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Meldrum K, Wallace V, Webb T, Ridgway L, Quigley R, Strivens E, Russell SG. A Delphi study and development of a social and emotional wellbeing screening tool for Australian First Nations Peoples living in the Torres Strait and Northern Peninsula Area of Australia. PLoS One 2024; 19:e0306316. [PMID: 38935759 PMCID: PMC11210860 DOI: 10.1371/journal.pone.0306316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 06/14/2024] [Indexed: 06/29/2024] Open
Abstract
Tools screening depression and anxiety developed using the Western biomedical paradigm are still used with First Nations Peoples globally, despite calls for cross-cultural adaption. Recent work by this research team found that tools used to screen for depression and anxiety were inappropriate for use with Australian First Nations Peoples living in the Torres Strait and Northern Peninsula Area of Australia. The objective of this Delphi study, the second phase of a broader four-phase project, was to gain consensus from an expert mental health and/or social and emotional wellbeing (SEWB) panel to inform the development of an appropriate screening tool. This Delphi study took place between March and May 2023. Three sequential rounds of anonymous online surveys delivered using QualtricsTM were planned, although only two were needed to reach 75% consensus. The first round sought consensus on whether a new screening tool needed to be developed or whether existing tools could be used. The second round achieved consensus. Twenty-eight experts (47% response rate) participated across the two Delphi rounds. In the second round, 83% of these experts agreed or strongly agreed that a new screening tool, using the holistic First Nations concept of social and emotional wellbeing, be developed. Ninety-four percent of them agreed that it should take a Yarning approach. These findings enabled the development of a new SEWB screening tool that adopted a Yarning (narrative) approach designed for use in primary care and geriatric settings in the region. The new tool has four different Yarning areas: Community engagement and behaviour; Stress worries; Risk; and Feeling strong. Guidelines for tool use are integrated as well as Summary and Recommendation sections. At a macro-level this project responds to the need for new screening tools that are underpinned by First Nations worldviews.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Lynne Ridgway
- North Coast Neuropsychology, East Ballina, New South Wales, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sarah G. Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
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de Groot A, Brown B, Lindsay D, Gall A, Hewlett N, Hickman A, Garvey G. 'How Your Spirit Is Travelling'-Understanding First Nations Peoples' Experiences of Living Well with and after Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:798. [PMID: 38929044 PMCID: PMC11203506 DOI: 10.3390/ijerph21060798] [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: 04/30/2024] [Revised: 06/08/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024]
Abstract
As the number of people living with cancer increases, it is important to understand how people can live well with and after cancer. First Nations people diagnosed with cancer in Australia experience survival disparities relating to health service accessibility and a lack of understanding of cultural needs and lived experiences. This study aimed to amplify the voices of First Nations individuals impacted by cancer and advance the development of a culturally informed care pathway. Indigenist research methodology guided the relational and transformative approach of this study. Participants included varied cancer experts, including First Nations people living well with and after cancer, health professionals, researchers, and policy makers. Data were collected through online Yarning circles and analysed according to an inductive thematic approach. The experience of First Nations people living well with and after cancer is inextricably connected with family. The overall themes encompass hope, family, and culture and the four priority areas included the following: strength-based understanding of cancer, cancer information, access to healthcare and support, and holistic cancer services. Respect for culture is interwoven throughout. Models of survivorship care need to integrate family-centred cancer care to holistically support First Nations people throughout and beyond their cancer journey.
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Affiliation(s)
- Anneliese de Groot
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- Australian Institute of Health Innovation, Macquarie University, Sydney 2113, Australia
| | - Bena Brown
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, Brisbane 4077, Australia
| | - Daniel Lindsay
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- QIMR Berghofer Medical Research Institute, Brisbane 4006, Australia
| | - Alana Gall
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore 2480, Australia
| | - Nicole Hewlett
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
| | - Amy Hickman
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
- College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia
| | - Gail Garvey
- School of Public Health, The University of Queensland, Brisbane 4006, Australia; (B.B.); (D.L.); (A.G.); (N.H.); (A.H.); (G.G.)
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Furst MA, McDonald T, McCalman J, Salinas-Perez J, Fagan R, Lee Hong A, Nona M, Saunders V, Salvador-Carulla L. Evaluating Aboriginal and Torres Strait Islander Social and Emotional Wellbeing services: A collective case study in Far North Queensland. Aust N Z J Psychiatry 2024; 58:506-514. [PMID: 38590033 PMCID: PMC11128140 DOI: 10.1177/00048674241242935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
BACKGROUND Access to a coordinated range of strengths-based, culturally appropriate community-led primary mental health and Social and Emotional Wellbeing services is critical to the mental health and wellbeing of young Aboriginal and Torres Strait Islander people, and is a policy commitment of the Australian government. However, complex and fragmented service networks and a lack of standardised service data are barriers in identifying what services are available and what care they provide. METHOD A standardised service classification tool was used to assess the availability and characteristics of Social and Emotional Wellbeing services for young Aboriginal and Torres Strait Islander people in two regions in Queensland, Australia. RESULTS We identified a complex pattern of service availability and gaps in service provision. Non-Indigenous non-governmental organisations provided a significant proportion of services, particularly 'upstream' support, while Aboriginal Community Controlled Organisations were more likely to provide 'downstream' crisis type care. Most services provided by the public sector were through Child Safety and Youth Justice departments. CONCLUSIONS Our findings demonstrate the complexity of current networks, and show that non-Indigenous organisations are disproportionately influential in the care received by young Aboriginal and Torres Strait Islander people, despite community goals of self-determination, and government commitment to increasing capacity of Aboriginal Community Controlled Organisations to support their local communities. These findings can be used to support decision making and planning.
