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Prince C. Emotional reactions to concepts of racism and white privilege in non-Aboriginal professionals working in remote Aboriginal communities. Rural Remote Health 2024; 24:7749. [PMID: 38453674 DOI: 10.22605/rrh7749] [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: 03/09/2024] Open
Abstract
INTRODUCTION This research, conducted by a non-Aboriginal, White researcher, examines how health professionals working in remote Aboriginal communities engage with antiracism as instructed by national standards, whether strong emotions are elicited while reflecting on these concepts, and how these reactions impact on antiracist professional practice. METHODS Eleven non-Indigenous allied health professionals were interviewed in a semi-structured format. Interviews were transcribed, thematically analysed and compared to existing literature. RESULTS AND DISCUSSION Every participant identified overwhelming emotions that they linked to reflecting on racism, White privilege and colonisation. Professionals reported grappling with denial, anger, guilt, shame, fear, anxiety and perfectionism, loss of belonging, disgust and care. They reported that these emotions caused overwhelm, exhaustion, tensions with colleagues and managers, and disengagement from antiracism efforts, and contributed to staff turmoil and turnover. CONCLUSION Previously, these emotional reactions and their impact on antiracism have only been described in the context of universities and by antiracist activists. This research identifies for the first time that these reactions also occur in health services in Aboriginal communities. Wider research is needed to better understand how these reactions impact on health service delivery to Aboriginal communities, and to evaluate ways of supporting staff to constructively navigate these reactions and develop antiracist, decolonised professional practice.
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Affiliation(s)
- Caitlin Prince
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, South Australia, Australia
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Upward K, Usher K, Saunders V, Maple M. Understanding solastalgia from a decolonised, Indigenist lens: a scoping review. Front Public Health 2024; 11:1261247. [PMID: 38288427 PMCID: PMC10824238 DOI: 10.3389/fpubh.2023.1261247] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/08/2023] [Indexed: 01/31/2024] Open
Abstract
The objective of this review is to use a decolonised, Indigenist lens to understand the definition of solastalgia from an Aboriginal perspective, as a potential emotional response experienced by Aboriginal communities impacted by increasingly frequent natural disasters, such as bushfires. Initial search results revealed a lack of literature referencing solastalgia in an Aboriginal-specific context. Indigenist research methodologies such as Heuristic inquiry and Aboriginal Participatory Action Research (APAR) contributed to the identification of alternative terminologies, which led to the majority of the included publications referring to solastalgia-related concepts, with one included publication mentioning solastalgia specifically. These methods were consequently used to synthesize data, confirm results and contribute to final discussions. Lastly, our results determined that at this stage there is insufficient evidence to conclusively suggest that Aboriginal Peoples in a general sense, experience solastalgia. Acknowledging the ethical dilemma and potential harm of generalising personal philosophies and experiences based on Culture. Thereby, signify the need for further research in this space and in particular, from a decolonised, Indigenist perspective. Preface In the context of this review, we as co-authors are mindful of and respect the tensions or politics associated with proclaiming or discussing the identities of Australia's First Peoples. Therefore, in the context of this review, the often preferred term Aboriginal refers to the traditional owners of Australia. Where possible, traditional place/tribe names are written to acknowledge the ownership and origins of the information referenced within this review. Furthermore, we wish to acknowledge the storeys and traditional knowledge shared by the authors of the studies referenced within this review. These words of Country and Kin have contributed to the development and conceptualisation of this literature review, and we wish to pay our respects and appreciation.
