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Crocetti AC, Walker T, Mitchell F, Sherriff S, Hill K, Paradies Y, Backholer K, Browne J. Making Big Business Everybody's Business: Aboriginal leaders' perspectives on commercial activities influencing aboriginal health in Victoria, Australia. Global Health 2024; 20:33. [PMID: 38637867 PMCID: PMC11025162 DOI: 10.1186/s12992-024-01038-8] [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: 12/06/2023] [Accepted: 04/02/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND The commercial determinants of health is a rapidly expanding field of research; however Indigenous perspectives remain notably underrepresented. For Indigenous peoples the intersection of globalisation, colonialism and capitalism may amplify commercially-driven health inequities. This study aimed to explore the perspectives of Aboriginal leaders regarding the influence of commercial activities on Aboriginal health and wellbeing in Victoria, Australia. METHODS Semi-structured interviews with 23 Aboriginal leaders from across five sectors (n = 15 urban, n = 8 rural/regional) were analysed through reflexive thematic analysis. RESULTS Three overarching themes were identified encompassing (i) harmful commercial practices and processes, (ii) improving corporate engagement and (iii) opportunities for self-determination through business. Participants expressed concern over aggressive marketing by the gambling industry, commercial exploitation of Aboriginal culture, the privatisation of public services, and lack of oversignt of corporate social responsibility strategies. Simultaneously, Aboriginal-led businesses were viewed as opportunities for cultural connection, and financial empowerment and self-determination. CONCLUSION Numerous commercial entities and activities are perceived to influence Aboriginal health and wellbeing. This study highlights the need for stronger policy and regulation to mitigate harmful industry practices while incentivising the potential positive impacts of the commercial activities on Aboriginal health and wellbeing.
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Affiliation(s)
- Alessandro Connor Crocetti
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia.
| | - Troy Walker
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Fiona Mitchell
- Deakin Rural Health, Faculty of Health, Deakin University, Warrnambool, VIC, Australia
| | - Simone Sherriff
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Karen Hill
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Yin Paradies
- Alfred Deakin Institute for Citizenship and Globalisation, Deakin University, Burwood, VIC, Australia
| | - Kathryn Backholer
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
| | - Jennifer Browne
- Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Geelong, VIC, Australia
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Gartland D, Nikolof A, Mensah F, Gee G, Glover K, Leane C, Carter H, Brown SJ. The Childhood Resilience Study: Resilience and emotional and behavioural wellbeing experienced by Australian Aboriginal and Torres Strait Islander boys and girls aged 5-9 years. PLoS One 2024; 19:e0301620. [PMID: 38626131 PMCID: PMC11020770 DOI: 10.1371/journal.pone.0301620] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 03/19/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Resilience is a process of drawing on internal or external strengths to regain, sustain or improve adaptive outcomes despite adversity. Using a child resilience measure co-designed with Aboriginal and Torres Strait Islander communities, we investigate: 1) children's personal, family, school and community strengths; 2) gender differences; and 3) associations between resilience and wellbeing. METHODS 1132 parent/caregivers of children aged 5-12 years were recruited to the Childhood Resilience Study, including through the Aboriginal Families Study. The Aboriginal Families Study is a population-based cohort of 344 mothers of an Aboriginal and/or Torres Strait Islander child. This paper focuses on the wave 2 survey data on child resilience at age 5-9 years (n = 231). Resilience was assessed with the Child Resilience Questionnaire-parent/caregiver report (CRQ-P/C), categorised into tertiles of low, moderate and high scores. Child emotional/behavioural wellbeing and mental health competence was assessed with the parent-report Strengths and Difficulties Questionnaire. All Tobit regression models adjusted for child age. OUTCOMES Aboriginal and Torres Strait Islander girls had higher resilience scores compared to boys (Adj.β = 0·9, 95%CI 0·9-1·4), with higher School Engagement, Friends and Connectedness to language scale scores. Resilience scores were strongly associated with wellbeing and high mental health competence. A higher proportion of girls with low resilience scores had positive wellbeing than did boys (73.3% versus 49.0%). High resilience scores were associated with lower SDQ total difficulties score after adjusting for child age, gender, maternal age and education and family location (major city, regional, remote) (Adj.β = -3.4, 95%CI -5.1, -1.7). Compared to the Childhood Resilience Study sample, Aboriginal Families Study children had higher mean CRQ-P/C scores in the personal and family domains. INTERPRETATION High family strengths can support Aboriginal and Torres Strait Islander children at both an individual and cultural level. Boys may benefit from added scaffolding by schools, family and communities to support their social and academic connectedness.
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Affiliation(s)
- Deirdre Gartland
- Murdoch Children’s Research Institute, Intergenerational Health, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Arwen Nikolof
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- South Australian Health and Medical Research Institute, Women’s and Kids Theme, Adelaide, South Australia, Australia
| | - Fiona Mensah
- Murdoch Children’s Research Institute, Intergenerational Health, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Graham Gee
- Murdoch Children’s Research Institute, Intergenerational Health, Melbourne, Victoria, Australia
- School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Karen Glover
- Murdoch Children’s Research Institute, Intergenerational Health, Melbourne, Victoria, Australia
- South Australian Health and Medical Research Institute, Women’s and Kids Theme, Adelaide, South Australia, Australia
| | - Cathy Leane
- Women’s and Children’s Health Network, South Australia Health, Adelaide, South Australia, Australia
| | - Heather Carter
- Department for Education, Aboriginal Education Directorate, Adelaide, South Australia, Australia
| | - Stephanie Janne Brown
- Murdoch Children’s Research Institute, Intergenerational Health, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- South Australian Health and Medical Research Institute, Women’s and Kids Theme, Adelaide, South Australia, Australia
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Lawler K, Dronavalli M, Page A, Lee E, Uebel H, Bajuk B, Burns L, Dickson M, Green C, Dicair L, Eastwood J, Oei JL. 'Joining the Dots: Linking Prenatal Drug Exposure to Childhood and Adolescence' - research protocol of a population cohort study. BMJ Paediatr Open 2024; 8:e002557. [PMID: 38604771 PMCID: PMC11015252 DOI: 10.1136/bmjpo-2024-002557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
INTRODUCTION Prenatal drug exposure (PDE) is one of the most important causes of child harm, but comprehensive information about the long-term outcomes of the families is difficult to ascertain. The Joining the Dots cohort study uses linked population data to understand the relationship between services, therapeutic interventions and outcomes of children with PDE. METHODS AND ANALYSIS Information from routinely collected administrative databases was linked for all births registered in New South Wales (NSW), Australia between 1 July 2001 and 31 December 2020 (n=1 834 550). Outcomes for seven mutually exclusive groups of children with varying prenatal exposure to maternal substances of addiction, including smoking, alcohol, prescription/illicit drugs and neonatal abstinence syndrome will be assessed. Key exposure measures include maternal drug use type, maternal social demographics or social determinants of health, and maternal physical and mental health comorbidities. Key outcome measures will include child mortality, academic standardised testing results, rehospitalisation and maternal survival. Data analysis will be conducted using Stata V.18.0. ETHICS AND DISSEMINATION Approvals were obtained from the NSW Population and Health Services Research Ethics Committee (29 June 2020; 2019/ETH12716) and the Australian Capital Territory Health Human Research Ethics Committee (11 October 2021; 2021-1231, 2021-1232, 2021-1233); and the Aboriginal Health and Medical Research Council (5 July 2022; 1824/21), and all Australian educational sectors: Board of Studies (government schools), Australian Independent Schools and Catholic Education Commission (D2014/120797). Data were released to researchers in September 2022. Results will be presented in peer-reviewed academic journals and at international conferences. Collaborative efforts from similar datasets in other countries are welcome.
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Affiliation(s)
- Kate Lawler
- School of Women's and Children's Health, Faculty of Medicine and Health, University of New South Wales, Randwick, New South Wales, Australia
| | - Mithilesh Dronavalli
- School of Women's and Children's Health, Faculty of Medicine and Health, University of New South Wales, Randwick, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Evelyn Lee
- Centre for Social Research in Health, University of New South Wales, Randwick, New South Wales, Australia
- Centre for Economic Impacts of Genomic Medicine, Macquarie University, North Ryde, New South Wales, Australia
| | - Hannah Uebel
- School of Women's and Children's Health, Faculty of Medicine and Health, University of New South Wales, Randwick, New South Wales, Australia
- Sydney Children's Hospital Randwick, Randwick, New South Wales, Australia
| | - Barbara Bajuk
- Critical Care Program, Sydney Children's Hospitals Network Randwick and Westmead, Westmead, New South Wales, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Randwick, New South Wales, Australia
| | - Michelle Dickson
- The Poche Centre for Indigenous Health, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | | | | | - John Eastwood
- National Public Health Service, Te Whatu Ora-Health New Zealand, Dunedin, New Zealand
- School of Population Health, University of New South Wales, Randwick, New South Wales, Australia
| | - Ju Lee Oei
- School of Women's and Children's Health, Faculty of Medicine and Health, University of New South Wales, Randwick, New South Wales, Australia
- Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia
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Sherriff S, Gwynn JD. Yarning together: toward targeted, co-designed parenting programs for Aboriginal Australians. Med J Aust 2024; 220:313-314. [PMID: 38379346 DOI: 10.5694/mja2.52238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/17/2024] [Indexed: 02/22/2024]
Affiliation(s)
- Simone Sherriff
- Poche Centre for Indigenous Health, the University of Sydney, Sydney, NSW
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Howard K, Garvey G, Anderson K, Dickson M, Viney R, Ratcliffe J, Howell M, Gall A, Cunningham J, Whop LJ, Cass A, Jaure A, Mulhern B. Development of the What Matters 2 Adults (WM2A) wellbeing measure for Aboriginal and Torres Strait Islander adults. Soc Sci Med 2024; 347:116694. [PMID: 38569315 DOI: 10.1016/j.socscimed.2024.116694] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 01/30/2024] [Accepted: 02/12/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE As wellbeing is culturally bound, wellbeing measures for Aboriginal and Torres Strait Islander peoples must be culturally relevant and grounded in Aboriginal and Torres Strait Islander values and preferences. We describe the development of a nationally-relevant and culturally grounded wellbeing measure for Aboriginal and Torres Strait Islander adults: the What Matters to Adults (WM2A) measure. METHODS We used a mixed methods approach to measure development, combining Indigenist methodologies and psychometric methods. Candidate items were derived through a large national qualitative study. Think-aloud interviews (n = 17) were conducted to assess comprehension, acceptability, and wording of candidate items. Two national surveys collected data on the item pool (n = 312, n = 354). Items were analysed using exploratory factor analysis (EFA), and item response theory (IRT) to test dimensionality, local dependence and item fit. A Collaborative Yarning approach ensured Aboriginal and Torres Strait Islander voices were privileged throughout. RESULTS Fifty candidate items were developed, refined, and tested. Using EFA, an eight factor model was developed. All items met pre-specified thresholds for maximum endorsement frequencies, and floor and ceiling effects; no item redundancy was identified. Ten items did not meet thresholds for aggregate adjacent endorsement frequencies. During Collaborative Yarning, six items were removed based on low factor loadings (<0.4) and twelve due to conceptual overlap, high correlations with other items, endorsement frequencies, and/or low IRT item level information. Several items were retained for content validity. The final measure includes 32 items across 10 domains (Balance & control; Hope & resilience; Caring for others; Culture & Country; Spirit & identity; Feeling valued; Connection with others; Access; Racism & worries; Pride & strength). CONCLUSIONS The unique combination of Indigenist and psychometric methodologies to develop WM2A ensures a culturally and psychometrically robust measure, relevant across a range of settings and applications.
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Affiliation(s)
- K Howard
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia.
| | - G Garvey
- The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia
| | - K Anderson
- The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia
| | - M Dickson
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; The Poche Centre for Indigenous Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia
| | - R Viney
- The Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Ultimo, NSW, 2007, Australia
| | - J Ratcliffe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, 5001, Australia
| | - M Howell
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia
| | - A Gall
- The First Nations Cancer & Wellbeing Research Team, The School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane Qld 4072, Australia
| | - J Cunningham
- Menzies School of Health Research, Charles Darwin University, Darwin NT, Australia
| | - L J Whop
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, 2600, Australia
| | - A Cass
- Menzies School of Health Research, Charles Darwin University, Darwin NT, Australia
| | - A Jaure
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, NSW, 2006, Australia
| | - B Mulhern
- The Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney, Ultimo, NSW, 2007, Australia
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Cullen T, Griffith M, Damodaran A, Lewis E, McMillan F, Sammel A, Honeysette R, Biles B, Beadman K, Nathan S. The First Nations experience of accessing rheumatology services in a metropolitan hospital: A qualitative study. Health Expect 2024; 27:e14049. [PMID: 38623822 PMCID: PMC11019439 DOI: 10.1111/hex.14049] [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: 01/18/2024] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
OBJECTIVE First Nations Australians experience a higher burden and severity of Rheumatic Disease with poorer outcomes than the general population. Despite a widely acknowledged need to improve health outcomes, there has been minimal research assessing existing models of care from a First Nations perspective in Australia. The objective of this study was to describe First Nations experiences and barriers and enablers to accessing a hospital-based adult Rheumatology service in Sydney. METHODS A qualitative study using semi-structured interviews was undertaken. Patients who self-identified as First Nations attending the Prince of Wales Hospital Rheumatology Clinic in 2021 were invited to participate. Interviews were conducted face-to-face or by telephone using culturally-appropriate Yarning methods with an Aboriginal Health Worker (AHW) at the request of participants. Thematic analysis was done in consultation with an Aboriginal Reference Group (ARG). RESULTS Four categories, which encapsulated 11 themes were identified. Participants reported barriers to care such as logistics of the referral process, not feeling culturally safe because of uncomfortable clinic environments and health worker behaviours, inadequate cultural support and community perceptions of the specialty. Enabling factors included family member involvement, AHW support and telehealth consultation. CONCLUSION The current model of care perpetuates access challenges for First Nations Australians within rheumatology. Barriers to care include the delayed referral process, limited cultural responsivity in the clinic environment and poor cross-cultural communication. There is a need for models of care that are co-designed with First Nations Peoples to address these barriers. PATIENT AND PUBLIC CONTRIBUTION Participants were First Nations Australians with lived experience attending the rheumatology clinic. All interviewees were offered the opportunity to review their transcripts to ensure trustworthiness of the data. Preliminary thematic analysis was conducted in partnership with the AHW who has over 20 years experience. Following preliminary coding, a list of themes were presented to the ARG for iterative discussion and refinement. The ARG provided community representation and ensured that First Nations voices were privileged in the analysis. It's intended that the findings of this study will support the upcoming co-design of a First Nations health service for Rheumatology patients.