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Affiliation(s)
- Mary Anne Furst
- Mental Health Policy Unit, Health Research Institute, University of Canberra, Bruce, ACT, Australia
| | - Tina McDonald
- Jawun Research Centre, Office of Indigenous Engagement, CQUniversity, Cairns, QLD, Australia
| | - Janya McCalman
- Jawun Research Centre, Office of Indigenous Engagement, CQUniversity, Cairns, QLD, Australia
| | - Jose Salinas-Perez
- Mental Health Policy Unit, Health Research Institute, University of Canberra, Bruce, ACT, Australia
- Department of Quantitative Methods, Universidad Loyola Andalucía, Seville, Spain
| | - Ruth Fagan
- Jawun Research Centre, Office of Indigenous Engagement, CQUniversity, Cairns, QLD, Australia
| | - Anita Lee Hong
- Gurriny Yealamucka Health Service Aboriginal Corporation, Yarrabah, QLD, Australia
| | - Merrissa Nona
- Deadly Inspiring Youth Doing Good (DIYDG) Aboriginal and Torres Strait Islander Corporation, Cairns, QLD, Australia
| | - Vicki Saunders
- Jawun Research Centre, Office of Indigenous Engagement, CQUniversity, Cairns, QLD, Australia
| | - Luis Salvador-Carulla
- Mental Health Policy Unit, Health Research Institute, University of Canberra, Bruce, ACT, Australia
- Menzies Centre for Health Policy, School of Public Health, The University of Sydney, Sydney, NSW, Australia
- National Centre for Epidemiology and Population Health (NCEPH), College of Health & Medicine, Australian National University, Canberra, ACT, Australia
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Howard K, Garvey G, Anderson K, Dickson M, Viney R, Ratcliffe J, Howell M, Gall A, Cunningham J, Whop LJ, Cass A, Jaure A, Mulhern B. Development of the What Matters 2 Adults (WM2A) wellbeing measure for Aboriginal and Torres Strait Islander adults. Soc Sci Med 2024; 347:116694. [PMID: 38569315 DOI: 10.1016/j.socscimed.2024.116694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 01/30/2024] [Accepted: 02/12/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE As wellbeing is culturally bound, wellbeing measures for Aboriginal and Torres Strait Islander peoples must be culturally relevant and grounded in Aboriginal and Torres Strait Islander values and preferences. We describe the development of a nationally-relevant and culturally grounded wellbeing measure for Aboriginal and Torres Strait Islander adults: the What Matters to Adults (WM2A) measure. METHODS We used a mixed methods approach to measure development, combining Indigenist methodologies and psychometric methods. Candidate items were derived through a large national qualitative study. Think-aloud interviews (n = 17) were conducted to assess comprehension, acceptability, and wording of candidate items. Two national surveys collected data on the item pool (n = 312, n = 354). Items were analysed using exploratory factor analysis (EFA), and item response theory (IRT) to test dimensionality, local dependence and item fit. A Collaborative Yarning approach ensured Aboriginal and Torres Strait Islander voices were privileged throughout. RESULTS Fifty candidate items were developed, refined, and tested. Using EFA, an eight factor model was developed. All items met pre-specified thresholds for maximum endorsement frequencies, and floor and ceiling effects; no item redundancy was identified. Ten items did not meet thresholds for aggregate adjacent endorsement frequencies. During Collaborative Yarning, six items were removed based on low factor loadings (<0.4) and twelve due to conceptual overlap, high correlations with other items, endorsement frequencies, and/or low IRT item level information. Several items were retained for content validity. The final measure includes 32 items across 10 domains (Balance & control; Hope & resilience; Caring for others; Culture & Country; Spirit & identity; Feeling valued; Connection with others; Access; Racism & worries; Pride & strength). CONCLUSIONS The unique combination of Indigenist and psychometric methodologies to develop WM2A ensures a culturally and psychometrically robust measure, relevant across a range of settings and applications.
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Affiliation(s)
- K Howard
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia.
| | - G Garvey
- The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia
| | - K Anderson
- The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia
| | - M Dickson
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; The Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia
| | - R Viney
- The Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - J Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, 5001, Australia
| | - M Howell
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia
| | - A Gall
- The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia
| | - J Cunningham
- Menzies School of Health Research, Charles Darwin University, Darwin NT, Australia
| | - L J Whop
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, 2600, Australia
| | - A Cass
- Menzies School of Health Research, Charles Darwin University, Darwin NT, Australia
| | - A Jaure
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia
| | - B Mulhern
- The Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Ultimo, NSW, 2007, Australia
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Anderson K, Elder-Robinson E, Ferguson M, Fredericks B, Sherriff S, Dickson M, Howard K, Garvey G. Pathways between foodways and wellbeing for first nations Australians. BMC Public Health 2024; 24:502. [PMID: 38365753 PMCID: PMC10873965 DOI: 10.1186/s12889-024-18005-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: 06/27/2023] [Accepted: 02/06/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Supporting the health and wellbeing of Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as First Nations peoples) is a national priority for Australia. Despite immense losses of land, language, and governance caused by the continuing impact of colonisation, First Nations peoples have maintained strong connections with traditional food culture, while also creating new beliefs, preferences, and traditions around food, which together are termed foodways. While foodways are known to support holistic health and wellbeing for First Nations peoples, the pathways via which this occurs have received limited attention. METHODS Secondary data analysis was conducted on two national qualitative datasets exploring wellbeing, which together included the views of 531 First Nations peoples (aged 12-92). Thematic analysis, guided by an Indigenist research methodology, was conducted to identify the pathways through which foodways impact on and support wellbeing for First Nations peoples. RESULTS AND CONCLUSIONS Five pathways through which wellbeing is supported via foodways for First Nations peoples were identified as: connecting with others through food; accessing traditional foods; experiencing joy in making and sharing food; sharing information about food and nutrition; and strategies for improving food security. These findings offer constructive, nationally relevant evidence to guide and inform health and nutrition programs and services to harness the strengths and preferences of First Nations peoples to support the health and wellbeing of First Nations peoples more effectively.
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Affiliation(s)
- Kate Anderson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.
| | - Elaina Elder-Robinson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Megan Ferguson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Bronwyn Fredericks
- Office of the Deputy Vice Chancellor (Indigenous Engagement), The University of Queensland, St. Lucia, QLD, Australia
- The Poche Centre for Indigenous Health, Faculty of Health and Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Simone Sherriff
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Sax Institute, Sydney, NSW, Australia
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Dickson
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Stanley RM, McKnight A, Probst Y, O'Flynn G, Tillott S. Strong culture, healthy lifestyles: a mixed methods feasibility study for a co-created afterschool cultural programme for Australian Aboriginal children. Pilot Feasibility Stud 2024; 10:31. [PMID: 38360808 PMCID: PMC10868114 DOI: 10.1186/s40814-023-01422-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/21/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Having a strong connection to culture and Country is fundamental to the health and wellbeing of Australian Aboriginal children. The aim of the research was to evaluate the feasibility of study methods and programme implementation of a co-created afterschool cultural programme, and identify areas for improvement. METHODS Aboriginal Relational Research Methodology and mixed methods were applied to evaluate the feasibility of the implementation of the programme and study methods using a non-randomised single-group study design. Australian Aboriginal children and their siblings aged 5-13 years were recruited within regional New South Wales, Australia. The primary outcomes for feasibility included recruitment rates of children and Aboriginal programme mentors, compliance rates of outcome data collection and of the planned programme activities, programme attendance, retention rates and mean enjoyment scores. Follow-up yarning circles were conducted with the children, their parents/caregivers, programme mentors and teachers to explore aspects of feasibility, and areas for improvement. RESULTS A total of 90 caregivers consented to their children (n = 111) being part of the research. Sixteen Aboriginal mentors were recruited to deliver the programmes across the communities. Overall, 74.4% of all health outcome measures were completed across baseline (86.5%) and follow-up (55.9%). Only 61.0% of the programme activities were delivered as originally planned. The average programme attendance rate was 70.0% with a 92.0% retention rate. Eighty-nine percent of children reported a high level of enjoyment with the programmes. Follow-up yarning identified the importance of relational methodologies and flexibility within the programme design and implementation to ensure programmes were adapted to the local community, conditions and differing age groups. Considerations for future programmes included the timing of the programme and identifying health outcome assessment tools and methods that acknowledge cultural protocols and experiences. CONCLUSIONS Engaging the communities in the development, implementation and evaluation of the programmes were key to community support of the programme and conducting the feasibility study. Future programmes and evaluations need to be built on strong partnerships and embrace flexible and culturally embedded methodologies in order to be adaptive and responsive to research approaches, communities and to Country. TRIAL REGISTRATION ACTRN12619001224112. Retrospectively registered on 05 September 2019.
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Affiliation(s)
- Rebecca M Stanley
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia.
