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Kurji J, Shackleford I, McDonough D, Andrews B, Andrews F, Cooke S, Garay M, Harrington T, Kennedy C, Lenoy J, Maclaine M, McCleary H, Randall L, Rose H, Rosendale D, Telfer J, Pearson O, Canuto K, Brodie T, Charles J, Elliott S, Brown A, Reilly R, Westhead S, Azzopardi P. Generating evidence to inform responsive and effective actions for Aboriginal and Torres Strait Islander adolescent health and well-being: a mix method protocol for evidence integration 'the Roadmap Project'. BMJ Open 2024; 14:e085109. [PMID: 39079726 PMCID: PMC11288137 DOI: 10.1136/bmjopen-2024-085109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 07/05/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Australia does not have a national strategy for Aboriginal and Torres Strait Islander adolescent health and as a result, policy and programming actions are fragmented and may not be responsive to needs. Efforts to date have also rarely engaged Aboriginal and Torres Strait Islander people in co-designing solutions. The Roadmap Project aims to work in partnership with young people to define priority areas of health and well-being need and establish the corresponding developmentally appropriate, evidence-based actions. METHODS AND ANALYSIS All aspects of this project are governed by a group of Aboriginal and Torres Strait Islander young people. Needs, determinants and corresponding responses will be explored with Aboriginal and Torres Strait Islander adolescents (aged 10-24 years) across Australia through an online qualitative survey, interviews and focus group discussions. Parents, service providers and policy makers (stakeholders) will share their perspectives on needs and support required through interviews. Data generated will be co-analysed with the governance group and integrated with population health data, policy frameworks and evidence of effective programmes (established through reviews) to define responsive and effective actions for Aboriginal and Torres Strait Islander adolescent health and well-being. ETHICS AND DISSEMINATION Ethical approval for this study has been obtained from the Aboriginal Health Council of South Australia (Ref: 04-21-956), the Aboriginal Health and Medical Research Council of New South Wales (Ref: 1918/22), the Western Australian Aboriginal Health Ethics Committee (Ref: HREC1147), the Northern Territory Health and Menzies School of Health Research (Ref: 2022-4371), ACT Health Human Research Ethics Committee (Ref: 2022.ETH.00133), the St. Vincent's Hospital, Victoria (Ref: HREC 129/22), University of Tasmania (Ref: 28020), Far North Queensland Human Research Ethics Committee (Ref: HREC/2023/QCH/89911) and Griffith University (Ref: 2023/135). Prospective adolescent participants will provide their own consent for the online survey (aged 13-24 years) and, interviews or focus group discussions (aged 15-24 years); with parental consent and adolescent assent required for younger adolescents (aged 10-14 years) participating in interviews.Study findings (priority needs and evidence-based responses) will be presented at a series of co-design workshops with adolescents and stakeholders from relevant sectors. We will also communicate findings through reports, multimedia clips and peer-reviewed publications as directed by the governance group.
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Affiliation(s)
- Jaameeta Kurji
- Adolescent Health & Wellbeing, Telethon Kids Institute, Adelaide, South Australia, Australia
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Australian National University, Canberra, Australian Capital Territory, Australia
| | - India Shackleford
- Adolescent Health & Wellbeing, Telethon Kids Institute, Adelaide, South Australia, Australia
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Daniel McDonough
- Adolescent Health & Wellbeing, Telethon Kids Institute, Adelaide, South Australia, Australia
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Brittney Andrews
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Felicity Andrews
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Sally Cooke
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Mahlia Garay
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Thomas Harrington
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Corey Kennedy
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Jaeda Lenoy
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Monique Maclaine
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Hannah McCleary
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Lorraine Randall
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Hamish Rose
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Daniel Rosendale
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Jakirah Telfer
- Governance Group, Roadmap for Aboriginal and Torres Strait Islander Adolescent Health, Adelaide, South Australia, Australia
| | - Odette Pearson
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Karla Canuto
- Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Tina Brodie
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - James Charles
- First People's Health Unit, Griffith University, Gold Coast, Queensland, Australia
| | - Salenna Elliott
- Poche Centre for Indigenous Health, The University of Queensland, Toowong, Queensland, Australia
| | - Alex Brown
- Australian National University, Canberra, Australian Capital Territory, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Rachel Reilly
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Seth Westhead
- Adolescent Health & Wellbeing, Telethon Kids Institute, Adelaide, South Australia, Australia
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Peter Azzopardi
- Adolescent Health & Wellbeing, Telethon Kids Institute, Adelaide, South Australia, Australia
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Australian National University, Canberra, Australian Capital Territory, Australia
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Hodgkinson L, Bowman S, Blunden S. Reconnecting with the Warrior Within: Australian Indigenous perspectives on the development of a social and emotional wellbeing program. Health Promot J Austr 2024; 35:784-793. [PMID: 37812937 DOI: 10.1002/hpja.805] [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: 06/20/2022] [Revised: 05/10/2023] [Accepted: 08/28/2023] [Indexed: 10/11/2023] Open
Abstract
ISSUE ADDRESSED Australian Indigenous youth are at high risk of developing mental health problems. Historical determinants and socioeconomic disadvantage continue to impact their social and emotional wellbeing (SEWB) and sense of identity. Previous literature suggests connecting to culture significantly impacts SEWB in Indigenous youth. Given the diversity of Indigenous culture, collaboration and consultation with specific cultural groups is required to develop appropriate and relevant psychological treatments for SEWB. The Warrior Within Program was developed to improve SEWB in Indigenous youth by assisting them to better understand their identity through participation in group-based cultural activities. This research aimed to understand Central Queensland Indigenous Development staff perspectives around (1) the process of developing the program and (2) how group-based cultural activities contributed to staff perceived improvements in SEWB of program participants. METHODS In this qualitative study, semi-structured individual interviews of 60-90 min were conducted with four Warrior Within Program staff of Central Queensland Indigenous Development. Transcripts were thematically analysed and the subthemes identified were categorised into main themes. RESULTS The process of developing the Warrior Within Program, cultural and Indigenous identity, reconnecting and knowledge emerged as the four main themes. CONCLUSIONS This study makes a unique and important contribution to the Australian Indigenous literature regarding the role and nature of culture in group-based programs and the importance of collaborating with Indigenous groups to increase our understanding of their usefulness and efficacy. This study also helps to bridge the gap between Indigenous ways of knowing in program development and non-Indigenous methods of evaluation. SO WHAT?: Acknowledging Australian Indigenous methods and ways of knowing are essential to the development and delivery of culturally appropriate group problems for addressing the psychological needs of this population. The methods used in this study could be used by others seeking to legitimise cultural ways of knowing.
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Affiliation(s)
- Luke Hodgkinson
- College of Psychology, CQUniversity, Rockhampton, Queensland, Australia
| | - Sarah Bowman
- College of Psychology, CQUniversity, Rockhampton, Queensland, Australia
| | - Sarah Blunden
- College of Psychology, CQUniversity, Rockhampton, Queensland, Australia
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Sise A, Azzopardi P, Brown A, Tewhaiti-Smith J, Westhead S, Kurji J, McDonough D, Reilly R, Bingham B, Brown N, Cassidy-Matthews C, Clark TC, Elliott S, Finlay SM, Hansen KL, Harwood M, Knapp JMF, Kvernmo S, Lee C, Watts RL, Nadeau M, Pearson O, Reading J, Saewyc E, Seljenes A, Stoor JPA, Aubrey P, Crengle S. Health and well-being needs of Indigenous adolescents: a protocol for a scoping review of qualitative studies. BMJ Open 2024; 14:e079942. [PMID: 38772588 PMCID: PMC11110593 DOI: 10.1136/bmjopen-2023-079942] [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] [Received: 09/16/2023] [Accepted: 04/15/2024] [Indexed: 05/23/2024] Open
Abstract
INTRODUCTION Improving the health of Indigenous adolescents is central to addressing the health inequities faced by Indigenous peoples. To achieve this, it is critical to understand what is needed from the perspectives of Indigenous adolescents themselves. There have been many qualitative studies that capture the perspectives of Indigenous young people, but synthesis of these has been limited to date. METHODS AND ANALYSIS This scoping review seeks to understand the specific health needs and priorities of Indigenous adolescents aged 10-24 years captured via qualitative studies conducted across Australia, Aotearoa New Zealand, Canada, the USA, Greenland and Sami populations (Norway and Sweden). A team of Indigenous and non-Indigenous researchers from these nations will systematically search PubMed (including the MEDLINE, PubMed Central and Bookshelf databases), CINAHL, Embase, Scopus, the Informit Indigenous and Health Collections, Google Scholar, Arctic Health, the Circumpolar Health Bibliographic Database, Native Health Database, iPortal and NZresearch.org, as well as specific websites and clearinghouses within each nation for qualitative studies. We will limit our search to articles published in any language during the preceding 5 years given that needs may have changed significantly over time. Two independent reviewers will identify relevant articles using a two-step process, with disagreements resolved by a third reviewer and the wider research group. Data will then be extracted from included articles using a standardised form, with descriptive synthesis focussing on key needs and priorities. This scoping review will be conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. ETHICS AND DISSEMINATION Ethics approval was not required for this review. Findings will be disseminated via a peer-reviewed journal article and will inform a broader international collaboration for Indigenous adolescent health to develop evidence-based actions and solutions.
