,000 Canadians. Safe and effective direct-acting antiviral therapies have contributed to decreased rates of chronic HCV infection and increased treatment uptake in Canada, but major challenges for HCV elimination remain. The 11th Canadian Symposium on Hepatitis C Virus took place in Ottawa, Ontario on May 13, 2022 as a hybrid conference themed 'Getting back on track towards hepatitis C elimination.' It brought together research scientists, clinicians, community health workers, patient advocates, community members, and public health officials to discuss priorities for HCV elimination in the wake of the COVID-19 pandemic, which had devastating effects on HCV care in Canada, particularly on priority populations. Plenary sessions showcased topical research from prominent international and national researchers, complemented by select abstract presentations. This event was hosted by the Canadian Network on Hepatitis C (CanHepC), with support from the Public Health Agency of Canada and the Canadian Institutes of Health Research and in partnership with the Canadian Liver Meeting. CanHepC has an established record in HCV research and in advocacy activities to address improved diagnosis and treatment, and immediate and long-term needs of those affected by HCV infection. The Symposium addressed the remaining challenges and barriers to HCV elimination in priority populations and principles for meaningful engagement of Indigenous communities and individuals with living and lived experience in HCV research. It emphasized the need for disaggregated data and simplified pathways for creating and monitoring interventions for equitably achieving elimination targets.
Collapse
Affiliation(s)
- Ana Maria Passos-Castilho
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sasha Tejna Persaud Udhesister
- Faculté de Médecine, Université de Montréal, Centre de Recherche du Centre hospitalier de l'Université de Montré (CRCHUM), Montréal, Québec, Canada
| | - Guillaume Fontaine
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dahn Jeong
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melisa Dickie
- Community Health Programming, CATIE, Toronto, Ontario, Canada
| | | | - Rodney Russell
- Division of BioMedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Nadine Kronfli
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montreal, Quebec, Canada.,Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | | |
Collapse
|
9
|
Starting the SToP trial: Lessons from a collaborative recruitment approach. PLoS One 2022; 17:e0273631. [PMID: 36395106 PMCID: PMC9671300 DOI: 10.1371/journal.pone.0273631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/14/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Recruitment in research can be challenging in Australian Aboriginal contexts. We aimed to evaluate the SToP (See, Treat, Prevent skin infections) trial recruitment approach for Aboriginal families to identify barriers and facilitators and understand the utility of the visual resource used. METHODS This qualitative participatory action research used purposive sampling to conduct six semi-structured interviews with staff and five yarning sessions with Aboriginal community members from the nine communities involved in the SToP trial that were audio recorded and transcribed verbatim before thematic analysis. FINDINGS Community members valued the employment of local Aboriginal facilitators who used the flipchart to clearly explain the importance of healthy skin and the rationale for the SToP trial while conducting recruitment. A prolonged process, under-developed administrative systems and stigma of the research topic emerged as barriers. CONCLUSION Partnering with a local Aboriginal organisation, employing Aboriginal researchers, and utilising flip charts for recruitment was seen by some as successful. Strengthening governance with more planning and support for recordkeeping emerged as future success factors. IMPLICATIONS FOR PUBLIC HEALTH Our findings validate the importance of partnership for this critical phase of a research project. Recruitment strategies should be co-designed with Aboriginal research partners. Further, recruitment rates for the SToP trial provide a firm foundation for building partnerships between organisations and ensuring Aboriginal perspectives determine recruitment methods.
Collapse
|
10
|
Lee RS, Brown HK, Salih S, Benoit AC. Systematic review of Indigenous involvement and content in mental health interventions and their effectiveness for Indigenous populations. Aust N Z J Psychiatry 2022; 56:1230-1251. [PMID: 35379008 PMCID: PMC9513504 DOI: 10.1177/00048674221089837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the effects of psychological, psychosocial, educational and alternative interventions on mental health outcomes of Indigenous adult populations in Australia, Canada, New Zealand and the United States and the Indigenous involvement and content in each study. METHODS We systematically searched databases, key journals and gray literature, for records until June 2020. Eligible studies were in English or French and examined the impact of interventions on mental health outcomes including anxiety disorders, posttraumatic stress disorder, depression, psychological distress or stress for Indigenous adults (⩾16 years). Data were extracted using a modified Cochrane Data Extraction Form and the Template for Intervention Description and Replication. Quality was evaluated using the Effective Public Health Practice Project quality assessment form. RESULTS In total, 21 studies were eligible, comprising 8 randomized controlled trials, 10 single-group pre-post studies and 3 pre-post studies with comparison groups. Twenty studies had Indigenous individuals or organizations involved in some decision-making capacity, though extent of involvement varied widely. In total, 9 studies were rated moderate and 12 weak in the Effective Public Health Practice Project quality assessment. Eight studies measuring depression, three measuring posttraumatic stress disorder, three measuring psychological distress and two measuring stress showed statistically significant improvements following the intervention. CONCLUSION A wide range of interventions demonstrated mental health improvements. However, it is difficult to draw generalizable conclusions on intervention effectiveness, given heterogeneity among studies. Studies should employ a thorough assessment of the Indigenous involvement and content of their interventions for reporting and for critical consideration of the implications of their research and whether they address Indigenous determinants of mental health.
Collapse
Affiliation(s)
- Rachel Seungyun Lee
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Hilary K Brown
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Department of Health and Society, University of Toronto Scarborough, Scarborough, ON, Canada,Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada
| | - Sarah Salih
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anita C Benoit
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada,Department of Health and Society, University of Toronto Scarborough, Scarborough, ON, Canada,Women’s College Research Institute, Women’s College Hospital, University of Toronto, Toronto, ON, Canada,Anita C Benoit, Department of Health and Society, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON M1C 1A4, Canada.
| |
Collapse
|
11
|
Wyatt TR. "The sins of our forefathers": reimagining research in health professions education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:1195-1206. [PMID: 35380319 DOI: 10.1007/s10459-022-10111-z] [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: 10/25/2021] [Accepted: 03/19/2022] [Indexed: 06/14/2023]
Abstract
As HPE begins to turn their attention to the lived experiences of minoritized groups in society, health professions education (HPE) researchers need to be aware of the history of social science research and the ways it contributes to creating systems of oppression. This is because as 'knowledge producers,' we make decisions about how to design our studies, analyze and interpret data, and report it in ways that are frequently oblivious to the harmful legacy of social science research, and how it continues to bring harm to minoritized communities. To not do so is to perpetuate a system that has historically served the dominant group at the expense of those who are limited in representing the world for themselves. This article proposes that HPE researchers engage in disruptive research practices by delinking with their disciplinary training, and reimagine their role in the research process. To accomplish this, I suggest that they engage in three strategies: attend to the research team's composition, embrace critical theory and investigate epistemological ignorance. These strategies are nowhere close to exhaustive, and they do not extend as far as the conversation must go in reimagining our role in the research enterprise. However, in providing some initial thoughts on this topic, I hope to invite the HPE community into discussion on how we might harness our collective responsibility to resist research practices that are harmful and unjust to minoritized communities.