- Illawarra Health and Medical Research Institute, Wollongong, NSW, 2500, Australia.
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia.
| | - Anthony McKnight
- School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Yasmine Probst
- Illawarra Health and Medical Research Institute, Wollongong, NSW, 2500, Australia
- Faculty of Health, Southern Cross University, Gold Coast Campus, Bilinga, QLD, 4225, Australia
| | - Gabrielle O'Flynn
- School of Education, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
| | - Sarah Tillott
- Faculty of Health, Southern Cross University, Gold Coast Campus, Bilinga, QLD, 4225, Australia
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Soares GH, Hedges J, Poirier B, Sethi S, Jamieson L. Deadly places: The role of geography in Aboriginal and Torres Strait Islander COVID-19 vaccination. Aust N Z J Public Health 2024; 48:100130. [PMID: 38354624 DOI: 10.1016/j.anzjph.2024.100130] [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: 02/15/2023] [Revised: 10/30/2023] [Accepted: 12/29/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE The objective of this study was to investigate the geospatial distribution of COVID-19 vaccination rates for Aboriginal and Torres Strait Islander Peoples across Local Government Areas in Australia. METHODS We described the patterns of COVID-19 vaccination across jurisdictions, identified clusters with different levels of vaccination uptake, and assessed the relationship between contextual factors and vaccination (spatial error model, spatial lag model, and geographic weighted regression). RESULTS The proportion of the Aboriginal and Torres Strait Islander population that received at least two doses of a COVID-19 vaccine by the last week of June 2022 ranged from 62.9% to 97.5% across Local Government Areas. The proportion of the overall population who is Aboriginal or Torres Strait Islander (β = 0.280, standard deviation [SD] = 1.92), proportion of the total labour force employed (β =0.286, SD = 0.98), and proportion of individuals who speak an Aboriginal or Torres Strait Islander language (β =0.215, SD = 0.15) had, on average, the strongest effects on COVID-19 vaccination rates. CONCLUSION Findings underscore the extent to which area-level demographic influence the COVID-19 vaccination for Aboriginal and Torres Strait Islander Australians. IMPLICATIONS FOR PUBLIC HEALTH Findings can inform vaccination strategies that prioritise geographic areas with higher vulnerability to promote equity for Aboriginal and Torres Strait Islander Peoples.
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Affiliation(s)
- Gustavo Hermes Soares
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia.
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
| | - Brianna Poirier
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia. https://twitter.com/@briannapoirier
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia. https://twitter.com/@drsnehasethi
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
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Nelson C, Mandrusiak A, Forbes R. Embarking on a cultural journey: a qualitative study of new graduate physiotherapists' experiences of working in First Nations Australian health settings. Physiother Theory Pract 2023:1-11. [PMID: 37585714 DOI: 10.1080/09593985.2023.2246547] [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: 05/08/2023] [Revised: 07/10/2023] [Accepted: 08/06/2023] [Indexed: 08/18/2023]
Abstract
INTRODUCTION Internationally, there is growing momentum in the physiotherapy profession to improve the cultural safety and capabilities of physiotherapists. In Australia, this is essential given the important role physiotherapists play in the delivery of healthcare to First Nations Australians. Understanding the experiences of the newest members of the profession who work with First Nations Australians is an important step in exploring the broader professions' cultural safety journey. OBJECTIVE To explore new graduate physiotherapists' experiences working in First Nations Australian health settings. METHODS The study used an interpretative phenomenological approach through semi-structured interviews to explore the experiences of seven new graduate physiotherapists, in their first 2 years of practice. All participants worked within a First Nations Australian health setting for some or all of their experience as a new graduate physiotherapist. RESULTS Three themes were generated: 1) enrichment through connection; 2) navigating challenges; and 3) a catalyst for self-reflection. CONCLUSION New graduate physiotherapists reported positive experiences when working within a First Nations Australian health setting, underpinned by building a strong therapeutic relationship through rapport building; navigating challenges alongside their clients; and delving into critical self-reflection.
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Affiliation(s)
- Curtley Nelson
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Allison Mandrusiak
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
| | - Roma Forbes
- School of Health and Rehabilitation Sciences, University of Queensland, St Lucia, Australia
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McEvoy PM, Holmes K, Smith BJ, Bullen J, Chiu VW, Wild J, Ashley J, Talbot R. Pathways from Men's Shed engagement to wellbeing, health-related quality of life, and lower loneliness. Health Promot Int 2023; 38:daad084. [PMID: 37584668 DOI: 10.1093/heapro/daad084] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023] Open
Abstract
Extensive qualitative evidence, but limited quantitative evidence, indicates that mutual aid organizations such as Men's Sheds have positive impacts on wellbeing, health-related quality of life, and loneliness. A recently developed theoretical model proposes that Men's Sheds may have these impacts via mediating factors such as broadening social networks, increasing behavioural activation and physical activity, reducing alcohol use, and providing meaning in life. The aim of this study was to quantitatively test a model whereby psychological safety (feeling safe, accepted, and valued) is associated with Men's Shed engagement (frequency of attendance, duration of membership, diversity of activities), which is associated with the hypothesized mediators, which, in turn, are associated with wellbeing, health-related quality of life, and loneliness. Men's Shed members (N = 333, Mage = 70.90 years, SD = 10.34, 98% male) completed a survey assessing the factors in the model. The hypothesized path model provided an excellent fit to the data. Findings indicated that higher psychological safety was associated with higher engagement, which, in turn, was associated with larger social networks and more meaning in life, which were associated with higher wellbeing and lower loneliness. Higher behavioural activation and less alcohol use were also associated with higher wellbeing. Higher Men's Shed engagement was not associated with higher behavioural activation and physical activity, or less alcohol use, but behavioural activation and alcohol use were directly associated with health-related quality of life. Implications for optimizing health outcomes within Men's Sheds are discussed.
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Affiliation(s)
- Peter M McEvoy
- School of Population Health, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
- Centre for Clinical Interventions, North Metropolitan Health Service, Perth, Western Australia, Australia
| | - Kirsten Holmes
- School of Management and Marketing, Curtin University, Perth, Western Australia, Australia
| | - Brendan J Smith
- School of Population Health, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Jonathan Bullen
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Vivian W Chiu
- School of Population Health, Perth, Western Australia, Australia
- enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - James Wild
- Men's Sheds of Western Australia, Perth, Western Australia, Australia
| | - Jaxon Ashley
- Men's Sheds of Western Australia, Perth, Western Australia, Australia
| | - Rebecca Talbot
- Men's Sheds of Western Australia, Perth, Western Australia, Australia
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Lyall V, Egert S, Reid N, Moritz K, Askew D. "Our Mothers Have Handed That to Us. Her Mother Has Handed That to Her": Urban Aboriginal and Torres Strait Islander Yarning about Community Wellbeing, Healthy Pregnancies, and the Prevention of Fetal Alcohol Spectrum Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095614. [PMID: 37174134 PMCID: PMC10178754 DOI: 10.3390/ijerph20095614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
In Australia, fetal alcohol spectrum disorder (FASD) is a largely hidden disability that is currently under-recognized, under-resourced, and under- or misdiagnosed. Unsurprisingly, efforts to prevent FASD in urban Aboriginal and Torres Strait Islander communities are lacking. Further, mainstream approaches are not compatible with diverse and distinct Aboriginal and Torres Strait Islander ways of approaching family, pregnancy, and parenting life. To support the creation of culturally appropriate urban Aboriginal and Torres Strait Islander FASD prevention strategies, we sought to understand local perspectives, experiences, and priorities for supporting healthy and alcohol-free pregnancies. Using a narrative methodology, we undertook research yarns with eight female and two male community participants. Data were analyzed using a narrative, thematic analysis and guided by an Indigenist research practice of reflexive listening. Participant yarns provided important insights into local urban Aboriginal and Torres Strait Islander cultural, social, and structural determinants that support family and child health, alcohol-free pregnancies, and the prevention of FASD. The results provide critical guidance for Indigenizing and decolonizing FASD prevention strategies to support culturally safe, relevant, and strengths-based services. This approach has critical implications for all health and social professionals and can contribute to Aboriginal and Torres Strait Islander peoples' justice, recovery, and healing from colonization.
