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Shrestha S, Wells Y, While C, Rahman MA. Caring Self-Efficacy of Personal Care Attendants From English-Speaking and Non-English-Speaking Countries Working in Australian Residential Aged Care Settings. J Aging Health 2024; 36:207-219. [PMID: 37313989 PMCID: PMC10832313 DOI: 10.1177/08982643231183466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objectives: This study compared the caring self-efficacy between personal care attendants (PCAs) from English-speaking and non-English-speaking countries, controlling for potential sociodemographic and work-related covariates. PCAs' perceptions of their caring self-efficacy were further explored. Methods: An independent samples t-test was used to determine the mean difference in the caring self-efficacy score between the two groups. A multivariate analysis was conducted to adjust for covariates. Thematic analysis was conducted on open-ended responses. Results: The results showed that caring self-efficacy was significantly influenced by whether participants primarily spoke English at home rather than where they were born. Younger age and everyday discrimination experiences were negatively associated with caring self-efficacy. Both groups perceived that inadequate resources and experiencing bullying and discrimination reduced their caring self-efficacy. Discussion: Access to organisational resources and training opportunities and addressing workplace bullying and discrimination against PCAs, particularly younger PCAs and those from non-English-speaking backgrounds, could improve their caring self-efficacy.
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Affiliation(s)
- Sumina Shrestha
- Australian Institute for Primary Care & Ageing, La Trobe University, Melbourne, VIC, Australia
| | - Yvonne Wells
- Australian Institute for Primary Care & Ageing, La Trobe University, Melbourne, VIC, Australia
| | - Christine While
- Australian Institute for Primary Care & Ageing, La Trobe University, Melbourne, VIC, Australia
| | - Muhammad Aziz Rahman
- Australian Institute for Primary Care & Ageing, La Trobe University, Melbourne, VIC, Australia
- Institute of Health and Wellbeing, Federation University, Berwick, VIC, Australia
- Department of Non-Communicable Diseases, Bangladesh University of Health Sciences (BUHS), Dhaka, Bangladesh
- Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
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2
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Khalifeh R, D’Hoore W, Saliba C, Salameh P, Dauvrin M. Healthcare bias and health inequalities towards displaced Syrians in Lebanon: a qualitative study. Front Public Health 2023; 11:1273916. [PMID: 38098832 PMCID: PMC10720425 DOI: 10.3389/fpubh.2023.1273916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction According to Lebanese official data, Lebanon hosts over 1.5 million displaced Syrians (DS). Research shows that migrants encounter barriers when accessing healthcare. The social determinants of health (SDOH) related to migration are an additional challenge for DS in Lebanon, though bias plays a significant factor in exacerbating health inequalities. This study aims to identify DS perception of healthcare biases in the Lebanese healthcare system, and its consequences on DS' accessing and receiving quality healthcare in Lebanon. Methods A qualitative analysis using in-depth, semi-structured interviews was utilized. 28 semi-structured interviews were conducted with doctors (n = 12) and nurses (n = 16) in 2021. Six group interviews were conducted with DS (n = 22) in Lebanese healthcare facilities. The recruitment of participants relied on reasoned and targeted sampling. Thematic analysis was performed to identify common themes in participants' experiences with DS accessing Lebanese healthcare. Results The findings indicated that there were barriers to accessing healthcare related to the SDOH, such as transportation and financial resources. The results also suggested that DS perceived health biases, including discriminatory behavior from Lebanese healthcare providers, stereotypes and racism leading to health inequalities. Conclusion Based on the perceptions and experiences reported by participants, the underlying causes of biases are due to the fragility of the Lebanese healthcare system when facing a humanitarian crisis as well as a collapsing infrastructure torn by past wars and the current socio-political and financial crises in the country. Global initiatives are required to provide the necessary resources needed for offering equitable health services. Such initiatives involve addressing biases, health inequities, discrimination, and the lack of a Lebanese infrastructure system for the provision of healthcare. Addressing health inequalities remains a major health objective in achieving health equity on the micro level (cultural awareness and competencies) and macro level (equitable distribution of resources, implementation of a universal health coverage) in order to guarantee quality healthcare services to DS.
