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Charania NA, Tonumaipe'a D, Barbarich-Unasa TW, Iusitini L, Davis G, Pacheco G, Wilson D. Exploring the impact of the COVID-19 pandemic on perceptions of national scheduled childhood vaccines among Māori and Pacific caregivers, whānau, and healthcare professionals in Aotearoa New Zealand. Hum Vaccin Immunother 2024; 20:2301626. [PMID: 38205779 DOI: 10.1080/21645515.2023.2301626] [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: 09/28/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024] Open
Abstract
In Aotearoa New Zealand, there has been a marked decrease in the uptake of routine childhood vaccinations since the onset of the COVID-19 pandemic, particularly among Māori and Pacific children. This Māori and Pacific-centered research used an interpretive description methodology. We undertook culturally informed interviews and discussions with Māori and Pacific caregivers (n = 24) and healthcare professionals (n = 13) to understand their perceptions of routine childhood vaccines. Data were analyzed using reflexive thematic analysis and privileged respective Māori and Pacific worldviews. Four themes were constructed. "We go with the norm" reflected how social norms, health personnel and institutions promoted (and sometimes coerced) participants' acceptance of routine vaccines before the pandemic. "Everything became difficult" explains how the pandemic added challenges to the daily struggles of whānau (extended family networks) and healthcare professionals. Participants noted how information sources influenced disease and vaccine perceptions and health behaviors. "It needed to have an ethnic-specific approach" highlighted the inappropriateness of Western-centric strategies that dominated during the initial pandemic response that did not meet the needs of Māori and Pacific communities. Participants advocated for whānau-centric vaccination efforts. "People are now finding their voice" expressed renewed agency among whānau about vaccination following the immense pressure to receive COVID-19 vaccines. The pandemic created an opportune time to support informed parental vaccine decision-making in a manner that enhances the mana (authority, control) of whānau. Māori and Pacific-led vaccination strategies should be embedded in immunization service delivery to improve uptake and immunization experiences for whānau.
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Affiliation(s)
- Nadia A Charania
- Department of Public Health, Auckland University of Technology, Auckland, New Zealand
| | - Daysha Tonumaipe'a
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Te Wai Barbarich-Unasa
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Leon Iusitini
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Georgina Davis
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
| | - Gail Pacheco
- New Zealand Work Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Denise Wilson
- Taupua Waiora Centre for Māori Health Research, Auckland University of Technology, Auckland, New Zealand
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Faruqui A, Tjong GB, Boutros HM, Stutz S, Mashford-Pringle A. Programs supporting incarcerated and previously incarcerated indigenous peoples: a scoping review protocol. Int J Circumpolar Health 2024; 83:2343144. [PMID: 38626421 DOI: 10.1080/22423982.2024.2343144] [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: 10/31/2023] [Accepted: 04/10/2024] [Indexed: 04/18/2024] Open
Abstract
The overincarceration of Indigenous peoples and its impacts on individual and community health is a growing concern across Canada and the United States. Federally run Healing Lodges in Canada are an example of support services for incarcerated and previously incarcerated Indigenous peoples to reintegrate into community and support their healing journey. However, there is a need to synthesise research which investigates these programmes. We report a protocol for a scoping review that is guided by the following research question: What is known about culturally informed programmes and services available to incarcerated and previously incarcerated Indigenous peoples in Canada and the US? This scoping review will follow guidelines published by the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. This review will only identify programmes that are guided by Indigenous ways of being and knowing in order to best serve Indigenous communities and our community partners. The results of this review will support the development of programmes that are necessary for understanding and addressing the diverse needs of incarcerated and previously incarcerated Indigenous peoples.
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Affiliation(s)
- Aisha Faruqui
- Waakebiness Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Gabriel B Tjong
- Waakebiness Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Helana Marie Boutros
- Waakebiness Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sterling Stutz
- Waakebiness Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Angela Mashford-Pringle
- Waakebiness Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Pettan-Brewer C, Penn G, Biondo AW, Jaenisch T, Grützmacher K, Kahn LH. Who coined the term "One Health"? Cooperation amid the siloization. One Health 2024; 18:100678. [PMID: 38304438 PMCID: PMC10831148 DOI: 10.1016/j.onehlt.2024.100678] [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: 12/11/2023] [Accepted: 01/11/2024] [Indexed: 02/03/2024] Open
Abstract
This short communication is an effort to describe and elucidate the trajectory of the modern historical concept of "One Health." It is dedicated to the many integrated approaches of health closely related to One Health, while also recognizing the contribution and origination of One Health perspectives/notions from those that have led the way and spearheaded this movement while considering Indigenous cultures across the world. The effects of synergies of those involved in building these integrative approaches are potentially bigger and better lasting than the sum of the individual players. It is only through collaboration, cooperation and diplomacy that we can achieve impactful transformation to benefit health. In this commentary, we aim to appropriately and accurately describe how the current use of "One Health" came to be and who were the main players.
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Affiliation(s)
- Christina Pettan-Brewer
- School of Medicine, University of Washington, Seattle, WA, USA
- One Health, Zoonoses & Shelter Medicine, School of Veterinary Medicine, Universidade Federal do Parana, Curitiba, Brazil
| | - Gillian Penn
- Colorado School of Public Health, Department of Environmental Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alexander W. Biondo
- One Health, Zoonoses & Shelter Medicine, School of Veterinary Medicine, Universidade Federal do Parana, Curitiba, Brazil
| | - Thomas Jaenisch
- Center for Global Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Kim Grützmacher
- Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ) GmbH, Sitz der Gesellschaft Bonn und Eschborn/Registered Offices Bonn and Eschborn, Berlin, Germany
| | - Laura H. Kahn
- One Health Initiative (pro bono), Program on Science and Global Security at the School of Public and International Affairs Princeton University, USA
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Van Bewer V, Sawchyn M. Enhancing nursing education for Indigenous students: Indigenous nursing students' insights and strategies. Nurse Education Today 2024; 137:106157. [PMID: 38503250 DOI: 10.1016/j.nedt.2024.106157] [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: 06/27/2023] [Revised: 02/20/2024] [Accepted: 03/08/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Indigenous nursing students contended with far-reaching challenges during the pandemic that significantly altered their experiences of nursing education. These experiences are poorly understood by nursing educators and strategies for Indigenous nursing student success rarely involve the insights of current Indigenous nursing students. AIM The aim of this article is to offer Indigenous-student derived recommendations regarding strategies for improving their experiences and success within nursing education during the pandemic and beyond. DESIGN AND METHODS This qualitative study employed an Indigenous methodology including land-based learning, ceremony, and sharing circles. PARTICIPANTS AND SETTING Indigenous nursing students (n = 17) from a Western Canadian school of nursing participated in one of three sharing circles. RESULTS Indigenous nursing students recommended institutional and program adaptations along with increases to cultural safety for enhancing their experience in nursing education. Institutional and program strategies included: decreasing course loads and class sizes; an Indigenous-specific cohort; a transition program after course failure; increasing academic supports such as additional clinical skills and academic writing practice. Recommendations for increasing cultural safety included: mandatory and recurrent cultural safety training for faculty, staff and students; differential learning and evaluation strategies; and increased inclusion of Indigenous ceremonies and practices. CONCLUSION The findings of this study provide insights that can help guide curriculum development, pedagogical approaches, and policy development to improve nursing education for Indigenous students.
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Affiliation(s)
- Vanessa Van Bewer
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB R3T 2N2, Canada.
| | - Morgan Sawchyn
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, 89 Curry Place, Winnipeg, MB R3T 2N2, Canada.
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Gibson M, Leske S, Ward R, Weir B, Russell K, Kolves K. Aboriginal and Torres Strait Islander youth suicide mortality and previous mental health, suicidality and service use in Queensland, Australia, from 2001 to 2021. J Affect Disord 2024; 354:55-61. [PMID: 38484672 DOI: 10.1016/j.jad.2024.03.013] [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: 07/13/2023] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND The current study aimed to compare current suicide rates, trends, previous treatment, suicidality and mental health diagnoses for First Nations and non-Indigenous young people who died by suicide. METHODS Age-specific suicide rates (ASSRs) were calculated per 100,000 persons/year using suicides aged 10-19 years in the Queensland Suicide Register. Rate Ratios (RRs) and 95 % CIs compared ASSRs for First Nations and non-Indigenous youth dying by suicide in Queensland, Australia, from 2001 to 2018. Risk ratios (RiskR) with 95 % CIs compared characteristics between First Nations and non-Indigenous youth suicides. Joinpoint regression was used to identify any changes in trends and annual percentage change (APC) in suicides with 95 % CIs. RESULTS The First Nations youth ASSR was 24.71 deaths per 100,000 persons/year, 4.5 times the non-Indigenous ASSR (95 % CI = 3.74-5.38, p < 0.001). Both non-Indigenous and First Nations suicide trends were stable with no joinpoints (APC: 0.3 %, 95 % CI: -1.6-2.2, p = 0.78; APC: 0.9 %, 95 % CI: -0.2-2.1, p = 0.11). Less than a quarter (23.9 %) of First Nations young people had ever received mental health treatment, significantly fewer than non-Indigenous youth (RiskR = 0.80, 95 % CI = 0.71-0.90, p < 0.001). Similarly, in the three months preceding their death, only 14.5 % of First Nations young people had received mental health treatment (RiskR = 0.89, 95 % CI = 0.83-97, p = 0.015). LIMITATIONS Reported mental illness, suicidality and help-seeking could be underreported due to concealment from family or police. CONCLUSIONS The current study finds no change in the gap between the First Nations and Non-Indigenous youth suicide rates nor evidence of decrease in the First Nations youth suicide rate. There is a need for alternative approaches to Indigenous youth suicide prevention, such as assertive outreach models outside of traditional triage and mental health systems to proactively build trusting relationships with young people in communities to identify young people needing support.
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Affiliation(s)
- M Gibson
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia.
| | - S Leske
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia; UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, Queensland, Australia
| | - R Ward
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia; Institute for Resilient Regions, Knowledge Broker First Nations Engagement Southern Queensland & Northern NSW Drought Resilience Adoption & Innovation Hub, University of Southern Queensland, Toowoomba, Queensland, Australia
| | - B Weir
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - K Russell
- Beyond the Pale Aboriginal and Torres Strait youth mental health support services, Australia
| | - K Kolves
- Australian Institute for Suicide Research and Prevention, WHO Collaborating Centre for Research and Training in Suicide Prevention, School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
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McCalman P, Forster D, Newton M, McLardie-Hore F, McLachlan H. "Safe, connected, supported in a complex system." Exploring the views of women who had a First Nations baby at one of three maternity services offering culturally tailored continuity of midwife care in Victoria, Australia. A qualitative analysis of free-text survey responses. Women Birth 2024; 37:101583. [PMID: 38302389 DOI: 10.1016/j.wombi.2024.01.009] [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: 10/11/2023] [Revised: 12/22/2023] [Accepted: 01/24/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND In Australia, continuity of midwife care is recommended for First Nations women to address the burden of inequitable perinatal outcomes experienced by First Nations women and newborns. AIMS This study aimed to explore the experiences of women having a First Nations baby who received care at one of three maternity services in Naarm (Melbourne), Victoria, where culturally tailored midwife continuity models had been implemented. METHODS Women having a First Nations baby who were booked for care at one of three study sites were invited to participate in an evaluation of care. Thematic analysis was used to analyse qualitative data from responses to free-text, open ended questions that were included in a follow-up questionnaire at 3-6 months after the birth. RESULTS In total, 213 women (of whom 186 had continuity of midwife care) participated. The global theme for what women liked about their care was 'Safe, connected, supported' including emotional and clinical safety, having a known midwife and being supported 'my way'. The global theme for what women did not like about their care was 'A complex, fragmented and unsupportive system' including not being listened to, things not being explained, and a lack of cultural safety. CONCLUSIONS Culturally tailored caseload midwifery models appear to make maternity care feel safer for women having a First Nations baby, however, the mainstream maternity care system remained challenging for some. These models should be implemented for First Nations women, and evidence-based frameworks, such as the RISE framework, should be used to facilitate change.
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Affiliation(s)
- P McCalman
- 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 3052, Australia.
| | - D 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
| | - M 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 3052, Australia
| | - F 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
| | - H 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 3052, Australia
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Simpson AK, Drysdale M, Gamberg M, Froese K, Brammer J, Dumas P, Ratelle M, Skinner K, Laird BD. Human biomonitoring of dioxins, furans, and non-ortho dioxin-like polychlorinated biphenyls (PCBs) in blood plasma from Old Crow, Yukon, Canada (2019). Sci Total Environ 2024; 923:171222. [PMID: 38408666 DOI: 10.1016/j.scitotenv.2024.171222] [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: 11/06/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Abstract
Dioxins, furans, and dioxin-like polychlorinated biphenyls (PCBs) are a group of persistent and toxic chemicals that are known to have human health effects at low levels. These chemicals have been produced for commercial use (PCBs) or unintentionally as by-products of industry or natural processes (PCBs, dioxins, and furans). Additionally, dioxin-like PCBs were formerly used in electrical applications before being banned internationally (2004). These chemicals are widely dispersed in the environment as they can contaminate air and travel hundreds to thousands of kilometers before depositing on land or water, thereafter, potentially entering food chains. Community concerns surrounding the safety of traditional foods prompted a human biomonitoring project in Old Crow, Yukon Territory (YT), Canada (2019). Through collaborative community engagement, dioxins and like compounds were identified as a priority for exposure assessment from biobanked samples. In 2022, biobanked plasma samples (n = 54) collected in Old Crow were used to measure exposures to seven dioxins, ten furans, and four dioxin-like PCBs. 1,2,3,6,7,8-HxCDD, 1,2,3,7,8,9-HxCDD, 1,2,3,4,6,7,8-HpCDD, OCDD, 2,3,4,7,8-PeCDF, 1,2,3,6,7,8-HxCDF, PCB 126, and PCB 169 were detected in at least 50 % of samples. Among these analytes, the only congener at elevated levels was PCB 169, which was approximately ∼2-fold higher than the general population of Canada. No significant sex-based or body mass index (BMI) differences in biomarker concentrations were observed. Generally, the concentrations of the detected congeners increased with age, except for 1,2,3,4,6,7,8-HpCDD. For the first time, this research measures dioxin and like-compound exposures in Old Crow, advancing the information available on chemical exposures in the Arctic. Further research could be directed towards the investigation of PCB 169 exposure sources and temporal monitoring of exposures and determinants.
