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George E, Fisher M, Mackean T, Baum F. Implementing 'Closing the Gap' policy through mainstream service provision: A South Australian case study. Health Promot J Austr 2024. [PMID: 38825392 DOI: 10.1002/hpja.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 04/19/2024] [Accepted: 05/16/2024] [Indexed: 06/04/2024] Open
Abstract
ISSUE ADDRESSED The Australian government's 'Closing the Gap' (CTG) strategy has been implemented via multiple strategies. We examined CTG policy in early childhood within Southern Adelaide during the first decade of implementation (2008-2018) and critiqued the complexity and challenges of policy that is designed to promote health and well-being of Aboriginal and Torres Strait Islander children but lacked Aboriginal control. METHODS A qualitative case study was conducted in Southern Adelaide, and we interviewed 16 policy actors from health and early childhood education sectors. Thematic analysis revealed key themes to show how policy had been implemented through mainstream structures. RESULTS The rapid roll out of the CTG strategy, the limitations of short-term funding, cuts to Aboriginal health services, tokenistic consultation, and the mainstreaming of service provision were key features of policy implementation. The influence of Aboriginal leaders varied across implementation contexts. Participants advocated for services in health and education that are culturally safe to improve health of children, families, and communities. CONCLUSIONS The implementation of the CTG strategy in Southern Adelaide was rushed, complex, and lacking Aboriginal control. This contributed to the marginalisation of Aboriginal leaders, and disengagement of families and communities. A more collaborative and Aboriginal led process for policy implementation is essential to reform policy implementation and address health inequity. SO WHAT?: Findings from this study suggest that policy has continued to be implemented I ways that reflect colonial power imbalances. Alternative processes that promote the recognition of Indigenous rights must be considered if we are to achieve the targets set within the CTG strategy.
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Affiliation(s)
- Emma George
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, South Australia, Australia
| | - Matt Fisher
- Stretton Health Equity, School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Tamara Mackean
- College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia
| | - Fran Baum
- Stretton Health Equity, School of Social Sciences, University of Adelaide, Adelaide, South Australia, Australia
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Moynihan KM, Sharma M, Mehta A, Lillie J, Ziegenfuss M, Festa M, Chan T, Thiagarajan R. Race-Conscious Research Using Extracorporeal Life Support Organization Registry Data: A Narrative Review. ASAIO J 2024:00002480-990000000-00468. [PMID: 38648078 DOI: 10.1097/mat.0000000000002206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Race-conscious research identifies health disparities with 1) rigorous and responsible data collection, 2) intentionality and considered analyses, and 3) interpretation of results that advance health equity. Individual registries must overcome specific challenges to promote race-conscious research, and this paper describes ways to achieve this with a focus on the international Extracorporeal Life Support Organization (ELSO) registry. This article reviews ELSO registry publications that studied race with outcomes to consider whether research outputs align with race-conscious concepts and describe the direction of associations reported. Studies were identified via secondary analysis of a comprehensive scoping review on ECMO disparities. Of 32 multicenter publications, two (6%) studied race as the primary objective. Statistical analyses, confounder adjustment, and inclusive, antibiased language were inconsistently used. Only two (6%) papers explicitly discussed mechanistic drivers of inequity such as structural racism, and five (16%) discussed race variable limitations or acknowledged unmeasured confounders. Extracorporeal Life Support Organization registry publications demonstrated more adverse ECMO outcomes for underrepresented/minoritized populations than non-ELSO studies. With the objective to promote race-conscious ELSO registry research outputs, we provide a comprehensive understanding of race variable limitations, suggest reasoned retrospective analytic approaches, offer ways to interpret results that advance health equity, and recommend practice modifications for data collection.
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Affiliation(s)
- Katie M Moynihan
- From the Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, Massachusetts
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Meesha Sharma
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, California
| | - Anuj Mehta
- Division of Pulmonary and Critical Care Medicine, Department of Medicine Denver Health and Hospital Authority, Denver, Colorado
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado
| | - Jon Lillie
- Pediatric Intensive Care, Evelina London Children's Hospital, London, United Kingdom
| | - Marc Ziegenfuss
- Adult Intensive Care Services, Prince Charles Hospital, Queensland Intensive Care Clinical Network and State Emergency Coordination Centre, Brisbane, Australia
- Australian and New Zealand Intensive Care Society (ANZICS), Australia
| | - Marino Festa
- New South Wales Kids ECMO Referral Service, Australia
- Kids Critical Care Research, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Titus Chan
- Department of Pediatrics, University of Washington, Seattle, Washington
| | - Ravi Thiagarajan
- From the Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts
- Sandra L. Fenwick Institute for Pediatric Health Equity and Inclusion, Boston Children's Hospital, Boston, Massachusetts
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Constantinides F, Orr N, Nash K, Evans JR, McMahon CM, Gunasekera H, Harkus S, Clague L, Cross C, Halvorsen L, Lumby N, Coates H, Macniven R. Examining relationships between parent-reported factors and recurring ear symptoms among Aboriginal and Torres Strait Islander children. Health Promot J Austr 2024; 35:225-234. [PMID: 36961054 DOI: 10.1002/hpja.719] [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: 07/19/2022] [Revised: 02/14/2023] [Accepted: 03/20/2023] [Indexed: 03/25/2023] Open
Abstract
ISSUE ADDRESSED Aboriginal and Torres Strait Islander child ear health is complex and multiple. We examined relationships between parent-reported sociodemographic, child health, health service access factors and ear symptoms among Aboriginal and Torres Strait Islander children aged 3 to 7 years. METHODS The Longitudinal Study of Indigenous Children is a large child cohort study with annual parent-reported data collection. Generalised linear mixed model analyses examined Wave 1 (1309 children 0-5 years; 2008) predictors of being free of parent-reported ear symptoms in both Waves 2 and 3. RESULTS A total of 1030 (78.7%) had no reported ear symptoms in either Wave 2 or 3. In the fully adjusted model, children who had been hospitalised in the past year (aOR = 2.16; 95% CI 1.19-3.93) and those with no ear symptoms (aOR = 2.94; 95% CI, 1.59-5.46) at Wave 1 had higher odds of no ear symptoms in both the subsequent waves. There were also relationships between parent main source of income-government pension or allowance as well as parents who reported no history of their own ear symptoms and higher odds of no ear symptoms in Waves 2 and 3 after partial adjustment for sociodemographic factors. CONCLUSION These findings suggest relationships between different sociodemographic and health factors and parent-reported ear symptoms among Aboriginal and Torres Strait Islander children that warrant further investigation. So what? Children with parent-reported ear symptoms during the early years need holistic support to prevent future ear symptoms that impact health, social and educational life trajectories.
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Affiliation(s)
- Fina Constantinides
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Neil Orr
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Kai Nash
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - John Robert Evans
- Moondani Toombadool Centre, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Catherine M McMahon
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Hasantha Gunasekera
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Children's Hospital Westmead Clinical School, Sydney, New South Wales, Australia
| | - Samantha Harkus
- National Acoustic Laboratories, Macquarie University, Sydney, New South Wales, Australia
| | - Liesa Clague
- School of Nursing and Midwifery, University of Notre Dame, Sydney, New South Wales, Australia
| | - Cara Cross
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Luke Halvorsen
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Noeleen Lumby
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Harvey Coates
- School of Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Rona Macniven
- Department of Linguistics, Faculty of Medicine, Health and Human Sciences, Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
- School of Population Health, UNSW Sydney, Sydney, New South Wales, Australia
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Yashadhana A, Zwi AB, Brady B, De Leeuw E, Kingsley J, O'Leary M, Raven M, Serova N, Topp SM, Fields T, Foster W, Jopson W, Biles B. Gaawaadhi Gadudha: understanding how cultural camps impact health, well-being and resilience among Aboriginal adults in New South Wales, Australia-a collaborative study protocol. BMJ Open 2023; 13:e073551. [PMID: 38135326 DOI: 10.1136/bmjopen-2023-073551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION The health and well-being of Aboriginal Australians is inextricably linked to culture and Country. Our study challenges deficit approaches to health inequities by seeking to examine how cultural connection, practice and resilience among Aboriginal peoples through participation in 'cultural camps' held on sites of cultural significance promotes health and well-being. METHODS AND ANALYSIS The study will be undertaken in close collaboration and under the governance of traditional cultural knowledge holders from Yuwaalaraay, Gamilaraay and Yuin nation groups in New South Wales, Australia. Three cultural camps will be facilitated, where participants (n=105) will engage in activities that foster a connection to culture and cultural landscapes. A survey assessing connection to culture, access to cultural resources, resilience, self-rated health and quality of life will be administered to participants pre-camp and post-camp participation, and to a comparative group of Aboriginal adults who do not attend the camp (n=105). Twenty participants at each camp (n=60) will be invited to participate in a yarning circle to explore cultural health, well-being and resilience. Quantitative analysis will use independent samples' t-tests or χ2 analyses to compare camp and non-camp groups, and linear regression models to determine the impact of camp attendance. Qualitative analysis will apply inductive coding to data, which will be used to identify connections between coded concepts across the whole data set, and explore phenomenological aspects. Results will be used to collaboratively develop a 'Model of Cultural Health' that will be refined through a Delphi process with experts, stakeholders and policymakers. ETHICS AND DISSEMINATION The study has ethics approval from the Aboriginal Health and Medical Research Council (#1851/21). Findings will be disseminated through a combination of peer-reviewed articles, media communication, policy briefs, presentations and summary documents to stakeholders.