Collapse
Affiliation(s)
- Tasha R Wyatt
- Uniformed Services University of the Health Sciences, Bethesda, MD, 20814, USA.
| |
Collapse
|
12
|
D’Costa B, Lobo R, Sibosado A, Leavy JE, Crawford G, Ward J. Evaluation of the Young, Deadly, Syphilis Free multi-media campaign in remote Australia. PLoS One 2022; 17:e0273658. [PMID: 36084099 PMCID: PMC9462794 DOI: 10.1371/journal.pone.0273658] [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: 09/01/2021] [Accepted: 08/14/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction
Since 2011, remote Australian Aboriginal and Torres Strait Islander communities have experienced an outbreak of infectious syphilis, with young people aged 15–29 years over-represented in notifications. The Young Deadly Syphilis Free multi-media campaign was implemented in 12 remote regions in four Australian jurisdictions over nine months from 2017–2018. Campaign components included television and radio advertisements, social media posts, and health promotion resources available via a dedicated website. The aim of this research was to evaluate the impacts (proximal, mediator, distal) of the Young Deadly Syphilis Free campaign for young Aboriginal people and health and community workers residing in remote campaign regions.
Methods
A cross-sectional (post-only) evaluation design was used. Data were collected through online surveys; metrics for social media (Facebook, Instagram) were also collected to determine campaign engagement via social media. A 22-item young people survey assessed campaign awareness, exposure, message recognition and diagnostics (proximal variables); along with intended behaviour and knowledge and attitudes (mediator variables). A 24-item health and community worker survey assessed campaign awareness, exposure, message recognition and diagnostics (proximal variables); and changes in professional practice (distal variable). Descriptive statistics summarised demographic characteristics and univariate analysis examined associations between key variables.
Results
Just over half (n = 25, 58%) of young people and three quarters (n = 36; 75%) of health and community workers were aware of the campaign. Recognition of key campaign messages was high for both participant groups (>64%), and television, Facebook, and website were the most common campaign exposure routes. Positive impacts on intended behaviour (young people) and professional practice (health and community workers) were also reported. Facebook was effective in engaging some young people in campaign content and was preferred by young people for accessing information.
Conclusion
The findings point to the value of utilising a multi-media campaign in raising awareness about syphilis among young Aboriginal people and health and community workers in remote Australian regions. A longer-term campaign that accommodates the diverse needs of Aboriginal young people from geographically remote communities would optimise campaign impacts and support behavioural change.
Collapse
Affiliation(s)
- Belinda D’Costa
- Sexual Health and Blood-Borne Virus Applied Research and Evaluation Network, Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- * E-mail:
| | - Roanna Lobo
- Sexual Health and Blood-Borne Virus Applied Research and Evaluation Network, Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Amanda Sibosado
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Justine E. Leavy
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Gemma Crawford
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Collaboration for Evidence, Research and Impact in Public Health, School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - James Ward
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- UQ Poche Centre for Indigenous Health, School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|
13
|
Strategies to Support Sustained Participant Engagement in an Oral Health Promotion Study for Indigenous Children and Their Families in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138112. [PMID: 35805767 PMCID: PMC9266323 DOI: 10.3390/ijerph19138112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/28/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022]
Abstract
The health inequities of Indigenous peoples compared with non-Indigenous peoples are significant and long-standing across many countries. Colonisation and dispossession of land and culture has led to profound and devastating consequences on the health of Indigenous peoples. A lack of trust and cultural security of health services remains a barrier to participation in health care services. Similarly, engagement in research activities is also hindered by a history of unethical research practices. Creating partnerships between researchers and Indigenous communities is key in developing research studies that are culturally appropriate, acceptable and relevant to the needs of Indigenous peoples. Baby Teeth Talk was a randomised controlled trial conducted with Indigenous children and their mothers in South Australia that tested an intervention involving dental care, anticipatory guidance on oral health and dietary intake, and motivational interviewing. The study was developed in consultation and partnership with local Indigenous communities in South Australia and overseen by the study’s Aboriginal reference group. The recruitment and retention of participants in the study has been strong over numerous waves of follow-up. The purpose of this paper is to describe the strategies employed in the study that contributed to the successful and sustained engagement of the participants. These strategies included the establishment of an Aboriginal reference group, building relationships with organisations and community, flexibility of appointment scheduling and allocating adequate time, reimbursement for participant time, developing rapport with participants, encouraging participant self-determination, and adaptation of dietary data collection to better suit participants.
Collapse
|
14
|
Dunn KPR, Williams KP, Egan CE, Potestio ML, Lee SS. ECHO+: Improving access to hepatitis C care within Indigenous communities in Alberta, Canada. CANADIAN LIVER JOURNAL 2022; 5:113-123. [PMID: 35991479 PMCID: PMC9236587 DOI: 10.3138/canlivj-2021-0027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 07/29/2023]
Abstract
BACKGROUND Indigenous populations experience higher rates of hepatitis C virus (HCV) infections in Canada. The Extension for Community Health Outcomes+ (ECHO+) telehealth model was implemented in Alberta to support HCV screening and treatment, using Zoom technology to support Indigenous patient access to specialist care closer to home. Our goal was to expand this program to more Indigenous communities in Alberta, using various Indigenous-led or co-designed methods. METHODS The ECHO+ team implemented a Two-Eyed Seeing framework, incorporating Indigenous wholistic approaches alongside Western treatment. This approach works with principles of respect, reciprocity, and relationality. The ECHO+ team identified Indigenous-specific challenges, including access to liver specialist care, HCV awareness, stigma, barriers to screening and lack of culturally relevant approaches. RESULTS Access to HCV care via this program significantly increased HCV antiviral use in the past 5 years. Key lessons learned include Indigenous-led relationship building and development of project outputs in response to community needs influences impact and increases relevant changes increasing access to HCV care. Implementation of ECHO+ was carried out through biweekly telehealth sessions, problem solving in partnership with Indigenous communities, increased HCV awareness, and flexibility resulting from the impacts of COVID-19. CONCLUSION Improving Indigenous patient lives and reducing inequity requires supporting local primary health care providers to create and sustain integrated HCV prevention, diagnosis, treatment, and support services within a culturally safe and reciprocal model. ECHO+ uses telehealth and culturally appropriate methodology and interventions alongside multiple stakeholder collaborations to improve health outcomes for HCV.
