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1
Foley, Dennis. "Entrepreneurship in Indigenous Australia: the importance of Education." Australian Journal of Indigenous Education 27, no. 2 (December 1999): 47–54. http://dx.doi.org/10.1017/s1326011100600571.
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In the Coalition’s Aboriginal and Torres Strait Islander Affairs 1998 election policy statement, The Honourable John Herron, Senator for Queensland and Minister for Aboriginal and Torres Strait Islander Affairs, claimed that a second term Howard/Fischer government would continue to assist Indigenous Australia to move beyond welfare by continuing to target key areas that include education and economic development (Herron 1998:1).
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McCausland, Ruth. "‘I’m sorry but I can’t take a photo of someone’s capacity being built’: Reflections on evaluation of Indigenous policy and programmes." Evaluation Journal of Australasia 19, no. 2 (June 2019): 64–78. http://dx.doi.org/10.1177/1035719x19848529.
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The Australian Government has recently increased resourcing for evaluation of Indigenous programmes following critical reports by the Australian National Audit Office and Productivity Commission around their failure to significantly reduce Indigenous disadvantage. Evaluation in Indigenous affairs has a long history, although not a consistent or coordinated one. While there is significant knowledge held by those with experience in commissioning and conducting evaluations for Indigenous programmes over a number of decades that could usefully inform current efforts, there has been little research focused on this area. This article outlines the findings of qualitative research about evaluation in Indigenous policy conducted with policymakers, senior public servants, programme managers, researchers and independent evaluation consultants that sought to privilege the voices and perspectives of Aboriginal and Torres Strait Islander people. It outlines key themes derived from those interviews relating to the methods, parameters, politics and accountability around government-commissioned evaluation in Indigenous policy and programmes and concludes by canvassing ways that evaluation could better serve the interests of Aboriginal and Torres Strait Islander peoples.
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Jones, Jocelyn, Mandy Wilson, Elizabeth Sullivan, Lynn Atkinson, Marisa Gilles, Paul L. Simpson, Eileen Baldry, and Tony Butler. "Australian Aboriginal women prisoners’ experiences of being a mother: a review." International Journal of Prisoner Health 14, no. 4 (December 17, 2018): 221–31. http://dx.doi.org/10.1108/ijph-12-2017-0059.
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PurposeThe rise in the incarceration of Aboriginal and Torres Strait Islander mothers is a major public health issue with multiple sequelae for Aboriginal children and the cohesiveness of Aboriginal communities. The purpose of this paper is to review the available literature relating to Australian Aboriginal women prisoners’ experiences of being a mother.Design/methodology/approachThe literature search covered bibliographic databases from criminology, sociology and anthropology, and Australian history. The authors review the literature on: traditional and contemporary Aboriginal mothering roles, values and practices; historical accounts of the impacts of white settlement of Australia and subsequent Aboriginal affairs policies and practices; and women’s and mothers’ experiences of imprisonment.FindingsThe review found that the cultural experiences of mothering are unique to Aboriginal mothers and contrasted to non-Aboriginal concepts. The ways that incarceration of Aboriginal mothers disrupts child rearing practices within the cultural kinship system are identified.Practical implicationsAboriginal women have unique circumstances relevant to the concept of motherhood that need to be understood to develop culturally relevant policy and programs. The burden of disease and cycle of incarceration within Aboriginal families can be addressed by improving health outcomes for incarcerated Aboriginal mothers and female carers.Originality/valueTo the authors’ knowledge, this is the first literature review on Australian Aboriginal women prisoners’ experiences of being a mother.
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Gunstone, Andrew. "Indigenous Education 1991–2000: Documents, Outcomes and Governments." Australian Journal of Indigenous Education 41, no. 2 (December 2012): 75–84. http://dx.doi.org/10.1017/jie.2012.26.
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There is often a disparity in Indigenous Affairs between many documents, such as policies, reports and legislation, and outcomes. This article explores this difference through analysing the policy area of Indigenous education during the period of 1991 to 2000. I examine three key documents relating to Indigenous education. These are theNational Aboriginal and Torres Strait Islander Education Policy, theCouncil for Aboriginal Reconciliation Act (Cth)and the report of theRoyal Commission into Aboriginal Deaths in Custody. I then analyse the abysmal outcomes of Indigenous education over this period, including educational access, educational attainment, school attendance and reading benchmarks. I argue that the substantial educational disadvantage experienced by Indigenous people is in stark contrast to the goals, policies and objectives contained in the numerous documents on Indigenous education. I then explore the role of governments in contributing to this disparity between documents and outcomes in Indigenous education, including their failure to acknowledge the history of Indigenous and non-Indigenous relations, their lack of commitment to address Indigenous educational disadvantage, their failure to recognise self-determination and the lack of cooperation between governments to address Indigenous educational disadvantage.
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Hunter, Ernest. "‘Best Intentions’ Lives on: Untoward Health Outcomes of Some Contemporary Initiatives in Indigenous Affairs." Australian & New Zealand Journal of Psychiatry 36, no. 5 (October 2002): 575–84. http://dx.doi.org/10.1046/j.1440-1614.2001.01040.x.
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Objective: A shortened version of a presentation to the Australian Institute of Aboriginal and Torres Strait Islander Studies, this paper raises questions regarding policy and program directions in Indigenous affairs with consequences for Indigenous health. Method: The author notes the inadequate Indigenous mental health database, and describes contemporary conflicts in the arena of Indigenous mental health, drawing on personal experience in clinical service delivery, policy and programme development. Results: Medicalized responses to the Stolen Generations report and constructions of suicide that accompanied the Royal Commission into Aboriginal Deaths in Custody are presented to demonstrate unforeseen health outcomes. Examples are also given of wellintentioned social interventions that, in the context of contemporary Indigenous society appear to be contributing to, rather than alleviating, harm. Problems of setting priorities that confront mental health service planners are considered in the light of past and continuing social disadvantage that informs the burden of mental disorder in Indigenous communities. Conclusions: The importance of acknowledging untoward outcomes of initiatives, even when motivated by concerns for social justice, is emphasized. The tension within mental health services of responding to the underpinning social issues versus providing equity in access to proven mental health services for Indigenous populations is considered.
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Costa, Nadia, Mary Sullivan, Rae Walker, and Kerin M. Robinson. "Emergency Department Presentations of Victorian Aboriginal and Torres Strait Islander People." Health Information Management Journal 37, no. 3 (October 2008): 15–25. http://dx.doi.org/10.1177/183335830803700303.
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This paper explains how routinely collected data can be used to examine the emergency department attendances of Victorian Aboriginal and Torres Strait Islander people. The data reported in the Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007 financial year were analysed. The presentations of Aboriginal and Torres Strait Islander and non-Aboriginal people were compared in terms of age, gender, hospital location (metropolitan and rural) and presenting condition. Aboriginal and Torres Strait Islander people were found to attend the emergency department 1.8 times more often than non-Aboriginal people. While the emergency department presentation rates of metropolitan Aboriginal and Torres Strait Islander and non-Aboriginal people were similar, rural Aboriginal and Torres Strait Islander people presented to the emergency department 2.3 times more often than non-Aboriginal people. The injuries or poisonings, respiratory conditions and mental disorders presentation rates of the Aboriginal and Torres Strait Islander and non-Aboriginal population were compared. No previous studies have assessed the accuracy of the Indigenous status and diagnosis fields in the VEMD; therefore the quality of this data is unknown.
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Jackson Pulver, Lisa R., Alison Bush, and Jeanette Ward. "Identification of Aboriginal and Torres Strait Islander women using an urban obstetric hospital." Australian Health Review 26, no. 2 (2003): 19. http://dx.doi.org/10.1071/ah030019.
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Objectives: To determine the accuracy of routine identification of Aboriginal and Torres Strait Islander womenconfining at King George V (KGV) Hospital, located in Sydney, Australia.Design: Interviewer-administered survey.Participants: Consecutive sample of women who delivered live, well infants from May to July 1999.Main Outcome Measure: Comparison of hospital documentation compared with confidential self-disclosureof Aboriginal or Torres Strait Islander status to a female Aboriginal health professional.Results: Of 536 women in our sample, 29 (5%) self-disclosed as being Aboriginal or Torres Strait Islander.Only 10 of these were identified as Aboriginal or Torres Strait Islander in hospital records (p<0.001). While specificity as determined by us was 100%, sensitivity was low (34.5%). Those Aboriginal and Torres Strait Islander women referred by another organisation were significantly more likely than those who self-referred to the hospital to be correctly identified (p=0.011). Only 1% of non-Aboriginal women indicated they would have objected to an explicit question by staff about their Aboriginal or Torres Strait Islander status.Conclusions: Routine identification significantly under-represents Aboriginal or Torres Strait Islander women giving birth at an urban obstetric hospital. We recommend the development and use of a sensitive but also specific series of questions to ensure women always are given the opportunity to disclose their status, especially as few women appear to mind such questions.