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Affiliation(s)
- Riwa Khalifeh
- Institute of Health and Society (IRSS), UCLouvain, Brussels, Belgium
- Legal Way for Advocacy and Research, Beirut, Lebanon
| | - William D’Hoore
- Institute of Health and Society (IRSS), UCLouvain, Brussels, Belgium
| | - Christiane Saliba
- Faculty of Public Health—Section 2 (CERIPH), Lebanese University, Fanar, Lebanon
| | - Pascale Salameh
- School of Medicine, Lebanese American University, Byblos, Lebanon
- Institut National de Santé Publique d’Épidémiologie Clinique et de Toxicologie-Liban (INSPECT LB), Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
| | - Marie Dauvrin
- Institute of Health and Society (IRSS), UCLouvain, Brussels, Belgium
- Belgian Health Care Knowledge Center, KCE, Brussels, Belgium
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Algarin AB, Yeager S, Patterson TL, Strathdee SA, Harvey-Vera A, Vera CF, Stamos-Buesig T, Artamanova I, Abramovitz D, Smith LR. The moderating role of resilience in the relationship between experiences of COVID-19 response-related discrimination and disinformation among people who inject drugs. Drug Alcohol Depend 2023; 246:109831. [PMID: 36924661 PMCID: PMC9981478 DOI: 10.1016/j.drugalcdep.2023.109831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
BACKGROUND Due to the persistence of COVID-19, it remains important to measure and examine potential barriers to COVID-19 prevention and treatment to avert additional loss of life, particularly among stigmatized populations, such as people who inject drugs (PWID), who are at high risk for contracting and spreading SARS-CoV-2. We assessed the psychometrics of a novel COVID-19 response-related discrimination scale among PWID, and characterized associations between COVID-19 response-related discrimination, resilience to adversity, and endorsement of COVID-19 disinformation. METHODS We assessed internal reliability, structural validity and construct validity of a 4-item COVID-19 response-related discrimination scale among PWID living in San Diego County, completing interviewer-administered surveys between October 2020 and September 2021. Using negative binomial regression, we assessed the relationship between COVID-19 response-related discrimination and disinformation and the potential moderating role of resilience. RESULTS Of 381 PWID, mean age was 42.6 years and the majority were male (75.6 %) and Hispanic (61.9 %). The COVID-19 response-related discrimination scale had modest reliability (α = 0.66, ω = 0.66) as a single construct with acceptable construct validity (all p ≤ 0.05). Among 216 PWID who completed supplemental surveys, a significant association between COVID-19 response-related discrimination and COVID-19 disinformation was observed, which was moderated by resilience (p = 0.044). Specifically, among PWID with high levels of resilience, endorsement of COVID-19 disinformation significantly increased as exposure to COVID-19 response-related discrimination increased (p = 0.011). CONCLUSIONS These findings suggest that intervening on COVID-19 response-related discrimination may offset the negative outcomes associated with COVID-19 disinformation.
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Affiliation(s)
- Angel B Algarin
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University - Downtown Campus, Phoenix, AZ, USA
| | - Samantha Yeager
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Thomas L Patterson
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Steffanie A Strathdee
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Alicia Harvey-Vera
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Facultad de Medicina, Universidad Xochicalco, Tijuana, Mexico; United States-Mexico Border Health Commission, Tijuana, Mexico
| | - Carlos F Vera
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | | | - Irina Artamanova
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Daniela Abramovitz
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Laramie R Smith
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA.