Collapse
Affiliation(s)
- Kate PR Dunn
- Indigenous Wellness Core, Alberta Health Services, Calgary, Alberta, Canada
- These authors contributed equally and are co-first authors
| | - Kienan P Williams
- Indigenous Wellness Core, Alberta Health Services, Calgary, Alberta, Canada
- These authors contributed equally and are co-first authors
| | - Cari E Egan
- Indigenous Wellness Core, Alberta Health Services, Calgary, Alberta, Canada
| | - Melissa L Potestio
- Indigenous Wellness Core, Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Co-senior authors
| | - Samuel S Lee
- Liver Unit, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
- Co-senior authors
| |
Collapse
|
15
|
Fowler F, Einsiedel L. A Qualitative Study Exploring Perceptions to the Human T Cell Leukaemia Virus Type 1 in Central Australia: Barriers to Preventing Transmission in a Remote Aboriginal Population. Front Med (Lausanne) 2022; 9:845594. [PMID: 35572972 PMCID: PMC9100826 DOI: 10.3389/fmed.2022.845594] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/28/2022] [Indexed: 01/24/2023] Open
Abstract
Background Central Australia has the highest recorded prevalence of infection with the human T cell leukaemia virus type 1 (HTLV-1) worldwide. Each of the clinical diseases associated with HTLV-1 have been reported in this region, including deaths due to adult T cell leukaemia, which is causally linked to HTLV-1. Nevertheless, no public health response has been implemented to reduce HTLV-1 transmission among the affected Aboriginal population. In the first study to explore the perceptions of healthcare professionals along with those of Aboriginal people whose communities are actually impacted by HTLV-1, we sought to understand the barriers to preventing HTLV-1 transmission in this remote area. Methodology/Principal Findings Semi and un-structured interviews were conducted with 30 Australian Aboriginal people, 26 non-Aboriginal healthcare professionals and 3 non-Aboriginal community workers. The purpose of the interviews was to explore perceptions towards HTLV-1 in a health context with a focus on sexual and reproductive rights. Deductive and inductive analyses were applied to the data and a decolonizing lens brought peripheral stories to the fore. A major finding was the contrast between views expressed by Aboriginal participants and healthcare professionals regarding the provision of knowledge to those affected. Aboriginal participants consistently articulated that they and their communities should be informed of, and can hold, knowledges pertaining to HTLV-1. This finding controverted the perceptions of healthcare professionals that the complexities of the virus would not be well-understood by their Aboriginal patients and that sharing HTLV-1 knowledges might overwhelm Aboriginal people. Further analyses revealed a spectrum of understanding and clinical practice, while also delineating signs of an imagined public health response. Conclusions/Significance HTLV-1 remains a neglected infection in Australia. Knowledge of HTLV-1 is held by a privileged medical elite and does not flow to marginalised Aboriginal people living in affected communities. We demonstrate that differences in the perspectives of stakeholders presents a significant barrier to the development of cohesive, culturally safe prevention programs that foster a shared knowledge of HTLV-1. The interview data suggests that a successful public health program is likely to require a dual approach that includes clinical care and community-driven health promotion. Aspects of this approach, which would raise awareness and potentially reduce transmission and lower HTLV-1 prevalence in Central Australia, may be applicable to other endemic settings with similar conditions of social disadvantage, geographic remoteness, resource limitations and cross-cultural challenges.
Collapse
Affiliation(s)
- Fiona Fowler
- Department of Social Work, Alice Salomon University of Applied Sciences, Berlin, Germany
| | | |
Collapse
|
16
|
Steele V, Patterson K, Berrang-Ford L, King N, Kulkarni M, Lwasa S, Namanya DB, Harper SL. Antenatal Care Research in East Africa During the Millennium Development Goals Initiative: A Scoping Review. Matern Child Health J 2022; 26:469-480. [PMID: 35028892 DOI: 10.1007/s10995-021-03355-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The global burden of maternal mortality remains high and inequitably distributed between countries. Antenatal care (ANC) was identified as critical component in achieving the Millennium Development Goal of improving maternal health. This scoping review aimed to summarize trends and critically explore research about ANC attendance for East African women conducted during the Millennium Development Goals initiative, with a specific focus on barriers to ANC access. METHODS Using a scoping review methodology, aggregator databases were searched for relevant articles. Articles were screened by independent reviewers using a priori inclusion criteria. Eligible articles were retained for data charting and analysis. RESULTS Following screening, 211 articles were analyzed. The number of relevant articles increased over time; utilized primarily quantitative methods; and involved authors with affiliations from various African countries. Many interrelated physical, social, and cultural factors influenced women's seeking, reaching, and receiving of quality ANC. The extent of studies identified suggest that ANC is a priority research area, yet key gaps in the literature exist. Limited qualitative research, and few articles examining ANC experiences of women from vulnerable groups (e.g. adolescents, women with a disability, and Indigenous women) were identified. DISCUSSION These context-specific findings are important considering the Sustainable Development Goals aim to nearly triple the maternal mortality reductions by 2030. In order to achieve this goal, interventions should focus on improving the quality of ANC care and patient-provider interactions. Furthermore, additional qualitative research examining vulnerable populations of women and exploring the inclusion of men in ANC would help inform interventions intended to improve ANC attendance in East Africa.
Collapse
Affiliation(s)
- Vivienne Steele
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada.
| | - Lea Berrang-Ford
- Priestley Centre for Climate Change, Leeds University, Leeds, LS2 9JT, York, UK
| | - Nia King
- School of Medicine, Queen's University, 15 Arch Street, Kingston, ON, K7L 3L4, Canada.
| | - Manisha Kulkarni
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON, K1G 5Z3, Canada
| | - Shuaib Lwasa
- Department of Geography, Makerere University, P.O. Box 7062, Kampala, Uganda
| | | | - Sherilee L Harper
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, ON, N1G 2W1, Canada. .,School of Public Health, University of Alberta, 116 St & 85 Ave, Edmonton, AB, T6G 1C9, Canada.
| |
Collapse
|
17
|
Chan AW, Reid C, Skeffington P, Gorman E, Marriott R. Experiences of using the Edinburgh Postnatal Depression Scale in the context of antenatal care for Aboriginal mothers: Women and midwives' perspectives. Women Birth 2021; 35:367-377. [PMID: 34531165 DOI: 10.1016/j.wombi.2021.09.004] [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: 06/23/2021] [Revised: 08/15/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
PROBLEM Routine administration of the Edinburgh Postnatal Depression Scale (EPDS) is intended to promote early detection and preventative support for those who may be at risk of perinatal depression and anxiety. The cultural suitability of the EPDS has not been validated in the Aboriginal Australian context. BACKGROUND Marked differences in health outcomes and service access between Australian Aboriginal and non-Aboriginal women and infants continue to exist. AIM This study aimed to explore the cultural validity of the EPDS through understanding the experiences of Aboriginal women and midwives. METHODS Qualitative data was drawn from semi-structured interviews/yarns with 13 Perth-based Aboriginal antenatal women and 10 non-Aboriginal midwives. FINDINGS Utilising a grounded theory approach, thematic analysis of verbatim transcripts revealed that, surprisingly, women expressed generally favourable views of the EPDS, especially when the relationships between women and midwives were focused on. Midwives, however, expressed reservations about administering the EPDS and used the EPDS as a conversation-starter rather than as a standardised, standalone tool. DISCUSSION In attempt to reconcile conflicting perspectives, analysis of recordings extended to evaluate micro-processes in the interviews. At the process level, it was clear that demand characteristics operated in some interviews, including socially desirable response biases, demand biases and acquiescent response styles. CONCLUSION This highlights the need for researchers and clinicians to be trained in non-leading interview questioning techniques and in yarning methodology. Researchers and clinicians should also be aware of the cognitive biases and demand characteristics that may influence responding, likely perpetuated by dominant forces of a colonised society.