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Affiliation(s)
- Ashlyn K Simpson
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
| | - Mallory Drysdale
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
| | - Mary Gamberg
- Gamberg Consulting, Whitehorse, Yukon Y1A 6N5, Canada
| | - Ken Froese
- GatePost Risk Analysis, Red Deer, Alberta T4R 0A9, Canada.
| | - Jeremy Brammer
- Vuntut Gwitchin Government, Old Crow, Yukon Y0B 1N0, Canada.
| | - Pierre Dumas
- Centre de Toxicologie du Québec (CTQ), Institut National de Santé Publique du Québec (INSPQ), Québec G1V 5B3, Canada.
| | - Mylène Ratelle
- École de santé publique, Université de Montréal, 7101, avenue du Parc, Montréal, Québec H3N 1X9, Canada.
| | - Kelly Skinner
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
| | - Brian D Laird
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
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Bradford BF, Cronin RS, Okesene-Gafa KA, Apaapa-Timu THS, Shashikumar A, Oyston CJ. Diabetes in pregnancy: Women's views of care in a multi-ethnic, low socioeconomic population with midwifery continuity-of-care. Women Birth 2024; 37:101579. [PMID: 38296743 DOI: 10.1016/j.wombi.2024.01.005] [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: 09/27/2023] [Revised: 12/10/2023] [Accepted: 01/14/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Diabetes in pregnancy is diagnosed in 6% of pregnancies annually in Aotearoa-New Zealand, disproportionately affecting multi-ethnic, low socio-economic women. Little is known about the care experience of this population within the model of midwifery continuity-of-care, including views of telehealth care. AIM Increase understanding of the experience of diabetes in pregnancy care, including telehealth, among multi-ethnic, low socio-economic women receiving midwifery continuity-of-care. METHODS Qualitative interview study with primarily indigenous and migrant women who had diabetes in pregnancy and gave birth 6-18 months previously. Interviewers were matched with participants by ethnicity. Transcripts were analysed using Framework analysis. RESULTS Participants were 19 women (5 Māori, 5 Pacific Peoples, 5 Asian, 4 European). Data analysis revealed three key themes: 1) 'shock, shame, and adjustment' to the diagnosis 2) 'learning to manage diabetes in pregnancy' and 3) 'preparation for birth and beyond' to the postpartum period. DISCUSSION Receiving the diagnosis of diabetes in pregnancy was a shock. Managing diabetes during pregnancy was particularly challenging for indigenous and migrant women, who wished for better access to culturally appropriate dietary and lifestyle information. Women appreciated having options of telehealth and face-to-face consultations. Preparation for birth and postpartum diabetes follow-up were areas requiring significant improvement. Challenges were mitigated through care from a consistent diabetes specialist midwife and community-based midwifery continuity-of-care. CONCLUSION Midwives were the backbone of diabetes in pregnancy care for this multi-ethnic, low socio-economic population. Care could be improved with more culturally appropriate diet and lifestyle information, better birth preparation, and expanded postpartum diabetes support.
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Affiliation(s)
- Billie F Bradford
- Obstetrics & Gynaecology, Monash Health, Monash University, Australia
| | - Robin S Cronin
- Te Whatu Ora Counties Manukau, Health New Zealand, New Zealand; Department of Obstetrics and Gynecology, University of Auckland, New Zealand
| | - Karaponi A Okesene-Gafa
- Te Whatu Ora Counties Manukau, Health New Zealand, New Zealand; Department of Obstetrics and Gynecology, University of Auckland, New Zealand
| | - Te Hao S Apaapa-Timu
- Te Whatu Ora Counties Manukau, Health New Zealand, New Zealand; Department of Obstetrics and Gynecology, University of Auckland, New Zealand
| | - Asha Shashikumar
- Department of Obstetrics and Gynecology, University of Auckland, New Zealand
| | - Charlotte J Oyston
- Te Whatu Ora Counties Manukau, Health New Zealand, New Zealand; Department of Obstetrics and Gynecology, University of Auckland, New Zealand.
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Sianturi EI, Longe VS, Arjadi R, Bakri NF, Gunawan E, Sinaga ES. Suicide Behavior Among Indigenous and Non-Indigenous Living with HIV: A Cross-Sectional Study in Indonesia. J Immigr Minor Health 2024:10.1007/s10903-024-01593-7. [PMID: 38619673 DOI: 10.1007/s10903-024-01593-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2024] [Indexed: 04/16/2024]
Abstract
Suicide remains a major public health problem, with nearly 1 million deaths per year. The number tends to increase over time and factors leading to suicide suicidal behaviors are complex. However, there is a paucity of evidence on suicidal behaviors and the associated factors among people living with HIV (PLWH) in Indonesia. Therefore, this study aimed to estimate the prevalence and associated factors of suicidal behavior between indigenous and non-indigenous living with HIV who were on Dolutegravir and Efavirenz therapies. The cross-sectional data were collected using questionnaires. Participants completed the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Depression Anxiety Stress Scale-42 (DASS-42), HIV Stigma-Sowell Scale, and demographic information questions. The outcome was low and high self-reported suicidal behaviors, while logistic regression analyses were used to estimate adjusted odds ratios (aOR) for associated factors of high suicidal behaviors. A total of 200 PLWH were enrolled and 8.5% of the participants had high levels of suicidal behaviors. The majority of participants were Efavirenz users (84.0%), and Papuans as Indigenous (75.5%). More than half had a high school education (60.5%), were female (58%), married (54%), and unpaid (59%). The multiple logistic regression model showed that indigenous (aOR = 0.122; 95% CI = 0.029-0.514), and people who had children (aOR = 0.221; 95% CI = 0.051-0.957) were more likely to have low suicidal behaviors. Participants who were aged 18-27 years (aOR = 5.894; 95% CI = 1.336-30.579), had high self-blame (aOR = 1.342; 95% CI) = 1.004-1.792), and detectable HIV viral load (aOR = 6.177; 95%CI = 1.118-34.119) had high suicidal behavior. This study identified the risk of suicidality among PLWHs is high and routine suicide assessment is prioritized. The findings are also useful for intervention design and the development of clinical practice guidelines to manage the well-being of PLWH such as using digital intervention to cope with hindrances.
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Affiliation(s)
- Elfride Irawati Sianturi
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Cenderawasih, Kamp Wolker, Uncen Waena, Jayapura, 99358, Papua, Indonesia.
| | - Viona Stephany Longe
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Cenderawasih, Kamp Wolker, Uncen Waena, Jayapura, 99358, Papua, Indonesia
| | - Retha Arjadi
- Faculty of Psychology, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Nur Fadilah Bakri
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Cenderawasih, Kamp Wolker, Uncen Waena, Jayapura, 99358, Papua, Indonesia
| | - Elsye Gunawan
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Cenderawasih, Kamp Wolker, Uncen Waena, Jayapura, 99358, Papua, Indonesia
| | - Ego Srivajawaty Sinaga
- Geophysical Engineering Study Program, Department of Physics, Universitas Cenderawasih, Jayapura, Indonesia
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Tallman PS, Miller AA, Brandley SR, Lee CC, Cepon-Robins TJ, Gildner TE, Collins SM. Helicobacter pylori exposure among the Awajún of the Peruvian Amazon: Prevalence and environmental, social, and biological associations. Am J Biol Anthropol 2024:e24941. [PMID: 38615180 DOI: 10.1002/ajpa.24941] [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] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/15/2024] [Accepted: 04/02/2024] [Indexed: 04/15/2024]
Abstract
OBJECTIVES Helicobacter pylori (H. pylori)-a gastric bacteria affecting almost 50% of the global population and leading to ulcers and cancer in severe cases-is a growing health concern among Indigenous populations who report a high burden of reported poor general health and gastrointestinal distress. We test hypothesized associations between H. pylori exposure patterns and environmental, social, and biological conditions among a sample of 212 Indigenous Awajún adults (112 males, 100 females, ages 18-65 years) living in the northern Peruvian Amazon. MATERIALS AND METHODS Dried blood spots were analyzed for H. pylori-specific IgG using a recently developed enzyme-linked immunosorbent assay. Resulting seropositivity rates and antibody concentrations, proxying past exposures to H. pylori were analyzed in relation to relevant environmental (toilet type, floor material, reported water quality), social (household size and education level), and biological (age, sex, BMI, blood pressure, immune and metabolic biomarkers) factors using multivariable regression analyses. RESULTS We found near ubiquitous seropositivity for H. pylori exposure in our sample (99.1% seropositive). In the regression analyses, elevations in H. pylori antibody concentrations were significantly higher among males compared to females (β = 0.36, p = 0.01). No associations were found with any other factors. DISCUSSION Anthropological research in the study communities suggests that the male bias in elevations of H. pylori antibody concentrations is related to cultural and biological factors. Future research is needed to further unravel these biocultural dynamics and determine whether elevations in H. pylori antibody concentrations have clinical relevance for gastrointestinal health outcomes in this population.
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Affiliation(s)
- Paula S Tallman
- Department of Anthropology, Loyola University Chicago, Chicago, Illinois, USA
| | - Aaron A Miller
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Sophea R Brandley
- Department of Anthropology, Loyola University Chicago, Chicago, Illinois, USA
| | - Cassie C Lee
- Department of Anthropology, Northwestern University, Evanston, Illinois, USA
| | - Tara J Cepon-Robins
- Department of Anthropology, University of Colorado Colorado Springs, Colorado Springs, Colorado, USA
| | - Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Shalean M Collins
- Department of International Health and Sustainable Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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11
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Estradé M, Bode B, Walls M, Lewis EC, Poirier L, Sundermeir SM, Gittelsohn J. Federal food assistance accessibility and acceptability among Indigenous Peoples in the United States: A scoping review. J Nutr 2024:S0022-3166(24)00220-7. [PMID: 38614239 DOI: 10.1016/j.tjnut.2024.04.017] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/11/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024] Open
Abstract
The purpose of this scoping review was to determine the extent to which accessibility and acceptability of federal food assistance programs in the United States (U.S.) have been evaluated among Indigenous Peoples, and to summarize what is currently known. Twelve publications were found that examine aspects of accessibility or acceptability by indigenous peoples of one or more federal food assistance programs, including the Supplemental Nutrition Assistance Program (SNAP) and/or the Food Distribution Program on Indian Reservations (FDPIR) (n=8), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) (n=3), and the National School Lunch Program (NSLP) (n=1). No publications were found to include the Commodity Supplemental Food Program (CSFP) or the Child and Adult Care Food Program (CACFP). Publications ranged in time from 1990 - 2023, and all reported on findings from rural populations, while three also included urban settings. Program accessibility varied by program type and geographic location. Road conditions, transportation access, telephone and internet connectivity, and overall number of food stores were identified as key access barriers to SNAP and WIC benefit redemption in rural areas. Program acceptability was attributed to factors such as being tribally administered, providing culturally sensitive services, and offering foods of cultural significance. For these reasons, FDPIR and WIC were more frequently described as acceptable compared to SNAP and NSLP. However, SNAP was occasionally described as more acceptable than other assistance programs because it allows participants autonomy to decide which foods to purchase and when. Overall, little attention has been paid to the accessibility and acceptability of federal food assistance programs among Indigenous Peoples in the U.S. More research is needed to understand and improve the participation experiences and health trajectories of these priority populations.
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Morey K, Keech W, McKivett A, Brown K, Pearson O, Mejia G, Sivak L, Brown A. Priority setting: Development of the South Australian Aboriginal Chronic Disease Consortium RoadMap for Action. Health Promot J Austr 2024. [PMID: 38605229 DOI: 10.1002/hpja.864] [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: 07/27/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/13/2024] Open
Abstract
ISSUES ADDRESSED Aboriginal and Torres Strait Islander (Aboriginal) people in South Australia are overburdened by cardiovascular disease, diabetes and cancer. The South Australian Aboriginal Chronic Disease Consortium (Consortium) was established in June 2017 as a collaborative partnership to lead the implementation of three state-wide chronic disease plans using a strategic approach to identifying key priority areas for action. METHODS In 2017-2018, the Consortium Coordinating Centre facilitated a priority setting process, which involved extensive consultation, including a prioritisation survey and stakeholder workshops. The Consortium's Aboriginal Community Reference Group was instrumental in leading the identification of priorities for action. RESULTS The Consortium RoadMap for Action identified seven across-plan priorities and six condition-specific priorities. It acknowledged that: strengthening social and emotional well-being is central to improving health outcomes; prevention and early detection, acute management and ongoing management are all components of the continuum of care; and improving access to services, strengthening the workforce, and monitoring and evaluation are required across the continuum of care. CONCLUSION Widespread implementation failure in the past across the health system and health services implementation and research translation highlights the value of the Consortium approach and its commitment to implementing the state-wide chronic disease plans in a collaborative manner. The Consortium relies on and fosters cross-sectoral alignment, with all key players including all public, private and Aboriginal Community Controlled health services, to progress its priorities and aspirations to improve health outcomes for Aboriginal people using evidence-based strategies. SO WHAT?: Rigorous and transparent priority setting processes that bring together research, clinical practice, health services operations, policy and community perspectives can foster intersectoral collaboration and partnership and support the implementation of shared priorities.