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Bourke, Christopher J., Andrew McAuliffe, and Lisa M. Jamieson. "Addressing the oral health workforce needs of Aboriginal and Torres Strait Islander Australians." Australian Health Review 45, no. 4 (2021): 407. http://dx.doi.org/10.1071/ah20295.
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Tooth decay and gum disease, the main dental diseases affecting Australians, can cause pain and deformity as well as affecting eating and speech. Dental practitioners are efficient and effective in relieving dental pain, and they can effectively restore oral function. There is good evidence that better health care outcomes for Aboriginal and Torres Strait Islander patients are associated with care from Aboriginal and Torres Strait Islander health professionals. Unfortunately, the representation of Aboriginal and Torres Strait Islander people within the dental practitioner workforce is very low. We argue that a strategic approach, along with additional investment, is needed to increase the number of Aboriginal and Torres Strait Islander people qualified as dental practitioners.
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McGarvie, N. "The Development of Inservice and Induction Programs for Teachers of Aboriginal and Torres Strait Islander Students in Queensland Schools: an Historical Overview." Aboriginal Child at School 16, no. 4 (September 1988): 29–46. http://dx.doi.org/10.1017/s0310582200015492.
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The Aboriginal/Islander population of Queensland was calculated by the 1981 census to be greater than 44,000 (Department of Aboriginal Affairs, 1984, p.11). However, for a slightly later estimate, the Annual Report of the Queensland Department of Aboriginal and Islander Advancement records a figure of 60,000 (Department of Aboriginal and Islander Advancement, 1984, p.l). Both of these figures could be substantially correct given a possibility that some Aboriginal people may not identify themselves as such on census returns. Whatever the reason for the difference in the figures, a total of some 50,000 is most likely conservative for the present time. This figure converts to a percentage of slightly over 2% of the Queensland population being Aboriginal or Torres Strait Islander. Of the 50,000 Aboriginal/Islander population some 24% are Torres Strait Islanders (Department of Aboriginal Affairs, 1984, p.11).
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Kee, Margaret Ah, and Clare Tilbury. "The Aboriginal and Torres Strait Islander Child Placement Principle is about self determination." Children Australia 24, no. 3 (1999): 4–8. http://dx.doi.org/10.1017/s1035077200009196.
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The Aboriginal and Torres Strait Islander Child Placement Principle has been the policy guiding the placement of indigenous children in most Australian child protection jurisdictions for around fifteen years. The Principle requires the involvement of Aboriginal and Torres Strait Islander community representatives in decision making concerning indigenous children, and ensuring that alternative care placements of Aboriginal and Torres Strait Islander children are with Aboriginal and Torres Strait Islander careproviders.Most Jurisdictions still have a significant number of Aboriginal and Torres Strait Islander children placed with non-indigenous careproviders, and community based Aboriginal and Islander child care agencies continue to express dissatisfaction about the nature and level of consultation which occurs when welfare departments are taking action to protect indigenous children.This paper, which was presented at the IFCO conference in Melbourne in July 1999, examines why there has been such limited improvement in Child Placement Principle outcomes. Work undertaken in Queensland to address the over representation of Aboriginal and Torres Strait Islander children in the child protection system will be outlined from both a departmental and community perspective. The paper argues that if strategies for addressing these issues are not located within a framework of self determination for Aboriginal and Torres Strait Islander people, then they will not work.
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Salisbury, Christine, and Sue Follent. "Bicultural Stress: An Aboriginal Community Perspective." Australian Journal of Primary Health 2, no. 2 (1996): 78. http://dx.doi.org/10.1071/py96032.
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A survey was designed to assess and to compare the levels of stress being experienced by Aboriginal and Torres Strait Islander and non-Aboriginal respondents. The survey covered a range of areas including demographics, access to transport, drug and alcohol use, use of public services, identification of stressful events in the past 12 months and a self evaluation of stress symptoms. The groups were matched by age, sex and income. The results showed differences between the stressful events and stress symptoms reported by the two groups, with the Aboriginal and Torres Strait Islander group reporting considerably higher levels. There were significant differences in access to transport and use of public health facilities. The barriers to the use of public health services were identified. A major finding was that 69% of the Aboriginal and Torres Strait Islander sample experienced more than one loss through death compared to 5% of the non-Aboriginal sample in the previous 12 months. It was concluded that the Aboriginal and Torres Strait Islander sample experienced more stressful events, had more stress related symptoms and used public mental health services less than the non-Aboriginal sample. The barriers to use of services were a lack of cultural sensitivity and the discomfort experienced by the Aboriginal and Torres Strait Islander sample when accessing services. A partnership with the Aboriginal and Torres Strait Islander community is required to develop a public health service that is acceptable and useful to the Aboriginal and Torres Strait Islander sample.
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Browne, Jennifer, Deborah Gleeson, Karen Adams, Deanne Minniecon, and Rick Hayes. "Strengthening Aboriginal and Torres Strait Islander health policy: lessons from a case study of food and nutrition." Public Health Nutrition 22, no. 15 (May 22, 2019): 2868–78. http://dx.doi.org/10.1017/s1368980019001198.
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AbstractObjective:To examine key factors influencing the prioritisation of food and nutrition in Aboriginal and Torres Strait Islander health policy during 1996–2015.Design:A qualitative policy analysis case study was undertaken, combining document analysis with thematic analysis of key informant interviews.Setting:Australia.Participants:Key actors involved in Aboriginal and Torres Strait Islander health policy between 1996 and 2015 (n 38).Results:Prioritisation of food and nutrition in policy reduced over time. Several factors which may have impeded the prioritisation of nutrition were identified. These included lack of cohesion among the community of nutritionists, Aboriginal and Torres Strait Islander leaders and civil society actors advocating for nutrition; the absence of an institutional home for nutrition policy; and lack of consensus and a compelling policy narrative about how priority nutrition issues should be addressed. Political factors including ideology, dismantling of public health nutrition governance structures and missing the opportunities presented by ‘policy windows’ were also viewed as barriers to nutrition policy change. Finally, the complexity and multifaceted nature of nutrition as a policy problem and perceived lack of evidence-based solutions may also have constrained its prioritisation in Aboriginal and Torres Strait Islander health policy.Conclusions:Future advocacy should focus on embedding nutrition within holistic approaches to health and building a collective voice through advocacy coalitions with Aboriginal and Torres Strait Islander leadership. Strategic communication and seizing political opportunities may be as important as evidence for raising the priority of Aboriginal and Torres Strait Islander health issues.
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Kelly, Janet, Anna Dowling, Katharine McBride, Wendy Keech, and Alex Brown. "‘We get so task orientated at times that we forget the people’: staff communication experiences when caring for Aboriginal cardiac patients." Australian Health Review 44, no. 1 (2020): 1. http://dx.doi.org/10.1071/ah17290.
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Objective The aim of this study was to describe the experiences of communication for staff providing cardiac care for Aboriginal and Torres Strait Islander patients in hospital and discuss potential improvements. Methods Focus group discussions were performed with 58 multidisciplinary staff who provide care for Aboriginal and Torres Strait Islander cardiac patients in two metropolitan and two regional hospitals in South Australia and Northern Territory. Inductive thematic analysis was undertaken to identify staff perceptions of communication challenges and strategies for improvement. Results There were five key themes: (1) communication is central to good care; (2) communication within busy clinical environments; (3) supporting a strong Aboriginal workforce; (4) a cultural as well as clinical focus; and (5) particular challenges working with patients from remote areas. Conclusions Providing effective communication that is both clinically and culturally appropriate is often challenging within a busy and non-adaptive hospital environment. Moving beyond clinical tasks, increased Aboriginal and Torres Strat Islander health workforce and cultural competency, supporting coordinated care and improved skills are required to meet the communication needs of Aboriginal and Torres Strait Islander patients. What is known about this topic? Communication between patients, their families and hospital staff is crucial for health care quality and safety. There is little understanding of the challenges and opportunities for staff to meet the communication needs of Aboriginal and Torres Strait Islander cardiac patients to address disparities in acute care settings. What does this paper add? This paper discusses the barriers and potential improvements, as identified by hospital staff providing care to Aboriginal and Torres Strait Islander cardiac patients in both metropolitan and regional settings. What are the implications for practitioners? Practitioners should be trained and supported in providing both clinically and culturally safe care for Aboriginal and Torres Strait Islander patients. This requires adequate time, two-way communication and resources to support and facilitate effective communication.
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Canuto, Kootsy, Stephen G. Harfield, Karla J. Canuto, and Alex Brown. "Aboriginal and Torres Strait Islander men and parenting: a scoping review." Australian Journal of Primary Health 26, no. 1 (2020): 1. http://dx.doi.org/10.1071/py19106.