Collapse
Affiliation(s)
| | - Corinne Reid
- Victoria University, Australia; Ngangk Yira: Research Centre for Aboriginal Health and Social Equity, Murdoch University, Australia
| | - Petra Skeffington
- Murdoch University, Australia; Ngangk Yira: Research Centre for Aboriginal Health and Social Equity, Murdoch University, Australia
| | | | - Rhonda Marriott
- Murdoch University, Australia; Ngangk Yira: Research Centre for Aboriginal Health and Social Equity, Murdoch University, Australia
| |
Collapse
|
18
|
Kingsley J, Munro-Harrison E, Jenkins A, Thorpe A. Developing a framework identifying the outcomes, principles and enablers of 'gathering places': Perspectives from Aboriginal people in Victoria, Australia. Soc Sci Med 2021; 283:114217. [PMID: 34256253 DOI: 10.1016/j.socscimed.2021.114217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 05/14/2021] [Accepted: 07/06/2021] [Indexed: 11/26/2022]
Abstract
Aboriginal 'gathering places' have been described as cultural hubs, healing centres, and social meeting places. This article explores a gap in the literature on the health and wellbeing outcomes of gathering places from the perspectives of Aboriginal people who attend them. The aim of this study was to develop a framework to articulate the enablers, principles, and outcomes of 'successful' Aboriginal gathering places. In this study, sixty-nine (n = 69) community members participated in qualitative interviews or focus group discussions across thirteen gathering place sites in Victoria (Australia). The research found that gathering places address social health disparities through the provision of a broad range of health and wellbeing programs that benefit Aboriginal community members accessing them. Gathering places were described by participants as providing connections to place, Aboriginal culture, and healing and mainstream health services that enhanced wellbeing. These findings contribute to a better understanding of how Aboriginal gathering places function and offer strategies for creating culturally safe and welcoming settings for Aboriginal peoples, with potential for consideration in international contexts. This research informed a best-practice framework and outlines different models for developing community empowering and culturally affirming gathering places for improving Aboriginal people's access to culturally appropriate health and support services, while simultaneously reducing health and social inequalities. Key elements of this framework that contribute to a successful gathering place include the people, place (location/facilities), programs and community themselves, whilst the principles that enable these places include elements like self-determination, respect of culture, sustainability and strong governance.
Collapse
Affiliation(s)
- Jonathan Kingsley
- School of Health Sciences, Swinburne University of Technology, 12 Wakefield Street (Swinburne Place West), Hawthorn, Victoria, 3122, Australia; Centre of Urban Transitions, Swinburne University of Technology, 12 Wakefield Street (Swinburne Place West), Hawthorn, Victoria, 3122, Australia.
| | - Emily Munro-Harrison
- School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3010, Australia; Intergenerational Health, Murdoch Children's Research Centre, Flemington Rd, Parkville, Victoria, 3052, Australia
| | - Anne Jenkins
- Oonah Health & Community Services Aboriginal Corporation, 1A Badger Creek Road, Healesville, Victoria, 3777, Australia
| | - Alister Thorpe
- School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3010, Australia
| |
Collapse
|
19
|
Krishnan A, Waite LM, Stanaway FF. Representation of racial and ethnic minority groups in cohort studies evaluating risk factors for dementia: protocol for a scoping review. BMJ Open 2021; 11:e044404. [PMID: 33986050 PMCID: PMC8126304 DOI: 10.1136/bmjopen-2020-044404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Available evidence suggests that some racial/ethnic minority populations may be disproportionately burdened by dementia. Cohort studies are an important tool for defining and understanding the causes behind these racial and ethnic inequalities. However, ethnic minority populations may be more likely to be excluded from such research. Therefore, the aim of this study is to systematically investigate and quantify racial and ethnic minority representation in dementia risk factor research. METHODS AND ANALYSIS The elements of this protocol have been designed in accordance with the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols which are specifically applicable to scoping review protocols. We will include population-based cohort studies looking at risk factors for dementia incidence in our review and assess the representation of racial and ethnic minority populations in these studies. We will use multiple strategies to identify relevant studies, including a systematic search of the following electronic databases: MEDLINE (Ovid SP), Embase (Ovid SP) and Scopus. Two review authors will independently perform title and abstract screening, full-text screening and data extraction. Included cohort studies will be evaluated using a comprehensive framework to assess racial/ethnic minority representation. Logistic regression will also be performed to describe associations between cohort study characteristics and outcomes related to racial and ethnic minority representation. ETHICS AND DISSEMINATION Formal ethical approval is not required to conduct this review as no primary data are to be collected. The final results of this scoping review will be disseminated through publication in peer-reviewed journals and conference presentations.
Collapse
Affiliation(s)
- Arjun Krishnan
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Louise M Waite
- Faculty of Medicine and Health, The University of Sydney Concord Clinical School, Sydney, New South Wales, Australia
- The University of Sydney Centre for Education and Research on Ageing, Sydney, New South Wales, Australia
| | - Fiona F Stanaway
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
20
|
Hiratsuka VY, Hahn MJ, Woodbury RB, Hull SC, Wilson DR, Bonham VL, Dillard DA, Avey JP, Beckel-Mitchener AC, Blome J, Claw K, Ferucci ED, Gachupin FC, Ghazarian A, Hindorff L, Jooma S, Trinidad SB, Troyer J, Walajahi H. Alaska Native genomic research: perspectives from Alaska Native leaders, federal staff, and biomedical researchers. Genet Med 2020; 22:1935-1943. [PMID: 32839571 PMCID: PMC7708301 DOI: 10.1038/s41436-020-0926-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/22/2020] [Accepted: 07/27/2020] [Indexed: 11/09/2022] Open
Abstract
Meaningful engagement of Alaska Native (AN) tribes and tribal health organizations is essential in the conduct of socially responsible and ethical research. As genomics becomes increasingly important to advancements in medicine, there is a risk that populations not meaningfully included in genomic research will not benefit from the outcomes of that research. AN people have historically been underrepresented in biomedical research; AN underrepresentation in genomics research is compounded by mistrust based on past abuses, concerns about privacy and data ownership, and cultural considerations specific to this type of research. Working together, the National Human Genome Research Institute and two Alaska Native health organizations, Southcentral Foundation and the Alaska Native Health Board, cosponsored a workshop in July 2018 to engage key stakeholders in discussion, strengthen relationships, and facilitate partnership and consideration of participation of AN people in community-driven biomedical and genomic research. AN priorities related to translation of genomics research to health and health care, return of genomic results, design of research studies, and data sharing were discussed. This report summarizes the perspectives that emerged from the dialogue and offers considerations for effective and socially responsible genomic research partnerships with AN communities.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Katrina Claw
- Department of Medicine-Bioinformatics, University of Colorado Denver, Aurora, CO, USA
| | | | - Francine C Gachupin
- Department of Family and Community Medicine, University of Arizona, Tucson, AZ, USA
| | | | | | - Sonya Jooma
- National Institutes of Health, Bethesda, MD, USA
| | - Susan B Trinidad
- Department of Bioethics, University of Washington, Seattle, WA, USA
| | | | | |
Collapse
|
21
|
Ortiz-Prado E, Simbaña-Rivera K, Gómez-Barreno L, Tamariz L, Lister A, Baca JC, Norris A, Adana-Diaz L. Potential research ethics violations against an indigenous tribe in Ecuador: a mixed methods approach. BMC Med Ethics 2020; 21:100. [PMID: 33069227 PMCID: PMC7568418 DOI: 10.1186/s12910-020-00542-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 10/06/2020] [Indexed: 01/22/2023] Open
Abstract
