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Owais S, Ospina MB, Ford C, Hill T, Savoy CD, Van Lieshout R. Screen Time and Socioemotional and Behavioural Difficulties Among Indigenous Children in Canada: Temps d'écran et difficultés socio-émotionnelles et comportementales chez les enfants autochtones du Canada. Can J Psychiatry 2024; 69:337-346. [PMID: 38151919 DOI: 10.1177/07067437231223333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
OBJECTIVES To describe screen time levels and determine their association with socioemotional and behavioural difficulties among preschool-aged First Nations, Métis, and Inuit children. METHOD Data were taken from the Aboriginal Children's Survey, a nationally representative survey of 2-5-year-old Indigenous children in Canada. Socioemotional and behavioural difficulties were defined using parent/guardian reports on the Strengths and Difficulties Questionnaire. Multiple linear regression analyses were conducted separately for First Nations, Métis, and Inuit participants, and statistically adjusted for child age, child sex, and parent/guardian education. Statistical significance was set at P < 0.002 to adjust for multiple comparisons. RESULTS Of these 2-5-year-old children (mean [M] = 3.57 years) 3,085 were First Nations (53.5%), 2,430 Métis (39.2%), and 990 Inuit (7.3%). Screen time exposure was high among First Nations (M = 2 h and 58 min/day, standard deviation [SD] = 1.89), Métis (M = 2 h and 50 min [SD = 1.83]), and Inuit children (M = 3 h and 25 min [SD = 2.20]), with 79.7% exceeding recommended guidelines (>1 h/day). After adjusting for confounders, screen time was associated with more socioemotional and behavioural difficulties among First Nations (total difficulties β = 0.15 [95% CI, 0.12 to 0.19]) and Métis (β = 0.16 [95% CI, 0.12 to 0.20]) but not Inuit children (β = 0.12 [95% CI, 0.01 to 0.23]). CONCLUSIONS Screen time exposure is high among Indigenous children in Canada, and is associated with more socioemotional and behavioural difficulties among First Nations and Métis children. Contributing factors could include enduring colonialism that resulted in family dissolution, lack of positive parental role models, and disproportionate socioeconomic disadvantage. Predictors of poor well-being should continue to be identified to develop targets for intervention to optimize the health and development of Indigenous children.
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Affiliation(s)
| | - Maria B Ospina
- Department of Public Health Sciences, Queen's University, Kingston, Canada
| | - Camron Ford
- Bachelor of Medical Sciences Program, Western University, London, Canada
| | - Troy Hill
- McMaster Alumni Association, McMaster University, Hamilton, Canada
| | - Calan D Savoy
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Ryan Van Lieshout
- McMaster University, Hamilton, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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Ireland S, Bukulatjpi DY, Bukulatjpi ED, Gundjarraŋbuy R, Adair R, Roe Y, Moore S, Kildea S, Maypilama EḺ. Djäkamirr: Exploring principles used in piloting the training of First Nations doulas in a remote multilingual Northern Australian community setting. Women Birth 2024; 37:101573. [PMID: 38310064 DOI: 10.1016/j.wombi.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 02/05/2024]
Abstract
PROBLEM AND BACKGROUND There is growing evidence in First Nations doula care as a strategy to address perinatal inequities and improve maternal care experiences. However, there is no evidence around the approach and principals required to successfully deliver First Nations doula (childbirth) training. QUESTION/AIM To explore and describe the approach and principles used in piloting the training of First Nations doulas in remote, multilingual Northern Australian community settings. METHODS Case study with participant interviews to identify principles underpinning our Decolonising Participatory Action Research (D-PAR) approach and training delivery. FINDINGS Reflections on our D-PAR research process identified enabling principles: 1) Use of metaphors for knowledge reflexivity, 2) Accommodate cultural constructions of time 3) Practice mental agility at the Cultural Interface, 4) Advocate and address inequities, 5) Prioritise meaningful curriculums and resources, 6) Establish cross-cultural recognition and validity; and 7) Ensure continuity of First Nations culture and language. DISCUSSION The success of our doula training pilot disrupts a pervasive colonial narrative of First Nation deficit and demonstrates that respectful, genuine, and authentic partnerships can power transformative individual and collective community change. Our D-PAR approach assumes mutual learning and expertise between community and researchers. It is well suited to collaborative design and delivery of First Nations reproductive health training.
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Affiliation(s)
- Sarah Ireland
- Molly Wardaguga Research Centre and Northern Institute, Charles Darwin University, Ellengowan Drive, Darwin, Northern Territory 0999, Australia.
| | | | - Evelyn Djotja Bukulatjpi
- Yalu Aboriginal Corporation, Lot 361, Galiwin'ku via Winnellie, Northern Territory 0822, Australia
| | - Rosemary Gundjarraŋbuy
- Molly Wardaguga Research Centre and Northern Institute, Charles Darwin University, Ellengowan Drive, Darwin, Northern Territory 0999, Australia
| | - Renee Adair
- Australian Doula College, Level 5 393-233 New South Head Rd, Edgecliff, New South Wales 2027, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre and Northern Institute, Charles Darwin University, Ellengowan Drive, Darwin, Northern Territory 0999, Australia
| | - Suzanne Moore
- Molly Wardaguga Research Centre and Northern Institute, Charles Darwin University, Ellengowan Drive, Darwin, Northern Territory 0999, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre and Northern Institute, Charles Darwin University, Ellengowan Drive, Darwin, Northern Territory 0999, Australia
| | - Elaine Ḻäwurrpa Maypilama
- Molly Wardaguga Research Centre and Northern Institute, Charles Darwin University, Ellengowan Drive, Darwin, Northern Territory 0999, Australia
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Sebai I, Deaconu A, Mobetty F, Nardocci M, Ing A, Batal M. Measurement of diet quality among First Nations peoples in Canada and associations with health: a scoping review. Nutr Rev 2024; 82:695-708. [PMID: 37421656 DOI: 10.1093/nutrit/nuad073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Given the increasing number and the diversity of dietary quality indices used for research, and the differences between settings, there is a need to identify valid indices of dietary quality in different contexts and populations and to identify their associations with health-related outcomes. OBJECTIVES The primary objective of this scoping review is to identify the tools used in determining dietary quality among First Nations and to describe the changes in diet. The second objective is to describe the associations identified in studies that have measured the relationship between health and dietary quality among First Nations; and the third objective is to identify factors associated with diet quality. METHODS PubMed, Embase, CINAHL, Global Health, and Web of Science were searched from inception to June 2021 and updated in February 2022. Articles were included if the research subjects were First Nations, or if articles reported disaggregated subset data for First Nations. Eligible studies focused on nutrition and diet and were published in English or French. RESULTS A total of 151 articles were included in the analysis. Studies used several indicators to measure if individuals adhered to dietary guidelines. Traditional food consumption was frequently used as an indicator of diet quality (n = 96). The consumption of store-bought foods was used as an indicator in 28 studies. Some studies used other diet quality indicators such as the Healthy Eating Index (n = 5) and ultra-processed food "NOVA" classification (n = 6). A trend for decreasing traditional food intake over time was apparent, alongside an increase in store-bought food intake. This trend was accompanied with declining health status, including the increased prevalence of overweight and obesity, diabetes, metabolic diseases, and dental caries. CONCLUSION This scoping review showed that diet quality among First Nations is improved when traditional foods are consumed. Reduced diet quality was associated with increased risk of noncommunicable diseases.
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Affiliation(s)
- Ines Sebai
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Montreal, Canada
- TRANSNUT, Département de Nutrition, Faculté de Médecine, Université de Montréal, Montreal, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Ana Deaconu
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Montreal, Canada
- TRANSNUT, Département de Nutrition, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Fabrice Mobetty
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Montreal, Canada
- TRANSNUT, Département de Nutrition, Faculté de Médecine, Université de Montréal, Montreal, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Milena Nardocci
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Montreal, Canada
- TRANSNUT, Département de Nutrition, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Amy Ing
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Montreal, Canada
- TRANSNUT, Département de Nutrition, Faculté de Médecine, Université de Montréal, Montreal, Canada
| | - Malek Batal
- Canada Research Chair in Nutrition and Health Inequalities (CIENS), Montreal, Canada
- TRANSNUT, Département de Nutrition, Faculté de Médecine, Université de Montréal, Montreal, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
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Mushquash AR, Neufeld T, Malik I, Toombs E, Olthuis JV, Schmidt F, Dunning C, Stasiuk K, Bobinski T, Ohinmaa A, Newton A, Stewart SH. Increasing access to mental health supports for 12-17-year-old Indigenous youth with the JoyPop mobile mental health app: study protocol for a randomized controlled trial. Trials 2024; 25:234. [PMID: 38575945 PMCID: PMC10993577 DOI: 10.1186/s13063-024-08076-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Indigenous youth in Northwestern Ontario who need mental health supports experience longer waits than non-Indigenous youth within the region and when compared to youth in urban areas. Limited access and extended waits can exacerbate symptoms, prolong distress, and increase risk for adverse outcomes. Innovative approaches are urgently needed to provide support for Indigenous youth in Northwestern Ontario. Using a randomized controlled trial design, the primary objective of this study is to determine the effectiveness of the JoyPop app compared to usual practice (UP; monitoring) in improving emotion regulation among Indigenous youth (12-17 years) who are awaiting mental health services. The secondary objectives are to (1) assess change in mental health difficulties and treatment readiness between youth in each condition to better understand the app's broader impact as a waitlist tool and (2) conduct an economic analysis to determine whether receiving the app while waiting for mental health services reduces other health service use and associated costs. METHODS A pragmatic, parallel arm randomized controlled superiority trial will be used. Participants will be randomly allocated in a 1:1 ratio to the control (UP) or intervention (UP + JoyPop) condition. Stratified block randomization will be used to randomly assign participants to each condition. All participants will be monitored through existing waitlist practices, which involve regular phone calls to check in and assess functioning. Participants in the intervention condition will receive access to the JoyPop app for 4 weeks and will be asked to use it at least twice daily. All participants will be asked to complete outcome measures at baseline, after 2 weeks, and after 4 weeks. DISCUSSION This trial will evaluate the effectiveness of the JoyPop app as a tool to support Indigenous youth waiting for mental health services. Should findings show that using the JoyPop app is beneficial, there may be support from partners and other organizations to integrate it into usual care pathways. TRIAL REGISTRATION https://clinicaltrials.gov/study/NCT05898516 [registered on June 1, 2023].
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Affiliation(s)
- Aislin R Mushquash
- Department of Psychology, Lakehead University, Thunder Bay, Canada.
- Dilico Anishinabek Family Care, Fort William First Nation, Canada.
| | - Teagan Neufeld
- Department of Psychology, Lakehead University, Thunder Bay, Canada
| | - Ishaq Malik
- Department of Psychology, Lakehead University, Thunder Bay, Canada
| | - Elaine Toombs
- Department of Psychology, Lakehead University, Thunder Bay, Canada
| | - Janine V Olthuis
- Department of Psychology, University of New Brunswick, Fredericton, Canada
| | - Fred Schmidt
- Department of Psychology, Lakehead University, Thunder Bay, Canada
- Children's Centre Thunder Bay, Thunder Bay, Canada
| | | | - Kristine Stasiuk
- Dilico Anishinabek Family Care, Fort William First Nation, Canada
| | - Tina Bobinski
- Ontario Native Women's Association, Thunder Bay, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Amanda Newton
- Department of Pediatrics, University of Alberta, Edmonton, Canada
| | - Sherry H Stewart
- Departments of Psychiatry and Psychology and Neuroscience, Dalhousie University, Halifax, Canada
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Ng LY, Howarth TP, Doss AX, Charakidis M, Karanth NV, Mo L, Heraganahally SS. Significance of lung nodules detected on chest CT among adult Aboriginal Australians - a retrospective descriptive study. J Med Radiat Sci 2024. [PMID: 38516966 DOI: 10.1002/jmrs.783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/10/2024] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION There are limited data on chest computed tomography (CT) findings in the assessment of lung nodules among adult Aboriginal Australians. In this retrospective study, we assessed lung nodules among a group of adult Aboriginal Australians in the Northern Territory of Australia. METHODS Patients who underwent at least two chest CT scans between 2012 and 2020 among those referred to undergo lung function testing (spirometry) were included. Chest CT scans were assessed for the number, location, size and morphological characteristics of lung nodules. RESULTS Of the 402 chest CTs assessed, 75 patients (18.7%) had lung nodules, and 57 patients were included in the final analysis with at least two CT scans available for assessment over a median follow-up of 87 weeks. Most patients (68%) were women, with a median age of 58 years and smoking history in 83%. The majority recorded only a single nodule 43 (74%). Six patients (10%) were diagnosed with malignancy, five with primary lung cancer and one with metastatic thyroid cancer. Of the 51 (90%) patients assessed to be benign, 64 nodules were identified, of which 25 (39%) resolved, 38 (59%) remained stable and one (1.8%) enlarged on follow-up. Nodules among patients with malignancy were typically initially larger and enlarged over time, had spiculated margins and were solid, showing no specific lobar predilection. CONCLUSIONS Most lung nodules in Aboriginal Australians are likely to be benign. However, a proportion could be malignant. Further prospective studies are required for prognostication and monitoring of lung nodules in this population.
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Affiliation(s)
- Lai Yun Ng
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia
| | - Timothy P Howarth
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia
- Department of Technical Physics, University of Eastern Finland, Kuopio, Finland
- Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Northern Savo, Finland
| | - Arockia X Doss
- Department of Medical Imaging, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- Curtin Medical School, Bentley, Western Australia, Australia
| | - Michail Charakidis
- Department of Medical Oncology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Narayan V Karanth
- Department of Medical Oncology, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Lin Mo
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia
| | - Subash S Heraganahally
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
- College of Medicine and Public Health, Flinders University, Darwin, Northern Territory, Australia
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Darwin, Northern Territory, Australia
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Dick S, Wheeler K, Keating SE. Opportunities for the management of metabolic dysfunction-associated fatty liver disease within Aboriginal and Torres Strait Islander peoples. Aust N Z J Public Health 2024; 48:100138. [PMID: 38442569 DOI: 10.1016/j.anzjph.2024.100138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/22/2024] [Accepted: 02/08/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
- Sarah Dick
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Kai Wheeler
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.