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Aboriginal and Torres Strait Islander men rarely rate a mention within discussions of parenting unless framed in the negative, or as the cause of dysfunctional family life. Consequently, the roles and responsibilities of Aboriginal and Torres Strait Islander men within parenting have largely been neglected or ignored. This scoping review aimed to identify and describe Aboriginal and Torres Strait Islander parenting programs that focused on male parents. A comprehensive search was conducted of databases, PubMed and Informit ATSIhealth, to identify peer-review publications, while relevant websites were also searched for grey literature. The review identified eight programs that met the inclusion criteria. The review highlights the lack of rigorously researched and published literature on parenting programs that focus on Aboriginal and Torres Strait Islander male parents. The programs all reported positive outcomes and demonstrate that given the opportunity, Aboriginal and Torres Strait Islander male parents are ready and determined to fulfil their roles and responsibilities as parents to the best of their ability for the benefit of their families and communities. The provision of inclusive parenting programs and services will equip Aboriginal and Torres Strait Islander male parents to better support their families during these important times.
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Williams, Megan. "Ngaa-bi-nya Aboriginal and Torres Strait Islander program evaluation framework." Evaluation Journal of Australasia 18, no. 1 (March 2018): 6–20. http://dx.doi.org/10.1177/1035719x18760141.
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The Ngaa-bi-nya framework presented here is a practical guide for the evaluation of Aboriginal and Torres Strait Islander health and social programs. It has a range of prompts to stimulate thinking about critical success factors in programs relevant to Aboriginal and Torres Strait Islander people’s lives. Ngaa-bi-nya was designed from an Aboriginal practitioner-scholar standpoint and was informed by the holistic concept of Aboriginal health, case studies with Aboriginal-led social and emotional well-being programs, human rights instruments, and the work of Stufflebeam. Aboriginal and Torres Strait Islander health and social programs have been described as suffering from a lack of evaluation. Ngaa-bi-nya is one of the few tools developed specifically to reflect Aboriginal and Torres Strait Islander peoples’ contexts. It prompts the user to take into account the historical, policy, and social landscape of Aboriginal and Torres Strait Islander people’s lives, existing and emerging cultural leadership, and informal caregiving that supports programs. Ngaa-bi-nya’s prompts across four domains—landscape factors, resources, ways of working, and learnings—provide a structure through which to generate insights necessary for the future development of culturally relevant, effective, translatable, and sustainable programs required for Australia’s growing and diverse Aboriginal and Torres Strait Islander populations.
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Castles, Simon, Zoe Wainer, and Harindra Jayasekara. "Risk factors for cancer in the Australian Aboriginal and Torres Strait Islander population: a systematic review." Australian Journal of Primary Health 22, no. 3 (2016): 190. http://dx.doi.org/10.1071/py15048.
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Cancer incidence in the Australian Aboriginal and Torres Strait Islander population is higher and survival lower compared with non-Indigenous Australians. A proportion of these cancers are potentially preventable if factors associated with carcinogenesis are known and successfully avoided. We conducted a systematic review of the published literature to examine risk factors for cancer in the Australian Aboriginal and Torres Strait Islander population. Electronic databases Medline, Web of Science and the Australian Aboriginal and Torres Strait Islander Health Bibliographic Index were searched through August 2014 using broad search terms. Studies reporting a measure of association between a risk factor and any cancer site in the Australian Aboriginal and Torres Strait Islander population were eligible for inclusion. Ten studies (1991–2014) were identified, mostly with small sample sizes, showing marked heterogeneity in terms of methods used to assess exposure and capture outcomes, and often using descriptive comparative analyses. Relatively young (as opposed to elderly) and geographically remote Aboriginal and Torres Strait Islanders were found to be at increased risk for selected cancers while most modifiable lifestyle and behavioural risk factors were rarely assessed. Further studies examining associations between potential risk factors and cancer will help define public health policy for cancer prevention in the Australian Aboriginal and Torres Strait Islander population.
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Spurling, Geoffrey, Catrina Felton-Busch, and Sarah Larkins. "Aboriginal and Torres Strait Islander health." Australian Journal of Primary Health 24, no. 5 (2018): i. http://dx.doi.org/10.1071/pyv24n5_ed.
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Gould, Gillian S., Andy McEwen, and Joanne Munn. "Jumping the Hurdles for Smoking Cessation in Pregnant Aboriginal and Torres Strait Islander Women in Australia." Journal of Smoking Cessation 6, no. 1 (June 1, 2011): 33–36. http://dx.doi.org/10.1375/jsc.6.1.33.
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AbstractTobacco smoking perpetuates the disadvantages experienced by Aboriginal and Torres Strait Islander people in Australia. Tobacco smoking is a risk factor for poor maternal and infant outcomes in pregnancy. Over half of Aboriginal and Torres Strait Islander women smoke during pregnancy and few successfully quit. Aboriginal and Torres Strait Islander women face many intrinsic barriers to quitting such as low socioeconomic disadvantage and patterns of use in family networks. There are also several extrinsic hurdles surrounding current practice guidelines and policy that may limit success in reducing smoking rates among Aboriginal and Torres Strait Islander women during pregnancy: the use of the Stages of Change (SOC) model; delay in the use of nicotine replacement therapy (NRT); and the absence of subsidised intermittent NRT. A more proactive approach towards smoking cessation for pregnant Aboriginal and Torres Strait Islander women may be necessary, including moving away from the SOC model approach and subsidised provision of intermittent NRT. Comprehensive programs that take into account the family network and wider social context are also recommended.
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Griffiths, Kalinda, Ian Ring, Richard Madden, and Lisa Jackson Pulver. "In the pursuit of equity: COVID-19, data and Aboriginal and Torres Strait Islander people in Australia." Statistical Journal of the IAOS 37, no. 1 (March 22, 2021): 37–45. http://dx.doi.org/10.3233/sji-210785.
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Since March 2020 in Australia, there has been decisive national, and state and territory policy as well as community led action involving Aboriginal and Torres Strait Islander people as information about COVID-19 arose. This has resulted in, what could only be framed as a success story in self-determination. However, there continues to be issues with the quality of data used for the surveillance and reporting of Aboriginal and Torres Strait Islander people during the pandemic. This article discusses some of the important events in pandemic planning regarding Aboriginal and Torres Strait Islander people and how this relates to surveillance and monitoring in the emerging and ongoing threat of COVID-19 within Aboriginal and Torres Strait Islander communities. The authors also identify some of the data considerations required in the future to monitor and address public health.
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Salisbury, Christine. "A Health Service and Aboriginal & Torres Strait Islander Partnership to Develop and Plan Mental Health Services." Australian Journal of Primary Health 4, no. 4 (1998): 18. http://dx.doi.org/10.1071/py98058.
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The aim of this study was to examine the effects of an action research partnership between the Tweed Valley Health Service (TVHS) and the Aboriginal & Torres Strait Islander community for the development and delivery of Aboriginal & Torres Strait Islander Mental Health Services. This partnership was based upon Labonte's (1989) view of empowerment where it is suggested that to be empowered means to have increased capacity to define, analyse and act upon one's problems. It was proposed that the establishment of a 'partnership' based upon these principles would assist in operationalising Indigenous community participation in TVHS planning. To achieve this type of 'partnership', the health service had to be willing to enter the partnership and to give the authority to the Aboriginal & Torres Strait Islander Health Outcome Council to seek and trial solutions on Aboriginal & Torres Strait Islander Mental Health matters. Key outcomes were defined as the extent to which the re-organised services proved to be acceptable and utilised by the local Aboriginal & Torres Strait Islander population. Outcomes were operationalised through measures of service utilisation and consumer satisfaction with accessibility, process and outcomes. The study trialed participatory action research as a method for Indigenous participation in Mental Health Service planning and development and concludes that it is a valid model for cross cultural research and health service development in a complex medical setting.
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Moore, Ellie, Sharon Lawn, Candice Oster, and Andrea Morello. "Self-management programs for Aboriginal and Torres Strait Islander Peoples with chronic conditions: A rapid review." Chronic Illness 15, no. 2 (December 29, 2017): 83–123. http://dx.doi.org/10.1177/1742395317750266.
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Objectives Review the evidence for the effectiveness of chronic condition self-management programs applied to Aboriginal and Torres Strait Islander Peoples. Methods A rapid review methodology was followed to develop an evidence summary from peer-reviewed and grey literature. Results Only seven peer-reviewed studies were identified. The evidence indicated that group programs, particularly the Stanford Program, and structured individual chronic condition self-management programs were of good quality for Aboriginal and Torres Strait Islander Peoples, although these need to be integrated into practice in order to see the greatest benefits. The Flinders Program showed promise as a standardised program with content designed specifically with and for these populations. Numerous grey literature sources were identified, many using strong participatory approaches developed locally within Aboriginal and Torres Strait Islander Peoples. However, few of these programs have been subject to rigorous evaluation. Discussion Despite the significant focus on chronic condition self-management programs to help address the burden of disease for Aboriginal and Torres Strait Islander Peoples, few studies exist that have been properly evaluated. The Closing the Gap Principles developed by the Australian Institute of Health and Welfare offer important guidance for how to proceed to maximise engagement, cultural appropriateness and ownership of program initiatives.