Background Biomedical and ethnographic studies among indigenous people are common practice in health and geographical research. Prior health research misconduct has been documented, particularly when obtaining genetic material. The objective of this study was to crossmatch previously published data with the perceptions of the Waorani peoples about the trading of their genetic material and other biological samples. Methods We conducted a mixed methods study design using a tailored 15-item questionnaire in 72 participants and in-depth interviews in 55 participants belonging to 20 Waorani communities about their experiences and perceptions of participating in biomedical research projects. Additionally, we conducted a systematic review of the literature in order to crossmatch the published results of studies stating the approval of an ethics committee and individual consent within their work. Results A total of 40 men (60%) and 32 women (40%), with a mean age of 57 ± 15 years agreed to be interviewed for inclusion. Five main categories around the violation of good clinical practices were identified, concerning the obtention of blood samples from a recently contacted Waorani native community within the Amazonian region of Ecuador. These themes are related to the lack of adequate communication between community members and researchers as well as the voluntariness to participate in health research. Additionally, over 40 years, a total of 38 manuscripts related to the use of biological samples in Waorani indigenous people were published. The majority of the studies (68%) did not state within their article obtaining research ethics board approval, and 71% did not report obtaining the informed consent of the participants prior to the execution of the project. Conclusion Clinical Research on the Waorani community in the Ecuadorian Amazon basin has been performed on several occasions. Unfortunately, the majority of these projects did not follow the appropriate ethical and professional standards in either reporting the results or fulfilling them. The results of our investigation suggest that biological material, including genetic material, has been used by researchers globally, with some omitting the minimum information required to guarantee transparency and good clinical practices. We highlight the importance of stating ethics within research to avoid breaches in research transparency.
Collapse
Affiliation(s)
- Esteban Ortiz-Prado
- One Health Research Group, Faculty of Medicine, Universidad de Las Americas, Ecuador Calle de los Colimes y Avenida De los Granados, Quito, 170137, Ecuador.
| | - Katherine Simbaña-Rivera
- One Health Research Group, Faculty of Medicine, Universidad de Las Americas, Ecuador Calle de los Colimes y Avenida De los Granados, Quito, 170137, Ecuador
| | - Lenin Gómez-Barreno
- One Health Research Group, Faculty of Medicine, Universidad de Las Americas, Ecuador Calle de los Colimes y Avenida De los Granados, Quito, 170137, Ecuador
| | - Leonardo Tamariz
- Division of Population Health and Computational Medicine, University of Miami, Florida, USA
| | - Alex Lister
- Public Health Program, Faculty of Medicine, University of Southampton, Southampton, England
| | - Juan Carlos Baca
- Grassland Group, Technical University of Munich, Munich, Germany
| | | | - Lila Adana-Diaz
- Faculty of Psychology, Universidad de Las Americas, Quito, Ecuador
| |
Collapse
|
22
|
Ivers R, Coombes J, Sherrington C, Mackean T, Tiedemann A, Hill AM, Keay L, Clemson L, Simpson J, Ryder C, Macniven R, Clapham K. Healthy ageing among older Aboriginal people: the Ironbark study protocol for a cluster randomised controlled trial. Inj Prev 2020; 26:581-587. [PMID: 33028649 DOI: 10.1136/injuryprev-2020-043915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/31/2020] [Accepted: 09/04/2020] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Older Aboriginal people have a strong leadership role in their community including passing on knowledge and teachings around culture and connections to Country. Falls significantly affect older people and are a growing concern for older Aboriginal people and their families. Regular participation in balance and strength exercise has been shown to be efficacious in reducing falls. A pilot study developed in partnership with Aboriginal communities, the Ironbark: Standing Strong and Tall programme, demonstrated high community acceptability and feasibility, and gains in balance and strength in Aboriginal participants. This cluster randomised controlled trial will assess the effectiveness of the programme in reducing the rate of falls in older Aboriginal people. METHODS We will examine the effectiveness and cost-effectiveness of the Ironbark group-based fall prevention programme compared with a group-based social programme, with Aboriginal people aged 45 years and older in three Australian states. The primary outcome is fall rates over 12 months, measured using weekly self-reported data. Secondary outcomes measured at baseline and after 12 months include quality of life, psychological distress, activities of daily living, physical activity, functional mobility and central obesity. Differences between study groups in the primary and secondary outcomes at 12 months will be estimated. CONCLUSION This is the first trial to investigate the effectiveness and cost-effectiveness of a fall prevention programme for Aboriginal peoples aged ≥45 years. The study has strong cultural and community governance, including Aboriginal investigators and staff, and is guided by a steering committee that includes representatives of Aboriginal community-controlled services. TRIAL REGISTRATION NUMBER ACTRN12619000349145.
Collapse
Affiliation(s)
- Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia .,The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Julieann Coombes
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, School of Public Health, The University of Sydney and Sydney Local Health District, Sydney, Australia, Sydney, New South Wales, Australia
| | - Tamara Mackean
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, South Australia, Australia
| | - Anne Tiedemann
- Institute for Musculoskeletal Health, School of Public Health, The University of Sydney and Sydney Local Health District, Sydney, Australia, Sydney, New South Wales, Australia
| | - Anne-Marie Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Lindy Clemson
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Judy Simpson
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Courtney Ryder
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,Southgate Institute for Health, Society, and Equity, Flinders University, Adelaide, South Australia, Australia
| | - Rona Macniven
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia.,Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kathleen Clapham
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute, The University of Wollongong, Wollongong, New South Wales, Australia
| | | |
Collapse
|
23
|
Grant AD, Wolf GI, Nebeker C. Approaches to governance of participant-led research: a qualitative case study. BMJ Open 2019; 9:e025633. [PMID: 30944134 PMCID: PMC6500204 DOI: 10.1136/bmjopen-2018-025633] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/18/2018] [Accepted: 02/18/2019] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Participant-led research (PLR) is a rapidly developing form of citizen science in which individuals can create personal and generalisable knowledge. Although PLR lacks a formal framework for ethical review, participants should not be excused from considering the ethical implications of their work. Therefore, a PLR cohort consisting of 24 self-trackers aimed to: (1) substitute research ethics board procedures with engagement in ethical reflection before and throughout the study and (2) draft principles to encourage further development of the governance and ethical review of PLR. METHODS A qualitative case study method was used to analyse the ethical reflection process. Participants discussed study risks, risk management strategies and benefits pre-project, during a series of weekly webinars, via individual meetings with the participant-organisers, and during semi-structured interviews at project completion. Themes arising from discussions and interviews were used to draft prospective principles to guide PLR. RESULTS Data control, aggregation and identifiability were the most common risks identified. These were addressed by a commitment to transparency among all participants and by establishing participant control via self-collection and self-management of data. Group discussions and resources (eg, assistance with experimental design and data analysis) were the most commonly referenced benefits of participation. Additional benefits included greater understanding of one's physiology and greater ability to structure an experiment. Nine principles were constructed to encourage further development of ethical PLR practices. All participants expressed interest in participating in future PLR. CONCLUSIONS Projects involving a small number of participants can sustain engagement in ethical reflection among participants and participant-organisers. PLR that prioritises transparency, participant control of data and ongoing risk-to-benefit evaluation is compatible with the principles that underlie traditional ethical review of health research, while being appropriate for a context in which citizen scientists play the central role.