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4
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Thurber KA, Brinckley MM, Jones R, Evans O, Nichols K, Priest N, Guo S, Williams DR, Gee GC, Joshy G, Banks E, Thandrayen J, Baffour B, Mohamed J, Calma T, Lovett R. Population-level contribution of interpersonal discrimination to psychological distress among Australian Aboriginal and Torres Strait Islander adults, and to Indigenous-non-Indigenous inequities: cross-sectional analysis of a community-controlled First Nations cohort study. Lancet 2022; 400:2084-2094. [PMID: 36502846 PMCID: PMC9807286 DOI: 10.1016/s0140-6736(22)01639-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 08/10/2022] [Accepted: 08/19/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND International and population-specific evidence identifies elevated psychological distress prevalence among those experiencing interpersonal discrimination. We aim to quantify the potential whole-of-population contribution of interpersonal discrimination to psychological distress prevalence and Indigenous-non-Indigenous gaps in Australia. METHODS We did a cross-sectional analysis of data from Mayi Kuwayu: the National Study of Aboriginal and Torres Strait Islander Wellbeing. Baseline surveys were completed between June 8, 2018, and Sept 28, 2022. We analysed responses from participants who were aged 18 years or older at survey completion, whose surveys were processed between Oct 1, 2018, and May 1, 2021. Sample weights were developed on the basis of national population benchmarks. We measured everyday discrimination using an eight-item measure modified from the Everyday Discrimination Scale and classified experiences as racial discrimination if participants attributed these experiences to their Indigeneity. Psychological distress was measured using a validated, modified Kessler-5 scale. Applying logistic regression, we calculated unadjusted odds ratios (ORs), to approximate incident rate ratios (IRRs), for high or very high psychological distress in relation to everyday discrimination and everyday racial discrimination across age-gender strata. Population attributable fractions (PAFs), under the hypothetical assumption that ORs represent causal relationships, were calculated using these ORs and population-level exposure prevalence. These PAFs were used to quantify the contribution of everyday racial discrimination to psychological distress gaps between Indigenous and non-Indigenous adults. FINDINGS 9963 survey responses were eligible for inclusion in our study, of which we analysed 9951 (99·9%); 12 were excluded due to responders identifying as a gender other than man or woman (there were too few responses from this demographic to be included as a category in stratified tables or adjusted analyses). The overall prevalence of psychological distress was 48·3% (95% CI 47·0-49·6) in those experiencing everyday discrimination compared with 25·2% (23·8-26·6) in those experiencing no everyday discrimination (OR 2·77 [95% CI 2·52-3·04]) and psychological distress prevalence was 49·0% (95% CI 47·3-50·6) in those experiencing everyday racial discrimination and 31·8% (30·6-33·1) in those experiencing no everyday racial discrimination (OR 2·06 [95% CI 1·88-2·25]. Overall, 49·3% of the total psychological distress burden among Aboriginal and Torres Strait Islander adults could be attributable to everyday discrimination (39·4-58·8% across strata) and 27·1% to everyday racial discrimination. Everyday racial discrimination could explain 47·4% of the overall gap in psychological distress between Indigenous and non-Indigenous people (40·0-60·3% across strata). INTERPRETATION Our findings show that interpersonal discrimination might contribute substantially to psychological distress among Aboriginal and Torres Strait Islander adults, and to inequities compared with non-Indigenous adults. Estimated PAFs include contributions from social and health disadvantage, reflecting contributions from structural racism. Although not providing strictly conclusive evidence of causality, this evidence is sufficient to indicate the psychological harm of interpersonal discrimination. Findings add weight to imperatives to combat discrimination and structural racism at its core. Urgent individual and policy action is required of non-Indigenous people and colonial structures, directed by Aboriginal and Torres Strait Islander peoples. FUNDING National Health and Medical Research Council of Australia, Ian Potter Foundation, Australian Research Council, US National Institutes of Health, and Sierra Foundation.
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Affiliation(s)
- Katherine A Thurber
- National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Acton, ACT, Australia.