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Wright, Alyson, Ray Lovett, Yvette Roe, and Alice Richardson. "Enhancing national data to align with policy objectives: Aboriginal and Torres Strait Islander smoking prevalence at finer geographic levels." Australian Health Review 42, no. 3 (2018): 348. http://dx.doi.org/10.1071/ah16269.
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Objectives The aim of the study was to assess the utility of national Aboriginal survey data in a regional geospatial analysis of daily smoking prevalence for Aboriginal and Torres Strait Islander Australians and discuss the appropriateness of this analysis for policy and program impact assessment. Methods Data from the last two Australian Bureau of Statistics (ABS) national surveys of Aboriginal and Torres Strait Islander people, the National Aboriginal and Torres Strait Islander Social Survey 2014–15 (n = 7022 adults) and the National Aboriginal and Torres Strait Islander Health Survey 2012–13 (n = 10 896 adults), were used to map the prevalence of smoking by Indigenous regions. Results Daily smoking prevalence in 2014–15 at Indigenous regions ranges from 27.1% (95%CI 18.9–35.3) in the Toowoomba region in Queensland to 68.0% (95%CI 58.1–77.9) in the Katherine region in the Northern Territory. The confidence intervals are wide and there is no significant difference in daily smoking prevalence between the two time periods for any region. Conclusion There are significant limitations with analysing national survey data at finer geographical scales. Given the national program for Indigenous tobacco control is a regional model, evaluation requires finer geographical analysis of smoking prevalence to inform public health progress, policy and program effects. Options to improve the data currently collected include increasing national survey sample sizes, implementing a smoking status question in census surveys, investing in current cohort studies focused on this population or implementing localised surveys. What is known about the topic? The last geospatial analysis of Aboriginal and Torres Strait Islander smoking prevalence was undertaken in 1997. Current national survey data have not been analysed geospatially. What does this paper add? This paper provides new insights into the use of national survey data for understanding regional patterns and prevalence levels of smoking in Aboriginal and Torres Strait Islander populations. What are the implications for practitioners? The findings of the study suggest caution when interpreting prevalence maps and highlight the need for greater sample sizes in national survey data. The analysis is also an opportunity to assess the use of national survey data in evaluating the policy impact of programs targeted at a regional level.
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Hogarth, Melitta. "The Power of Words: Bias and Assumptions in the Aboriginal and Torres Strait Islander Education Action Plan." Australian Journal of Indigenous Education 46, no. 1 (January 24, 2017): 44–53. http://dx.doi.org/10.1017/jie.2016.29.
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This paper argues that genuine engagement and consultation is required where Indigenous voice is prevalent within the policy development process for true progress to be achieved in the educational attainments of Aboriginal and Torres Strait Islander students. It is important to note that there has been little critical analysis of policy discourses. More specifically, analysis of how language is used to maintain societal constructs. By providing an Indigenous standpoint, it is anticipated that this paper makes explicit to policymakers the bias and taken for granted assumptions held by those who produced it. This paper is derived from a larger project, namely my Masters of Education (Research) thesis (Hogarth, 2015). The major findings that emerged from the data included (a) the homogenous grouping of Aboriginal and Torres Strait Islander people, (b) the maintenance of the prevalent dominant ideology of a deficit view within policy and finally (c) the expectation of government of increased engagement and connections with and by Aboriginal and Torres Strait Islander peoples in education without consideration of the detrimental effects of past policies and reforms. The potential implications of making explicit how language positions Aboriginal and Torres Strait Islander students’ educational attainment can inform future policymaking and contribute to the struggle for self-determination.
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Tieman, Jennifer J., Mikaela A. Lawrence, Raechel A. Damarell, Ruth M. Sladek, and Arwen Nikolof. "LIt.search: fast tracking access to Aboriginal and Torres Strait Islander health literature." Australian Health Review 38, no. 5 (2014): 541. http://dx.doi.org/10.1071/ah14019.
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Objective To develop and validate a PubMed search filter, LIt.search, that automatically retrieves Aboriginal and Torres Strait Islander health literature and to make it publicly accessible through the Lowitja Institute website. Methods Search filter development phases included: (1) scoping of the publication characteristics of Aboriginal and Torres Start Islander literature; (2) advisory group input and review; (3) systematic identification and testing of MeSH and text word terms; (4) relevance assessment of the search filter’s retrieved items; and (5) translation for use in PubMed through the web. Results Scoping study analyses demonstrated complexity in the nature and use of possible search terms and publication characteristics. The search filter achieved a recall rate of 84.8% in the full gold standard test set. To determine real-world performance, post-hoc assessment of items retrieved by the search filter in PubMed was undertaken with 87.2% of articles deemed as relevant. The search filter was constructed as a series of URL hyperlinks to enable one-click searching. Conclusion LIt.search is a search tool that facilitates research into practice for improving outcomes in Aboriginal and Torres Strait Islander health and is publicly available on the Lowitja Institute website. What is known about this topic? Health professionals, researchers and decision makers can find it difficult to retrieve published literature on Aboriginal and Torres Strait Islander health easily, effectively and in a timely way. What does this paper add? This paper describes a new web-based searching tool, LIt.search, which facilitates access to the relevant literature. What are the implications for practice? Ready access to published literature on Aboriginal and Torres Strait Islander health reduces a barrier to the use of this evidence in practice. LIt.search encourages the use of this evidence to inform clinical judgement and policy and service decision-making as well as reducing the burdens associated with searching for community practitioners, academics and policy makers.
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Allen, Bridget, Karla Canuto, John Robert Evans, Ebony Lewis, Josephine Gwynn, Kylie Radford, Kim Delbaere, et al. "Facilitators and Barriers to Physical Activity and Sport Participation Experienced by Aboriginal and Torres Strait Islander Adults: A Mixed Method Review." International Journal of Environmental Research and Public Health 18, no. 18 (September 20, 2021): 9893. http://dx.doi.org/10.3390/ijerph18189893.
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Physical activity has cultural significance and population health benefits. However, Aboriginal and Torres Strait Islander adults may experience challenges in participating in physical activity. This mixed methods systematic review aimed to synthetize existing evidence on facilitators and barriers for physical activity participation experienced by Aboriginal and Torres Strait Islander adults in Australia. The Joanna Briggs Institute methodology was used. A systematic search was undertaken of 11 databases and 14 grey literature websites during 2020. The included studies reported physical activity facilitators and barriers experienced by Aboriginal or Torres Strait Islander participants aged 18+ years, living in the community. Twenty-seven studies met the inclusion criteria. Sixty-two facilitators were identified: 23 individual, 18 interpersonal, 8 community/environmental and 13 policy/program facilitators. Additionally, 63 barriers were identified: 21 individual, 17 interpersonal, 15 community/environmental and 10 policy/program barriers. Prominent facilitators included support from family, friends, and program staff, and opportunities to connect with community or culture. Prominent barriers included a lack of transport, financial constraints, lack of time, and competing work, family or cultural commitments. Aboriginal and Torres Strait Islander adults experience multiple facilitators and barriers to physical activity participation. Strategies to increase participation should seek to enhance facilitators and address barriers, collaboratively with communities, with consideration to the local context.
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Spurling, Geoffrey K., Chelsea J. Bond, Philip J. Schluter, Corey I. Kirk, and Deborah A. Askew. "'I'm not sure it paints an honest picture of where my health's at' – identifying community health and research priorities based on health assessments within an Aboriginal and Torres Strait Islander community: a qualitative study." Australian Journal of Primary Health 23, no. 6 (2017): 549. http://dx.doi.org/10.1071/py16131.
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Aboriginal and Torres Strait Islander health assessments are conducted annually in Australian primary care to detect risk factors, chronic diseases and implement preventive health measures. At the Inala Indigenous Health Service, health assessment data have also been used for research purposes. This research has been investigator-driven, which risks misinterpreting or ignoring community priorities compared with community-led research. The objective of this research was to learn about the Aboriginal and Torres Strait Islander community’s health priorities that could be translated into research themes, and investigate these using health assessment data. A thematic analysis of data was conducted from 21 semi-structured interviews with purposively selected key informants from an urban Aboriginal and Torres Strait Islander community. Key informants articulated an authoritative understanding of how interrelated, inter-generational, social, cultural and environmental determinants operated in a ‘cycle’ to influence the community’s health. Key informant views supported the inclusion of these determinants in health assessments, reinforced the importance of comprehensive primary healthcare and strengthened referral pathways to community resources. Some key informants were ambivalent about Aboriginal and Torres Strait Islander health assessments because of their biomedical emphasis. This research also revealed limitations of health assessment-based research and the biomedical emphasis of the health system more broadly.