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Roe Y, Allen J, Haora P, Hickey S, Briggs M, Wilkes L, Nelson C, Watego K, Coddington R, Ireland S, Kruske S, Gao Y, Kildea S. Enabling the context for Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services: Participatory action research. Women Birth 2024; 37:368-378. [PMID: 38097448 DOI: 10.1016/j.wombi.2023.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 03/05/2024]
Abstract
PROBLEM Establishment of Birthing on Country services owned and governed by Aboriginal and Torres Strait Islander Community Controlled Health Services has been slow. BACKGROUND Birthing on Country services have demonstrated health and cost benefits and require redesign of maternity care. During the Building On Our Strengths feasibility study, use of endorsed midwives and licensing of birth centres has proven difficult. QUESTION What prevents Community Controlled Health Services from implementing Birthing on Country services in Queensland and New South Wales? METHODS Participatory action research identified implementation barriers. We conducted iterative document analysis of instruments to inform government lobbying through synthesis of policy, economic, social, technological, legal, and environmental factors. FINDINGS Through cycles of participatory action research, we analysed 17 documents: 1) policy barriers prevent Community Controlled Health Services from employing endorsed midwives to provide intrapartum care in public hospitals; 2) economic barriers include lack of sustainable funding stream and inadequate Medicare-billing for endorsed midwives; and 3) legal barriers require a medical practitioner in a birth centre. While social barriers (e.g., colonisation, medicalisation) underpin regulations, these were beyond the scope; technological and environmental barriers were not identified. DISCUSSION Findings are consistent with the literature on barriers to midwifery practice. Recommendations include a national audit of barriers to Birthing on Country services including healthcare practice insurance, and development of a funding stream. Additionally, private maternity facility regulation must align with evidence on safe birth centre operation. CONCLUSION Government can address barriers to scale-up of Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services.
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Affiliation(s)
- Yvette Roe
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Jyai Allen
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia.
| | - Penny Haora
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Melanie Briggs
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia; Waminda South Coast Women's Health and Welfare Aboriginal Corporation, Nowra, Australia
| | - Liz Wilkes
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia; My Midwives, Brisbane, Australia
| | - Carmel Nelson
- Institute for Urban Indigenous Health, Brisbane, Australia
| | - Kristie Watego
- Institute for Urban Indigenous Health, Brisbane, Australia
| | - Rebecca Coddington
- Waminda South Coast Women's Health and Welfare Aboriginal Corporation, Nowra, Australia
| | - Sarah Ireland
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Yu Gao
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
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Kenny KS, Wall-Wieler E, Frank K, Courchene L, Burton M, Dreaver C, Champagne M, Nickel NC, Brownell M, Rocke C, Bennett M, Urquia ML, Anderson M. Identifying newborn discharge to child protective services: Comparing discharge codes from birth hospitalization records and child protection case files. Ann Epidemiol 2024; 91:44-50. [PMID: 38184029 DOI: 10.1016/j.annepidem.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 01/08/2024]
Abstract
PURPOSE Newborn removal by North America's child protective services (CPS) disproportionately impacts Indigenous and Black families, yet its implications for population health inequities are not well understood. To guide this as a domain for future research, we measured validity of birth hospitalization discharge codes categorizing newborns discharged to CPS. METHODS Using data from 309,260 births in Manitoba, Canada, we compared data on newborns discharged to CPS from hospital discharge codes with the presumed gold standard of custody status from CPS case reports in overall population and separately by First Nations status (categorization used in Canada for Indigenous peoples who are members of a First Nation). RESULTS Of 309,260 newborns, 4562 (1.48%) were in CPS custody at hospital discharge according to CPS case reports and 2678 (0.87%) were coded by hospitals as discharged to CPS. Sensitivity of discharge codes was low (47.8%), however codes were highly specific (99.8%) with a positive predictive value (PPV) of 81.4%, and a negative predictive value (NPV) of 99.2%. Sensitivity, PPV and specificity were equal for all newborns but NPV was lower for First Nations newborns. CONCLUSIONS Canadian hospital discharge records underestimate newborn discharge to CPS, with no difference in misclassication based on First Nations status.
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Affiliation(s)
- Kathleen S Kenny
- Manitoba Centre for Health Policy, University of Manitoba, Room 408-727 McDermot Avenue, Winnipeg R3E 3P5, Manitoba, Canada; Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg R3E 0W3, Manitoba, Canada.
| | - Elizabeth Wall-Wieler
- Manitoba Centre for Health Policy, University of Manitoba, Room 408-727 McDermot Avenue, Winnipeg R3E 3P5, Manitoba, Canada; Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg R3E 0W3, Manitoba, Canada
| | - Kayla Frank
- First Nations Family Advocate Office, 200-286 Smith Street, Winnipeg, R3C 1K4, Manitoba, Canada
| | - Lindey Courchene
- First Nations Family Advocate Office, 200-286 Smith Street, Winnipeg, R3C 1K4, Manitoba, Canada
| | - Mary Burton
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg R3E 0W3, Manitoba, Canada; Fearless R2W, PO Box 44095 Redwood Postal Outlet, Winnipeg, R2W 5M3, Manitoba, Canada
| | - Cheryle Dreaver
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg R3E 0W3, Manitoba, Canada
| | - Micheal Champagne
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg R3E 0W3, Manitoba, Canada; Fearless R2W, PO Box 44095 Redwood Postal Outlet, Winnipeg, R2W 5M3, Manitoba, Canada
| | - Nathan C Nickel
- Manitoba Centre for Health Policy, University of Manitoba, Room 408-727 McDermot Avenue, Winnipeg R3E 3P5, Manitoba, Canada; Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg R3E 0W3, Manitoba, Canada
| | - Marni Brownell
- Manitoba Centre for Health Policy, University of Manitoba, Room 408-727 McDermot Avenue, Winnipeg R3E 3P5, Manitoba, Canada; Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg R3E 0W3, Manitoba, Canada
| | - Cathy Rocke
- Faculty of Social Work, University of Regina, Education Building 456, Regina S4S 0A2, Saskatchewan, Canada
| | - Marlyn Bennett
- Faculty of Social Work, University of Calgary, 2500 University Dr NW MacKimmie Tower 301, Calgary T2N 1N4, Alberta, Canada
| | - Marcelo L Urquia
- Manitoba Centre for Health Policy, University of Manitoba, Room 408-727 McDermot Avenue, Winnipeg R3E 3P5, Manitoba, Canada; Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg R3E 0W3, Manitoba, Canada; Dalla Lana School of Public Health, Faculty of Medicine, University of Toronto, 155 College Street, Room 500, Toronto M5T 3M7, Ontario, Canada
| | - Marcia Anderson
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Room S113 - 750 Bannatyne Avenue, Winnipeg R3E 0W3, Manitoba, Canada; Ongomiizwin Indigenous Institute of Health and Healing, Rady Faculty of Health Sciences, University of Manitoba, P122 Pathology Building, 770 Bannatyne Ave, Winnipeg R3W 0W3, Manitoba, Canada
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Groot G, Marques Santos JD, Witham S, Leeder E, Carr T. "Somebody That can Meet you on Your Level:" Cancer Survivors' Perspectives on the Role of Indigenous Patient Navigators in Cancer Care. Can J Nurs Res 2024:8445621241230099. [PMID: 38373404 DOI: 10.1177/08445621241230099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Cancer incidence has increased for First Nations and Métis Peoples in Canada over recent years. Despite a growing cancer burden, there remain challenges to accessing culturally appropriate and quality care in Saskatchewan. OBJECTIVE The study aimed to explore, from cancer survivors' perspectives, the potential of Indigenous patient navigators to enhance the healthcare experiences of First Nations and Métis cancer survivors in Saskatchewan. METHODS We conducted semi-structured interviews with 19 First Nations and Métis cancer survivors. Participants were interviewed by phone between May 2022 to March 2023. Thematic analysis was conducted to generate themes, categories, and codes reflecting participants' experiences with patient navigators. RESULTS Participants reported several supports to help patients with cancer through their cancer journey, including family, community, traditional ways, and First Nations and Métis health support services. Challenges to accessing care included language and communication barriers, logistical challenges, cultural differences, financial challenges, and gaps in care. Indigenous patient navigators may play a critical role in overcoming barriers by providing communication, translation, coordination, education, advocacy, and guidance to Indigenous cancer survivors. In participants' view, the tasks of Indigenous patient navigators could vary, ranging from helping schedule appointments to advocating for the patient's treatment preferences. In addition, Indigenous patient navigators could be helpful bridging Western medicine with traditional medicine when supporting patients seeking cancer care. CONCLUSION According to study participants, Indigenous patient navigators could be beneficial to Indigenous cancer survivors in Saskatchewan.
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Affiliation(s)
- Gary Groot
- Department of Community Health and Epidemiology and Department of Surgery, University of Saskatchewan, Saskatoon, Canada
| | | | - Stephanie Witham
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
| | - Erin Leeder
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
| | - Tracey Carr
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Canada
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Anderson K, Elder-Robinson E, Ferguson M, Fredericks B, Sherriff S, Dickson M, Howard K, Garvey G. Pathways between foodways and wellbeing for first nations Australians. BMC Public Health 2024; 24:502. [PMID: 38365753 PMCID: PMC10873965 DOI: 10.1186/s12889-024-18005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/06/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Supporting the health and wellbeing of Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as First Nations peoples) is a national priority for Australia. Despite immense losses of land, language, and governance caused by the continuing impact of colonisation, First Nations peoples have maintained strong connections with traditional food culture, while also creating new beliefs, preferences, and traditions around food, which together are termed foodways. While foodways are known to support holistic health and wellbeing for First Nations peoples, the pathways via which this occurs have received limited attention. METHODS Secondary data analysis was conducted on two national qualitative datasets exploring wellbeing, which together included the views of 531 First Nations peoples (aged 12-92). Thematic analysis, guided by an Indigenist research methodology, was conducted to identify the pathways through which foodways impact on and support wellbeing for First Nations peoples. RESULTS AND CONCLUSIONS Five pathways through which wellbeing is supported via foodways for First Nations peoples were identified as: connecting with others through food; accessing traditional foods; experiencing joy in making and sharing food; sharing information about food and nutrition; and strategies for improving food security. These findings offer constructive, nationally relevant evidence to guide and inform health and nutrition programs and services to harness the strengths and preferences of First Nations peoples to support the health and wellbeing of First Nations peoples more effectively.
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Affiliation(s)
- Kate Anderson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.
| | - Elaina Elder-Robinson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Megan Ferguson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Bronwyn Fredericks
- Office of the Deputy Vice Chancellor (Indigenous Engagement), The University of Queensland, St. Lucia, QLD, Australia
- The Poche Centre for Indigenous Health, Faculty of Health and Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Simone Sherriff
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Sax Institute, Sydney, NSW, Australia
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Dickson
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Eurich DT, Wozniak LA, Soprovich A, Lee C, Minhas-Sandhu JK, Crowshoe L, Johnson JA, Samanani S. Effectiveness of RADAR on diabetes processes of care for First Nations communities in Alberta, Canada. Prim Care Diabetes 2024; 18:104-107. [PMID: 37951724 DOI: 10.1016/j.pcd.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/29/2023] [Accepted: 11/07/2023] [Indexed: 11/14/2023]
Abstract
The epidemic of type-2 diabetes in First Nations communities is tragic. Culturally-appropriate approaches addressing multiple components, focusing beyond glycemic control, are urgently needed. Using an intention-to-treat framework, 13 processes of care indicators were assessed to compare proportions of patients who received care at baseline relative to 2-year follow-up. Clinical improvements were demonstrated across major process of care indicators (e.g. screening, education, and vaccination activities). We found RADAR improved reporting for most diabetes processes of care across seven FN communities and was effective in supporting diabetes care for FN communities, in Alberta Canada.
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Affiliation(s)
- Dean T Eurich
- School of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Alliance for Canadian Health Outcomes Research in Diabetes, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada.
| | - Lisa A Wozniak
- School of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Alliance for Canadian Health Outcomes Research in Diabetes, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
| | - Allison Soprovich
- School of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Alliance for Canadian Health Outcomes Research in Diabetes, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
| | - Cerina Lee
- School of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Alliance for Canadian Health Outcomes Research in Diabetes, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
| | - Jasjeet K Minhas-Sandhu
- School of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Alliance for Canadian Health Outcomes Research in Diabetes, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
| | - Lynden Crowshoe
- Cumming School of Medicine & Indigenous, Local and Global Health Office, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1, Canada
| | - Jeffrey A Johnson
- School of Public Health, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; Alliance for Canadian Health Outcomes Research in Diabetes, 2-040 Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada
| | - Salim Samanani
- OKAKI Health Intelligence Inc., P.O. Box 84210 Market Mall, Calgary, Alberta T3A 5C4, Canada
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De La Sablonnière-Griffin M, Collin-Vézina D, Esposito T, Dion J. Recurrent child protection post-investigation services for First Nations children in the province of Quebec. Child Abuse Negl 2024; 148:106243. [PMID: 37258368 DOI: 10.1016/j.chiabu.2023.106243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/12/2023] [Accepted: 05/10/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND The longitudinal trajectory of Indigenous children within child protection (CP) services, including their recurrent involvement, has yet to be documented. OBJECTIVES 1) To document whether First Nations children were at increased risk of a first recurrence of post-investigation CP services compared to children from the majority group. 2) To identify the characteristics associated with recurrence for First Nations children, and to compare these results to those for children from the majority group. METHOD Anonymized CP administrative data (2002-2014; n = 1150) of a region in the province of Quebec were used to conduct Cox proportional hazards modeling, in partnership with an advisory committee. RESULTS The risk of recurrence of First Nations children did not significantly differ from the risk for children from the majority group (HR: 0.980, n.s.) while controlling for covariates. Among First Nations children (n = 459), being under two at the case closure (HR: 2.718, p < .05), having received short-term intervention (HR: 5.027, p < .001) and coming from a family already known to the CP agency (HR: 2.023, p < .001) were associated with an increased risk of recurrence. CONCLUSIONS The findings highlight the importance of studying First Nations children's trajectories within CP services as a group deserving full attention and for First Nations to be able to design or demand appropriate services responding to their population's needs. A family-based research perspective is recommended to understand better the full family history leading to and in relation to CP services, which could provide more sound practice recommendations.
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Affiliation(s)
- Mireille De La Sablonnière-Griffin
- INRS-UQAT Joint Research Unit in Indigenous Studies, Urbanisation Culture Société Research Centre, Institut national de la recherche scientifique, Val-d'Or, Quebec, Canada.
| | | | - Tonino Esposito
- Canada Research Chair in Social Services for Vulnerable Children, School of Social Work, Université de Montréal, Montreal, Quebec, Canada.
| | - Jacinthe Dion
- Department of Health Sciences, Université du Québec à Chicoutimi, Saguenay, Quebec, Canada.