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Affiliation(s)
- Vivian Lyall
- Medical School, General Practice Clinical Unit, Level 8 Health Sciences Building, Royal Brisbane & Women's Hospital, The University of Queensland, Herston, QLD 4029, Australia
| | - Sonya Egert
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland Health, P.O. Box 52, Inala, QLD 4077, Australia
| | - Natasha Reid
- Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia
| | - Karen Moritz
- Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia
| | - Deborah Askew
- Medical School, General Practice Clinical Unit, Level 8 Health Sciences Building, Royal Brisbane & Women's Hospital, The University of Queensland, Herston, QLD 4029, Australia
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Bullen J, Hill-Wall T, Anderson K, Brown A, Bracknell C, Newnham EA, Garvey G, Waters L. From Deficit to Strength-Based Aboriginal Health Research-Moving toward Flourishing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5395. [PMID: 37048008 PMCID: PMC10094537 DOI: 10.3390/ijerph20075395] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Aboriginal Australians have a fundamental human right to opportunities that lead to healthy and flourishing lives. While the impact of trauma on Aboriginal Australians is well-documented, a pervasive deficit narrative that focuses on problems and pathology persists in research and policy discourse. This narrative risks further exacerbating Aboriginal disadvantage through a focus on 'fixing what is wrong' with Aboriginal Australians and the internalising of these narratives by Aboriginal Australians. While a growing body of research adopts strength-based models, limited research has sought to explore Aboriginal flourishing. This conceptual paper seeks to contribute to a burgeoning paradigm shift in Aboriginal research, seeking to understand what can be learned from Aboriginal people who flourish, how we best determine this, and in what contexts this can be impactful. Within, we argue the case for a new approach to exploring Aboriginal wellbeing that integrates salutogenic, positive psychology concepts with complex systems theory to understand and promote Aboriginal wellbeing and flourishing. While deeper work may be required to establish the parameters of a strength-based, culturally aligned Aboriginal conceptualisation of positive psychology, we suggest the integration of Aboriginal and Western methodologies offers a unique and potent means of shifting the dial on seemingly intractable problems.
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Affiliation(s)
- Jonathan Bullen
- EnAble Institute, Curtin University, Perth, WA 6102, Australia
- Telethon Kids Institute, Perth, WA 6009, Australia;
| | - Trish Hill-Wall
- EnAble Institute, Curtin University, Perth, WA 6102, Australia
| | - Kate Anderson
- Faculty of Medicine, The School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Alex Brown
- Telethon Kids Institute, Perth, WA 6009, Australia;
- National Centre for Indigenous Genomics, The John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Clint Bracknell
- School of Languages and Cultures, The University of Queensland, St. Lucia, QLD 4067, Australia
| | - Elizabeth A. Newnham
- EnAble Institute, Curtin University, Perth, WA 6102, Australia
- School of Population Health, Curtin University, Perth, WA 6102, Australia
- FXB Center for Health and Human Rights, Harvard University, Boston, MA 02115, USA
| | - Gail Garvey
- Faculty of Medicine, The School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Lea Waters
- Centre for Wellbeing Science, Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC 3101, Australia
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12
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Hewlett N, Hayes L, Williams R, Hamilton S, Holland L, Gall A, Doyle M, Goldsbury S, Boaden N, Reid N. Development of an Australian FASD Indigenous Framework: Aboriginal Healing-Informed and Strengths-Based Ways of Knowing, Being and Doing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20065215. [PMID: 36982125 PMCID: PMC10049125 DOI: 10.3390/ijerph20065215] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 05/27/2023]
Abstract
Aboriginal culture intuitively embodies and interconnects the threads of life that are known to be intrinsic to human wellbeing: connection. Therefore, Aboriginal wisdom and practices are inherently strengths-based and healing-informed. Underpinned by an Indigenist research methodology, this article presents findings from a collaboration of Aboriginal and non-Aboriginal peoples to develop an Australian Fetal Alcohol Spectrum Disorder (FASD) Indigenous Framework during 2021 to 2023. The FASD Indigenous Framework unfolds the changes that non-Aboriginal clinicians and Aboriginal peoples each need to make in their respective ways of knowing, being and doing in order to facilitate access to healing-informed, strengths-based and culturally responsive FASD knowledge, assessment, diagnosis and support services among Aboriginal peoples. Drawing on the Aboriginal practices of yarning and Dadirri, written and oral knowledges were gathered. These knowledges were mapped against Aboriginal cultural responsiveness and wellbeing frameworks and collaboratively and iteratively reflected upon throughout. This article brings together Aboriginal wisdom (strengths-based, healing-informed approaches grounded in holistic and integrated support) and Western wisdom (biomedicine and therapeutic models) in relation to FASD. From a place of still awareness (Dadirri), both forms of wisdom were drawn upon to create Australia's first FASD Indigenous Framework, a new practice in the assessment and diagnosis of FASD, which offers immense benefit to equity, justice, support and healing for Aboriginal families with a lived experience of FASD.