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Affiliation(s)
- Kisani Upward
- School of Health, University of New England, Armidale, NSW, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, NSW, Australia
| | - Vicki Saunders
- Centre for Indigenous Health Equity Research, First Nations Academy, Central Queensland University, Townsville, QLD, Australia
| | - Myfanwy Maple
- School of Health, University of New England, Armidale, NSW, Australia
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3
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Dawson AP, Warrior E, Pearson O, Boyd MA, Dwyer J, Morey K, Brodie T, Towers K, Waters S, Avila C, Hammond C, Lake KJ, Lampard ‘UF, Wanganeen ‘UF, Bennell O, Bromley D, Shearing T, Rigney N, Czygan S, Clinch N, Pitson A, Brown A, Howard NJ. Exploring self-determined solutions to service and system challenges to promote social and emotional wellbeing in Aboriginal and Torres Strait Islander people: a qualitative study. Front Public Health 2023; 11:1206371. [PMID: 37809004 PMCID: PMC10556859 DOI: 10.3389/fpubh.2023.1206371] [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: 05/03/2023] [Accepted: 08/28/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Many Aboriginal and Torres Strait Islander people living on Kaurna Country in northern Adelaide experience adverse health and social circumstances. The Taingiwilta Pirku Kawantila study sought to understand challenges facing Aboriginal and Torres Strait Islander communities and identify solutions for the health and social service system to promote social and emotional wellbeing. Methods This qualitative study applied Indigenous methodologies undertaken with Aboriginal and Torres Strait Islander governance and leadership. A respected local Aboriginal person engaged with Aboriginal and Torres Strait Islander community members and service providers through semi-structured interviews and yarning circles that explored community needs and challenges, service gaps, access barriers, success stories, proposed strategies to address service and system challenges, and principles and values for service design. A content analysis identified the breadth of challenges in addition to describing key targets to empower and connect communities and optimize health and social services to strengthen individual and collective social and emotional wellbeing. Results Eighty-three participants contributed to interviews and yarning circles including 17 Aboriginal community members, 38 Aboriginal and Torres Strait Islander service providers, and 28 non-Indigenous service providers. They expressed the need for codesigned, strengths-based, accessible and flexible services delivered by Aboriginal and Torres Strait Islander workers with lived experience employed in organisations with Aboriginal and Torres Strait Islander leadership and governance. Community hubs and cultural events in addition to one-stop-shop service centres and pre-crisis mental health, drug and alcohol and homelessness services were among many strategies identified. Conclusion Holistic approaches to the promotion of social and emotional wellbeing are critical. Aboriginal and Torres Strait Islander people are calling for places in the community to connect and practice culture. They seek culturally safe systems that enable equitable access to and navigation of health and social services. Aboriginal and Torres Strait Islander workforce leading engagement with clients is seen to safeguard against judgement and discrimination, rebuild community trust in the service system and promote streamlined access to crucial services.
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Affiliation(s)
- Anna P. Dawson
- Wardliparingga Aboriginal Health Equity, South Australian Health and Research Institute, Adelaide, SA, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Eugene Warrior
- Wardliparingga Aboriginal Health Equity, South Australian Health and Research Institute, Adelaide, SA, Australia
| | - Odette Pearson
- Wardliparingga Aboriginal Health Equity, South Australian Health and Research Institute, Adelaide, SA, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Mark A. Boyd
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
- Division of Medicine, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Judith Dwyer
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Kim Morey
- Wardliparingga Aboriginal Health Equity, South Australian Health and Research Institute, Adelaide, SA, Australia
| | - Tina Brodie
- Wardliparingga Aboriginal Health Equity, South Australian Health and Research Institute, Adelaide, SA, Australia
| | - Kurt Towers
- Division of Medicine, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Sonia Waters
- Aboriginal Services, AnglicareSA, Adelaide, SA, Australia
| | | | - Courtney Hammond
- Wardliparingga Aboriginal Health Equity, South Australian Health and Research Institute, Adelaide, SA, Australia
| | - Katherine J. Lake
- Wardliparingga Aboriginal Health Equity, South Australian Health and Research Institute, Adelaide, SA, Australia
- Indigenous Health Equity, Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC, Australia
| | - ‘Uncle’ Frank Lampard
- Division of Medicine, Northern Adelaide Local Health Network, Adelaide, SA, Australia
- Executive Office, Kaurna Elder and Aboriginal Community Representative, Adelaide, SA, Australia
| | - ‘Uncle’ Frank Wanganeen
- Executive Office, Kaurna Elder and Aboriginal Community Representative, Adelaide, SA, Australia
| | - Olive Bennell
- Executive Office, Nunga Mi:Minars Inc., Adelaide, SA, Australia
| | | | - Toni Shearing
- Division of Medicine, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Nathan Rigney
- Aboriginal Health Promotion, Wellbeing SA, Adelaide, SA, Australia
| | | | - Nikki Clinch
- Statewide Operations, South Australian Department for Corrections, Adelaide, SA, Australia