| | - Makayla-May Brinckley
- National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Acton, ACT, Australia
| | - Roxanne Jones
- National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Acton, ACT, Australia
| | - Olivia Evans
- Research School of Psychology, Australian National University, Acton, ACT, Australia
| | - Kirsty Nichols
- National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Acton, ACT, Australia
| | - Naomi Priest
- Centre for Social Research and Methods, College of Arts and Social Sciences, Australian National University, Acton, ACT, Australia; Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Shuaijun Guo
- Centre for Community Child Health, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - David R Williams
- Department of Social and Behavioural Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Gilbert C Gee
- Department of Community Health, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Grace Joshy
- National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Acton, ACT, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Acton, ACT, Australia
| | - Joanne Thandrayen
- National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Acton, ACT, Australia
| | - Bernard Baffour
- School of Demography, College of Arts and Social Sciences, Australian National University, Acton, ACT, Australia
| | | | - Tom Calma
- University of Canberra, Bruce, ACT, Australia; Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Raymond Lovett
- National Centre for Epidemiology and Population Health, College of Health & Medicine, Australian National University, Acton, ACT, Australia
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Ryder C, Stephens JH, Ullah S, Coombes J, Cominos N, Sharpe P, D’Angelo S, Cameron D, Hayes C, Bennett-Brook K, Mackean T. Community Engagement and Psychometric Methods in Aboriginal and Torres Strait Islander Patient-Reported Outcome Measures and Surveys-A Scoping Review and Critical Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10354. [PMID: 36011989 PMCID: PMC9407920 DOI: 10.3390/ijerph191610354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: In healthcare settings, patient-reported outcome measures (PROMs) and surveys are accepted, patient-centered measures that provide qualitative information on dimensions of health and wellbeing. The level of psychometric assessment and engagement with end users for their design can vary significantly. This scoping review describes the psychometric and community engagement processes for PROMs and surveys developed for Aboriginal and Torres Strait Islander communities. (2) Methods: The PRISMA ScR guidelines for scoping reviews were followed, aimed at those PROMs and surveys that underwent psychometric assessment. The Aboriginal and Torres Strait Islander Quality Appraisal Tool and a narrative synthesis approach were used. (3) Results: Of 1080 articles, 14 were eligible for review. Most articles focused on a validity assessment of PROMs and surveys, with reliability being less common. Face validity with Aboriginal and Torres Strait Islander communities was reported in most studies, with construct validity through exploratory factor analyses. Methodological design risks were identified in the majority of studies, notably the absence of explicit Indigenous knowledges. Variability existed in the development of PROMs and surveys for Aboriginal and Torres Strait Islander communities. (4) Conclusions: Improvement in inclusion of Indigenous knowledges and research approaches is needed to ensure relevance and appropriate PROM structures. We provide suggestions for research teams to assist in future design.
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Affiliation(s)
- Courtney Ryder
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
- The George Institute for Global Health Australia, University of New South Wales (UNSW), Missenden Rd., Sydney, NSW 2052, Australia
- School of Population Health, University of New South Wales (UNSW), Sydney, NSW 2052, Australia
| | - Jacqueline H. Stephens
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
| | - Shahid Ullah
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
| | - Julieann Coombes
- The George Institute for Global Health Australia, University of New South Wales (UNSW), Missenden Rd., Sydney, NSW 2052, Australia
| | - Nayia Cominos
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
| | - Patrick Sharpe
- Far West Community Partnerships, Ceduna, SA 5690, Australia
| | - Shane D’Angelo
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
| | - Darryl Cameron
- Moorundi Aboriginal Community Controlled Health Service, Lot 1 Wharf Road, Murray Bridge, SA 5253, Australia
| | - Colleen Hayes
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
| | - Keziah Bennett-Brook
- The George Institute for Global Health Australia, University of New South Wales (UNSW), Missenden Rd., Sydney, NSW 2052, Australia
| | - Tamara Mackean
- College of Medicine and Public Health, Flinders University, Adelaide, SA 5001, Australia
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, SA 5001, Australia
- The George Institute for Global Health Australia, University of New South Wales (UNSW), Missenden Rd., Sydney, NSW 2052, Australia
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6
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A systematic review and meta-analysis of the Everyday Discrimination Scale and biomarker outcomes. Psychoneuroendocrinology 2022; 142:105772. [PMID: 35490482 PMCID: PMC9997446 DOI: 10.1016/j.psyneuen.2022.105772] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/01/2022] [Accepted: 04/17/2022] [Indexed: 02/08/2023]
Abstract
Discrimination has consistently been associated with multiple adverse health outcomes. Like other psychosocial stressors, discrimination is thought to impact health through stress-related physiologic pathways including hypothalamic-pituitary-adrenal (HPA) axis activation, dysregulation of inflammation responses, and accelerated cellular aging. Given growing attention to research examining the biological pathways through which discrimination becomes embodied, this systematic review and meta-analysis synthesizes empirical evidence examining relationships between self-reported discrimination and four biomarker outcomes (i.e., cortisol, C-reactive protein (CRP), interleukin-6 (IL-6), and telomere length) among studies that have used the Everyday Discrimination Scale. We conducted a systematic review of studies discussing self-reported, everyday, or chronic discrimination in the context of health by searching Medline / PubMed (National Library of Medicine, NCBI), PsycInfo (APA, Ebsco) and Web of Science Core Collection (Clarivate). Twenty-five articles met the criteria for meta-analysis, with several reporting on multiple outcomes. Discrimination was associated with elevated CRP levels (r = 0.11; 95% CI: 0.01, 0.20, k = 10), though not cortisol (r = 0.05; 95% CI: -0.06, 0.16, k = 9), IL-6 (r = 0.05; 95% CI: -0.32, 0.42, k = 5), or telomere length (r = 0.03; 95% CI: -0.01, 0.07, k = 6). We identify several points of consideration for future research including addressing heterogeneity in assessment of biomarker outcomes and the need for longitudinal assessments of relationships between discrimination and biomarker outcomes.