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Affiliation(s)
- Nicole Hewlett
- Child Health Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Lorian Hayes
- Child Health Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Robyn Williams
- Curtin Medical School, Curtin University, Perth, WA 6000, Australia
| | - Sharynne Hamilton
- Faculty of Health, School of Nursing and Midwifery, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Lorelle Holland
- Child Health Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alana Gall
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW 2480, Australia
| | - Michael Doyle
- Faculty of Medicine and Health, University of New South Wales, Sydney, NSW 2052, Australia
| | - Sarah Goldsbury
- Māori/Indigenous Health Innovation, University of Otago Christchurch, Christchurch 8013, New Zealand
| | - Nirosha Boaden
- Faculty of Social Work, The University of New South Wales, Sydney, NSW 2052, Australia
| | - Natasha Reid
- Child Health Research Centre, The University of Queensland, Brisbane, QLD 4072, Australia
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Saunders V, McCalman J, Tsey S, Askew D, Campbell S, Jongen C, Angelo C, Spurling G, Cadet-James Y. Counting what counts: a systematic scoping review of instruments used in primary healthcare services to measure the wellbeing of Indigenous children and youth. BMC PRIMARY CARE 2023; 24:51. [PMID: 36803458 PMCID: PMC9936129 DOI: 10.1186/s12875-023-02001-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 02/02/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND Primary healthcare services have principal responsibility for providing child and youth wellbeing and mental health services, but have lacked appropriate measurement instruments to assess the wellbeing of Indigenous children and youth or to evaluate the effectiveness of programs and services designed to meet their needs. This review assesses the availability and characteristics of measurement instruments that have been applied in primary healthcare services in Canada, Australia, New Zealand and the United States (CANZUS countries) to assess the wellbeing of Indigenous children and youth. METHODS Fifteen databases and 12 websites were searched in December 2017 and again in October 2021. Pre-defined search terms pertained to Indigenous children and youth, CANZUS country names, and wellbeing or mental health measures. PRISMA guidelines were followed, with eligibility criteria guiding screening of titles and abstracts, and selected full-text papers. Results are presented based on the characteristics of documented measurement instruments assessed according to five desirability criteria: development for Indigenous youth populations, adherence to relational strength-based constructs, administration by child and or youth self-report, reliability and validity, and usefulness for identifying wellbeing or risk levels. RESULTS Twenty-one publications were found that described the development and or use by primary healthcare services of 14 measurement instruments, employed across 30 applications. Four of the 14 measurement instruments were developed specifically for Indigenous youth populations, four focused solely on strength-based wellbeing concepts but none included all Indigenous wellbeing domains. CONCLUSION There is a diversity of measurement instruments available, but few fit our desirability criteria. Although it is possible that we missed relevant papers and reports, this review clearly supports the need for further research to develop, refine or adapt instruments cross-culturally to measure the wellbeing of Indigenous children and youth.
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Affiliation(s)
- Vicki Saunders
- Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD, 4870, Australia.
| | - Janya McCalman
- grid.1023.00000 0001 2193 0854Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD 4870 Australia
| | - Sena Tsey
- grid.1023.00000 0001 2193 0854Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD 4870 Australia
| | - Deborah Askew
- grid.1003.20000 0000 9320 7537General Practice Clinical Unit and School of Public Health, Faculty of Medicine, University of Queensland, Level 2, Public Health Building, 288 Herston Road, Brisbane, QLD 4006 Australia
| | - Sandy Campbell
- grid.1043.60000 0001 2157 559XMolly Wardaguga Research Centre, Charles Darwin University, Level 11, 410 Ann St, Brisbane, QLD 4000 Australia
| | - Crystal Jongen
- grid.1023.00000 0001 2193 0854Jawun Research Centre, Central Queensland University, Cnr Shields and Aplin St, Cairns, QLD 4870 Australia
| | - Candace Angelo
- grid.1013.30000 0004 1936 834XAboriginal and Torres Strait Islander Public Health, Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Edward Ford Building, Fisher Road, Sydney, NSW 2006 Australia
| | - Geoff Spurling
- grid.1003.20000 0000 9320 7537General Practice Clinical Unit and School of Public Health, Faculty of Medicine, University of Queensland, Level 2, Public Health Building, 288 Herston Road, Brisbane, QLD 4006 Australia
| | - Yvonne Cadet-James
- Yvonne Cadet-James, Apunipima Cape York Health Council, 186 McCoombe St, Cairns, QLD 4870 Australia
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Hine R, Krakouer J, Elston J, Fredericks B, Hunter SA, Taylor K, Stephens T, Couzens V, Manahan E, DeSouza R, Boyle J, Callander E, Cunningham H, Miller R, Willey S, Wilton K, Skouteris H. Identifying and dismantling racism in Australian perinatal settings: Reframing the narrative from a risk lens to intentionally prioritise connectedness and strengths in providing care to First Nations families. Women Birth 2023; 36:136-140. [PMID: 35487864 DOI: 10.1016/j.wombi.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 01/25/2023]
Abstract
INTRODUCTION The perinatal period is a time when provision of responsive care offers a life course opportunity for positive change to improve health outcomes for mothers, infants and families. Australian perinatal systems carry the legacy of settler-colonialism, manifesting in racist events and interactions that First Nations parents encounter daily. OBJECTIVE The dominance of a western risk lens, and conscious and unconscious bias in the child protection workforce, sustains disproportionately high numbers of First Nations infants being removed from their parents' care. Cascading medical interventions compound existing stressors and magnify health inequities for First Nations women. DESIGN Critical discourse was informed by Indigenous ways of knowing, being and doing via targeted dialogue with a group of First Nations and non-Indigenous experts in Australian perinatal care who are co-authors on this paper. Dynamic discussion evolved from a series of yarning circles, supplemented by written exchanges and individual yarns as themes were consolidated. RESULTS First Nations maternity services prioritise self-determination, partnership, strengths and communication and have demonstrated positive outcomes with, and high satisfaction from First Nations women. Mainstream perinatal settings could be significantly enhanced by embracing similar principles and models of care. CONCLUSIONS AND RELEVANCE The Australian Anti-racism in Perinatal Practice (AAPP) Alliance calls for urgent transformations to Australian perinatal models of care whereby non-Indigenous health policy makers, managers and clinicians take a proactive role in identifying and redressing ethnocentrism, judgemental and culturally blind practices, reframing the risk narrative, embedding strength-based approaches and intentionally prioritising engagement and connectedness within service delivery.
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Affiliation(s)
| | - Jacynta Krakouer
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University.
| | - Jacinta Elston
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University; William Cooper Institute, Monash University, Australia
| | | | | | | | | | | | | | - Ruth DeSouza
- College of Design and Social Context, RMIT University, Australia
| | | | - Emily Callander
- Public Health and Preventative Medicine, Monash University, Australia
| | | | | | - Sue Willey
- Nursing and Midwifery, Monash University, Australia
| | | | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University and Warwick Business School, University of Warwick, Coventry, UK
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15
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Reid N, Liu W, Morrissey S, Page M, McDonald T, Hawkins E, Wood A, Parker-Tomlin M, Myatt G, Webster H, Greathead B, Shelton D, Horton S, Katsikitis M, Shanley D. Enhancing interprofessional practice through the co-design of a holistic culturally and developmentally informed First Nations child health assessment. Aust J Prim Health 2023; 29:30-37. [PMID: 36372153 DOI: 10.1071/py21293] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 10/04/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND This qualitative study explored staff experiences of co-designing and implementing a novel interprofessional (IP) First Nations child health assessment (the helpful check), developed in partnership with a remote North-Queensland Aboriginal CommunityControlled Health Organisation. METHOD Eleven staff across two teams (family health and allied health) were involved in co-designing and implementing the child health assessment and associated IP practices. Interviews were undertaken using a semi-structured interview template and were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. RESULTS Three overarching themes were developed: (1) connect teams by building strong relationships; (2) leave space for helpful check processes to evolve; and (3) integrate helpful check processes into routine practice to sustain change. CONCLUSIONS Results demonstrate how the incorporation of IP practices into a remote primary healthcare setting led to perceived benefits for both the health service staff and clients.