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Jayakody, Amanda, Mariko Carey, Jamie Bryant, Stephen Ella, Paul Hussein, Eloise Warren, Shanell Bacon, Belinda Field, and Rob Sanson-Fisher. "Exploring experiences and perceptions of Aboriginal and Torres Strait Islander peoples readmitted to hospital with chronic disease in New South Wales, Australia: a qualitative study." Australian Health Review 45, no. 4 (2021): 411. http://dx.doi.org/10.1071/ah20342.
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ObjectiveThis study explored the experiences and perceptions of unplanned hospital readmissions from the perspective of Aboriginal and Torres Strait Islander peoples with chronic disease. MethodWe conducted semi-structured interviews with Aboriginal and Torres Strait Islander patients readmitted to hospital with chronic disease. Interviews covered perceptions of avoidable readmissions, experiences of health care, medications and carer support. Inductive thematic analysis was used to code and analyse the data. ResultsFifteen patients with multiple chronic diseases were interviewed. Several participants believed their readmission was unavoidable due to their poor health, while others considered their readmission was avoidable due to perceived health professional and system failures. Enablers to chronic disease management included the importance of continuity of care and strong family networks, although a few participants struggled with isolation. Four themes emerged as barriers: poor communication from health professionals; low levels of health literacy and adherence to chronic disease management; poor access to community services; and health risk behaviours. ConclusionsThe participants in our study identified complex and interacting patient-, environmental-, encounter- and organisational-level factors as contributing to chronic disease management and unplanned readmissions. Our findings suggest systemic failures remain in access to basic services and access to culturally appropriate care. Family support and continuity of care were valued by participants. What is known about the topic?Aboriginal and Torres Strait Islander peoples with chronic diseases are more likely to be readmitted to hospital compared with non-Aboriginal people. Unplanned readmissions are associated with high health system costs, as well as poorer quality of life and psychological distress for the patient. What does this paper add?This paper describes the experiences and perceptions of unplanned readmissions by Aboriginal and Torres Strait Islander peoples with chronic disease. Our findings suggest systemic failures exist in access to basic services for a safe and secure living environment, and access to culturally appropriate care that is delivered in a manner which promotes health literacy and self-management capacity. What are the implications for practitioners?Practitioners and policy makers should consider involving family members in discharge planning and other medical care, and funding for Aboriginal and Torres Strait Islander health and community services to enhance transport, care coordination, culturally appropriate disability and housing services, and health promotion.
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Wright, Kathleen M., Joanne Dono, Aimee L. Brownbill, Odette Pearson (nee Gibson), Jacqueline Bowden, Thomas P. Wycherley, Wendy Keech, et al. "Sugar-sweetened beverage (SSB) consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review." BMJ Open 9, no. 2 (February 2019): e023630. http://dx.doi.org/10.1136/bmjopen-2018-023630.
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ObjectivesSugar-sweetened beverage (SSB) consumption in Australian Aboriginal and Torres Strait Islander people is reported to be disproportionally high compared with the general Australian population. This review aimed to scope the literature documenting SSB consumption and interventions to reduce SSB consumption among Australian Aboriginal and Torres Strait Islander people. Findings will inform strategies to address SSB consumption in Aboriginal and Torres Strait Islander communities.MethodsPubMed, SCOPUS, CINAHL, Informit, Joanna Briggs Institute EBP, Mura databases and grey literature were searched for articles published between January 1980 and June 2018. Studies were included if providing data specific to an Australian Aboriginal and/or Torres Strait Islander population’s SSB consumption or an intervention that focused on reducing SSB consumption in this population.DesignSystematic scoping review.Results59 articles were included (1846 screened). While reported SSB consumption was high, there were age-related and community-related differences observed in some studies. Most studies were conducted in remote or rural settings. Implementation of nutrition interventions that included an SSB component has built progressively in remote communities since the 1980s with a growing focus on community-driven, culturally sensitive approaches. More recent studies have focused exclusively on SSB consumption. Key SSB-related intervention elements included incentivising healthier options; reducing availability of less-healthy options; nutrition education; multifaceted or policy implementation (store nutrition or government policy).ConclusionsThere was a relatively large number of studies reporting data on SSB consumption and/or sales, predominantly from remote and rural settings. During analysis it was subjectively clear that the more impactful studies were those which were community driven or involved extensive community consultation and collaboration. Extracting additional SSB-specific consumption data from an existing nationally representative survey of Aboriginal and Torres Strait Islander people could provide detailed information for demographic subgroups and benchmarks for future interventions. It is recommended that a consistent, culturally appropriate, set of consumption measures be developed.
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Spurling, Geoffrey K. P., Deborah A. Askew, Philip J. Schluter, Fiona Simpson, and Noel E. Hayman. "Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study." Australian Journal of Primary Health 20, no. 3 (2014): 285. http://dx.doi.org/10.1071/py13009.
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Few epidemiological studies of middle ear disease have been conducted in Aboriginal and Torres Strait Islander populations, yet the disease is common and causes hearing impairment and poorer educational outcomes. The objective of this study is to identify factors associated with abnormal middle ear appearance, a proxy for middle ear disease. Aboriginal and Torres Strait Islander children aged 0–14 years receiving a Child Health Check (CHC) at an urban Indigenous Health Service, Brisbane, Australia were recruited from 2007 to 2010. Mixed-effects models were used to explore associations of 10 recognised risk factors with abnormal middle ear appearance at the time of the CHC. Ethical approval and community support for the project were obtained. Four hundred and fifty-three children were included and 54% were male. Participants were Aboriginal (92%), Torres Strait Islander (2%) or both (6%). Abnormal middle ear appearance was observed in 26 (6%) children and was significantly associated with previous ear infection (odds ratio (OR), 8.8; 95% confidence interval (CI), 3.2–24.0) and households with eight or more people (OR, 3.8; 95% CI, 1.1–14.1) in the imputed multivariable mixed-effects model. No significant associations were found for the other recognised risk factors investigated. Overcrowding should continue to be a core focus for communities and policy makers in reducing middle ear disease and its consequences in Aboriginal and Torres Strait Islander peoples.
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Bird, Jennifer, Darlene Rotumah, James Bennett-Levy, and Judy Singer. "Diversity in eMental Health Practice: An Exploratory Qualitative Study of Aboriginal and Torres Strait Islander Service Providers." JMIR Mental Health 4, no. 2 (May 29, 2017): e17. http://dx.doi.org/10.2196/mental.7878.
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Background In Australia, mental health services are undergoing major systemic reform with eMental Health (eMH) embedded in proposed service models for all but those with severe mental illness. Aboriginal and Torres Strait Islander service providers have been targeted as a national priority for training and implementation of eMH into service delivery. Implementation studies on technology uptake in health workforces identify complex and interconnected variables that influence how individual practitioners integrate new technologies into their practice. To date there are only two implementation studies that focus on eMH and Aboriginal and Torres Strait Islander service providers. They suggest that the implementation of eMH in the context of Aboriginal and Torres Strait Islander populations may be different from the implementation of eMH with allied health professionals and mainstream health services. Objective The objective of this study is to investigate how Aboriginal and Torres Strait Islander service providers in one regional area of Australia used eMH resources in their practice following an eMH training program and to determine what types of eMH resources they used. Methods Individual semistructured qualitative interviews were conducted with a purposive sample of 16 Aboriginal and Torres Strait Islander service providers. Interviews were co-conducted by one indigenous and one non-indigenous interviewer. A sample of transcripts were coded and thematically analyzed by each interviewer and then peer reviewed. Consensus codes were then applied to all transcripts and themes identified. Results It was found that 9 of the 16 service providers were implementing eMH resources into their routine practice. The findings demonstrate that participants used eMH resources for supporting social inclusion, informing and educating, assessment, case planning and management, referral, responding to crises, and self and family care. They chose a variety of types of eMH resources to use with their clients, both culturally specific and mainstream. While they referred clients to online treatment programs, they used only eMH resources designed for mobile devices in their face-to-face contact with clients. Conclusions This paper provides Aboriginal and Torres Strait islander service providers and the eMH field with findings that may inform and guide the implementation of eMH resources. It may help policy developers locate this workforce within broader service provision planning for eMH. The findings could, with adaptation, have wider application to other workforces who work with Aboriginal and Torres Strait Islander clients. The findings highlight the importance of identifying and addressing the particular needs of minority groups for eMH services and resources.
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Barlow, Alex. "Equality or Equity? : Education for Aboriginal and Torres Strait Islander Futures." Aboriginal Child at School 18, no. 4 (September 1990): 19–35. http://dx.doi.org/10.1017/s1326011100600376.