Collapse
Affiliation(s)
- Azure Dominique Grant
- Neuroscience, University of California, Berkeley, Berkeley, California, USA
- Quantified Self Labs, Berkeley, California, USA
| | | | - Camille Nebeker
- Family Medicine and Public Health, School of Medicine, University of California, San Diego, La Jolla, California, USA
| |
Collapse
|
24
|
Long CR, Purvis RS, Flood-Grady E, Kimminau KS, Rhyne RL, Burge MR, Stewart MK, Jenkins AJ, James LP, McElfish PA. Health researchers' experiences, perceptions and barriers related to sharing study results with participants. Health Res Policy Syst 2019; 17:25. [PMID: 30832733 PMCID: PMC6399828 DOI: 10.1186/s12961-019-0422-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/05/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Although research participants are generally interested in receiving results from studies in which they participate, health researchers rarely communicate study findings to participants. The present study was designed to provide opportunity for a broad group of health researchers to describe their experiences and concerns related to sharing results (i.e. aggregate study findings) with research participants. METHODS We used a mixed-methods concurrent triangulation design, relying on an online survey to capture health researchers' experiences, perceptions and barriers related to sharing study results with participants. Respondents were health researchers who conduct research that includes the consent of human subjects and hold a current appointment at an accredited academic medical institution within the United States. For quantitative data, the analytic strategy focused on item-level descriptive analyses. For the qualitative data, analyses focused on a priori themes and emergent subthemes. RESULTS Respondents were 414 researchers from 44 academic medical institutions; 64.5% reported that results should always be shared with participants, yet 60.8% of respondents could identify studies in which they had a leadership role where results were not shared. Emergent subthemes from researchers' reasons why results should be shared included participant ownership of findings and benefits of results sharing to science. Reasons for not sharing included concerns related to participants' health literacy and participants' lack of desire for results. Across all respondents who described barriers to results sharing, the majority described logistical barriers. CONCLUSIONS Study findings contribute to the literature by documenting researchers' perspectives and experiences about sharing results with research participants, which can inform efforts to improve results sharing. Most respondents indicated that health research results should always be shared with participants, although the extent to which many respondents described barriers to results sharing as well as reported reasons not to share results suggests difficulties with a one-size-fits-all approach to improving results sharing.
Collapse
Affiliation(s)
- Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, United States of America
| | - Rachel S Purvis
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, United States of America
| | - Elizabeth Flood-Grady
- STEM Translational Communication Center, College of Journalism and Communications and Recruitment Center, Clinical Translational Science Institute, University of Florida, 1185 Stadium Road, Gainesville, FL, 32611, United States of America
| | - Kim S Kimminau
- Department of Family Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, 66160, United States of America
| | - Robert L Rhyne
- Department of Family and Community Medicine, School of Medicine, University of New Mexico, MSC09 5040, Albuquerque, NM, 87131, United States of America
| | - Mark R Burge
- Clinical and Translational Science Center, Health Science Center, University of New Mexico, Albuquerque, NM, 87131, United States of America
| | - M Kathryn Stewart
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, 4301 W. Markham, Little Rock, AR, 72205, United States of America
| | - Amy J Jenkins
- Translational Research Institute, University of Arkansas for Medical Sciences, 4301 W. Markham, Little Rock, AR, 72205, United States of America
| | - Laura P James
- Department of Pediatrics, University of Arkansas for Medical Sciences, 4301 W. Markham, Little Rock, AR, 72205, United States of America
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, United States of America.
| |
Collapse
|
25
|
Abadie R, Goldenberg S, Welch-Lazoritz M, Fisher CB. Establishing trust in HIV/HCV research among people who inject drugs (PWID): Insights from empirical research. PLoS One 2018; 13:e0208410. [PMID: 30517202 PMCID: PMC6281254 DOI: 10.1371/journal.pone.0208410] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 11/17/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The establishment of trust between researchers and participants is critical to advance HIV and HCV prevention particularly among people who inject drugs (PWID) and other marginalized populations, yet empirical research on how to establish and maintain trust in the course of community health research is lacking. This paper documents ideas about trust between research participants and researchers amongst a sub-sample of PWID who were enrolled in a large, multi-year community health study of social networks and HIV/HCV risk that was recently conducted in rural Puerto Rico. METHODS Qualitative research was nested within a multi-year Social Network and HIV/HCV Risk study involving N = 360 PWID > 18 years of age living in four small, rural Puerto Rican communities. Semi-structured interviews were conducted between March 2017 and April 2017 with a subset of 40 active PWID who had been enrolled in the parent study. Interview questions invited participants to draw upon their recent experience as research participants to better understand how PWID perceive and understand participant-researcher trust within the context of HIV/HCV-related epidemiological research. RESULTS Fear of police, stigma and concerns regarding confidentiality and anonymity were identified as structural factors that could compromise participation in HIV/HCV-related research for PWID. While monetary compensation was an important motivation, participants also valued the opportunity to learn about their HIV/HCV status. During their participation in the study, gaining knowledge of safe injection practices was perceived as a valuable benefit. Participant narratives suggested that PWID may adopt an incremental and ongoing approach in their assessment of the trustworthiness of researchers, continuously assessing the extent to which they trust the research staff throughout the course of the research. Trust was initially generated through peer Respondent Driven Sampling recruitment. Research staff who maintained a presence in the community for the entire duration of the prospective study reinforced trust between participants and the research team. CONCLUSION Although PWID face numerous structural barriers to research-related trust in HIV/HCV research, we found that using a peer-based recruitment method like RDS, and employing a research staff who are knowledgeable about the targeted population, culturally sensitive to their needs, and who maintain a long-term presence in the community may help mitigate many of these barriers. The reputation of the research is built incrementally as participants join the study. This contributes to a "street reputation" that grows as current or former participants vouch for the study. Establishing trust was identified as only the first step towards building a collaborative relationship with participants, and our findings suggest that steps to address criminalization and stigmatization also are necessary to support research trust.