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Affiliation(s)
- Kim Morey
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Wendy Keech
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Andrea McKivett
- University of Adelaide, Adelaide, South Australia, Australia
| | - Katharine Brown
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Odette Pearson
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Gloria Mejia
- University of Adelaide, Adelaide, South Australia, Australia
| | - Leda Sivak
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Alex Brown
- Australian National University, Canberra, Australian Capital Territory, Australia
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Rink E, Stotz SA, Johnson-Jennings M, Huyser K, Collins K, Manson SM, Berkowitz SA, Hebert L, Byker Shanks C, Begay K, Hicks T, Dennison M, Jiang L, Firemoon P, Johnson O, Anastario M, Ricker A, GrowingThunder R, Baldwin J. "We don't separate out these things. Everything is related": Partnerships with Indigenous Communities to Design, Implement, and Evaluate Multilevel Interventions to Reduce Health Disparities. Prev Sci 2024:10.1007/s11121-024-01668-9. [PMID: 38598040 DOI: 10.1007/s11121-024-01668-9] [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] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
Multilevel interventions (MLIs) are appropriate to reduce health disparities among Indigenous peoples because of their ability to address these communities' diverse histories, dynamics, cultures, politics, and environments. Intervention science has highlighted the importance of context-sensitive MLIs in Indigenous communities that can prioritize Indigenous and local knowledge systems and emphasize the collective versus the individual. This paradigm shift away from individual-level focus interventions to community-level focus interventions underscores the need for community engagement and diverse partnerships in MLI design, implementation, and evaluation. In this paper, we discuss three case studies addressing how Indigenous partners collaborated with researchers in each stage of the design, implementation, and evaluation of MLIs to reduce health disparities impacting their communities. We highlight the following: (1) collaborations with multiple, diverse tribal partners to carry out MLIs which require iterative, consistent conversations over time; (2) inclusion of qualitative and Indigenous research methods in MLIs as a way to honor Indigenous and local knowledge systems as well as a way to understand a health disparity phenomenon in a community; and (3) relationship building, maintenance, and mutual respect among MLI partners to reconcile past research abuses, prevent extractive research practices, decolonize research processes, and generate co-created knowledge between Indigenous and academic communities.
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Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, 312 Herrick Hall, Bozeman, MT, 59715, USA.
| | - Sarah A Stotz
- Department of Food Science and Human Nutrition, Colorado State University, 502 West Lake Street, Fort Collins, CO, 80526, USA
| | - Michelle Johnson-Jennings
- Division of Indigenous Environmental Health and Land-Based Healing, Indigenous Wellness Research Institute, University of Washington, Gergerding Hall GBO, Box 351202, Seattle, WA, USA
| | - Kimberly Huyser
- Department of Sociology, Research, and Development/CIEDAR Center, COVID-19 Indigenous Engagement, University of British Columbia, 310-6251 Cecil Green Park Road, Vancouver, BC, V6T 1Z1, Canada
| | - Katie Collins
- CIEDAR co-Lead. Department of Psychology, University of Saskatchewan, 9 Campus Drive, 154 Arts, Saskatoon, SK, S7N 5A5, Canada
| | - Spero M Manson
- Colorado School of Public Health, Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, Aurora, CO, 80045, USA
| | - Seth A Berkowitz
- Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC; Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 M.L.K. Jr Blvd, Chapel Hill, NC, 27516, USA
| | - Luciana Hebert
- Institute for Research and Education to Advance Community Health (IREACH), Elson S. Floyd College of Medicine, Washington State University, 1100 Olive Way #1200, Seattle, WA, 98101, USA
| | - Carmen Byker Shanks
- Gretchen Swanson Center for Nutrition, 14301 FNB Pkwy #100, Omaha, NE, 68154, USA
| | - Kelli Begay
- Maven Collective Consulting, LLC, 15712 N Pennsylvania Avenue Cube 5, Edmond, OK, 73013, USA
| | - Teresa Hicks
- Teresa Hicks Consulting, 1107 East Babcock Street, Bozeman, MT, 59715, USA
| | - Michelle Dennison
- Oklahoma City Indian Clinic, 4913 W Reno Ave, 856 Health Sciences Quad, Suite 3400, Oklahoma City, OK, 73127, USA
| | - Luohua Jiang
- Department of Epidemiology and Biostatistics; UCI Health Sciences Complex, University of California Irvine, Program in Public Health, 856 Health Sciences Quad, Suite 3400, Irvine, CA, 92617, USA
| | - Paula Firemoon
- Fort Peck Community College, 605 Indian Ave.,, Poplar, MT, 59255, USA
| | - Olivia Johnson
- Fort Peck Community College, 605 Indian Ave.,, Poplar, MT, 59255, USA
| | - Mike Anastario
- Center for Health Equity Research, Northern Arizona University, P.O. Box 4065, Suite 120, Flagstaff, AZ, 86011-4065, USA
| | - Adriann Ricker
- Fort Peck Tribal Health Department, 501 Medicine Bear Road, Poplar, MT, 59255, USA
| | - Ramey GrowingThunder
- Fort Peck Tribes Language and Culture Department, 603 Court Ave., Poplar, MT, 59255, USA
| | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, P.O. Box 4065, Suite 120, Flagstaff, AZ, 86011-4065, USA
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Chai L. Interplay between actual and perceived weight on mental health among Canadian Indigenous post-secondary students. J Am Coll Health 2024:1-9. [PMID: 38592936 DOI: 10.1080/07448481.2024.2338419] [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] [Received: 02/03/2022] [Accepted: 03/22/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Research increasingly focuses on the mental health implications of both actual and perceived weight, particularly among post-secondary students. Considering their unique socio-cultural context and the frequent oversight in research, this study examines these implications specifically among Canadian Indigenous post-secondary students. Recent evidence indicates that students with normal weight may also experience increased mental health risks due to negative weight perceptions. Therefore, this study explores the independent and combined effects of actual and perceived weight on the mental health of this group. PARTICIPANTS AND METHODS This study utilized data from the 2017 Aboriginal Peoples Survey, a nationally representative sample of First Nations peoples living off-reserve, Métis, and Inuit. The focus was on Canadian Indigenous post-secondary students aged 19-34 years (n = 1,518). Logistic regression models, stratified by sex, were employed to analyze the data. RESULTS Perceptions of being overweight were linked to a higher risk of mood and anxiety disorders, poor self-rated mental health, and suicidal ideation among female students. This pattern was less evident among male students. Notably, female students who were overweight and perceived themselves as such were more likely to report poor mental health across all four indicators examined. In contrast, male students exhibited a less clear pattern. Diverging from recent studies, the findings indicated less robust mental health disparities among students with normal weight who perceived themselves as overweight, potentially due to the insufficient cell size of this category among Indigenous post-secondary students. CONCLUSIONS The study highlights the complex interplay between actual and perceived weight and its impact on mental health, particularly among female Indigenous post-secondary students.
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Affiliation(s)
- Lei Chai
- Department of Sociology, University of Toronto, Toronto, Ontario, 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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Henningham M, Gilroy J, McGlone J, Meehan D, Nila F, McAtamney A, Buchanan T. Utilising the CREATE quality appraisal tool to analyse Aboriginal and Torres Strait Islander peoples' involvement and reporting of cancer research in Australia. Aust N Z J Public Health 2024; 48:100142. [PMID: 38574430 DOI: 10.1016/j.anzjph.2024.100142] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/28/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE We aimed to evaluate Aboriginal and Torres Strait Islander involvement in research focusing on cancer experiences using an Aboriginal and Torres Strait Islander quality appraisal tool (the QAT). METHODS We conducted a systematic review of the peer-reviewed literature on Aboriginal and Torres Strait Islander peoples' experiences associated with cancer, recently published elsewhere. We then appraised articles for the inclusion of Aboriginal and Torres Strait Islander-led research, community consultation, and involvement. RESULTS 91 articles were appraised. A lack of Aboriginal and Torres Strait Islander-led research and consultation was reported in the majority of articles, only 10 (11%) demonstrated success across seven (50%) or more questions of the QAT. CONCLUSIONS This review underscores the need for anti-racist research and publication practices that actively engage Aboriginal and Torres Strait Islander peoples and researchers. This approach is vital to enhance cancer outcomes within these communities. IMPLICATIONS FOR PUBLIC HEALTH To advance and prioritise appropriate involvement of Aboriginal and Torres Strait Islander peoples in cancer research, the onus must be on 'systems owners,' including academic journals and institutions, to require and report genuine engagement as standard practice. Researchers will produce higher-calibre research with a strengths-based focus, advancing the cause of equitable research.
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Affiliation(s)
- Mandy Henningham
- Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - John Gilroy
- Charles Perkins Centre and Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | - Drew Meehan
- Cancer Council Australia, Sydney, NSW, 2000, Australia
| | - Farhana Nila
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
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Tsang TW, Allen T, Turner A, Bowyer J, Fitzpatrick J, Latimer J, Oscar J, Carter M, Elliott EJ. Ophthalmic Findings in Aboriginal Children with High Rates of Prenatal Alcohol Exposure and Fetal Alcohol Spectrum Disorder: The Lililwan Project. Ophthalmic Epidemiol 2024:1-8. [PMID: 38569083 DOI: 10.1080/09286586.2024.2331539] [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: 06/18/2023] [Accepted: 03/08/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE To describe ophthalmic findings in an Indigenous paediatric population and the associations between fetal alcohol spectrum disorder (FASD), prenatal alcohol exposure (PAE), and eye anomalies. METHODS Medical records were reviewed for eye problems, and eye assessments were conducted by an orthoptist or ophthalmologist in the Lililwan Project cohort, which comprised 108 (81%) of all children born between 2002 and 2003, and residing in the remote Fitzroy Valley, Western Australia in 2010. Values from ophthalmic assessments and prevalence of abnormalities were presented for the total cohort and stratified by group: FASD; PAE (no FASD); and No PAE. RESULTS Of children, 55% had PAE and 19% FASD. Most (98%) had normal vision; 15.6% had keratometry cylinder values indicating astigmatism and potential for improved vision with glasses. Strabismus (22.3%), short palpebral fissure length (PFL; 21.3%), upslanting palpebral fissures (12.0%), follicular trachomatous inflammation (6.9%), abnormal slit lamp assessments (6.7%), retinal tortuosity (6.7%), and blepharoptosis (5.6%) were identified. Strabismus and trachoma rates were higher than in the general child population. Ophthalmic findings were similar between groups except for prevalence of short PFL (FASD > No PAE; p = 0.003); abnormal keratometry cylinder values (FASD [29.4%] and PAE (no FASD) [20.0%] > No PAE [5.3%]; p = 0.031) and blepharoptosis (FASD [9.5%] > other groups [0%]; p = 0.040). CONCLUSION Despite the small sample, some eye abnormalities were higher in children with PAE and/or FASD. Access to eye services or assessment of vision and structural eye anomalies is essential for Indigenous children, particularly those with PAE or FASD to allow early effective treatment.