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Affiliation(s)
- Andrew Sise
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Aotearoa New Zealand
| | - Peter Azzopardi
- Adolescent Health and Wellbeing, Telethon Kids Institute, Adelaide, South Australia, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute and Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alex Brown
- National Centre for Indigenous Genomics, Australian National University, Canberra, Australian Capital Territory, Australia
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | | | - Seth Westhead
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Jaameeta Kurji
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel McDonough
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Rachel Reilly
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Brittany Bingham
- Faculty of Medicine, Division of Social Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Gender & Sexual Health Equity, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ngiare Brown
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Chenoa Cassidy-Matthews
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Terryann C Clark
- School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, Aotearoa New Zealand
| | - Salenna Elliott
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Summer May Finlay
- School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Ketil Lenert Hansen
- Regional Centre for Child, Youth Mental Health and Child Welfare North (RKBU North), Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Matire Harwood
- Department of General Practice and Primary Care, University of Auckland, Auckland, Aotearoa New Zealand
| | | | - Siv Kvernmo
- Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Crystal Lee
- College of Population Health, University of New Mexico, Albuquerque, New Mexico, USA
| | | | - Melanie Nadeau
- Department of Indigenous Health, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Odette Pearson
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Jeff Reading
- Faculty of Health Sciences, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Elizabeth Saewyc
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Amalie Seljenes
- Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Jon Petter A Stoor
- Department of Epidemiology and Global Health, Lávvuo-Research and Education for Sámi Health, Umeå University, Umeå, Sweden
- Centre for Sami Health Research, Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Paula Aubrey
- Indigenous Health Department, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - Sue Crengle
- Ngāi Tahu Māori Health Research Unit, University of Otago, Dunedin, Aotearoa New Zealand
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McCormack H, Wand H, Newman CE, Bourne C, Kennedy C, Guy R. Exploring Whether the Electronic Optimization of Routine Health Assessments Can Increase Testing for Sexually Transmitted Infections and Provider Acceptability at an Aboriginal Community Controlled Health Service: Mixed Methods Evaluation. JMIR Med Inform 2023; 11:e51387. [PMID: 38032729 PMCID: PMC10722379 DOI: 10.2196/51387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/22/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND In the context of a syphilis outbreak in neighboring states, a multifaceted systems change to increase testing for sexually transmitted infections (STIs) among young Aboriginal people aged 15 to 29 years was implemented at an Aboriginal Community Controlled Health Service (ACCHS) in New South Wales, Australia. The components included electronic medical record prompts and automated pathology test sets to increase STI testing in annual routine health assessments, the credentialing of nurses and Aboriginal health practitioners to conduct STI tests independently, pathology request forms presigned by a physician, and improved data reporting. OBJECTIVE We aimed to determine whether the systems change increased the integration of STI testing into routine health assessments by clinicians between April 2019 and March 2020, the inclusion of syphilis tests in STI testing, and STI testing uptake overall. We also explored the understandings of factors contributing to the acceptability and normalization of the systems change among staff. METHODS We used a mixed methods design to evaluate the effectiveness and acceptability of the systems change implemented in 2019. We calculated the annual proportion of health assessments that included tests for chlamydia, gonorrhea, and syphilis, as well as an internal control (blood glucose level). We conducted an interrupted time series analysis of quarterly proportions 24 months before and 12 months after the systems change and in-depth semistructured interviews with ACCHS staff using normalization process theory. RESULTS Among 2461 patients, the annual proportion of health assessments that included any STI test increased from 16% (38/237) in the first year of the study period to 42.9% (94/219) after the implementation of the systems change. There was an immediate and large increase when the systems change occurred (coefficient=0.22; P=.003) with no decline for 12 months thereafter. The increase was greater for male individuals, with no change for the internal control. Qualitative data indicated that nurse- and Aboriginal health practitioner-led testing and presigned pathology forms proved more difficult to normalize than electronic prompts and shortcuts. The interviews identified that staff understood the modifications to have encouraged cultural change around the role of sexual health care in routine practice. CONCLUSIONS This study provides evidence for the first time that optimizing health assessments electronically is an effective and acceptable strategy to increase and sustain clinician integration and the completeness of STI testing among young Aboriginal people attending an ACCHS. Future strategies should focus on increasing the uptake of health assessments and promote whole-of-service engagement and accountability.
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Affiliation(s)
- Heather McCormack
- Kirby Institute, University of New South Wales, Kensington, Australia
- Centre for Population Health, New South Wales Ministry of Health, Sydney, Australia
| | - Handan Wand
- Kirby Institute, University of New South Wales, Kensington, Australia
| | - Christy E Newman
- Centre for Social Research in Health, University of New South Wales, Kensington, Australia
| | - Christopher Bourne
- Kirby Institute, University of New South Wales, Kensington, Australia
- Centre for Population Health, New South Wales Ministry of Health, Sydney, Australia
- Sydney Sexual Health Centre, Sydney, Australia
| | | | - Rebecca Guy
- Kirby Institute, University of New South Wales, Kensington, Australia
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O’Bryan E, McKay CD, Eades S, Gubhaju L, Pearson O, Kerr JA, Brown A, Azzopardi PS. Cardiometabolic Risk Markers for Aboriginal and Torres Strait Islander Children and Youths: A Systematic Review of Data Quality and Population Prevalence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6228. [PMID: 37444076 PMCID: PMC10341665 DOI: 10.3390/ijerph20136228] [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: 05/08/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023]
Abstract
Cardiovascular disease and type 2 diabetes mellitus are leading contributors to the health inequity experienced by Aboriginal and Torres Strait Islander peoples, and their antecedents can be identified from early childhood. We aimed to establish the quality of available data and the prevalence of cardiometabolic risk markers among Aboriginal and Torres Strait Islander children and youths (0-24-year-olds) to inform public health approaches. A systematic review of the peer-reviewed and grey literature was conducted between 1 January 2000-28 February 2021. Included studies reported population prevalence of cardiometabolic risks, including elevated blood pressure, obesity, central adiposity, dyslipidaemia, hyperglycaemia, and 'metabolic syndrome' for Aboriginal and Torres Strait Islander people aged 0-24 years. Fifteen studies provided population estimates. Data quality was limited by low response rates (10/15 studies) and suboptimal outcome measurements. Obesity is the most reported risk (13/15 studies). Aboriginal and Torres Strait Islander children have an excess risk of obesity from early childhood and prevalence increases with age: 32.1% of Aboriginal and Torres Strait Islander 18-24-year-olds had obesity and 50.8% had central adiposity. In a cohort of 486 9-14-year-olds in Darwin, 70% had ≥1 component of metabolic syndrome; 14% met the full criteria for the syndrome. The prevalence of cardiometabolic risk in Aboriginal and Torres Strait Islander young people is difficult to estimate due to limitations in measurement quality and sampling representativeness. Available data suggest that cardiometabolic risk markers are evident from early childhood. The establishment of national and state-level datasets and a core outcome set for cardiometabolic screening would provide opportunities for preventative action.
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Affiliation(s)
- Eamon O’Bryan
- Global Adolescent Health Group, Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC 3010, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Christopher D. McKay
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Sandra Eades
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia
| | - Lina Gubhaju
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Odette Pearson
- Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Jessica A. Kerr
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch 8011, New Zealand
- Centre for Adolescent Health, Population Health Theme, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, 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
| | - Peter S. Azzopardi
- Global Adolescent Health Group, Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC 3010, Australia
- Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
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Gartland D, Nikolof A, Glover K, Leane C, Cahir P, Hameed M, Brown SJ. Patterns of Health and Health Service Use in a Prospective Cohort of Aboriginal and Torres Strait Islander Children Aged 5-9 Years Living in Urban, Regional and Remote Areas of South Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6172. [PMID: 37372759 DOI: 10.3390/ijerph20126172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
Despite longstanding recognition of disparities in Aboriginal and Torres Strait Islander child health, progress to reduce disparities is slow. To improve the capacity of policy makers to target resources, there is an urgent need for epidemiological studies providing prospective data on child health outcomes. We undertook a prospective population-based study of 344 Aboriginal and Torres Strait Islander children born in South Australia. Mothers and caregivers reported on child health conditions, use of health services and the social and familial context of the children. A total of 238 children with a mean age of 6.5 years participated in wave 2 follow-up. Overall, 62.7% of the children experienced one or more physical health conditions in the 12 months prior to wave 2 follow-up, 27.3% experienced a mental health condition and 24.8% experienced a developmental condition. The 12-month period prevalence of physical, developmental and mental health conditions was similar for children living in urban, regional and remote areas. While most children had had at least one visit with a general practitioner, some children experiencing physical, developmental and mental health conditions appear to be missing out on specialist and allied health care. Greater efforts by governments and policy makers are needed to strengthen outreach, recognition, referral and follow-up.
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Affiliation(s)
- Deirdre Gartland
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Arwen Nikolof
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Karen Glover
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Cathy Leane
- Women's and Children's Health Network, SA Health, North Adelaide, SA 5006, Australia
| | - Petrea Cahir
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Mohajer Hameed
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
| | - Stephanie J Brown
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, The University of Melbourne, Parkville, VIC 3010, Australia
- Women and Kids Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
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Graham S, Martin K, Beadman M, Doyle M, Bolt R. Our relationships, our values, our culture - Aboriginal young men's perspectives about sex, relationships and gender stereotypes in Australia. CULTURE, HEALTH & SEXUALITY 2023; 25:304-319. [PMID: 35192437 DOI: 10.1080/13691058.2022.2039776] [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: 09/15/2021] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Studies of Aboriginal young people have often followed a deficit approach depicting them as 'risky' and in need of help. In contrast, this study took a strengths-based approach and focussed on what Aboriginal young people value, how they stay safe and how their culture impacts their lives. 16 Aboriginal men aged 16 to 24 years were interviewed in Sydney, Australia. We examined Aboriginal young men's perspectives about relationships, sex and gender. Interviews were conducted by young Aboriginal men in 2019 and 2020. Overall, four features of positive sexual and romantic relationships were discussed: (1) love, connection and support; (2) enjoyment and fun; (3) responsibility, safety and consent; and 4) honesty, respect and trust. Additionally, three topics related to gender roles: (1) becoming a man; (2) sex as a masculine achievement; and (3) inequality and gender stereotypes. Our study suggests that Aboriginal young men are exploring sexual and romantic relationships, and although they value enjoyment and fun, they are aware of broader issues such as consent and respect. The young men acknowledged gender stereotypes faced by young women. Our results could be used by future school safe sex education programmes to better meet the needs of Aboriginal young men.