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13
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Hamel-Charest L. Non-Indigenous and Indigenous food-related interactions: How does the transmission of a normativity perpetuate colonialism? Can J Public Health 2024; 115:80-88. [PMID: 38052883 PMCID: PMC10868566 DOI: 10.17269/s41997-023-00834-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/02/2023] [Indexed: 12/07/2023]
Abstract
OBJECTIVES Type 2 diabetes has been considered an epidemic among Indigenous Peoples in Canada. They also suffer more from obesity than non-Indigenous people in the country, a condition that is considered an epidemic worldwide. Various public health and social services professionals are working in Indigenous communities across the country to raise awareness about certain lifestyle habits. The main objective of this article is to analyze the food normativity transmitted to an Indigenous population and to examine its reception. More specifically, the aim is to understand the opportunities of transmission (content and format) and the relational dynamics that these encounters between mostly non-Indigenous professionals and Indigenous Peoples imply. METHOD The analysis is based on an ethnographic fieldwork in the Anicinabe community of Lac Simon (Abitibi, Quebec). Conducted with a relational approach, interviews and participant observation were carried out. RESULTS It appears that the Anicinabek have a great knowledge of the "good" eating habits as defined by a biomedical food normativity. A reflexive analysis of my presence in the community as a non-Indigenous anthropologist and an analysis of the Anicinabek's responses to food recommendations lead me to argue that a form of food colonialism, inscribed in welfare (assistance) colonialism, persists while food surveillance seems to be integrated by the Anicinabek. This food normativity is the bearer of a biomedical conception of food and the colonial history of the country colours its transmission to Indigenous Peoples. CONCLUSION Greater autonomy, namely Indigenous food sovereignty, seems necessary to deconstruct this food assistance structure.
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Affiliation(s)
- Laurence Hamel-Charest
- Département d'études urbaines et touristiques, Université du Québec à Montréal, Montréal, QC, Canada.
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Kerrigan V, McGrath SY, Doig C, Herdman RM, Daly S, Puruntatameri P, Lee B, Hefler M, Ralph AP. Evaluating the impact of 'Ask the Specialist Plus': a training program for improving cultural safety and communication in hospital-based healthcare. BMC Health Serv Res 2024; 24:119. [PMID: 38254093 PMCID: PMC10804863 DOI: 10.1186/s12913-024-10565-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND First Nations peoples in colonised countries often feel culturally unsafe in hospitals, leading to high self-discharge rates, psychological distress and premature death. To address racism in healthcare, institutions have promised to deliver cultural safety training but there is limited evidence on how to teach cultural safety. To that end, we created Ask the Specialist Plus: a training program that focuses on improving healthcare providers intercultural communication skills to improve cultural safety. Our aim is to describe training implementation and to evaluate the training according to participants. METHODS Inspired by cultural safety, Critical Race Theory and Freirean pedagogy, Ask the Specialist Plus was piloted at Royal Darwin Hospital in Australia's Northern Territory in 2021. The format combined listening to an episode of a podcast called Ask the Specialist with weekly, one-hour face-to-face discussions with First Nations Specialists outside the clinical environment over 7 to 8 weeks. Weekly surveys evaluated teaching domains using five-point Likert scales and via free text comments. Quantitative data were collated in Excel and comments were collated in NVivo12. Results were presented following Kirkpatrick's evaluation model. RESULTS Fifteen sessions of Ask the Specialist Plus training were delivered. 90% of participants found the training valuable. Attendees enjoyed the unique format including use of the podcast as a catalyst for discussions. Delivery over two months allowed for flexibility to accommodate clinical demands and shift work. Students through to senior staff learnt new skills, discussed institutionally racist systems and committed to behaviour change. Considering racism is commonly denied in healthcare, the receptiveness of staff to discussing racism was noteworthy. The pilot also contributed to evidence that cultural safety should be co-taught by educators who represent racial and gender differences. CONCLUSION The Ask the Specialist Plus training program provides an effective model for cultural safety training with high potential to achieve behaviour change among diverse healthcare providers. The training provided practical information on how to improve communication and fostered critical consciousness among healthcare providers. The program demonstrated that training delivered weekly over two months to clinical departments can lead to positive changes through cycles of learning, action, and reflection.
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Affiliation(s)
- Vicki Kerrigan
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia.
| | - Stuart Yiwarr McGrath
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Cassandra Doig
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Rarrtjiwuy Melanie Herdman
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Shannon Daly
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Pirrawayingi Puruntatameri
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Bilawara Lee
- Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Marita Hefler
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
| | - Anna P Ralph
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, NT, 0811, Australia
- Royal Darwin Hospital, Darwin, NT, 0811, Australia
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15
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Morisano D, Robinson M, Rush B, Linklater R. Conducting research with Indigenous Peoples in Canada: ethical and policy considerations. Front Psychol 2024; 14:1214121. [PMID: 38356990 PMCID: PMC10866143 DOI: 10.3389/fpsyg.2023.1214121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 12/13/2023] [Indexed: 02/16/2024] Open
Abstract
The international context of Indigenous mental health and wellbeing has been shaped by a number of key works recognizing Indigenous rights. Despite international recognitions, the mental health and wellness of Indigenous Peoples continues to be negatively affected by policies that ignore Indigenous rights, that frame colonization as historical rather than ongoing, or that minimize the impact of assimilation. Research institutions have a responsibility to conduct ethical research; yet institutional guidelines, principles, and policies often serve Indigenous Peoples poorly by enveloping them into Western knowledge production. To counter epistemological domination, Indigenous Peoples assert their research sovereignty, which for the purposes of this paper we define as autonomous control over research conducted on Indigenous territory or involving Indigenous Peoples. Indigenous sovereignty might also be applied to research impacting the landscape and the web of animal and spiritual lives evoked in a phrase such as "all my relations." This narrative review of material developed in the Canadian context examines the alignment with similar work in the international context to offer suggestions and a practice-based implementation tool to support Indigenous sovereignty in research related to wellness, mental health, and substance use. The compilation of key guidelines and principles in this article is only a start; addressing deeper issues requires a research paradigm shift.
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Affiliation(s)
- Dominique Morisano
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Ottawa, Ottawa, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Margaret Robinson
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Departments of English and Sociology & Social Anthropology, Dalhousie University, Halifax, NS, Canada
| | - Brian Rush
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Renee Linklater
- Shkaabe Makwa, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Karunanayake CP, Pahwa P, Kirychuk S, Fenton M, Ramsden VR, Seeseequasis J, Seesequasis W, Skomro R, Rennie DC, McMullin K, Russell BP, Koehncke N, Abonyi S, King M, Dosman JA. Sleep Efficiency and Sleep Onset Latency in One Saskatchewan First Nation. Clocks Sleep 2024; 6:40-55. [PMID: 38247884 PMCID: PMC10801613 DOI: 10.3390/clockssleep6010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Sleep efficiency and sleep onset latency are two measures that can be used to assess sleep quality. Factors that are related to sleep quality include age, sex, sociodemographic factors, and physical and mental health status. This study examines factors related to sleep efficiency and sleep onset latency in one First Nation in Saskatchewan, Canada. METHODS A baseline survey of the First Nations Sleep Health project was completed between 2018 and 2019 in collaboration with two Cree First Nations. One-night actigraphy evaluations were completed within one of the two First Nations. Objective actigraphy evaluations included sleep efficiency and sleep onset latency. A total of 167 individuals participated, and of these, 156 observations were available for analysis. Statistical analysis was conducted using logistic and linear regression models. RESULTS More females (61%) than males participated in the actigraphy study, with the mean age being higher for females (39.6 years) than males (35.0 years). The mean sleep efficiency was 83.38%, and the mean sleep onset latency was 20.74 (SD = 27.25) minutes. Age, chronic pain, ever having high blood pressure, and smoking inside the house were associated with an increased risk of poor sleep efficiency in the multiple logistic regression model. Age, chronic pain, ever having anxiety, heart-related illness, and smoking inside the house were associated with longer sleep onset latency in the multiple linear regression model. CONCLUSIONS Sleep efficiency and sleep onset latency were associated with physical and environmental factors in this First Nation.
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Affiliation(s)
- Chandima P. Karunanayake
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
| | - Punam Pahwa
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (S.A.); (M.K.)
| | - Shelley Kirychuk
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Mark Fenton
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Vivian R. Ramsden
- Department of Academic Family Medicine, University of Saskatchewan, West Winds Primary Health Centre, 3311 Fairlight Drive, Saskatoon, SK S7M 3Y5, Canada;
| | - Jeremy Seeseequasis
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
| | | | - Robert Skomro
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Donna C. Rennie
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada;
| | - Kathleen McMullin
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
| | - Brooke P. Russell
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
| | - Niels Koehncke
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
| | - Sylvia Abonyi
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (S.A.); (M.K.)
| | - Malcolm King
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada; (S.A.); (M.K.)
| | - James A. Dosman
- Canadian Centre for Rural and Agricultural Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada; (P.P.); (S.K.); (J.S.); (K.M.); (B.P.R.); (N.K.); (J.A.D.)
- Department of Medicine, University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, SK S7N 0W8, Canada; (M.F.); (R.S.)
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Jessop S, Hill S, Bicanin K, Day T, Turner J, O'Connell M, Highfold R, Revesz T. Aboriginal children with cancer: The patient and healthcare worker perspective. Pediatr Blood Cancer 2024; 71:e30747. [PMID: 37880841 DOI: 10.1002/pbc.30747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/10/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Abstract
There are inequitable health outcomes for Aboriginal children with cancer. A quality improvement audit performed at our institution through interviews with families and healthcare workers has highlighted individual, systematic and cultural barriers to equitable and culturally safe healthcare for Aboriginal patients, in addition to facilitators and recommendations for improvements.
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Affiliation(s)
- Sophie Jessop
- Department of Haematology and Oncology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
- University of Adelaide, North Adelaide, South Australia, Australia
| | - Shandelle Hill
- Department of Haematology and Oncology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Kon Bicanin
- Department of Haematology and Oncology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Tanya Day
- Aboriginal Health Division, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Jess Turner
- Taikurrinthi Aboriginal Liaison Office, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Megan O'Connell
- Taikurrinthi Aboriginal Liaison Office, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Rose Highfold
- Taikurrinthi Aboriginal Liaison Office, Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Tom Revesz
- Department of Haematology and Oncology, Women's and Children's Hospital, North Adelaide, South Australia, Australia
- University of Adelaide, North Adelaide, South Australia, Australia
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Grosman S, Tesiram J, Hayman N, Benham H. Rheumatology specialist care delivered at the Southern QLD Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care. Intern Med J 2024; 54:115-120. [PMID: 37255053 DOI: 10.1111/imj.16144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/15/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND There is limited literature on the prevalence of rheumatologic conditions in Australian First Nations people. Existing evidence suggests a high disease burden with poorer outcomes. In 2016 a rheumatology clinic was established at The Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (CoE). AIMS To improve knowledge of rheumatic diseases presentations in an urban First Nations cohort and to assess the effectiveness of the CoE clinic. METHODS Data on attendance, diagnosis, treatment and demographics were obtained retrospectively from clinical records at the CoE from 2016 to 2020. Administrative attendance data for the largest public general rheumatology clinic in the region for the 4 years preceding the establishment of the CoE clinic were used as a historic cohort control. RESULTS A cohort of 93 patients was seen at the CoE with 439 appointments compared to 207 in the historical control. Common diagnoses were osteoarthritis (24%), seropositive rheumatoid arthritis (17%), gout (13%) and spondyloarthropathies (10%). Forty per cent of the cohort at CoE were treated with at least one disease-modifying antirheumatic drug (DMARD) and 12% with a biologic or targeted synthetic DMARD. Seventy-five per cent of appointments were attended versus 71% in control group. Adjusted odds ratio of attendance was 1.35 (P = 0.07). CONCLUSIONS Provision of rheumatology specialty care in an urban primary health setting aimed specifically at the needs of First Nations people led to increased uptake and engagement. A broad range of rheumatologic diagnoses was made and significant DMARD treatments commenced.
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Affiliation(s)
- Sergei Grosman
- Rheumatology Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Joanne Tesiram
- Rheumatology Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Noel Hayman
- Centre of Excellence Inala Southern QLD in Aboriginal and Torres Strait Islander Primary Health Care, Inala, Queensland, Australia
| | - Helen Benham
- Rheumatology Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
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Letendre A, Shewchuk B, Healy BA, Chiang B, Bill L, Newsome J, Rahul CR, Yang H, Kopciuk KA. Assessing Breast Cancer Screening and Outcomes Among First Nations Women in Alberta. Cancer Control 2024; 31:10732748241230763. [PMID: 38299564 PMCID: PMC10836128 DOI: 10.1177/10732748241230763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Breast cancer (BC) incidence rates for First Nations (FN) women in Canada have been steadily increasing and are often diagnosed at a later stage. Despite efforts to expand the reach of BC screening programs for FN populations in Alberta (AB), gaps in screening and outcomes exist. METHODS Existing population-based administrative databases including the AB BC Screening Program, the AB Cancer Registry, and an AB-specific FN registry data were linked to evaluate BC screening participation, detection, and timeliness of outcomes in this retrospective study. Tests of proportions and trends compared the findings between FN and non-FN women, aged 50-74 years, beginning in 2008. Incorporation of FN principles of ownership, control, access, and possession (OCAP®) managed respectful sharing and utilization of FN data and findings. RESULTS The average age-standardized participation (2013-8) and retention rates (2015-6) for FN women compared to non-FN women in AB were 23.8% (P < .0001) and 10.3% (P = .059) lower per year, respectively. FN women were diagnosed with an invasive cancer more often in Stage II (P-value = .02). Following 90% completion of diagnostic assessments, it took 2-4 weeks longer for FN women to receive their first diagnosis as well as definitive diagnoses than non-FN women. CONCLUSION Collectively, these findings suggest that access to and provision of screening services for FN women may not be equitable and may contribute to higher BC incidence and mortality rates. Collaborations between FN groups and screening programs are needed to eliminate these inequities to prevent more cancers in FN women.