| | - Andrea Pitson
- Aboriginal Education Directorate, South Australian Department for Education, Adelaide, SA, Australia
| | - Alex Brown
- Indigenous Genomics, Telethon Kids Institute, Adelaide, South Australia, Australia
- National Centre for Indigenous Genomics, Australian National University, Canberra, ACT, Australia
| | - Natasha J. Howard
- Wardliparingga Aboriginal Health Equity, South Australian Health and Research Institute, Adelaide, SA, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Cama E, Beadman M, Beadman K, Hopwood M, Treloar C. Health workers' perspectives of hepatitis B-related stigma among Aboriginal and Torres Strait Islander people in New South Wales, Australia. Harm Reduct J 2023; 20:116. [PMID: 37633903 PMCID: PMC10463284 DOI: 10.1186/s12954-023-00844-4] [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: 03/31/2023] [Accepted: 07/28/2023] [Indexed: 08/28/2023] Open
Abstract
BACKGROUND Experiences of stigma and discrimination can act as a significant barrier to testing, monitoring, and treatment for hepatitis B virus (HBV). Aboriginal and Torres Strait Islander Australians are a population disproportionately impacted by HBV and yet limited research has explored HBV-related stigma in these communities. To begin preliminary explorations of HBV-related stigma among Aboriginal and Torres Strait Islander people, we interviewed health workers about their perceptions regarding HBV infection and HBV-related stigma. METHODS Participants were recruited from staff involved in the Deadly Liver Mob (DLM) program which is a health promotion program that offers incentives for Aboriginal and Torres Strait Islander clients to be educated on viral hepatitis, recruit and educate peers, and receive screening and treatment for blood-borne viruses (BBVs) and sexually transmissible infections (STIs), and vaccination. Semi-structured interviews were conducted with 11 Aboriginal and Torres Strait Islander and non-Aboriginal or Torres Strait Islander health workers who have been involved in the development, implementation, and/or management of the DLM program within participating services in New South Wales, Australia. RESULTS Findings suggest that stigma is a barrier to accessing mainstream health care among Aboriginal and Torres Strait Islander clients, with stigma being complex and multi-layered. Aboriginal and Torres Strait Islander people contend with multiple and intersecting layers of stigma and discrimination in their lives, and thus HBV is just one dimension of those experiences. Health workers perceived that stigma is fuelled by multiple factors, including poor HBV health literacy within the health workforce broadly and among Aboriginal and Torres Strait Islander clients, shame about social practices associated with viral hepatitis, and fear of unknown transmission risks and health outcomes. The DLM program was viewed as helping to resist and reject stigma, improve health literacy among both health workers and clients, and build trust and confidence in mainstream health services. CONCLUSIONS Health promotion programs have the potential to reduce stigma by acting as a 'one stop shop' for BBVs and STIs through one-on-one support, yarning, and promotion of the HBV vaccine, monitoring for chronic HBV, and treatment (where required).
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Affiliation(s)
- Elena Cama
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia.
| | - Mitch Beadman
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Kim Beadman
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Max Hopwood
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, 2052, Australia
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Gilchrist L, Hyde Z, Petersen C, Douglas H, Hayden S, Bessarab D, Flicker L, LoGiudice D, Ratcliffe J, Clinch C, Taylor K, Bradley K, Smith K. Validation of the Good Spirit, Good Life quality-of-life tool for older Aboriginal Australians. Australas J Ageing 2023; 42:302-310. [PMID: 36085595 PMCID: PMC10946526 DOI: 10.1111/ajag.13128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Improving the quality of life (QoL) of older people is a key priority for governments, clinicians, researchers and service providers worldwide. However, the lack of culturally appropriate QoL tools for First Nations people is a major barrier to such efforts. The purpose of this study was to evaluate the psychometric properties of the Good Spirit, Good Life (GSGL) QoL tool for older Aboriginal Australians. METHODS One hundred and twenty older Aboriginal people living in Perth and Melbourne, Australia, were administered the GSGL tool, along with several other instruments assessing cognition (KICA-Cog), depression (KICA-Dep), anxiety (GAI-SF), health and well-being (EQ-5D-5L and ICECAP-O) and resilience (ARRQ-25). Associations between these instruments and the GSGL tool were explored to determine concurrent and known-groups validity. Internal consistency was assessed with split-half reliability and Cronbach's alpha. Exploratory factor analysis was performed to investigate construct validity. RESULTS GSGL scores were positively correlated with ICECAP-O and ARRQ-25 scores, and negatively correlated with EQ-5D-5L score. GSGL scores differed significantly between participants with a probable anxiety disorder or depression, but not those with cognitive impairment. The Spearman-Brown prophecy estimate was 0.83 and Cronbach's alpha was 0.75. Principal component analysis identified two factors, which were labelled foundation and external. CONCLUSIONS The GSGL tool is a valid tool to assess quality of life in older Aboriginal Australians. The tool demonstrates acceptable convergent, concurrent and known-groups validity. It was co-designed at all stages with older Aboriginal people contributing to its strong face and content validity.