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Affiliation(s)
- Taylor Cullen
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
- Department of RheumatologyPrince of Wales HospitalSydneyAustralia
| | - Miki Griffith
- Aboriginal and Torres Strait Islander Community ServicesPrince of Wales HospitalSydneyAustralia
| | - Arvin Damodaran
- Department of RheumatologyPrince of Wales HospitalSydneyAustralia
- School of Clinical Medicine, Faculty of Medicine and Health, UNSWSydneyAustralia
| | - Ebony Lewis
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
| | - Faye McMillan
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
- School of Public HealthUniversity of TechnologySydneyAustralia
| | - Anthony Sammel
- Department of RheumatologyPrince of Wales HospitalSydneyAustralia
- School of Clinical Medicine, Faculty of Medicine and Health, UNSWSydneyAustralia
| | - Rhiana Honeysette
- Aboriginal and Torres Strait Islander Community ServicesPrince of Wales HospitalSydneyAustralia
| | - Brett Biles
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
| | | | - Sally Nathan
- School of Population Health, Faculty of Medicine and Health, UNSWSydneyAustralia
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MacDonald J, Young M, Barclay B, McMullen S, Knox J, Morgan P. The participation of Aboriginal and Torres Strait Islander parents in Australian trials of parenting programs for improving children's health: a scoping review. Med J Aust 2024; 220:331-335. [PMID: 38186285 DOI: 10.5694/mja2.52198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/15/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVES To assess the inclusion of Aboriginal and Torres Strait Islander parents in trials of parenting programs in Australia; the involvement of Indigenous fathers in such studies; and whether parenting programs are designed to be culturally appropriate for Aboriginal and Torres Strait Islander people. STUDY DESIGN Scoping review of peer-reviewed journal publications that report quantitative outcomes for Australian randomised control trials of parenting programs in which the participants were parents or caregivers of children under 18 years of age, and with at least one outcome related to children's health, health behaviour, or wellbeing. DATA SOURCES MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Scopus databases. DATA SYNTHESIS Of 109 eligible publications, nine reported how many participants were Aboriginal or Torres Strait Islander people; three specified whether they were Aboriginal, Torres Strait Islander, or both. Two publications described specific interventions for Aboriginal and Torres Strait Islander children; both reported consultation with Indigenous people regarding program design. Of the 15 559 participating parents in all included publications, 93 were identified as Aboriginal or Torres Strait Islander people. No publications noted as study limitations the absence of consultation with Indigenous people or the low participation rate of Aboriginal and Torres Strait Islander families. CONCLUSIONS The specific needs and interests of Aboriginal and Torres Strait Islander families have not generally been considered in Australian trials of parenting programs that aim to improve the mental and physical health of children. Further, Indigenous people are rarely involved in the planning and implementation of the interventions, few of which are designed to be culturally appropriate for Indigenous people. If parenting research in Australia is to support Aboriginal and Torres Strait Islander families, it must include consultation with local communities, adapt interventions and research methods to the needs of the participating parents and their communities, and improve the recruitment and retention of Aboriginal and Torres Strait Islander participants.
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Affiliation(s)
- Jake MacDonald
- Office of Indigenous Strategy and Leadership, University of Newcastle, Newcastle, NSW
| | | | - Briana Barclay
- Centre for Active Living and Learning, University of Newcastle, Newcastle, NSW
| | | | - James Knox
- The University of Newcastle, Newcastle, NSW
| | - Philip Morgan
- Centre for Active Living and Learning, University of Newcastle, Newcastle, NSW
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McKnight ADB, Probst Y, O'Flynn G, Tillott S, Stanley RM. Relationships are essential but not always easy: The role of methodology in embedding Aboriginal community and Country in academic research. Health Promot J Austr 2024; 35:518-524. [PMID: 37491724 DOI: 10.1002/hpja.781] [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: 03/04/2022] [Revised: 06/16/2023] [Accepted: 07/10/2023] [Indexed: 07/27/2023] Open
Abstract
This article is told as a story about how a project, Strong culture, healthier lifestyles, took steps towards decolonisation as an evolving methodological journey with Country. The story is primarily about how our methodology moved from a Western model of 'doing' research, to the research team being part of the research process, as team members with Country and the participating local community members: a methodology of partnership. First, we provide a general overview of the initial project to set up how we came to understand its disconnection to community and Country. Second, we unpack the storying approach as methodology that is bound with the local Country: Yuin on the South Coast of New South Wales, Australia. Third, using the storying approach, we reflect through Country and the community to discover ways forward in Aboriginal and non-Aboriginal knowledge partnerships. We share our story in an attempt to limit colonial practice (decolonisation) and replace it with a re-culturalising approach; the re-connecting of Country as a source of interconnectedness into the research process. Country includes all the living communities of nature, and we explore how this relationship in the human element (community) impacted and developed our methodology of partnership.
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Affiliation(s)
- Anthony David Blake McKnight
- Faculty of the Arts, Social Sciences and Humanities, School of Education, University of Wollongong, Wollongong, New South Wales, Australia
| | - Yasmine Probst
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Gabrielle O'Flynn
- Faculty of the Arts, Social Sciences and Humanities, School of Education, University of Wollongong, Wollongong, New South Wales, Australia
| | - Sarah Tillott
- Faculty of Science, Medicine and Health, School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Rebecca Megan Stanley
- Faculty of the Arts, Social Sciences and Humanities, School of Health and Society, Early Start, Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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Urquhart L, Roberts K, Duncanson K, Brown LJ, Fisher K. Sustaining an Aboriginal wellbeing program: Informing health promotion practice and policy. Health Promot J Austr 2024; 35:457-469. [PMID: 37466162 DOI: 10.1002/hpja.776] [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: 03/18/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/20/2023] Open
Abstract
ISSUE ADDRESSED Aboriginal and Torres Strait Islander Peoples' holistic concepts of wellbeing are inadequately represented in the health promotion discourse. The aim of this article was to explore what sustains an Aboriginal wellbeing program, to inform critical reflection and reorientation to empower Aboriginal wellbeing approaches in health promotion practice and policy. METHODS Aboriginal and non-Indigenous researchers collaboratively designed a critically framed, strengths-based research approach with Aboriginal Community Controlled Health Service staff and wellbeing program participants. Data from Individual Yarning (n = 15) with program participants and staff inspired co-researchers to co-develop interpretations over two half-day Collaborative Yarning sessions (n = 9). RESULTS Co-researchers depicted five lifeworld qualities that sustain an Aboriginal wellbeing program: love, connection, respect, culture and belonging. The lifeworld qualities are relational, communicative and involve the dynamics of identity, power and self-determination. CONCLUSIONS The five qualities support a lifeworld approach to an Aboriginal wellbeing program, opening communicative and relational opportunities to mediate culturally responsive interactions. The qualities mediated interactions between people in the lifeworld including program participants and coordinators, and systems representatives including health service providers. A lifeworld approach provides a way to empower Aboriginal self-determination and leadership through embedment of cultural determinants of health in wellbeing programs. SO WHAT?: Health service providers and policy makers can use lifeworld approaches to guide critical reflection and reorient practice and policy related to Aboriginal health. The lifeworld qualities that encompass this approach in wellbeing programs are communicative and relational, centred on local community voices and co-produced with community for Aboriginal identity, empowerment and self-determination.
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Affiliation(s)
- Lisa Urquhart
- Department of Rural Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Coffs Harbour, New South Wales, Australia
| | - Karen Roberts
- Galambila Aboriginal Health Service, Coffs Harbour, New South Wales, Australia
| | - Kerith Duncanson
- Centre of Research Excellence in Digestive Health, University of Newcastle, Callaghan, New South Wales, Australia
- College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, New South Wales, Australia
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Leanne J Brown
- Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
- Department of Rural Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Tamworth, New South Wales, Australia
| | - Karin Fisher
- Department of Rural Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Tamworth, New South Wales, Australia
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Fox H, Hempenstall A, Pilot P, Callander E, Smith S, McDonald MI, Hanson J. Significant healthcare resource utilisation in the management of skin and soft tissue infections in the Torres Strait, Australia. Rural Remote Health 2024; 24:8572. [PMID: 38632695 DOI: 10.22605/rrh8572] [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: 04/19/2024] Open
Abstract
INTRODUCTION Aboriginal and Torres Strait Islander Peoples (First Nations Australians) living in remote communities are hospitalised with skin and soft tissue infections (SSTIs) at three times the rate of non-First Nations Australians. The Torres Strait in tropical northern Australia has a highly dispersed population mainly comprising First Nations Australians. This study aimed to define the health service utilisation and health system costs associated with SSTIs in the Torres Strait and to improve the quality of regional healthcare delivery. METHODS The research team conducted a retrospective, de-identified audit of health records for a 2-year period, 2018-2019. The aim was to define health service utilisation, episodes of outpatient care, emergency department care, inpatient care and aeromedical retrieval services for SSTIs. RESULTS Across 2018 - 2019, there were 3509 outpatient episodes of care for SSTIs as well as 507 emergency department visits and 100 hospitalisations. For individuals with an SSTI, the mean outpatient clinic episode cost $240; the mean emergency department episode cost $400.85, the mean inpatient episode cost $8403.05 while an aeromedical retrieval service cost $18,670. The total costs to the health system for all services accessed for SSTI management was $6,169,881 per year, 3% of the total annual health service budget. CONCLUSION Healthcare costs associated with SSTIs in the Torres Strait are substantial. The implementation of effective preventative and primary care interventions may enable resources to be reallocated to address other health priorities in the Torres Strait.
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Affiliation(s)
- Haylee Fox
- School of Nursing and Midwifery, Griffith University, 1 Parklands Drive, Gold Coast, Qld 4215, Australia
| | - Allison Hempenstall
- Thursday Island Hospital, Torres and Cape Hospital and Health Service, 165 Douglas St, Thursday Island, Qld 4875, Australia
| | - Pelista Pilot
- Thursday Island Hospital, Torres and Cape Hospital and Health Service, 165 Douglas St, Thursday Island, Qld 4875, Australia
| | - Emily Callander
- School of Public Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007, Australia
- College of Medicine and Dentistry, James Cook University, 1/14-88 McGregor Rd, Smithfield, Qld 4878, Australia
| | - Simon Smith
- Cairns Hospital, Cairns Hospital and Hinterland Health Service, 165 The Esplanade, Cairns, Qld 4870, Australia
| | - Malcolm I McDonald
- College of Public Health, Medical and Vet Sciences, James Cook University, 1/14-88 McGregor Rd, Smithfield, Qld 4878, Australia
| | - Josh Hanson
- The Kirby Institute, University of New South Wales, Cnr High St and Botony St, Kensington, NSW 2052, Australia
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Burchill L, Dos Santos A. Progress towards cultural safety in Indigenous cardiovascular health care and research. Lancet Glob Health 2024; 12:e541-e542. [PMID: 38485418 DOI: 10.1016/s2214-109x(24)00080-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Luke Burchill
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA.
| | - Angela Dos Santos
- Department of Medicine and Health, University of New South Wales, Campbelltown, NSW, Australia
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D'Aprano A, Hunter SA, Fry R, Savaglio M, Carmody S, Boffa J, Cooke L, Dent A, Docksey A, Douglas J, Dunn A, Halfpenny N, Hewett M, Lipscomb A, Manahan E, Morton B, Mosse H, Ross D, Skouteris H. 'All Aboriginal and Torres Strait Islander children should have access to the ASQ-TRAK': Shared vision of an implementation support model for the ASQ-TRAK developmental screener. Health Promot J Austr 2024; 35:433-443. [PMID: 37431858 DOI: 10.1002/hpja.773] [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: 02/09/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/12/2023] Open
Abstract
ISSUE ADDRESSED The ASQ-TRAK, a strengths-based approach to developmental screening, has high acceptability and utility across varied Aboriginal and Torres Strait Islander contexts. While substantive knowledge translation has seen many services utilise ASQ-TRAK, we now need to move beyond distribution and support evidence-based scale-up to ensure access. Through a co-design approach, we aimed to (1) understand community partners' perspectives of barriers and enablers to ASQ-TRAK implementation and (2) develop an ASQ-TRAK implementation support model to inform scale-up. METHODS The co-design process had four phases: (i) partnership development with five community partners (two Aboriginal Community Controlled Organisations); (ii) workshop planning and recruitment; (iii) co-design workshops; and (iv) analysis, draft model and feedback workshops. RESULTS Seven co-design meetings and two feedback workshops with 41 stakeholders (17 were Aboriginal and Torres Strait Islander), identified seven key barriers and enablers, and a shared vision - all Aboriginal and Torres Strait Islander children and their families have access to the ASQ-TRAK. Implementation support model components agreed on were: (i) ASQ-TRAK training, (ii) ASQ-TRAK support, (iii) local implementation support, (iv) engagement and communications, (v) continuous quality improvement and (vi) coordination and partnerships. CONCLUSIONS This implementation support model can inform ongoing processes necessary for sustainable ASQ-TRAK implementation nationally. This will transform the way services provide developmental care to Aboriginal and Torres Strait Islander children, ensuring access to high quality, culturally safe developmental care. SO WHAT?: Well-implemented developmental screening leads to more Aboriginal and Torres Strait Islander children receiving timely early childhood intervention services, improving developmental trajectories and optimising long-term health and wellbeing.