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Affiliation(s)
- Aryati Yashadhana
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Anthony B Zwi
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Brooke Brady
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Evelyne De Leeuw
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- École de Santé Publique, l'Université de Montréal, Montréal, Quebec, Canada
| | - Jonathan Kingsley
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Michelle O'Leary
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Miri Raven
- Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Nina Serova
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephanie M Topp
- School of Social Sciences, Faculty of Arts and Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Ted Fields
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Warren Foster
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Wendy Jopson
- Social Policy Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Brett Biles
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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White SJ, Condon B, Ditton-Phare P, Dodd N, Gilroy J, Hersh D, Kerr D, Lambert K, McPherson ZE, Mullan J, Saad S, Stubbe M, Warren-James M, Weir KR, Gilligan C. Enhancing effective healthcare communication in Australia and Aotearoa New Zealand: Considerations for research, teaching, policy, and practice. PEC INNOVATION 2023; 3:100221. [PMID: 37822775 PMCID: PMC10562187 DOI: 10.1016/j.pecinn.2023.100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/08/2023] [Accepted: 09/25/2023] [Indexed: 10/13/2023]
Abstract
Objective In this article we present a conceptual framework for enhancing effective healthcare communication in Australia and Aotearoa New Zealand. Methods Through an iterative, deliberative dialogue approach, we, as experts from a variety of health professions and academic disciplines, worked together to identify core values and considerations for healthcare communication across numerous health professions and disciplines and within research, teaching, policy, and practice contexts. Results The framework developed includes five core values at its centre: equitable, inclusive, evidence-based, collaborative, reflective. Around this are concentric circles showing key elements of collaborators, modality, context, and purpose. Each of these is explored. Conclusion This work may support benchmarking for healthcare providers, researchers, policymakers, and educators across a breadth of professions to help improve communication in clinical practice. The framework will also help to identify areas across disciplines that are shared and potentially idiosyncratic for various professions to promote interprofessional recognition, education, and collaboration. Innovation This framework is designed to start conversations, to form the foundation of a dialogue about the priorities and key considerations for developing teaching curricula, professional development, and research programs related to healthcare communication, providing a set of values specifically for the unique contexts of Australia and Aotearoa New Zealand. It can also be used to guide interdisciplinary healthcare professionals in advancing research, teaching, policy, and practice related to healthcare communication.
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Affiliation(s)
- Sarah J. White
- Centre for Social Impact, University of New South Wales, Sydney, Australia
| | - Brendan Condon
- Warrnambool Clinical School, Deakin University, Warrnambool, Australia
| | - Philippa Ditton-Phare
- School of Medicine & Public Health, The University of Newcastle, Newcastle, Australia
| | - Natalie Dodd
- School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast, Sippy Downs, Australia
| | - John Gilroy
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Deborah Hersh
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Debra Kerr
- Institute for Healthcare Transformation, Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University, Geelong, Australia
| | - Kelly Lambert
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, Australia
| | | | - Judy Mullan
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
| | - Shannon Saad
- RPA Virtual Hospital, Sydney Local Health District, Sydney, Australia
| | - Maria Stubbe
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
| | - Matthew Warren-James
- School of Nursing, Midwifery and Paramedicine, University of Sunshine Coast, Sippy Downs, Australia
| | - Kristie R. Weir
- Sydney School of Public Health, University of Sydney, Sydney, Australia and Institute of Primary Health Care BIHAM, University of Bern, Bern, Switzerland
| | - Conor Gilligan
- School of Medicine & Public Health, The University of Newcastle, Newcastle, Australia
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Hedges J, Poirier B, Soares G, Haag D, Sethi S, Santiago PR, Cachagee M, Jamieson L. Journeying towards decolonising Aboriginal and Torres Strait Islander oral health re-search. Community Dent Oral Epidemiol 2023; 51:1232-1240. [PMID: 37294001 DOI: 10.1111/cdoe.12881] [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: 01/04/2023] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Arguably, the deficit narrative of oral health inequities, perpetuated by colonial re-search agendas, media and sociopolitical discourse, contributes to oral disease burden and fatalism among Aboriginal and Torres Strait Islander Peoples. There remains a need to evolve the way oral health is understood, in a manner that reflects the lived experiences of Aboriginal and Torres Strait Islander Peoples. METHODS This paper proposes decolonising methodologies as a strategy to ensure oral health re-search creates more equitable oral health outcomes and realities for Aboriginal and Torres Strait Islander Communities. Anchored by a critical reflection of the failure of dominant oral health inequity re-search practices to address Indigenous oral health, both in Australia and internationally, we propose five explicit pathways for decolonising Aboriginal and Torres Strait Islander oral health re-search. RESULTS We argue the need for (1) positionality statements in all re-search endeavours, (2) studies that honour reciprocal relationships through the development of proposals that ask questions and follow models based on Traditional Knowledges, (3) the development of culturally secure and strengths-based data capturing tools, (4) frameworks that address the intersection of multiple axes of oppression in creating inequitable conditions and (5) decolonising knowledge translation techniques. CONCLUSION Importantly, we recognize that re-search will never be entirely 'decolonised' due to the colonial foundations upheld by academic institutions and society more broadly; however, as oral health re-searchers, we ascertain that there is an ethical compulsion to drive decolonising re-search pursuits that produce equitable oral health outcomes for Aboriginal and Torres Strait Islander Communities.
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Affiliation(s)
- Joanne Hedges
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Brianna Poirier
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Gustavo Soares
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Dandara Haag
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Sneha Sethi
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Pedro Ribeiro Santiago
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Madison Cachagee
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
| | - Lisa Jamieson
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, Australia
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Bullen J, Hill-Wall T, Anderson K, Brown A, Bracknell C, Newnham EA, Garvey G, Waters L. From Deficit to Strength-Based Aboriginal Health Research-Moving toward Flourishing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5395. [PMID: 37048008 PMCID: PMC10094537 DOI: 10.3390/ijerph20075395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Aboriginal Australians have a fundamental human right to opportunities that lead to healthy and flourishing lives. While the impact of trauma on Aboriginal Australians is well-documented, a pervasive deficit narrative that focuses on problems and pathology persists in research and policy discourse. This narrative risks further exacerbating Aboriginal disadvantage through a focus on 'fixing what is wrong' with Aboriginal Australians and the internalising of these narratives by Aboriginal Australians. While a growing body of research adopts strength-based models, limited research has sought to explore Aboriginal flourishing. This conceptual paper seeks to contribute to a burgeoning paradigm shift in Aboriginal research, seeking to understand what can be learned from Aboriginal people who flourish, how we best determine this, and in what contexts this can be impactful. Within, we argue the case for a new approach to exploring Aboriginal wellbeing that integrates salutogenic, positive psychology concepts with complex systems theory to understand and promote Aboriginal wellbeing and flourishing. While deeper work may be required to establish the parameters of a strength-based, culturally aligned Aboriginal conceptualisation of positive psychology, we suggest the integration of Aboriginal and Western methodologies offers a unique and potent means of shifting the dial on seemingly intractable problems.
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Affiliation(s)
- Jonathan Bullen
- EnAble Institute, Curtin University, Perth, WA 6102, Australia
- Telethon Kids Institute, Perth, WA 6009, Australia;
| | - Trish Hill-Wall
- EnAble Institute, Curtin University, Perth, WA 6102, Australia
| | - Kate Anderson
- Faculty of Medicine, The School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Alex Brown
- Telethon Kids Institute, Perth, WA 6009, Australia;
- National Centre for Indigenous Genomics, The John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Clint Bracknell
- School of Languages and Cultures, The University of Queensland, St. Lucia, QLD 4067, Australia
| | - Elizabeth A. Newnham
- EnAble Institute, Curtin University, Perth, WA 6102, Australia
- School of Population Health, Curtin University, Perth, WA 6102, Australia
- FXB Center for Health and Human Rights, Harvard University, Boston, MA 02115, USA
| | - Gail Garvey
- Faculty of Medicine, The School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Lea Waters
- Centre for Wellbeing Science, Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC 3101, Australia
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Parter C, Rambaldini B, Wilson S, Gwynn J, C Skinner J, Calma Ao T. Heal country, heal our nation: Talking up racism ☆. Aust N Z J Public Health 2023; 47:100037. [PMID: 37023483 DOI: 10.1016/j.anzjph.2023.100037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 04/08/2023] Open
Affiliation(s)
- Carmen Parter
- Department of Health Sciences, Faculty of Medicine, Health and Human Services, Djurali Aboriginal and Torres Strait Islander Research and Education, Six First Walk, Macquarie University, NSW, 2109, Australia.