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Affiliation(s)
- Simon Graham
- Department of Infectious Diseases, Melbourne Medical School, Peter Doherty Institute for Infection and Immunity, University of Melbourne, VIC, Australia
| | - Kacey Martin
- Centre for Social Research in Health, UNSW Sydney, NSW, Australia
| | - Mitchell Beadman
- Centre for Social Research in Health, UNSW Sydney, NSW, Australia
| | - Michael Doyle
- NHMRC Centre for Research Excellence in Indigenous Health and Alcohol, Central Clinical School, Faculty of Medicine and Health, University of Sydney, NSW, Australia
| | - Reuben Bolt
- Charles Darwin University, Casuarina, NT, Australia
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Potential Determinants of Cardio-Metabolic Risk among Aboriginal and Torres Strait Islander Children and Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159180. [PMID: 35954531 PMCID: PMC9368168 DOI: 10.3390/ijerph19159180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Abstract
Prevention initiatives during childhood and adolescence have great potential to address the health inequities experienced by Aboriginal and Torres Strait Islander (Indigenous) populations in Australia by targeting modifiable risk factors for cardio-metabolic diseases. We aimed to synthesize existing evidence about potential determinants of cardio-metabolic risk markers—obesity, elevated blood pressure, elevated blood glucose, abnormal lipids, or a clustering of these factors known as the metabolic syndrome (MetS)—for Indigenous children and adolescents. We systematically searched six databases for journal articles and three websites for relevant grey literature. Included articles (n = 47) reported associations between exposures (or interventions) and one or more of the risk markers among Indigenous participants aged 0–24 years. Data from 18 distinct studies about 41 exposure–outcome associations were synthesized (by outcome: obesity [n = 18]; blood pressure [n = 9]; glucose, insulin or diabetes [n = 4]; lipids [n = 5]; and MetS [n = 5]). Obesity was associated with each of the other cardio-metabolic risk markers. Larger birth size and higher area-level socioeconomic status were associated with obesity; the latter is opposite to what is observed in the non-Indigenous population. There were major gaps in the evidence for other risk markers, as well as by age group, geography, and exposure type. Screening for risk markers among those with obesity and culturally appropriate obesity prevention initiatives could reduce the burden of cardio-metabolic disease.
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Browne J, Becker D, Orellana L, Ryan J, Walker T, Whelan J, Alston L, Egan M, Johnson B, Rossignoli A, Crooks N, Brown AD, Bolton KA, Fraser P, Le H, Bell C, Hayward J, Sanigorski A, Backholer K, Allender S, Strugnell C. Healthy weight, health behaviours and quality of life among Aboriginal children living in regional Victoria. Aust N Z J Public Health 2022; 46:595-603. [DOI: 10.1111/1753-6405.13271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/01/2022] [Accepted: 05/01/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jennifer Browne
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Denise Becker
- Biostatistics Unit, Faculty of Health Deakin University Geelong Victoria
| | - Liliana Orellana
- Biostatistics Unit, Faculty of Health Deakin University Geelong Victoria
| | - Joleen Ryan
- School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Troy Walker
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Jill Whelan
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- School of Medicine, Faculty of Health Deakin University Geelong Victoria
| | - Laura Alston
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Deakin Rural Health, Faculty of Health Deakin University Warrnambool Victoria
| | - Mikaela Egan
- Victorian Aboriginal Community Controlled Health Organisation Melbourne Victoria
| | - Brittney Johnson
- Victorian Aboriginal Community Controlled Health Organisation Melbourne Victoria
| | - Amy Rossignoli
- Victorian Aboriginal Community Controlled Health Organisation Melbourne Victoria
| | - Nicholas Crooks
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Andrew D. Brown
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Kristy A. Bolton
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Faculty of Health Deakin University Geelong Victoria
| | - Penny Fraser
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- School of Medicine, Faculty of Health Deakin University Geelong Victoria
| | - Ha Le
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Deakin Health Economics, Faculty of Health Deakin University Geelong Victoria
| | - Colin Bell
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- School of Medicine, Faculty of Health Deakin University Geelong Victoria
| | - Josh Hayward
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Andrew Sanigorski
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Kathryn Backholer
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
| | - Steven Allender
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
- Deakin Rural Health, Faculty of Health Deakin University Warrnambool Victoria
| | - Claudia Strugnell
- Global Obesity Centre (GLOBE), Institute for Health Transformation, School of Health and Social Development, Faculty of Health Deakin University Geelong Victoria
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Westhead S, Appleby Q, Andrews B, Brodie T, Brown A, Canuto K, Cooke J, Garay M, Harrington T, Hunter D, Kennedy C, Lenoy J, Lester O, McCleary H, Pearson O, Randall L, Reilly R, Rose H, Rosendale D, Telfer J, Azzopardi P. The need for a roadmap to guide actions for Aboriginal and Torres Strait Islander adolescent health: youth governance as an essential foundation. Med J Aust 2022; 217:13-15. [PMID: 35661364 PMCID: PMC9543177 DOI: 10.5694/mja2.51592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Seth Westhead
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Quinton Appleby
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Brittney Andrews
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Tina Brodie
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Alex Brown
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Karla Canuto
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Josh Cooke
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Mahlia Garay
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Thomas Harrington
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Djai Hunter
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Corey Kennedy
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Jaeda Lenoy
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Olivia Lester
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Hannah McCleary
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Odette Pearson
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Lorraine Randall
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Rachel Reilly
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Hamish Rose
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Daniel Rosendale
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Jakirah Telfer
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
| | - Peter Azzopardi
- Aboriginal Health EquitySouth Australian Health and Medical Research InstituteAdelaideSA
- Burnet InstituteMelbourneVIC
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McCormack H, Guy R, Bourne C, Newman CE. Integrating testing for sexually transmissible infections into routine primary care for Aboriginal young people: a strengths-based qualitative analysis. Aust N Z J Public Health 2022; 46:370-376. [PMID: 35238454 DOI: 10.1111/1753-6405.13208] [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: 09/01/2021] [Revised: 11/01/2021] [Accepted: 12/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES This paper examines factors that enabled successful integration of testing for sexually transmissible infections into routine care in Aboriginal Community Controlled Health Services. METHODS This paper reports analysis of qualitative interview data recorded with 19 purposively sampled key informants in New South Wales, Australia, representing six Aboriginal Community Controlled Health Services and five government health bodies supporting those services. The analysis explicitly adopted a strengths-based approach. RESULTS Participants reported a strong belief that routine screening overcomes shame and increases engagement with sexual health screening. Incorporating sexual health screening into general medical consultations increases the capture of asymptomatic cases. The Medicare Benefits Schedule 715 Adult Health Check was highlighted as an ideal lever for effective integration into routine care. CONCLUSION Integration of testing for sexually transmissible infections into routine care is widely perceived as best practice by senior stakeholders in Aboriginal healthcare in NSW. Findings support continued work to optimise the MBS 715 as a lever to increase testing. IMPLICATIONS FOR PUBLIC HEALTH Identifying accessible strategies to increase testing for sexually transmissible infections in Aboriginal Community Controlled Health Services can reduce disparities in notifications affecting Aboriginal young people.
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Affiliation(s)
- Heather McCormack
- The Kirby Institute, UNSW Sydney, New South Wales
- NSW STI Programs Unit, Centre for Population Health, New South Wales Health
| | - Rebecca Guy
- The Kirby Institute, UNSW Sydney, New South Wales
| | - Christopher Bourne
- The Kirby Institute, UNSW Sydney, New South Wales
- NSW STI Programs Unit, Centre for Population Health, New South Wales Health
- Sydney Sexual Health Centre, New South Wales
| | - Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, New South Wales
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Xu G, Modi D, Hunter KE, Askie LM, Jamieson LM, Brown A, Seidler AL. Landscape of clinical trial activity focusing on Indigenous health in Australia: an overview using clinical trial registry data from 2008-2018. BMC Public Health 2022; 22:971. [PMID: 35568933 PMCID: PMC9107126 DOI: 10.1186/s12889-022-13338-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 04/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as Indigenous Australians) represent about 3% of the total Australian population. Major health disparities exist between Indigenous and Non-Indigenous Australians. To address this, it is vital to understand key health priorities and knowledge gaps in the current landscape of clinical trial activity focusing on Indigenous health in Australia. METHODS Australian-based clinical trials registered on the Australian New Zealand Clinical Trials Registry or ClinicalTrials.gov from 2008 to 2018 were analysed. Australian clinical trials with and without a focus on Indigenous health were compared in terms of total numbers, participant size, conditions studied, design, intervention type and funding source. RESULTS Of the 9206 clinical trials included, 139 (1.5%) focused on Indigenous health, with no proportional increase in Indigenous trials over the decade (p = 0.30). Top conditions studied in Indigenous-focused trials were mental health (n = 35, 28%), cardiovascular disease (n = 20, 20%) and infection (n = 16, 16%). Compared to General Australian trials, Indigenous-focused trials more frequently studied ear conditions (OR 20.26, 95% CI 10.32-37.02, p < 0.001), infection (OR 3.11, 95% CI 1.88-4.85, p < 0.001) and reproductive health (OR 2.59, 95% CI 1.50-4.15, p < 0.001), and less of musculoskeletal conditions (OR 0.09, 95% CI 0.00-0.37, p < 0.001), anaesthesiology (OR 0.16, 95% CI 0.01-0.69, p = 0.021) and surgery (OR 0.17, 95% CI 0.01-0.73, p = 0.027). For intervention types, Indigenous trials focused more on prevention (n = 48, 36%) and screening (n = 18, 13%). They were far less involved in treatment (n = 72, 52%) as an intervention than General Australian trials (n = 6785, 75%), and were less likely to be blinded (n = 48, 35% vs n = 4273, 47%) or have industry funding (n = 9, 7% vs 1587, 17%). CONCLUSIONS Trials with an Indigenous focus differed from General Australian trials in the conditions studied, design and funding source. The presented findings may inform research prioritisation and alleviate the substantial burden of disease for Indigenous population.