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Affiliation(s)
- Natasha Reid
- University of Queensland, Child Health Research Centre, Brisbane, Qld, Australia
| | - Wei Liu
- Griffith University, Menzies Health Institute of Queensland, Gold Coast, Qld, Australia
| | - Shirley Morrissey
- Griffith University, School of Applied Psychology, Gold Coast, Qld, Australia
| | | | | | - Erinn Hawkins
- Griffith University, Menzies Health Institute of Queensland, Gold Coast, Qld, Australia; and Griffith University, School of Applied Psychology, Gold Coast, Qld, Australia
| | - Andrew Wood
- University of the Sunshine Coast, School of Health and Behavioural Sciences, Sunshine Coast, Qld, Australia
| | - Michelle Parker-Tomlin
- Griffith University, Menzies Health Institute of Queensland, Gold Coast, Qld, Australia; and Gidgee Healing, Mount Isa, Qld, Australia
| | | | - Heidi Webster
- Griffith University, Menzies Health Institute of Queensland, Gold Coast, Qld, Australia
| | | | - Doug Shelton
- Gold Coast University Hospital, Women's and Children's Health Services, Gold Coast, Qld, Australia
| | | | - Mary Katsikitis
- Flinders University, College of Education, Psychology and Social Work, Adelaide, SA, Australia
| | - Dianne Shanley
- Griffith University, Menzies Health Institute of Queensland, Gold Coast, Qld, Australia; and Griffith University, School of Applied Psychology, Gold Coast, Qld, Australia
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Chakraborty A, Walke E, Bainbridge R, Bailie R, Matthews V, Larkins S, Burgess P, Askew D, Langham E, Smorgon S, Swaminathan G, Cameron D, Piccoli T, Passey M. VOICE-Validating Outcomes by Including Consumer Experience: A Study Protocol to Develop a Patient Reported Experience Measure for Aboriginal and Torres Strait Islander Peoples Accessing Primary Health Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:357. [PMID: 36612678 PMCID: PMC9819546 DOI: 10.3390/ijerph20010357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/21/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
Aboriginal and Torres Strait Islander peoples' (hereafter respectfully referred to as Indigenous Australians) experiences of health care are shaped by historical, social and cultural factors, with cultural security critical to effective care provision and engagement between services and community. Positive patient experiences are associated with better health outcomes. Consequently, it is an accreditation requirement that primary health care (PHC) services must formally gather and respond to patient feedback. However, currently available patient feedback tools were not developed with Indigenous Australians, and do not reflect their values and world views. Existing tools do not capture important experiences of care of Indigenous Australians in PHC settings, nor return information that assists services to improve care. Consistent with the principles of Indigenous Data Sovereignty, we will co-design and validate an Indigenous-specific Patient Reported Experience Measure (PREM) that produces data by and for community, suitable for use in quality improvement in comprehensive PHC services. This paper presents the protocol of the study, outlining the rationale, methodologies and associated activities that are being applied in developing the PREM. Briefly, guided by an Aboriginal and Torres Strait Islander Advisory Group, our team of Indigenous and non-Indigenous researchers, service providers and policy makers will use a combination of Indigenous methodologies, participatory, and traditional western techniques for scale development. We will engage PHC service staff and communities in eight selected sites across remote, regional, and metropolitan communities in Australia for iterative cycles of data collection and feedback throughout the research process. Yarning Circles with community members will identify core concepts to develop an "Experience of Care Framework", which will be used to develop items for the PREM. Staff members will be interviewed regarding desirable characteristics and feasibility considerations for the PREM. The PREM will undergo cognitive and psychometric testing.
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Affiliation(s)
- Amal Chakraborty
- University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia
| | - Emma Walke
- University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia
| | - Roxanne Bainbridge
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia
| | - Sarah Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia
| | - Paul Burgess
- NT Health, Northern Territory Government, Casuarina, NT 0811, Australia
| | - Deborah Askew
- School of Medicine, Faculty of Medicine, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Erika Langham
- Poche Centre for Indigenous Health, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD 4067, Australia
- School of Public Health, Faculty of Medicine, The University of Queensland, St Lucia, QLD 4067, Australia
| | - Samantha Smorgon
- The Royal Australian College of General Practitioners (RACGP), East Melbourne, VIC 3002, Australia
| | - Girish Swaminathan
- Australian Commission on Safety and Quality in Health Care (ACSQHC), Sydney, NSW 2000, Australia
| | - Danielle Cameron
- University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia
| | - Tracey Piccoli
- University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia
| | - Megan Passey
- University Centre for Rural Health, The University of Sydney, Lismore, NSW 2480, Australia
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17
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Anderson K, Gall A, Butler T, Ngampromwongse K, Hector D, Turnbull S, Lucas K, Nehill C, Boltong A, Keefe D, Garvey G. Development of Key Principles and Best Practices for Co-Design in Health with First Nations Australians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:147. [PMID: 36612467 PMCID: PMC9819583 DOI: 10.3390/ijerph20010147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND While co-design offers potential for equitably engaging First Nations Australians in findings solutions to redressing prevailing disparities, appropriate applications of co-design must align with First Nations Australians' culture, values, and worldviews. To achieve this, robust, culturally grounded, and First Nations-determined principles and practices to guide co-design approaches are required. AIMS This project aimed to develop a set of key principles and best practices for co-design in health with First Nations Australians. METHODS A First Nations Australian co-led team conducted a series of Online Yarning Circles (OYC) and individual Yarns with key stakeholders to guide development of key principles and best practice approaches for co-design with First Nations Australians. The Yarns were informed by the findings of a recently conducted comprehensive review, and a Collaborative Yarning Methodology was used to iteratively develop the principles and practices. RESULTS A total of 25 stakeholders participated in the Yarns, with 72% identifying as First Nations Australian. Analysis led to a set of six key principles and twenty-seven associated best practices for co-design in health with First Nations Australians. The principles were: First Nations leadership; Culturally grounded approach; Respect; Benefit to community; Inclusive partnerships; and Transparency and evaluation. CONCLUSIONS Together, these principles and practices provide a valuable starting point for the future development of guidelines, toolkits, reporting standards, and evaluation criteria to guide applications of co-design with First Nations Australians.
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Affiliation(s)
- Kate Anderson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | - Alana Gall
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore 2480, Australia
| | - Tamara Butler
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | | | | | | | | | | | - Anna Boltong
- Cancer Australia, Sydney 2010, Australia
- Kirby Institute, UNSW Medicine, The University of New South Wales, Kensington 2052, Australia
| | | | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
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18
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Ramirez-Duran D, Stokes H, Kern ML. Going within, between and beyond: An exploration of regular Ashtanga Yoga practitioners' conceptualizations of five dimensions of wellbeing. Front Psychol 2022; 13:1018620. [PMID: 36619108 PMCID: PMC9811318 DOI: 10.3389/fpsyg.2022.1018620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022] Open
Abstract
Yoga is an embodied practice underpinned by philosophical elements, seeking to evolve different dimensions of human existence for optimal functioning in relation to oneself, others and beyond. This mixed-methods research focused on 137 regular Ashtanga Yoga practitioners (AYPs) by investigating their conceptualizations of five dimensions of wellbeing (i.e., physical, emotional, psychological, social, spiritual). Conceptualizations were analysed through word count analysis and Reflexive Thematic Analysis separately for each dimension, yielding four themes in each case, which partly aligned with existing wellbeing and yoga models, and partly extended on the existing literature. Further higher level analysis identified shared meanings across these five dimensions, expressed in themes grouped within five topics (i.e., freedom from and managing suffering, a positive and integrated sense of self, a sense of equanimity and steadiness, the self in relation to others and the world, meta-awareness). Furthermore, it also portrayed each dimension as multileveled, represented in three levels of human functioning. The foundational level encompassed the absence and managing suffering, representing functioning in coping and recovery mode. The optimal functioning level included a positive and integrated sense of self, a sense of equanimity and steadiness, and the self in relation to others and the world, representing functioning in personal development and growth mode. The contemplative and transcendental level involved meta-awareness in every dimension of wellbeing, representing functioning in transpersonal mode. As a result, we propose a preliminary model informed both by this empirical work and previous theories. While the continuousness of themes across dimensions reinforces the importance of embodiment and transcendence in wellbeing frameworks, the notion of the self as a multi-level system could be further explored in relation to knowing about and cultivating wellbeing.