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Affiliation(s)
- Lianne Gilchrist
- Centre for Aboriginal Medical and Dental Health, Medical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Zoë Hyde
- Western Australian Centre for Health and Ageing, Medical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Carina Petersen
- School of Population and Global HealthUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Harry Douglas
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneMelbourneVictoriaAustralia
| | - Shondell Hayden
- Centre for Aboriginal Medical and Dental Health, Medical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Dawn Bessarab
- Centre for Aboriginal Medical and Dental Health, Medical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Leon Flicker
- Western Australian Centre for Health and Ageing, Medical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Dina LoGiudice
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneMelbourneVictoriaAustralia
| | - Julie Ratcliffe
- Caring Futures Institute, College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Christine Clinch
- Centre for Aboriginal Medical and Dental Health, Medical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Kevin Taylor
- Centre for Aboriginal Medical and Dental Health, Medical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
| | - Kate Bradley
- Faculty of Medicine, Dentistry and Health SciencesThe University of MelbourneMelbourneVictoriaAustralia
| | - Kate Smith
- Centre for Aboriginal Medical and Dental Health, Medical SchoolUniversity of Western AustraliaPerthWestern AustraliaAustralia
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Bullen J, Hill-Wall T, Anderson K, Brown A, Bracknell C, Newnham EA, Garvey G, Waters L. From Deficit to Strength-Based Aboriginal Health Research-Moving toward Flourishing. Int J Environ Res Public Health 2023; 20:5395. [PMID: 37048008 PMCID: PMC10094537 DOI: 10.3390/ijerph20075395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
Aboriginal Australians have a fundamental human right to opportunities that lead to healthy and flourishing lives. While the impact of trauma on Aboriginal Australians is well-documented, a pervasive deficit narrative that focuses on problems and pathology persists in research and policy discourse. This narrative risks further exacerbating Aboriginal disadvantage through a focus on 'fixing what is wrong' with Aboriginal Australians and the internalising of these narratives by Aboriginal Australians. While a growing body of research adopts strength-based models, limited research has sought to explore Aboriginal flourishing. This conceptual paper seeks to contribute to a burgeoning paradigm shift in Aboriginal research, seeking to understand what can be learned from Aboriginal people who flourish, how we best determine this, and in what contexts this can be impactful. Within, we argue the case for a new approach to exploring Aboriginal wellbeing that integrates salutogenic, positive psychology concepts with complex systems theory to understand and promote Aboriginal wellbeing and flourishing. While deeper work may be required to establish the parameters of a strength-based, culturally aligned Aboriginal conceptualisation of positive psychology, we suggest the integration of Aboriginal and Western methodologies offers a unique and potent means of shifting the dial on seemingly intractable problems.