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Affiliation(s)
- Angeline Letendre
- Public Health Evidence & Innovation, Provincial, Population and Public Health, Alberta Health Services, Edmonton, AB, Canada
| | - Brittany Shewchuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Bonnie A Healy
- Siksikaitsitapi - Blackfoot Confederacy Tribal Council, Calgary, AB, Canada
| | - Bonnie Chiang
- Screening Programs, Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Lea Bill
- Alberta First Nations Information Governance Centre, Calgary, AB, Canada
| | - James Newsome
- Screening Programs, Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Chinmoy Roy Rahul
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB, Canada
| | - Huiming Yang
- Screening Programs, Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Karen A Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Oncology, University of Calgary, Calgary, AB, Canada
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20
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Sarovich E, Lowrie D, Geia L, Kris S, Cairns A. Different meanings… what we want in our lives… a qualitative exploration of the experience of Aboriginal and/or Torres Strait Islander peoples in a co-designed community rehabilitation service. Disabil Rehabil 2024; 46:354-361. [PMID: 36576264 DOI: 10.1080/09638288.2022.2161645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/17/2022] [Indexed: 12/29/2022]
Abstract
PURPOSE Promoting positive psychological, social and functional health outcomes for Aboriginal and Torres Strait Islander people requires health services to be culturally safe, respecting culture as central to the individuals and their communities. This study explored the experience of Aboriginal and Torres Strait Islander people, participating in a co-designed student-assisted community rehabilitation service in a remote Aboriginal community in Far North Queensland. MATERIALS AND METHODS Observation, informal yarning and semi-structured interviews with older Aboriginal and Torres Strait Islander people (n = 6) engaged in the service was conducted over a 7 week period. Interpretive phenomenological analysis was applied through inductive thematic analysis. RESULTS Four themes illustrated that experiences within the program promoted: A connection to people, both within the program and those significant in people's lives; a connection to past experiences, roles and events; a connection to the future of cultural knowledge; and a sense of achievement and fun. Participants shared their unique stories on their positive experience of the culturally responsive approach in the activities. CONCLUSIONS These results suggest that knowledge translation and reciprocity provide a strong foundation for rehabilitation programs that support healthy ageing for Aboriginal and Torres Strait Islander people and encourage active and ongoing individual and community involvement.
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Affiliation(s)
- Emma Sarovich
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Daniel Lowrie
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Lynore Geia
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Sylvia Kris
- College of Healthcare Sciences, James Cook University, Weipa, Australia
| | - Alice Cairns
- College of Healthcare Sciences, James Cook University, Townsville, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
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21
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Monteith H, Mamakeesick M, Rae J, Galloway T, Harris SB, Birken C, Hamilton J, Maguire JL, Parkin P, Zinman B, Hanley AJG. Determinants of Anishinabeck infant and early childhood growth trajectories in Northwestern Ontario, Canada: a cohort study. BMC Pediatr 2023; 23:641. [PMID: 38115010 PMCID: PMC10729431 DOI: 10.1186/s12887-023-04449-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/29/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The Developmental Origins of Health and Disease (DOHaD) paradigm emphasizes the significance of early life factors for the prevention of chronic health conditions, like type 2 diabetes (T2DM) and obesity, which disproportionately affect First Nations communities in Canada. Despite increasing DOHaD research related to maternal health during pregnancy, early childhood growth patterns, and infant feeding practices with many populations, data from First Nations communities in Canada are limited. In partnership with Sandy Lake First Nation, the aims of this project were to characterize birthweights and growth patterns of First Nations infants/children over the first 6 years of life and to study the impact of maternal and infant social and behavioral factors on birthweight and growth trajectories. METHODS We recruited 194 families through community announcements and clinic visits. Infant/child length/height and weight were measured at 1 and 2 weeks; 1, 2, 6, 12, and 18 months; and 2, 3, 4, 5 and 6 years. Maternal and infant/child questionnaires captured data about health, nutrition, and social support. Weight-for-Age z-score (WAZ), Height-for-Age z-score (HAZ), and BMI-for-Age z-score (BAZ) were calculated using WHO reference standards and trajectories were analyzed using generalized additive models. Generalized estimating equations and logistic regression were used to determine associations between exposures and outcomes. RESULTS WAZ and BAZ were above the WHO mean and increased with age until age 6 years. Generalized estimating equations indicated that WAZ was positively associated with age (0.152; 95% CI 0.014, 0.29), HAZ was positively associated with birthweight (0.155; 95% CI 0.035, 0.275), and BAZ was positively associated with caregiver's BMI (0.049; 95% CI 0.004, 0.090). There was an increased odds of rapid weight gain (RWG) with exposure to gestational diabetes (OR: 7.47, 95% CI 1.68, 46.22). Almost 70% of parents initiated breastfeeding, and breastfeeding initiation was modestly associated with lower WAZ (-0.18; 95% CI -0.64, 0.28) and BAZ (-0.23; 95% CI -0.79, 0.34). CONCLUSIONS This work highlights early life factors that may contribute to T2DM etiology and can be used to support community and Indigenous-led prevention strategies.
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Affiliation(s)
- Hiliary Monteith
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5253A, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | | | - Joan Rae
- Sandy Lake First Nation, Sandy Lake, ON, P0V 1V0, Canada
| | - Tracey Galloway
- Department of Anthropology, University of Toronto Mississauga Campus, Terrence Donnelly Health Sciences Complex, Room 354, 3359 Mississauga Rd, Mississauga, ON, L5L 1C6, Canada
| | - Stewart B Harris
- Schulich School of Medicine and Dentistry, Western Centre for Public Health & Family Medicine, Western University, 1465 Richmond St, London, N6G 2M1, ON, Canada
| | - Catherine Birken
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5271, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Jill Hamilton
- Division of Endocrinology, Hospital for Sick Children, Department of Nutritional Sciences, University of Toronto, 555 University Ave, Toronto, ON, M5S 1X8, Canada
| | - Jonathon L Maguire
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5271, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Patricia Parkin
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5271, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Bernard Zinman
- Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, 600 University Ave, Toronto, ON, M5G 1X5, Canada
| | - Anthony J G Hanley
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, University of Toronto Medical Sciences Building, 5Th Floor, Room 5253A, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
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22
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Gibbs M, Ross P, Scanes E, Gibbs J, Rotolo-Ross R, Parker L. Extending conservation of coastal and oyster reef restoration for First Nations cultural revitalization. Conserv Biol 2023; 37:e14158. [PMID: 37489094 DOI: 10.1111/cobi.14158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 06/27/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Mitchell Gibbs
- Dunghutti Nation, Schools of History and Philosophy of Science and Geosciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Pauline Ross
- School of Life and Environmental Sciences, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Elliot Scanes
- Climate Change Cluster, University of Technology, Sydney, New South Wales, Australia
| | - James Gibbs
- Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Raphaela Rotolo-Ross
- Faculty of Arts and Social Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Laura Parker
- Wiradjuri Nation, School of Biological, Earth and Environmental Sciences, The University of New South Wales, Sydney, New South Wales, Australia
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23
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Snoswell CL, Vitangcol KJ, Haydon HM, Gray LC, Leedie F, Smith AC, Caffery LJ. Cost-effectiveness of remote patient monitoring for First Nations peoples living with diabetes in regional Australia. J Telemed Telecare 2023; 29:3S-7S. [PMID: 38007695 DOI: 10.1177/1357633x231214019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2023]
Abstract
The aim of this study was to determine the cost-effectiveness of remote patient monitoring (RPM) with First Nations peoples living with diabetes. This study was set at the Goondir Health Service (GHS), an Aboriginal and Torres Strait Islander Community-Controlled Health in South-West Queensland. Electronic medical records and RPM data were provided by the GHS. Clinical effectiveness was determined by comparing mean HbA1c before and after enrolment in the RPM service. Our analysis found no statistically significant effect between the mean HbA1c before and after enrolment, so this analysis focused on net-benefit and return on investment for costs from the perspective of the GHS. The 6-month RPM service for 84 clients cost AUD $67,841 to cover RPM equipment, ongoing technology costs, and a dedicated Virtual Care Manager, equating to $808 per client. There were 199 additional client-clinician interactions in the period after enrolment resulting in an additional $4797 revenue for the GHS. Therefore, the program cost the GHS $63,044 to deliver, representing a return on investment of around 7 cents for every dollar they spent. Whilst the diabetes RPM service was equally effective as usual care and resulted in increased interactions with clients, the cost for the service was substantially more than the additional revenue generated from increased interactions. This evidence highlights the need for alternative funding models for RPM services and demonstrates the need to focus future research on long-term clinical effects and the extra-clinical benefits resulting from services of this type.
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Affiliation(s)
- Centaine L Snoswell
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Kathryn J Vitangcol
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Helen M Haydon
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Leonard C Gray
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | | | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
- Centre for Innovative Medical Technology, University of Southern Denmark, Odense, Denmark
| | - Liam J Caffery
- Centre for Online Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
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24
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Stalwick JA, Ratelle M, Gurney KEB, Drysdale M, Lazarescu C, Comte J, Laird B, Skinner K. Sources of exposure to lead in Arctic and subarctic regions: a scoping review. Int J Circumpolar Health 2023; 82:2208810. [PMID: 37196187 DOI: 10.1080/22423982.2023.2208810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 05/19/2023] Open
Abstract
Understanding lead exposure pathways is a priority because of its ubiquitous presence in the environment as well as the potential health risks. We aimed to identify potential lead sources and pathways of lead exposure, including long-range transport, and the magnitude of exposure in Arctic and subarctic communities. A scoping review strategy and screening approach was used to search literature from January 2000 to December 2020. A total of 228 academic and grey literature references were synthesised. The majority of these studies (54%) were from Canada. Indigenous people in Arctic and subarctic communities in Canada had higher levels of lead than the rest of Canada. The majority of studies in all Arctic countries reported at least some individuals above the level of concern. Lead levels were influenced by a number of factors including using lead ammunition to harvest traditional food and living in close proximity to mines. Lead levels in water, soil, and sediment were generally low. Literature showed the possibility of long-range transport via migratory birds. Household lead sources included lead-based paint, dust, or tap water. This literature review will help to inform management strategies for communities, researchers, and governments, with the aim of decreasing lead exposure in northern regions.
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Affiliation(s)
- Jordyn A Stalwick
- Environment and Climate Change Canada, Science and Technology Branch, Prairie and Northern Wildlife Research Centre, Saskatoon, Canada
| | - Mylène Ratelle
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Kirsty E B Gurney
- Environment and Climate Change Canada, Science and Technology Branch, Prairie and Northern Wildlife Research Centre, Saskatoon, Canada
| | - Mallory Drysdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Calin Lazarescu
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Jérôme Comte
- Institut National de Recherche Scientifique (INRS), Eau Terre Environnement Centre, Québec, Canada
| | - Brian Laird
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Kelly Skinner
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
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25
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Orr PH, McMullin K, Larcombe L. The Medicine Wheel: informing the management of tuberculosis outbreaks in Indigenous communities. Int J Circumpolar Health 2023; 82:2269678. [PMID: 37898997 PMCID: PMC10997302 DOI: 10.1080/22423982.2023.2269678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/07/2023] [Indexed: 10/31/2023] Open
Abstract
Many Indigenous communities in Canada experience endemic tuberculosis with superimposed periodic epidemic outbreaks. Failures in outbreak management have resulted in the "seeding" of future infection and disease. In this paper we present a model that may be used in planning, implementation and review of tuberculosis outbreak management in Cree Indigenous communities in Canada, based on the Medicine Wheel, a paradigm for holistic living. In the context of tuberculosis management, the Medicine Wheel provides a path for the establishment of respectful cross-cultural relationships, the expression of values through action, true community engagement and partnership, and the establishment of culture-based processes of transparency, accountability and change.
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Affiliation(s)
- Pamela H. Orr
- Departments of Internal Medicine, Medical Microbiology and Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Kathleen McMullin
- College of Medicine, University of Saskatchewan; Member, Lac LaRonge Indian Band, Saskatchewan, Canada
| | - Linda Larcombe
- Departments of Internal Medicine, Medical Microbiology and Community Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Anthropology, University of Manitoba, Winnipeg, Canada
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Crooks K, Taylor K, Burns K, Campbell S, Degeling C, Williams J, Andrews R, Massey P, McVernon J, Miller A. Having a real say: findings from first nations community panels on pandemic influenza vaccine distribution. BMC Public Health 2023; 23:2377. [PMID: 38037021 PMCID: PMC10691077 DOI: 10.1186/s12889-023-17262-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/18/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Recent deliberations by Australian public health researchers and practitioners produced an ethical framework of how decisions should be made to distribute pandemic influenza vaccine. The outcome of the deliberations was that the population should be considered in two categories, Level 1 and Level 2, with Level 1 groups being offered access to the pandemic influenza vaccine before other groups. However, the public health researchers and practitioners recognised the importance of making space for public opinion and sought to understand citizens values and preferences, especially First Nations peoples. METHODS We conducted First Nations Community Panels in two Australian locations in 2019 to assess First Nations people's informed views through a deliberative process on pandemic influenza vaccination distribution strategies. Panels were asked to make decisions on priority levels, coverage and vaccine doses. RESULTS Two panels were conducted with eighteen First Nations participants from a range of ages who were purposively recruited through local community networks. Panels heard presentations from public health experts, cross-examined expert presenters and deliberated on the issues. Both panels agreed that First Nations peoples be assigned Level 1 priority, be offered pandemic influenza vaccination before other groups, and be offered two doses of vaccine. Reasons for this decision included First Nations people's lives, culture and families are important; are at-risk of severe health outcomes; and experience barriers and challenges to accessing safe, quality and culturally appropriate healthcare. We found that communication strategies, utilising and upskilling the First Nations health workforce, and targeted vaccination strategies are important elements in pandemic preparedness and response with First Nations peoples. CONCLUSIONS First Nations Community Panels supported prioritising First Nations peoples for pandemic influenza vaccination distribution and offering greater protection by using a two-dose full course to fewer people if there are initial supply limitations, instead of one dose to more people, during the initial phase of the vaccine roll out. The methodology and findings can help inform efforts in planning for future pandemic vaccination strategies for First Nations peoples in Australia.
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Affiliation(s)
- Kristy Crooks
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, Australia.
- Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia.
| | - Kylie Taylor
- Population Health, Hunter New England Local Health District, Tamworth, NSW, Australia
| | - Kiara Burns
- Wuchopperen Health Service, Cairns, QLD, Australia
| | - Sandy Campbell
- Faculty of Health, Charles Darwin University, Casuarina, NT, Australia
| | - Chris Degeling
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, School of Health and Society, Wollongong, NSW, Australia
| | - Jane Williams
- Australian Centre for Health Engagement, Evidence and Values, University of Wollongong, School of Health and Society, Wollongong, NSW, Australia
| | - Ross Andrews
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Peter Massey
- Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
| | - Jodie McVernon
- Victorian Infectious Disease Reference Laboratory Epidemiology Unit, The Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
- Department of Infectious Diseases, The University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
| | - Adrian Miller
- Office of Indigenous Engagement, Central Queensland University, Townsville, QLD, Australia
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Massi L, Hickey S, Maidment SJ, Roe Y, Kildea S, Kruske S. "This has changed me to be a better mum": A qualitative study exploring how the Australian Nurse-Family Partnership Program contributes to the development of First Nations women's self-efficacy. Women Birth 2023; 36:e613-e622. [PMID: 37302902 DOI: 10.1016/j.wombi.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND The Australian Nurse-Family Partnership Program is based on the Nurse-Family Partnership program from the United States, which was designed to support first-time mothers experiencing social and economic disadvantage from early in pregnancy until their child's second birthday. International trials have demonstrated this program measurably improves family environment, maternal competencies, and child development. The Australian program has been tailored for mothers having a First Nations baby. AIM This study aimed to understand how the program impacts self-efficacy using a qualitative interpretive approach. METHODS The study took place in two sites within one Aboriginal Community Controlled Health Service in Meanjin (Brisbane), Australia. Twenty-nine participants were interviewed: first-time mothers having a First Nations baby who had accessed the program (n = 26), their family members (n = 1), and First Nations Elders (n = 2). Interviews were conducted either face-to-face or by telephone, using a yarning tool and method, to explore women's experiences and perceptions. Yarns were analysed using reflexive thematic analysis. FINDINGS Three main themes were generated: 1) sustaining connections and relationships; 2) developing self-belief and personal skills; and 3) achieving transformation and growth. We interpret that when the program facilitates the development of culturally safe relationships with staff and peers, it enables behaviour change, skill development, personal goal setting and achievement, leading to self-efficacy. DISCUSSION Located within a community-controlled health service, the program can foster cultural connection, peer support and access to health and social services; all contributing to self-efficacy. CONCLUSION We recommend the program indicators are strengthened to reflect these findings and enable monitoring and reporting of activities that facilitate self-efficacy, growth, and empowerment.
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Affiliation(s)
- Luciana Massi
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Sarah-Jade Maidment
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Australia.
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Sadler S, Gerrard J, Searle A, Lanting S, West M, Wilson R, Ginige A, Fang KY, Chuter V. The Use of mHealth Apps for the Assessment and Management of Diabetes-Related Foot Health Outcomes: Systematic Review. J Med Internet Res 2023; 25:e47608. [PMID: 37792467 PMCID: PMC10585435 DOI: 10.2196/47608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/19/2023] [Accepted: 08/04/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Globally, diabetes affects approximately 500 million people and is predicted to affect up to 700 million people by 2045. In Australia, the ongoing impact of colonization produces inequity in health care delivery and inequality in health care outcomes for First Nations Peoples, with diabetes rates 4 times those of non-Indigenous Australians. Evidence-based clinical practice has been shown to reduce complications of diabetes-related foot disease, including ulceration and amputation, by 50%. However, factors such as a lack of access to culturally safe care, geographical remoteness, and high costs associated with in-person care are key barriers for First Nations Peoples in accessing evidence-based care, leading to the development of innovative mobile health (mHealth) apps as a way to increase access to health services and improve knowledge and self-care management for people with diabetes. OBJECTIVE This study aims to evaluate studies investigating the use of mHealth apps for the assessment and management of diabetes-related foot health in First Nations Peoples in Australia and non-Indigenous populations globally. METHODS PubMed, Informit's Indigenous Collection database, Ovid MEDLINE, Embase, CINAHL Complete, and Scopus were searched from inception to September 8, 2022. Hand searches of gray literature and reference lists of included studies were conducted. Studies describing mHealth apps developed for the assessment and management of diabetes-related foot health were eligible. Studies must include an evaluation (qualitative or quantitative) of the mHealth app. No language, publication date, or publication status restrictions were used. Quality appraisal was performed using the revised Cochrane risk-of-bias tool for randomized trials and the Health Evidence Bulletins Wales checklists for observational, cohort, and qualitative studies. RESULTS No studies specifically including First Nations Peoples in Australia were identified. Six studies in non-Indigenous populations with 361 participants were included. Foot care education was the main component of all mHealth apps. Of the 6 mHealth apps, 2 (33%) provided functionality for participants to enter health-related data; 1 (17%) included a messaging interface. The length of follow-up ranged from 1-6 months. Of the 6 studies, 1 (17%) reported high levels of acceptability of the mHealth app content for self-care by people with diabetes and diabetes specialists; the remaining 5 (83%) reported that participants had improved diabetes-related knowledge and self-management skills after using their mHealth app. CONCLUSIONS The findings from this systematic review provide an overview of the features deployed in mHealth apps and indicate that this type of intervention can improve knowledge and self-care management skills in non-Indigenous people with diabetes. Future research needs to focus on mHealth apps for populations where there is inadequate or ineffective service delivery, including for First Nations Peoples and those living in geographically remote areas, as well as evaluate direct effects on diabetes-related foot disease outcomes. TRIAL REGISTRATION PROSPERO CRD42022349087; https://tinyurl.com/35u6mmzd.
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Affiliation(s)
- Sean Sadler
- Western Sydney University, Campbelltown, Australia
- University of Newcastle, Ourimbah, Australia
| | - James Gerrard
- Western Sydney University, Campbelltown, Australia
- University of Newcastle, Ourimbah, Australia
- Central Australian Aboriginal Congress, Mparntwe (Alice Springs), Australia
| | | | - Sean Lanting
- Western Sydney University, Campbelltown, Australia
- University of Newcastle, Ourimbah, Australia
| | - Matthew West
- Western Sydney University, Campbelltown, Australia
| | - Rhonda Wilson
- University of Newcastle, Gosford, Australia
- Massey University, Auckland, New Zealand
| | | | - Kerry Y Fang
- Western Sydney University, Campbelltown, Australia
| | - Vivienne Chuter
- Western Sydney University, Campbelltown, Australia
- University of Newcastle, Ourimbah, Australia
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Prest A. Listening with 'Big Ears': Accountability in cross-cultural music education research with Indigenous partners. Res Stud Music Educ 2023; 45:431-443. [PMID: 37868093 PMCID: PMC10584657 DOI: 10.1177/1321103x221140988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
In this theoretical article, I examine various conceptions of focused listening-including those held by specific First Nations communities-to determine how each conception might offer insights for listening while conducting cross-cultural music education research. First, I discuss the notion of "Big Ears," as it is understood by the jazz community. Then, I turn to scholars from various First Nations in British Columbia to learn about their conceptions of listening. I outline decolonial listening strategies as proposed by Indigenous Arts scholar Dylan Robinson, before learning about the role of listening from a settler-Canadian who formally Witnessed the testimonies of Indigenous residential school survivors over a period of years while working for the Truth and Reconciliation Commission of Canada. I examine the writings of music education researchers who have proposed listening as an important strategy in cross-cultural/intercultural pedagogy and research, albeit in different circumstances and for different reasons. Finally, I describe/reflect on my process of learning to listen cross-culturally as a settler-Canadian music education researcher engaged in community-based participatory research (CBPR) over the course of three studies, and list some of the ongoing questions I have. I conclude by proposing a revised understanding of Listening with "Big Ears" as one possible way for non-Indigenous researchers using a CBPR approach to enhance their application of Indigenist research methodology, especially in demonstrating their accountability to Indigenous co-researchers, participants, and communities, as they engage collaboratively in music education research.
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Dimopoulos-Bick T, Follent D, Kostovski C, Middleton V, Paulson C, Sutherland S, Cawley M, Files M, Follent S, Osten R, Trevena L. Finding Your Way - A shared decision making resource developed by and for Aboriginal people in Australia: Perceived acceptability, usability, and feasibility. Patient Educ Couns 2023; 115:107920. [PMID: 37531789 DOI: 10.1016/j.pec.2023.107920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 07/06/2023] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Finding Your Way is a culturally adapted shared decision making (SDM) resource for Aboriginal (First Nations) people of Australia. It integrates the Eight Ways of Aboriginal Learning (8 Ways) and was created by Aboriginal health workers and community members in New South Wales (NSW), Australia. OBJECTIVE To explore the perceived acceptability, usability, and feasibility of Finding Your Way as a SDM resource for Aboriginal people making health and wellbeing decisions. METHODS The web-based resources were disseminated using social media, professional networks, publications, and the 'Koori grapevine'. Thirteen 'champions' also promoted the resources. An online questionnaire was available on the website for three months. Framework analysis determined early indications of its acceptability, usability, and feasibility. Web and social media analytics were also analysed. Partnership with and leadership by Aboriginal people was integrated at all phases of the project. RESULTS The main landing page was accessed 5219 times by 4259 users. 132 users completed the questionnaire. The non-linear and visual aspects of the resources 'speak to mob' and identified with Aboriginal culture. The inclusion of social and emotional well-being, and the holistic approach were well received by the small number of users who opted to provide feedback. They suggested that non-digital formats and guidance on the resources are required to support use in clinical practice. CONCLUSION The 8 Ways enabled the development of a culturally safe SDM resource for Aboriginal people, which was well received by users who took the time to provide feedback after a brief dissemination process. Additional accessible formats, practice guides and training are required to support uptake in clinical practice. PRACTICE IMPLICATIONS Finding Your Way could be used to help improve experiences, health literacy, decision making quality and outcomes of healthcare for Aboriginal Australians.
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Affiliation(s)
| | | | | | | | - Cory Paulson
- Royal Flying Doctor Service, South Eastern Section, NSW, Australia
| | - Stewart Sutherland
- College of Health and Medicine, Australian National University, Canberra, Australia
| | - Melissa Cawley
- South Eastern Sydney Local Health District, NSW, Australia
| | - Marsha Files
- Katungul Aboriginal Corporation Regional Health and Community Services, NSW, Australia
| | | | | | - Lyndal Trevena
- School of Public Health, University of Sydney, NSW, Australia
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Bateman S, Riceman M, Owen K, Pearson O, Lester R, Sinclair N, McDonald S, Howell M, Tunnicliffe DJ, Jesudason S. Models of care to address disparities in kidney health outcomes for First Nations people. Kidney Int 2023; 104:681-689. [PMID: 37437810 DOI: 10.1016/j.kint.2023.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 05/26/2023] [Accepted: 06/02/2023] [Indexed: 07/14/2023]
Affiliation(s)
- Samantha Bateman
- Central Northern Adelaide Renal and Transplantation Service, Central Adelaide Local Health Network, Adelaide, South Australia, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
| | - Michael Riceman
- Central Northern Adelaide Renal and Transplantation Service, Central Adelaide Local Health Network, Adelaide, South Australia, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Kelli Owen
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia; AKction Community Reference Group, University of Adelaide, Adelaide, South Australia, Australia
| | - Odette Pearson
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Rhanee Lester
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; AKction Community Reference Group, University of Adelaide, Adelaide, South Australia, Australia
| | - Nari Sinclair
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; AKction Community Reference Group, University of Adelaide, Adelaide, South Australia, Australia
| | - Stephen McDonald
- Central Northern Adelaide Renal and Transplantation Service, Central Adelaide Local Health Network, Adelaide, South Australia, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Martin Howell
- Sydney School of Public Health, the University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - David J Tunnicliffe
- Sydney School of Public Health, the University of Sydney, Sydney, New South Wales, Australia; Centre for Kidney Research, the Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Shilpanjali Jesudason
- Central Northern Adelaide Renal and Transplantation Service, Central Adelaide Local Health Network, Adelaide, South Australia, Australia; Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Australian and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Hummelen R, Sodhi S, Poirier J, Gordon J, Asokan S, Matsumoto CL, Kelly L. Progression From Gestational Diabetes Mellitus to Type 2 Diabetes Mellitus Among First Nations Women in Northwest Ontario: A Retrospective Cohort Study. Can J Diabetes 2023; 47:566-570. [PMID: 37196981 DOI: 10.1016/j.jcjd.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 03/07/2023] [Accepted: 05/09/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE Our aim in this study was to identify the incidence of type 2 diabetes mellitus among First Nations women in northwest Ontario with a history of gestational diabetes mellitus (GDM). METHODS This work was a retrospective cohort study of women diagnosed with GDM using a 50-gram oral glucose challenge test or a 75-gram oral glucose tolerance test from January 1, 2010, to December 31, 2017, at the Sioux Lookout Meno Ya Win Health Centre. Outcomes were assessed based on glycated hemoglobin (A1C) measurements performed between January 1, 2010, and December 31, 2019. RESULTS The cumulative incidence of T2DM among women with a history of GDM was 18% (42 of 237) at 2 years and 39% (76 of 194) at 6 years. Women with GDM who developed T2DM were of similar age and parity and had equivalent C-section rates (26%) compared to those who did not develop T2DM. They had higher birth weights (3,866 grams vs 3,600 grams, p=0.006) and rates of treatment with insulin (24% vs 5%, p<0.001) and metformin (16% vs 5%, p=0.005). CONCLUSIONS GDM confers a significant risk for the development of T2DM in First Nations women. Broad community-based resources, food security, and social programming are required.
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Affiliation(s)
- Ruben Hummelen
- Division of Clinical Sciences, Northern Ontario School of Medicine, Sioux Lookout, Ontario, Canada
| | - Sumeet Sodhi
- Department of Family and Community Medicine, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Jenna Poirier
- Sioux Lookout Northern Ontario School of Medicine Local Education Group, Sioux Lookout, Ontario, Canada
| | - Janet Gordon
- Sioux Lookout First Nations Health Authority, Sioux Lookout, Ontario, Canada
| | - Shanthive Asokan
- Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, Ontario, Canada
| | - Cai-Lei Matsumoto
- Sioux Lookout Northern Ontario School of Medicine Local Education Group, Sioux Lookout, Ontario, Canada
| | - Len Kelly
- Sioux Lookout Meno Ya Win Health Centre, Sioux Lookout, Ontario, Canada.