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Affiliation(s)
- Ge Xu
- NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, NSW 2050 Australia
| | - Danai Modi
- NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, NSW 2050 Australia
| | - Kylie E. Hunter
- NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, NSW 2050 Australia
| | - Lisa M. Askie
- NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, NSW 2050 Australia
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, Australia
| | - Alex Brown
- South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Anna Lene Seidler
- NHMRC Clinical Trials Centre, the University of Sydney, Camperdown, NSW 2050 Australia
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Smallwood R, Usher K, Woods C, Sampson N, Jackson D. De-problematising Aboriginal young peoples' health and well-being through their voice: An Indigenous scoping review. J Clin Nurs 2022; 32:2086-2101. [PMID: 35352432 DOI: 10.1111/jocn.16308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 02/14/2022] [Accepted: 03/02/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The continued use of a deficit discourse when researching Aboriginal and Torres Strait Islander Peoples of Australia is problematic. Understanding and challenging the researchers position and the power of the words they use is important. It will ensure we do not persist in framing Aboriginal and Torres Strait Islander People as a problem to be solved. DESIGN Indigenist review of the evidence of Aboriginal young people's health and well-being. METHODS This review was conducted using an Indigenist approach to identify texts which amplified the voices of Aboriginal young people of Australia and presents a narrative summary of their accounts. This review is reported in line with the PRISMA-ScR reporting guidelines. RESULTS Culture and connection are critical components of Aboriginal young people's health and well-being. Aboriginal young people describe feeling of powerlessness to influence health and well-being of their community, and they understood the risks they and their communities faced. Young people identified the importance of connection to culture, community and Elders as crucial to their social and emotional well-being. CONCLUSION By harnessing an Indigenous analysis, we were able to reveal a strong counter narrative of strength and resilience within their historical, social, and political contexts through the storied accounts of Aboriginal young people. RELEVANCE TO CLINICAL PRACTICE Most of the currently available evidence about Aboriginal health and well-being is immersed in deficit discourse. Literature reviews being the foundation of research and informing nursing practice, we call for a purposeful shift towards the adoption of an Indigenist strength-based approach which emphasises the strength and resilience of Aboriginal young people.
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Affiliation(s)
- Reakeeta Smallwood
- School of Nursing and Midwifery, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Cindy Woods
- Health Research Institute,, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | | | - Debra Jackson
- Faculty of Medicine and Health, Research Academic Director (Health Services), The University of Sydney, Sydney, New South Wales, Australia
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Luke JN, Thorpe A, Black C, Thorpe L, Thomas D, Eades S, Rowley K. Collaborative Social-Epidemiology: A Co-analysis of the Cultural and Structural Determinants of Health for Aboriginal Youth in Victorian Schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8674. [PMID: 34444421 PMCID: PMC8393666 DOI: 10.3390/ijerph18168674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/13/2021] [Accepted: 08/13/2021] [Indexed: 11/16/2022]
Abstract
Social-epidemiology that excludes Aboriginal voices often fails to capture the full and complex social worlds of Aboriginal people. Using data from an existing co-designed Victorian government Adolescent Health and Wellbeing Survey (2008/9), we worked with Aboriginal organizations to identify data priorities, select measures, interpret data, and contextualize findings. Using this participatory co-analysis approach, we selected "cultural" and "structural" determinants identified by Aboriginal organizations as important and modelled these using principal component analysis. Resulting components were then modelled using logistic regression to investigate associations with "likely being well" (Kessler-10 score < 20) for 88 Aboriginal adolescents aged 11-17 years. Principal component analysis grouped 11 structural variables into four components and 11 cultural variables into three components. Of these, "grew up in Aboriginal family/community and connected" associated with significantly higher odds of "likely being well" (OR = 2.26 (1.01-5.06), p = 0.046). Conversely, "institutionally imposed family displacement" had significantly lower odds (OR = 0.49 (0.24-0.97), p = 0.040) and "negative police contact and poverty" non-significantly lower odds (OR = 0.53 (0.26-1.06), p = 0.073) for "likely being well". Using a co-analysis participatory approach, the voices of Aboriginal researchers and Aboriginal organizations were able to construct a social world that aligned with their ways of knowing, doing, and being. Findings highlighted institutionally imposed family displacement, policing, and poverty as social sites for health intervention and emphasized the importance of strong Aboriginal families for adolescents.
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Affiliation(s)
- Joanne Nicole Luke
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
| | - Alister Thorpe
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
| | - Carlina Black
- The Victorian Aboriginal Child Care Agency, Preston 3072, Australia;
| | - Lisa Thorpe
- Bubup Wilam-Aboriginal Child and Family Centre, Thomastown 3074, Australia;
| | - David Thomas
- Menzies School of Health Research, Charles Darwin University, Darwin 0810, Australia;
| | - Sandra Eades
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
- Curtin Medical School, Curtin University, Bentley 6102, Australia
| | - Kevin Rowley
- School of Population and Global Health, The University of Melbourne, Carlton 3053, Australia; (A.T.); (S.E.); (K.R.)
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Lloyd-Johnsen C, Eades S, McNamara B, D'Aprano A, Goldfeld S. A global perspective of Indigenous child health research: a systematic review of longitudinal studies. Int J Epidemiol 2021; 50:1554-1568. [PMID: 33864092 DOI: 10.1093/ije/dyab074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Rigorously designed longitudinal studies can inform how best to reduce the widening health gap between Indigenous and non-Indigenous children. METHODS A systematic review was performed to identify and present the breadth and depth of longitudinal studies reporting the health and well-being of Indigenous children (aged 0-18 years) globally. Databases were searched up to 23 June 2020. Study characteristics were mapped according to domains of the life course model of health. Risk of bias was assessed using the National Institutes of Health (NIH) Study Quality Assessment Tools. Reported level of Indigenous involvement was also appraised; PROSPERO registration CRD42018089950. RESULTS From 5545 citations, 380 eligible papers were included for analysis, representing 210 individual studies. Of these, 41% were located in Australia (n = 88), 22.8% in the USA (n = 42), 11.9% in Canada (n = 25) and 10.9% in New Zealand (n = 23). Research tended to focus on either health outcomes (50.9%) or health-risk exposures (43.8%); 55% of studies were graded as 'good' quality; and 89% of studies made at least one reference to the involvement of Indigenous peoples over the course of their research. CONCLUSIONS We identified gaps in the longitudinal assessment of cultural factors influencing Indigenous child health at the macrosocial level, including connection to culture and country, intergenerational trauma, and racism or discrimination. Future longitudinal research needs to be conducted with strong Indigenous leadership and participation including holistic concepts of health. This is critical if we are to better understand the systematic factors driving health inequities experienced by Indigenous children globally.
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Affiliation(s)
- Catherine Lloyd-Johnsen
- Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Sandra Eades
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Bridgette McNamara
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Anita D'Aprano
- Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Sharon Goldfeld
- Centre for Community Child Health, Royal Children's Hospital, Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
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Walker T, Molenaar A, Palermo C. A qualitative study exploring what it means to be healthy for young Indigenous Australians and the role of social media in influencing health behaviour. Health Promot J Austr 2020; 32:532-540. [PMID: 32726490 DOI: 10.1002/hpja.391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 07/20/2020] [Indexed: 02/03/2023] Open
Abstract
ISSUE ADDRESSED This study explored what it means to young Indigenous people to be healthy and how social media influences health behaviours. METHODS Indigenous people (17-24 years) participated in face-to-face interviews or online Facebook conversations. Discussions were informed by the Integrated Model of Behaviour Change exploring perceptions of self, health and wellbeing, social media use, decision making around health and environmental influences on their health. Interviews and online conversations were analysed using thematic analysis. RESULTS Eighteen young Indigenous Australians participated. Three themes were identified (a) Family and community connection in constructing health beliefs; (b) Individual health-seeking behaviours, mental health status and the importance of physical activity; and (c) peers and others were key influencers of health behaviour on social media. CONCLUSIONS Social connection and social media may provide platforms for young Indigenous people to facilitate exchange of culturally relevant information and encourage behaviour change alongside family, peer and community support. SO WHAT?: Unless accompanied with environmental changes, young adults may struggle to assert their individual agency and realise healthful behaviours, therefore strategies to change the environment are urgently required.
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Affiliation(s)
- Troy Walker
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Annika Molenaar
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, Australia
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Gwynn J, Skinner J, Dimitropoulos Y, Masoe A, Rambaldini B, Christie V, Sohn W, Gwynne K. Community based programs to improve the oral health of Australian Indigenous adolescents: a systematic review and recommendations to guide future strategies. BMC Health Serv Res 2020; 20:384. [PMID: 32375764 PMCID: PMC7204065 DOI: 10.1186/s12913-020-05247-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To review the international literature on community-based interventions aiming to improve the oral health of Indigenous adolescents and identify which demonstrate a positive impact. METHODS Data sources were MEDLINE, EMBASE, CINAHL, SCOPUS, the COCHRANE library and the Australian Indigenous HealthInfoNet. Articles were included where they: were published in English from 1990 onwards; described oral health outcomes for Indigenous adolescents aged 10 to 19 years; implemented a community based oral health intervention. The Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project was applied. RESULTS Nine studies met inclusion criteria; two rated strong in quality; only one study was conducted with an urban community; five reported moderate community engagement. Five intervention strategies were identified, and schools were the most common setting reported. Statistically significant improvements were described in eight studies with the most frequently reported outcome being change in decayed missing or filled teeth. CONCLUSIONS Few good quality peer reviewed international studies of community-based oral health interventions which address the needs of Indigenous adolescents exist. Studies must include strong Indigenous community leadership and governance at all stages of the research, adopt participatory action-based research approaches, and are required in urban communities.