| | - Boe Rambaldini
- Department of Health Sciences, Faculty of Medicine, Health and Human Services, Djurali Aboriginal and Torres Strait Islander Research and Education, Six First Walk, Macquarie University, NSW, 2109, Australia
| | - Shawn Wilson
- Irving K Barber Faculty of Arts + Social Science | Community, Culture, and Global Studies, University of British, Columbia, Okanagan, Canada; Gnibi College of Indigenous Australian Peoples, Southern Cross University, Australia
| | - Josephine Gwynn
- Charles Perkins Centre, Faculty of Medicine and Health The University of Sydney, Australia
| | - John C Skinner
- Department of Health Sciences, Faculty of Medicine, Health and Human Sciences; Djurali Aboriginal and Torres Strait Islander Health Research and Education, Six First Walk Macquarie University, NSW, 2109, Australia
| | - Tom Calma Ao
- University of Sydney, Australia; Macquarie University, Australia
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9
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Maddox R, Kennedy M, Drummond A, Waa A, Bradbrook S, Tautolo ES, Calma T, Whop LJ. 'Dispelling the smoke to reflect the mirror': the time is now to eliminate tobacco related harms. Aust N Z J Public Health 2022; 46:727-729. [PMID: 36190195 DOI: 10.1111/1753-6405.13313] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Raglan Maddox
- Bagumani (Modewa) Clan, Papua New Guinea.,National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory
| | - Michelle Kennedy
- Wiradjuri.,College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales; Hunter Medical Research Institute, Newcastle, New South Wales
| | - Ali Drummond
- Meriam and Wuthathi.,Congress of Aboriginal and Torres Strait Islander Nurses and Midwives., Canberra, Australian Capital Territory
| | - Andrew Waa
- Ngāti Hine/Ngāpuhi.,Eru Pomare Māori Health Research Unit and ASPIRE2025 Research Centre, University of Otago., Wellington, Aotearoa (New Zealand)
| | - Shane Bradbrook
- Ngāi Tāmanuhiri, Rongowhakaata.,Ngāti Kahungunu. Wellington, Aotearoa (New Zealand)
| | - El-Shadan Tautolo
- Samoa/Ngāti Tapuniu.,AUT Pacific Health Research Centre, Auckland University of Technology, Auckland, New Zealand
| | - Tom Calma
- Elder from the Kungarakan tribal group and a member of the Iwaidja tribal group.,Office of the National Coordinator, Tackling Indigenous Smoking., Canberra, Australian Capital Territory.,Poche Indigenous Health Network., Sydney, New South Wales.,Ninti One., Adelaide, South Australia
| | - Lisa J Whop
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory.,Wagadagam
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10
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Macniven R, Simon A, Wilson R, Howie A, Stewart G, Ma T, Turner NJ, Cairnduff S, Coombes J. Ironbark: Developing a healthy community program for older Aboriginal people. Health Promot J Austr 2022; 33 Suppl 1:128-133. [PMID: 35148452 PMCID: PMC9790301 DOI: 10.1002/hpja.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED Programs by, with and for Aboriginal older people must be culturally safe and relevant. Successful elements include being Aboriginal specific and group based. Co-design with Aboriginal people and stakeholders is essential. We describe the co-design process of developing the Ironbark: Healthy Community program. METHODS Aboriginal ways of knowing, being and doing and yarning conversational methods guided the development process, during 2018. A desktop review provided details of current group characteristics and key community stakeholders. Stakeholder engagement regarding views about group operations, participants and benefits also occurred. Aboriginal Elders views of their groups were gathered through yarning circles in New South Wales (NSW). Grounded theory approach was used to ascertain key themes. RESULTS Initial engagement occurred with 13 different community stakeholders and organisations in three Australian states (NSW, South Australia (SA), Western Australia (WA)). Three yarning circles occurred with Elders from urban (N = 10), regional coastal (N = 10) and regional country (N = 4) groups. Six key themes were organised in three groups according to an Aboriginal ontology. 1. Knowing: groups provide opportunities to share knowledge and connect socially. Adequate program resourcing and sustainability are valued. 2. Being: groups strengthen culture, providing important social, emotional and other forms of support to age well. 3. Doing: previous program experiences inform perceptions for new program operations. Group venues and operational aspects should be culturally safe, acknowledging diversity among Elders, their preferences and community control. Themes were used to develop the program and its resource manual that were finalised with stakeholders, including steering committee approval. CONCLUSIONS Stakeholder feedback at multiple stages and Aboriginal Elders' perspectives resulted in a new co-designed community program involving weekly yarning circles and social activities. So what?: Co-design, guided by Aboriginal ways of knowing, being and doing, can develop programs relevant for Aboriginal people.
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Affiliation(s)
- Rona Macniven
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,Faculty of Health, Medicine and Human SciencesMacquarie UniversityNew South WalesAustralia
| | | | - Roland Wilson
- Southgate Institute for Health, Society, and EquityFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Adam Howie
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Georgia Stewart
- Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research InstituteThe University of WollongongWollongongNew South WalesAustralia
| | - Tracey Ma
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,The George Institute for Global HealthSydneyNew South WalesAustralia
| | - Norma Jean Turner
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia
| | - Sallie Cairnduff
- School of Population HealthUNSW SydneySydneyNew South WalesAustralia,The George Institute for Global HealthSydneyNew South WalesAustralia
| | - Julieann Coombes
- The George Institute for Global HealthSydneyNew South WalesAustralia
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11
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Parent wellbeing, family screen time and socioeconomic status during early childhood predict physical activity of aboriginal and Torres Strait islander children at ages 8–13. J Sci Med Sport 2022; 25:896-902. [DOI: 10.1016/j.jsams.2022.09.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 08/30/2022] [Accepted: 09/14/2022] [Indexed: 11/18/2022]
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12
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Lovell J, Clark L. Implementing Interventions to Improve Health Communication Equity for First Nations People: Guidance from a Rapid Realist Review. JOURNAL OF HEALTH COMMUNICATION 2022; 27:555-562. [PMID: 36217757 DOI: 10.1080/10810730.2022.2134523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Effective communication is critical for engagement between clients and health professionals, transfer of health information and health decision-making. Internationally, there is recognition that if health communication interventions were successfully implemented, then health communication equity would improve. This rapid realist review was undertaken with the aim of providing guidance on the circumstances in which communication interventions were likely to work in regional health service settings accessed by First Nations people from remote and very remote geographic areas of Australia. The realist review involved a process of searching literature on key terms and the identification of relevant studies and policies by a content expert group, including non-Indigenous and First Nations health researchers. Evidence was extracted to inform and synthesize into guiding principles, using a realist perspective. This review identified studies that provided evidence from 37 Australian and international settings where the dominant language and culture of the health sector differs from that of the majority of service users. A number of guiding principles were synthesized: 1) to build trust and respect by inclusion of an individual patient's cultural perspective; 2) to enhance concordant understanding of health information through two-way health literacies and learning; 3) to recognize the entanglement of health communication equity with regional socio-cultural and health determinants. This review generated realist informed guiding principles to suggest how and under what conditions health communication interventions can enable healthcare decision-making at an individual and service level.
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Affiliation(s)
- Judith Lovell
- Northern Institute, Charles Darwin University, Alice Springs, Sadadeen, NT, Australia
| | - Louise Clark
- Tasmanian School of Medicine, University of Tasmania, Hobart, TAS, Australia
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13
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Talley NJ, Zuccala E, Geronimo F, Janusic T, Villanueva EV. Strengthening the presence of Aboriginal and Torres Strait Islander voices in the
Medical Journal of Australia. Med J Aust 2022; 217:24-25. [DOI: 10.5694/mja2.51608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | | | - Elmer V Villanueva
- Medical Journal of Australia Sydney NSW
- Xi'an Jiaotong–Liverpool University Suzhou China
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14
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Kennedy M, Bennett J, Maidment S, Chamberlain C, Booth K, McGuffog R, Hobden B, Whop LJ, Bryant J. Interrogating the intentions for Aboriginal and Torres Strait Islander health: a narrative review of research outputs since the introduction of Closing the Gap. Med J Aust 2022; 217:50-57. [PMID: 35686477 PMCID: PMC9545599 DOI: 10.5694/mja2.51601] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/15/2021] [Accepted: 01/19/2022] [Indexed: 11/25/2022]
Abstract
Despite the "best of intentions", Australia has fallen short of federal targets to close the gap in disproportionate health outcomes between Aboriginal and non-Aboriginal Australians. We examined 2150 original research articles published over the 12-year period (from 2008 to 2020), of which 58% used descriptive designs and only 2.6% were randomised controlled trials. There were few national studies. Studies were most commonly conducted in remote settings (28.8%) and focused on specific burdens of disease prevalent in remote areas, such as infectious disease, hearing and vision. Analytic observational designs were used more frequently when addressing burdens of disease, such as cancer and kidney and urinary, respiratory and endocrine diseases. The largest number of publications focused on mental and substance use disorders (n = 322, 20.5%); infectious diseases (n = 222, 14.1%); health services planning, delivery and improvement (n = 193, 33.5%); and health and wellbeing (n = 170, 29.5%). This review is timely given new investments in Aboriginal health, which highlights the importance of Aboriginal researchers, community leadership and research priority. We anticipate future outputs for Aboriginal health research to change significantly from this review, and join calls for a broadening of our intellectual investment in Aboriginal health.
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Affiliation(s)
- Michelle Kennedy
- University of NewcastleNewcastleNSW
- Hunter Medical Research InstituteUniversity of NewcastleNewcastleNSW
| | - Jessica Bennett
- University of NewcastleNewcastleNSW
- Hunter Medical Research InstituteUniversity of NewcastleNewcastleNSW
| | | | - Catherine Chamberlain
- Centre for Health EquityUniversity of MelbourneMelbourneVIC
- Judith Lumley CentreLa Trobe UniversityMelbourneVIC
| | - Kate Booth
- University of NewcastleNewcastleNSW
- Hunter Medical Research InstituteUniversity of NewcastleNewcastleNSW
| | | | - Bree Hobden
- University of NewcastleNewcastleNSW
- Hunter Medical Research InstituteUniversity of NewcastleNewcastleNSW
| | - Lisa J Whop
- National Centre for Epidemiology and Population HealthAustralian National UniversityCanberraACT
| | - Jamie Bryant
- University of NewcastleNewcastleNSW
- Hunter Medical Research InstituteUniversity of NewcastleNewcastleNSW
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15
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Are Australian Universities Perpetuating the Teaching of Racism in Their Undergraduate Nurses in Discrete Aboriginal and Torres Strait Islander Courses? A Critical Race Document Analysis Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137703. [PMID: 35805370 PMCID: PMC9266075 DOI: 10.3390/ijerph19137703] [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: 03/17/2022] [Revised: 06/14/2022] [Accepted: 06/17/2022] [Indexed: 11/27/2022]
Abstract
Systemic racism has a profound negative impact on the health outcomes of Australia’s First Nations peoples, hereafter referred to as Aboriginal and Torres Strait Islander peoples, where racism and white privilege have largely become normalised and socially facilitated. A national framework is being mobilised within the tertiary-level nursing curriculum to equip future health professionals with cultural capabilities to ensure culturally safe, equitable health care for Aboriginal and Torres Strait Islander peoples. In 2019, nurses comprised more than half of all registered health professionals in Australia, and current national standards for nursing state that Australian universities should be graduating registered nurses capable of delivering care that is received as culturally safe. It is therefore critical to evaluate where learning objectives within nursing curricula may lead to the reinforcement and teaching of racist ideologies to nursing students. This protocol outlines a framework and methodology that will inform a critical race document analysis to evaluate how learning objectives assert the social construction of “race” as a tool of oppressive segregation. The document analysis will include each discrete Aboriginal and Torres Strait Islander health course within all undergraduate nursing programs at Australian universities. The approach outlined within this protocol is developed according to an Indigenous research paradigm and Colonial Critical Race Theory as both the framework and methodology. The purpose of the framework is a means for improving health professional curriculum by reducing racism as highlighted in nation-wide strategies for curriculum reform.