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The Hon. John Dawkins (then) Minister for Employment, Education and Training, launched the Aboriginal Education Policy at a grand event in the Committee Room at Parliament House on 26th October 1989. The Prime Minister blessed the occasion with his presence and a short speech. Three of the former Chairs of the the National Aboriginal Education Committee were there, as were Aboriginal and Torres Strait Islander educationists from most Australian states. Only New South Wales, which decided to boycott the launch, wasn’t officially represented.There are two reasons for calling the policy that the Minister launched the Aboriginal Education Policy. Firstly, because it is the first policy formally endorsed by any National government; and secondly, because it responds to the call made in the 1988 Report of the Aboriginal Education Policy Task Force, for a concerted national effort – to achieve broad equity between Aboriginal people and other Australians in access, participation and outcomes at all stages of education. (National Aboriginal and Torres Strait Islander Education Policy, 1989: 1.2.6 – Draft).
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Tsey, Komla, Philemon Chigeza, Carol A. Holden, Jack Bulman, Hilton Gruis, and Mark Wenitong. "Evaluation of the pilot phase of an Aboriginal and Torres Strait Islander Male Health Module." Australian Journal of Primary Health 20, no. 1 (2014): 56. http://dx.doi.org/10.1071/py12033.
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This article evaluates the pilot phase of an Aboriginal and Torres Strait Islander Male Health Module. Although men experience higher levels of illness and die younger than women, educational programs to support health workers utilise a gender-based approach to increase participation of Aboriginal and Torres Strait Islander males in health care are rare and lack appropriate content. Recognising this gap in service provision, and under the guidance of a Reference Group comprising community leaders in Aboriginal and Torres Strait male health, a comprehensive and culturally appropriate Male Health Module has been developed to enhance the capacity of health workers to improve access to services for Aboriginal and Torres Strait Islander males. Methods used were: in-depth interviews with Module developers, pilot workshops for trainers and health workers, questionnaires and focus group discussions with workshop participants, and participant observations. As well as enhancing capacity to facilitate access to health services for men, the Module was deemed relevant because of its potential to promote health worker empowerment and wellbeing. Findings revealed that improving access to services for men required male and female health workers working in partnership. Despite overall enthusiasm for the Module, the findings also revealed deep fear that it would end up ‘collecting dust on shelves’. Strategies to improve the Module quality and accessibility are highlighted.
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Mitchell, Scott, Hayley Michael, Stephanie Highden-Smith, Vivian Bryce, Sean Grugan, Hua Bing Yong, Sonia Renouf, Tanya Kitchener, and William Y. S. Wang. "Culturally safe and sustainable solution for Closing the Gap-registered patients discharging from a tertiary public hospital." Australian Health Review 44, no. 2 (2020): 200. http://dx.doi.org/10.1071/ah18160.
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This case study describes the development, implementation and review of a sustainable and culturally sensitive procedure for a hospital-funded discharge medicine subsidy for Aboriginal and Torres Strait Islander patients registered with the Closing the Gap (CTG) program discharging from a public hospital. A 7-day fully subsidised medication supply was approved to be offered to Aboriginal and Torres Strait Islander patients admitted under cardiac care teams, including cardiology and cardiothoracic surgery patients. Patients were offered the option of a 7-day supply free of cost to them or a full Pharmaceutical Benefits Scheme (PBS) supply if preferred. A general practitioner (GP) appointment was organised within 7 days of discharge to ensure patients received ongoing supply of their medications as well as timely clinical review after discharge. Over a 34-month period from September 2015 to June 2018, 535 Aboriginal and Torres Strait Islander patients were admitted to the hospital under cardiac care teams. Of these patients, 296 received a subsidised discharge medication supply with a total cost of A$6314.56 to the hospital over the trial period, with a mean cost of A$21.26 per discharge. The provision of subsidised medications through the CTG program has improved the continuity of care for Aboriginal and Torres Strait Islander patients. The culturally sensitive approach is well received and has allowed smooth transition back to the community. This site-specific and state-based funding model was found to be financially sustainable at a public hospital. What is known about the topic?The CTG PBS program is not applicable to discharge prescriptions from public hospitals. As such, patients are required to either leave the hospital with no medicines or leave the hospital with medicines for which they have to pay full PBS price. This creates a huge financial barrier to the care for CTG-registered patients in the acute care setting. What does this paper add?A sustainable solution to the problem was found via a state-funded model while providing a supportive team to ensure GP follow-up and continuity of care after discharge. What are the implications for practitioners?If similar approvals are granted and supported at other public hospital sites, practitioners will be afforded one less barrier to provide patient-centred care for Aboriginal and Torres Strait Islander patients.
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Milligan, Eleanor, Roianne West, Vicki Saunders, Andrea Bialocerkowski, Debra Creedy, Fiona Rowe Minniss, Kerry Hall, and Stacey Vervoort. "Achieving cultural safety for Australia’s First Peoples: a review of the Australian Health Practitioner Regulation Agency-registered health practitioners’ Codes of Conduct and Codes of Ethics." Australian Health Review 45, no. 4 (2021): 398. http://dx.doi.org/10.1071/ah20215.
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Objective Health practitioners’ Codes of Conduct and Codes of Ethics articulate practice standards across multiple domains, including the domain of cultural safety. As key tools driving individual practice and systems reform, Codes are integral to improving health outcomes for Aboriginal and Torres Strait Islander peoples. It is, therefore, critical that their contents specify meaningful cultural safety standards as the norm for institutional and individual practice. This research assessed all Codes for cultural safety specific content. MethodsFollowing the release of the Australian Health Practitioner Regulation Agency’s (Ahpra) Health and Cultural Safety strategy 2020–25, the 16 Ahpra registered health practitioner Board Codes of Conduct and professional Codes of Ethics were analysed by comparing content to Ahpra’s new cultural safety objectives. Two Codes of Conduct, Nursing and Midwifery, met these objectives. The Aboriginal and Torres Strait Islander Health Practitioners Code partially met these objectives. ResultsMost Codes of Conduct (14 of 16) conflated Aboriginal and Torres Strait Islander peoples with culturally and linguistically diverse (CALD) communities undermining the sovereignty of Australia’s First Peoples. Eleven professions had a Code of Ethics, including the Physiotherapy Code of Conduct, which outlined the values and ethical principles of practice commonly associated with a Code of Ethics. Of the 11 professions with a Code of Ethics, two (Pharmacy and Psychology) articulated specific ethical responsibilities to First Peoples. Physiotherapy separately outlined cultural safety obligations through their reconciliation action plan (RAP), meeting all Ahpra cultural safety objectives. The remaining eight advocated respect of culture generally rather than respect for Aboriginal and Torres Strait Islander cultures specifically. ConclusionsThe review identified multiple areas to improve the codes for cultural safety content for registered health professions, providing a roadmap for action to strengthen individual and systems practice while setting a clear regulatory standard to ensure culturally safe practice becomes the new norm. It recommends the systematic updating of all professional health practitioner Board Codes of Conduct and professional Codes of Ethics based on the objectives outlined in Ahpra’s Cultural Safety Strategy. What is known about the topic?Systemic racism and culturally unsafe work environments contribute to poor health outcomes for Aboriginal and Torres Strait Islander peoples. They also contribute to the under-representation of Aboriginal and Torres Strait Islander peoples in the health workforce, denying the system, and the people who use and work in it, much needed Indigenous knowledge. Creating a culturally safe healthcare system requires all health practitioners to reflect on their own cultural background, to gain appreciation of the positive and negative impacts of individually held cultural assumptions on the delivery of healthcare services. Competence in cultural safety as a required standard of practice is therefore essential if broad, sustainable and systemic cultural change across the health professions and ultimately across Australia’s healthcare system is to be achieved. Given that Codes of Conduct and Codes of Ethics are integral in setting the practical and moral standards of the professions, their contents with respect to cultural competence are of great importance. What does this paper add?A review of this type has not been undertaken previously. Following the establishment of the Ahpra Aboriginal and Torres Strait Islander Health Strategy Group, release of Ahpra’s 2018 Statement of intent, and the 2019 Aboriginal and Torres Strait Islander Health and Cultural Safety strategic plan and Reconciliation Action Plan, we analysed the content of each of the 16 registered health professions Codes of Conduct and Code of Ethics looking for content and guidance in accordance with the new national cultural safety definition. Several opportunities to improve the Codes of Conduct and Codes of Ethics were identified to realise the vision set out in the statement of intent including through the application of the National Law. This analysis provides a baseline for future improvements and confirms that although some current health practitioner Codes of Conduct and Codes of Ethics have begun the journey of recognising the importance of cultural safety in ensuring good health outcomes for Australia’s Indigenous peoples, there is broad scope for change. What are the implications for practitioners?The gaps identified in this analysis provide a roadmap for improvement and inclusion of Aboriginal and Torres Strait Islander Health and cultural safety as a required standard in Codes of Conduct and Codes of Ethics for all registered health practitioners. Although it is recognised that Codes alone may not change hearts and minds, codifying the clinical competency of cultural safety provides a portal, and a requirement, for each individual practitioner to engage meaningfully and take responsibility to improve practice individually and organisationally.