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Affiliation(s)
- Anita D'Aprano
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sue-Anne Hunter
- Sue-Anne Hunter Cultural Consultant, Melbourne, Victoria, Australia
| | - Rebecca Fry
- Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Melissa Savaglio
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sarah Carmody
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Louise Cooke
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Abigail Dent
- Aboriginal Children's Healing Team, Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Amanda Docksey
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Josie Douglas
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
- Central Land Council, Alice Springs, Northern Territory, Australia
| | - Adam Dunn
- Aboriginal Team, Take Two, Berry Street, Richmond, Victoria, Australia
| | - Nick Halfpenny
- MacKillop Family Services, Melbourne, Victoria, Australia
| | - Meg Hewett
- Department of Education, Connected Beginnings Program, Darwin, Northern Territory, Australia
| | - Adrienne Lipscomb
- Aboriginal Children's Healing Team, Victorian Aboriginal Child Care Agency, Preston, Victoria, Australia
| | - Esmai Manahan
- MacKillop Family Services, Melbourne, Victoria, Australia
| | - Belinda Morton
- Department of Education, Northern Territory Government, Darwin, Northern Territory, Australia
| | - Holly Mosse
- Aboriginal Team, Take Two, Berry Street, Richmond, Victoria, Australia
- Uniting, University of Warwick, Melbourne, Victoria, Australia
| | - Dawn Ross
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Warwick Business School, University of Warwick, Coventry, UK
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Gidgup MJR, Kickett M, Francis-Coad J, Hill K, Umbella J, Coombes J, Ivers R, Bowser N, Palacios V, Hill AM. 'Nih Waangkiny Kaadatjiny': 'Listening, learning and knowing': Stakeholders' perspectives about barriers and enablers to delivering a successful physical activity program for older Aboriginal people. Health Promot J Austr 2024; 35:444-456. [PMID: 37489774 DOI: 10.1002/hpja.774] [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: 09/23/2022] [Revised: 05/19/2023] [Accepted: 06/26/2023] [Indexed: 07/26/2023] Open
Abstract
There is limited evidence about how physical activity (PA) programs should be provided for older Aboriginal and Torres Strait Islander peoples. Recently two groups of Aboriginal Elders on Noongar Boodja (Country) in Western Australia participated in the Ironbark PA program. ISSUE ADDRESSED The objective of this study was to explore the views of key stakeholders about the barriers and enablers to delivering a successful PA program and provide feedback for future program delivery. METHODS The research took a 'Nih (listening), Waangkiny (learning), Kaadatjiny (knowing)' approach. The lead researcher, a Noongar Wadjuk woman, conducted semi-structured interviews (n = 17) with key stakeholders: Aboriginal and non-Aboriginal workers who assisted to deliver the program, and family and local members of the communities. Data were also collected through weekly program notes and researcher diary entries. Data were analysed thematically. RESULTS The overarching theme highlighted that stakeholders felt a sense of building a PA program that was culturally appropriate. They reflected that the program attracted older Aboriginal people because it was designed to make them feel welcomed with a sense of belonging. Five major themes were identified: Relationships, Belonging, Program structure, Benefits of the program and Future planning. Positive changes observed in Elders' health and well-being were a source of inspiration for team workers. CONCLUSIONS Key enablers to delivering a PA program for older Aboriginal people are building a culturally strong program that creates a sense of belonging for the participants. SO WHAT?: Practitioners who are planning PA programs for older Aboriginal people should prioritise the development of cultural safety and security.
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Affiliation(s)
- Margaret J R Gidgup
- School of Allied Health, Faculty of Health Science, Curtin University, Perth, Australia
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, Australia
| | | | - Jacqueline Francis-Coad
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, Australia
| | - Keith Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Josephine Umbella
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, Australia
| | | | - Rebecca Ivers
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Nicole Bowser
- South West Aboriginal Medical Service Aboriginal Corporation, Bunbury, Australia
| | | | - Anne-Marie Hill
- School of Allied Health, WA Centre for Health and Ageing, The University of Western Australia, Perth, Australia
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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] [MESH Headings] [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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15
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Yadav UN, Davis JM, Bennett-Brook K, Coombes J, Wyber R, Pearson O. A rapid review to inform the policy and practice for the implementation of chronic disease prevention and management programs for Aboriginal and Torres Strait Islander people in primary care. Health Res Policy Syst 2024; 22:34. [PMID: 38509612 PMCID: PMC10956197 DOI: 10.1186/s12961-024-01121-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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/10/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND More than 35% of Aboriginal and Torres Strait Islander adults live with cardiovascular disease, diabetes, or chronic kidney disease. There is a pressing need for chronic disease prevention and management among Aboriginal and Torres Strait Islander people in Australia. Therefore, this review aimed to synthesise a decade of contemporary evidence to understand the barriers and enablers of chronic disease prevention and management for Aboriginal and Torres Strait Islander People with a view to developing policy and practice recommendations. METHODS We systematically searched for peer-reviewed published articles between January 2014 to March 2023 where the search was performed using subject headings and keywords related to "Aboriginal and Torres Strait Islander peoples," "Chronic Disease," and "Primary Health Care". Quality assessment for all included studies was conducted using the Aboriginal and Torres Strait Islander Quality Appraisal Tool. The data were extracted and summarised using a conventional content analysis approach and applying strength-based approaches. RESULTS Database searches identified 1653 articles where 26 met inclusion criteria. Studies varied in quality, primarily reporting on 14 criteria of the Aboriginal and Torres Strait Islander Quality Appraisal Tool. We identified six key domains of enablers and barriers of chronic disease prevention and management programs and implied a range of policy and practice options for improvement. These include culturally acceptable and safe services, patient-provider partnerships, chronic disease workforce, primary health care service attributes, clinical care pathways, and accessibility to primary health care services. This review also identified the need to address social and cultural determinants of health, develop the Aboriginal and Torres Strait Islander and non-Indigenous chronic disease workforce, support multidisciplinary teams through strengthening clinical care pathways, and engage Aboriginal and Torres Strait Islander communities in chronic disease prevention and management program design and delivery. CONCLUSION Enabling place-based partnerships to develop contextual evidence-guided strategies that align with community priorities and aspirations, with the provision of funding mechanisms and models of care through policy and practice reforms will strengthen the chronic disease prevention and management program for Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Uday Narayan Yadav
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, ACT, Australia.
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
| | | | | | | | - Rosemary Wyber
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, ACT, Australia
- Telethon Kids Institute, Perth, WA, Australia
| | - Odette Pearson
- South Australian Health and Medical Research Institute, Adelaide, SA, Australia
- Faculty of Health and Medical Science, University of Adelaide, Adelaide, SA, Australia
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16
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Garvey G, Howard K, Garvey D, Dickson M, Howell M, Butler TL, Cadet-James Y, Cunningham J, Bainbridge R, McGorry P, Williamson A, Anderson KM. What Matters to Aboriginal and Torres Strait Islander Youth (WM2Y): a study protocol to develop a national youth well-being measure. BMJ Open 2024; 14:e076119. [PMID: 38508611 PMCID: PMC10952880 DOI: 10.1136/bmjopen-2023-076119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION Adolescents face challenges associated with unprecedented environmental, social and technological changes. The impacts of colonisation, intergenerational trauma, racism and socioeconomic disadvantage intensify these challenges for many Aboriginal and Torres Strait Islander adolescents. However, Aboriginal and Torres Strait Islander adolescents also have cultural, spiritual, family and community capital that fosters their well-being.To date, little research has focused on understanding and appropriately measuring the well-being of Aboriginal and Torres Strait Islander adolescents, a pivotal factor in informing and guiding programmes and interventions that support them. This study will identify the domains of well-being and develop a new preference-based well-being measure based on the values and preferences of Aboriginal and Torres Strait Islander youth (aged 12-17 years). METHODS AND ANALYSIS This project will be conducted across three research phases: (1) qualitative exploration of well-being using PhotoYarning and yarns with adult mentors to develop candidate items; (2) Think Aloud study, quantitative survey, psychometric analysis, validity testing of candidate items and finalisation of the descriptive system; and (3) scoring development using a quantitative preference-based approach. A multinomial (conditional) logit framework will be used to analyse responses and generate a scoring algorithm for the new preference-based well-being measure. ETHICS AND DISSEMINATION Ethics approvals have been obtained from: the Human Research Ethics Committees for each state and territory where data are being collected, the institutions where the research is being conducted and from the relevant Departments of Education. The new well-being measure will have wide applicability and can be used in assessing the effectiveness of programmes and services. This new national measure will ensure benefit and positive impact through the ability to identify and measure the aspects of well-being important to and valued by Aboriginal and Torres Strait Islander youth. Results will be published in international peer-reviewed journals and presented at conferences, and summaries will be provided to the study partner organisations and other relevant organisations.
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Affiliation(s)
- Gail Garvey
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Kirsten Howard
- The University of Sydney, Sydney, New South Wales, Australia
| | - Darren Garvey
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | | | - M Howell
- The University of Sydney, Sydney, New South Wales, Australia
| | - Tamara L Butler
- Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | | | - Joan Cunningham
- Charles Darwin University, Casuarina, Northern Territory, Australia
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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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Kirkham R, Puszka S, Titmuss A, Freeman N, Weaver E, Morris J, Mack S, O'Donnell V, Boffa J, Dowler J, Ellis E, Corpus S, Graham S, Scott L, Sinha AK, Connors C, Shaw JE, Azzopardi P, Brown A, Davis E, Wicklow B, Maple-Brown L. Codesigning enhanced models of care for Northern Australian Aboriginal and Torres Strait Islander youth with type 2 diabetes: study protocol. BMJ Open 2024; 14:e080328. [PMID: 38453190 PMCID: PMC10921539 DOI: 10.1136/bmjopen-2023-080328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/13/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Premature onset of type 2 diabetes and excess mortality are critical issues internationally, particularly in Indigenous populations. There is an urgent need for developmentally appropriate and culturally safe models of care. We describe the methods for the codesign, implementation and evaluation of enhanced models of care with Aboriginal and Torres Strait Islander youth living with type 2 diabetes across Northern Australia. METHODS AND ANALYSIS Our mixed-methods approach is informed by the principles of codesign. Across eight sites in four regions, the project brings together the lived experience of Aboriginal and Torres Strait Islander young people (aged 10-25) with type 2 diabetes, their families and communities, and health professionals providing diabetes care through a structured yet flexible codesign process. Participants will help identify and collaborate in the development of a range of multifaceted improvements to current models of care. These may include addressing needs identified in our formative work such as the development of screening and management guidelines, referral pathways, peer support networks, diabetes information resources and training for health professionals in youth type 2 diabetes management. The codesign process will adopt a range of methods including qualitative interviews, focus group discussions, art-based methods and healthcare systems assessments. A developmental evaluation approach will be used to create and refine the components and principles of enhanced models of care. We anticipate that this codesign study will produce new theoretical insights and practice frameworks, resources and approaches for age-appropriate, culturally safe models of care. ETHICS AND DISSEMINATION The study design was developed in collaboration with Aboriginal and Torres Strait Islander and non-Indigenous researchers, health professionals and health service managers and has received ethical approval across all sites. A range of outputs will be produced to disseminate findings to participants, other stakeholders and the scholarly community using creative and traditional formats.