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Jull J, Fairman K, Oliver S, Hesmer B, Pullattayil AK. Interventions for Indigenous Peoples making health decisions: a systematic review. Arch Public Health 2023; 81:174. [PMID: 37759336 PMCID: PMC10523645 DOI: 10.1186/s13690-023-01177-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Shared decision-making facilitates collaboration between patients and health care providers for informed health decisions. Our review identified interventions to support Indigenous Peoples making health decisions. The objectives were to synthesize evidence and identify factors that impact the use of shared decision making interventions. METHODS An Inuit and non-Inuit team of service providers and academic researchers used an integrated knowledge translation approach with framework synthesis to coproduce a systematic review. We developed a conceptual framework to organize and describe the shared decision making processes and guide identification of studies that describe interventions to support Indigenous Peoples making health decisions. We conducted a comprehensive search of electronic databases from September 2012 to March 2022, with a grey literature search. Two independent team members screened and quality appraised included studies for strengths and relevance of studies' contributions to shared decision making and Indigenous self-determination. Findings were analyzed descriptively in relation to the conceptual framework and reported using guidelines to ensure transparency and completeness in reporting and for equity-oriented systematic reviews. RESULTS Of 5068 citations screened, nine studies reported in ten publications were eligible for inclusion. We categorized the studies into clusters identified as: those inclusive of Indigenous knowledges and governance ("Indigenous-oriented")(n = 6); and those based on Western academic knowledge and governance ("Western-oriented")(n = 3). The studies were found to be of variable quality for contributions to shared decision making and self-determination, with Indigenous-oriented studies of higher quality overall than Western-oriented studies. Four themes are reflected in an updated conceptual framework: 1) where shared decision making takes place impacts decision making opportunities, 2) little is known about the characteristics of health care providers who engage in shared decision making processes, 3) community is a partner in shared decision making, 4) the shared decision making process involves trust-building. CONCLUSIONS There are few studies that report on and evaluate shared decision making interventions with Indigenous Peoples. Overall, Indigenous-oriented studies sought to make health care systems more amenable to shared decision making for Indigenous Peoples, while Western-oriented studies distanced shared decision making from the health care settings. Further studies that are solutions-focused and support Indigenous self-determination are needed.
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Affiliation(s)
- Janet Jull
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
| | - Kimberly Fairman
- Institute for Circumpolar Health Research, Northwest Territories, Yellowknife, Canada
| | | | - Brittany Hesmer
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON Canada
| | | | - Not Deciding Alone Team
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON Canada
- Institute for Circumpolar Health Research, Northwest Territories, Yellowknife, Canada
- University College London, London, UK
- Queen’s University, Kingston, ON Canada
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McLardie-Hore FE, McLachlan HL, Forster DA, Holmlund S, McCalman P, Newton MS. Comparing the views of caseload midwives working with First Nations families in an all-risk, culturally responsive model with midwives working in standard caseload models, using a cross-sectional survey design. Women Birth 2023; 36:469-480. [PMID: 37407296 DOI: 10.1016/j.wombi.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 07/07/2023]
Abstract
PROBLEM Little is known about midwives' views and wellbeing when working in an all-risk caseload model. BACKGROUND Between March 2017 and December 2020 three maternity services in Victoria, Australia implemented culturally responsive caseload models for women having a First Nations baby. AIM Explore the views, experiences and wellbeing of midwives working in an all-risk culturally responsive model for First Nations families compared to midwives in standard caseload models in the same services. METHODS A survey was sent to all midwives in the culturally responsive (CR) model six-months and two years after commencement (or on exit), and to standard caseload (SC) midwives two years after the culturally responsive model commenced. Measures used included the Midwifery Process Questionnaire and Copenhagen Burnout Inventory (CBI). FINDINGS 35 caseload midwives (19 CR, 16 SC) participated. Both groups reported positive attitudes towards their professional role, trending towards higher median levels of satisfaction for the culturally responsive midwives. Midwives valued building close relationships with women and providing continuity of care. Around half reported difficulty maintaining work-life balance, however almost all preferred the flexible hours to shift work. All agreed that a reduced caseload is needed for an all-risk model and that supports around the model (e.g. nominated social workers, obstetricians) are important. Mean CBI scores showed no burnout in either group, with small numbers of individuals having burnout in both groups. DISCUSSION AND CONCLUSION Midwives were highly satisfied working in both caseload models, but decreased caseloads and more organisational supports are needed in all-risk models.
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Affiliation(s)
- Fiona E McLardie-Hore
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; The Royal Women's Hospital, Parkville, Victoria 3052 Australia.
| | - Helen L McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
| | - Della A Forster
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; The Royal Women's Hospital, Parkville, Victoria 3052 Australia
| | - Sophia Holmlund
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; Department of Nursing, Umeå University, Umeå, Sweden; Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Pamela McCalman
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
| | - Michelle S Newton
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia; School of Nursing and Midwifery, La Trobe University, Bundoora, Victoria 3086 Australia
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Bowden ER, Toombs MR, Chang AB, McCallum GB, Williams RL. Listening to First Nations women's voices, hearing requests for continuity of carer, trusted knowledge and family involvement: A qualitative study in urban Darwin. Women Birth 2023; 36:e509-e517. [PMID: 37246054 DOI: 10.1016/j.wombi.2023.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 03/21/2023] [Accepted: 05/12/2023] [Indexed: 05/30/2023]
Abstract
PROBLEM Australian First Nations women are more likely to commence care later in pregnancy and underutilise maternal health services than non-First Nations women. BACKGROUND Disrespectful maternity care is a major barrier to care-seeking in pregnancy, often resulting in later commencement and underutilisation of care. AIM We aimed to identify barriers and enablers to pregnancy-related care-seeking for Australian First Nations women living in the Darwin region through yarning about their experiences of pregnancy care. METHODS Ten Australian First Nations women shared stories about their pregnancy care journeys. Yarns took place at a time and location determined by the women, with recruitment continuing until saturation was reached. FINDINGS Emerging themes included a desire for continuity of carer, particularly with midwives; access to trustworthy information, enabling informed decision-making; and a need to have family involved in all aspects of care. No specific barriers were identified within this cohort DISCUSSION: Universal access to continuity of carer models would provide women with the relational care they are asking for as well as address other identified needs, such as a desire for information relevant to their pregnancy; and space for partners/family members to be involved. The themes that emerged provide a picture of what a positive, respectful pregnancy care experience could be for First Nations women within the Darwin Region, thus enabling care-seeking in pregnancy. CONCLUSION Although the public sector and Aboriginal Controlled Community Health Organisations currently provide continuity of carer models, robust systems ensuring these models are made available to all women are lacking.
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Affiliation(s)
- Emily R Bowden
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Charles Darwin University, Darwin, Northern Territory, Australia.
| | - Maree R Toombs
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, Queensland, Australia
| | - Anne B Chang
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Australia; Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, Brisbane, Australia
| | - Gabrielle B McCallum
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Robyn L Williams
- Child Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Charles Darwin University, Darwin, Northern Territory, Australia
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Kelley ML. Developing a compassionate community: a Canadian conceptual model for community capacity development. Palliat Care Soc Pract 2023; 17:26323524231193040. [PMID: 37654733 PMCID: PMC10467181 DOI: 10.1177/26323524231193040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/21/2023] [Indexed: 09/02/2023] Open
Abstract
The purpose of this article is to share a Canadian model called Developing a Compassionate Community (DCC) in which aging, dying, caregiving, and grieving are everyone's responsibility. The model provides a research-informed practice guide for people who choose to adopt a community capacity development approach to developing a compassioante community. Based on 30 years of Canadian research by the author in rural, urban, First Nations communities, and long-term care homes, the DCC model offers a practice theory and practical tool. The model incorporates the principles of community capacity development which are as follows: change is incremental and in phases, but nonlinear and dynamic; the change process takes time; development is essentially about developing people; development builds on existing resources (assets); development cannot be imposed from the outside; and development is ongoing (never-ending). Community capacity development starts with citizens who want to make positive changes in their lives and their community. They become empowered by gaining the knowledge, skills, and resources they need. The community mobilizes around finding solutions rather than discussing problems. Passion propels their action and commitment drives the process. The strategy for change is engaging, empowering, and educating community members to act on their own behalf. It requires mobilizing networks of families, friends, and neighbors across the community, wherever people live, work, or play. Community networks are encouraged to prepare for later life, and for giving and getting help among themselves. This Canadian model offers communities one approach to developing a compassionate community and is a resource for implementing a public health approach to end-of-life care in Canada. The model is also available to be evaluated for its applicability beyond Canada and is designed to be adapted to new contexts if desired.
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Affiliation(s)
- Mary Lou Kelley
- School of Social Work, Lakehead University, #704-530 de Mazenod Ave, Ottawa, ON, K1S 5W8, Canada
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Tsuji SRJ, Zuk AM, Solomon A, Edwards-Wheesk R, Ahmed F, Tsuji LJS. What Is Wellbeing, and What Is Important for Wellbeing? Indigenous Voices from across Canada. Int J Environ Res Public Health 2023; 20:6656. [PMID: 37681798 PMCID: PMC10487260 DOI: 10.3390/ijerph20176656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/15/2023] [Accepted: 08/19/2023] [Indexed: 09/09/2023]
Abstract
Indigenous peoples' perceptions of wellbeing differ from non-Indigenous constructs. Thus, it is imperative to recognize that Indigenous peoples will conceptualize wellbeing from their perspectives and set their own wellbeing priorities. In keeping with this viewpoint, the aims of the present study were to conceptualize wellbeing and determine what was (and is) important for wellbeing from Canadian Indigenous peoples' perspectives. In this paper, we take a partnership approach based on the elements of respect, equity, and empowerment. One primary data source and two existing data sources were examined and analyzed thematically utilizing a combination approach of deductive and inductive coding. Indigenous leadership and organizations viewed wellbeing holistically and conceptualized wellbeing multidimensionally. From across Canada, wellbeing was communicated as physical, economic, political, social, and cultural. The scaling of wellbeing represented a collectivist perspective, and land was the connecting thread between all types of wellbeing, being a place to practice cultural traditions, reassert one's Indigenous identity, find solace, and pass on Indigenous knowledge and languages. Although wellbeing was discussed in the context of the individual, family, community, and nation, wellbeing was most often discussed at the cultural level by regional and national Indigenous leadership and organizations. Even in acknowledging the great cultural diversity among Canadian Indigenous nations, four concordant themes were identified regionally and nationally, with respect to what was important for cultural wellbeing: land and water, sustainability, and inherent obligations; being on the land, and indigenous languages and knowledge systems; sustainable development; and meaningful involvement in decision-making, and free, prior, and informed consent. Taking into account these themes is foundational for any interaction with Indigenous peoples, especially in the context of land, culture, and development. There needs to be a new beginning on the journey to reconciliation with land and cultural wellbeing at the forefront.
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Affiliation(s)
- Stephen R. J. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada; (A.M.Z.); (F.A.); (L.J.S.T.)
- School of Environmental Studies, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Aleksandra M. Zuk
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada; (A.M.Z.); (F.A.); (L.J.S.T.)
- School of Nursing, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Andrew Solomon
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada
| | | | - Fatima Ahmed
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada; (A.M.Z.); (F.A.); (L.J.S.T.)
| | - Leonard J. S. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada; (A.M.Z.); (F.A.); (L.J.S.T.)
- Department of Health and Society, University of Toronto, Toronto, ON M1C 1A4, Canada
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Miller A, Brown L, Tamu C, Cairns A. Cape York Kidney Care: service description and baseline characteristics of a client-centred multidisciplinary specialist kidney health service in remote Australia. BMC Health Serv Res 2023; 23:907. [PMID: 37620879 PMCID: PMC10463956 DOI: 10.1186/s12913-023-09887-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Chronic Kidney disease (CKD) is over-represented amongst First Nation people with more than triple the rate of CKD in those aged 15 years and over. The impact of colonisation, including harmful experiences of health practices and research, has contributed to these health inequities. Cape York Kidney Care (CYKC) has been created as an unique service which provides specialist care that aims to centre the client within a multidisciplinary team that is integrated within the primary care setting of the remote health clinics in six communities in western Cape York, Australia. This research aims to describe the Cape York Kidney Care service delivery model, and baseline service data, including aggregated client health measures. METHODS The model of care is described in detail. Review of the first 12 months of service provision has been undertaken with client demographic and clinical profile baseline data collected including kidney health measures. Participants are adults (> 18 years if age) with CKD grades 1-5. This data has been de-identified and aggregated. RESULTS CYKC reviewed 204 individuals, with 182 not previously been reviewed by specialist kidney health services. Three quarters of clients identified as Aboriginal. The average age was 55 with a high level of comorbidity, with majority having a history of hypertension and Type 2 diabetes (average Hba1c 8.2%). Just under one third had cardiovascular disease. A large proportion of people had either Grade 2 CKD (32%) or Grade 3 CKD (~ 30%), and over half had severely increased albuminuria (A3), with Type 2 diabetes being the predominant presumed cause of CKD. Most clients did not meet evidence-based targets for diabetes, blood pressure or lipids and half were self-reported smokers. The proportion of clients reviewed represents 6.2% of the adult population in the participating First Nation communities. CONCLUSION The CYKC model was able to target those clients at high risk of progression and increase the number of people with chronic kidney disease reviewed by specialist kidney services within community. Baseline data demonstrated a high burden of chronic disease that subsequently will increase risk of CKD progression and cardiovascular disease. People were seen to have more severe disease at younger ages, with a substantial number demonstrating risk factors for rapid progression of kidney disease including poorly controlled Type 2 diabetes and severely increased albuminuria. Further evaluation concerning implementation challenges, consumer and community satisfaction, and health outcomes is required.
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Affiliation(s)
- Andrea Miller
- Torres and Cape Hospital and Health Service, PO Box 341, Weipa, QLD, Australia.