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Affiliation(s)
- Tracey W Tsang
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Kids Research, Westmead, New South Wales, Australia
| | - Tiffany Allen
- Department of Adolescent Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Angus Turner
- Lions Eye Institute, Nedlands, Washington, Australia
- University of Western Australia, Perth, Western Australia, Australia
| | - Joshua Bowyer
- Lions Eye Institute, Nedlands, Washington, Australia
- University of Western Australia, Perth, Western Australia, Australia
- St. John of God Hospital Midland, Midland, Western Australia, Australia
| | - James Fitzpatrick
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
| | - Jane Latimer
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - June Oscar
- Marninwarntikura Women's Resource Centre, Fitzroy Crossing, Australia
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Fitzroy Crossing, Australia
| | - Elizabeth J Elliott
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
- Sydney Children's Hospital Network, Kids Research, Westmead, New South Wales, Australia
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18
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James MH, Prokopiv V, Barbagallo MS, Porter JE, Johnson N, Jones J, Smitherson T. Indigenous experiences and underutilisation of disability support services in Australia: a qualitative meta-synthesis. Disabil Rehabil 2024; 46:1438-1449. [PMID: 37029626 DOI: 10.1080/09638288.2023.2194681] [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: 08/17/2022] [Accepted: 03/18/2023] [Indexed: 04/09/2023]
Abstract
Purpose: Aboriginal and Torres Strait Islander People with a disability continue to experience barriers to service engagement such as mistrust of government services, lack of culturally appropriate support, marginalisation and disempowerment. This meta-synthesis reviews current literature regarding these experiences to explain why services are underutilised.Methods: The meta-synthesis was conducted using a meta-ethnographic approach to synthesise existing studies into new interpretive knowledge. The approach was supported by a search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).Results: Ten original research papers utilising a qualitative methodology were extracted. Synthesis of the articles revealed four concepts that were developed into a conceptual model. These include:1) History Matters; 2) Cultural Understanding of Disability Care; 3) Limitations to Current Service Provision; and 4) Delivery of Effective Services.Conclusions: Disability services do not adequately consider the cultural needs of Aboriginal and Torres Strait Islander People or communicate in a culturally appropriate manner. There are expectations that Aboriginal and Torres Strait Islander People acknowledge their disability in alignment with western definitions of disability in order to access services. More work is needed to align disability services with culturally appropriate support to provide better health outcomes.Implications for RehabilitationAboriginal and Torres Strait Islander people with a disability continue to experience barriers to service engagement which must be addressed.An essential gap that must be filled in providing disability services to Aboriginal and Torres Strait Islander people is the acknowledgment of culture as a resolute influence on all client interactions with providers.A cultural model of disability may better align with the experiences of Aboriginal and Torres Strait Islander people than current medical and social models used in healthcare.Disability services need to align better with culturally appropriate support to provide better health outcomes for Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Michelle H James
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Valerie Prokopiv
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Michael S Barbagallo
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Joanne E Porter
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Nicholas Johnson
- Aboriginal Student Success Officer, Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Jan Jones
- Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia
| | - Tanisha Smitherson
- Business Manager, Gippsland Aboriginal Advocacy Support Service, Morwell, Australia
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Sobhy MM, Brand M, Henshall K, MacCormick AD. Investigating major trauma in Māori youth at Te Whatu Ora Counties Manukau. ANZ J Surg 2024; 94:580-584. [PMID: 38486439 DOI: 10.1111/ans.18948] [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: 12/22/2023] [Revised: 02/25/2024] [Accepted: 03/06/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The Ninth Perioperative Mortality Review Committee (POMRC) report found the likelihood of death was over three times higher in Māori youth compared to non-Māori (age: 15-18 years) in the 30-days following major trauma. The aim of our study is to investigate variations in care provided to Māori youth presenting to Te Whatu Ora Counties Manukau (TWO-CM) with major trauma, to inform policies and improve care. METHODS This was a retrospective, observational study of 15-18-year-olds admitted to Middlemore Hospital from January 2018 to December 2021 following major trauma (Injury Severity Score (ISS) >12 or with (ISS) <12 who died). Data were obtained from the New Zealand Trauma Registry (NZTR). Six key performance indicators were studied against hospital guidelines/international consensus: Deaths, Cause-of-death, trauma call, RedBlanket activations, time-to-computed tomography (CT), and time-to-operating theatre (OT). RESULTS Of 77 patients, five deaths occurred, four non-Māori, and one Māori (P = 0.645). Five trauma calls were not activated (P = 0.642). There was no statistically significant difference for both median time to CT (P = 0.917) and time to CT for patients with GCS >13 (P = 0.778) between Māori and non-Māori. Five patients did not meet guidelines for time-to-OT (three non-Māori and two Māori) (P = 0.377). CONCLUSION No statistically significant variations in care were present for Māori youth presenting with major trauma, these findings did not match the national trend.
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Affiliation(s)
- Mira M Sobhy
- Department of Surgery, Te Waipapa Taumata Rau (University of Auckland), Tāmaki Makaurau, Aotearoa, New Zealand
- Dunedin School of Medicine, Ōtākou Whakaihu Waka (University of Otago), Dunedin, Aotearoa, New Zealand
| | - Maria Brand
- Department of Surgery, Te Waipapa Taumata Rau (University of Auckland), Tāmaki Makaurau, Aotearoa, New Zealand
- Department of Surgery, Te Whatu Ora Counties Manukau, Auckland, Aotearoa, New Zealand
| | - Kevin Henshall
- Department of Surgery, Te Whatu Ora Counties Manukau, Auckland, Aotearoa, New Zealand
| | - Andrew D MacCormick
- Department of Surgery, Te Waipapa Taumata Rau (University of Auckland), Tāmaki Makaurau, Aotearoa, New Zealand
- Department of Surgery, Te Whatu Ora Counties Manukau, Auckland, Aotearoa, New Zealand
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20
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Chettri D, Verma AK, Verma AK. Bioaugmentation: an approach to biological treatment of pollutants. Biodegradation 2024; 35:117-135. [PMID: 37684525 DOI: 10.1007/s10532-023-10050-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/15/2023] [Indexed: 09/10/2023]
Abstract
Industrial development and the associated generation of waste requires attention for their management, treatment, and reduction without further degrading the quality of life. Microbes and plant-based bioremediation approaches are some of the sustainable strategies for the biodegradation of harmful pollutants instead of chemical-based treatment. Bioaugmentation is one such approach where microbial strains with the ability to degrade the targeted pollutant are introduced in a polluted environment. Harnessing of microbes from various locations, especially from the site of contamination (indigenous microbes), followed by optimization of the strains, inoculum size, media, and genetic engineering of the microbes along with a combination of strategies such as bio stimulation, phytoremediation is being applied to increase the efficiency of bioaugmentation. Further, bioaugmentation is influenced by various factors such as temperature, the composition of the pollutant, and microbial inoculum which needs to be considered for maximum efficiency of the treatment process. It has numerous advantages such as low cost, sustainability, and easy handling of the contaminants however, the major limitation of bioaugmentation is to increase the survival rate of the microbes involved in remediation for a longer duration in such a highly toxic environment. The review discusses these various aspects of bioaugmentation in brief for its large-scale implementation to address the global issue of pollution and environment management.
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Affiliation(s)
- Dixita Chettri
- Department of Microbiology, Sikkim University, Gangtok, Sikkim, 737102, India
| | - Ashwani Kumar Verma
- Department of Biosciences and Bioengineering, Indian Institute of Technology, Guwahati, India
| | - Anil Kumar Verma
- Department of Microbiology, Sikkim University, Gangtok, Sikkim, 737102, India.
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Babu BV, Hazarika CR, Raina SK, Masoodi SR, Basappa YC, Thomas N, Kerketta AS, Menon NK, Jebasingh FK. Prevalence of type 2 diabetes among tribal population of india: a multi-centric cross-sectional study. J Natl Med Assoc 2024; 116:153-164. [PMID: 38290904 DOI: 10.1016/j.jnma.2024.01.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/12/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND The perception among healthcare workers is that the Indian tribal (indigenous) population are less affected by diabetes. This paper reports the prevalence of type 2 diabetes and its associated factors among tribal populations from six districts across India. METHODOLOGY Random blood glucose (RBG) and fasting blood glucose (FBG) were measured for 8486 and 3131 adults, respectively, with a glucose meter. FBG ≥ 126 mg/dL (7.0 mmol/L) and RBG ≥ 200 mg/dL (11.1 mmol/L) were used to diagnose diabetes. In addition, blood pressure, anthropometric (height, weight, waist and hip circumferences), socio-demographic (age, gender, education, type of tribe and type of village) and behavioural data (tobacco smoking, non-smoking tobacco use and alcohol consumption) were collected. RESULTS The overall prevalence of type 2 diabetes, based on RBG, was 4.77% (95% CI: 4.33-5.25). The prevalence of type 2 diabetes and prediabetes, based on FBG, was 6.80% (95% CI: 5.95-7.74) and 8.69% (7.72-9.73), respectively. The prevalence of type 2 diabetes was significantly associated with age (p<0.001), smokeless tobacco use (p < 0.05), hypertension (p < 0.001) and obesity (p < 0.01). CONCLUSION The prevalence of type 2 diabetes among the Indian tribal population reported in this study is less than the national average of 7.3% for the general population. Hypertension and obesity were the major risk factors. Due to changing behavioural patterns, including dietary behaviour, there is likely to be an increase in the prevalence of hypertension and obesity, which further leads to increased prevalence of type 2 diabetes. Hence, appropriate interventions are to be initiated by the primary healthcare system.
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Affiliation(s)
- Bontha V Babu
- Socio Behavioral, Health Systems and Implementation Research Division, Indian Council of Medical Research, New Delhi, India.
| | - Chaya R Hazarika
- Socio Behavioral, Health Systems and Implementation Research Division, Indian Council of Medical Research, New Delhi, India
| | - Sunil K Raina
- Department of Community Medicine, Dr Rajendra Prasad Government Medical College, Tanda, Kangra, Himachal Pradesh, India
| | - Shariq R Masoodi
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | | | - Nihal Thomas
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
| | | | | | - Felix K Jebasingh
- Department of Endocrinology, Diabetes & Metabolism, Christian Medical College, Vellore, India
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Maclennan B, Wyeth E, Derrett S. Health-related quality of life following trauma: Prevalence of problems and factors associated with six-month outcomes in a New Zealand cohort. Injury 2024; 55:111468. [PMID: 38452699 DOI: 10.1016/j.injury.2024.111468] [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: 10/18/2023] [Revised: 02/01/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
Injury is a leading cause of health loss in Aotearoa me Te Waipounamu (New Zealand; NZ). The NZ Trauma Registry was established in 2015 to monitor outcomes in those experiencing severe injury and to identify ways of improving the quality of care for these patients. Few NZ studies have assessed outcomes in trauma patients using patient-reported outcome measures (PROMs) despite increasing recognition that the impacts of injury are better understood through PROMs. Our aim was to estimate the prevalence of self-reported problems with health-related quality of life (HRQoL) outcomes six months post-injury, and identify factors associated with these, in a cohort of Māori (the Indigenous population of NZ) and non-Māori individuals who had experienced major trauma. HRQoL outcomes were measured according to the five dimensions of the EQ-5D-5L. This information, along with sociodemographic data, was collected via structured telephone interviews. Participants (n = 870), aged 16 years or more, were recruited following admission to a trauma hospital in one of three (of NZ's four) trauma regions. Multivariable models were developed using modified Poisson Regression to identify factors associated with outcomes for both Māori and non-Māori patients. The prevalence and severity of problems across each of the five EQ-5D-5L dimensions was similar for Māori and non-Māori except for Anxiety/Depression. The prevalence and severity of problems with Anxiety/Depression was greater for Māori. Factors associated with HRQoL problems at six-months were also largely similar for each cohort. Those commonly associated with outcomes were age, hospital length of stay, adequacy of household income, and participants' expectations regarding recovery from injury. Further research examining recovery expectations in trauma patients to determine which factors contribute to formulating recovery expectations, and the potential impact of recovery expectations on treatment and rehabilitation, would be of value. Should expectations, at least in part, influence HRQoL outcomes, then routinely collecting data on patients' recovery expectations, adequacy of household income and potential barriers to treatment and rehabilitation, could help inform post-hospital treatment plans, and identify those who may require additional support following discharge from hospital.
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Affiliation(s)
- Brett Maclennan
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Division of Health Sciences, University of Otago, New Zealand
| | - Emma Wyeth
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Division of Health Sciences, University of Otago, New Zealand.
| | - Sarah Derrett
- Te Roopū Rakahau Hauora Māori a Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Division of Health Sciences, University of Otago, New Zealand
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Jones C, Auger MD, Paul W, Monchalin R. "I'm still not over feeling so isolated": Métis women, Two-Spirit, and gender-diverse people's experiences of the COVID-19 pandemic. Can J Public Health 2024; 115:199-208. [PMID: 38231468 PMCID: PMC11006636 DOI: 10.17269/s41997-023-00849-3] [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: 03/10/2022] [Accepted: 12/05/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVES The aim of this study was to explore and learn from the experiences of Métis women, Two-Spirit, and gender-diverse people accessing health and social services in Victoria, British Columbia, during the COVID-19 pandemic. METHODS This paper comes from a larger study exploring Métis women, Two-Spirit, and gender-diverse people's experiences accessing health and social services in Victoria. Using a by-and-for Métis approach that employed a conversational interview method, we conducted interviews with Métis women, Two-Spirit, and gender-diverse people who lived in and/or accessed services in Victoria in December 2020 and January 2021. This paper focuses specifically on data addressing how COVID-19 impacted these participants. RESULTS A total of 24 Métis women, Two-Spirit, and gender-diverse people participated in the study. Overall, three themes specific to COVID-19 were identified. First, participants described the detrimental impacts of COVID-19 on their ability to connect with their Métis community and practice their culture, as well as their overall feelings of isolation. Second, participants highlighted some of the ways that COVID-19 has exacerbated existing barriers to culturally safe healthcare. Last, participants spoke about the mixed economic impacts that COVID-19 has had for them, sharing insight into the ways in which gender, in particular, has shaped their financial instability. CONCLUSION Improving access to culturally safe health and social services by incorporating the experiences and expertise of Métis women, Two-Spirit, and gender-diverse people is crucial to mitigating the disproportional negative impacts of the pandemic and improving overall health outcomes within Métis communities across Canada.