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Affiliation(s)
- Renae Kirkham
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Stefanie Puszka
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Angela Titmuss
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- Department of Paediatrics, Royal Darwin Hospital, Casuarina, Northern Territory, Australia
| | - Natasha Freeman
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Emma Weaver
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Jade Morris
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Shiree Mack
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Vicki O'Donnell
- Kimberley Aboriginal Medical Services, Broome, Western Australia, Australia
| | - John Boffa
- Central Australian Aboriginal Congress, Alice Springs, Northern Territory, Australia
| | - James Dowler
- Department of Paediatrics, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Elna Ellis
- Department of Medicine, Alice Springs Hospital, Alice Springs, Northern Territory, Australia
| | - Sumaria Corpus
- Endocrine Department, Royal Darwin Hospital, Casuarina, Northern Territory, Australia
| | - Sian Graham
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
| | - Lydia Scott
- WA Country Health Service - Kimberley, Broome, Western Australia, Australia
| | - Ashim K Sinha
- Endocrinology Department, Cairns Hospital, Cairns, Queensland, Australia
| | - Christine Connors
- Northern Territory Department of Health, Darwin, Northern Territory, Australia
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter Azzopardi
- Burnet Institute, Melbourne, Victoria, Australia
- National Centre for Indigenous Genomics, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alex Brown
- National Centre for Indigenous Genomics, Australian National University, Canberra, Australian Capital Territory, Australia
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth Davis
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- Department of Endocrinology and Diabetes, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Brandy Wicklow
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Pediatric Endocrinology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Louise Maple-Brown
- Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
- Endocrine Department, Royal Darwin Hospital, Casuarina, Northern Territory, Australia
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19
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Thapa S, Gibbs P, Ross N, Newman J, Allan J, Dalton H, Mahmood S, Kalinna BH, Ross AG. Are adverse childhood experiences (ACEs) the root cause of the Aboriginal health gap in Australia? BMJ Glob Health 2024; 9:e014901. [PMID: 38442985 DOI: 10.1136/bmjgh-2023-014901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/04/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
- Subash Thapa
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Peter Gibbs
- Regional Enterprise Development Institute (REDI.E), Dubbo, New South Wales, Australia
| | - Nancy Ross
- School of Social Work, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jamie Newman
- Orange Aboriginal Medical Service, Orange, New South Wales, Australia
| | - Julaine Allan
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Hazel Dalton
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Shakeel Mahmood
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Bernd H Kalinna
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
| | - Allen G Ross
- Rural Health Research Institute, Charles Sturt University, Orange, New South Wales, Australia
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20
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Lafferty L, Beadman M, Ward J, Flynn E, Hosseini-Hooshyar S, Martinello M, Treloar C. Patient and healthcare provider perceptions of acceptability of fingerstick point-of-care hepatitis C testing at Aboriginal Community Controlled Health Services in Australia. Int J Drug Policy 2024; 125:104335. [PMID: 38342050 DOI: 10.1016/j.drugpo.2024.104335] [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: 09/07/2023] [Revised: 12/13/2023] [Accepted: 01/21/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND Hepatitis C (HCV) is highly prevalent in First Nations communities globally. Barriers in the uptake of testing and treatment create challenges to realise elimination of HCV in these communities. In efforts to reduce barriers to testing and treatment, the SCALE-C study implemented an HCV test-and-treat intervention integrating point-of-care HCV testing and FibroScan®. SCALE-C was carried out at four Aboriginal Community Controlled Health Services (ACCHS; renowned for providing culturally safe care) in four regional towns in Australia. This qualitative analysis sought to understand healthcare provider and patient perceptions of acceptability of a community-based HCV test-and-treat intervention within ACCHS. METHODS Semi-structured interviews were undertaken with 23 patient participants and 14 healthcare personnel (including Aboriginal Health Workers/Practitioners, nurses, general practitioners, and practice managers) from across the four ACCHS involved in SCALE-C. A coding framework was developed among study authors and informed by Sekhon's Theoretical Framework of Acceptability. RESULTS The SCALE-C intervention enabled opportunities for healthcare providers to listen to patients, and for patients to feel heard (affective attitude). HCV testing was opportunistic and often occurred outside of the allocated SCALE-C clinical hours (burden). For patients, HCV testing within SCALE-C was viewed as a moral responsibility and ensured protection of self and others (ethicality). For personnel, SCALE-C (including following up visits) was regarded as an opportunity to engage with patients especially those with complex health needs which may be unrelated to HCV risk factors (ethicality). Patients and personnel widely regarded the SCALE-C intervention to be effective, and the test-and-treat model was preferable for both patients and personnel. CONCLUSION The SCALE-C intervention was broadly perceived to be acceptable among both healthcare providers and patients within ACCHS. Whilst the prioritisation of HCV was viewed as increasing patient engagement, it was also regarded as an opportunity for addressing other healthcare needs within Aboriginal communities. HCV test-and-treat models of care delivered by ACCHS simplify the HCV care pathway and ensure all HCV care is provided in a culturally safe setting (e.g., patients did not need to attend external services such as pathology).
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Affiliation(s)
- Lise Lafferty
- Centre for Social Research in Health, UNSW Sydney, Australia; The Kirby Institute, UNSW Sydney, Australia.
| | | | - James Ward
- Poche Centre for Indigenous Health, The University of Queensland, Toowong, Australia
| | - Erin Flynn
- Poche Centre for Indigenous Health, The University of Queensland, Toowong, Australia; Wardliparingga Aboriginal Health Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia
| | | | | | - Carla Treloar
- Centre for Social Research in Health, UNSW Sydney, Australia
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21
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Leeies M, Landry C, Blouw M, Butcher J, Hrymak CS, Vazquez-Grande G, Valiani S, Prakash V, Haddara WMR, Taneja R, Whittemore KG, MacRedmond RE, Paunovic BN, Downar J, Farrell CA, Murthy S, Haroon BA, DosSantos C, Balan M, Rochwerg B, D'Aragon F, Buss M, Burns KEA. Canadian Critical Care Society position statement on reconciliation, decolonization, and Indigenous engagement. Can J Anaesth 2024; 71:311-321. [PMID: 38332414 DOI: 10.1007/s12630-023-02682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 02/10/2024] Open
Affiliation(s)
- Murdoch Leeies
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada.
- Department of Emergency Medicine, University of Manitoba, S203 Medical Services Bldg., 750 Bannatyne Avenue, Winnipeg, MB, R3E 0W2, Canada.
| | - Cameron Landry
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Marcus Blouw
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Joshua Butcher
- Department of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada
| | - Carmen S Hrymak
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada
- Department of Emergency Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | - Sabira Valiani
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Varuna Prakash
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
| | - Wael M R Haddara
- Division of Critical Care Medicine, Western University, London, ON, Canada
- Critical Care Medicine Program, London Health Sciences Centre, London, ON, Canada
| | - Ravi Taneja
- Division of Critical Care Medicine, Western University, London, ON, Canada
- Department of Anesthesia & Perioperative Medicine, Western University, London, ON, Canada
| | - Kathryn G Whittemore
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
- Department of Critical Care, Regina General Hospital, Regina, SK, Canada
| | - Ruth E MacRedmond
- Critical Care Medicine, St. Paul's Hospital, Providence Health Care, Vancouver, BC, Canada
- Division of Critical Care Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Bojan N Paunovic
- Section of Critical Care Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - James Downar
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Division of Palliative Care, University of Toronto, Toronto, ON, Canada
| | - Catherine A Farrell
- Division of Pediatric Intensive Care, Centre hospitalier universitaire de Sainte-Justine, Montreal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
| | - Srinivas Murthy
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Babar A Haroon
- Department of Critical Care, Dalhousie University, Halifax, NS, Canada
| | - Claudia DosSantos
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Marko Balan
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Bram Rochwerg
- Department of Medicine, Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada
| | - Frédérick D'Aragon
- Department of Anesthesiology, Université de Sherbrooke, Sherbrooke, QC, Canada
- Centre de Recherche du Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Mandy Buss
- Department of Family Medicine, University of Manitoba, Winnipeg, MB, Canada
- Indigenous Physicians Association of Canada, Vancouver, BC, Canada
| | - Karen E A Burns
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Division of Critical Care, Department of Medicine, Unity Health Toronto - St. Michael's Hospital, Toronto, ON, Canada
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22
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Hillier S, Lodge D, Nolan J, Yandell R, Chur-Hansen A, George S, Lynch E. Clinical research imperatives: principles and priorities from the perspective of Allied Health executives and managers. AUST HEALTH REV 2024; 48:AH23262. [PMID: 38447201 DOI: 10.1071/ah23262] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
Objective It is widely understood that a key means of improving health systems and patient outcomes is through research - accessing, understanding, generating and applying research evidence-based practice. To promote more targeted and strategic research in Allied Health practice, this study sought to establish the principles, areas and priorities for clinical research as perceived by Allied Health leaders in the South Australian public health system. Methods The study used a mixed-methods design (full, sequential and equal model). Participants were recruited from theSouth Australian Department of Health and Wellbeing employment lists for Allied Health senior leaders. Consenting participants attended face-to-face focus groups; after an overview presentation, they discussed the principles for Allied Health research, followed by areas and priorities for research. Summaries of the responses were themed descriptively and circulated electronically so participants could confirm the research areas and ascribe priority ratings, clinical populations and services. Results A total of 28 people attended the stakeholder forum (5 online); 20 responded to the second-round electronic summary. Nine principles of research action were agreed. Fourteen research areas were identified and prioritised. There was a relatively consistent prioritisation of measuring Allied Health value, Allied Health workforce, hospital avoidance and closing the gap for Aboriginal health outcomes - whether the individuals were thinking about their own service or the state as a whole. Conclusions Allied Health leadership identified key principles and priorities for research to improve service delivery and patient outcomes. These priorities should generate further discussion and interest for novice and experienced researchers and leaders and can be used to inform granting and project plans.
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Affiliation(s)
- Susan Hillier
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Duncan Lodge
- Department of Health and Wellbeing, SA Health and Southern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia
| | - Jo Nolan
- Allied and Scientific Health Office, SA Health and Southern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia
| | - Rosalie Yandell
- Department of Health and Wellbeing, SA Health and Southern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia
| | | | - Stacey George
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Elizabeth Lynch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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23
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Roe Y, Allen J, Haora P, Hickey S, Briggs M, Wilkes L, Nelson C, Watego K, Coddington R, Ireland S, Kruske S, Gao Y, Kildea S. Enabling the context for Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services: Participatory action research. Women Birth 2024; 37:368-378. [PMID: 38097448 DOI: 10.1016/j.wombi.2023.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 03/05/2024]
Abstract
PROBLEM Establishment of Birthing on Country services owned and governed by Aboriginal and Torres Strait Islander Community Controlled Health Services has been slow. BACKGROUND Birthing on Country services have demonstrated health and cost benefits and require redesign of maternity care. During the Building On Our Strengths feasibility study, use of endorsed midwives and licensing of birth centres has proven difficult. QUESTION What prevents Community Controlled Health Services from implementing Birthing on Country services in Queensland and New South Wales? METHODS Participatory action research identified implementation barriers. We conducted iterative document analysis of instruments to inform government lobbying through synthesis of policy, economic, social, technological, legal, and environmental factors. FINDINGS Through cycles of participatory action research, we analysed 17 documents: 1) policy barriers prevent Community Controlled Health Services from employing endorsed midwives to provide intrapartum care in public hospitals; 2) economic barriers include lack of sustainable funding stream and inadequate Medicare-billing for endorsed midwives; and 3) legal barriers require a medical practitioner in a birth centre. While social barriers (e.g., colonisation, medicalisation) underpin regulations, these were beyond the scope; technological and environmental barriers were not identified. DISCUSSION Findings are consistent with the literature on barriers to midwifery practice. Recommendations include a national audit of barriers to Birthing on Country services including healthcare practice insurance, and development of a funding stream. Additionally, private maternity facility regulation must align with evidence on safe birth centre operation. CONCLUSION Government can address barriers to scale-up of Aboriginal and Torres Strait Islander Community Controlled Birthing on Country services.
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Affiliation(s)
- Yvette Roe
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Jyai Allen
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia.
| | - Penny Haora
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sophie Hickey
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Melanie Briggs
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia; Waminda South Coast Women's Health and Welfare Aboriginal Corporation, Nowra, Australia
| | - Liz Wilkes
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia; My Midwives, Brisbane, Australia
| | - Carmel Nelson
- Institute for Urban Indigenous Health, Brisbane, Australia
| | - Kristie Watego
- Institute for Urban Indigenous Health, Brisbane, Australia
| | - Rebecca Coddington
- Waminda South Coast Women's Health and Welfare Aboriginal Corporation, Nowra, Australia
| | - Sarah Ireland
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sue Kruske
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Yu Gao
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
| | - Sue Kildea
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Australia
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24
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Bauer KL, Mitchell AL, Mays GP. Examining Characteristics of Local Public Health Systems With Exceptional Tribal Organization Participation. J Public Health Manag Pract 2024; 30:274-284. [PMID: 38030145 PMCID: PMC10833201 DOI: 10.1097/phh.0000000000001840] [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: 12/01/2023]
Abstract
OBJECTIVE To learn feasible ways to increase multisector community partnership with tribal organizations, meaning tribal health authorities or American Indian and Alaska Native (AI/AN)-serving organizations, by examining characteristics of local public health systems with exceptional tribal organization participation. DESIGN, SETTING, AND PARTICIPANTS In total, 728 local public health departments were surveyed in 2018 to generate a nationally representative sample of local public health systems in the United States. A positive deviance approach using logistic regression helped identify local public health systems that had tribal organization participation despite characteristics that make such participation statistically unlikely. Local public health systems with exceptional tribal organization participation were compared with systems with conventional participation, examining measures known to impact the formation of public health partnerships. MAIN OUTCOME MEASURE This study used an exploratory logistic regression approach to identify unique characteristics of local public health systems with exceptional tribal organization participation. RESULTS Of 728 health systems surveyed, 21 were identified as having exceptional tribal organization participation. Across varying thresholds to identify exceptional participation, having a higher network density and prioritizing equity in public health activities were found to consistently distinguish exceptional tribal organization participation in both nonrural and rural areas. CONCLUSIONS Public health partnerships with tribal organizations are possible even in circumstances that make them unlikely. Efforts to build denser networks of collaborating organizations and prioritize equity may help public health systems achieve success with tribal organization partnerships.