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Affiliation(s)
- Daniela Ramirez-Duran
- Centre for Wellbeing Science, Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
| | - Helen Stokes
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
| | - Margaret L. Kern
- Centre for Wellbeing Science, Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia
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19
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Butler T, Gall A, Garvey G, Ngampromwongse K, Hector D, Turnbull S, Lucas K, Nehill C, Boltong A, Keefe D, Anderson K. A Comprehensive Review of Optimal Approaches to Co-Design in Health with First Nations Australians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192316166. [PMID: 36498237 PMCID: PMC9735487 DOI: 10.3390/ijerph192316166] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 06/12/2023]
Abstract
BACKGROUND Australia's social, structural, and political context, together with the continuing impact of colonisation, perpetuates health care and outcome disparities for First Nations Australians. A new approach led by First Nations Australians is required to address these disparities. Co-design is emerging as a valued method for First Nations Australian communities to drive change in health policy and practice to better meet their needs and priorities. However, it is critical that co-design processes and outcomes are culturally safe and effective. Aims: This project aimed to identify the current evidence around optimal approaches to co-design in health with First Nations Australians. METHODS First Nations Australian co-led team conducted a comprehensive review to identify peer-reviewed and grey literature reporting the application of co-design in health-related areas by and with First Nations Australians. A First Nations Co-Design Working Group (FNCDWG) was established to guide this work and team.A Collaborative Yarning Methodology (CYM) was used to conduct a thematic analysis of the included literature. RESULTS After full-text screening, 99 studies were included. Thematic analysis elicited the following six key themes, which included 28 practical sub-themes, relevant to co-design in health with First Nations Australians: First Nations Australians leadership; Culturally grounded approach; Respect; Benefit to First Nations communities; Inclusive partnerships; and Evidence-based decision making. CONCLUSION The findings of this review provide a valuable snapshot of the existing evidence to be used as a starting point to guide appropriate and effective applications of co-design in health with First Nations Australians.
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Affiliation(s)
- Tamara Butler
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | - Alana Gall
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore 2480, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
| | | | | | | | | | | | - Anna Boltong
- Cancer Australia, Sydney 2010, Australia
- Kirby Institute, UNSW Medicine, The University of New South Wales, Kensington 2052, Australia
| | | | - Kate Anderson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston 4006, Australia
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Anderson K, Elder-Robinson E, Gall A, Ngampromwongse K, Connolly M, Letendre A, Willing E, Akuhata-Huntington Z, Howard K, Dickson M, Garvey G. Aspects of Wellbeing for Indigenous Youth in CANZUS Countries: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13688. [PMID: 36294264 PMCID: PMC9602510 DOI: 10.3390/ijerph192013688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Indigenous children and young people (hereafter youth) across CANZUS nations embody a rich diversity of cultures and traditions. Despite the immense challenges facing these youth, many harness cultural and personal strengths to protect and promote their wellbeing. To support this for all youth, it is critical to understand what contributes to their wellbeing. This review aims to identify components contributing to wellbeing for Indigenous youth in CANZUS nations. Five databases were searched from inception to August 2022. Papers were eligible if they: focused on Indigenous youth in CANZUS nations; included views of youth or proxies; and focused on at least one aspect of wellbeing. We identified 105 articles for inclusion (Canada n = 42, Australia n = 27, Aotearoa New Zealand n = 8, USA n = 28) and our analysis revealed a range of thematic areas within each nation that impact wellbeing for Indigenous youth. Findings highlight the unique challenges facing Indigenous youth, as well as their immense capacity to harness cultural and personal strengths to navigate into an uncertain future. The commonalities of Indigenous youth wellbeing across these nations provide valuable insights into how information and approaches can be shared across borders to the benefit of all Indigenous youth and future generations.
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Affiliation(s)
- Kate Anderson
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Elaina Elder-Robinson
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Alana Gall
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | | | - Michele Connolly
- International Group for Indigenous Health Statistics, Columbia, MD 21045, USA
| | - Angeline Letendre
- Alberta Cancer Prevention Legacy Fund, Population, Public and Indigenous Health, Alberta Health Services, 102 Anderson Hall, 10959 102 ST NW, Edmonton, AB T5H 3V9, Canada
| | - Esther Willing
- Kōhatu–Centre for Hauora Māori, University of Otago, Dunedin 9054, New Zealand
| | | | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
| | - Michelle Dickson
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Gail Garvey
- School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
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21
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Gentile V, Jobson L, Carter A, Adams K. Much being Written about Us, not much being Written with Us: Examining how alcohol and other drug use by indigenous Australians is portrayed in Australian Government policies and strategies: A discourse analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 109:103855. [PMID: 36130419 DOI: 10.1016/j.drugpo.2022.103855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 08/30/2022] [Accepted: 09/08/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Using critical discourse analysis, this study examined the portrayal of Aboriginal and Torres Strait Islander people in Australian Government policies regarding alcohol and other drug (AOD) use. METHODS We used critical discourse analysis, informed by an Indigenous Research Paradigm, to analyse texts and contexts of six key Australian Government AOD drug policies; two Aboriginal AOD data documents, two reporting documents and two AOD strategy documents. RESULTS The social practice analysis found issues of power imbalance relating to the socio-political situation the documents were created in. Textual analysis identified: culture being performative or functional in documents; cultural unsafety in construction of targets and outcomes, and; the decentring of Aboriginal peoples in the framing of the documents. The discourse analysis identified that the documents often wrote about Aboriginal peoples rather than writing documents with or by Aboriginal peoples. This typically: absented complexities of consultation occurring within a complex power imbalanced cultural interface; did not support an Aboriginal paradigm; centred Gubba people in power and; promoted a paternalistic view of 'helping' Aboriginal people. CONCLUSIONS There is an urgent need to move from policy relating to Aboriginal affairs that relies on a deficit discourse, to more effective AOD policy that improves power balance in policy development, is written with or by Aboriginal people, is inclusive of Aboriginal epistemologies and ontologies, and represents a paradigm-shift to a strength-based approach.