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Affiliation(s)
- Josephine Gwynn
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - John Skinner
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney, Australia
| | - Yvonne Dimitropoulos
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney, Australia
| | - Angela Masoe
- NSW Ministry of Health Centre for Oral Health Strategy, 30 Christie Street, Wollstonecraft, Australia
| | - Boe Rambaldini
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney, Australia
| | - Vita Christie
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney, Australia
| | - Woosung Sohn
- The University of Sydney School of Dentistry, 1 Mons Road, Westmead, Australia
| | - Kylie Gwynne
- Poche Centre for Indigenous Health, The University of Sydney, Room 224 Edward Ford Building, Sydney, Australia
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18
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Burt A, Mitchison D, Dale E, Bussey K, Trompeter N, Lonergan A, Hay P. Prevalence, features and health impacts of eating disorders amongst First-Australian Yiramarang (adolescents) and in comparison with other Australian adolescents. J Eat Disord 2020; 8:10. [PMID: 32190326 PMCID: PMC7066723 DOI: 10.1186/s40337-020-0286-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 02/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to support previous research conducted with First-Australians (FA) by establishing the prevalence of eating disorders, and their demographic distribution and burden in adolescent First-Australians compared to other-Australians (OA). METHODS Data were used from the baseline survey of the EveryBODY Study, a longitudinal investigation of eating disorders among Australian adolescents. Of the 5068 participants included, 402 (8%) identified as FA, 4586 (90.5%) identified as OA. Diagnosis of eating disorders was based on the Diagnostic and Statistical Manual version 5. Socioeconomic status and measures of impairment were assessed using validated instruments. Body mass index was calculated based on self-reported weight and height. Statistical analyses used data weighted to the distribution of gender in adolescents in New South Wales in the 2016 Australian Census. Chi-square tests were performed to determine prevalence of eating disorders amongst FA and to compare to OA. ANOVA and logistic regression analyses where conducted to examine the moderation effect of sociodemographic status, measures of impairment and FA status on the distribution of eating disorders. RESULTS The prevalence rates for eating disorder diagnoses where similar for FA and OA with the exception of Night eating Syndrome (OSFED-NES), which occurred in 7.14% (95%CI 4.81-10.49) of FA vs. 3.72% (95%CI 3.17-4.36) in OA. The greater prevalence of OSFED-NES in FA was largely explained by poorer psychosocial quality of life amongst FA. CONCLUSION Eating disorders are common amongst First-Australian adolescents and are associated with poor psychosocial quality of life. These findings are consistent with previous research conducted with First-Australian adults. There is a need to screen for eating disorders amongst First-Australian adolescent girls and boys.
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Affiliation(s)
- Adam Burt
- 1School of Medicine, Western Sydney University, Sydney, Campbelltown Australia
| | - Deborah Mitchison
- 2Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, Campbelltown Australia.,3Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales Australia
| | - Elizabeth Dale
- 4Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute and Illawarra Health and Medical Research Institute, School of Psychology, University of Wollongong, Wollongong, New South Wales Australia
| | - Kay Bussey
- 5Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Nora Trompeter
- 5Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Alexandra Lonergan
- 5Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia
| | - Phillipa Hay
- 2Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Sydney, Campbelltown Australia.,6Campbelltown Hospital, SWSLHD, Sydney, Campbelltown Australia
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Kalucy D, Nixon J, Parvizian M, Fernando P, Sherriff S, McMellon J, D’Este C, Eades SJ, Williamson A. Exploring pathways to mental healthcare for urban Aboriginal young people: a qualitative interview study. BMJ Open 2019; 9:e025670. [PMID: 31371286 PMCID: PMC6677949 DOI: 10.1136/bmjopen-2018-025670] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 06/28/2019] [Accepted: 06/28/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore the perceptions of Aboriginal Community Controlled Health Service (ACCHS) staff involved in providing mental healthcare to Aboriginal young people of the current and ideal pathways to mental healthcare for urban Aboriginal young people attending ACCHSs, and to identify what additional supports staff may need to provide optimal mental healthcare to Aboriginal young people. DESIGN Qualitative interview study conducted during May 2016-2017. SETTING Primary care, at two ACCHSs participating in the Study of Environment on Aboriginal Resilience and Child Health in New South Wales. PARTICIPANTS Purposive sampling of staff involved in mental healthcare pathways of Aboriginal young people, including general practitioners (GPs), nurses and Aboriginal Health Workers (AHWs). RESULTS All individuals approached for interview (n=21) participated in the study. Four overarching themes and seven sub-themes were identified: availability and use of tools in practice (valuing training and desire for tools and established pathways), targeting the ideal care pathway (initiating care and guiding young people through care), influencing the care pathway (adversities affecting access to care and adapting the care pathway) and assessing future need (appraising service availability). CONCLUSIONS Participants desired screening tools, flexible guidelines and training for healthcare providers to support pathways to mental healthcare for Aboriginal young people. Both GPs and AHWs were considered key in identifying children at risk and putting young people onto a pathway to receive appropriate mental healthcare. AHWs were deemed important in keeping young people on the care pathway, and participants felt care pathways could be improved with the addition of dedicated child and adolescent AHWs. The ACCHSs were highlighted as essential to providing culturally appropriate care for Aboriginal young people experiencing mental health problems, and funding for mental health specialists to be based at the ACCHSs was considered a priority.
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Affiliation(s)
- Deanna Kalucy
- The Sax Institute, Sydney, New South Wales, Australia
| | - Janice Nixon
- The Sax Institute, Sydney, New South Wales, Australia
| | - Michael Parvizian
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Simone Sherriff
- The Sax Institute, Sydney, New South Wales, Australia
- Sydney School of Public Health, Poche Centre for Indigenous Health, Sydney, New South Wales, Australia
| | - Jennifer McMellon
- Riverina Medical and Dental Aboriginal Corporation, Wagga Wagga, New South Wales, Australia
| | - Catherine D’Este
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Sandra J Eades
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Anna Williamson
- The Sax Institute, Sydney, New South Wales, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
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20
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Gubhaju L, Banks E, Ward J, D’Este C, Ivers R, Roseby R, Azzopardi P, Williamson A, Chamberlain C, Liu B, Hotu C, Boyle J, McNamara B, Eades SJ. 'Next Generation Youth Well-being Study:' understanding the health and social well-being trajectories of Australian Aboriginal adolescents aged 10-24 years: study protocol. BMJ Open 2019; 9:e028734. [PMID: 30862639 PMCID: PMC6429910 DOI: 10.1136/bmjopen-2018-028734] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Australian Aboriginal and/or Torres Strait Islander (hereafter referred to as 'Aboriginal') adolescents (10-24 years) experience multiple challenges to their health and well-being. However, limited evidence is available on factors influencing their health trajectories. Given the needs of this group, the young age profile of the Aboriginal population and the long-term implications of issues during adolescence, reliable longitudinal data are needed. METHODS AND ANALYSIS The 'Next Generation: Youth Well-being Study' is a mixed-methods cohort study aiming to recruit 2250 Aboriginal adolescents aged 10-24 years from rural, remote and urban communities in Central Australia, Western Australia and New South Wales. The study assesses overall health and well-being and consists of two phases. During phase 1, we qualitatively explored the meaning of health and well-being for adolescents and accessibility of health services. During phase 2, participants are being recruited into a longitudinal cohort. Recruitment is occurring mainly through community networks and connections. At baseline, participants complete a comprehensive survey and undertake an extensive age relevant clinical assessment. Survey and clinical data will be linked to various databases including those relating to health services; medication; immunisation; hospitalisations and emergency department presentations; death registrations; education; child protection and corrective services. Participants will receive follow-up surveys approximately 2 years after their baseline visit. The 'Next Generation' study will fill important evidence gaps by providing longitudinal data on the health and social well-being of Aboriginal adolescents supplemented with narratives from participants to provide context. ETHICS AND DISSEMINATION Ethics approvals have been sought and granted. Along with peer-reviewed publications and policy briefs, research findings will be disseminated via reports, booklets and other formats that will be most useful and informative to the participants and community organisations.
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Affiliation(s)
- Lina Gubhaju
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Emily Banks
- ANU College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - James Ward
- Infection and Immunity, South Australia Health and Medical Research Centre, Adelaide, South Australia, Australia
- Flinders University Faculty of Medicine Nursing and Health Sciences, Adelaide, South Australia, Australia
| | - Catherine D’Este
- National Centre for Epidemiology and Population Health (NCEPH), ANU College of Medicine, Biology and Environment, The Australian National University, Callaghan, Western Australia, Australia
| | - Rebecca Ivers
- Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Robert Roseby
- Monash Children’s Hospital, Monash Health, Clayton, Victoria, Australia
| | - Peter Azzopardi
- Infection and Immunity, South Australia Health and Medical Research Centre, Adelaide, South Australia, Australia
- Burnet Institute, Melbourne, Victoria, Australia
| | | | - Catherine Chamberlain
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Bette Liu
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Cheri Hotu
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Jacqueline Boyle
- Monash Children’s Hospital, Monash Health, Clayton, Victoria, Australia
| | - Bridgette McNamara
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Sandra J Eades
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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21
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Azzopardi PS, Sawyer SM, Carlin JB, Degenhardt L, Brown N, Brown AD, Patton GC. Health and wellbeing of Indigenous adolescents in Australia: a systematic synthesis of population data. Lancet 2018; 391:766-782. [PMID: 29146122 DOI: 10.1016/s0140-6736(17)32141-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Indigenous populations have high rates of disease and premature mortality. Most Indigenous communities are young, and adolescence (age 10-24 years) provides great opportunities for population health gain. However, the absence of a comprehensive account of Indigenous adolescents' health has been a barrier to effective policy. We aimed to report a national health profile for Indigenous adolescents in Australia. METHODS We undertook a systematic synthesis of population data to report the health and wellbeing of Indigenous adolescents in Australia. A reporting framework for Indigenous adolescent health in Australia was defined to measure health outcomes, health risks, and sociocultural determinants. Available data (primary data from national surveys and administrative datasets, and available published data) were mapped against the defined reporting framework, and the quality graded, with the highest quality data selected to report a health profile for Indigenous adolescents. Comparison with non-Indigenous adolescents was made where possible, and estimates (disaggregated by age, sex, and remoteness) were reported as relative risks. A national advisory group (six Indigenous young people, three Indigenous adult community members, three researchers, three policy makers, and two service providers, all aged ≥16 years) provided input about the reporting framework, interpretation of findings, and policy recommendations. FINDINGS Data were available for 184 (79%) of 234 elements of the reporting framework. All-cause mortality for Indigenous adolescents (70 per 100 000) was more than twice that of non-Indigenous adolescents, with about 60% of deaths due to intentional self-harm and road traffic injury. 80% of all deaths among Indigenous adolescents were considered as potentially avoidable in the current health system. Communicable diseases (particularly sexually transmitted infections) were leading contributors to morbidity. Almost a third of Indigenous adolescents aged 18-24 years reported high levels of psychological distress (twice the non-Indigenous rate). There was an excess burden of mental disorders and substance use, alongside emerging type 2 diabetes and ischaemic heart disease. Additionally, there were excess intentional and unintentional injuries. Many aspects of this health profile differed markedly from that of non-Indigenous adolescents: rates of acute rheumatic fever, pneumococcal infection, gonorrhoea, and type 2 diabetes resulting in admission to hospital were ten times higher; rates of assault and childbirth in those aged 15-19 years were five times higher; whereas rates of eating disorders, melanoma and other skin cancers, and anaphylaxis were significantly lower. Risks for future ill-health were common; 43% of 15-24 year olds were current tobacco smokers and about 45% had high body mass (overweight or obese). Disadvantage across sociocultural health determinants also emerged, particularly around education. INTERPRETATION Despite Australia's adolescents having one of the best health profiles globally, Indigenous adolescents have largely been left behind. Adequate responses will require intersectoral actions, including a health system responsive to the needs of Indigenous adolescents. Without a specific focus on adolescents, Australia will not redress Indigenous health inequalities. FUNDING Australia's National Health and Medical Research Council, Sidney Myer Foundation, and the Murdoch Children's Research Institute.