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7
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Implementing Optimal Care Pathways for Aboriginal and Torres Strait Islander People With Cancer: A Survey of Rural Health Professionals’ Self-Rated Learning Needs. Int J Integr Care 2022; 22:27. [PMID: 35431703 PMCID: PMC8973837 DOI: 10.5334/ijic.6028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 03/16/2022] [Indexed: 11/20/2022] Open
Abstract
Objective: Methods: Results: Conclusion:
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Ben J, Elias A, Issaka A, Truong M, Dunn K, Sharples R, McGarty C, Walton J, Mansouri F, Denson N, Paradies Y. Racism in Australia: a protocol for a systematic review and meta-analysis. Syst Rev 2022; 11:47. [PMID: 35300718 PMCID: PMC8929717 DOI: 10.1186/s13643-022-01919-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 03/02/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Racism has been identified as a major source of injustice and a health burden in Australia and across the world. Despite the surge in Australian quantitative research on the topic, and the increasing recognition of the prevalence and impact of racism in Australian society, the collective evidence base has yet to be comprehensively reviewed or meta-analysed. This protocol describes the first systematic review and meta-analysis of racism in Australia at the national level, focussing on quantitative studies. The current study will considerably improve our understanding of racism, including its manifestations and fluctuation over time, variation across settings and between groups, and associations with health and socio-economic outcomes. METHODS The research will consist of a systematic literature review and meta-analysis. Searches for relevant studies will focus on the social and health science databases CINAHL, PsycINFO, PubMed and Scopus. Two reviewers will independently screen eligible papers for inclusion and extract data from included studies. Studies will be included in the review and meta-analysis where they meet the following criteria: (1) report quantitative empirical research on self-reported racism in Australia, (2) report data on the prevalence of racism, or its association with health (e.g. mental health, physical health, health behaviours) or socio-economic outcomes (e.g. education, employment, income), and (3) report Australian data. Measures of racism will focus on study participants' self-reports, with a separate analysis dedicated to researcher-reported measures, such as segregation and differential outcomes across racial/ethnic groups. Measures of health and socio-economic outcomes will include both self-reports and researcher-reported measures, such as physiological measurements. Existing reviews will be manually searched for additional studies. Study characteristics will be summarised, and a meta-analysis of the prevalence of racism and its associations will be conducted using random effects models and mean weighted effect sizes. Moderation and subgroup analyses will be conducted as well. All analyses will use the software CMA 3.0. DISCUSSION This study will provide a novel and comprehensive synthesis of the quantitative evidence base on racism in Australia. It will answer questions about the fluctuation of racism over time, its variation across settings and groups, and its relationship with health and socio-economic outcomes. Findings will be discussed in relation to broader debates in this growing field of research and will be widely disseminated to inform anti-racism research, action and policy nationally. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021265115 .
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Affiliation(s)
- Jehonathan Ben
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia. .,Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia.
| | - Amanuel Elias
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Ayuba Issaka
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia.,School of Health and Social Development, Deakin University, Melbourne, Victoria, Australia
| | - Mandy Truong
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia.,Menzies School of Health Research, Darwin, NT, Australia
| | - Kevin Dunn
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,School of Social Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Rachel Sharples
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,School of Social Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Craig McGarty
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,School of Psychology, Western Sydney University, Penrith, New South Wales, Australia
| | - Jessica Walton
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Fethi Mansouri
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
| | - Nida Denson
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,School of Social Sciences, Western Sydney University, Penrith, New South Wales, Australia
| | - Yin Paradies
- Centre for Resilient and Inclusive Societies (CRIS), Melbourne, Victoria, Australia.,Alfred Deakin Institute for Citizenship and Globalization, Faculty of Arts and Education, Deakin University, Melbourne, Victoria, Australia
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9
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Hayes C. Treading carefully on sovereign ground: reflections of a settler teaching an Indigenous health and wellbeing subject in Australia. Contemp Nurse 2022; 57:312-316. [PMID: 35001847 DOI: 10.1080/10376178.2022.2027255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This paper was written on the lands of the Gadigal people. I pay my respect to Elders past and present and the Traditional Custodians of the Aboriginal and Torres Strait Islander Nations across the continent now known as Australia. I acknowledge the continuing connection to culture, lands, waters and sky and that sovereignty was never ceded.