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Butler, Brian. "Aboriginal & Torres Strait Islander Children: Present and Future Services & Policy." Children Australia 18, no. 1 (1993): 4–8. http://dx.doi.org/10.1017/s1035077200003254.
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This paper will address the overall approach of the present government to the provision of Aboriginal children's services in the context of the social indicators about Aboriginal children within Aboriginal society and non-Aboriginal society. It will then outline the proper and appropriate frameworks for the development of services for Aboriginal children.
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Bramwell, Leigh, Wendy Foley, and Tanya Shaw. "Putting urban Aboriginal and Torres Strait Islander food insecurity on the agenda." Australian Journal of Primary Health 23, no. 5 (2017): 415. http://dx.doi.org/10.1071/py17073.
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Food insecurity adversely affects diet quality, physical, mental and social wellbeing and the capacity to act on health advice recommended by primary healthcare providers. In this article, an overview of the neglected issue of food insecurity in urban Aboriginal and Torres Strait Islander communities is provided. Policy and action on food security for urban Aboriginal and Torres Strait Islander people is reviewed, and it is argued that for primary health care to better address food insecurity, an evidence base is needed to understand the experiences of individuals and households and how to work effectively to support food insecure clients.
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Palmer, Kingsley. "Comparing the Policy of Aboriginal Assimilation, by Andrew Armitage; Vancouver, BC: University of British Columbia Press, 1995." Journal of Political Ecology 2, no. 1 (December 1, 1995): 21. http://dx.doi.org/10.2458/v2i1.20169.
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Comparing the Policy of Aboriginal Assimilation, by Andrew Armitage; Vancouver, BC: University of British Columbia Press, 1995. xiii + 286 pp. Reviewed by Kingsley Palmer, Deputy Principal, Australian Institute for Aboriginal and Torres Strait Islander Studies, Canberra, Australia.
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Nangala, Stanley. "Aboriginal and Torres Strait Islander Health: today's challenges, tomorrow's opportunities." Australian Health Review 32, no. 2 (2008): 302. http://dx.doi.org/10.1071/ah080302.
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THIS FESTSCHRIFT PRESENTS a unique opportunity to pay a warm tribute to Professor Ken Donald who has built important foundations that will very much benefit future generations, especially for those of us who belong to the Aboriginal and Torres Strait Islander nations of peoples.
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Mackean, Tamara, Matthew Fisher, Sharon Friel, and Frances Baum. "A framework to assess cultural safety in Australian public policy." Health Promotion International 35, no. 2 (February 22, 2019): 340–51. http://dx.doi.org/10.1093/heapro/daz011.
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Abstract The concept of cultural safety (CS) has been developed as a critical perspective on healthcare provided to Indigenous service users in neo-colonial countries such as New Zealand, Australia and Canada. Unlike other frameworks for culturally competent healthcare, a CS approach recognizes impacts of colonization and power inequalities on Indigenous peoples and asks how these may manifest in healthcare settings. It has been argued that CS thinking is suited to critical analysis of public policy, but there has been limited work in this direction. Drawing on literature on CS in Australian healthcare, we defined a CS framework consisting of five concepts: reflexivity, dialogue, reducing power differences, decolonization and regardful care. Our research examined whether and in what terms this framework could be adapted as a tool for critical analysis of Australian public policy as it affects Aboriginal and Torres Strait Islander peoples. We used a collaborative inquiry process combining perspectives of an Aboriginal researcher and a non-Indigenous researcher. We developed a thematic analysis framework to examine how the five concepts might be reflected in contemporary writings on policy by leading Aboriginal or Torres Strait Islander thinkers. We found the framework is applicable as a tool for policy analysis; bringing together key concerns raised by Aboriginal and Torres Strait Islander leaders and critical concepts such as sovereignty and interface thinking. We concluded the framework is likely to be a useful tool for critical, systemic thinking about public policy as it affects Indigenous peoples and for specifying areas where performance can be improved to achieve culturally safe policy.
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Watson, Karen, Jeanine Young, and Margaret Barnes. "What constitutes ‘support’ for the role of the Aboriginal and Torres Strait Islander child health workforce?" Australian Health Review 37, no. 1 (2013): 112. http://dx.doi.org/10.1071/ah11079.
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As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship. What is known about the topic? Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this population. What does this paper add? Through consultation with a sample of Indigenous child health workers and child health workers key areas necessary to provide support for the individuals working in these roles have been identified. What are the implications for practitioners? The findings from this study will inform policy and program development in order to more comprehensively support health workers in the community and contribute towards workforce development and satisfaction, recruitment and retention.
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Bobba, Samantha. "Ethics of medical research in Aboriginal and Torres Strait Islander populations." Australian Journal of Primary Health 25, no. 5 (2019): 402. http://dx.doi.org/10.1071/py18049.
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Conducting ethical health research in Aboriginal and Torres Strait Islander populations requires an understanding of their unique cultural values and the historical context. The assimilation of Indigenous people with the broader community through colonial policies such as the dispossession of land and forcible removal of children from their families in the Stolen Generation, deprived entire communities of their liberty. Poorly designed research protocols can perpetuate discriminatory values, reinforce negative stereotypes and stigmas and lead to further mistrust between the Indigenous community and healthcare professionals. The manuscript offers a fresh perspective and an up-to-date literature review on the ethical implications of conducting health research in Aboriginal and Torres Strait Islander communities.
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Anderson, Ian, Harriet Young, Milica Markovic, and Lenore Manderson. "Koori Primary Health Care in Victoria: Developments in Service Planning." Australian Journal of Primary Health 6, no. 4 (2000): 24. http://dx.doi.org/10.1071/py00031.
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The Alma Ata 1978 Declaration on primary health care has conventionally been applied in developing countries, where medically trained personnel and other highly skilled health professionals and medical infrastructure are limited. Although such concepts have salience in relatively resource rich countries such as Australia, it is in Aboriginal and Torres Strait Islander health policy that they have become pivotal. A growing national focus on the development of Aboriginal primary health care capacity followed the release of the National Aboriginal Health Strategy (NAHS) in 1989 (Anderson, 1997). This focus consolidated further, following the evaluation of the National Aboriginal Health Strategy implementation in 1994 which preceded the transfer of administrative responsibility for the Commonwealth Aboriginal health program from the Aboriginal and Torres Strait Islander Commission (ATSIC) to the Commonwealth Health portfolio (DHFS, 1994). Within the strategic framework provided by federal state agreements, the development of primary health care services is a priority. In the current national policy framework domains of policy and strategy development have been identified as key developmental themes.
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Hu, Jie, Tabinda Basit, Alison Nelson, Emma Crawford, and Lyle Turner. "Does attending Work It Out – a chronic disease self-management program – affect the use of other health services by urban Aboriginal and Torres Strait Islander people with or at risk of chronic disease? A comparison between program participants and non-participants." Australian Journal of Primary Health 25, no. 5 (2019): 464. http://dx.doi.org/10.1071/py18089.
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Work It Out is a holistic chronic disease self-management program for urban Aboriginal and Torres Strait Islander people in Queensland, which is part of an integrated and comprehensive system of care for chronic disease management. This study examines differences in primary healthcare services use between Work It Out participants and non-participants. This retrospective observational study of services use, analysed data extracted from the clinical medical records system and Work It Out program assessments. General practitioner and allied health services use were compared among the participants and non-participants using logistic regression models and zero-truncated Poisson and negative binomial regression models. Compared with non-participants, Work It Out participants were more likely to use GP management plans, GP team care arrangements, GP mental health consultation and subsequent allied health services. Among those who used the services more than once, Work It Out participants had higher service use rates than non-participants for Aboriginal and Torres Strait Islander health assessments, GP management plans, team care arrangements and podiatry, physiotherapy and dietetic services. Engagement in Work It Out can facilitate the use of primary healthcare services, which are important for chronic disease management for urban Aboriginal and Torres Strait Islander people.
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FISHER, MATTHEW, SAMANTHA BATTAMS, DENNIS MCDERMOTT, FRAN BAUM, and COLIN MACDOUGALL. "How the Social Determinants of Indigenous Health became Policy Reality for Australia's National Aboriginal and Torres Strait Islander Health Plan." Journal of Social Policy 48, no. 1 (May 28, 2018): 169–89. http://dx.doi.org/10.1017/s0047279418000338.