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Affiliation(s)
- Peter S Azzopardi
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; Maternal and Child Health Program, International Development Discipline, Burnet Institute, Melbourne, VIC, Australia.
| | - Susan M Sawyer
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Royal Children's Hospital Centre for Adolescent Health, Parkville, VIC, Australia
| | - John B Carlin
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales Sydney, Sydney, NSW, Australia
| | - Ngiare Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Alex D Brown
- Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia
| | - George C Patton
- Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia; Murdoch Children's Research Institute, Parkville, VIC, Australia; Royal Children's Hospital Centre for Adolescent Health, Parkville, VIC, Australia
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Farnbach S, Evans J, Eades AM, Gee G, Fernando J, Hammond B, Simms M, DeMasi K, Hackett M. Process evaluation of a primary healthcare validation study of a culturally adapted depression screening tool for use by Aboriginal and Torres Strait Islander people: study protocol. BMJ Open 2017; 7:e017612. [PMID: 29102990 PMCID: PMC5722089 DOI: 10.1136/bmjopen-2017-017612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Process evaluations are conducted alongside research projects to identify the context, impact and consequences of research, determine whether it was conducted per protocol and to understand how, why and for whom an intervention is effective. We present a process evaluation protocol for the Getting it Right research project, which aims to determine validity of a culturally adapted depression screening tool for use by Aboriginal and Torres Strait Islander people. In this process evaluation, we aim to: (1) explore the context, impact and consequences of conducting Getting It Right, (2) explore primary healthcare staff and community representatives' experiences with the research project, (3) determine if it was conducted per protocol and (4) explore experiences with the depression screening tool, including perceptions about how it could be implemented into practice (if found to be valid). We also describe the partnerships established to conduct this process evaluation and how the national Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research is met. METHODS AND ANALYSIS Realist and grounded theory approaches are used. Qualitative data include semistructured interviews with primary healthcare staff and community representatives involved with Getting it Right. Iterative data collection and analysis will inform a coding framework. Interviews will continue until saturation of themes is reached, or all participants are considered. Data will be triangulated against administrative data and patient feedback. An Aboriginal and Torres Strait Islander Advisory Group guides this research. Researchers will be blinded from validation data outcomes for as long as is feasible. ETHICS AND DISSEMINATION The University of Sydney Human Research Ethics Committee, Aboriginal Health and Medical Research Council of New South Wales and six state ethics committees have approved this research. Findings will be submitted to academic journals and presented at conferences. TRIAL REGISTRATION NUMBER ACTRN12614000705684.
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Affiliation(s)
- Sara Farnbach
- The George Institute for Global Health, Camperdown, New South Wales, Australia
- University of New South Wales, Sydney, New SouthWales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - John Evans
- The University of Technology and The University of Sydney, Sydney, New South Wales, Australia
| | - Anne-Marie Eades
- The George Institute for Global Health, Camperdown, New South Wales, Australia
- University of New South Wales, Sydney, New SouthWales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
- Murdoch University, Western Australia, Australia
| | - Graham Gee
- Victorian Aboriginal Health Service, Victoria, Australia
| | | | - Belinda Hammond
- Nunkuwarrin Yunti of South Australia, South Australia, Australia
| | - Matty Simms
- The Glen Centre (Ngampie), New South Wales, Australia
| | - Karrina DeMasi
- Danila Dilba Health Service, Northern Territory, Australia
| | - Maree Hackett
- The George Institute for Global Health, Camperdown, New South Wales, Australia
- University of New South Wales, Sydney, New SouthWales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Health and Wellbeing, The University of Central Lancashire, Preston, Lancashire, UK
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Schawo S, Bouwmans C, van der Schee E, Hendriks V, Brouwer W, Hakkaart L. The search for relevant outcome measures for cost-utility analysis of systemic family interventions in adolescents with substance use disorder and delinquent behavior: a systematic literature review. Health Qual Life Outcomes 2017; 15:179. [PMID: 28927410 PMCID: PMC5606120 DOI: 10.1186/s12955-017-0722-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Accepted: 07/17/2017] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Systemic family interventions have shown to be effective in adolescents with substance use disorder and delinquent behavior. The interventions target interactions between the adolescent and involved systems (i.e. youth, family, peers, neighbors, school, work, and society). Next to effectiveness considerations, economic aspects have gained attention. However, conventional generic quality of life measures used in health economic evaluations may not be able to capture the broad effects of systemic interventions. This study aims to identify existing outcome measures, which capture the broad effects of systemic family interventions, and allow use in a health economic framework. METHODS We based our systematic review on clinical studies in the field. Our goal was to identify effectiveness studies of psychosocial interventions for adolescents with substance use disorder and delinquent behavior and to distill the instruments used in these studies to measure effects. Searched databases were PubMed, Education Resource Information Center (ERIC), Cochrane and Psychnet (PsycBOOKSc, PsycCRITIQUES, print). Identified instruments were ranked according to the number of systems covered (comprehensiveness). In addition, their use for health economic analyses was evaluated according to suitability characteristics such as brevity, accessibility, psychometric properties, etc. RESULTS One thousand three hundred seventy-eight articles were found and screened for eligibility. Eighty articles were selected, 8 instruments were identified covering 5 or more systems. CONCLUSIONS The systematic review identified instruments from the clinical field suitable to evaluate systemic family interventions in a health economic framework. None of them had preference-weights available. Hence, a next step could be to attach preference-weights to one of the identified instruments to allow health economic evaluations of systemic family interventions.
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Affiliation(s)
- S. Schawo
- Institute for Medical Technology Assessment & Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - C. Bouwmans
- Institute for Medical Technology Assessment & Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - E. van der Schee
- Parnassia Addiction Research Centre (PARC), Brijder Addiction Treatment, Parnassia Bavo Group, Monsterseweg 83, 2553 RJ The Hague, The Netherlands
| | - V. Hendriks
- Parnassia Addiction Research Centre (PARC), Brijder Addiction Treatment, Parnassia Bavo Group, Monsterseweg 83, 2553 RJ The Hague, The Netherlands
- Curium, Leiden University Medical Centre, Department of Child and Adolescent Psychiatry, Leiden University, Leiden, The Netherlands
| | - W. Brouwer
- Institute for Medical Technology Assessment & Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
| | - L. Hakkaart
- Institute for Medical Technology Assessment & Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
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Graham VE, Campbell S, West C, Clough AR. Substance misuse intervention research in remote Indigenous Australian communities since the NHMRC ‘Roadmap’. Aust N Z J Public Health 2017; 41:424-431. [DOI: 10.1111/1753-6405.12691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/01/2017] [Accepted: 04/01/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Veronica E. Graham
- Australian Institute of Tropical Health and Medicine; James Cook University; Queensland
| | - Sandra Campbell
- Centre for Chronic Disease Prevention; James Cook University; Queensland
| | - Caryn West
- School of Nursing, Midwifery & Nutrition; James Cook University; Queensland
| | - Alan R. Clough
- Australian Institute of Tropical Health and Medicine; James Cook University; Queensland
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Clifford A, Shakeshaft A. A bibliometric review of drug and alcohol research focused on Indigenous peoples of Australia, New Zealand, Canada and the United States. Drug Alcohol Rev 2017; 36:509-522. [PMID: 28334457 DOI: 10.1111/dar.12510] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 09/04/2016] [Accepted: 09/14/2016] [Indexed: 12/15/2022]
Abstract
ISSUES Indigenous peoples of Australia, New Zealand, Canada and the United States experience a disproportionately high burden of harms from substance misuse. Research is therefore required to improve our understanding of substance use in Indigenous populations and provide evidence on strategies effective for reducing harmful use. APPROACH A search of 13 electronic databases for peer-reviewed articles published between 1993 and 2014 focusing on substance use and Indigenous peoples of Australia, New Zealand, Canada and the United States. Relevant abstracts were classified as data or non-data based research. Data-based studies were further classified as measurement, descriptive or intervention and their trends examined by country and drug type. Intervention studies were classified by type and their evaluation designs classified using the Cochrane Effective Practice and Organisation of Care (EPOC) data collection checklist. KEY FINDINGS There was a statistically significant increase from 1993 to 2014 in the percentage of total publications that were data-based (P < 0.001). Overall, data-based publications were mostly descriptive for all countries (84-93%) and drug types (74-95%). There were fewer measurement (0-4%) and intervention (0-14%) publications for all countries and the percentage of these did not change significantly over time. Forty-two percent of intervention studies employed an EPOC evaluation design. IMPLICATIONS Strategies to increase the frequency and quality of measurement and intervention research in the Indigenous drug and alcohol field are required. CONCLUSION The dominance of descriptive research in the Indigenous drug and alcohol field is less than optimal for generating evidence to inform Indigenous drug and alcohol policy and programs. [Clifford A, Shakeshaft A. A bibliometric review of drug and alcohol research focused on Indigenous peoples of Australia, New Zealand, Canada and the United States. Drug Alcohol Rev 2017;36:509-522].