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Affiliation(s)
- Carly Jones
- School of Social Work, University of Victoria, Victoria, BC, Canada
| | - Monique D Auger
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Willow Paul
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Renée Monchalin
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
- Well Living House, Unity Health Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
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Cochrane F, Singleton-Bray J, Canendo W, Cornwell P, Siyambalapitiya S. "Working together… I can't stress how important it is": Indigenous Health Liaison Officers' insights into working with speech-language pathologists and Aboriginal and Torres Strait Islander peoples with stroke and TBI. Int J Speech Lang Pathol 2024; 26:149-161. [PMID: 37552611 DOI: 10.1080/17549507.2023.2181225] [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: 08/10/2023]
Abstract
PURPOSE Providing culturally safe speech-language pathology services to Aboriginal and Torres Strait Islander peoples with acquired communication disorders (ACDs) may be challenging for non-Indigenous speech-language pathologists (SLPs). Indigenous Health Liaison Officers (IHLOs) may share common histories and culture with patients, and provide valuable insights about cultural safety. The study aim was to explore IHLOs' experiences of working with Aboriginal and Torres Strait Islander adults post-stroke or traumatic brain injury (TBI), and with the SLPs who provide services to these peoples. METHOD Using an interpretive description collaborative research design informed by culturally responsive principles, IHLOs (n = 7) participated in interviews facilitated by Aboriginal researchers and the principal investigator. Data were analysed using qualitative content analysis, informed by perspectives of Aboriginal researchers. RESULT Two themes, Connection and Spirit and Emotion, and six interdependent categories described how Aboriginal and Torres Strait Islander peoples have, and need, strong connections to family, country, health professionals, and ACD practices. Without these connections, patients' wellbeing may be deeply affected. CONCLUSION SLPs must collaborate with IHLOs and patients' family members and draw on their cultural knowledge, expertise, and guidance when working with Aboriginal and Torres Strait Islander peoples and ensure connections are created. These connections contribute to culturally safe and responsive speech-language pathology practice.
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Affiliation(s)
- Frances Cochrane
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Jenna Singleton-Bray
- College of Healthcare Sciences, James Cook University, Townsville, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Waverley Canendo
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Petrea Cornwell
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Samantha Siyambalapitiya
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
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Renn T, Moore J, Schultz KA, Veeh CA. Comparing Behavioral Health Outcomes and Treatment Utilization of Those With and Without Justice Involvement Within the Past Year Among American Indian and Alaska Native Adults. J Racial Ethn Health Disparities 2024; 11:685-695. [PMID: 36929492 DOI: 10.1007/s40615-023-01552-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
Similar to other populations, worse health, increased emergency healthcare utilization, and heightened substance misuse are correlated with higher justice involvement among American Indian/Alaska Native (AI/AN) populations. The historical context and resulting contemporary injustices for AI/AN populations have directly contributed to higher rates of these health and behavioral health conditions among this population. As a result, AI/AN individuals have disproportionate rates of incarceration in the USA, with young AI/AN males having the highest odds of incarceration when compared to any other group. American Indian and Alaska Native populations are overrepresented in the criminal justice system across different touchpoints. However, there remains a scarcity of data and research on AI/AN peoples' involvement with the justice system, and what their lives look like prior to, during, and after justice involvement. The current study addresses this gap in the literature by exploring rates of substance use and mental health diagnoses and treatment utilization among justice-involved and non-justice-involved AI/AN samples. Further, we examined correlates associated with past-year service utilization. Data from the 2015-2019 National Survey on Drug Use and Health (N = 214,505 adults aged 18+) was used. For this study, we examined a subsample of 3068 AI/AN adults. Quantitative data analyses using STATA 16 were run to test for differences on service utilization, mental health status, and substance misuse between AI/AN non-justice-involved and justice-involved samples. Among adults in the sample, 446 (15%) reported justice involvement in the past year. Justice-involved AI/AN individuals were significantly more likely to use the emergency department, utilize mental health treatment, and access substance use treatment in the past year. Additionally, justice-involved AI/AN individuals reported significantly higher rates of mental illness and past-year substance use disorder. In regression models, justice involvement was significantly associated with past-year substance use treatment and past-year mental health treatment. The findings from this work highlight the differences among substance use, mental illness, and treatment utilization between justice-involved and non-justice-involved AI/AN individuals. Findings suggest that justice-involved individuals fair worse in all areas and argue for the consideration of interventions that incorporate both culturally sensitive and justice-responsive models to improve the behavioral health outcomes of these populations. Lastly, while justice-involved AI/AN populations utilize treatment services at higher and disproportionate levels, there is reason to believe that there continues to be a mismatch of need and utilization and further exploration is warranted.
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Affiliation(s)
- Tanya Renn
- Florida State University College of Social Work, Tallahassee, FL, USA.
| | - John Moore
- Florida State University College of Social Work, Tallahassee, FL, USA
| | - Katie A Schultz
- Florida State University College of Social Work, Tallahassee, FL, USA
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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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Virtue C, Goffe C, Shiang E, McKenzie Z, Shields W. Surveillance methods and interventions implemented in American Indian and Alaska Native communities to increase child restraint device and seat belt use in motor vehicles: a systematic review. Inj Prev 2024; 30:92-99. [PMID: 38302282 DOI: 10.1136/ip-2023-045044] [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: 07/17/2023] [Accepted: 12/03/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND American Indian/Alaska Native (AI/AN) children are disproportionately affected by injuries and deaths related to motor vehicle crashes. We aimed to synthesise published evidence on surveillance methods and interventions implemented in AI/AN communities and analyse characteristics that make them successful in increasing child restraint devices and seat belt use. METHODS Studies were collected from the PubMed, Scopus, and TRID databases and the CDC Tribal Road Safety website, Community Guide, and Indian Health Service registers. Included studies collected primary data on AI/AN children (0-17) and reported morbidity/mortality outcomes related to child restraint devices or seat belt use. Studies with poor methodological quality, published before 2002, whose data were collected outside of the USA, or were non-English, were excluded. Checklists from the Joanna Briggs Institute were used to assess the risk of bias. In the synthesis of results, studies were grouped by whether a surveillance method or intervention was employed. RESULTS The final review included 9 studies covering 72 381 participants. Studies conducted surveillance methods, interventions involving law enforcement only and multipronged interventions. Multipronged approaches were most effective by using the distribution of child restraint devices combined with at least some of the following components: educational programmes, media campaigns, enactment/enforcement of child passenger restraint laws, incentive programmes and surveillance. DISCUSSION Although this review was limited by the number and quality of included studies, available resources suggest that we need multipronged, culturally tailored and sustainable interventions fostered by mutually beneficial and trusting partnerships. Continued investment in AI/AN road safety initiatives is necessary.
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Affiliation(s)
- Cierra Virtue
- Family Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Chelsea Goffe
- Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Evelyn Shiang
- Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Zoann McKenzie
- Injury Prevention Program, Indian Health Service, Rockville, Maryland, USA
| | - Wendy Shields
- Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Oetzel J, Ngawati R, Penetito-Hemara D, Puke TT, Henry A, Povaru-Bourne S, Sika-Paotonu D. Facilitators and barriers for implementation of health programmes with Māori communities. Implement Sci Commun 2024; 5:26. [PMID: 38500225 PMCID: PMC10946171 DOI: 10.1186/s43058-024-00567-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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 03/09/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Addressing health inequities that Māori (Indigenous peoples) communities face in New Zealand is a key aim of researchers and practitioners. However, there is limited understanding of the implementation processes and outcomes of health programmes for addressing these inequities. The aim of this study was twofold: (a) to identify correlates of implementation outcomes and (b) to identify facilitators and barriers to implementation effectiveness. METHODS The study involved a concurrent mixed method approach. Through an online survey, 79 participants with experience in implementing a health programme with a Māori community identified outcomes and processes of the programme. Additionally, nine Māori community providers shared their perceptions and experience of facilitators and barriers to implementation effectiveness through an in-depth interview. The quantitative and qualitative findings were integrated to address the aims of the study. RESULTS For the first aim, we identified two key outcomes: overall health impacts and sustainability. Three of the variables had significant and positive bivariate correlations with health impacts: cultural alignment, community engagement, and individual skills. The only significant correlate of sustainability was evidence-based. For the second aim, participants described four facilitators (leadership, whanaungatanga [relationships], sharing information, digestible information) and four barriers (system constraints, lack of funding, cultural constraints, lack of engagement) to effective implementation. CONCLUSION Overall, leadership, aligning culture, and building on whanaungatanga, while getting financial resources and systems support, are the core elements to supporting implementation efforts in Māori communities.
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Affiliation(s)
- John Oetzel
- University of Waikato, Private Bag 3105, Hamilton, 3240, New Zealand.
| | - Renei Ngawati
- Te Hotu Manawa Māori trading as Toi Tangata, 9 Kalmia Street, Auckland, 1051, New Zealand
| | - Darrio Penetito-Hemara
- Te Hotu Manawa Māori trading as Toi Tangata, 9 Kalmia Street, Auckland, 1051, New Zealand
| | - Tori Te Puke
- Te Hotu Manawa Māori trading as Toi Tangata, 9 Kalmia Street, Auckland, 1051, New Zealand
- South Waikato Pacific Islands Community Services Trust, 1 Maraetai Lane, Tokoroa, 3420, New Zealand
| | - Akarere Henry
- South Waikato Pacific Islands Community Services Trust, 1 Maraetai Lane, Tokoroa, 3420, New Zealand
| | - Sulita Povaru-Bourne
- South Waikato Pacific Islands Community Services Trust, 1 Maraetai Lane, Tokoroa, 3420, New Zealand
| | - Dianne Sika-Paotonu
- University of Otago, Wellington, 23A Mein Street, Wellington, 6242, New Zealand
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Chappell E, Chan E, Deen C, Brimblecombe J, Cadet-James Y, Hefler M, Stubbs E, Ferguson M. Using photovoice to generate solutions to improve food security among families living in remote Aboriginal and/or Torres Strait Islander communities in Australia. BMC Public Health 2024; 24:785. [PMID: 38481178 PMCID: PMC10935805 DOI: 10.1186/s12889-024-18200-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/23/2024] [Indexed: 03/17/2024] Open
Abstract
The right to food security has been recognised internationally, and nationally in Australia by Aboriginal Community Controlled Health Organisations. This study aims to explore food (in)security and solutions for improvement of food security in remote Aboriginal and/or Torres Strait Islander communities in Australia, from the perspective of caregivers of children within the context of the family using photovoice. Participants took part in workshops discussing participant photographs of food (in)security, including solutions. Themes and sub-themes with associated solutions included traditional food use, sharing as a part of culture, the cost of healthy food, energy and transport, and housing and income. Community leaders used these data in setting priorities for advocacy to improve food security in their communities.
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Affiliation(s)
- Emma Chappell
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia.
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia.
| | - Ellie Chan
- Central Australian Aboriginal Congress, Alice Springs, NT, 0871, Australia
| | - Caroline Deen
- Apunipima Cape York Health Council, Bungalow, QLD, 4870, Australia
| | - Julie Brimblecombe
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
- Department of Nutrition, Dietetics and Food , Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
| | - Yvonne Cadet-James
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Apunipima Cape York Health Council, Bungalow, QLD, 4870, Australia
- Indigenous Education and Research Centre, James Cook University, Bungalow, QLD, 4870, Australia
| | - Marita Hefler
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
| | - Emma Stubbs
- Central Australian Aboriginal Congress, Alice Springs, NT, 0871, Australia
| | - Megan Ferguson
- School of Public Health, The University of Queensland, Herston, QLD, 4006, Australia
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT, 0811, Australia
- Department of Nutrition, Dietetics and Food , Monash University, Level 1, 264 Ferntree Gully Road, Notting Hill, VIC, 3168, Australia
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Verburg L, Gabriel V, McCaffrey G. The impact of burn injuries on indigenous populations: A literature review. Burns 2024:S0305-4179(24)00058-5. [PMID: 38570250 DOI: 10.1016/j.burns.2024.02.023] [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: 11/04/2023] [Revised: 01/31/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Ethnic minorities experience disparities in prevention and treatment of burn injury. Research focused on burn injuries in Indigenous populations is limited. This review summarizes literature on burn injuries in Indigenous populations to be considered to inform new research. METHODS A search was conducted in CINAHL, Ovid MEDLINE, PSYCinfo and SocINDEX. for "burn OR scars OR scald OR deformity OR disfigurement" and "Aboriginal OR Indigenous OR First Nation OR American Indian OR Maori OR Native OR Torres Strait Islander OR Amerindian OR Inuit OR Metis OR Pacific Islander". Inclusion 1) peer reviewed studies of burns in Indigenous persons 2) in English. Exclusion 1) no data specific to Indigenous burns 2) not peer reviewed 3) not in full text 4) protocol publications. RESULTS The search identified 1091 studies with 51 for review. Sixteen were excluded. The 35 included publications were published between 1987 and 2022. Findings indicated higher incidence of injury and poorer outcomes amongst Indigenous people. Indigenous people suffered more flame and inhalation burns, had longer lengths of stay, and more complications including hypertrophic scarring. Australian Indigenous patients struggle with a lack of culturally safe communication and support for aftercare. CONCLUSION Racial disparities exist in burn injury incidence and outcome for Indigenous persons. Qualitative research in this area will help providers better understand the experiences of Indigenous burn patients to develop more culturally competent care. We are currently developing a study using qualitative hermeneutic methodology to learn about the experiences of Indigenous burn survivors' injuries, recovery, and social reintegration.
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Affiliation(s)
- Leah Verburg
- Faculty of Nursing, University of Calgary, Canada.