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Affiliation(s)
- Jonathan Bullen
- EnAble Institute, Curtin University, Perth, WA 6102, Australia
- Telethon Kids Institute, Perth, WA 6009, Australia;
| | - Trish Hill-Wall
- EnAble Institute, Curtin University, Perth, WA 6102, Australia
| | - Kate Anderson
- Faculty of Medicine, The School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Alex Brown
- Telethon Kids Institute, Perth, WA 6009, Australia;
- National Centre for Indigenous Genomics, The John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Clint Bracknell
- School of Languages and Cultures, The University of Queensland, St. Lucia, QLD 4067, Australia
| | - Elizabeth A. Newnham
- EnAble Institute, Curtin University, Perth, WA 6102, Australia
- School of Population Health, Curtin University, Perth, WA 6102, Australia
- FXB Center for Health and Human Rights, Harvard University, Boston, MA 02115, USA
| | - Gail Garvey
- Faculty of Medicine, The School of Public Health, The University of Queensland, Herston, QLD 4006, Australia
| | - Lea Waters
- Centre for Wellbeing Science, Melbourne Graduate School of Education, The University of Melbourne, Parkville, VIC 3101, Australia
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Breth-Petersen M, Garay J, Clancy K, Dickson M, Angelo C. Homesickness at Home: A Scoping Review of Solastalgia Experiences in Australia. Int J Environ Res Public Health 2023; 20:2541. [PMID: 36767914 PMCID: PMC9916141 DOI: 10.3390/ijerph20032541] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Solastalgia is a term used to describe the pain and distress experienced by those witnessing their home environments destroyed or changed in unwelcome ways. Solastalgia is expected to become more prominent as climate change worsens and transforms landscapes. This scoping review examines and maps the existing literature on solastalgia in Australia, particularly focusing on Aboriginal and Torres Strait Islander experiences. Four focus questions guided the review to explore how solastalgia is conceptualized, highlight risk and protective factors, and identify strategies for addressing solastalgia. Eighteen papers met the criteria for inclusion. Overall, our results show a minimal evidence base on solastalgia in Australia with an even greater gap in exploring solastalgia from Aboriginal and Torres Strait Islander perspectives. A strong connection to home environments was suggested as both a risk and protective factor for experiencing solastalgia. Aboriginal and Torres Strait Islander peoples are considered at risk due to intimate connections to home environments, and since the invasion, have experienced mental distress resulting from significant, damaging changes to landscapes and home environments. We recommend further exploration of lived experiences of solastalgia across a greater diversity of Australian contexts, particularly amongst Aboriginal and Torres Strait Islander peoples, including a focus on practical implications.
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Milroy H, Kashyap S, Collova JR, Platell M, Gee G, Ohan JL. Identifying the key characteristics of a culturally safe mental health service for Aboriginal and Torres Strait Islander peoples: A qualitative systematic review protocol. PLoS One 2023; 18:e0280213. [PMID: 36634056 PMCID: PMC9836303 DOI: 10.1371/journal.pone.0280213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/21/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Mental health inequities between Indigenous and non-Indigenous populations are well documented. There is growing recognition of the role that culturally safety plays in achieving equitable outcomes. However, a clear understanding of the key characteristics of culturally safe mental health care is currently lacking. This protocol outlines a qualitative systematic review that aims to identify the key characteristics of culturally safe mental health care for Aboriginal and Torres Strait Islander peoples, at the individual, service, and systems level. This knowledge will improve the cultural safety of mental health care provided to Indigenous peoples, with a focus on Aboriginal and Torres Strait Islander peoples in Australia. METHODS AND EXPECTED OUTPUTS Through a review of academic, grey, and cultural literature, we will identify the key characteristics of culturally safe mental health care for Aboriginal and Torres Strait Islander peoples in Australia. We will consider the characteristics of culturally safe care at the individual practitioner, service, and systems levels. PROSPERO REGISTRATION NUMBER CRD42021258724.