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AbstractThe paper analyses the policy process which enabled the successful adoption of Australia's National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (NATSIHP), which is grounded in an understanding of the Social Determinants of Indigenous Health (SDIH). Ten interviews were conducted with key policy actors directly involved in its development. The theories we used to analyse qualitative data were the Advocacy Coalition Framework, the Multiple Streams Approach, policy framing and critical constructionism. We used a complementary approach to policy analysis. The NATSIHP acknowledges the importance of Aboriginal and Torres Strait Islander (hereafter, Aboriginal) culture and the health effects of racism, and explicitly adopts a human-rights-based approach. This was enabled by a coalition campaigning to ‘Close the Gap’ (CTG) in health status between Aboriginal and non-Aboriginal Australians. The CTG campaign, and key Aboriginal health networks associated with it, operated as an effective advocacy coalition, and policy entrepreneurs emerged to lead the policy agenda. Thus, Aboriginal health networks were able to successfully contest conventional problem conceptions and policy framings offered by government policy actors and drive a paradigm shift for Aboriginal health to place SDIH at the centre of the NATSIHP policy. Implications of this research for policy theory and for other policy environments are considered along with suggestions for future research.
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Mohamed, Dr Janine. "Growing and supporting the Aboriginal and Torres Strait Islander health workforce." Australian Health Review 45, no. 4 (2021): 397. http://dx.doi.org/10.1071/ahv45n4_ed2.
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McCarthy, Leisa, Anne Chang, and Julie Brimblecombe. "Food Security Experiences of Aboriginal and Torres Strait Islander Families with Young Children in An Urban Setting: Influencing Factors and Coping Strategies." International Journal of Environmental Research and Public Health 15, no. 12 (November 26, 2018): 2649. http://dx.doi.org/10.3390/ijerph15122649.
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Evidence on Aboriginal and Torres Strait Islander peoples’ food security experiences and coping strategies used when food insecurity occurs is limited. Such evidence is important to inform policies that can reduce the consequences of food insecurity. This study investigated factors perceived by Aboriginal and Torres Strait Islander families with young children to influence household food security, and coping strategies used, in an urban setting. A qualitative research inductive approach was used. Data were collected through an iterative process of inquiry through initial interviews with 30 primary care-givers, followed by in-depth interviews with six participants to further explore emerging themes. Major topics explored were: influencing factors, food insecurity experiences, impact on food selection, and coping strategies. Food affordability relating to income and living expenses was a major barrier to a healthy diet with large household bills impacting food choice and meal quality. Access to family support was the main reported coping strategy. Food insecurity is experienced by Aboriginal and Torres Strait Islander families, it is largely intermittent occurring especially when large household bills are due for payment. Family support provides an essential safety net and the implications of this are important to consider in public policy to address food insecurity.
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Guenther, John, and Samuel Osborne. "Did DI do it? The impact of a programme designed to improve literacy for Aboriginal and Torres Strait Islander students in remote schools." Australian Journal of Indigenous Education 49, no. 2 (January 15, 2020): 163–70. http://dx.doi.org/10.1017/jie.2019.28.
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AbstractOver the 10 years of ‘Closing the Gap’, several interventions designed to improve outcomes for Aboriginal and Torres Strait Islander students have been trialled. In 2014 the Australian Government announced the ‘Flexible Literacy for Remote Primary Schools Programme’ (FLFRPSP) which was designed primarily to improve the literacy outcomes of students in remote schools with mostly Aboriginal and Torres Strait Islander students. The programme, using Direct Instruction (DI) or Explicit Direct Instruction, was extended to 2019 with more than $30 million invested. By 2017, 34 remote schools were participating in the Northern Territory, Queensland and Western Australia. This paper analyses My School data for 25 ‘very remote’ FLFRPSP schools with more than 80% Aboriginal or Torres Strait Islander students. It considers Year 3 and 5 NAPLAN reading results and attendance rates for participating and non-participating primary schools in the 3 years before the programme's implementation and compares them with results since. Findings show that, compared to very remote schools without FLFRPSP, the programme has not improved students' literacy abilities and results. Attendance rates for intervention schools have declined faster than for non-intervention schools. The paper questions the ethics of policy implementation and the role of evidence as a tool for accountability.
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Lakhan, Prabha, Deborah Askew, Mark F. Harris, Corey Kirk, and Noel Hayman. "Understanding health talk in an urban Aboriginal and Torres Strait Islander primary healthcare service: a cross-sectional study." Australian Journal of Primary Health 23, no. 4 (2017): 335. http://dx.doi.org/10.1071/py16162.
Full textAbstract:
Health literacy is an important determinant of health status. This cross-sectional study aimed to describe the prevalence of adequate health literacy among Aboriginal and Torres Strait Islander patients or their carers including parents of sick children attending an urban primary healthcare clinic in Australia, and their experiences of communication with General Practitioners (GPs). A questionnaire, including questions from the Brief Health Literacy Screen (BHLS) and questions from the Consumer Assessment of Healthcare Providers and Systems (CAHPS): Communication with Provider, was administered to 427 participants. Descriptive statistics, Pearson’s Chi-Square test and logistic regression analysis were used to describe the prevalence and risk factors associated with health literacy and any associations between the CAHPS questions and health literacy. In total, 72% of participants had adequate health literacy. An age of ≥50 years was independently associated with inadequate health literacy, and completion of secondary or post-secondary schooling was protective. Communication questions that identified areas for improvement included less use of incomprehensible medical words and more frequent use of visual aids. The study provides useful information on health literacy among Aboriginal and Torres Strait Islander patients, or their carers, and their experiences of communication with GPs. Further population-based research is required to investigate the effect of health literacy on health outcomes of Aboriginal and Torres Strait Islander patients.
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Bartlett, Ben, and John Boffa. "The impact of Aboriginal community controlled health service advocacy on Aboriginal health policy." Australian Journal of Primary Health 11, no. 2 (2005): 53. http://dx.doi.org/10.1071/py05022.
Full textAbstract:
This paper reviews the advocacy role of Aboriginal community controlled health services (ACCHSs) in the development of Aboriginal health policy over the past 30 years, with a specific focus on the recent changes in Commonwealth funding and administrative responsibility - the transfer of Aboriginal health service funding from the Aboriginal and Torres Strait Islander Commission (ATSIC) to the Office of Aboriginal and Torres Strait Islander Health Services (OATSIHS) within the Commonwealth Department of Health and Ageing (DoHA), and the development of policies aimed at Aboriginal health services accessing mainstream (Medical Benefits Scheme [MBS]) funds. The outcomes of this policy change include a significant increase in funding to Aboriginal primary health care (PHC), the inclusion of ACCHSs in collaborative strategic relationships, and the development of new arrangements involving regional planning and access to per capita funds based on MBS equivalents. However, the community sector remains significantly disadvantaged in participating in this collaborative effort, and imposed bureaucratic processes have resulted in serious delays in releasing funds for actual services in communities. Government agencies need to take greater heed of community advocacy, and provide appropriate resourcing to enable community organisations to better direct government effort, especially at the implementation phase. These remain major concerns and should be considered by non-health sectors in the development of new funding and program development mechanisms in the wake of the abolition of ATSIC.
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Smith, James A., Anthony Merlino, Ben Christie, Mick Adams, Jason Bonson, Richard Osborne, Barry Judd, Murray Drummond, David Aanundsen, and Jesse Fleay. "‘Dudes Are Meant to be Tough as Nails’: The Complex Nexus Between Masculinities, Culture and Health Literacy From the Perspective of Young Aboriginal and Torres Strait Islander Males – Implications for Policy and Practice." American Journal of Men's Health 14, no. 3 (May 2020): 155798832093612. http://dx.doi.org/10.1177/1557988320936121.
Full textAbstract:
Health literacy is generally conceptualized as skills related to successfully navigating health – ultimately linked to well-being and improved health outcomes. Culture, gender and age are considered to be influential determinants of health literacy. The nexus between these determinants, and their collective relationship with health literacy, remains understudied, especially with respect to Indigenous people globally. This article presents findings from a recent study that examined the intersections between masculinities, culture, age and health literacy among young Aboriginal and Torres Strait Islander males, aged 14–25 years in the Northern Territory, Australia. A mixed-methods approach was utilized to engage young Aboriginal and Torres Strait Islander males. The qualitative components included Yarning Sessions and Photovoice using Facebook, which are used in this article. Thematic Analysis and Framework Analysis were used to group and analyse the data. Ethics approval was granted by Charles Darwin University Human Research Ethics Committee (H18043). This cohort constructs a complex interface comprising Western and Aboriginal cultural paradigms, through which they navigate health. Alternative Indigenous masculinities, which embrace and resist hegemonic masculine norms simultaneously shaped this interface. External support structures – including family, friends and community engagement programs – were critical in fostering health literacy abilities among this cohort. Young Aboriginal and Torres Strait Islander males possess health literacy abilities that enable them to support the well-being of themselves and others. Health policymakers, researchers and practitioners can help strengthen and expand existing support structures for this population by listening more attentively to their unique perspectives.