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Affiliation(s)
- Carolyn Hayes
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Level 8 D18 - Susan Wakil Health Building, Western Avenue, Sydney NSW 2006
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10
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Thurber KA, Colonna E, Jones R, Gee GC, Priest N, Cohen R, Williams DR, Thandrayen J, Calma T, Lovett R. Prevalence of Everyday Discrimination and Relation with Wellbeing among Aboriginal and Torres Strait Islander Adults in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126577. [PMID: 34207406 PMCID: PMC8296443 DOI: 10.3390/ijerph18126577] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/08/2021] [Accepted: 06/15/2021] [Indexed: 11/18/2022]
Abstract
Discrimination is a fundamental determinant of health and health inequities. However, despite the high prevalence of discrimination exposure, there is limited evidence specific to Indigenous populations on the link between discrimination and health. This study employs a validated measure to quantify experiences of everyday discrimination in a national sample of Aboriginal and Torres Strait Islander (Australia’s Indigenous peoples) adults surveyed from 2018 to 2020 (≥16 years, n = 8108). It quantifies Prevalence Ratios (PRs) and 95% Confidence Intervals (CIs) for wellbeing outcomes by level of discrimination exposure, and tests if associations vary by attribution of discrimination to Indigeneity. Of the participants, 41.5% reported no discrimination, 47.5% low, and 11.0% moderate-high. Discrimination was more commonly reported by younger versus older participants, females versus males, and those living in remote versus urban or regional areas. Discrimination was significantly associated in a dose-response manner, with measures of social and emotional wellbeing, culture and identity, health behaviour, and health outcomes. The strength of the association varied across outcomes, from a 10–20% increased prevalence for some outcomes (e.g., disconnection from culture (PR = 1.08; 95% CI: 1.03, 1.14), and high blood pressure (1.20; 1.09, 1.32)), to a five-fold prevalence of alcohol dependence (4.96; 3.64, 6.76), for those with moderate-high versus no discrimination exposure. The association was of consistent strength and direction whether attributed to Indigeneity or not—with three exceptions. Discrimination is associated with a broad range of poor wellbeing outcomes in this large-scale, national, diverse cohort of Aboriginal and Torres Strait Islander adults. These findings support the vast potential to improve Aboriginal and Torres Strait Islander peoples’ wellbeing, and to reduce Indigenous-non-Indigenous inequities, by reducing exposure to discrimination.
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Affiliation(s)
- Katherine A. Thurber
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2600, Australia; (E.C.); (R.J.); (R.C.); (J.T.); (R.L.)
- Correspondence:
| | - Emily Colonna
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2600, Australia; (E.C.); (R.J.); (R.C.); (J.T.); (R.L.)
| | - Roxanne Jones
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2600, Australia; (E.C.); (R.J.); (R.C.); (J.T.); (R.L.)
| | - Gilbert C. Gee
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA 90024, USA;
| | - Naomi Priest
- Centre for Social Research and Methods, College of Arts and Social Sciences, Australian National University, Canberra, ACT 2600, Australia;
- Population Health, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC 3052, Australia
| | - Rubijayne Cohen
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2600, Australia; (E.C.); (R.J.); (R.C.); (J.T.); (R.L.)
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Joanne Thandrayen
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2600, Australia; (E.C.); (R.J.); (R.C.); (J.T.); (R.L.)
| | - Tom Calma
- Poche Indigenous Health Network New South Wales, University of Sydney, Camperdown, NSW 2006, Australia;
- University of Canberra, Bruce, ACT 2617, Australia
- Ninti One, Hackney, SA 5071, Australia
| | - Raymond Lovett
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2600, Australia; (E.C.); (R.J.); (R.C.); (J.T.); (R.L.)
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