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Affiliation(s)
- Helen Milroy
- UWA Medical School, University of Western Australia, Perth, Western Australia, Australia
- Bilya Marlee School of Indigenous Studies, University of Western Australia, Perth, Western Australia, Australia
| | - Shraddha Kashyap
- Bilya Marlee School of Indigenous Studies, University of Western Australia, Perth, Western Australia, Australia
| | - Jemma R. Collova
- Bilya Marlee School of Indigenous Studies, University of Western Australia, Perth, Western Australia, Australia
| | - Monique Platell
- School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Graham Gee
- Murdoch Children’s Research Institute, The Royal Children’s Hospital, Parkville, Victoria, Australia
- Mebourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Jeneva L. Ohan
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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Milroy H, Kashyap S, Collova J, Mitchell M, Derry KL, Alexi J, Chang EP, Dudgeon P. Co-designing research with Aboriginal and Torres Strait Islander consumers of mental health services, mental health workers, elders and cultural healers. Aust J Rural Health 2022; 30:772-781. [PMID: 36448573 PMCID: PMC10947239 DOI: 10.1111/ajr.12945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 10/07/2022] [Accepted: 10/26/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION The disparity in mental health outcomes compared with non-Indigenous Australians means that there is an urgent need to develop an evidence base around how services can better support Aboriginal and Torres Strait Islander communities. A critical first step is to embed cultural safety into research methodologies. OBJECTIVE Here, we aim to establish the foundation of a research project through co-designing a qualitative interview with Aboriginal and Torres Strait Islander consumers and community members about experiences of cultural safety with mainstream mental health services. DESIGN Voices of Aboriginal and Torres Strait Islander peoples must be empowered across all stages of research. An Aboriginal-led research team conducted focus groups to understand clear, sensitive, and culturally appropriate ways of asking about experiences in mental health care, to co-design an interview on this topic. Participants were Aboriginal and Torres Strait Islander consumers of mental health services, carers, mental health workers, Elders and Cultural Healers, living in Metropolitan and Regional Western Australia. FINDINGS Results suggest that Indigenous governance, together with investing in ongoing, and meaningful cultural awareness and cultural safety training (cultural awareness being a first step towards safety) for non-Indigenous researchers, together with taking the time to build respectful partnerships with communities through ongoing consultation, were appropriate and comprehensive methods of co-designing an interview. DISCUSSION The process of working with Aboriginal and Torres Strait Islander peoples in research is as important as the outcome. Aboriginal and Torres Strait Islander leadership, self-determination, and relationship building with communities are essential. CONCLUSION Empowering co-design methodologies are flexible, iterative, and ensure that the experiences and views of participants are valued, leading to more meaningful results.
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Affiliation(s)
- Helen Milroy
- UWA Medical SchoolUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Shraddha Kashyap
- Poche Centre for Indigenous Health, Bilya Marlee School of Indigenous StudiesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Jemma Collova
- Poche Centre for Indigenous Health, Bilya Marlee School of Indigenous StudiesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Michael Mitchell
- Poche Centre for Indigenous Health, Bilya Marlee School of Indigenous StudiesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Kate Loren Derry
- Poche Centre for Indigenous Health, Bilya Marlee School of Indigenous StudiesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Joanna Alexi
- Poche Centre for Indigenous Health, Bilya Marlee School of Indigenous StudiesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Ee Pin Chang
- Poche Centre for Indigenous Health, Bilya Marlee School of Indigenous StudiesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Pat Dudgeon
- Poche Centre for Indigenous Health, Bilya Marlee School of Indigenous StudiesUniversity of Western AustraliaCrawleyWestern AustraliaAustralia
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Black O, Wright CJC, Clifford S, Erwin M, Canuto K, Wakerman J, Rossingh B, Morgan J, Smith J. YArnhem: Co-designing a model of social and emotional wellbeing stepped care for young people of the north east Arnhem region: A development study protocol. Aust J Rural Health 2022; 30:730-737. [PMID: 36226980 DOI: 10.1111/ajr.12926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 08/25/2022] [Accepted: 09/11/2022] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION More Aboriginal and Torres Strait Islander young people experience high or very high levels of psychological distress compared to their non-Indigenous counterparts. This may be partly attributed to systemic barriers resulting in lower rates of help-seeking, sub-optimal identification of psychological challenges, and undertreatment. Reducing these barriers within health systems is an important factor in reducing the Social and Emotional Wellbeing (SEWB) health burden on young Aboriginal and Torres Strait Islander people. OBJECTIVES In partnership with Miwatj Health Aboriginal Corporation (Miwatj), this project will co-design an integrated youth Social and Emotional Wellbeing (SEWB) and mental health stepped care model for remote Aboriginal communities in the north east Arnhem region of the Northern Territory. DESIGN A collaborative research approach using co-design methods will underpin a community-centric stepped care allocation method, to which culturally appropriate SEWB and mental health interventions and treatments are assigned. These components of the project will inform a digital platform which will facilitate access to SEWB care for young people in north east Arnhem land. This concept was co-developed in a partnership between researchers and Miwatj and builds on Miwatj's previous work to map the stepped needs of young people. The co-design of the content and features of these outputs will be facilitated through community participation and overseen by community, health, and cultural governance structures. This will ensure the solutions developed by the project are culturally responsive, fit for purpose, and will enhance self-determination while reducing systemic barriers to care.