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Aker AM, Friesen M, Ronald LA, Doyle-Waters MM, Takaro TJ, Thickson W, Levin K, Meyer U, Caron-Beaudoin E, McGregor MJ. The human health effects of unconventional oil and gas development (UOGD): A scoping review of epidemiologic studies. Can J Public Health 2024:10.17269/s41997-024-00860-2. [PMID: 38457120 DOI: 10.17269/s41997-024-00860-2] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/23/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE Unconventional oil and gas development (UOGD, sometimes termed "fracking" or "hydraulic fracturing") is an industrial process to extract methane gas and/or oil deposits. Many chemicals used in UOGD have known adverse human health effects. Canada is a major producer of UOGD-derived gas with wells frequently located in and around rural and Indigenous communities. Our objective was to conduct a scoping review to identify the extent of research evidence assessing UOGD exposure-related health impacts, with an additional focus on Canadian studies. METHODS We included English- or French-language peer-reviewed epidemiologic studies (January 2000-December 2022) which measured exposure to UOGD chemicals directly or by proxy, and where health outcomes were plausibly caused by UOGD-related chemical exposure. Results synthesis was descriptive with results ordered by outcome and hierarchy of methodological approach. SYNTHESIS We identified 52 studies from nine jurisdictions. Only two were set in Canada. A majority (n = 27) used retrospective cohort and case-control designs. Almost half (n = 24) focused on birth outcomes, with a majority (n = 22) reporting one or more significant adverse associations of UOGD exposure with: low birthweight; small for gestational age; preterm birth; and one or more birth defects. Other studies identified adverse impacts including asthma (n = 7), respiratory (n = 13), cardiovascular (n = 6), childhood acute lymphocytic leukemia (n = 2), and all-cause mortality (n = 4). CONCLUSION There is a growing body of research, across different jurisdictions, reporting associations of UOGD with adverse health outcomes. Despite the rapid growth of UOGD, which is often located in remote, rural, and Indigenous communities, Canadian research on its effects on human health is remarkably sparse. There is a pressing need for additional evidence.
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Affiliation(s)
- Amira M Aker
- Université Laval, CHU de Quebec - Université Laval, Québec, QC, Canada
| | - Michael Friesen
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Lisa A Ronald
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Mary M Doyle-Waters
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Tim J Takaro
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Willow Thickson
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Karen Levin
- Emerald Environmental Consulting, Kent, OH, USA
| | - Ulrike Meyer
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Elyse Caron-Beaudoin
- Department of Health and Society and Department of Physical and Environmental Sciences, University of Toronto Scarborough, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Margaret J McGregor
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Dertadian GC. The Coloniality of drug prohibition. Int J Drug Policy 2024; 126:104368. [PMID: 38452423 DOI: 10.1016/j.drugpo.2024.104368] [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: 10/24/2023] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
There have been several recent commentaries which have highlighted the relevance of the postcolonial perspective to drug prohibition and called for the decolonisation of drug policy (Daniels et al., 2021; Hillier, Winkler & Lavallée, 2020; Lasco, 2022; Mills, 2019). While these are significant interventions in the field, sparse drugs scholarship has engaged more directly with well-developed literature and concepts from Critical Indigenous Studies (Moreton-Robinson, 2016) and Indigenous Standpoint Theory (Moreton-Robinson, 2013; Nakata, 2007) and reflected on its applicability to the drug and alcohol field. In contrast to the postcolonial perspective, which understands colonisation as a historical event with contemporary impacts, Indigenous scholarship conceptualises colonisation as an active and ongoing part of how the settler-state continues to impose itself. From this vantage point I explore coloniality as a system of power and reflect on the way prohibition acts as a key arm of the settler-colonial state. The paper explores the way concepts like vulnerability, marginality, overrepresentation, disproportionality and addiction involve colonial violence, knowledge practices and narratives which are central to the way coloniality is maintained and continues to assert itself in contemporary settler societies.
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Schweda D, Bracamonte J. Of a "certain age" - Menopause in Native American women: A cultural perspective. Maturitas 2024:107947. [PMID: 38503606 DOI: 10.1016/j.maturitas.2024.107947] [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: 01/31/2024] [Accepted: 02/18/2024] [Indexed: 03/21/2024]
Affiliation(s)
- Denise Schweda
- Mayo Clinic, Dept of Family Medicine, AZ, United States of America.
| | - Jesse Bracamonte
- Mayo Clinic, Dept of Family Medicine, AZ, United States of America
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Drysdale M, Gamberg M, Brammer J, Majowicz SE, Packull-McCormick S, Skinner K, Laird BD. Hexachlorobenzene and omega-3 fatty acid intake from traditional foods in the northern Yukon: A risk and benefit analysis. Sci Total Environ 2024; 914:169205. [PMID: 38145675 DOI: 10.1016/j.scitotenv.2023.169205] [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: 10/13/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/27/2023]
Abstract
A human biomonitoring study was conducted in the community of Old Crow, Yukon, in 2019, finding that levels of hexachlorobenzene (HCB) in plasma were elevated in the community relative to the general Canadian population. The aim of this study was to estimate dietary intake of both hexachlorobenzene, and the nutrient omega-3 fatty acids from locally harvested traditional foods in Old Crow, with the aim of identifying possible regional sources of exposure. A stochastic model was constructed to estimate intake of both hexachlorobenzene and the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Average predicted hexachlorobenzene exposure levels from traditional food consumption in Old Crow were below the tolerable daily intake of 1600-1700 ng/kg body weight/day in both average (18 ng/kg body weight/day) and short-term maximum (27 ng/kg body weight/day) exposure models. The primary contributors to average hexachlorobenzene intake were caribou fat, bone marrow, ribs, and kidneys, and Chinook salmon muscle. Average estimated dietary EPA + DHA intake levels from traditional foods were below the recommendation of 2.1 to 3.2 g of EPA + DHA per week in the average (1.6 g/week) exposure model, but above this recommendation in the short-term maximum model (3.3 g/week). The primary contributors to average EPA + DHA intake were the meat of Chinook, coho, and, chum salmon muscle, and whitefish muscle and eggs. The results of this study support the message that traditional foods continue to be an important source of nutrients and other health benefits and that the health benefits of traditional foods generally outweigh contaminant risks.
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Affiliation(s)
- Mallory Drysdale
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Mary Gamberg
- Gamberg Consulting, P.O. Box 11267, Whitehorse, Yukon Y1A 6N5, Canada
| | - Jeremy Brammer
- Vuntut Gwitchin Government, Old Crow, Yukon Y0B 1N0, Canada
| | - Shannon E Majowicz
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Sara Packull-McCormick
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Kelly Skinner
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Brian D Laird
- School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
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Liao ZY, Kean S, Haycock-Stuart E. Indigenous lands and health access: The influence of a sense of place on disparities in post-stroke recovery in Taiwan. Health Place 2024; 86:103210. [PMID: 38354468 DOI: 10.1016/j.healthplace.2024.103210] [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: 07/07/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
Despite many countries having policies and systems for universal healthcare coverage, health disparity persists, with significant variations in disease prevalence and life expectancy between different groups of people. This focused ethnography explored the post-stroke recovery of Indigenous and non-Indigenous populations in three geographical areas in Taiwan. Forty-eight observations and 24 interviews were carried out with 12 dyads of stroke survivors and family caregivers, revealing their varied experiences of healthcare. Findings indicate that repeatedly engaging in social activities in the same place increases stroke survivors' attachment to the environment, facilitating their reintegration into the community and improving wellbeing following stroke. The significance of 'place' in post-stroke life and healthcare access is particularly salient for Indigenous people's recovery. Indigenous people tend to employ cultural symbols, such as Indigenous languages and kinship ties, to define and interpret their surrounding environment and identity. Indigenous people residing within or close to their own native communities make better recoveries than those based in urban settings, who are attached to and yet located away from their native lands. A sense of place contributes to identity, while loss of it leads to invisibility and healthcare inaccessibility. To promote equitable healthcare access, future policymaking and care practices should address the environmental and cultural geography and structural barriers that impede the connection between minority groups and the mainstream community healthcare system. The study findings suggest extending welfare resources beyond Indigenous administrative regions and establishing partnerships between Indigenous organisations and the mainstream healthcare system. Leveraging Indigenous people's attachment to cultural symbols and increasing healthcare facilities staffed with Indigenous healthcare workers could help ease structural barriers, maintain identifiable Indigenous beneficiaries and increase entry points into the mainstream healthcare system.
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Affiliation(s)
- Zih-Yong Liao
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Taiwan.
| | - Susanne Kean
- Nursing Studies, School of Health in Social Science, The University of Edinburgh, UK.
| | - Elaine Haycock-Stuart
- Nursing Studies, School of Health in Social Science, The University of Edinburgh, UK.
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Bedi S, Strachan R, Zehbe I. Awareness of human papillomavirus infection among Indigenous males in North America and Oceania: a Scoping Review. Cancer Causes Control 2024; 35:437-449. [PMID: 37831275 DOI: 10.1007/s10552-023-01804-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/15/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE Human papillomavirus (HPV) is the most commonly transmitted sexually transmitted infection. HPV infections have been on the rise among males, especially in the form of oropharyngeal cancer. Despite this, there is a gap in healthcare guidelines to increase HPV vaccine administration among males. In this study, we focus on the Indigenous population of North America and Oceania to determine existing barriers resulting in low HPV vaccination rates among the population. METHOD We surveyed peer-reviewed literature on the awareness of HPV infection among Indigenous males in North America and Oceania. Using keywords HPV plus male, men or boy, and ethnical filters such as Indigenous, Aboriginal or First Nations, we retrieved 54 articles based on titles, of which 15 were included after reading the abstracts. RESULTS Reported HPV awareness was generally low in Indigenous males in North America, with no peer-reviewed data from Oceania. The lower understanding by males compared to females was largely attributable to misconceptions about HPV-related diseases, their transmission, and prevention. Lack of awareness and concern toward the risk of contracting HPV infection in Indigenous males suggests an impediment in disseminating health information about this cancer-causing virus. CONCLUSION Culturally sensitive education, with emphasis on Indigenous males, is needed to improve this group's HPV knowledge. Researchers should also engage meaningfully with Indigenous communities by building rapport to achieve a positive change in attitude.
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Affiliation(s)
- Simran Bedi
- Biology Department, Lakehead University, Thunder Bay, ON, P7B5E1, Canada.
| | - Robert Strachan
- Biology Department, Lakehead University, Thunder Bay, ON, P7B5E1, Canada
- Probe Development and Biomarker Exploration, Thunder Bay Regional Research Institute, Thunder Bay, ON, Canada
| | - Ingeborg Zehbe
- Biology Department, Lakehead University, Thunder Bay, ON, P7B5E1, Canada
- Probe Development and Biomarker Exploration, Thunder Bay Regional Research Institute, Thunder Bay, ON, Canada
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37
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de Souza JC, Letson HL, Gibbs CR, Dobson GP. The burden of head trauma in rural and remote North Queensland, Australia. Injury 2024; 55:111181. [PMID: 37951809 DOI: 10.1016/j.injury.2023.111181] [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: 09/20/2023] [Revised: 10/29/2023] [Accepted: 10/31/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Head trauma is a leading cause of death and disability worldwide. Young males, Indigenous people, and rural/remote residents have been identified as high-risk populations for head trauma, however, Australian research is limited. Our aim was to define and describe the incidence, demographics, causes, prehospital interventions, and outcomes of head trauma patients transported by aeromedical services within North Queensland, Australia. We hypothesized that young, Indigenous males living remotely would be disproportionately affected by head trauma. METHODS We conducted a retrospective study of all head trauma patients transferred by air to or between Townsville, Cairns, Mount Isa and Mackay Hospitals between January 1, 2016 and December 31, 2018. Patients were identified from the Trauma Care in the Tropics data registry and followed for a median 30-months post-injury. Primary endpoints were patient and injury characteristics. Secondary outcome measures were hospital stay and mortality. RESULTS A total of 981 patients were included and 31.1 % were Indigenous. Sixty-seven percent of injuries occurred remotely and the median time from injury to hospital was 5.8-hours (range 67-3780 min). Eighty percent of severe head injuries occurred in males (p = 0.007). Indigenous and remote patients were more likely to sustain mild injuries. The most common mechanism of injury overall was vehicle accident (37.5 %), compared to assault in the Indigenous subgroup (46.6 %, p<0.001). The overall mortality rate was 4.9 %, with older age and lower initial Glasgow Coma Score significant predictors of in-hospital mortality. Prehospital intubation was associated with a 7-fold increased risk of mortality (p = 0.056), while patients that received tranexamic acid (TXA) were almost 5-times more likely to die. CONCLUSIONS In North Queensland, young Indigenous males are at highest risk of traumatic head injuries. Vehicle accidents are an important preventable cause of head injury in the region. TXA administration is an important consideration for remote head trauma retrievals, in which time to emergency care is prolonged. Appropriate treatment and risk stratification strategies considering time to definitive care, severity of injury, and other prehospital patient factors require further investigation.