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16
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Callander E, Fox H, Mills K, Stuart-Butler D, Middleton P, Ellwood D, Thomas J, Flenady V. Inequitable use of health services for Indigenous mothers who experience stillbirth in Australia. Birth 2022; 49:194-201. [PMID: 34617314 DOI: 10.1111/birt.12593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 09/10/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of this study was to identify differences in health service expenditure on Indigenous and non-Indigenous women who experience a stillbirth, women's out-of-pocket costs, and health service use. METHODS The project used a whole-of-population linked data set called "Maternity1000," which includes all women who gave birth in Queensland, Australia, between July 1, 2012, and June 30, 2018 (n = 396 158). Multivariable analysis was undertaken to assess differences in mean health service expenditure; and number of health care services accessed between Indigenous and non-Indigenous women who had a stillbirth from birth to twelve months postpartum. Costs are presented in 2019/20 Australian dollars. RESULTS There was a total of 1864 babies stillborn to women in Queensland between July 1, 2012, and June 30, 2018, with 135 being born to Indigenous women and 1729 born to non-Indigenous women. There was significantly lower total expenditure per woman for Indigenous women compared with non-Indigenous women ($16 083 and $18 811, respectively). This was consistent across public hospital inpatient ($12 564 compared with $14 075), outpatient ($1127 compared with $1470), community-based services ($198 compared with $313), pharmaceuticals ($8 compared with $22), private hospital ($434 compared with $1265), and for individual out-of-pocket fees ($21 compared with $86). Mean expenditure on emergency department services per woman was higher for Indigenous women compared with non-Indigenous women ($947 compared with $643). Indigenous women who experienced a stillbirth accessed fewer general practitioners, allied health, specialist, obstetrics, and outpatient services, and fewer pathology and diagnostic test than their non-Indigenous counterparts. CONCLUSIONS Inequities in access to health services exist between Indigenous and non-Indigenous women who experience a stillbirth.
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Affiliation(s)
- Emily Callander
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Haylee Fox
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Kyly Mills
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Deanna Stuart-Butler
- Stillbirth Centre of Research Excellence, Mater Research, South Brisbane, Queensland, Australia
| | - Philippa Middleton
- South Australian Health & Medical Research Institute Women and Kids, Adelaide, South Australia, Australia.,The University of Adelaide, Adelaide, South Australia, Australia
| | - David Ellwood
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Joseph Thomas
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Vicki Flenady
- Stillbirth Centre of Research Excellence, Mater Research, South Brisbane, Queensland, Australia
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17
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Dudgeon P, Derry KL, Mascall C, Ryder A. Understanding Aboriginal Models of Selfhood: The National Empowerment Project's Cultural, Social, and Emotional Wellbeing Program in Western Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4078. [PMID: 35409761 PMCID: PMC8997958 DOI: 10.3390/ijerph19074078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/13/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023]
Abstract
Culturally safe and responsive interventions that acknowledge Aboriginal models of selfhood are needed. Such interventions empower Aboriginal peoples and communities by increasing self-determination over individual and community social and emotional wellbeing (SEWB). In response to this need, the National Empowerment Project developed the Cultural, Social, and Emotional Wellbeing Program (CSEWB). The CSEWB aims to strengthen SEWB and cultural identity and subsequently reduce psychological distress in Aboriginal peoples. An Aboriginal Participatory Action Research approach ensured community ownership and engagement. Seven research questions and a culturally modified adaption of the Most Significant Change technique informed a thematic analysis of the evaluation content. Aboriginal adults (n = 49; 53% ≥50 years, 66% female, 34% male) from three Western Australian urban communities participated in the program evaluation workshops. Participants reported the benefits of enhanced SEWB and reduced psychological distress. This research reaffirms the need for culturally safe programs that acknowledge social determinants of health and are guided by the SEWB framework. Long-term commitment from the government is needed to support such programs.
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Affiliation(s)
- Pat Dudgeon
- Poche Centre for Indigenous Health, School of Indigenous Studies, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Kate L. Derry
- Poche Centre for Indigenous Health, School of Indigenous Studies, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Carolyn Mascall
- Relationships Australia WA, West Leederville, WA 6007, Australia; Langford Aboriginal Association, Langford, WA 6147, Australia; (C.M.); (A.R.)
| | - Angela Ryder
- Relationships Australia WA, West Leederville, WA 6007, Australia; Langford Aboriginal Association, Langford, WA 6147, Australia; (C.M.); (A.R.)
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18
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Options for improving low birthweight and prematurity birth outcomes of indigenous and culturally and linguistically diverse infants: a systematic review of the literature using the social-ecological model. BMC Pregnancy Childbirth 2022; 22:3. [PMID: 34979997 PMCID: PMC8722221 DOI: 10.1186/s12884-021-04307-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prematurity and low birthweight are more prevalent among Indigenous and Culturally and Linguistically Diverse infants. METHODS To conduct a systematic review that used the social-ecological model to identify interventions for reducing low birthweight and prematurity among Indigenous or CALD infants. Scopus, PubMed, CINAHL, and Medline electronic databases were searched. Studies included those published in English between 2010 and 2021, conducted in high-income countries, and reported quantitative results from clinical trials, randomized controlled trials, case-control studies or cohort studies targeting a reduction in preterm birth or low birthweight among Indigenous or CALD infants. Studies were categorized according to the level of the social-ecological model they addressed. FINDINGS Nine studies were identified that met the inclusion criteria. Six of these studies reported interventions targeting the organizational level of the social-ecological model. Three studies targeted the policy, community, and interpersonal levels, respectively. Seven studies presented statistically significant reductions in preterm birth or low birthweight among Indigenous or CALD infants. These interventions targeted the policy (n = 1), community (n = 1), interpersonal (n = 1) and organizational (n = 4) levels of the social-ecological model. INTERPRETATION Few interventions across high-income countries target the improvement of low birthweight and prematurity birth outcomes among Indigenous or CALD infants. No level of the social-ecological model was found to be more effective than another for improving these outcomes.
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Whettam L, Bergmeier H, Chung A, Skouteris H. The ongoing impact of colonisation on childhood obesity prevention: a First Nations' perspective. Aust N Z J Public Health 2021; 46:3-6. [PMID: 34897899 DOI: 10.1111/1753-6405.13170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Louisa Whettam
- Ngiyambalgarra Consultancy, Queensland.,National Health and Medical Research Council Centre of Research Excellence in Health in Preconception and Pregnancy Consumer Advisory Committee, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria
| | - Heidi Bergmeier
- National Health and Medical Research Council Centre of Research Excellence in Health in Preconception and Pregnancy, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria.,Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria
| | - Alexandra Chung
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria
| | - Helen Skouteris
- National Health and Medical Research Council Centre of Research Excellence in Health in Preconception and Pregnancy, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria.,Warwick Business School, University of Warwick, Coventry, United Kingdom
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20
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de Leeuw E, Harris P, Kim J, Yashadhana A. A health political science for health promotion. Glob Health Promot 2021; 28:17-25. [PMID: 34510937 DOI: 10.1177/17579759211034418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
If health promotion as a field of change for human and ecological health is to maintain its urgency, it needs to continue building its policy credentials. This paper charts the development of policy as a concern for IUHE/IUHPE (International Union for Health Education/International Union for Health Promotion and Education) from the mid-1970s when 'health education policies' were prominent issues, to the launch of Healthy Public Policy (in the 1980s) and Health in All Policy (in the 2000s). We argue that solid conceptual and theoretical foundations exist to frame and develop the relevance and connectedness of health promotion more prominently. We start off with a brief introduction into (health) political science, and then illustrate the urgency of the argument with three case studies. The first takes a critical realist perspective on 'closing the gap' in Australian Indigenous populations. With recent evidence it demonstrates that the core of the policymaking process needs to re-align itself with an Indigenous narrative. The second case study reviews the politics of healthy urban planning and health equity in cities. Taking a critical theory institutionalist view, the case describes how the political and narrative parallels between urban theory and health equity have gone underexplored. With an explicit gaze to connect the two, the field could become a large and influential driver of enhanced health promotion and public health policy. The third case describes the languages, policy frames, and distinctions, in four urban/health paradigms. It shows that unconscious policy and practice bias exists in policy priorities and processes. We conclude with observations and recommendations on the role of health promotion as a conceptual realm and field of activity. We show that all health promoters should be aware of the political nature of their enterprise. Tools and analyses exist to help further action.