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Affiliation(s)
- Oliver Black
- Flinders University, Darwin, Northern Territory, Australia
| | - Cassandra J C Wright
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
- Burnet Institute, Melbourne, Victoria, Australia
- Centre for Alcohol Policy Research, Melbourne, Victoria, Australia
| | - Sarah Clifford
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Michelle Erwin
- Miwatj Health Aboriginal Organisation, Darwin, Northern Territory, Australia
| | - Kootsy Canuto
- Flinders University, Darwin, Northern Territory, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - John Wakerman
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Bronwyn Rossingh
- Miwatj Health Aboriginal Organisation, Darwin, Northern Territory, Australia
| | - John Morgan
- Miwatj Health Aboriginal Organisation, Darwin, Northern Territory, Australia
| | - James Smith
- Flinders University, Darwin, Northern Territory, Australia
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Santiago PHR, Soares GH, Smithers LG, Roberts R, Jamieson L. Psychological Network of Stress, Coping and Social Support in an Aboriginal Population. Int J Environ Res Public Health 2022; 19:15104. [PMID: 36429821 PMCID: PMC9690794 DOI: 10.3390/ijerph192215104] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 06/16/2023]
Abstract
Over the past decades, increasing research interest has been directed towards the psychosocial factors that impact Aboriginal health, including stress, coping and social support. However, there has been no study that examined whether the behaviours, cognitions and emotions related to stress, coping and social support constitute a psychological network in an Aboriginal population and that examined its properties. To address this gap, the current study employed a new methodology, network psychometrics, to evaluate stress, coping and social support in an Aboriginal Australian population. This study conducted a secondary analysis of the South Australian Aboriginal Birth Cohort (SAABC) study, a randomised controlled trial in South Australia, which included 367 pregnant Aboriginal women at study baseline. The Gaussian Graphical Model was estimated with least absolute shrinkage and selection operator (LASSO). Node centrality was evaluated with eigencentrality, strength and bridge centrality. Network communities were investigated with the walktrap algorithm. The findings indicated that stress, coping and social support constituted a connected psychological network in an Aboriginal population. Furthermore, at the centre of the network were the troubles experienced by the Aboriginal pregnant women, bridging their perceptions of stress and coping and constituting a potential target for future interventions.
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Affiliation(s)
- Pedro Henrique Ribeiro Santiago
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
- School of Public Health, The University of Adelaide, Adelaide 5005, Australia
| | - Gustavo Hermes Soares
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
| | - Lisa Gaye Smithers
- School of Public Health, The University of Adelaide, Adelaide 5005, Australia
- School of Health and Society, University of Wollongong, Wollongong 2500, Australia
| | - Rachel Roberts
- School of Psychology, The University of Adelaide, Adelaide 5000, Australia
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide 5000, Australia
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12
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Graham S, Blaxland M, Bolt R, Beadman M, Gardner K, Martin K, Doyle M, Beetson K, Murphy D, Bell S, Newman CE, Bryant J. Aboriginal peoples' perspectives about COVID-19 vaccines and motivations to seek vaccination: a qualitative study. BMJ Glob Health 2022; 7:e008815. [PMID: 35858705 PMCID: PMC9304971 DOI: 10.1136/bmjgh-2022-008815] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/07/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Aboriginal and Torres Strait Islander (Aboriginal) people compared with non-Aboriginal people in Australia have higher rates of chronic conditions. These conditions increase the risk of poorer health outcomes if infected with COVID-19, highlighting the importance of COVID-19 vaccination. This study examined what Aboriginal people think about COVID-19 vaccines, reasons why they were vaccinated or not vaccinated and factors involved in receiving COVID-19 vaccination. METHODS We used a participatory peer researcher method to interview 35 Aboriginal people aged 15-80 years living in Western Sydney, Australia. Local Aboriginal people who had ties with the community conducted the interviews. The questions and analyses were framed using the WHO's Behavioural and Social Drivers of COVID-19 model. Interviews occurred between February 2021 and March 2021. Peer researchers were paid for their time in training and to conduct the interviews and each participant received $50. RESULTS Reasons why participants would seek vaccination included: to protect themselves from infection and severe illness, to protect others in their community, to travel again and to return to 'normal life'. Reasons why some participants were hesitant about being vaccinated included: fear of vaccine side effects; negative stories on social media; and distrust in Australian governments and medical institutions. Aboriginal people preferred to access COVID-19 vaccination through their local Aboriginal Health Service or a general practitioner they already knew. CONCLUSION Achieving high vaccination rates in Aboriginal communities is possible if vaccination programmes are delivered through trusted general practitioners or Aboriginal Health Services.