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Affiliation(s)
- Julia Chequer de Souza
- College of Medicine & Dentistry, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia
| | - Hayley L Letson
- College of Medicine & Dentistry, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia.
| | - Clinton R Gibbs
- Retrieval Services Queensland, 100 Angus Smith Drive, Douglas, Queensland 4814, Australia; Emergency Department, Townsville University Hospital, Townsville Hospital and Health Service, 100 Angus Smith Drive, Douglas, Queensland 4814, Australia; College of Public Health, Medical and Veterinary Sciences, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia
| | - Geoffrey P Dobson
- College of Medicine & Dentistry, James Cook University, 1 James Cook Drive, Townsville, Queensland 4811, Australia
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Kim SM, Lewis JP. Protective Factors in the Context of Successful Aging in Urban-Dwelling Alaska Native Elders. J Cross Cult Gerontol 2024; 39:53-71. [PMID: 38112906 DOI: 10.1007/s10823-023-09493-3] [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] [Accepted: 11/21/2023] [Indexed: 12/21/2023]
Abstract
Successful aging in rural Alaska communities has been established as a characteristic best described by reaching "Eldership," conveying reverence and respect from the community and implying leadership responsibilities. Most Alaska Native (AN) Elders believe that aging successfully or aging well happens within their home communities. However, limited rural resources lead Elders to relocate to urban settings. While protective factors supporting aging well in rural communities have been established, little is known about which factors support aging well after relocation to an urban setting. This exploratory, qualitative, community-based participatory research study explored AN Elder's (ages 48-84) experiences comparing successful aging within four rural Alaska communities and of Elders who relocated from a rural to an urban community. Thirteen rural-based Elders and 12 urban-based Elders semi-structured interviews were compared to explore how successful aging was experienced similarly and differently in rural and urban settings. To age well in urban Alaska, access to health care services, family, and community engagement were essential. The main challenges for urban Elders involved establishing a sense of community, intergenerational involvement, and the ability to continue traditional ways of living. This research identified challenges, similarities, and differences in aging well in an urban community. The findings of this study inform practices, services, and policies to improve existing urban services and initiate needed urban services to foster successful aging after relocation from remote rural areas into urban communities in Alaska.
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Affiliation(s)
- Steffi M Kim
- University of Alaska Anchorage, 3211 Providence Drive, Anchorage, AK, 99508, USA.
| | - Jordan P Lewis
- University of Minnesota Medical School, Duluth campus, Memory Keepers Medical Discovery Team - Health Equity, 624 E. 1st. Street, Suite 201, Duluth, MN, 55805, USA
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O'Dea B, Roe Y, Gao Y, Kruske S, Nelson C, Hickey S, Carson A, Watego K, Currie J, Blackman R, Reynolds M, Wilson K, Costello J, Kildea S. Breaking the cycle: Effect of a multi-agency maternity service redesign on reducing the over-representation of Aboriginal and Torres Strait Islander newborns in out-of-home care: A prospective, non-randomised, intervention study in urban Australia. Child Abuse Negl 2024; 149:106664. [PMID: 38354600 DOI: 10.1016/j.chiabu.2024.106664] [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: 09/24/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Strategies to reduce over-representation of Indigenous children in out-of-home care must start in pregnancy given Indigenous babies are 6 % of infants (<1 year), yet 43 % of infants in out-of-home care. OBJECTIVE To determine if an Indigenous-led, multi-agency, partnership redesign of maternity services decreases the likelihood of babies being removed at birth. PARTICIPANTS AND SETTING Women carrying an Indigenous baby/babies who gave birth at the Mater Mothers' Public Hospital, Brisbane (2013-2019). METHODS A prospective, non-randomised, intervention trial evaluated a multi-agency service redesign. Women pregnant with an Indigenous baby birthing at a tertiary hospital were offered standard care or Birthing in Our Community (BiOC) service. We compared likelihood of babies being removed by Child Protection Services (CPS) at birth by model of care. Inverse probability of treatment propensity score weighting controlled baseline confounders and calculated treatment effect. Standardized differences were calculated to assess balance of risk factors for each copy of multiple imputation. Australian New Zealand Clinical Trial Registry, ACTRN12618001365257. RESULTS In 2013-2019, 1988 women gave birth to 2044 Indigenous babies, with 40 women having babies removed at birth (9 BiOC, 31 standard care). Adjusted odds of baby removal were significantly lower for mothers in BiOC compared to standard care (AOR 0.37, 95 % CI 0.16, 0.84). In total, 2.0 % of Indigenous babies were removed by CPS; eight times higher than non-Indigenous babies at the same hospital (0.25 %). CONCLUSIONS BiOC reduced removals of newborn Indigenous babies likely disrupting generational cycles of CPS contact, trauma, and maltreatment, and contributing to short and long-term health and wellbeing benefits for mothers and babies.
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Affiliation(s)
- Birri O'Dea
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Yvette Roe
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Yu Gao
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Carmel Nelson
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia
| | - Adrian Carson
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
| | - Kristie Watego
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
| | - Jody Currie
- Aboriginal and Torres Strait Islander Community Health Service Brisbane Limited, 55 Annerley Rd, Woolloongabba, Queensland 4103, Australia
| | - Renee Blackman
- Aboriginal and Torres Strait Islander Community Health Service Brisbane Limited, 55 Annerley Rd, Woolloongabba, Queensland 4103, Australia
| | - Maree Reynolds
- Mater Hospital, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Kay Wilson
- Mater Hospital, Aubigny Place, Raymond Terrace, South Brisbane, Queensland 4101, Australia
| | - Jo Costello
- Institute for Urban Indigenous Health, 22 Cox Rd, Windsor, Queensland 4030, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane City, Queensland 4000, Australia.
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Del Brutto OH, Mera RM, Rundek T, Del Brutto VJ, Khasiyev F, Rumbea DA, Elkind MSV, Gutierrez J. Dietary oily fish intake is inversely associated with moderate-to-severe intracranial artery stenosis in older adults of indigenous Ecuadorian ancestry. Atherosclerosis 2024; 390:117456. [PMID: 38262274 DOI: 10.1016/j.atherosclerosis.2024.117456] [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: 10/23/2023] [Revised: 12/14/2023] [Accepted: 01/08/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND AND AIMS Information on the association between dietary oily fish intake and intracranial atherosclerosis is limited and contradictory. Inconsistencies might be in part related to heterogeneous designs and differences in race/ethnicity of study populations. We aim to assess whether oily fish intake is inversely associated with intracranial artery stenosis (ICAS) in frequent fish consumers of indigenous ancestry living in coastal Ecuador. METHODS The study included 384 participants aged ≥60 years enrolled in the Atahualpa Project Cohort. Dietary oily fish intake was quantified systematically via validated surveys and all participants received a time-of-flight MRA of intracranial vessels. Poisson regression models, adjusted for demographics, level of education, traditional risk factors and severe tooth loss, were fitted to assess the association between amounts of oily fish intake and the number of intracranial arteries with moderate-to-severe (≥50 %) stenosis. RESULTS Participants had a mean age of 67.7 ± 7 years, and 56 % were women. The mean oily fish intake was 8.9 ± 5.2 servings/week; 283 (74 %) participants consumed ≥5.2 servings/week (2nd to 4th quartiles of fish intake). Forty-three (11 %) participants had at least one major intracranial artery with moderate-to-severe stenosis. Both univariate and multivariate models showed a significant inverse association between consumption of oily fish in the 2nd to 4th quartiles and ≥50 % stenosis in at least one artery (β: 0.46; 95 % C.I.: 0.27-077, and β: 0.52; 95 % C.I.: 0.30-0.90, respectively). CONCLUSIONS Consumption of more than five oily fish servings/week is associated with lower prevalence of moderate-to-severe ICAS in indigenous Ecuadorians.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine and Research Center, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador.
| | - Robertino M Mera
- Biostatistics/Epidemiology, Freenome, Inc., South San Francisco, CA, USA
| | - Tatjana Rundek
- Evelyn McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Victor J Del Brutto
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Fl, USA
| | | | - Denisse A Rumbea
- School of Medicine and Research Center, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador
| | - Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - José Gutierrez
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
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Lewis JP, Kim SM, Asquith-Heinz Z, Thompson L. Cyclical Migration in Alaska Native Elders and Its Impact on Elders' Identity and Later Life Well-Being. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad072. [PMID: 37167633 DOI: 10.1093/geronb/gbad072] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 10/01/2022] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVES This paper outlines the unique culturally driven cyclical migration of Alaska Native (AN) Elders, distinct from previously described migration patterns in that Elders spend extended time in more than one community. We describe this Indigenous cyclical migration of AN Elders and its influence on their identity and later life health and well-being. METHODS Interviews with 124 AN Elders were conducted across 5 regions of Alaska: Bristol Bay, Interior, Norton Sound, Aleutian Pribilof Islands, and Southcentral. Within this sample, 87 participants engaged in cyclical migration. Thematic analysis was employed to identify themes related to Elders' cyclical migration between rural and urban communities and the impact on their identity and later life health and well-being. RESULTS We identified 2 distinct patterns of Indigenous cyclical migration-Elders living primarily in rural communities migrating to urban communities and Elders living primarily in urban communities migrating to rural communities. Elders engaged in these 2 patterns of cyclical migration to maintain cultural practices, access social, and health care services to maintain their physical health and well-being, and continue their community roles contributing to their AN Elder identity. DISCUSSION This study builds upon existing migration theories by introducing a cyclical pattern uniquely driven by AN identity, culture, and traditional practices. Findings illustrate how AN communities can support Elders who experience cyclical migration patterns to ensure they age successfully in both locations. Future research should explore cyclical migration patterns among other Indigenous populations with migration histories.
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Affiliation(s)
- Jordan P Lewis
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, Duluth, Minnesota, USA
| | - Steffi M Kim
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, Duluth, Minnesota, USA
- Department of Psychology. University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Zayla Asquith-Heinz
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, Duluth, Minnesota, USA
| | - Lena Thompson
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth Campus, Duluth, Minnesota, USA
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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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Cella E, Sutcliffe CG, Grant LR, Tso C, Weatherholtz RC, Littlepage S, Becenti L, Jubair M, Simons BC, Harker-Jones M, Reid R, Yazzie D, Santosham M, O'Brien KL, Hammitt LL, Azarian T. Streptococcus pneumoniae serotype 3 population structure in the era of conjugate vaccines, 2001-2018. Microb Genom 2024; 10. [PMID: 38498591 DOI: 10.1099/mgen.0.001196] [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: 03/20/2024] Open
Abstract
Background. Despite use of highly effective conjugate vaccines, invasive pneumococcal disease (IPD) remains a leading cause of morbidity and mortality and disproportionately affects Indigenous populations. Although included in the 13-valent pneumococcal conjugate vaccine (PCV13), which was introduced in 2010, serotype 3 continues to cause disease among Indigenous communities in the Southwest USA. In the Navajo Nation, serotype 3 IPD incidence increased among adults (3.8/100 000 in 2001-2009 and 6.2/100 000 in 2011-2019); in children the disease persisted although the rates dropped from 5.8/100 000 to 2.3/100 000.Methods. We analysed the genomic epidemiology of serotype 3 isolates collected from 129 adults and 63 children with pneumococcal carriage (n=61) or IPD (n=131) from 2001 to 2018 of the Navajo Nation. Using whole-genome sequencing data, we determined clade membership and assessed changes in serotype 3 population structure over time.Results. The serotype 3 population structure was characterized by three dominant subpopulations: clade II (n=90, 46.9 %) and clade Iα (n=59, 30.7 %), which fall into Clonal Complex (CC) 180, and a non-CC180 clade (n=43, 22.4 %). The proportion of clade II-associated IPD cases increased significantly from 2001 to 2010 to 2011-2018 among adults (23.1-71.8 %; P<0.001) but not in children (27.3-33.3 %; P=0.84). Over the same period, the proportion of clade II-associated carriage increased; this was statistically significant among children (23.3-52.6 %; P=0.04) but not adults (0-50.0 %, P=0.08).Conclusions. In this setting with persistent serotype 3 IPD and carriage, clade II has increased since 2010. Genomic changes may be contributing to the observed trends in serotype 3 carriage and disease over time.
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Affiliation(s)
- Eleonora Cella
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida
| | - Catherine G Sutcliffe
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lindsay R Grant
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Carol Tso
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Robert C Weatherholtz
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Shea Littlepage
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Ladonna Becenti
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mohammad Jubair
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida
| | - Brenna C Simons
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Marcella Harker-Jones
- Arctic Investigations Program, Centers for Disease Control and Prevention, Anchorage, Alaska
| | - Raymond Reid
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Del Yazzie
- Navajo Epidemiology Center, Window Rock, Arizona
| | - Mathuram Santosham
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Katherine L O'Brien
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Laura L Hammitt
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Taj Azarian
- Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida
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Joseph G. The role of sovereignty in Indigenous community-based health interventions: A qualitative metasynthesis. Am J Community Psychol 2024; 73:216-233. [PMID: 37058286 DOI: 10.1002/ajcp.12670] [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: 10/01/2021] [Revised: 06/01/2022] [Accepted: 01/10/2023] [Indexed: 06/19/2023]
Abstract
Indigenous peoples around the world suffer from health disparities attributed to a plethora of risk factors and social determinants of health stemming from colonialism and systemic oppression. Community-based health interventions have been identified as a means for addressing and reducing Indigenous health disparities by allowing for Indigenous sovereignty to be respected and centered. However, sovereignty relating to Indigenous health and well-being is underresearched. The present article explores the role of sovereignty in Indigenous community-based health interventions. A qualitative metasynthesis was conducted among 14 primary research studies co-authored by Indigenous people describing and evaluating Indigenous community-based health interventions. Five conceptual themes emerged as aspects of sovereignty which benefit Indigenous health and well-being outcomes: integration of culture; relocation of knowledge; connectedness; self-actualization; and stewardship. Implications are discussed, with the goal of creating a decolonial framework rooted in Indigenous epistemologies and perspectives for how sovereignty impacts Indigenous health, as well as strengthening a clear need for further research on and praxis of sovereignty in Indigenous healthcare.