- Murtupuni Centre for Rural and Remote Health, & Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia.
| | - Leanne Brown
- Torres and Cape Hospital and Health Service, PO Box 341, Weipa, QLD, Australia
- Murtupuni Centre for Rural and Remote Health, & Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
| | - Clara Tamu
- Torres and Cape Hospital and Health Service, Ngurapai/Horn Island Primary Health Care Centre, Horn Island, Queensland, Australia
| | - Alice Cairns
- Murtupuni Centre for Rural and Remote Health, & Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Queensland, Australia
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Domingo A, Yessis J, Charles KA, Skinner K, Hanning RM. Integrating knowledge and action: learnings from an implementation program for food security and food sovereignty with First Nations communities within Canada. Implement Sci 2023; 18:34. [PMID: 37573323 PMCID: PMC10422772 DOI: 10.1186/s13012-023-01291-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/31/2023] [Indexed: 08/14/2023] Open
Abstract
BACKGROUND Collaborative approaches to knowledge translation (KT) are important for advancing community-engaged research. However, there is a need for examples of participatory approaches that have effectively supported public health research, program development, and implementation with First Nations communities. To strengthen KT with communities, we proposed a set of guiding principles for participatory planning and action for local food system change. Principles emerged from a cross-community analysis of Learning Circles: Local Healthy Food to School (LC:LHF2S) a participatory program (2015-2019) for Indigenous food system action. The objective was to identify guiding principles for participatory planning and action from key learnings and successes on scaling-up of the Learning Circles (LC) model vertically in Haida Nation, British Columbia (BC), and horizontally in three distinct community contexts: Gitxsan Nation, Hazelton /Upper Skeena, BC; Ministikwan Lake. The application of these principles is discussed in the context of our ongoing partnership with Williams Treaties First Nations to support community planning to enhance food security and sovereignty. METHODS A cross-community thematic analysis was conducted and guided by an implementation science framework, Foster-Fishman and Watson's (2012) ABLe Change Framework, to identify key learnings and successes from adapting the LC approach. Information gathered from interviews (n = 55) and meeting reports (n = 37) was thematically analyzed to inform the development of guiding principles. Community sense-making of findings informed applicability in a new community context embarking on food systems work. RESULTS Emergent guiding principles for participatory food system planning and action are described within four main areas: (1) create safe and ethical spaces for dialog by establishing trust and commitment from the ground up, (2) understand the context for change through community engagement, (3) foster relationships to strengthen and sustain impact, and (4) reflect and embrace program flexibility to integrate learnings. CONCLUSIONS Emergent principles offer guidance to supporting Indigenous community-led research and mobilization of knowledge into action. Principles are intended to support researchers and health system administrators with taking a collaborative approach that fosters relationships and integration of community leadership, knowledge, and action for food system change. Application of principles with implementation frameworks can strengthen KT in Indigenous contexts by incorporating community protocols and perspectives in support of Indigenous self-determined priorities.
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Affiliation(s)
- Ashleigh Domingo
- Faculty of Health, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Jennifer Yessis
- Faculty of Health, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | | | - Kelly Skinner
- Faculty of Health, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Rhona M Hanning
- Faculty of Health, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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Thompson F, Russell S, Quigley R, Sagigi B, Taylor S, McDonald M, Campbell S, Esterman A, Harriss LR, Miller G, Strivens E, McDermott R. Erratum: Potentially preventable dementia in a First Nations population in the Torres Strait and Northern Peninsula Area of North Queensland, Australia: a cross sectional analysis using population attributable fractions. Lancet Reg Health West Pac 2023; 37:100856. [PMID: 37693869 PMCID: PMC10485659 DOI: 10.1016/j.lanwpc.2023.100856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
[This corrects the article DOI: 10.1016/j.lanwpc.2023.100855.][This corrects the article DOI: 10.1016/j.lanwpc.2022.100532.].
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Affiliation(s)
- Fintan Thompson
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD, Australia
- University of South Australia, SA, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
| | - Betty Sagigi
- Queensland Health, Torres and Cape Hospital and Health Service, Thursday Island, QLD, Australia
| | - Sean Taylor
- Top End Health Service, Northern Territory Government, Darwin, NT, Australia
| | - Malcolm McDonald
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
| | - Sandy Campbell
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, QLD, Australia
| | | | - Linton R. Harriss
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
| | - Gavin Miller
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
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Dyck RF, Pahwa P, Karunanayake C, Osgood ND. The Contribution of Gestational Diabetes to Diabetes Risk Among First Nations and Non-First Nations Women in Saskatchewan: Results From the DIP: ORRIIGENSS Project. Can J Diabetes 2023; 47:509-518. [PMID: 37150508 DOI: 10.1016/j.jcjd.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/23/2023] [Accepted: 04/28/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVES Our aim in this study was to determine the risk for diabetes mellitus (DM) among Saskatchewan First Nations (FN) and non-FN women with prior gestational DM (GDM). METHODS Using Ministry of Health administrative databases, we conducted a retrospective cohort study of DM risk by GDM occurrence among FN and non-FN women giving birth from 1980 to 2009 and followed to March 31, 2013. We determined frequencies and odds ratios (ORs) of DM in women with/without prior GDM after stratifying by FN status, while adjusting for other DM determinants. Survival curves of women until DM diagnosis were obtained by prior GDM occurrence and stratified by ethnicity and total parity. RESULTS De-identified data were obtained for 202,588 women. Of those who developed DM, 2,074 of 10,114 (20.5%) had previously experienced GDM (811 of 3,128 [25.9%]) FN and 1,263 of 6,986 [18.1%] non-FN). Cumulative survival of women with prior GDM until DM was higher for FN than for non-FN women (82% vs 46%), but prior GDM was a stronger predictor of DM within the non-FN cohort (prior GDM vs no GDM: OR, 9.64 for non-FN; OR, 7.05 for FN). Finally, higher total parity interacted with prior GDM to increase DM risk in both groups. With prior GDM and parity ≥3, 93% of FN and 57% of non-FN women subsequently developed DM. CONCLUSIONS GDM is a leading determinant of T2DM among FN and non-FN women, amplified by higher parity. This contributes to earlier onset diabetes, affecting subsequent pregnancies and increasing risk for chronic diabetic complications. It may also factor into higher type 2 DM rates observed in FN women compared with men.
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Affiliation(s)
- Roland F Dyck
- Department of Medicine, Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| | - Punam Pahwa
- Department of Medicine, Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Chandima Karunanayake
- Department of Medicine, Canadian Center for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nathaniel D Osgood
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Department of Computer Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Taunton C, Hawthorne L, Matysek R, Neville J, Coates M, Pickering E, Hanson J, Smith S, Hempenstall A. A low burden of severe illness: the COVID-19 Omicron outbreak in the remote Torres and Cape region of Far North Queensland. Commun Dis Intell (2018) 2023; 47. [PMID: 37817302 DOI: 10.33321/cdi.2023.47.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Indexed: 10/12/2023]
Abstract
A coronavirus disease 2019 (COVID-19) outbreak was declared in the remote Torres and Cape region of Far North Queensland soon after the Queensland border opened for quarantine-free domestic travel in December 2021, with a total of 7,784 cases notified during the first ten-month outbreak period. We report a crude attack rate among residents of 25.6% (95% confidence interval [95% CI]: 25.1-26.1%), a hospitalisation rate of 1.6% (95% CI: 1.3-1.9%) and a crude case fatality rate of 0.05% (95% CI: 0.01-0.13%). Hospitalisation and case fatality rates were similar among First Nations and non-Indigenous people, with double dose COVID-19 vaccination rates higher among First Nations than non-Indigenous people by the end of the outbreak period. We attribute the low burden of severe illness to local community leadership, community engagement, vaccination coverage and recency, and community participation in a local culturally considered COVID-19 care-in-the-home program.
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Affiliation(s)
- Caroline Taunton
- Public Health Unit, Torres and Cape Hospital and Health Service, Queensland, Australia.
| | - Leanne Hawthorne
- Public Health Unit, Torres and Cape Hospital and Health Service, Queensland, Australia
| | - Rittia Matysek
- Public Health Unit, Torres and Cape Hospital and Health Service, Queensland, Australia
| | - Johanna Neville
- Public Health Unit, Torres and Cape Hospital and Health Service, Queensland, Australia
| | - Marlow Coates
- Public Health Unit, Torres and Cape Hospital and Health Service, Queensland, Australia
| | - Emma Pickering
- Public Health Unit, Torres and Cape Hospital and Health Service, Queensland, Australia
| | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Allison Hempenstall
- Public Health Unit, Torres and Cape Hospital and Health Service, Queensland, Australia
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Davies A, Gwynn J, Allman-Farinelli M, Flood V, Dickson M, Turner N, Porykali B, Lock Ngiyampaa M. Programs Addressing Food Security for First Nations Peoples: A Scoping Review. Nutrients 2023; 15:3127. [PMID: 37513545 PMCID: PMC10384335 DOI: 10.3390/nu15143127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Access to food is a right that every individual must have to ensure a standard of living that is sufficient for maintaining good health and wellbeing. This review, developed and implemented by a team of First Nations and non-First Nations peoples, aimed to scope the literature on programs addressing food security for First Nations peoples in Australia, Aotearoa/New Zealand, Canada, and the United States of America. Collectively, First Nations groups share continued traumas, disadvantages, and devastation brought upon them as a result of British colonisation. Despite the impacts of colonial conquest, the resilience of First Nations peoples continues through the fight for self-determination, sovereignty, equity, and equality. Three databases and grey literature were searched from 2010. Two reviewers completed screening, data extraction, and critical appraisal. Nine food security programs were included in this review. Five were from the United States of America and four from Canada, with no program from Australia or Aotearoa/New Zealand meeting the inclusion criteria. The programs that appear to be most suitable for addressing food security for First Nations peoples were participatory in design, had community governance, integrated cultural knowledge and food systems to increase the accessibility and availability of cultural foods, incorporated educational components, and utilized collaborations among various agencies. Findings showed that while it is important to address short-term emergency food relief, the aim should be sustainable food security through a longer-term system and policy change underpinned by co-designed research and evaluation.
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Affiliation(s)
- Alyse Davies
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Josephine Gwynn
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Margaret Allman-Farinelli
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Victoria Flood
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- University Centre for Rural Health, Northern Rivers, Faculty of Medicine and Health, The University of Sydney, Lismore, NSW, 2480, Australia
| | - Michelle Dickson
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
| | - Nicole Turner
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Bobby Porykali
- Aboriginal and Torres Strait Islander Health Program, George Institute for Global Health, Sydney, NSW 2042, Australia
| | - Mark Lock Ngiyampaa
- Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Melbourne, VIC 3220, Australia
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Ciccia D, Doyle AK, Ng CHM, Armour M. Indigenous Peoples' Experience and Understanding of Menstrual and Gynecological Health in Australia, Canada and New Zealand: A Scoping Review. Int J Environ Res Public Health 2023; 20:6321. [PMID: 37444168 PMCID: PMC10341312 DOI: 10.3390/ijerph20136321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/13/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
There are a variety of cultural and religious beliefs and customs worldwide related to menstruation, and these often frame discussing periods and any gynecological issues as taboo. While there has been previous research on the impact of these beliefs on menstrual health literacy, this has almost entirely been confined to low- and middle-income countries, with very little information on high-income countries. This project used the Joanna Briggs Institute (JBI) scoping review methodology to systematically map the extent and range of evidence of health literacy of menstruation and gynecological disorders in Indigenous people in the colonized, higher-income countries of Australia, Canada, and New Zealand. PubMed, CINHAL, PsycInfo databases, and the grey literature were searched in March 2022. Five studies from Australia and New Zealand met the inclusion criteria. Only one of the five included studies focused exclusively on menstrual health literacy among the Indigenous population. Despite considerable research on menstrual health globally, studies focusing on understanding the menstrual health practices of the Indigenous populations of Australia, New Zealand, and Canada are severely lacking, and there is little to no information on how Indigenous beliefs of colonized people may differ from the broader society in which they live.
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Affiliation(s)
- Donna Ciccia
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia
| | - Aunty Kerrie Doyle
- School of Medicine, Western Sydney University, Campbelltown 2560, Australia
| | - Cecilia H. M. Ng
- School of Clinical Medicine, Health and Medicine, Division of Obstetrics and Gynaecology, University of New South Wales, Sydney 2052, Australia
- Gynaecological Research and Clinical Evaluation (GRACE) Unit, Royal Hospital for Women and University of New South Wales, Randwick 2031, Australia
- Jean Hailes for Women’s Health, Melbourne 3002, Australia
- Global Women’s Health, The George Institute for Global Health, Sydney 2042, Australia
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Sydney 2145, Australia
- Medical Research Institute of New Zealand (MRINZ), Wellington 6021, New Zealand
- Translational Health Research Institute (THRI), Western Sydney University, Sydney 2145, Australia
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Zigras T, Mayrand MH, Bouchard C, Salvador S, Eiriksson L, Almadin C, Kean S, Dean E, Malhotra U, Todd N, Fontaine D, Bentley J. Canadian Guideline on the Management of a Positive Human Papillomavirus Test and Guidance for Specific Populations. Curr Oncol 2023; 30:5652-5679. [PMID: 37366908 DOI: 10.3390/curroncol30060425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/26/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
The purpose of this paper is to provide evidence-based guidance on the management of a positive human papilloma virus (HPV) test and to provide guidance around screening and HPV testing for specific patient populations. The guideline was developed by a working group in collaboration with the Gynecologic Oncology Society of Canada (GOC), Society of Colposcopists of Canada (SCC), and the Canadian Partnership Against Cancer. The literature informing these guidelines was obtained through a systematic review of relevant literature by a multi-step search process led by an information specialist. The literature was reviewed up to July 2021 with manual searches of relevant national guidelines and more recent publications. The quality of the evidence and strength of recommendations were developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. The intended users of this guideline include primary care providers, gynecologists, colposcopists, screening programs, and healthcare facilities. The implementation of the recommendations will ensure an optimum implementation of HPV testing with a focus on the management of positive results. Recommendations for appropriate care for underserved and marginalized groups are made.