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Affiliation(s)
- Kyla L. Bauer
- Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Amelia L. Mitchell
- Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Glen P. Mays
- Department of Health Systems, Management, and Policy, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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25
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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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26
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Sheridan N, Jansen RM, Harwood M, Love T, Kenealy T. Hauora Māori - Māori health: a right to equal outcomes in primary care. Int J Equity Health 2024; 23:42. [PMID: 38413987 PMCID: PMC10898093 DOI: 10.1186/s12939-023-02071-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 12/01/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND For more than a century, Māori have experienced poorer health than non-Māori. In 2019 an independent Tribunal found the Government had breached Te Tiriti o Waitangi by "failing to design and administer the current primary health care system to actively address persistent Māori health inequities". Many Māori (44%) have unmet needs for primary care. Seven models of primary care were identified by the funders and the research team, including Māori-owned practices. We hypothesised patient health outcomes for Māori would differ between models of care. METHODS Cross-sectional primary care data were analysed at 30 September 2018. National datasets were linked to general practices at patient level, to measure associations between practice characteristics and patient health outcomes. PRIMARY OUTCOMES polypharmacy (≥ 55 years), HbA1c testing, child immunisations, ambulatory sensitive hospitalisations (0-14, 45-64 years) and emergency department attendances. Regressions include only Māori patients, across all models of care. RESULTS A total of 660,752 Māori patients were enrolled in 924 practices with 124,854 in 65 Māori-owned practices. Māori practices had: no significant association with HbA1c testing, ambulatory sensitive hospitalisations or ED attendances, and a significant association with lower polypharmacy (3.7% points) and lower childhood immunisations (13.4% points). Māori practices had higher rates of cervical smear and cardiovascular risk assessment, lower rates of HbA1c tests, and more nurse (46%) and doctor (8%) time (FTE) with patients. The average Māori practice had 52% Māori patients compared to 12% across all practices. Māori practices enrolled a higher percentage of children and young people, five times more patients in high deprivation areas, and patients with more multimorbidity. More Māori patients lived rurally (21.5% vs 15%), with a greater distance to the nearest ED. Māori patients were more likely to be dispensed antibiotics or tramadol. CONCLUSIONS Māori practices are an expression of autonomy in the face of enduring health system failure. Apart from lower immunisation rates, health outcomes were not different from other models of care, despite patients having higher health risk profiles. Across all models, primary care need was unmet for many Māori, despite increased clinical input. Funding must support under-resourced Māori practices and ensure accountability for the health outcomes of Māori patients in all models of general practice.
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Grants
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Health Research Council of New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
- 18/788 Ministry of Health, New Zealand
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Affiliation(s)
| | | | | | - Tom Love
- Sapere Research Group, Wellington, Aotearoa New Zealand
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27
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Gilroy J, Henningham M, Meehan D, Nila F, McGlone J, McAtamney A, Whittaker K, Brown B, Varlow M, Buchanan T. Systematic review of Aboriginal and Torres Strait Islander peoples' experiences and supportive care needs associated with cancer. BMC Public Health 2024; 24:523. [PMID: 38378574 PMCID: PMC10877816 DOI: 10.1186/s12889-024-18070-3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Persistent disparities exist between Aboriginal and Torres Strait Islander peoples (the Indigenous peoples of Australia) and non-Indigenous Australians associated with cancer, with Aboriginal and Torres Strait Islander peoples experiencing a longer time to treatment, higher morbidity rates, and higher mortality rates. This systematic review aimed to investigate findings and recommendations in the literature about the experiences and supportive care needs of Aboriginal and Torres Strait Islander peoples with cancer in Australia. METHODS A qualitative systematic review was conducted using thematic analysis. Database searches were conducted in CINAHL, Informit, MEDLINE, ProQuest, Scopus, and Web of Science for articles published between January 2000 and December 2021. There were 91 included studies which were appraised using the Mixed Methods Appraisal Tool. The included studies reported on the experiences of cancer and supportive care needs in Aboriginal and Torres Strait Islander populations. RESULTS Six key themes were determined: Culture, family, and community; cancer outcomes; psychological distress; access to health care; cancer education and awareness; and lack of appropriate data. Culture was seen as a potential facilitator to achieving optimal cancer care, with included studies highlighting the need for culturally safe cancer services and the routine collection of Aboriginal and Torres Strait Islander status in healthcare settings. CONCLUSION Future work should capitalize on these findings by encouraging the integration of culture in healthcare settings to increase treatment completion and provide a positive experience for Aboriginal and Torres Strait Islander peoples with cancer.
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Affiliation(s)
- John Gilroy
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Mandy Henningham
- Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Drew Meehan
- Cancer Council Australia, Sydney, NSW, 2000, Australia.
| | - Farhana Nila
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | | | | | | | - Bena Brown
- Inala Indigenous Health Service, Metro South Health, Inala, QLD, 4077, Australia
| | - Megan Varlow
- Cancer Council Australia, Sydney, NSW, 2000, Australia
| | - Tanya Buchanan
- Cancer Council Australia, Sydney, NSW, 2000, Australia
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, 2522, Australia
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28
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Anderson K, Elder-Robinson E, Ferguson M, Fredericks B, Sherriff S, Dickson M, Howard K, Garvey G. Pathways between foodways and wellbeing for first nations Australians. BMC Public Health 2024; 24:502. [PMID: 38365753 PMCID: PMC10873965 DOI: 10.1186/s12889-024-18005-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/06/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Supporting the health and wellbeing of Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as First Nations peoples) is a national priority for Australia. Despite immense losses of land, language, and governance caused by the continuing impact of colonisation, First Nations peoples have maintained strong connections with traditional food culture, while also creating new beliefs, preferences, and traditions around food, which together are termed foodways. While foodways are known to support holistic health and wellbeing for First Nations peoples, the pathways via which this occurs have received limited attention. METHODS Secondary data analysis was conducted on two national qualitative datasets exploring wellbeing, which together included the views of 531 First Nations peoples (aged 12-92). Thematic analysis, guided by an Indigenist research methodology, was conducted to identify the pathways through which foodways impact on and support wellbeing for First Nations peoples. RESULTS AND CONCLUSIONS Five pathways through which wellbeing is supported via foodways for First Nations peoples were identified as: connecting with others through food; accessing traditional foods; experiencing joy in making and sharing food; sharing information about food and nutrition; and strategies for improving food security. These findings offer constructive, nationally relevant evidence to guide and inform health and nutrition programs and services to harness the strengths and preferences of First Nations peoples to support the health and wellbeing of First Nations peoples more effectively.
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Affiliation(s)
- Kate Anderson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia.
| | - Elaina Elder-Robinson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Megan Ferguson
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Bronwyn Fredericks
- Office of the Deputy Vice Chancellor (Indigenous Engagement), The University of Queensland, St. Lucia, QLD, Australia
- The Poche Centre for Indigenous Health, Faculty of Health and Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Simone Sherriff
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- The Sax Institute, Sydney, NSW, Australia
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Dickson
- The Poche Centre for Indigenous Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Doery E, Satyen L, Paradies Y, Gee G, Toumbourou JW. Impact of community-based employment on Aboriginal and Torres Strait Islander wellbeing, aspirations, and resilience. BMC Public Health 2024; 24:497. [PMID: 38365659 PMCID: PMC10870455 DOI: 10.1186/s12889-024-17909-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 01/29/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND This study evaluated a research project that provided employment in an Aboriginal and Torres Strait Islander community-based setting and supported participants to identify and achieve their goals and aspirations. The evaluation examined changes in personal, relationship, community and cultural strengths and resources and explored empowerment and resilience, in terms of promoting wellbeing. METHODS Ten Aboriginal people employed as life coaches and peer researchers participated in semi-structured interviews and also completed the Aboriginal Resilience and Recovery Questionnaire at the beginning of their employment and 6-months after employment. Interviews with the 10 participants explored changes in their wellbeing, relationships, resilience, opportunity to lead, aspirations, goal setting skills, connection to culture and community, and empowerment. RESULTS Participants personal strengths, and cultural and community strengths, sub-scale scores showed improvements across the 6-month period, however these changes were not statistically significant. Using reflexive thematic analysis, we generated five themes including Aspirations; Personal capabilities; Constraints to wellbeing; Community engagement and cultural connection; and Employment facilitators. Overall, participants identified that despite the challenges of their work and the additional challenges posed by the COVID-19 lockdowns, they were able to develop their skills to set and achieve goals. They reported feeling empowered and proud of their work, and engaged more frequently with their communities and culture. CONCLUSIONS The study outcomes evidence the role of employment in an Aboriginal and Torres Strait Islander community-based project in strengthening wellbeing, enhancing resilience, and supporting participants to advance their personal goals and aspirations. These findings reinforce the importance of supporting the aspirations and employment of Aboriginal and Torres Strait Islander Peoples through employment.
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Affiliation(s)
- Elizabeth Doery
- School of Psychology, Deakin University, Burwood, Australia.
| | - Lata Satyen
- School of Psychology, Deakin University, Burwood, Australia
| | - Yin Paradies
- School of Humanities and Social Science, Deakin University, Burwood, Australia
| | - Graham Gee
- Murdoch Children's Research Institute, Melbourne, Australia
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Lloyd-Johnsen C, Hampton A, Stubbs E, Moore S, Eades S, D'Aprano A, Goldfeld S. "I want to see them thrive!": exploring health service research priorities for young Aboriginal children growing up in Alice Springs - a qualitative study. BMC Health Serv Res 2024; 24:205. [PMID: 38355508 PMCID: PMC10868103 DOI: 10.1186/s12913-024-10642-8] [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: 02/28/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
To better understand the specific influences of early life on the long-term health and well-being of local Aboriginal children in Alice Springs, high-quality local longitudinal data is required. The Central Australian Aboriginal Congress and the Murdoch Children's Research Institute are exploring the feasibility of establishing a cohort study to fill this gap. A nested qualitative study was conducted to identify priority issues that can be translated into research questions answerable through the proposed cohort study. Semi-structured interviews and focus group discussions (FGDs) were conducted with a range of key community stakeholders, parents and caregivers of young Aboriginal children from Alice Springs in the Northern Territory between 2020 and 2021. Two Aboriginal and two non-Aboriginal researchers conducted 27 interviews and 3 FGDs with 42 participants. Three broad themes were constructed through reflexive thematic analysis representing the areas of focus community stakeholders and parents want future research to prioritise: (1) social determinants of health (2) building positive connections, and (3) making sure kids grow up strong and healthy. Priority setting for future research should be driven by Aboriginal and Torres Strait Islander peoples in order to be of practical benefit to their community. This qualitative study found that housing, transport and positive connections through nurturing and engaged parents were some of the most important issues raised. Participants also wanted future research to focus on issues specific to children such as nutrition, hearing loss, language development and capacity to learn. These findings will guide future work led by local Aboriginal researchers to co-design the proposed cohort study.
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Affiliation(s)
- C Lloyd-Johnsen
- Centre for Community Child Health, Murdoch Children's Research Institute, Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
| | - A Hampton
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - E Stubbs
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
| | - S Moore
- Central Australian Aboriginal Congress, Alice Springs, NT, Australia
- Menzies School of Health Research, Darwin, NT, Australia
- Flinders University, Adelaide, SA, Australia
| | - S Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - A D'Aprano
- Centre for Community Child Health, Murdoch Children's Research Institute, Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Royal Children's Hospital, Melbourne, VIC, Australia
| | - S Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Flemington Rd, Parkville, Melbourne, VIC, 3052, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Royal Children's Hospital, Melbourne, VIC, Australia
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van Burgel E, Fairweather M, Hill A, Christian M, Ferguson M, Lee A, Funston S, Fredericks B, McMahon E, Pollard C, Brimblecombe J. Development of a survey tool to assess the environmental determinants of health-enabling food retail practice in Aboriginal and Torres Strait Islander communities of remote Australia. BMC Public Health 2024; 24:442. [PMID: 38347471 PMCID: PMC10863203 DOI: 10.1186/s12889-024-17945-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 02/01/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Environmental factors can impact the ability of food retail businesses to implement best practice health-enabling food retail. METHODS We co-designed a short-item survey on factors influencing food retail health-enabling practice in a remote Australian setting. Publicly available submissions to an Australian Parliamentary Inquiry into food pricing and food security in remote Indigenous communities were coded using an existing remote community food systems assessment tool and thematically analysed. Themes informed survey questions that were then prioritised, refined and pre-tested with expert stakeholder input. RESULTS One-hundred and eleven submissions were coded, and 100 themes identified. Supply chain related data produced the most themes (n = 25). The resulting 26-item survey comprised questions to assess the perceived impact of environmental factors on a store's health-enabling practice (n = 20) and frequency of occurrence (n = 6). CONCLUSIONS The application of this evidence-informed, co-designed survey will provide a first-time cross-sectional analysis and the potential for ongoing longitudinal data and advocacy on how environmental factors affect the operations of remote stores.
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Affiliation(s)
- Emma van Burgel
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia.
| | - Molly Fairweather
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Amanda Hill
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Meaghan Christian
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
| | - Megan Ferguson
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Amanda Lee
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Sarah Funston
- Arnhem Land Progress Aboriginal Corporation, Darwin, NT, Australia
| | - Bronwyn Fredericks
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Emma McMahon
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Christina Pollard
- School of Population Health, Curtin University, Perth, WA, Australia
| | - Julie Brimblecombe
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, 3168, Australia
- Menzies School of Health Research, Royal Darwin Hospital Campus, Darwin, NT, Australia
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
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Biles B, Christian B, Marshall C, McMillan F, Sara G, Anderson J, Davies N, Fealy S, Biles J. 'DANMM that's good!': evaluating the feasibility and acceptability of the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) Programme across rural, regional and metropolitan NSW-a collaborative study protocol. BMJ Open 2024; 14:e079416. [PMID: 38341205 PMCID: PMC10862277 DOI: 10.1136/bmjopen-2023-079416] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION This paper will describe the research protocol for the Deadly Aboriginal and Torres Strait Islander Nursing and Midwifery Mentoring (DANMM) Project, which will determine the feasibility and acceptability of a cultural mentoring programme designed for Aboriginal and Torres Strait Islander nurses and midwives across five diverse local health districts in New South Wales, Australia. Government and health agencies highlight the importance of culturally appropriate and safe environments for Aboriginal people. Specifically, New South Wales Health prioritises workforce strategies that support Aboriginal people to enter and stay in the health workforce. However, retaining Aboriginal nurses and midwives remains challenging. The DANMM Project aligns with these local and state-wide health plans and strategies, addressing critical issues of workforce cultural safety and retention. METHODS AND ANALYSIS A mixed-methods study design will be employed to assess feasibility, acceptability and preliminary efficacy of the DANMM Programme across five publicly funded local health districts in New South Wales, Australia. Adhering to cultural safety, a project cultural governance group will be formed. Quantitative outcome measures include the use of questionnaires (Nursing Workplace Satisfaction Questionnaire, Ganngaleh nga Yagaleh Cultural Safety assessment tool). Resource implications will be measured using the Organisational Commitment and Health Professional Program Readiness Assessment Compass. These will be triangulated with individual and group yarning circles to provide a holistic evaluation of the programme. ETHICS AND DISSEMINATION The study has ethics approval: Aboriginal Health and Medical Research Council (#2054/23); New South Wales Health Human Research Committees (Greater Western Human Research Committee #2022/ETH01971, Murrumbidgee-site-specific approval, Sydney Local Health District-site-specific approval, Western Sydney Local Health District-site-specific approval and Mid North Coast-site-specific approval); and Charles Sturt University Human Research Committee (#2054/23). Findings will be disseminated through peer-reviewed articles, conferences and through roundtable discussions with key stakeholders.