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Affiliation(s)
- Anton Clifford
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Anthony Shakeshaft
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Kinchin I, Mccalman J, Bainbridge R, Tsey K, Lui FW. Does Indigenous health research have impact? A systematic review of reviews. Int J Equity Health 2017; 16:52. [PMID: 28327137 PMCID: PMC5361858 DOI: 10.1186/s12939-017-0548-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 03/13/2017] [Indexed: 12/18/2022] Open
Abstract
Background Aboriginal and Torres Strait Islander Australians (hereafter respectfully Indigenous Australians) claim that they have been over-researched without corresponding research benefit. This claim raises two questions. The first, which has been covered to some extent in the literature, is about what type(s) of research are likely to achieve benefits for Indigenous people. The second is how researchers report the impact of their research for Indigenous people. This systematic review of Indigenous health reviews addresses the second enquiry. Methods Fourteen electronic databases were systematically searched for Indigenous health reviews which met eligibility criteria. Two reviewers assessed their characteristics and methodological rigour using an a priori protocol. Three research hypotheses were stated and tested: (1) reviews address Indigenous health priority needs; (2) reviews adopt best practice guidelines on research conduct and reporting in respect to methodological transparency and rigour, as well as acceptability and appropriateness of research implementation to Indigenous people; and (3) reviews explicitly report the incremental impacts of the included studies and translation of research. We argue that if review authors explicitly address each of these three hypotheses, then the impact of research for Indigenous peoples’ health would be explicated. Results Seventy-six reviews were included; comprising 55 journal articles and 21 Australian Government commissioned evidence review reports. While reviews are gaining prominence and recognition in Indigenous health research and increasing in number, breadth and complexity, there is little reporting of the impact of health research for Indigenous people. This finding raises questions about the relevance of these reviews for Indigenous people, their impact on policy and practice and how reviews have been commissioned, reported and evaluated. Conclusions The findings of our study serve two main purposes. First, we have identified knowledge and methodological gaps in documenting Indigenous health research impact that can be addressed by researchers and policy makers. Second, the findings provide the justification for developing a framework allowing researchers and funding bodies to structure future Indigenous health research to improve the reporting and assessment of impact over time. Electronic supplementary material The online version of this article (doi:10.1186/s12939-017-0548-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Irina Kinchin
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Sciences, Psychology and Public Health Department, CQUniversity Australia, Cairns Square, Corner Abbott and Shields Streets, Cairns, Qld, 4870, Australia. .,The Cairns Institute, James Cook University, Building D3, Smithfield, Qld, 4870, Australia.
| | - Janya Mccalman
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Sciences, Psychology and Public Health Department, CQUniversity Australia, Cairns Square, Corner Abbott and Shields Streets, Cairns, Qld, 4870, Australia.,The Cairns Institute, James Cook University, Building D3, Smithfield, Qld, 4870, Australia
| | - Roxanne Bainbridge
- Centre for Indigenous Health Equity Research, School of Health, Medical and Applied Sciences, Psychology and Public Health Department, CQUniversity Australia, Cairns Square, Corner Abbott and Shields Streets, Cairns, Qld, 4870, Australia.,The Cairns Institute, James Cook University, Building D3, Smithfield, Qld, 4870, Australia
| | - Komla Tsey
- The Cairns Institute, James Cook University, Building D3, Smithfield, Qld, 4870, Australia
| | - Felecia Watkin Lui
- The Cairns Institute, James Cook University, Building D3, Smithfield, Qld, 4870, Australia
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Iyngkaran P, Kangaharan N, Zimmet H, Arstall M, Minson R, Thomas MC, Bergin P, Atherton J, MacDonald P, Hare DL, Horowitz JD, Ilton M. Heart Failure in Minority Populations - Impediments to Optimal Treatment in Australian Aborigines. Curr Cardiol Rev 2016; 12:166-79. [PMID: 27280307 PMCID: PMC5011191 DOI: 10.2174/1573403x12666160606115034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/18/2015] [Accepted: 01/11/2016] [Indexed: 01/30/2023] Open
Abstract
Chronic heart failure (CHF) among Aboriginal/Indigenous Australians is endemic. There are also grave concerns for outcomes once acquired. This point is compounded by a lack of prospective and objective studies to plan care. To capture the essence of the presented topic it is essential to broadly understand Indigenous health. Key words such as ‘worsening’, ‘gaps’, ‘need to do more’, ‘poorly studied’, or ‘future studies should inform’ occur frequently in contrast to CHF research for almost all other groups. This narrative styled opinion piece attempts to discuss future directions for CHF care for Indigenous Australians. We provide a synopsis of the problem, highlight the treatment gaps, and define the impediments that present hurdles in optimising CHF care for Indigenous Australians.
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Affiliation(s)
- Pupalan Iyngkaran
- Cardiologist and Senior Lecturer NT Medical School, Flinders University, Tiwi, NT 0811, Australia.
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Möller H, Falster K, Ivers R, Falster MO, Clapham K, Jorm L. Closing the Aboriginal child injury gap: targets for injury prevention. Aust N Z J Public Health 2016; 41:8-14. [DOI: 10.1111/1753-6405.12591] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 05/01/2016] [Accepted: 06/01/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Holger Möller
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
| | - Kathleen Falster
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
- National Centre for Epidemiology and Population Health; The Australian National University; Australian Capital Territory
- The Sax Institute; New South Wales
| | - Rebecca Ivers
- The George Institute for Global Health; New South Wales
| | - Michael O. Falster
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
| | - Kathleen Clapham
- The Australian Health Services Research Institute; University of Wollongong; New South Wales
| | - Louisa Jorm
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
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Harlow AF, Bohanna I, Clough A. A systematic review of evaluated suicide prevention programs targeting indigenous youth. CRISIS 2016; 35:310-21. [PMID: 25115489 DOI: 10.1027/0227-5910/a000265] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Indigenous young people have significantly higher suicide rates than their non-indigenous counterparts. There is a need for culturally appropriate and effective suicide prevention programs for this demographic. AIMS This review assesses suicide prevention programs that have been evaluated for indigenous youth in Australia, Canada, New Zealand, and the United States. METHOD The databases MEDLINE and PsycINFO were searched for publications on suicide prevention programs targeting indigenous youth that include reports on evaluations and outcomes. Program content, indigenous involvement, evaluation design, program implementation, and outcomes were assessed for each article. RESULTS The search yielded 229 articles; 90 abstracts were assessed, and 11 articles describing nine programs were reviewed. Two Australian programs and seven American programs were included. Programs were culturally tailored, flexible, and incorporated multiple-levels of prevention. No randomized controlled trials were found, and many programs employed ad hoc evaluations, poor program description, and no process evaluation. CONCLUSION Despite culturally appropriate content, the results of the review indicate that more controlled study designs using planned evaluations and valid outcome measures are needed in research on indigenous youth suicide prevention. Such changes may positively influence the future of research on indigenous youth suicide prevention as the outcomes and efficacy will be more reliable.
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Affiliation(s)
- Alyssa F Harlow
- James Cook University School of Public Health, Tropical Medicine, and Rehabilitation Sciences, Cairns, Queensland, Australia
| | - India Bohanna
- James Cook University School of Public Health, Tropical Medicine, and Rehabilitation Sciences, Cairns, Queensland, Australia
| | - Alan Clough
- James Cook University School of Public Health, Tropical Medicine, and Rehabilitation Sciences, Cairns, Queensland, Australia
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Crinall B, Boyle J, Gibson-Helm M, Esler D, Larkins S, Bailie R. Cardiovascular disease risk in young Indigenous Australians: a snapshot of current preventive health care. Aust N Z J Public Health 2016; 41:460-466. [PMID: 27372907 DOI: 10.1111/1753-6405.12547] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/01/2015] [Accepted: 03/01/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To examine preventive health attendance and recording of type 2 diabetes and cardiovascular disease risk factors and their management in young Aboriginal peoples and Torres Strait Islanders (Indigenous Australians) at primary health care centres (PHCs). METHODS This descriptive cross-sectional study audited medical records of 1,986 Indigenous people aged 15-34 years attending 93 Australian PHCs. Measurements included blood pressure (BP), blood glucose level (BGL), smoking status, body mass index (BMI) and lipid profile. RESULTS Last attendance was most commonly for acute care (46%); 12% attended for preventive assessment. BP was recorded in 85% (1,686/1,986), BGL 63% (1,244/1,986), smoking status 52% (1,033/1,986), BMI 37% (743/1,986) and lipids 31% (625/1,986). Of those with a recorded assessment, elevated BGL (39%, 479/1,244), smoking (63%, 649/1,033), overweight/obesity (51%, 381/743) and dyslipidaemia (73%, 458/625) were common. Follow-up of abnormal results was documented for elevated BP 28% (34/120), elevated BGL 17% (79/479), smoking 65% (421/649), overweight/obesity 11% (40/381) and abnormal lipids 16% (75/458). CONCLUSIONS These findings highlight the importance of raising awareness and assessment of chronic disease risk factors in young Indigenous people and implementing preventive health care strategies. IMPLICATIONS Strengthening the capacity of PHCs to provide preventive health care may contribute to reducing the chronic disease burden experienced by young Indigenous people.