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Affiliation(s)
- Evelyne de Leeuw
- Centre for Health Equity Research, Training and Evaluation CHETRE, University of New South Wales, South Western Sydney Local Health District, and Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Patrick Harris
- Centre for Health Equity Research, Training and Evaluation CHETRE, University of New South Wales, South Western Sydney Local Health District, and Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Jinhee Kim
- Centre for Health Equity Research, Training and Evaluation CHETRE, University of New South Wales, South Western Sydney Local Health District, and Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Aryati Yashadhana
- Centre for Health Equity Research, Training and Evaluation CHETRE, University of New South Wales, South Western Sydney Local Health District, and Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
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21
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Black to the Future: Making the Case for Indigenist Health Humanities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168704. [PMID: 34444453 PMCID: PMC8393378 DOI: 10.3390/ijerph18168704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/17/2022]
Abstract
This paper outlines the development of Indigenist Health Humanities as a new and innovative field of research building an intellectual collective capable of bridging the knowledge gap that hinders current efforts to close the gap in Indigenous health inequality. Bringing together health and the humanities through the particularity of Indigenous scholarship, a deeper understanding of the human experience of health will be developed alongside a greater understanding of the enablers to building a transdisciplinary collective of Indigenist researchers. The potential benefits include a more sustainable, relational, and ethical approach to advancing new knowledge, and health outcomes, for Indigenous people in its fullest sense.
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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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Culturally Adaptive Governance-Building a New Framework for Equity in Aboriginal and Torres Strait Islander Health Research: Theoretical Basis, Ethics, Attributes and Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157943. [PMID: 34360234 PMCID: PMC8345529 DOI: 10.3390/ijerph18157943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/20/2021] [Accepted: 07/25/2021] [Indexed: 11/17/2022]
Abstract
Indigenous health inequities persist in Australia due to a system of privilege and racism that has political, economic and social determinants, rather than simply genetic or behavioural causes. Research involving Aboriginal and Torres Strait Islander (‘Indigenous’) communities is routinely funded to understand and address these health inequities, yet current ethical and institutional conventions for Indigenous health research often fall short of community expectations. Typically, mainstream research projects are undertaken using traditional “top-down” approaches to governance that hold inherent tensions with other dominant governance styles and forms. This approach perpetuates long-held power imbalances between those leading the research and those being researched. As an alternative, Indigenous governance focuses on the importance of place, people, relationships and process for addressing power imbalances and achieving equitable outcomes. However, empowering principles of Indigenous governance in mainstream environments is a major challenge for research projects and teams working within organisations that are regulated by Western standards and conventions. This paper outlines the theoretical basis for a new Culturally Adaptive Governance Framework (CAGF) for empowering principles of Indigenous governance as a prerequisite for ethical conduct and practice in Indigenous health research. We suggest new orientations for mainstream research project governance, predicated on translating theoretical and practical attributes of real-world ethics, adaptive governance and critical allyship frameworks to Indigenous health research. The CAGF is being implemented in a national Indigenous multicenter trial evaluating the use of continuous blood glucose monitors as a new technology with the potential to improve diabetes care and treatment for Indigenous Australians—the FlashGM Study. The CAGF is a governance framework that identifies the realities of power, acknowledges the complexities of culture and emerging health technologies, and foregrounds the principle of equity for mainstream Indigenous health research.
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Macniven R, Canuto KJ, Evans JR. Facilitators and barriers to physical activity participation experienced by Aboriginal and Torres Strait Islander adults: a mixed methods systematic review protocol. JBI Evid Synth 2021; 19:1659-1667. [PMID: 33394622 DOI: 10.11124/jbies-20-00339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To synthesize the existing research about physical activity and sport facilitators and barriers experienced by Aboriginal and Torres Strait Islander adults in Australia. INTRODUCTION Physical activity and sport have cultural importance for First Nations peoples. Achieving health and broader benefits from physical activity and sport is impacted by experiences of both facilitators and barriers to participation. Identifying how to facilitate participation and overcome barriers to physical activity and sport is important to develop strategies to increase physical activity levels and sport participation among Aboriginal and Torres Strait Islander adults. Several studies have examined physical activity and sport facilitators and barriers experienced by Aboriginal and Torres Strait Islander adults, and collective synthesis of these studies can provide a more comprehensive understanding of their findings. INCLUSION CRITERIA This mixed methods systematic review will consider studies that include Aboriginal and Torres Strait Islander peoples aged 18 years and over from any setting or region of Australia. Studies will be considered if they report on facilitators and barriers to physical activity and/or sport participation. METHODS Eleven databases will be searched, as well as gray literature sources, and a selection of websites containing resources relevant to physical activity participation for Aboriginal and Torres Strait Islander adults. Studies published in English will be included. No date limits will be set. After screening the titles and abstracts of identified citations, potentially relevant studies will be retrieved in full. Study selection, critical appraisal, data extraction, and data synthesis will be undertaken according to the convergent integrated approach to mixed methods reviews. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020162134.
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Affiliation(s)
- Rona Macniven
- School of Population Health, The University of New South Wales, Sydney, NSW, Australia
- Faculty of Medicine and Health, Poche Centre for Indigenous Health, The University of Sydney, Sydney, NSW, Australia
| | - Karla J Canuto
- Wardliparingga Aboriginal Health Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - John R Evans
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
- Sydney School of Education and Social Work, The University of Sydney, Sydney, NSW, Australia
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Coyle M, Sandover S, Poobalan A, Bullen J, Cleland J. Meritocratic and fair? The discourse of UK and Australia's widening participation policies. MEDICAL EDUCATION 2021; 55:825-839. [PMID: 33346380 DOI: 10.1111/medu.14442] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/10/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Globally, people with the academic and personal attributes to successfully study medicine experience disadvantages associated with sociodemographic factors. Governments have attempted to address this issue via macrolevel policies aimed at widening participation (WP) to medicine. These policies differ by country, suggesting much can be learned from examining and comparing international policy discourses of WP. Our question was: How are discourses of WP to higher and medical education positioned in the UK and Australia? METHODS A systematic search strategy was guided by five a priori themes inspired by United Nations Sustainability Goals (2015). Seventeen policy documents (UK n = 9, Australia n = 8) published between 2008 and 2018 were identified. Analysis involved two over-arching, iterative stages: a document analysis then a Foucauldian critical discourse analysis, the latter with the aim of unveiling the power dynamics at play within policy-related discourses. RESULTS Discourses of social mobility and individual responsibility within a meritocracy are still paramount in the UK. In contrast, the dominant discourse in Australia is social accountability in achieving equity and workforce diversity, prioritising affirmative action and community values. Similarities between the two countries in terms of WP policy and policy levers have changed over time, linked to the divergence of internal drivers for societal change. Both nations recognise tensions inherent in striving to achieve both local and global goals, but Australia appears to prioritise community values in working towards 'nation building' whereas in the UK the focus on individuality and meritocracy at times seems at odds with achieving parity for disadvantaged individuals. DISCUSSION WP policies and practices are situated and contextual so caution must be taken when extrapolating lessons from one context to another. The history of a country and the nature of marginalisation in that country must be scrutinised when trying to understand what drives WP policy.
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Affiliation(s)
- Maeve Coyle
- Institute of Education in Medical and Dental Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Amudha Poobalan
- Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | | | - Jennifer Cleland
- Nanyang Technological University Singapore, Singapore, Singapore
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Atkins S, Banerjee AT, Bachynski K, Daftary A, Desai G, Gross A, Hedt-Gauthier B, Mendenhall E, Meier BM, Nixon SA, Nolan A, Palermo TM, Phelan A, Pyzik O, Roach P, Sangaramoorthy T, Standley CJ, Yamey G, Abimbola S, Pai M. Using the COVID-19 pandemic to reimagine global health teaching in high-income countries. BMJ Glob Health 2021; 6:bmjgh-2021-005649. [PMID: 33811100 PMCID: PMC8023723 DOI: 10.1136/bmjgh-2021-005649] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 03/11/2021] [Indexed: 12/12/2022] Open
Affiliation(s)
- Salla Atkins
- New Social Research and Faculty of Social Sciences, Tampere University, Tampere, Pirkanmaa, Finland.,Department of Global Public Health, Karolinska Institute, Stockholm, Stockholm County, Sweden
| | - Ananya Tina Banerjee
- School of Population and Global Health, McGill University Montreal, Montreal, Quebec, Canada
| | | | - Amrita Daftary
- Dahdaleh Institute of Global Health Research, York University, Toronto, Ontario, Canada.,CAPRISA, Durban, South Africa
| | - Gauri Desai
- Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Aeyal Gross
- Faculty of Law, Tel Aviv University, Tel Aviv, Israel
| | - Bethany Hedt-Gauthier
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Emily Mendenhall
- Edmund A Walsh School of Foreign Service, Georgetown University, Washington, District of Columbia, USA
| | - Benjamin Mason Meier
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC, USA
| | - Stephanie A Nixon
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Ann Nolan
- Trinity Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Tia M Palermo
- Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Alexandra Phelan
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | - Oksana Pyzik
- School of Pharmacy, University College London, London, UK
| | - Pamela Roach
- Departments of Family Medicine and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | | | - Claire J Standley
- Center for Global Health Science and Security, Georgetown University, Washington, District of Columbia, USA
| | - Gavin Yamey
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Seye Abimbola
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Madhukar Pai
- School of Population and Global Health, McGill University, Montreal, Quebec, Canada
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Gerrard JM, Godwin S, Chuter V, Munteanu SE, West M, Hawke F. Release of the National Scheme's Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025; the impacts for podiatry in Australia: a commentary. J Foot Ankle Res 2021; 14:38. [PMID: 33971934 PMCID: PMC8108329 DOI: 10.1186/s13047-021-00466-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/16/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Developing since colonisation, Australia's healthcare system has dismissed an ongoing and successful First Nations health paradigm in place for 60,000 years. From Captain James Cook documenting 'very old' First Nations Peoples being 'far more happier than we Europeans' and Governor Arthur Phillip naming Manly in admiration of the physical health of Gadigal men of the Eora Nation, to anthropologist Daisy Bates' observation of First Nations Peoples living 'into their eighties' and having a higher life expectancy than Europeans; our healthcare system's shameful cultural safety deficit has allowed for an Aboriginal and Torres Strait Islander child born in Australia today to expect to live 9 years less than a non-Indigenous child. Disproportionately negative healthcare outcomes including early onset diabetes-related foot disease and high rates of lower limb amputation in Aboriginal and Torres Strait Islander Peoples contribute to this gross inequity. MAIN BODY In 2020, the Australian Health Practitioner Regulation Authority released the National Scheme's Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy 2020-2025 - empowering all registered health practitioners within Australia to provide health care to Aboriginal and Torres Strait Islander Peoples that is inclusive, respectful and safe, as judged by the recipient of care. This recently released strategy is critically important to the podiatry profession in Australia. As clinicians, researchers and educators we have a collective responsibility to engage with this strategy of cultural safety. This commentary defines cultural safety for podiatry and outlines the components of the strategy in the context of our profession. Discussion considers the impact of the strategy on podiatry. It identifies mechanisms for podiatrists in all settings to facilitate safer practice, thereby advancing healthcare to produce more equitable outcomes. CONCLUSION Aboriginal and Torres Strait Islander Peoples access health services more frequently and have better health outcomes where provision of care is culturally safe. By engaging with the National Scheme's Aboriginal and Torres Strait Islander Health and Cultural Safety Strategy, all registered podiatrists in Australia can contribute to achieving equity in health outcomes for Aboriginal and Torres Strait Islander Peoples.