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Affiliation(s)
- Brett Biles
- University of New South Wales, Sydney, New South Wales, Australia
| | - Bradley Christian
- Population Oral Health, The University of Sydney School of Dentistry, Surry Hills, New South Wales, Australia
| | - Charmaine Marshall
- New South Wales Health Murrumbidgee Local Health District, Wagga Wagga, New South Wales, Australia
| | - Faye McMillan
- School of Public Health, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Grant Sara
- InforMH, System Information and Analytics Branch, NSW Ministry of Health, North Ryde, New South Wales, Australia
| | - Judith Anderson
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Nicolle Davies
- Charles Sturt University, Albury, New South Wales, Australia
| | - Shanna Fealy
- Charles Sturt University, Port Macquarie, New South Wales, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Jessica Biles
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University-Albury-Wodonga Campus, Albury, New South Wales, Australia
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Hindman E, Hassmén P, Orchard A, Radford K, Delbaere K, Garvey G. Clinicians' views on cognitive assessment with Aboriginal Australians. Aust N Z J Psychiatry 2024; 58:134-141. [PMID: 37353895 DOI: 10.1177/00048674231183354] [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] [Indexed: 06/25/2023]
Abstract
BACKGROUND A shortage of standardised cognitive assessment tools for use with Aboriginal Australians is evident. Clinicians also miss the range of guidelines necessary to inform test selection and interpretation for all Aboriginal clients. This mixed methods study examines clinicians' confidence, views and current practices when conducting cognitive assessments with Aboriginal Australian clients. METHODS Clinicians were asked about factors that influence their likelihood of using standardised testing in Aboriginal vs non-Indigenous Australian people. Twenty-one health professionals with experience conducting cognitive assessments with Aboriginal and non-Aboriginal Australians participated. Clinicians were presented with a series of different scenarios per the client's level of education and language of origin via an online survey. Clinicians rated their likelihood and confidence using standardised cognitive assessment for each scenario. Open-ended questions captured clinicians' views and information about their current clinical practices. RESULTS Clients' age, education and language of origin influence the likelihood of clinicians' use of standardised cognitive assessment measures with Aboriginal people. Overall, clinicians reported feeling only slightly more confident working with non-Indigenous clients than Aboriginal clients. Qualitative data indicate a lack of consistency regarding test selection. CONCLUSION Clinicians expressed concerns about the validity of available cognitive assessment tools for use with Aboriginal Australians and the absence of evidence to assist decision-making. Cited barriers included language, educational attainment and cultural factors.
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Affiliation(s)
- Emily Hindman
- Coffs Harbour Aboriginal Community Care Inc. (ABCARE), Coffs Harbour, NSW, Australia
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Peter Hassmén
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Abbey Orchard
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
| | - Kylie Radford
- Faculty of Health, Southern Cross University, Coffs Harbour, NSW, Australia
- Neuroscience Research Australia, Randwick, NSW, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, Randwick, NSW, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia
- School of Population Health, University of New South Wales, Sydney, NSW, Australia
| | - Gail Garvey
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD, Australia
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Woodland R, Morgan P, MacLean S, Downey H. The experiences of a regional Aboriginal community accessing primary health care during times of crisis. Aust J Rural Health 2024; 32:80-89. [PMID: 37985472 DOI: 10.1111/ajr.13064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/04/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION The importance of primary health care (PHC) to Aboriginal Australians is widely acknowledged, as is the underservicing of the Aboriginal Australian population. Aboriginal People continue to face significant obstacles when accessing and using health care services. OBJECTIVE This study identifies environmental factors (beyond personal and service delivery) that functioned as barriers and enablers to Aboriginal Australians' experiences accessing PHC during crises and recommends approaches during future events. DESIGN This research utilised a case study approach. Data were collected through in-depth interviews and analysed using thematic analysis. The study was set in Lakes Entrance, a regional Victorian locality with a sizable Aboriginal community, which was affected by bushfires during 2019/2020 and COVID-19 restrictions during 2020-2021. Participants were 18 Aboriginal People over the age of 18 living in the locality during either bushfires or COVID-19. FINDINGS The barriers identified included the impact on PHC access of priorities other than health, including housing; financial constraints; difficulties with transport; medical bureaucracy and the physical environment of the health care setting, including appointment-making processes; interactions with medical reception staff; and waiting room environments. Enablers identified included the supportive role of the local Aboriginal Community Controlled Health Organisations (ACCHO) and their staff, which was highlighted in participant responses. DISCUSSION The preference of many Aboriginal people to access PHC via their local ACCHO, rather than mainstream health care services, appears even more salient during crises than in normal times. This research identified that ACCHOs are ideally placed to promote and protect the health of Aboriginal communities during crises. CONCLUSION Results may help direct interventions to improve PHC access and experiences for regional Aboriginal communities both during and outside periods of crisis.
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Affiliation(s)
- Rebecca Woodland
- Gippsland Lakes Complete Health, Lakes Entrance, Victoria, Australia
| | - Paula Morgan
- Lakes Entrance Aboriginal Health Association, Lakes Entrance, Victoria, Australia
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Taylor AD, Connolly J, Pearce C. A rural doctor's telehealth training program during the COVID-19 pandemic. Rural Remote Health 2024; 24:8032. [PMID: 38296265 DOI: 10.22605/rrh8032] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
INTRODUCTION In Australia, remote consultations have been used as an adjunct to traditional healthcare delivery during the COVID-19 pandemic using telephone and video techniques with an increase in the use of telephone consultations, and to a lesser extent video consultations, for management of patient conditions, assessment, treatment, monitoring and diagnosis. METHODS To establish the needs of rural doctors for training in the provision of remote consultations, an online survey of members of the Australian College of Rural and Remote Medicine was undertaken. Subsequently an online scenario-based training program was designed to improve the competencies of members in providing these consultations. The outcomes of this program were analysed using pre- and post-intervention surveys, and qualitative analysis of session recordings. RESULTS The program improved trainee confidence and competence in providing safe, quality remote consultations, particularly when using video technologies. Competencies in communication, history taking, physical online examination, clinical management and professionalism improved. Trainees adapted their practice because they were then able to manage potential issues, were more aware of the capabilities of telehealth technologies and could assist a health professional, such as a nurse or Aboriginal Health Worker (with the patient) to do an examination. Concerns remained about set-up time, technical quality, privacy, interaction with and examination of patients, and how to assess the severity of conditions. CONCLUSION The outcomes of the program showed significant improvement in the levels of confidence and competencies required for providing remote consultations using telehealth services. A need remains to improve virtual interactions with patients, and to acquire better technology and financial support for remote consultations. In an environment where government is asking whether remote consultations are appropriate and clinically effective, these findings provide guidance from a professional group of experienced rural practitioners.
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Prentice S, Barrett A, Benson J, Elliott T. 'Being in a place where it matters': GPs who do and do not work in Aboriginal Health Services. Aust J Prim Health 2024; 30:NULL. [PMID: 37653685 DOI: 10.1071/py23105] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 08/15/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND Few general practitioners (GPs) pursue a career in Aboriginal and Torres Strait Islander health. This research examined factors motivating Australian General Practice Training Program (AGPT) graduates to remain in, or leave, Aboriginal Medical Services (AMSs). METHODS AGPT graduates who remained (n =11) and left (n =9) AMSs after placements participated in semi-structured interviews across two studies. Thematic analysis informed by grounded theory was employed. RESULTS Both participant groups highlighted similar motivations for requesting an AMS placement, particularly their interest in Aboriginal health or culture. Participants enjoyed organisational structures and relationships, and faced similar barriers to working in AMSs. Those who left placed greater emphasis on the politics and bureaucracy, and unpredictability, and also faced the barrier of ties to their current practice. Those who remained in Aboriginal health more proactively addressed barriers and had a more external view of barriers. CONCLUSIONS Factors influencing career decisions of GPs in Aboriginal health overlap with those for GPs in rural and other under-served areas. Training providers can better prepare (e.g. more comprehensive orientations) and support registrars during their placements (e.g. greater mentoring). Registrars' perceptions of, and reactions to, barriers may be pivotal in determining whether they remain in Aboriginal health. This article provides guidance for training providers to better support AMS registrars and encourage more GPs to work in this sector.
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Affiliation(s)
- Shaun Prentice
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia; and General Practice Training Research Department, The Royal Australian College of General Practitioners, Melbourne, Vic., Australia
| | - Alexandra Barrett
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Jill Benson
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia; and The Royal Australian College of General Practitioners, Melbourne, Vic., Australia
| | - Taryn Elliott
- The Royal Australian College of General Practitioners, Melbourne, Vic., Australia
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Soares GH, Hedges J, Poirier B, Sethi S, Jamieson L. Deadly places: The role of geography in Aboriginal and Torres Strait Islander COVID-19 vaccination. Aust N Z J Public Health 2024; 48:100130. [PMID: 38354624 DOI: 10.1016/j.anzjph.2024.100130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 10/30/2023] [Accepted: 12/29/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE The objective of this study was to investigate the geospatial distribution of COVID-19 vaccination rates for Aboriginal and Torres Strait Islander Peoples across Local Government Areas in Australia. METHODS We described the patterns of COVID-19 vaccination across jurisdictions, identified clusters with different levels of vaccination uptake, and assessed the relationship between contextual factors and vaccination (spatial error model, spatial lag model, and geographic weighted regression). RESULTS The proportion of the Aboriginal and Torres Strait Islander population that received at least two doses of a COVID-19 vaccine by the last week of June 2022 ranged from 62.9% to 97.5% across Local Government Areas. The proportion of the overall population who is Aboriginal or Torres Strait Islander (β = 0.280, standard deviation [SD] = 1.92), proportion of the total labour force employed (β =0.286, SD = 0.98), and proportion of individuals who speak an Aboriginal or Torres Strait Islander language (β =0.215, SD = 0.15) had, on average, the strongest effects on COVID-19 vaccination rates. CONCLUSION Findings underscore the extent to which area-level demographic influence the COVID-19 vaccination for Aboriginal and Torres Strait Islander Australians. IMPLICATIONS FOR PUBLIC HEALTH Findings can inform vaccination strategies that prioritise geographic areas with higher vulnerability to promote equity for Aboriginal and Torres Strait Islander Peoples.
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Affiliation(s)
- Gustavo Hermes Soares
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia.
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
| | - Brianna Poirier
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia. https://twitter.com/@briannapoirier
| | - Sneha Sethi
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia. https://twitter.com/@drsnehasethi
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, Australia
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Hu D, Comben C, Diminic S, Pagliaro C. Review of Australia's funding commitments for suicide prevention from 2021-22 to 2026-27. AUST HEALTH REV 2024; 48:45-51. [PMID: 38105034 DOI: 10.1071/ah23176] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
Objective Examine the distribution of funding for suicide prevention in Australia from 2021-22 to 2026-27. Methods Government websites were reviewed to locate budget documents related to suicide prevention funding. Information was extracted on the program/service to be funded, and the funder entity, duration, and year allocation. Extracted data was reviewed to identify commonly targeted sub-populations. Results The majority of suicide prevention-related funding was allocated to aftercare for persons who have attempted suicide, consistent with the effectiveness of these services, followed by programs targeting the general population. Little funding was allocated to other specific sub-populations, such as young people and Aboriginal and Torres Strait Islander peoples. The amount of funding allocated to suicide prevention varied across jurisdictions, which is only partially explained by suicide rates. Conclusions There is a need for greater investment in care for specific sub-populations who are at higher risk of suicide. This study provides a baseline for comparing future investments in suicide prevention in Australia.