Collapse
Affiliation(s)
- Roberto Abadie
- Department of Sociology, University of Nebraska-Lincoln, Lincoln, NE, United States of America
| | - Shira Goldenberg
- Faculty of Health Sciences, Simon Fraser University, Bumaby, BC, Canada
| | - Melissa Welch-Lazoritz
- Pharmaceutical and Nutrition Care, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Celia B. Fisher
- Department of Psychology, Fordham University, Bronx, NY, United States of America
| |
Collapse
|
26
|
"Here we are part of a living culture": Understanding the cultural determinants of health in Aboriginal gathering places in Victoria, Australia. Health Place 2018; 54:210-220. [PMID: 30368099 DOI: 10.1016/j.healthplace.2018.10.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 02/03/2023]
Abstract
This article provides an exploration of the cultural determinants of health, based on a research evaluation investigating a number of Aboriginal gathering places in Victoria (Australia). Gathering places are recognised as settings in which people practice and learn about local Aboriginal culture, history and place. Academic literature on gathering places is sparse. Thirteen gathering places were evaluated in this research. Each site is unique and has a specific story that connects it to the history and geography of the place in which it is located. Sixty-nine gathering place members participated in qualitative semi-structured interviews or focus groups. Using thematic analysis, the findings were divided into four key themes associated with cultural determinants of health (social networks; inclusiveness; empowerment; connections). These elements create a safe place to learn about culture and Country, and support an environment for strengthening identity, improving health and building resilience. The findings from this study highlight the benefits of using gathering places to explore the cultural determinants of health.
Collapse
|
27
|
Cooper E, Driedger S. Creative, strengths-based approaches to knowledge translation within indigenous health research. Public Health 2018; 163:61-66. [DOI: 10.1016/j.puhe.2018.06.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/31/2018] [Accepted: 06/30/2018] [Indexed: 11/26/2022]
|
28
|
Thurber KA, Olsen A, Guthrie J, McCormick R, Hunter A, Jones R, Maher B, Banwell C, Jones R, Calabria B, Lovett R. 'Telling our story... Creating our own history': caregivers' reasons for participating in an Australian longitudinal study of Indigenous children. Int J Equity Health 2018; 17:143. [PMID: 30219069 PMCID: PMC6138915 DOI: 10.1186/s12939-018-0858-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/03/2018] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Improving the wellbeing of Indigenous populations is an international priority. Robust research conducted with Aboriginal and Torres Strait Islander peoples is key to developing programs and policies to improve health and wellbeing. This paper aims to quantify the extent of participation in a national longitudinal study of Aboriginal and Torres Strait Islander (Indigenous Australian) children, and to understand the reasons why caregivers participate in the study. METHODS This mixed methods study uses data from Wave 6 of Footprints in Time, the Longitudinal Study of Indigenous Children. We conducted descriptive analysis of quantitative variables to characterise the sample and retention rates. We applied conventional content analysis to 160 caregivers' open-ended responses to the question, 'Why do you stay in the study?', identifying themes and overarching meta-themes. RESULTS The study has maintained a high retention rate, with 70.4% (n = 1239/1671) of the baseline sample participating in the study's 6th wave. We identified seven themes related to why participants stay in the study: telling our story, community benefit, satisfaction, tracking Study Child's progress, study processes, receiving study gifts, and valuing what the study stands for. These related to two meta-themes: reciprocity, and trust and connection. Caregivers reported that participation was associated with benefits for their family and community as well as for the study. They identified specific features of the Footprints in Time study design that built and maintained trust and connection between participants and the study. CONCLUSIONS Our findings support the assertion that Aboriginal and Torres Strait Islander people want to be involved in research when it is done 'the right way'. Footprints in Time has successfully recruited and retained the current-largest cohort of Aboriginal and Torres Strait Islander children in Australia through the use of participatory research methodologies, suggesting effective study implementation and processes. Participants indicated ongoing commitment to the study resulting from perceptions of reciprocity and development of trust in the study. Footprints in Time can serve as a successful model of Aboriginal and Torres Strait Islander health research, to promote good research practice and provides lessons for research with other Indigenous populations.
Collapse
Affiliation(s)
- Katherine Ann Thurber
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT 2601 Australia
| | - Anna Olsen
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT 2601 Australia
| | - Jill Guthrie
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT 2601 Australia
| | - Rachael McCormick
- Medical School, The Australian National University, Acton, ACT 2601 Australia
| | - Andrew Hunter
- Medical School, The Australian National University, Acton, ACT 2601 Australia
| | - Roxanne Jones
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT 2601 Australia
| | - Bobby Maher
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT 2601 Australia
| | - Cathy Banwell
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT 2601 Australia
| | - Rochelle Jones
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT 2601 Australia
| | - Bianca Calabria
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT 2601 Australia
| | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT 2601 Australia
| |
Collapse
|
29
|
Guillemin M, Barnard E, Allen A, Stewart P, Walker H, Rosenthal D, Gillam L. Do Research Participants Trust Researchers or Their Institution? J Empir Res Hum Res Ethics 2018; 13:285-294. [PMID: 29561215 DOI: 10.1177/1556264618763253] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Relationships of trust between research participants and researchers are often considered paramount to successful research; however, we know little about participants' perspectives. We examined whom research participants trusted when taking part in research. Using a qualitative approach, we interviewed 36 research participants, including eight Indigenous participants. Thematic analysis was used to analyze the data. This article focuses on findings related to non-Indigenous participants. In contrast to Indigenous participants, non-Indigenous participants placed their trust in research institutions because of their systems of research ethics, their reputation and prestige. Researchers working in non-Indigenous contexts need to be cognizant that the trust that participants place in them is closely connected with the trust that participants have in the institution.
Collapse
Affiliation(s)
| | - Emma Barnard
- 1 The University of Melbourne, Parkville, Australia
| | - Anton Allen
- 1 The University of Melbourne, Parkville, Australia
| | - Paul Stewart
- 1 The University of Melbourne, Parkville, Australia
| | | | | | - Lynn Gillam
- 1 The University of Melbourne, Parkville, Australia
| |
Collapse
|
30
|
Hiratsuka VY, Avey JP, Beans JA, Dirks LG, Caindec K, Dillard DA. Approach and Methods of the 2016 Alaska Native Research Forum. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2018; 25:19-29. [PMID: 29671855 PMCID: PMC6392196 DOI: 10.5820/aian.2501.2018.19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Southcentral Foundation, a tribal health organization serving Alaska Native and American Indian (AN/AI) people in southcentral Alaska, convened the Alaska Native Health Research Forum (Forum) for AN/AI people in May 2016. The purpose of the Forum was to obtain AN/AI community member feedback about sharing health research results. This article describes the funding mechanism that provided resources for the Forum and other factors that were considered when designing the Forum. This is followed by a description of how attendees were invited, the audience response system, and process used to collect quantitative data on participants and qualitative feedback from small group discussions with Forum attendees. Finally, we describe the quantitative and qualitative data analysis processes used to evaluate responses.