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Affiliation(s)
- Tiffany Zigras
- Trillium Health Partners, Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON M5G 1E2, Canada
| | - Marie-Hélène Mayrand
- Département d'obstétrique-gynécologie, Université de Montréal, Montreal, QC H3C 3J7, Canada
| | - Celine Bouchard
- Clinique de Researche en Sante des femmes, Quebec City, QC G1V 3M7, Canada
| | - Shannon Salvador
- Department of Obstetrics and Gynecology, McGill University, Montreal, QC H3A 0G4, Canada
| | - Lua Eiriksson
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Chelsea Almadin
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, QC H3Z 2H5, Canada
| | - Sarah Kean
- Department of Obstetrics, Gynecology and Reproductive Sciences, Winnipeg, MB R3J 3T7, Canada
| | - Erin Dean
- Department of Obstetrics, Gynecology and Reproductive Sciences, Winnipeg, MB R3J 3T7, Canada
| | - Unjali Malhotra
- Office of the Chief Medical Officer, First Nations Health Authority, West Vancouver, BC V7T 1A2, Canada
| | - Nicole Todd
- Department of Obstetrics and Gynecology UBC, Vancouver, BC V5Z 4E1, Canada
| | - Daniel Fontaine
- Department of Pathology and Laboratory Medicine, Valley Regional Hospital, Kentville, NS B4N 5E3, Canada
| | - James Bentley
- Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS B3H 4R2, Canada
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Coombes J, Holland AJA, Ryder C, Finlay SM, Hunter K, Bennett-Brook K, Orcher P, Scarcella M, Briscoe K, Forbes D, Jacques M, Maze D, Porykali B, Bourke E, Kairuz Santos CA. Discharge interventions for First Nations people with a chronic condition or injury: a systematic review. BMC Health Serv Res 2023; 23:604. [PMID: 37296401 DOI: 10.1186/s12913-023-09567-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/17/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Aboriginal and Torres Strait Islander peoples have a unique place in Australia as the original inhabitants of the land. Similar to other First Nations people globally, they experience a disproportionate burden of injury and chronic health conditions. Discharge planning ensures ongoing care to avoid complications and achieve better health outcomes. Analysing discharge interventions that have been implemented and evaluated globally for First Nations people with an injury or chronic conditions can inform the implementation of strategies to ensure optimal ongoing care for Aboriginal and Torres Strait Islander people. METHODS A systematic review was conducted to analyse discharge interventions conducted globally among First Nations people who sustained an injury or suffered from a chronic condition. We included documents published in English between January 2010 and July 2022. We followed the reporting guidelines and criteria set in Preferred Reporting Items for Systematic Review (PRISMA). Two independent reviewers screened the articles and extracted data from eligible papers. A quality appraisal of the studies was conducted using the Mixed Methods Appraisal Tool and the CONSIDER statement. RESULTS Four quantitative and one qualitative study out of 4504 records met inclusion criteria. Three studies used interventions involving trained health professionals coordinating follow-up appointments, linkage with community care services and patient training. One study used 48-hour post discharge telephone follow-up and the other text messages with prompts to attend check-ups. The studies that included health professional coordination of follow-up, linkage with community care and patient education resulted in decreased readmissions, emergency presentations, hospital length of stay and unattended appointments. CONCLUSION Further research on the field is needed to inform the design and delivery of effective programs to ensure quality health aftercare for First Nations people. We observed that discharge interventions in line with the principal domains of First Nations models of care including First Nations health workforce, accessible health services, holistic care, and self-determination were associated with better health outcomes. REGISTRATION This study was prospectively registered in PROSPERO (ID CRD42021254718).
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Affiliation(s)
- Julieann Coombes
- The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW, 2042, Australia
| | - Andrew J A Holland
- Department of Paediatric Surgery, The Children's Hospital at Westmead, Corner Hawkesbury Road and, Hainsworth St, Westmead, NSW, 2145, Australia
| | - Courtney Ryder
- The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW, 2042, Australia
- Indigenous Health College of Medicine and Public Health, Flinders University, Adelaide, SA, 5042, Australia
| | - Summer May Finlay
- School of Health and Society, Wollongong University, Wollongong, NSW, 2522, Australia
| | - Kate Hunter
- The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW, 2042, Australia
| | - Keziah Bennett-Brook
- The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW, 2042, Australia
| | - Phillip Orcher
- Agency for Clinical Innovations, 1 Reserve Rd, St Leonards, NSW, 2065, Australia
| | - Michele Scarcella
- The Sydney Children's Hospital Network (SCHN), Sydney, NSW, 2145, Australia
| | - Karl Briscoe
- National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners (NAATSIHWP), 31-37 Townshend Street, Phillip ACT, 2606, Australia
| | - Dale Forbes
- Department Community and Justice NSW, Sydney, NSW, 2012, Australia
| | - Madeleine Jacques
- Department of Paediatric Surgery, The Children's Hospital at Westmead, Corner Hawkesbury Road and, Hainsworth St, Westmead, NSW, 2145, Australia
| | - Deborah Maze
- Department of Paediatric Surgery, The Children's Hospital at Westmead, Corner Hawkesbury Road and, Hainsworth St, Westmead, NSW, 2145, Australia
| | - Bobby Porykali
- The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW, 2042, Australia
| | - Elizabeth Bourke
- The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW, 2042, Australia
| | - Camila A Kairuz Santos
- The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW, 2042, Australia.
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Dingwall KM, Povey J, Sweet M, Friel J, Shand F, Titov N, Wormer J, Mirza T, Nagel T. Feasibility and Acceptability of the Aboriginal and Islander Mental Health Initiative for Youth App: Nonrandomized Pilot With First Nations Young People. JMIR Hum Factors 2023; 10:e40111. [PMID: 37285184 DOI: 10.2196/40111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 02/13/2023] [Accepted: 04/17/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Despite young First Nations Australians being typically healthy, happy, and connected to family and culture, high rates of emotional distress, suicide, and self-harm are also observed. Differing worldviews of service providers and First Nations young people regarding illness and treatment practices, language differences, culturally inappropriate service models, geographical remoteness, and stigma can all inhibit access to appropriate mental health support. Mental health treatments delivered digitally (digital mental health; dMH) offer flexible access to evidence-based, nonstigmatizing, low-cost treatment and early intervention on a broad scale. There is a rapidly growing use and acceptance of these technologies among young First Nations people. OBJECTIVE The objective was to assess the feasibility, acceptability, and use of the newly developed Aboriginal and Islander Mental Health Initiative for Youth (AIMhi-Y) app and determine the feasibility of study procedures in preparation for future assessments of effectiveness. METHODS This was a nonrandomized pre-post study using mixed methods. First Nations young people aged 12-25 years who provided consent (with parental consent where appropriate) and possessed the ability to navigate a simple app with basic English literacy were included. Researchers conducted one face-to-face 20-minute session with participants to introduce and orient them to the AIMhi-Y app. The app integrates culturally adapted low-intensity cognitive behavioral therapy (CBT), psychoeducation, and mindfulness-based activities. Participants received supportive text messages weekly throughout the 4-week intervention period and completed assessments of psychological distress, depression, anxiety, substance misuse, help-seeking, service use, and parent-rated strengths and difficulties at baseline and 4 weeks. Qualitative interviews and rating scales were completed at 4 weeks to gain feedback on subjective experience, look and style, content, overall rating, check-ins, and involvement in the study. App use data were collected. RESULTS Thirty young people (17 males and 13 females) aged between 12 and 18 (mean 14.0, SD 1.55) years were assessed at baseline and 4 weeks. Repeated measures 2-tailed t tests showed improvements in well-being measures that were statistically and clinically significant for psychological distress (Kessler Psychological Distress Scale, 10-item) and depressive symptoms (Patient Health Questionnaire, 2-item). Participants spent on average 37 minutes in the app. The app was rated positively, with mean ratings of 4 out of 5 points (on scales of 1-5). Participants reported that they found the app easy to use, culturally relevant, and useful. The feasibility of the study was demonstrated with a 62% recruitment rate, a 90% retention rate, and high study acceptability ratings. CONCLUSIONS This study supports earlier research suggesting that dMH apps that are appropriately designed with and for the target populations are a feasible and acceptable means of lowering symptoms for mental health disorders among First Nations youth.
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Affiliation(s)
- Kylie M Dingwall
- Menzies School of Health Research, Charles Darwin University, Alice Springs, Australia
| | - Josie Povey
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Michelle Sweet
- Menzies School of Health Research, Charles Darwin University, Adelaide, Australia
| | - Jaylene Friel
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Nickolai Titov
- MindSpot Clinic, Macquarie University, Sydney, Australia
| | - Julia Wormer
- headspace Darwin, Anglicare NT, Darwin, Australia
| | - Tamoor Mirza
- headspace Darwin, Anglicare NT, Darwin, Australia
| | - Tricia Nagel
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
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Thompson F, Russell S, Quigley R, Sagigi B, Miller G, Esterman A, Harriss LR, Taylor S, McDermott R, Strivens E. Dementia Risk Models in an Australian First Nations Population: Cross-Sectional Associations and Preparation for Follow-Up. J Alzheimers Dis Rep 2023; 7:543-555. [PMID: 37313487 PMCID: PMC10259055 DOI: 10.3233/adr-220093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/01/2023] [Indexed: 06/15/2023] Open
Abstract
Background Reducing the burden of dementia in First Nations populations may be addressed through developing population specific methods to quantify future risk of dementia. Objective To adapt existing dementia risk models to cross-sectional dementia prevalence data from a First Nations population in the Torres Strait region of Australia in preparation for follow-up of participants. To explore the diagnostic utility of these dementia risk models at detecting dementia. Methods A literature review to identify existing externally validated dementia risk models. Adapting these models to cross-sectional data and assessing their diagnostic utility through area under the receiver operating characteristic curve (AUROC) analyses and calibration using Hosmer-Lemeshow Chi2. Results Seven risk models could be adapted to the study data. The Aging, Cognition and Dementia (AgeCoDe) study, the Framingham Heart Study (FHS), and the Brief Dementia Screening Indicator (BDSI) had moderate diagnostic utility in identifying dementia (i.e., AUROC >0.70) before and after points for older age were removed. Conclusion Seven existing dementia risk models could be adapted to this First Nations population, and three had some cross-sectional diagnostic utility. These models were designed to predict dementia incidence, so their applicability to identify prevalent cases would be limited. The risk scores derived in this study may have prognostic utility as participants are followed up over time. In the interim, this study highlights considerations when transporting and developing dementia risk models for First Nations populations.
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Affiliation(s)
- Fintan Thompson
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
- University of South Australia, SA, Australia
| | - Sarah Russell
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
| | - Rachel Quigley
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
| | - Betty Sagigi
- Queensland Health, Torres and Cape Hospital and Health Service, Thursday Island, QLD, Australia
| | - Gavin Miller
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
| | | | - Linton R. Harriss
- Australian Institute of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, QLD, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
| | - Sean Taylor
- Top End Health Service, Northern Territory Government, Darwin, NT, Australia
| | | | - Edward Strivens
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, QLD, Australia
- College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
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Courtney A, Lopez DJ, Lowe AJ, Holmes Z, Su JC. Burden of Disease and Unmet Needs in the Diagnosis and Management of Atopic Dermatitis in Diverse Skin Types in Australia. J Clin Med 2023; 12:jcm12113812. [PMID: 37298007 DOI: 10.3390/jcm12113812] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
Atopic dermatitis (AD) is a common, chronic, inflammatory skin disease affecting Australians of all ages, races, ethnicities, and social classes. Significant physical, psychosocial, and financial burdens to both individuals and Australian communities have been demonstrated. This narrative review highlights knowledge gaps for AD in Australian skin of colour. We searched PubMed, Wiley Online Library, and Cochrane Library databases for review articles, systematic reviews, and cross-sectional and observational studies relating to AD in Australia for skin of colour and for different ethnicities. Statistical data from the Australian Institute of Health and Welfare and the Australian Bureau of Statistics was collected. In recent years, there has been substantially increased awareness of and research into skin infections, such as scabies and impetigo, among various Australian subpopulations. Many such infections disproportionately affect First Nations Peoples. However, data for AD itself in these groups are limited. There is also little written regarding AD in recent, racially diverse immigrants with skin of colour. Areas for future research include AD epidemiology and AD phenotypes for First Nations Peoples and AD trajectories for non-Caucasian immigrants. We also note the evident disparity in both the level of understanding and the management standards of AD between urban and remote communities in Australia. This discrepancy relates to a relative lack of healthcare resources in marginalised communities. First Nations Peoples in particular experience socioeconomic disadvantage, have worse health outcomes, and experience healthcare inequality in Australia. Barriers to effective AD management must be identified and responsibly addressed for socioeconomically disadvantaged and remote-living communities to achieve healthcare equity.
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Affiliation(s)
- Ashling Courtney
- Department of Dermatology, Eastern Health, Monash University, Melbourne, VIC 3128, Australia
- Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
| | - Diego J Lopez
- Allergy and Lung Health Unit, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Adrian J Lowe
- Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
- Allergy and Lung Health Unit, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Zack Holmes
- Department of Dermatology, Alfred Health, Melbourne, VIC 3004, Australia
| | - John C Su
- Department of Dermatology, Eastern Health, Monash University, Melbourne, VIC 3128, Australia
- Murdoch Children's Research Institute, Melbourne, VIC 3052, Australia
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Culbong H, Ramirez-Watkins A, Anderson S, Culbong T, Crisp N, Pearson G, Lin A, Wright M. "Ngany Kamam, I Speak Truly": First-Person Accounts of Aboriginal Youth Voices in Mental Health Service Reform. Int J Environ Res Public Health 2023; 20:6019. [PMID: 37297622 PMCID: PMC10253012 DOI: 10.3390/ijerph20116019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/22/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
Aboriginal young people are experts in their own experience and are best placed to identify the solutions to their mental health and wellbeing needs. Given that Aboriginal young people experience high rates of mental health concerns and are less likely than non-Indigenous young people to access mental health services, co-design and evaluation of appropriate mental health care is a priority. Increasing Aboriginal young people's participation in mental health service reform is key to ensuring services are culturally secure, relevant and accessible. This paper presents first-person accounts from three Aboriginal young people who worked alongside their Elders and in a positive and constructive partnership with mainstream mental health services on a three-year participatory action research project in Perth, Western Australia, in Whadjuk Nyoongar boodja (Country). The young people recount their experiences as participants and co-researchers on a systems change mental health research project and share their views on the importance of privileging Aboriginal youth voices. Their accounts highlight that Aboriginal young people's participation and leadership must be understood through a decolonising lens and that working in genuine partnership with the community is key to increasing their contact and engagement with mental health care and improving mental health and wellbeing outcomes.
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Affiliation(s)
- Hunter Culbong
- College of Arts and Social Sciences, Australian National University, Canberra 2601, Australia;
| | | | - Shae Anderson
- Kulbardi Aboriginal Centre, Murdoch University, Perth 6150, Australia;
| | - Tiana Culbong
- School of Nursing and Midwifery, The University of Technology, Sydney 2000, Australia;
| | - Nikayla Crisp
- Design Participation and Inclusion, Neami National, Perth 6000, Australia;
| | - Glenn Pearson
- Telethon Kids Institute, University of Western Australia, Perth 6000, Australia; (G.P.); (A.L.)
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Perth 6000, Australia; (G.P.); (A.L.)
| | - Michael Wright
- School of Allied Health, Faculty of Health Sciences, Curtin University, Bentley 6102, Australia
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