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Affiliation(s)
- Gillian Joseph
- Center for World Indigenous Studies, Olympia, Washington, USA
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45
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Muslim A, Aazmi S, Er YX, Shahrizal S, Lim YAL. Ascaris lumbricoides harbors a distinct gut microbiota profile from its human host: Preliminary insights. Food Waterborne Parasitol 2024; 34:e00223. [PMID: 38323096 PMCID: PMC10844936 DOI: 10.1016/j.fawpar.2024.e00223] [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: 11/11/2023] [Revised: 01/07/2024] [Accepted: 01/25/2024] [Indexed: 02/08/2024] Open
Abstract
In indigenous populations where soil-transmitted helminths (STH) infections are endemic, STH parasites (i.e., Ascaris lumbricoides, Trichuris trichiura, hookworms) often co-exist and co-evolve with the gut microbiota of their human hosts. The association between STH infections and the gut microbiota of the colonized human hosts has been established, but few studies explored the gut microbiota of the parasites. This preliminary study aimed to characterize the microbiota of the STH parasite for further understanding the STH parasite-host relationship. The gut microbial genomic DNA from four adult A. lumbricoides worms recovered from a six-year-old indigenous Negrito boy living in an STH-endemic village in Perak, Peninsular Malaysia was extracted and sequenced for the V3-V4 region of the 16S rRNA. The microbiota profiles of these worms were characterized and compared with the gut microbiota of their human host, including the profiles from four STH-positive and three STH-negative individuals from the same tribe and village. The gut microbial structure of A. lumbricoides was found to be differed significantly from their human host. The worms contained lower gut bacterial abundance and diversity than human. This difference was evident in the beta diversity analysis which showed a clear separation between the two sample types. While both Firmicutes (52.3%) and Bacteroidetes (36.6%) are the predominant phyla followed by Proteobacteria (7.2%) in the human gut, the microbiota of Ascaris gut is highly dominated by Firmicutes, constituting 84.2% relative abundance (mainly from the genus Clostridium), followed by Proteobacteria (11.1%), Tenericutes (1.8%) and Bacteroidetes (1.5%). The parasites were also found to alter the microbial structure of the human gut following infection based on the relatively higher bacterial abundance in STH-positive versus STH-negative participants. Further studies with a greater number of Ascaris adults and human hosts are needed to confirm the gut microbiota profiles.
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Affiliation(s)
- Azdayanti Muslim
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus), Jalan Hospital, Sungai Buloh, Selangor, Malaysia
- Institute for Biodiversity and Sustainable Development, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
- Microbiome Health and Environment (MiHeaRT), Faculty of Applied Sciences, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
| | - Shafiq Aazmi
- Microbiome Health and Environment (MiHeaRT), Faculty of Applied Sciences, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
- School of Biology, Faculty of Applied Science, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia
| | - Yi Xian Er
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Shezryna Shahrizal
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus), Jalan Hospital, Sungai Buloh, Selangor, Malaysia
| | - Yvonne Ai Lian Lim
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Suarez-Balcazar Y, Buckingham S, Rusch DB, Charvonia A, Young RI, Lewis RK, Ford-Paz RE, Mehta TG, Perez CM. Reproductive justice for Black, Indigenous, Women of Color: Uprooting race and colonialism. Am J Community Psychol 2024; 73:159-169. [PMID: 36912117 DOI: 10.1002/ajcp.12650] [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: 10/01/2021] [Revised: 07/01/2022] [Accepted: 11/25/2022] [Indexed: 06/18/2023]
Abstract
Historically, atrocities against Black, Indigenous, and Women of Color's (BIWoC) reproductive rights have been committed and continue to take place in contemporary society. The atrocities against BIWoC have been fueled by White supremacy ideology of the "desirable race" and colonial views toward controlling poverty and population growth, particularly that of "undesirable" races and ethnicities. Grounded in Critical Race Theory, this paper aims to provide a critical analysis of historical and contemporary violations of BIWoC reproductive rights; discuss interventions based on empowerment and advocacy principles designed to promote women's reproductive justice; and discuss implications for future research, action, and policy from the lenses of Critical Race Theory and Community Psychology. This paper contributes to the special issue by critically analyzing historical and contemporary racism and colonialism against BIWoC, discussing implications for future research and practice, and making policy recommendations.
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Affiliation(s)
| | - Sara Buckingham
- Department of Psychology, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Dana B Rusch
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois Chicago, Chicago, Illinois, USA
| | - Alissa Charvonia
- Department of Psychology, Howard University, Washington, District of Columbia, USA
| | | | - Rhonda K Lewis
- Department of Psychology, Wichita State University, Wichita, Kansas, USA
| | - Rebecca E Ford-Paz
- Pritzker Department of Psychiatry and Behavioral Health; Ann & Robert H. Lurie Children's Hospital of Chicago; Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Tara G Mehta
- Department of Psychiatry, Institute for Juvenile Research, University of Illinois Chicago, Chicago, Illinois, USA
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Mokiao RH, Carlin K, Spencer MS, Young BA, Fretts AM. The social drivers of health for Native Hawaiian and Pacific Islander youth in the United States. Prev Med Rep 2024; 39:102658. [PMID: 38380385 PMCID: PMC10878780 DOI: 10.1016/j.pmedr.2024.102658] [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: 11/06/2023] [Revised: 02/09/2024] [Accepted: 02/15/2024] [Indexed: 02/22/2024] Open
Abstract
Objectives To describe the social drivers of health and health status of Native Hawaiian and Pacific Islander (NHPI) youth in the US. Methods This is a cross-sectional analysis of the 2014 NHPI National Health Interview Survey (NHIS) which surveyed about 3,000 NHPI households, including 1,428 NHPI youth (884 0-12 yo, 421 13-17 yo, and 123 18-21 yo). We described domains of social drivers of health (SDoH), health conditions, and associations of income and food insecurity with body mass index (BMI) for NHPI youth. Results NHPI youth come from households with a wide range in income. Approximately 20% of the cohort were food insecure. Among 18-21 yo, 10% report chronic medical conditions (5% with prediabetes). 33% of 13-17 yo and 52% of 18-21 yo were overweight/ obese. For 13-17 yo, lower income was associated with higher BMI. There was no association between food insecurity and BMI for any age group. Conclusions Overweight/ obesity are highly prevalent among NHPI youth which is concerning for development of diabetes, hypertension, cardiovascular and kidney disease. Health efforts should focus on SDoH, obesity prevention and management for NHPI youth.
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Affiliation(s)
- Reya H. Mokiao
- University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA
- Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA
| | - Kristen Carlin
- Seattle Children’s Research Institute, 1920 Terry Ave, Seattle, WA 98101, USA
| | - Michael S. Spencer
- University of Washington School of Social Work, 4101 15 Ave NE, Seattle, WA 98105, USA
| | - Bessie A. Young
- University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Amanda M. Fretts
- University of Washington School of Public Health, 3980 15 Ave NE, Seattle, WA 98195, USA
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Held S, Feng D, McCormick A, Schure M, Other Medicine L, Hallett J, Inouye J, Allen S, Holder S, Bull Shows B, Trottier C, Kyro A, Kropp S, Turns Plenty N. The Báa nnilah Program: Results of a Chronic-Illness Self-Management Cluster Randomized Trial with the Apsáalooke Nation. Int J Environ Res Public Health 2024; 21:285. [PMID: 38541285 PMCID: PMC10970069 DOI: 10.3390/ijerph21030285] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024]
Abstract
Indigenous people in Montana are disproportionately affected by chronic illness (CI), a legacy of settler colonialism. Existing programs addressing CI self-management are not appropriate because they are not consonant with Indigenous cultures in general and the Apsáalooke culture specifically. A research partnership between the Apsáalooke (Crow Nation) non-profit organization Messengers for Health and Montana State University co-developed, implemented, and evaluated a CI self-management program for community members. This article examines qualitative and quantitative program impacts using a pragmatic cluster randomized clinical trial design with intervention and waitlist control arms. The quantitative and qualitative data resulted in different stories on the impact of the Báa nnilah program. Neither of the quantitative hypotheses were supported with one exception. The qualitative data showed substantial positive outcomes across multiple areas. We examine why the data sets led to two very different stories, and provide study strengths and limitations, recommendations, and future directions.
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Affiliation(s)
- Suzanne Held
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Du Feng
- Department of Nursing, University of Nevada, Las Vegas, NV 89154, USA;
| | - Alma McCormick
- Messengers for Health, Crow Agency, MT 59022, USA; (A.M.); (L.O.M.)
| | - Mark Schure
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | | | - John Hallett
- Petaluma Health Center, Petaluma, CA 94954, USA;
| | - Jillian Inouye
- Manoa School of Nursing, University of Hawaii, Honolulu, HI 96822, USA;
| | - Sarah Allen
- Department of Family Life & Human Development, Southern Utah University, Cedar City, UT 84720, USA;
| | - Shannon Holder
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Brianna Bull Shows
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Coleen Trottier
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Alexi Kyro
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Samantha Kropp
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
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George MS, Ramu KA, Prasad R, Prashanth NS, Kenjoor S, Grant JB. "How can our children learn from us about our way of life or understand who they are?": Residential schools and their impact on the wellbeing of Indigenous youth in Attapadi, South India. Transcult Psychiatry 2024:13634615231213834. [PMID: 38404061 DOI: 10.1177/13634615231213834] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Residential schools are commonly used in India to provide education for Indigenous youth, which requires young people to stay for long periods at distance from their families and communities. Internationally, there is clear evidence for the deleterious effects of residential schools on the mental health and social and community outcomes of Indigenous children, however little is known about the Indian Indigenous experience. This study examined the impact of residential schooling on Indigenous children's wellbeing and that of their communities, using data from an ethnographic research project in Attapadi, Kerala, including interviews, focus group discussions and participant observation with Indigenous communities. Key outcomes from residential schooling reported by the participants include the fear of losing Indigenous identity, shame of being Indigenous, change in the attitude of young people when they returned from schools, and feelings of confusion and stress that young Indigenous participants felt trying to fit into their communities on their return. Findings suggest that these Indigenous youth felt disconnected from several factors that are known to promote resilience for Indigenous communities including a strong cultural identity, connection to the land and ancestors, thereby making them more vulnerable to poor mental health and negative impacts on their overall wellbeing. Addressing these concerns requires a detailed understanding of the specific factors influencing outcomes for Indigenous youth within the Indian residential schooling system, and designing and implementing data-informed conceptual, structural and policy change including the provision of culturally safe mental health services.
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Affiliation(s)
| | - K A Ramu
- Karrara, Attapadi, Palakkad, Kerala, India
| | | | - N S Prashanth
- Institute of Public Health, Banashankari Stage II, Bengaluru, Karnataka, India
| | - Susheela Kenjoor
- Department of Social Work, Mysore University, Mysuru, Karnataka, India
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Ross A, MacPherson C, Baker L, Kim S, Njau G, Williams AD. Impact of Breastfeeding Barriers on Racial/Ethnic Disparities in Breastfeeding Outcomes in North Dakota. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01943-z. [PMID: 38393463 DOI: 10.1007/s40615-024-01943-z] [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: 10/31/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE Exclusive breastfeeding is recommended for the first 6 months of life, but there are racial/ethnic disparities in meeting this recommendation. METHODS 2017-2020 North Dakota Pregnancy Risk Assessment Monitoring System (weighted N = 11,754) data were used to examine racial/ethnic differences in the association between self-reported breastfeeding barriers and breastfeeding duration. Breastfeeding duration was self-reported breastfeeding at 2 and 4 months, and number of weeks until breastfeeding cessation. Self-reported breastfeeding barriers were yes/no responses to 13 barriers (e.g., "difficulty latching," "household duties"). Logistic regression estimated odds ratios and 95% confidence intervals to determine if barriers accounted for breastfeeding disparities by race/ethnicity. Cox proportional hazard models estimated hazard ratios for stopping breastfeeding for American Indian and other race/ethnicity individuals, compared to White individuals. Models were adjusted for birthing parents' demographic and medical factors. RESULTS Logistic regression results suggest American Indian birthing parents had similar odds for breastfeeding duration (2-month duration: OR 0.94 (95%CI 0.50, 1.77); 4-month duration: OR 1.24 (95%CI 0.43, 3.62)) compared to White birthing parents, after accounting for breastfeeding barriers. Cox proportional hazard models suggest American Indian birthing parents had a lower hazard of stopping breastfeeding (HR 0.76 (95%CI 0.57, 0.99)) than White parents, after accounting for breastfeeding barriers. CONCLUSIONS Accounting for breastfeeding barriers eliminated observed disparities in breastfeeding outcomes between American Indian and White birthing parents. Targeted and culturally safe efforts to reduce barriers to breastfeeding are warranted to reduce racial/ethnic disparities in breastfeeding.
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Affiliation(s)
- Anna Ross
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC, 20037, USA
| | - Cora MacPherson
- Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave NW #2, Washington, DC, 20037, USA
| | - Lannesse Baker
- University of North Dakota School of Medicine and Health Sciences, Room E166, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA
| | - Soojung Kim
- Department of Communication, University of North Dakota, O'Kelly Hall Room 202, 221 Centennial Drive Stop 7169, Grand Forks, ND, 58202-7169, USA
| | - Grace Njau
- North Dakota Department of Health & Human Services, 600 E Boulevard Ave Dept 325, Bismarck, ND, 58505, USA
| | - Andrew D Williams
- University of North Dakota School of Medicine and Health Sciences, Room E166, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202-9037, USA.
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