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Affiliation(s)
- Di Hu
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Queensland Centre for Mental Health Research, Brisbane, Qld, Australia
| | - Charlotte Comben
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Queensland Centre for Mental Health Research, Brisbane, Qld, Australia
| | - Sandra Diminic
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Queensland Centre for Mental Health Research, Brisbane, Qld, Australia
| | - Claudia Pagliaro
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Qld, Australia; and Queensland Centre for Mental Health Research, Brisbane, Qld, Australia
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Levy M, Holder M, Fairman M, Bulls ST, Ramirez L, Holmes C, Jung E, Hicks C, Mendenhall AN. Growing stronger together: Implementing the Strengthening Families Program with Indigenous communities. Child Abuse Negl 2024; 148:106241. [PMID: 37225638 DOI: 10.1016/j.chiabu.2023.106241] [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: 11/29/2022] [Revised: 04/13/2023] [Accepted: 05/08/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Child welfare agencies commonly seek to use evidence-based programs (EBPs) for their demonstrated results. Challenges remain in adapting programs to fit for Indigenous populations. We suggest that relationality holds promise as a guide in the implementation of EBPs with Indigenous families and children. OBJECTIVE We provide the story of a culturally integrated implementation of the EBP, Strengthening Families Program (SFP), with Indigenous families. PARTICIPANTS AND SETTING Insights from the staff who implemented SFP, project leadership and a community steering committee were brought together to create the collective implementation story. METHODS A relational approach was used in thematic analysis with a focus on the three Rs - responsibility, respect, and reciprocity- that support Indigenous knowledge organization. RESULTS Findings offer insight into cultural integrations in the implementation of SFP. The program centered Indigenous and community identities through meals, gifts, parenting practice examples and discussions tailored by each group of families and staff. Practices related to responsibility, respect and reciprocity each proved to be essential concepts in the relationship building among caregivers, children, SFP staff, project leadership, and community supporters that led to program success. CONCLUSION Cultural integration created a space that reflected Indigenous knowledge relationality. It respected the uniqueness among groups of families who participated in the evidence-based SFP. Our story supports the importance of having Indigenous staff and group leaders to guide cultural integration in relationship with tribal communities.
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Affiliation(s)
- Michelle Levy
- University of Kansas School of Social Welfare, United States.
| | - Melissa Holder
- University of Kansas School of Social Welfare, United States
| | - Maria Fairman
- University of Kansas School of Social Welfare, United States
| | | | - Laura Ramirez
- University of Kansas School of Social Welfare, United States
| | - Cheryl Holmes
- University of Kansas School of Social Welfare, United States
| | - Euijin Jung
- Boston College School of Social Work Research Program on Children and Adversity, United States
| | - Camilah Hicks
- University of Kansas School of Social Welfare, United States
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Graham K, Fitzpatrick K, Agius J, Loughry C, Ong E, McMillan N, Gunn K, Fitridge R. A qualitative exploration of the experiences of Aboriginal and Torres Strait Islander people using a real-time video-based telehealth service for diabetes-related foot disease. Rural Remote Health 2024; 24:7970. [PMID: 38413381 DOI: 10.22605/rrh7970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
INTRODUCTION Diabetes-related foot disease (DFD) is one of the most prevalent causes of global hospitalisation and morbidity, and it accounts for up to 75% of lower-extremity amputations globally. The 5-year mortality rate following any amputation ranges from 53% to 100%. Early identification of wounds and multidisciplinary management can reduce amputation rates by 39-56%. Rural and remote communities and Indigenous populations are disproportionately affected by DFD. This is reflected in amputation rates, which are much higher for Indigenous than for non-Indigenous Australians and for those in very remote areas than for those in major cities or inner regional areas. The large geographical spread of the population in Australia is a substantial barrier for those providing or accessing health services, particularly multidisciplinary and specialist services, which undoubtedly contributes to poorer DFD outcomes in rural and remote communities. METHODS A real-time, video-based telehealth service for DFD management was established at the Royal Adelaide Hospital Vascular Services clinic to improve access to specialist services for rural and remote Aboriginal and Torres Strait Islander communities. An exploratory qualitative study that utilised one-on-one, semi-structured interviews was conducted with 11 participants who identified as Aboriginal and who had participated in the telehealth foot service. Interviews were transcribed, de-identified and analysed using thematic analysis, using an inductive approach. RESULTS Four interrelated themes emerged. 'Practical benefits of staying home' describes the reduced burden of travel and advantages of having local healthcare providers and support people at consultations. 'Access to specialists and facilities' highlights how some participants felt that there was a lack of appropriate facilities in their area and appreciated the improved access telehealth provided. 'Feeling reassured that a specialist has seen their feet' reflects the positive impact on wellbeing that participants experienced when their feet were seen by specialist health staff. 'Facilitates communication' describes how participants felt included in consultations and how seeing a person on screen assisted conversation. CONCLUSION The advantages of real-time, video-based telehealth go beyond reduced travel burden and improved access to specialist care. This model of care may facilitate relationship-building, patient wellbeing, and feelings of trust and safety for Aboriginal and Torres Strait Islander DFD patients.
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Affiliation(s)
- Kristin Graham
- Allied Health and Human Performance, The University of South Australia, North Terrace, Adelaide, SA 5000, Australia
| | - Katrina Fitzpatrick
- Department of Podiatry, Central Adelaide Local Health Network, Adelaide, SA, Australia; and Watto Purrunna Aboriginal Health Service, Port Adelaide, SA, Australia
| | - Joseph Agius
- Department of Podiatry, Central Adelaide Local Health Network, Adelaide, SA, Australia
| | - Cathy Loughry
- Allied Health and Human Performance, The University of South Australia, North Terrace, Adelaide, SA 5000, Australia; and Department of Podiatry, Central Adelaide Local Health Network, Adelaide, SA, Australia
| | - Emilee Ong
- Allied Health and Human Performance, The University of South Australia, North Terrace, Adelaide, SA 5000, Australia
| | - Neil McMillan
- Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia; and Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
| | - Kate Gunn
- Allied Health and Human Performance, The University of South Australia, North Terrace, Adelaide, SA 5000, Australia
| | - Robert Fitridge
- Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, SA, Australia; and Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
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Cilloni L, Dowdy DW. Tuberculosis in US Indigenous Communities: A Need for Public Health Prioritization. Am J Public Health 2024; 114:149-151. [PMID: 38335488 PMCID: PMC10862196 DOI: 10.2105/ajph.2023.307544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Affiliation(s)
- Lucia Cilloni
- The authors are with the Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - David W Dowdy
- The authors are with the Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
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Ummer-Christian R, Widdicombe D, Raichur A, Couch D. Aboriginal Health Practitioners obtaining, possessing and administering fluoride varnish: self-determination driven regulation amendment for integrated oral health care for Aboriginal children. Aust J Prim Health 2024; 30:NULL. [PMID: 38211943 DOI: 10.1071/py23201] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024]
Abstract
Self-determination informed policies are key to improved outcomes for Aboriginal health. Aboriginal leadership must be reflected throughout any public health reform process that affects Aboriginal communities. This paper presents a body of oral health policy work, undertaken under Loddon Mallee Aboriginal Reference Group's (LMARG's) leadership, as an exemplar of a self-determination informed change, that led to an amendment of an Australian state (Victoria) regulation - The Drugs, Poisons and Controlled Substances Amendment (Registered Aboriginal and Torres Strait Islander Health Practitioners [AHPs]) Regulations 2022. A summary of activities undertaken by LMARG, from advocacy to leading the submission, to amend the regulation, is provided. The amendment, now in place, authorises registered AHPs to obtain, possess, and administer fluoride varnish (FV) as a part of health services they provide. FV is a concentrated form of fluoride applied to tooth surfaces to prevent tooth decay. The practical implication of this amendment is delivery of a culturally appropriate integrated oral health promotion FV model that addresses mainstream dental access barriers commonly experienced by Aboriginal people. The model aims at upskilling an Aboriginal workforce to facilitate timely FV application to Aboriginal children.
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Affiliation(s)
- Rahila Ummer-Christian
- Loddon Mallee Aboriginal Reference Group Strategic/Bendigo and District Aboriginal Cooperative, North Bendigo, Vic. 3550, Australia
| | - Dallas Widdicombe
- Loddon Mallee Aboriginal Reference Group Strategic/Bendigo and District Aboriginal Cooperative, North Bendigo, Vic. 3550, Australia
| | - Anil Raichur
- Victoria State Department of Health, 50 Lonsdale Street, Melbourne, Vic. 3000, Australia
| | - Danielle Couch
- Monash Rural Health, Monash University, 26 Mercy Street, Bendigo, Vic. 3550, Australia
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Cowley S, Baigrie K, Panaretto K, Trudgen K, Clements V, Whitehead O, Lacey R. Empowering our First Nations workforce: evaluation of a First Nations COVID-19 vaccination training program. Aust J Prim Health 2024; 30:NULL. [PMID: 38104344 DOI: 10.1071/py23027] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 11/01/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND A COVID-19 vaccination training program was designed for Aboriginal and Torres Strait Islander (First Nations) health workers and practitioners in Queensland to expand their scope of practice to include COVID-19 immunisation. In the setting of a global pandemic, the project aimed to improve vaccination levels and show how First Nations staff are central to community-led responses to effectively address their community's health needs. METHODS The program, consisting of an online module and face to face workshop, is described and then evaluated with the RE-AIM framework via mixed methods of participant training surveys and qualitative feedback. RESULTS The program reached 738 online and 329 workshop participants with the majority identifying as First Nations. The 52 workshops were attended by participants from 12 different hospital and health services in Queensland and 13 Aboriginal Community Controlled Health Organisations (ACCHOs). Feedback was positive, with participants rating the training highly. Of the First Nations Health Workers and Practitioners who responded to the workshop follow up survey, the majority (34/40) implemented their new skills in practice helping minimise the impact of COVID-19 outbreaks in their community. Most respondents (38/40) considered vaccination should be permanently in their scope of practice. CONCLUSIONS The successful implementation of the vaccination training project was an example of First Nations led health care. Improving scope of practice for First Nations health staff can improve not just career retention and progression but also the delivery of primary care to a community that continues to bear the inequity of poorer health outcomes.
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Affiliation(s)
- Sean Cowley
- Office of First Nations Health, Queensland Health, Brisbane, QLD 4000, Australia
| | - Karina Baigrie
- Office of First Nations Health, Queensland Health, Brisbane, QLD 4000, Australia; and Cunningham Centre, Darling Downs Health, Toowoomba, QLD 4350, Australia
| | - Katie Panaretto
- Office of First Nations Health, Queensland Health, Brisbane, QLD 4000, Australia; and Darling Downs Health, Toowoomba, QLD 4350, Australia
| | - Kelly Trudgen
- Office of First Nations Health, Queensland Health, Brisbane, QLD 4000, Australia
| | - Vanessa Clements
- Office of First Nations Health, Queensland Health, Brisbane, QLD 4000, Australia
| | - Oscar Whitehead
- Torres and Cape Hospital and Health Service, Cairns, QLD 4870, Australia
| | - Rica Lacey
- Darling Downs Health, Toowoomba, QLD 4350, Australia
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Ivers R, Dickson M, Taylor K, Levett T, Wynn K, Trees J, Webster E, Garvey G, Cunningham J, Whop L, Diaz A. Barriers and facilitators to adherence to Optimal Care Pathways for diagnosis and treatment of cancer for Aboriginal and Torres Strait Islander people. Aust J Prim Health 2024; 30:NULL. [PMID: 37667463 DOI: 10.1071/py22181] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND The Optimal Care Pathways (OCP) are a framework to promote high-quality and integrated cancer care for all Australians, from prevention through to end-of-life-care. Aboriginal and Torres Strait Islander people experience disproportionate cancer incidence and mortality, but little research has addressed whether cancer care for Aboriginal people meets the standards prescribed by the OCPs. This study aims to consider barriers and facilitators to quality cancer care for Aboriginal people. METHODS Semi-structured interviews were conducted with 30 health professionals who deliver care to Aboriginal people with cancer in primary care and hospital settings in New South Wales, Australia. Health professionals included Aboriginal Health Workers, nurses, general practitioners, and community workers. Interviews were conducted in 2019-2020 and explored participant perspectives of barriers and facilitators of optimal cancer care, particularly related to prevention, early detection, diagnosis, and treatment for Aboriginal people. Data were qualitatively analysed using framework analysis. RESULTS In general, participants perceived Aboriginal patients to have good access to preventive care. In terms of early detection and diagnosis, access to primary care, pathology, radiology, and some specialists (e.g. respiratory physicians) was seen as optimal. However, access to hospital-based gastroenterologists for colonoscopy was perceived to be poor due to long wait times. Access to optimal care for cancer treatment was perceived to be hindered due to the lack of bulk-billing for bowel cancer, breast cancer, and cardiothoracic surgery. Other barriers to care identified by participants included unclear referral pathways, poor communication between patient and the treating team, and a lack of timely provision of discharge summaries. CONCLUSIONS Facilitators of optimal care during treatment and survivorship included: the Integrated Team Care and Close the Gap programs, and presence of key health workers to help patients navigate the health system. The major barriers to quality cancer care for Aboriginal people appeared to be to specialist and procedural access, demonstrating that the 'Inverse Care' law applied in reducing access for populations at higher risk of cancer.