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Affiliation(s)
- Simon Graham
- Department of Infectious Diseases, The Peter Doherty Institute for Infection and Immunity, Melbourne Medical School, University of Melbourne, Melbourne, Victoria, Australia
| | - Megan Blaxland
- Social Policy Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
| | - Reuben Bolt
- Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Mitchell Beadman
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kristy Gardner
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kacey Martin
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Michael Doyle
- NHMRC Centre for Research Excellence in Indigenous Health and Alcohol, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Karen Beetson
- Department of Aboriginal Health, South Western Sydney Local Health District, Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Dean Murphy
- The Kirby Institute for Infection and Immunity, UNSW Sydney, Sydney, New South Wales, Australia
| | - Stephen Bell
- Social Policy Research Centre, UNSW Sydney, Sydney, New South Wales, Australia
- UQ Poche Centre for Indigenous Health, The University of Queensland, Saint Lucia, Queensland, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Christy E Newman
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Joanne Bryant
- Centre for Social Research in Health, UNSW Sydney, Sydney, New South Wales, Australia
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13
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Dudgeon P, Derry KL, Mascall C, Ryder A. Understanding Aboriginal Models of Selfhood: The National Empowerment Project's Cultural, Social, and Emotional Wellbeing Program in Western Australia. Int J Environ Res Public Health 2022; 19:4078. [PMID: 35409761 PMCID: PMC8997958 DOI: 10.3390/ijerph19074078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/13/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023]
Abstract
Culturally safe and responsive interventions that acknowledge Aboriginal models of selfhood are needed. Such interventions empower Aboriginal peoples and communities by increasing self-determination over individual and community social and emotional wellbeing (SEWB). In response to this need, the National Empowerment Project developed the Cultural, Social, and Emotional Wellbeing Program (CSEWB). The CSEWB aims to strengthen SEWB and cultural identity and subsequently reduce psychological distress in Aboriginal peoples. An Aboriginal Participatory Action Research approach ensured community ownership and engagement. Seven research questions and a culturally modified adaption of the Most Significant Change technique informed a thematic analysis of the evaluation content. Aboriginal adults (n = 49; 53% ≥50 years, 66% female, 34% male) from three Western Australian urban communities participated in the program evaluation workshops. Participants reported the benefits of enhanced SEWB and reduced psychological distress. This research reaffirms the need for culturally safe programs that acknowledge social determinants of health and are guided by the SEWB framework. Long-term commitment from the government is needed to support such programs.
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Affiliation(s)
- Pat Dudgeon
- Poche Centre for Indigenous Health, School of Indigenous Studies, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Kate L. Derry
- Poche Centre for Indigenous Health, School of Indigenous Studies, The University of Western Australia, Crawley, WA 6009, Australia;
| | - Carolyn Mascall
- Relationships Australia WA, West Leederville, WA 6007, Australia; Langford Aboriginal Association, Langford, WA 6147, Australia; (C.M.); (A.R.)
| | - Angela Ryder
- Relationships Australia WA, West Leederville, WA 6007, Australia; Langford Aboriginal Association, Langford, WA 6147, Australia; (C.M.); (A.R.)
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