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Affiliation(s)
- James M Gerrard
- College of Health, Medicine and Wellbeing, School of Health Sciences, University of Newcastle, Ourimbah, NSW, 2258, Australia. .,Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086, Australia.
| | - Shirley Godwin
- Rural Department of Nursing & Midwifery, La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, 3552, Australia
| | - Vivienne Chuter
- College of Health, Medicine and Wellbeing, School of Health Sciences, University of Newcastle, Ourimbah, NSW, 2258, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - Shannon E Munteanu
- Discipline of Podiatry, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086, Australia.,La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, 3086, Australia
| | - Matthew West
- College of Health, Medicine and Wellbeing, School of Health Sciences, University of Newcastle, Ourimbah, NSW, 2258, Australia
| | - Fiona Hawke
- College of Health, Medicine and Wellbeing, School of Health Sciences, University of Newcastle, Ourimbah, NSW, 2258, Australia.,Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Ourimbah, NSW, 2258, Australia
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Balabanski AH, Dos Santos A, Woods JA, Thrift AG, Kleinig TJ, Suchy-Dicey A, Siri SR, Boden-Albala B, Krishnamurthi R, Feigin VL, Buchwald D, Ranta A, Mienna CS, Zavaleta C, Churilov L, Burchill L, Zion D, Longstreth WT, Tirschwell DL, Anand S, Parsons MW, Brown A, Warne DK, Harwood M, Katzenellenbogen JM. The Incidence of Stroke in Indigenous Populations of Countries With a Very High Human Development Index: A Systematic Review Protocol. Front Neurol 2021; 12:661570. [PMID: 33967945 PMCID: PMC8100239 DOI: 10.3389/fneur.2021.661570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Despite known Indigenous health and socioeconomic disadvantage in countries with a Very High Human Development Index, data on the incidence of stroke in these populations are sparse. With oversight from an Indigenous Advisory Board, we will undertake a systematic review of the incidence of stroke in Indigenous populations of developed countries or regions, with comparisons between Indigenous and non-Indigenous populations of the same region, though not between different Indigenous populations. Methods: Using PubMed, OVID-EMBASE, and Global Health databases, we will examine population-based incidence studies of stroke in Indigenous adult populations of developed countries published 1990-current, without language restriction. Non-peer-reviewed sources, studies including <10 Indigenous People, or with insufficient data to determine incidence, will be excluded. Two reviewers will independently validate the search strategies, screen titles and abstracts, and record reasons for rejection. Relevant articles will undergo full-text screening, with standard data extracted for all studies included. Quality assessment will include Sudlow and Warlow's criteria for population-based stroke incidence studies, the Newcastle-Ottawa Scale for risk of bias, and the CONSIDER checklist for Indigenous research. Results: Primary outcomes include crude, age-specific and/or age-standardized incidence of stroke. Secondary outcomes include overall stroke rates, incidence rate ratio and case-fatality. Results will be synthesized in figures and tables, describing data sources, populations, methodology, and findings. Within-population meta-analysis will be performed if, and where, methodologically sound and comparable studies allow this. Conclusion: We will undertake the first systematic review assessing disparities in stroke incidence in Indigenous populations of developed countries. Data outputs will be disseminated to relevant Indigenous stakeholders to inform public health and policy research.
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Affiliation(s)
- Anna H. Balabanski
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash Universit, Melbourne, VIC, Australia,Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia,*Correspondence: Anna H. Balabanski
| | - Angela Dos Santos
- Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia
| | - John A. Woods
- Western Australian Centre for Rural Health, School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Amanda G. Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash Universit, Melbourne, VIC, Australia
| | - Timothy J. Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, SA, Australia
| | - Astrid Suchy-Dicey
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Susanna Ragnhild Siri
- Department of Community Medicine, Faculty of Health Sciences, Centre for Sami Health Research, UiT the Arctic University of Norway, Tromso, Norway
| | - Bernadette Boden-Albala
- Department of Population Health and Disease Prevention, Department of Epidemiology, University of California, Irvine, Irvine, CA, United States
| | - Rita Krishnamurthi
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Valery L. Feigin
- National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, United States
| | - Annemarei Ranta
- Department of Medicine, University of Otago, Wellington, New Zealand
| | | | - Carol Zavaleta
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Leonid Churilov
- Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia
| | - Luke Burchill
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Deborah Zion
- Human Research Ethics Committee, Victoria University, Melbourne, VIC, Australia
| | - W. T. Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, United States
| | - David L. Tirschwell
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, United States
| | - Sonia Anand
- Department of Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Mark W. Parsons
- Department of Medicine and Neurology, Melbourne Brain Centre at Royal Melbourne, Melbourne, VIC, Australia,University of New South Wales (UNSW) South Western Sydney Clinical School, Liverpool, NSW, Australia
| | - Alex Brown
- Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
| | - Donald K. Warne
- School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Matire Harwood
- Te Kupenga Hauora Māori, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Gatwiri K, Rotumah D, Rix E. BlackLivesMatter in Healthcare: Racism and Implications for Health Inequity among Aboriginal and Torres Strait Islander Peoples in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094399. [PMID: 33919080 PMCID: PMC8122304 DOI: 10.3390/ijerph18094399] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/13/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022]
Abstract
Despite decades of evidence showing that institutional and interpersonal racism serve as significant barriers to accessible healthcare for Aboriginal and Torres Strait Islander Peoples, attempts to address this systemic problem still fall short. The social determinants of health are particularly poignant given the socio-political-economic history of invasion, colonisation, and subsequent entrenchment of racialised practices in the Australian healthcare landscape. Embedded within Euro-centric, bio-medical discourses, Western dominated healthcare processes can erase significant cultural and historical contexts and unwittingly reproduce unsafe practices. Put simply, if Black lives matter in healthcare, why do Aboriginal and Torres Strait Islander Peoples die younger and experience 'epidemic' levels of chronic diseases as compared to white Australians? To answer this, we utilise critical race perspectives to theorise this gap and to de-center whiteness as the normalised position of 'doing' healthcare. We draw on our diverse knowledges through a decolonised approach to promote a theoretical discussion that we contend can inform alternative ways of knowing, being, and doing in healthcare practice in Australia.
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Affiliation(s)
- Kathomi Gatwiri
- Center for Children & Young People, Faculty of Health, Southern Cross University, Gold Coast, QLD 4225, Australia
- Correspondence:
| | - Darlene Rotumah
- Gnibi College, Southern Cross University, Gold Coast, QLD 4225, Australia;
| | - Elizabeth Rix
- Faculty of Health, Southern Cross University, Gold Coast, QLD 4225, Australia;
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30
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Chakraborty A, Daniel M, Howard NJ, Chong A, Slavin N, Brown A, Cargo M. Identifying Environmental Determinants Relevant to Health and Wellbeing in Remote Australian Indigenous Communities: A Scoping Review of Grey Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084167. [PMID: 33920765 PMCID: PMC8071139 DOI: 10.3390/ijerph18084167] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/31/2022]
Abstract
The high prevalence of preventable infectious and chronic diseases in Australian Indigenous populations is a major public health concern. Existing research has rarely examined the role of built and socio-political environmental factors relating to remote Indigenous health and wellbeing. This research identified built and socio-political environmental indicators from publicly available grey literature documents locally-relevant to remote Indigenous communities in the Northern Territory (NT), Australia. Existing planning documents with evidence of community input were used to reduce the response burden on Indigenous communities. A scoping review of community-focused planning documents resulted in the identification of 1120 built and 2215 socio-political environmental indicators. Indicators were systematically classified using an Indigenous indicator classification system (IICS). Applying the IICS yielded indicators prominently featuring the "community infrastructure" domain within the built environment, and the "community capacity" domain within the socio-political environment. This research demonstrates the utility of utilizing existing planning documents and a culturally appropriate systematic classification system to consolidate environmental determinants that influence health and disease occurrence. The findings also support understanding of which features of community-level built and socio-political environments amenable to public health and social policy actions might be targeted to help reduce the prevalence of infectious and chronic diseases in Indigenous communities.
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Affiliation(s)
- Amal Chakraborty
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (M.D.); (N.J.H.); (A.B.); (M.C.)