Collapse
|
31
|
Hiratsuka VY, Avey JP, Beans JA, Dirks LG, Caindec K, Dillard DA. Approach and Methods of the 2016 Alaska Native Research Forum. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2018. [PMID: 29671855 DOI: 10.5820/aian.2501.2018.19018.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
Southcentral Foundation, a tribal health organization serving Alaska Native and American Indian (AN/AI) people in southcentral Alaska, convened the Alaska Native Health Research Forum (Forum) for AN/AI people in May 2016. The purpose of the Forum was to obtain AN/AI community member feedback about sharing health research results. This article describes the funding mechanism that provided resources for the Forum and other factors that were considered when designing the Forum. This is followed by a description of how attendees were invited, the audience response system, and process used to collect quantitative data on participants and qualitative feedback from small group discussions with Forum attendees. Finally, we describe the quantitative and qualitative data analysis processes used to evaluate responses.
Collapse
|
32
|
Williams L, Gott M, Moeke-Maxwell T, Black S, Kothari S, Pearson S, Morgan T, Wharemate MR, Hansen WW. Can digital stories go where palliative care research has never gone before? A descriptive qualitative study exploring the application of an emerging public health research method in an indigenous palliative care context. BMC Palliat Care 2017; 16:46. [PMID: 28870189 PMCID: PMC5584042 DOI: 10.1186/s12904-017-0216-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 06/23/2017] [Indexed: 11/23/2022] Open
Abstract
Background The World Health Organization (WHO) has called for global approaches to palliative care development. Yet it is questionable whether one-size-fits-all solutions can accommodate international disparities in palliative care need. More flexible research methods are called for in order to understand diverse priorities at local levels. This is especially imperative for Indigenous populations and other groups underrepresented in the palliative care evidence-base. Digital storytelling (DST) offers the potential to be one such method. Digital stories are short first-person videos that tell a story of great significance to the creator. The method has already found a place within public health research and has been described as a useful, emergent method for community-based participatory research. Methods The aim of this study was to explore Māori participants’ views on DST’s usefulness, from an Indigenous perspective, as a research method within the discipline of palliative care. The digital storytelling method was adapted to include Māori cultural protocols. Data capturing participant experience of the study were collected using participant observation and anonymous questionnaires. Eight participants, seven women and one man, took part. Field notes and questionnaire data were analysed using critical thematic analysis. Results Two main themes were identified during analyses: 1) issues that facilitated digital storytelling’s usefulness as a research method for Māori reporting on end of life caregiving; and 2) issues that hindered this process. All subthemes identified: recruitment, the pōwhiri process, (Māori formal welcome of visitors) and technology, related to both main themes and are presented in this way. Conclusion Digital storytelling is an emerging method useful for exploring Indigenous palliative care issues. In line with a Health Promoting Palliative Care approach that centres research in communities, it helps meet the need for diverse approaches to involve underrepresented groups.
Collapse
Affiliation(s)
- Lisa Williams
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Stella Black
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Shuchi Kothari
- Media and Communication, School of Social Sciences, Faculty of the Arts, University of Auckland, Auckland, New Zealand
| | - Sarina Pearson
- Media and Communication, School of Social Sciences, Faculty of the Arts, University of Auckland, Auckland, New Zealand
| | - Tessa Morgan
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Matua Rawiri Wharemate
- Kaumātua, Te Ārai: Palliative Care and End of Life Research Group, School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Whaea Whio Hansen
- Kaumātua, Te Ārai: Palliative Care and End of Life Research Group, School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| |
Collapse
|
33
|
Simpson S, D'Aprano A, Tayler C, Toon Khoo S, Highfold R. Validation of a culturally adapted developmental screening tool for Australian Aboriginal children: Early findings and next steps. Early Hum Dev 2016; 103:91-95. [PMID: 27544061 DOI: 10.1016/j.earlhumdev.2016.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/09/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Early detection of developmental problems is important for facilitating access to targeted intervention and maximising its positive effects. The later problems are identified, the more likely that they will become increasingly difficult to ameliorate. Standardised developmental screening tools are known to improve detection rates of developmental problems compared to clinical judgement alone and are widely recommended for use with all children. The Ages and Stages Questionnaire (ASQ-3) is a tool that is widely used in Australia. However, mainstream screening tools may not be appropriate for remote-dwelling Australian Aboriginal children. While Australian Aboriginal children face multiple developmental risk factors, there are no developmental screening tools that have been validated for use in this population. AIMS To determine the concurrent validity of the culturally adapted ASQ-3 - the ASQ-TRAK - for Australian Aboriginal children compared to the Bayley Scales of Infant and Toddler Development (Bayley-III), a standardised, professionally administered developmental assessment. SUBJECTS The ASQ-TRAK and Bayley-III were administered cross-sectionally to 67 Central Australian Aboriginal children between 2 and 36months of age. RESULTS The ASQ-TRAK communication, gross motor, fine motor and problem-solving domains and the corresponding domains on the Bayley-III were moderately correlated. Overall sensitivity for the ASQ-TRAK was 71% (95% CI 29-96) and specificity was 92% (95% CI 88-99). Percentage agreement between the ASQ-TRAK and the Bayley-III was 90%. CONCLUSIONS The ASQ-TRAK shows promise as a tool that can be used to improve developmental monitoring for remote dwelling Australian Aboriginal children. Further research is necessary to build on the current findings.
Collapse
Affiliation(s)
- Samantha Simpson
- Melbourne Graduate School of Education, The University of Melbourne, 100 Leicester Street, Carlton, VIC 3053, Australia.
| | - Anita D'Aprano
- Melbourne Graduate School of Education, The University of Melbourne, 100 Leicester Street, Carlton, VIC 3053, Australia
| | - Collette Tayler
- Melbourne Graduate School of Education, The University of Melbourne, 100 Leicester Street, Carlton, VIC 3053, Australia
| | - Siek Toon Khoo
- Australian Council for Educational Research, 19 Prospect Hill Road, Camberwell, VIC 3124, Australia
| | - Roxanne Highfold
- Central Australian Aboriginal Congress, PO Box 1604, Alice Springs, NT 0871, Australia
| |
Collapse
|
34
|
Guillemin M, Gillam L, Barnard E, Stewart P, Walker H, Rosenthal D. “Doing Trust”. J Empir Res Hum Res Ethics 2016; 11:370-381. [DOI: 10.1177/1556264616668975] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Trust in research is important but not well understood. We examine the ways that researchers understand and practice trust in research. Using a qualitative research design, we interviewed 19 researchers, including eight researchers involved in Australian Indigenous research. The project design focused on sensitive research including research involving vulnerable participants and sensitive research topics. Thematic analysis was used to analyze the data. We found that researchers’ understanding of trust integrates both the conceptual and concrete; researchers understand trust in terms of how it relates to other similar concepts and how they practice trust in research. This provides a sound basis to better understand trust in research, as well as identifying mechanisms to regain trust when it is lost in research.
Collapse
|