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Affiliation(s)
- Bethany Crinall
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria.,Monash Health, Diabetes and Vascular Medicine, Victoria.,School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Queensland
| | - Jacqueline Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria.,Menzies School of Health Research, Charles Darwin University, Queensland
| | - Melanie Gibson-Helm
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria
| | - Danielle Esler
- School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Queensland
| | - Sarah Larkins
- Anton Breinl Research Centre for Health Systems Strengthening, College of Medicine and Dentistry, James Cook University, Queensland
| | - Ross Bailie
- Menzies School of Health Research, Charles Darwin University, Queensland
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An Australian model of the First 1000 Days: an Indigenous-led process to turn an international initiative into an early-life strategy benefiting indigenous families. GLOBAL HEALTH EPIDEMIOLOGY AND GENOMICS 2016; 1:e11. [PMID: 29868203 PMCID: PMC5870429 DOI: 10.1017/gheg.2016.7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 05/09/2016] [Accepted: 05/20/2016] [Indexed: 11/13/2022]
Abstract
Internationally, the 1000 days movement calls for action and investment in improving nutrition for the period from a child's conception to their second birthday, thereby providing an organising framework for early-life interventions. To ensure Australian Indigenous families benefit from this 1000 days framework, an Indigenous-led year-long engagement process was undertaken linking early-life researchers, research institutions, policy-makers, professional associations and human rights activists with Australian Indigenous organisations and families. The resultant model, First 1000 Days Australia, broadened the international concept beyond improving nutrition. The First 1000 Days Australia model was built by adhering to Indigenous methodologies, a recognition of the centrality of culture that reinforces and strengthens families, and uses a holistic view of health and wellbeing. The First 1000 Days Australia was developed under the auspice of Indigenous people's leadership using a collective impact framework. As such, the model emphasises Indigenous leadership, mutual trust and solidarity to achieve early-life equity.
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Möller H, Falster K, Ivers R, Falster M, Randall D, Clapham K, Jorm L. Inequalities in Hospitalized Unintentional Injury Between Aboriginal and Non-Aboriginal Children in New South Wales, Australia. Am J Public Health 2016; 106:899-905. [PMID: 26890169 DOI: 10.2105/ajph.2015.303022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To quantify inequalities in rates of unintentional injury-related hospitalizations between Australian Aboriginal and non-Aboriginal children. METHODS We used linked hospital and mortality data to construct a retrospective whole-of-population birth cohort including 1,124,717 children born in the state of New South Wales, Australia, between July 1, 2000 and December 31, 2012. We adjusted hazard ratios (HRs) of first injury hospitalization for geographic clustering and individual- and area-level factors. RESULTS Aboriginal children were 1.6 times more likely than were non-Aboriginal children to be hospitalized for an unintentional injury. The largest inequalities were for poisoning (HR = 2.7; 95% CI = 2.4, 3.0) and injuries stemming from exposure to fire, flames, heat, and hot substances (HR = 2.4; 95% CI = 2.1, 2.7). Adjustment reduced the inequality for all unintentional injury overall (HR = 1.4; 95% CI = 1.3, 1.4) and within leading injury mechanisms. CONCLUSIONS Australian Aboriginal children suffer a disproportionately high burden of unintentional injury.
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Affiliation(s)
- Holger Möller
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Kathleen Falster
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Rebecca Ivers
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Michael Falster
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Deborah Randall
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Kathleen Clapham
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Louisa Jorm
- Holger Möller, Michael Falster, Deborah Randall, and Louisa Jorm are with the Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia. Kathleen Falster is with National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia. Rebecca Ivers is with the Injury Division, George Institute for Global Health, Sydney, Australia. Kathleen Clapham is with the Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
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Hopkins KD, Shepherd CCJ, Taylor CL, Zubrick SR. Relationships between Psychosocial Resilience and Physical Health Status of Western Australian Urban Aboriginal Youth. PLoS One 2015; 10:e0145382. [PMID: 26716829 PMCID: PMC4696679 DOI: 10.1371/journal.pone.0145382] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 12/01/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Psychosocial processes are implicated as mediators of racial/ethnic health disparities via dysregulation of physiological responses to stress. Our aim was to investigate the extent to which factors previously documented as buffering the impact of high-risk family environments on Aboriginal youths' psychosocial functioning were similarly beneficial for their physical health status. METHOD AND RESULTS We examined the relationship between psychosocial resilience and physical health of urban Aboriginal youth (12-17 years, n = 677) drawn from a representative survey of Western Australian Aboriginal children and their families. A composite variable of psychosocial resilient status, derived by cross-classifying youth by high/low family risk exposure and normal/abnormal psychosocial functioning, resulted in four groups- Resilient, Less Resilient, Expected Good and Vulnerable. Separate logistic regression modeling for high and low risk exposed youth revealed that Resilient youth were significantly more likely to have lower self-reported asthma symptoms (OR 3.48, p<.001) and carer reported lifetime health problems (OR 1.76, p<.04) than Less Resilient youth. CONCLUSION The findings are consistent with biopsychosocial models and provide a more nuanced understanding of the patterns of risks, resources and adaptation that impact on the physical health of Aboriginal youth. The results support the posited biological pathways between chronic stress and physical health, and identify the protective role of social connections impacting not only psychosocial function but also physical health. Using a resilience framework may identify potent protective factors otherwise undetected in aggregated analyses, offering important insights to augment general public health prevention strategies.
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Affiliation(s)
- Katrina D. Hopkins
- Telethon Kids Institute, The University of Western Australia, Crawley, Western Australia, Australia
| | | | - Catherine L. Taylor
- Telethon Kids Institute, The University of Western Australia, Crawley, Western Australia, Australia
| | - Stephen R. Zubrick
- Telethon Kids Institute, The University of Western Australia, Crawley, Western Australia, Australia
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Wallis BA, Watt K, Franklin RC, Kimble RM. Drowning in Aboriginal and Torres Strait Islander children and adolescents in Queensland (Australia). BMC Public Health 2015; 15:795. [PMID: 26286446 PMCID: PMC4545709 DOI: 10.1186/s12889-015-2137-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 08/10/2015] [Indexed: 11/09/2022] Open
Abstract
Background Aboriginal and Torres Strait Islander (Indigenous) children are at greater risk of drowning than other children, however little is known about drowning of Indigenous children. This study identifies the previously unpublished incidence and characteristics of fatal and non-fatal drowning in Indigenous children and adolescents. Methods Retrospective data (Jan 2002-Dec 2008) on fatal and non-fatal drowning events among Indigenous and Non-Indigenous Queensland residents aged 0-19 years were obtained from multiple sources across the continuum of care (pre-hospital; emergency department; admitted patients; fatality) and manually linked. Crude incidence rates for fatal and non-fatal events were calculated using population data from the Australian Bureau of Statistics. Results There were 87 (6.7 % of all events) fatal and non-fatal (combined) Indigenous drowning events yielding a crude Incidence Rate of 16.8/100,000/annum. This is 44 % higher than the incidence rate for Non-Indigenous children. For every fatality, nine others were rescued and sought medical treatment (average 12 per year). There were no significant changes in Indigenous drowning incidents over the study period. Drowning rates were higher for Indigenous females than males. Overall incidence was higher among Indigenous children and adolescents than Non-Indigenous children for every calendar year and age-group (0-4 years; 5-9 years; 10-14 years) except those aged 15-19 years where no drowning events were recorded for males. Location of drowning sites was similar in both populations 0-19 years, however there were slight differences in frequency at each of the locations. The three leading drowning locations for Indigenous 0-19 years olds were pool (48 %), bath (21 %) and natural water (16 %), and for non-Indigenous 0-19 years the leading locations were pool (66 %), natural water (13 %) and bath (12 %) (p < .01). Except for pool drowning, Indigenous drowning occurred more often in geographic areas of relative disadvantage. Among Indigenous children drowning location varied with age (p < .001). Most frequent locations by age were: <1 year bath (71 %); 1-4 years pools (80 %); 5-9 years pools (75 %) and 10-19 years beach/ocean (36 %). Severity of event differed statistically with Indigenous status and by remoteness with all fatal drowning events occurring in Regional or Remote areas, and none in Major Cities. Conclusions For every fatal drowning among Indigenous children in Queensland aged 0-19 years there are nine non-fatal events. This previously unreported survival ratio of 9:1 indicates the non-fatal injury burden in Indigenous children aged 0-19 years. Although higher Indigenous drowning rates prevailed, no significant changes over time are concerning. Equally the apparent over-representation of Indigenous adolescent females should be weighed against the absence of drowning among Indigenous male adolescents in the same age group in consecutive years of the study. Further investigation around behaviour and culture may highlight protective factors. Culturally specific prevention strategies which take into account social and demographic indicators identified in this study should be delivered to carers and peers of vulnerable age groups who frequent specific locations. Females, swimming ability, supervision and the young are areas which need to be incorporated into Indigenous-specific interventions for drowning prevention.
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Affiliation(s)
- Belinda A Wallis
- Queensland Children's Medical Research Institute, Brisbane, Australia. .,University of Queensland, Brisbane, Australia. .,Royal Children's Hospital, Brisbane, Australia.
| | - Kerrianne Watt
- Queensland Children's Medical Research Institute, Brisbane, Australia. .,University of Queensland, Brisbane, Australia. .,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia.
| | - Richard C Franklin
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia. .,Royal Life Saving Society Australia, Sydney, Australia.
| | - Roy M Kimble
- Queensland Children's Medical Research Institute, Brisbane, Australia. .,University of Queensland, Brisbane, Australia. .,Royal Children's Hospital, Brisbane, Australia.
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Möller H, Falster K, Ivers R, Jorm L. Inequalities in unintentional injuries between indigenous and non-indigenous children: a systematic review. Inj Prev 2014; 21:e144-52. [DOI: 10.1136/injuryprev-2013-041133] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Affiliation(s)
- George C Patton
- Department of Pediatrics, University of Melbourne, Murdoch Children's Research Institute, Center for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia
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Peralta LR, O’Connor D, Cotton WG, Bennie A. The Effects of a Community and School Sport-Based Program on Urban Indigenous Adolescents’ Life Skills and Physical Activity Levels: The <i>SCP</i> Case Study. Health (London) 2014. [DOI: 10.4236/health.2014.618284] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Malseed C, Nelson A, Ware R. Evaluation of a School-Based Health Education Program for Urban Indigenous Young People in Australia. Health (London) 2014. [DOI: 10.4236/health.2014.67077] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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