- Research Centre for Palliative Care, Death and Dying, College of Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia
- Correspondence: ; Tel.: +61-(0)-422-473-881
| | - Mark Daniel
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (M.D.); (N.J.H.); (A.B.); (M.C.)
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia
- South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
| | - Natasha J. Howard
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (M.D.); (N.J.H.); (A.B.); (M.C.)
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Alwin Chong
- Australian Centre for Child Protection, University of South Australia, Adelaide, SA 5001, Australia;
| | - Nicola Slavin
- Environmental Health Branch, Department of Health, Northern Territory Government, Casuarina, NT 0810, Australia;
| | - Alex Brown
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (M.D.); (N.J.H.); (A.B.); (M.C.)
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Margaret Cargo
- School of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia; (M.D.); (N.J.H.); (A.B.); (M.C.)
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2601, Australia
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Bond CJ, Singh D, Tyson S. Black bodies and Bioethics: Debunking Mythologies of Benevolence and Beneficence in Contemporary Indigenous Health Research in Colonial Australia. JOURNAL OF BIOETHICAL INQUIRY 2021; 18:83-92. [PMID: 33443724 DOI: 10.1007/s11673-020-10079-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
We seek to bring Black bodies and lives into full view within the enterprise of Indigenous health research to interrogate the unquestioned good that is taken to characterize contemporary Indigenous health research. We articulate a Black bioethics that is not premised upon a false logic of beneficence, rather we think through a Black bioethics premised upon an unconditional love for the Black body. We achieve this by examining the accounts of two Black mothers, fictional and factual rendering visible the racial violence Black bodies have been subjected to. We call for a Black bioethics that reimagines the Black body as beautiful and belonging-to both someone and somewhere.
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Affiliation(s)
- Chelsea J Bond
- University of Queensland, St Lucia, Brisbane, Qld, 4072, Australia.
| | - David Singh
- University of Queensland, St Lucia, Brisbane, Qld, 4072, Australia
| | - Sissy Tyson
- The Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, Brisbane, Qld, 4072, Australia
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32
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Kevat PM, Gunnarsson R, Reeves BM, Ruben AR. Adherence rates and risk factors for suboptimal adherence to secondary prophylaxis for rheumatic fever. J Paediatr Child Health 2021; 57:419-424. [PMID: 33340191 PMCID: PMC8048926 DOI: 10.1111/jpc.15239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/19/2020] [Accepted: 10/06/2020] [Indexed: 11/28/2022]
Abstract
AIM Secondary prophylaxis with 3-4 weekly benzathine penicillin G injections is necessary to prevent disease morbidity and cardiac mortality in patients with acute rheumatic fever (ARF) and rheumatic heart disease (RHD). This study aimed to determine secondary prophylaxis adherence rates in the Far North Queensland paediatric population and to identify factors contributing to suboptimal adherence. METHODS A retrospective analysis of data recorded in the online RHD register for Queensland, Australia, was performed for a 10-year study period. The proportion of benzathine penicillin G injections delivered within intervals of ≤28 days and ≤35 days was measured. A multi-level mixed model logistic regression assessed the influence of age, gender, ethnicity, suburb, Accessibility and Remoteness Index of Australia class, number of people per dwelling, Index of Relative Socio-economic Advantage and Disadvantage, Index of Education and Occupation, year of inclusion on an ARF/RHD register and individual effect. RESULTS The study included 277 children and analysis of 7374 injections. No children received ≥80% of recommended injections within a 28-day interval. Four percent received ≥50% of injections within ≤28 days and 46% received ≥50% of injections at an extended interval of ≤35 days. Increasing age was associated with reduced delivery of injections within 35 days. Increasing year of inclusion was associated with improved delivery within 28 days. The random effect of individual patients was significantly associated with adherence. CONCLUSIONS Improved timely delivery of secondary prophylaxis for ARF and RHD is needed as current adherence is very low. Interventions should focus on factors specific to each individual child or family unit.
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Affiliation(s)
- Priya M Kevat
- College of Medicine and DentistryJames Cook UniversityCairnsQueenslandAustralia
- Clinical ServicesApunipima Cape York Health CouncilCairnsQueenslandAustralia
- Department of PaediatricsCairns and Hinterland Hospital and Health ServiceCairnsQueenslandAustralia
- The Royal Children's HospitalMelbourneVictoriaAustralia
| | - Ronny Gunnarsson
- College of Medicine and DentistryJames Cook UniversityCairnsQueenslandAustralia
- Research, Development, Education and InnovationPrimary Health CareGothenburgRegion Västra GötalandSweden
- General Practice/Family Medicine, Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Benjamin M Reeves
- Department of PaediatricsCairns and Hinterland Hospital and Health ServiceCairnsQueenslandAustralia
| | - Alan R Ruben
- Clinical ServicesApunipima Cape York Health CouncilCairnsQueenslandAustralia
- Medical Services, Torres and Cape Hospital and Health ServiceCairnsQueenslandAustralia
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Truong M, Sharif MZ. We're in This Together: A Reflection on How Bioethics and Public Health Can Collectively Advance Scientific Efforts Towards Addressing Racism. JOURNAL OF BIOETHICAL INQUIRY 2021; 18:113-116. [PMID: 33415592 DOI: 10.1007/s11673-020-10069-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 11/24/2020] [Indexed: 06/12/2023]
Abstract
Racism is a key driver of the social, political, and economic injustices that cause and maintain health inequities. Over centuries and across continents, racism has become deeply ingrained within societies. Therefore, we believe that it is our professional and ethical obligation as scientists, and public health scholars specifically, to address racism head on in order to ameliorate racialized health disparities. We argue that greater focus is needed on addressing racism rather than race and how race is described or defined. We offer input from public health scholarship to help bioethicists and other scientists contribute to addressing racism. To do so effectively and comprehensively, public health scholars, bioethicists, and other scientists should work together to identify and implement equity-driven collaborations to eliminate the deleterious effects of racism on individuals, families, and communities.
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Affiliation(s)
- Mandy Truong
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Science, Monash University, Clayton, VIC, Australia.
| | - Mienah Z Sharif
- Center for the Study of Racism, Social Justice and Health, UCLA Fielding School of Public Health, 650 Charles E. Young Drive South 21-275E CHS, Los Angeles, CA, 90095-1772, USA
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Mukandi B. Being Seen by the Doctor: A Meditation on Power, Institutional Racism, and Medical Ethics. JOURNAL OF BIOETHICAL INQUIRY 2021; 18:33-44. [PMID: 33449314 DOI: 10.1007/s11673-021-10087-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
The following pages sketch the outlines of "a Canaanite reading" of the health system. Beginning with the Black person-African, Afro-diasporic, Aboriginal, and Torres Strait Islander-who is seen by a health professional, the functions and effects of the racializing gaze are examined. I wrestle with Al Saji's understanding of "colonial disregard," Whittaker's insights into the extractive disposition of settler institutions vis-à-vis Indigenous peoples, and Saidiya Hartman and Fred Moten's struggle with the spectacular. This leads me to conclude that the situation of the Black within the health system is a tragic one. The prescription for the path out of this tragedy that I settle on, responding to Okiji's opening call, is found in Vernon Ah Kee's "Unwritten" series.
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Affiliation(s)
- Bryan Mukandi
- St Lucia Clinical Unit, Faculty of Medicine, The University of Queensland, Room 415, Building 69, St Lucia, Brisbane, QLD, 4072, Australia.
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Affiliation(s)
| | - Lilon G Bandler
- Leaders in Indigenous Medical Education (LIME) Network, University of Melbourne, Melbourne, VIC.,Royal Flying Doctor Service of Australia, Broken Hill, NSW
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Bovill M, Chamberlain C, Bennett J, Longbottom H, Bacon S, Field B, Hussein P, Berwick R, Gould G, O’Mara P. Building an Indigenous-Led Evidence Base for Smoking Cessation Care among Aboriginal and Torres Strait Islander Women during Pregnancy and Beyond: Research Protocol for the Which Way? Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1342. [PMID: 33540747 PMCID: PMC7908248 DOI: 10.3390/ijerph18031342] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/19/2021] [Accepted: 01/27/2021] [Indexed: 12/21/2022]
Abstract
Strong and healthy futures for Aboriginal and Torres Strait Islander people requires engagement in meaningful decision making which is supported by evidence-based approaches. While a significant number of research publications state the research is co-designed, few describe the research process in relation to Indigenous ethical values. Improving the health and wellbeing of Aboriginal and Torres Strait Islander mothers and babies is crucial to the continuation of the oldest living culture in the world. Developing meaningful supports to empower Aboriginal and Torres Strait Islander mothers to quit smoking during pregnancy is paramount to addressing a range of health and wellbeing outcomes. Aboriginal and Torres Strait Islander women have called for non-pharmacological approaches to smoking cessation during pregnancy. We describe a culturally responsive research protocol that has been co-designed and is co-owned with urban and regional Aboriginal communities in New South Wales. The project has been developed in line with the AH&MRC's (Aboriginal Health & Medical Research Council) updated guidelines for ethical research with Aboriginal and Torres Strait Islander communities. Ethics approvals have been granted by AH&MRC #14541662 University of Newcastle HREC H-2020-0092 and the Local Health District ethics committee 2020/ETH02095. Results will be disseminated through peer reviewed articles, community reports, infographics, and online social media content.