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Affiliation(s)
- Victoria Gentile
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Faculty Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Australia.
| | - Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Faculty Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Australia
| | - Adrian Carter
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Faculty Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Australia
| | - Karen Adams
- Gukwonderuk Indigenous Health Unit, Faculty Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Australia
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22
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Protective Factors against Self-Harm and Suicidality among Australian Indigenous Adolescents: A Strengths-Based Analysis of the Longitudinal Study of Indigenous Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159131. [PMID: 35897497 PMCID: PMC9330702 DOI: 10.3390/ijerph19159131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 12/10/2022]
Abstract
Background: Understanding and encouraging social and emotional well-being (SEWB) among Indigenous adolescents is vital in countering the impacts of colonisation and intergenerational trauma. As self-harm and suicidality are considered markers of poor SEWB among Indigenous communities, we aimed to identify the individual-level and community-level factors protecting Indigenous adolescents from self-harm and suicidality. Methods: Data came from Footprints in Time—The Longitudinal Study of Indigenous Children (waves 10 and 11), conducted among Indigenous families across Australia. A strengths-based analysis fitted multilevel logistic regression to explore associations with factors proposed as protective against self-reported self-harm and suicidality among Indigenous adolescents. Results: Our study cohort included 365 adolescents with complete data for the variables of interest. Adolescents had a mean (SD) age of 14.04 (0.45) years and a sex ratio of almost 1:1, and most were attending school (96.2%). Previous self-harm was reported by 8.2% (n = 30); previous suicidality was reported by 4.1% (n = 15). Individual-level factors protecting against self-harm and suicidality were being male, living in a cohesive family, and having low total Strengths and Difficulty Questionnaire scores (p < 0.05 for all). Residing in major cities compared with regional/remote areas was protective against self-harm (OR 5.94, 95% CI 1.31−26.81). Strong cultural identity was not found to be a protective factor against self-harm and/or suicidality in the sample. Conclusions: This study identified key individual- and community-level factors that can protect Australian Indigenous adolescents against self-harm and suicidality, particularly family cohesion. Identifying strengths for this at-risk population can inform prevention strategies, particularly for rural living adolescents with high distress.
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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.
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Affiliation(s)
- Fiona Fowler
- Department of Social Work, Alice Salomon University of Applied Sciences, Berlin, Germany
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Flemington T, Fraser J, Gibbs C, Shipp J, Bryant J, Ryan A, Wijetilaka D, Marks S, Scarcella M, Tzioumi D, Ramanathan S, Clague L, Hartz D, Lonne B, Lock (Ngiyampaa) M. The Daalbirrwirr Gamambigu (Safe Children) Model: Embedding Cultural Safety in Child Protection Responses for Australian Aboriginal Children in Hospital Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5381. [PMID: 35564775 PMCID: PMC9102959 DOI: 10.3390/ijerph19095381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 02/01/2023]
Abstract
The aim of this paper is to describe the development of a model of care to embed cultural safety for Aboriginal children into paediatric hospital settings. The Daalbirrwirr Gamambigu (pronounced "Dahl-beer-weer gum-um-be-goo" in the Gumbaynggirr language means 'safe children') model encompasses child protection responses at clinical, managerial and organisational levels of health services. A review of scholarly articles and grey literature followed by qualitative interviews with Aboriginal health professionals formed the evidence base for the model, which then underwent rounds of consultation for cultural suitability and clinical utility. Culturally appropriate communication with children and their families using clinical yarning and a culturally adapted version of ISBAR (a mnemonic for Identify, Situation, Background, Assessment and Recommendation) for interprofessional communication is recommended. The model guides the development of a critical consciousness about cultural safety in health care settings, and privileges the cultural voices of many diverse Aboriginal peoples. When adapted appropriately for local clinical and cultural contexts, it will contribute to a patient journey experience of respect, dignity and empowerment.
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Affiliation(s)
- Tara Flemington
- Nursing, Midwifery and Service Reform, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
- Faculty of Medicine and Health, Susan Wakil School of Nusing and Midwifery, University of Sydney, Camperdown, NSW 2006, Australia
| | - Jennifer Fraser
- Faculty of Medicine and Health, Susan Wakil School of Nusing and Midwifery, University of Sydney, Camperdown, NSW 2006, Australia
- Nursing, Midwifery and Education, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia
| | - Clinton Gibbs
- Health Reform, Opportunities and Transition, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Joanne Shipp
- Integrated Child, Youth and Family Wellbeing, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Joe Bryant
- Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
| | - Amanda Ryan
- Aboriginal Health Strategy Unit, Mid North Coast Local Health District, Port Macquarie, NSW 2444, Australia;
| | - Devika Wijetilaka
- Paediatrics, Mid North Coast Local Health District, Coffs Harbour, NSW 2450, Australia;
| | - Susan Marks
- Child Protection Unit, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia;
| | - Mick Scarcella
- Aboriginal Health, The Sydney Children’s Hospitals Network, Westmead, NSW 2145, Australia;
| | - Dimitra Tzioumi
- Child Protection Unit, The Sydney Children’s Hospitals Network, Randwick, NSW 2031, Australia;
- Child Protection and Wellbeing, Ministry of Health, St Leonards, NSW 2065, Australia
- Faculty of Medicine, School of Women’s and Children’s Health, University of New South Wales, Kensington, NSW 2052, Australia
| | - Shanthi Ramanathan
- Health Research Economics, Hunter Medical Research Institute, New Lambton Heights, NSW 2305, Australia;
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Liesa Clague
- School of Nursing, Midwifery, Health Science and Physiotherapy, The University of Notre Dame, Darlinghurst, NSW 2010, Australia;
| | - Donna Hartz
- School of Nursing and Midwifery, College of Medicine Health & Wellbeing, University of Newcastle, Gosford, NSW 2250, Australia;
| | - Bob Lonne
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia;
| | - Mark Lock (Ngiyampaa)
- Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, NSW 2007, Australia;
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The Health and Wellbeing of Indigenous and Tribal Peoples around the Globe: Ensuring and Promoting Best Practice in Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010261. [PMID: 35010521 PMCID: PMC8751189 DOI: 10.3390/ijerph19010261] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022]
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Gall A, Diaz A, Garvey G, Anderson K, Lindsay D, Howard K. An exploration of the sociodemographic and health conditions associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults. BMC Res Notes 2021; 14:386. [PMID: 34600592 PMCID: PMC8487334 DOI: 10.1186/s13104-021-05794-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/20/2021] [Indexed: 11/21/2022] Open
Abstract
Objective To identify sociodemographic factors and health conditions associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults. Participants were recruited via investigator networks and an online panel provider with an established nationwide panel of Aboriginal and Torres Strait Islander adults. Those interested were invited to complete a survey that included an assessment of wellbeing using a visual analogue scale. Data was collected from October–November 2019 and August–September 2020. Exploratory analyses were conducted to ascertain factors associated with self-rated wellbeing for Aboriginal and Torres Strait Islander adults. Results Having more than enough money to last until next pay day, full-time employment, completion of grade 12, having a partner, and living with others were significantly associated with higher wellbeing among Aboriginal and Torres Strait Islander adults. A self-reported history of depression, anxiety, other mental health conditions, heart disease, or disability were associated with lower self-rated wellbeing scores. Our findings indicate a need for further investigation among these socioeconomic and patient groups to identify how to improve and support the wellbeing of Aboriginal and Torres Strait Islander adults. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05794-3.
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Affiliation(s)
- A Gall
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.
| | - A Diaz
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - G Garvey
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.,School of Public Health, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, 2006, Australia.,School of Public Health, University of Queensland, Brisbane, Australia
| | - K Anderson
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - D Lindsay
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia
| | - K Howard
- School of Public Health, Faculty of Medicine & Health, University of Sydney, Sydney, NSW, 2006, Australia.,Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, 2006, Australia
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