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Affiliation(s)
- Rowena Ivers
- Illawarra Aboriginal Medical Service, Wollongong, NSW 2500, Australia; and University of Wollongong (UOW), Wollongong, NSW 2522, Australia
| | | | - Kathleen Taylor
- University of Wollongong (UOW), Wollongong, NSW 2522, Australia
| | - Trish Levett
- Illawarra Aboriginal Medical Service, Wollongong, NSW 2500, Australia
| | - Kyla Wynn
- University of Wollongong (UOW), Wollongong, NSW 2522, Australia
| | - Janelle Trees
- University of Wollongong (UOW), Wollongong, NSW 2522, Australia
| | - Emma Webster
- University of Sydney, Sydney, NSW 2006, Australia
| | - Gail Garvey
- First Nations Cancer and Wellbeing Research Team, School of Public Health, University of Queensland, Herston, Qld 4006, Australia; and Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Joan Cunningham
- Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
| | - Lisa Whop
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT 2600, Australia
| | - Abbey Diaz
- First Nations Cancer and Wellbeing Research Team, School of Public Health, University of Queensland, Herston, Qld 4006, Australia; and Menzies School of Health Research, Charles Darwin University, Casuarina, NT 0810, Australia
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Clark B, Green S, Gill N. The socio-demographics and clinical profile of patients referred to the GP liaison psychiatry service within a metropolitan Aboriginal medical service. Australas Psychiatry 2024; 32:79-83. [PMID: 37967815 DOI: 10.1177/10398562231214130] [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] [Indexed: 11/17/2023]
Abstract
OBJECTIVE This study aimed to describe the social demographics and clinical profile of patients referred to the psychiatry service within the local Queensland metropolitan Aboriginal Medical Service (AMS). METHOD This was a retrospective cohort study of patients referred to the psychiatry service provided at three clinics of a metropolitan AMS, over an 18-month period. Medical records were accessed to determine demographic and diagnostic information. RESULTS Diagnostically, 53% of patients had mood/anxiety disorders, 10% psychosis, 23% substance use and 14% with other diagnoses. There was approximately 50% non-attendance rate with no statistical difference between gender and age groups. The highest proportion of non-attenders within age groups was males 45-54 years old. The patients needed to travel an average of 20 km to attend the AMS. CONCLUSION The high non-attendance rates, and proportionately more males within the age group 45-54 years who were more likely to not attend their mental health appointments, suggested a target area for outreach services which have been implemented in the AMS. Some of the recommended solutions included confirming attendance the day prior and supporting with transport. This study highlighted the large distance that Aboriginal and Torres Strait Islander people must travel to access culturally appropriate service.
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Affiliation(s)
- Belinda Clark
- Mental Health and Specialist Services, Gold Coast Health, Gold Coast, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
| | - Sonya Green
- Mental Health and Specialist Services, Gold Coast Health, Gold Coast, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
| | - Neeraj Gill
- Mental Health and Specialist Services, Gold Coast Health, Gold Coast, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia; and
- Mental Health Policy Unit, Health Research Institute, University of Canberra, Canberra, ACT, Australia
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46
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Ghamrawi W, Benson J, Kennedy E. Communicating medical information with Aboriginal patients: lessons learned from GPs and GP registrars in Aboriginal primary health care. Aust J Prim Health 2024; 30:NULL. [PMID: 37710389 DOI: 10.1071/py23128] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 08/21/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Aboriginal culture stands as the oldest continuous culture in the world. It gives paramount importance to a harmonious balance between personal connections to the body, spirit, and mind, as well as collective relationships with family, land, and community, integral to the wellbeing of Aboriginal people. However, obstacles can emerge for patients due to language barriers, cultural differences, or a historical lack of trust in the healthcare system. The establishment of Aboriginal Community Controlled Health Organisations (ACCHOs) has undoubtedly improved the healthcare experience for Aboriginal patients, yet there is limited research on the specific approaches utilised by general practitioners (GPs) working in these clinics. METHODS Twelve semi-structured interviews were conducted with two groups of GPs working in Aboriginal health. Each GP was presented with three scenarios and asked questions related to each scenario. Braun and Clarke's method of thematic analysis was applied to transcribed interviews. RESULTS Patient-doctor relationship, health literacy, and engagement with the health system emerged as key factors influencing communication with Aboriginal patients. Experienced GPs, despite differing clinical backgrounds, shared concise yet similar ideas to their less experienced counterparts. Notably, experienced GPs prioritised non-medical conversations and mindful body language, emphasising the importance of building strong patient relationships over other consultation aspects. CONCLUSIONS This research provides initial insights for GPs in Aboriginal health, comparing experienced GPs with more than 10years experience to novices. However, further research involving Aboriginal patients is needed to validate GP strategies and understand their significance from the patients' perspective.
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Affiliation(s)
- Wissam Ghamrawi
- Flinders University, College of Medicine and Public Health, Bedford Park, NT 41326, Australia; and GPEx, Research Department, Unley, SA 5061, Australia
| | - Jill Benson
- Flinders University, College of Medicine and Public Health, Bedford Park, NT 41326, Australia; and GPEx, Research Department, Unley, SA 5061, Australia
| | - Emma Kennedy
- Flinders University, College of Medicine and Public Health, Bedford Park, NT 41326, Australia
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47
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Claw KG, Dorr CR, Woodahl EL. Implementing community-engaged pharmacogenomics in Indigenous communities. Nat Commun 2024; 15:920. [PMID: 38296967 PMCID: PMC10831049 DOI: 10.1038/s41467-024-45032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Affiliation(s)
- Katrina G Claw
- Department of Biomedical Informatics, Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Casey R Dorr
- Hennepin Healthcare Research Institute, Minneapolis, MN, USA
- Nephrology Division, Department of Medicine, Hennepin Healthcare, University of Minnesota, Minneapolis, MN, USA
- Experimental and Clinical Pharmacology Department, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
- Clinical and Translational Sciences Institute, University of Minnesota, Minneapolis, MN, USA
| | - Erica L Woodahl
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, MT, USA
- L.S. Skaggs Institute for Health Innovation, University of Montana, Missoula, MT, USA
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Taylor EV, Dugdale S, Connors CM, Garvey G, Thompson SC. "A Huge Gap": Health Care Provider Perspectives on Cancer Screening for Aboriginal and Torres Strait Islander People in the Northern Territory. Int J Environ Res Public Health 2024; 21:141. [PMID: 38397632 PMCID: PMC10887611 DOI: 10.3390/ijerph21020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024]
Abstract
Cancer is one of the leading causes of death for Aboriginal and Torres Strait Islander people in the Northern Territory (NT). Accessible and culturally appropriate cancer screening programs are a vital component in reducing the burden of cancer. Primary health care plays a pivotal role in facilitating the uptake of cancer screening in the NT, due to the significant challenges caused by large distances, limited resources, and cultural differences. This paper analyses health care provider perspectives and approaches to the provision of cancer screening to Aboriginal people in the NT that were collected as part of a larger study. Semi-structured interviews were conducted with 50 staff from 15 health services, including 8 regional, remote, and very remote primary health care (PHC) clinics, 3 hospitals, a cancer centre, and 3 cancer support services. Transcripts were thematically analysed. Cancer screening by remote and very remote PHC clinics in the NT is variable, with some staff seeing cancer screening as a "huge gap", while others see it as lower priority compared to other conditions due to a lack of resourcing and the overwhelming burden of acute and chronic disease. Conversely, some clinics see screening as an area where they are performing well, with systematic screening, targeted programs, and high screening rates. There was a large variation in perceptions of the breast screening and cervical screening programs. However, participants universally reported that the bowel screening kit was complicated and not culturally appropriate for their Aboriginal patients, which led to low uptake. System-level improvements are required, including increased funding and resourcing for screening programs, and for PHC clinics in the NT. Being appropriately resourced would assist PHC clinics to incorporate a greater emphasis on cancer screening into adult health checks and would support PHCs to work with local communities to co-design targeted cancer screening programs and culturally relevant education activities. Addressing these issues are vital for NT PHC clinics to address the existing cancer screening gaps and achieving the Australian Government pledge to be the first nation in the world to eliminate cervical cancer as a public health problem by 2035. The implementation of the National Lung Cancer Screening Program in 2025 also presents an opportunity to deliver greater benefits to Aboriginal communities and reduce the cancer burden.
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Affiliation(s)
- Emma V Taylor
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA 6530, Australia
| | - Sarah Dugdale
- Health Statistics and Informatics, NT Health, Darwin, NT 0800, Australia
| | | | - Gail Garvey
- The School of Public Health, Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia
| | - Sandra C Thompson
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, WA 6530, Australia
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Hosking K, De Santis T, Vintour-Cesar E, Wilson PM, Bunn L, Garambaka Gurruwiwi G, Wurrawilya S, Bukulatjpi SM, Nelson S, Ross C, Stuart-Carter KA, Ngurruwuthun T, Dhagapan A, Binks P, Sullivan R, Ward L, Schroder P, Tate-Baker J, Davis JS, Connors C, Davies J. "Putting the power back into community": A mixed methods evaluation of a chronic hepatitis B training course for the Aboriginal health workforce of Australia's Northern Territory. PLoS One 2024; 19:e0288577. [PMID: 38266007 PMCID: PMC10807824 DOI: 10.1371/journal.pone.0288577] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/20/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Chronic hepatitis B (CHB) is endemic in the Aboriginal and Torres Strait Islander population of Australia's Northern Territory. Progression to liver disease can be prevented if holistic care is provided. Low health literacy amongst health professionals is a known barrier to caring for people living with CHB. We co-designed and delivered a culturally safe "Managing hepatitis B" training course for the Aboriginal health workforce. Here, we present an evaluation of the course. OBJECTIVES 1. To improve course participants CHB-related knowledge, attitudes, and clinical practice. 2. To evaluate the "Managing hepatitis B" training course. 3. To enable participants to have the skills and confidence to be part of the care team. METHODS We used participatory action research and culturally safe principles. We used purpose-built quantitative and qualitative evaluation tools to evaluate our "Managing hepatitis B" training course. We integrated the two forms of data, deductively analysing codes, grouped into categories, and assessed pedagogical outcomes against Kirkpatrick's training evaluation framework. RESULTS Eight courses were delivered between 2019 and 2023, with 130 participants from 32 communities. Pre- and post-course questionnaires demonstrated statistically significant improvements in all domains, p<0.001 on 93 matched pairs. Thematic network analysis demonstrated high levels of course acceptability and significant knowledge acquisition. Other themes identified include cultural safety, shame, previous misinformation, and misconceptions about transmission. Observations demonstrate improvements in post-course engagement, a deep understanding of CHB as well as increased participation in clinical care teams. CONCLUSIONS The "Managing hepatitis B" training course led to a sustained improvement in the knowledge and attitudes of the Aboriginal health workforce, resulting in improved care and treatment uptake for people living with CHB. Important non-clinical outcomes included strengthening teaching and leadership skills, and empowerment.
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Affiliation(s)
- Kelly Hosking
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Northern Territory, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Teresa De Santis
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Emily Vintour-Cesar
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Northern Territory, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Phillip Merrdi Wilson
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Linda Bunn
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - George Garambaka Gurruwiwi
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Shiraline Wurrawilya
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | | | - Sandra Nelson
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Cheryl Ross
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Kelly-Anne Stuart-Carter
- Centre for Disease Control, Northern Territory Health, Alice Springs, Northern Territory, Australia
| | - Terese Ngurruwuthun
- Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia
| | - Amanda Dhagapan
- Miwatj Aboriginal Health Corporation, Nhulunbuy, East Arnhem Land, Northern Territory, Australia
| | - Paula Binks
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Richard Sullivan
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- UNSW School of Clinical Medicine, St George & Sutherland Campus, Jannali, NSW, Australia
| | - Linda Ward
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Phoebe Schroder
- Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine, Sydney, NSW, Australia
| | - Jaclyn Tate-Baker
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospital, Northern Territory Health, Darwin, Northern Territory, Australia
| | - Joshua S. Davis
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Christine Connors
- Public Health Directorate, Office of the Chief Health Officer, Northern Territory Health, Northern Territory, Australia
- Population and Primary Health Care Branch, Top End Health Service, Northern Territory Health, Northern Territory, Australia
| | - Jane Davies
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Department of Infectious Diseases, Royal Darwin and Palmerston Hospital, Northern Territory Health, Darwin, Northern Territory, Australia
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50
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Williams R, Hayton S, Campbell A, Kemp H, Badry D. Strong Born-A First of Its Kind National FASD Prevention Campaign in Australia Led by the National Aboriginal Community Controlled Health Organisation (NACCHO) in Collaboration with the Aboriginal Community Controlled Health Organisations (ACCHOs). Int J Environ Res Public Health 2024; 21:85. [PMID: 38248547 PMCID: PMC10815402 DOI: 10.3390/ijerph21010085] [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: 09/25/2023] [Revised: 11/21/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024]
Abstract
The Strong Born Campaign (2022-2025) was launched by the National Aboriginal Community Controlled Health Organisation (NACCHO) in 2023. Strong Born is the first of its kind national Aboriginal and Torres Strait Islander health promotion campaign to address Fetal Alcohol Spectrum Disorder (FASD) within Australia. Strong Born was developed to address a longstanding, significant gap in health promotion and sector knowledge on FASD, a lifelong disability that can result from alcohol use during pregnancy. Utilizing a strengths-based and culturally sound approach, NACCHO worked closely with the Aboriginal Community Controlled Health Organisations (ACCHOs) to develop the campaign through co-design, as described in this paper. Since its inception, the ACCHOs have continually invested in driving change towards improvements in Aboriginal health determinants and health promotion. The Strong Born Campaign developed culturally safe health promotion tool kits designed for the community and health sector staff and also offered communities the opportunity to apply for FASD Communications and Engagement Grants to engage in local campaign promotion. The tool kits have been disseminated to 92 ACCHOs across Australia. This paper describes the development of the Strong Born Campaign and activities following its launch in February 2023 from an Indigenous context within Australia, as described by NACCHO.
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Affiliation(s)
- Robyn Williams
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley 6102, Australia
| | - Sarah Hayton
- National Aboriginal Community Controlled Health Organisation (NACCHO), Canberra 2601, Australia; (A.C.); (H.K.)
| | - Annabel Campbell
- National Aboriginal Community Controlled Health Organisation (NACCHO), Canberra 2601, Australia; (A.C.); (H.K.)
| | - Holly Kemp
- National Aboriginal Community Controlled Health Organisation (NACCHO), Canberra 2601, Australia; (A.C.); (H.K.)
| | - Dorothy Badry
- Faculty of Social Work, University of Calgary, Calgary, AB T2N 1N4, Canada;
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