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Affiliation(s)
- Michelle Bovill
- School of Health and Medicine, University of Newcastle, UON, Callaghan, NSW 2308, Australia; (J.B.); (G.G.); (P.O.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | | | - Jessica Bennett
- School of Health and Medicine, University of Newcastle, UON, Callaghan, NSW 2308, Australia; (J.B.); (G.G.); (P.O.)
| | - Hayley Longbottom
- Waminda- South Coast Women’s Health and Welfare Aboriginal Coorporation, Nowra, NSW 2541, Australia;
| | - Shanell Bacon
- Nunyara Aboriginal Health Unit, Gosford, NSW 2250, Australia;
| | - Belinda Field
- Yerin-Eleanor Duncan Aboriginal Health Centre, Wyong, NSW 2259, Australia; (B.F.); (P.H.)
| | - Paul Hussein
- Yerin-Eleanor Duncan Aboriginal Health Centre, Wyong, NSW 2259, Australia; (B.F.); (P.H.)
| | - Robert Berwick
- Tamworth Aboriginal Medical Centre, Tamworth, NSW 2340, Australia;
| | - Gillian Gould
- School of Health and Medicine, University of Newcastle, UON, Callaghan, NSW 2308, Australia; (J.B.); (G.G.); (P.O.)
- Hunter Medical Research Institute, Newcastle, NSW 2305, Australia
| | - Peter O’Mara
- School of Health and Medicine, University of Newcastle, UON, Callaghan, NSW 2308, Australia; (J.B.); (G.G.); (P.O.)
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John T, Cooper WA, Wright G, Siva S, Solomon B, Marshall HM, Fong KM. Lung Cancer in Australia. J Thorac Oncol 2021; 15:1809-1814. [PMID: 33246594 DOI: 10.1016/j.jtho.2020.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Thomas John
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia.
| | - Wendy A Cooper
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, Australia; Sydney Medical School, University of Sydney, Sydney, Australia; School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Gavin Wright
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Surgery, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Shankar Siva
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Benjamin Solomon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Henry M Marshall
- Thoracic Research Centre, University of Queensland, Queensland, Australia; Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia
| | - Kwun M Fong
- Thoracic Research Centre, University of Queensland, Queensland, Australia; Thoracic Medicine, The Prince Charles Hospital, Brisbane, Australia
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Jennings W, Spurling G, Shannon B, Hayman N, Askew D. Rapid review of five years of Aboriginal and Torres Strait Islander health research in Australia - persisting under-representation of urban populations. Aust N Z J Public Health 2021; 45:53-58. [PMID: 33522668 DOI: 10.1111/1753-6405.13072] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 07/01/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To review how published Aboriginal and Torres Strait Islander health research reflects the geographical distribution of the Indigenous population of Australia. METHODS Rapid review using Lowitja Institute Lit.search tool for PubMed indexed Indigenous health research papers (January 2013 to January 2018). Geographic location, participant age, study type and recruitment site were identified for each paper. RESULTS A total of 1,258 research papers were identified: 190 (15%) focused exclusively on Indigenous people living in urban areas; 563 (45%) in rural/remote areas; and 505 (40%) spanned urban and rural/remote areas. Despite similar burdens of disease, three times as many papers were published per 1,000 DALYs for rural/remote areas than urban areas. CONCLUSIONS Indigenous health research publications have more than doubled since 2010. However, research focusing on the health needs of urban Indigenous people remains low relative to disease burden and population. Implications for public health: More research to address the health needs of Indigenous people living in urban areas is required although this should not be at the expense of research for rural and remote areas. Increased funding quarantined for Indigenous health research, coupled with self-determination of the research agenda and reporting on the geographic representativeness of research, may help address geographical inequities in research outputs.
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Affiliation(s)
- Warren Jennings
- Primary Care Clinical Unit, The University of Queensland, Royal Brisbane and Women's Hospital, Queensland.,Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland
| | - Geoffrey Spurling
- Primary Care Clinical Unit, The University of Queensland, Royal Brisbane and Women's Hospital, Queensland.,Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland
| | - Brett Shannon
- Aboriginal and Torres Strait Islander Community Health Service, Queensland.,LIME Medicolegal, Queensland
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland
| | - Deborah Askew
- Primary Care Clinical Unit, The University of Queensland, Royal Brisbane and Women's Hospital, Queensland.,Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Queensland
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Wyber R, Noonan K, Halkon C, Enkel S, Cannon J, Haynes E, Mitchell AG, Bessarab DC, Katzenellenbogen JM, Bond-Smith D, Seth R, D'Antoine H, Ralph AP, Bowen AC, Brown A, Carapetis JR. Ending rheumatic heart disease in Australia: the evidence for a new approach. Med J Aust 2020; 213 Suppl 10:S3-S31. [PMID: 33190287 DOI: 10.5694/mja2.50853] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
■The RHD Endgame Strategy: the blueprint to eliminate rheumatic heart disease in Australia by 2031 (the Endgame Strategy) is the blueprint to eliminate rheumatic heart disease (RHD) in Australia by 2031. Aboriginal and Torres Strait Islander people live with one of the highest per capita burdens of RHD in the world. ■The Endgame Strategy synthesises information compiled across the 5-year lifespan of the End Rheumatic Heart Disease Centre of Research Excellence (END RHD CRE). Data and results from priority research projects across several disciplines of research complemented literature reviews, systematic reviews and narrative reviews. Further, the experiences of those working in acute rheumatic fever (ARF) and RHD control and those living with RHD to provide the technical evidence for eliminating RHD in Australia were included. ■The lived experience of RHD is a critical factor in health outcomes. All future strategies to address ARF and RHD must prioritise Aboriginal and Torres Strait Islander people's knowledge, perspectives and experiences and develop co-designed approaches to RHD elimination. The environmental, economic, social and political context of RHD in Australia is inexorably linked to ending the disease. ■Statistical modelling undertaken in 2019 looked at the economic and health impacts of implementing an indicative strategy to eliminate RHD by 2031. Beginning in 2019, the strategy would include: reducing household crowding, improving hygiene infrastructure, strengthening primary health care and improving secondary prophylaxis. It was estimated that the strategy would prevent 663 deaths and save the health care system $188 million. ■The Endgame Strategy provides the evidence for a new approach to RHD elimination. It proposes an implementation framework of five priority action areas. These focus on strategies to prevent new cases of ARF and RHD early in the causal pathway from Streptococcus pyogenes exposure to ARF, and strategies that address the critical systems and structural changes needed to support a comprehensive RHD elimination strategy.
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Affiliation(s)
- Rosemary Wyber
- George Institute for Global Health, Sydney, NSW.,Telethon Kids Institute, Perth, WA
| | | | | | | | | | | | | | | | | | | | - Rebecca Seth
- Telethon Kids Institute, Perth, WA.,University of Western Australia, Perth, WA
| | | | | | - Asha C Bowen
- Telethon Kids Institute, Perth, WA.,Perth Children's Hospital, Perth, WA
| | - Alex Brown
- South Australian Health and Medical Research Institute, Adelaide, SA.,University of South Australia, Adelaide, SA
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Friend N, Hughes J, Kisely S, Kumar R, Siskind D. Appraisal of physical health guidelines for severe mental illness. AUST HEALTH REV 2020; 44:904-915. [PMID: 33250071 DOI: 10.1071/ah20080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/15/2020] [Indexed: 11/23/2022]
Abstract
Objectives The aim of this study was to identify current physical health guidelines for severe mental illness (SMI) and appraise them using the Appraisal of Guidelines for Research and Evaluation (AGREE) II Instrument. Methods Relevant research databases and grey literature were systematically searched to identify physical health guidelines for people with SMI. The grey literature was explored by web searches and targeted searches of the English websites of relevant peak bodies and government health agencies from Organisation for Economic Co-operation and Development countries. Included guidelines were independently appraised by two authors (NF and JH) using the AGREE II Instrument. Results Of the 5352 records screened, 33 were assessed for eligibility. Fifteen practice guidelines met the inclusion criteria. The median domain scores as rated by the AGREE II Instrument ranged from 17% to 69%. The World Health Organization guideline, which demonstrated a broad range of clinical recommendations and sound methodological rigour, was rated the best. Conclusions Most guidelines scored poorly when rated by the AGREE II Instrument. However, these guidelines may still be useful in assisting evidence-based clinical practice. The methodological rigour of future guidelines can be improved by ensuring the AGREE II domains are addressed during the development phase. What is known about the topic? Compared with the general population, people with SMI experience greater chronic disease morbidity and mortality. There is limited evidence from randomised controlled trials to guide physical health care monitoring for people with SMI. Current guidelines and practice are largely based on expert consensus, clinical experience and good intentions. What does this paper add? Using the AGREE II Instrument, this paper appraises the current physical health guidelines for people with SMI. The attributes of the guidelines examined included the evidence base, clarity of presentation, applicability in the real world, the involvement of stakeholders and conflicts of interest of various parties involved in guideline development. What are the implications for practitioners? This review highlights the scarcity of high-quality and evidence-based guidelines for clinicians and researchers to address the physical health of people with SMI.
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Affiliation(s)
- Nadia Friend
- Sunshine Coast Mental Health and Addiction Services, Maroochydore, Qld 4558, Australia.; and Corresponding author.
| | - Jade Hughes
- Metro North Mental Health Service, Royal Brisbane and Women's Hospital, Herston, Qld 4029, Australia.
| | - Steve Kisely
- University of Queensland, School of Medicine, Brisbane, Qld 4102, Australia. ;
| | - Ratika Kumar
- The University of Newcastle, Faculty of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia.
| | - Dan Siskind
- University of Queensland, School of Medicine, Brisbane, Qld 4102, Australia. ;
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Bond CJ, Whop LJ, Singh D, Kajlich H. "Now we say Black Lives Matter but … the fact of the matter is, we just Black matter to them". Med J Aust 2020; 213:248-250.e1. [PMID: 32799385 DOI: 10.5694/mja2.50727] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Lisa J Whop
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT
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More than words - ANZJPH declares an urgent call for manuscripts that address Indigenous health. Aust N Z J Public Health 2020; 44:175-176. [PMID: 32367671 DOI: 10.1111/1753-6405.12995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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