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Clark (Adnyamathanha), Justine R., Jessica Buck (Kamilaroi), Amanda Richards‐Satour (Adnyamathanha and Barngarla), Louise Lyons (Jaadwa), and Alex Brown (Yuin). "Towards precision cancer medicine for Aboriginal and Torres Strait Islander cancer health equity." Medical Journal of Australia 221, no. 1 (July 2024): 68–73. http://dx.doi.org/10.5694/mja2.52346.
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Summary Delivering cancer control at scale for Aboriginal and Torres Strait Islander communities is a national priority that requires Aboriginal and Torres Strait Islander leadership and codesign, as well as significant involvement of the Aboriginal community‐controlled health sector. The unique genomic variation observed among Aboriginal and Torres Strait Islander peoples may have implications for standard and precision medicine. Yet, Aboriginal and Torres Strait Islander peoples are absent from, or under‐represented within, human reference genome resources, genomic studies, cancer studies, cancer cell lines, patient‐derived xenografts and cancer clinical trials. Genomics‐guided precision cancer medicine offers an opportunity to reduce cancer health disparities experienced by Aboriginal and Torres Strait Islander peoples through personalising prevention, diagnosis, treatment and long term management. Here, we describe what is required to ensure that Aboriginal and Torres Strait Islander peoples can receive the benefits of precision cancer medicine. Equity of access to care, an Aboriginal and Torres Strait Islander cancer workforce, and appropriate genome reference resources are important for safe and effective cancer medicine. Building Indigenous data sovereignty principles and Aboriginal and Torres Strait Islander governance into research is required to protect Aboriginal and Torres Strait Islander rights and collective interests. Aboriginal and Torres Strait Islander community engagement should be undertaken to develop an understanding of the unique cultural and ethical considerations for precision cancer research. Local and national genomic health research guidelines are needed to define a consensus best practice in genomics research with Aboriginal and Torres Strait Islander peoples.
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McGuffog, Romany, Catherine Chamberlain, Jaqui Hughes, Kelvin Kong, Mark Wenitong, Jamie Bryant, Alex Brown, et al. "Murru Minya–informing the development of practical recommendations to support ethical conduct in Aboriginal and Torres Strait Islander health research: a protocol for a national mixed-methods study." BMJ Open 13, no. 2 (February 2023): e067054. http://dx.doi.org/10.1136/bmjopen-2022-067054.
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IntroductionConducting ethical and high-quality health research is crucial for informing public health policy and service delivery to reduce the high and inequitable burden of disease experienced by Aboriginal and Torres Strait Islander people. Ethical guidelines and principles specifically for health research with Aboriginal and Torres Strait Islander people have been developed for use since 1987. However, there has been limited examination of how these are being applied to the conduct of research.Methods and analysisMurru Minyawill be a large-scale national study to examine the implementation of ethical processes in Aboriginal and Torres Strait Islander health research. A mixed-methods design will be used in fourbaarra(steps). The first threebaarrawill collect knowledge, experiences and wisdom from three key groups: Aboriginal and Torres Strait Islander communities, research academics, and Human Research Ethics Committees using online surveys, yarning, and semistructured interviews. This knowledge will inform the finalbaarraof developing a set of practical recommendations to support ethical conduct in Aboriginal and Torres Strait Islander health research into the future.Ethics and disseminationEthical approval for this research project has been granted by National, State and Territory Human Research Ethics Committees. This research has been developed in collaboration with Aboriginal and Torres Strait Islander researchers, Aboriginal Community Controlled Health Organisation representatives, Aboriginal community members, the National Health Leadership Forum, and Aboriginal and Torres Strait Islander research team. The knowledge translation plan will be integrated and revised throughout the project as partnerships and engagement with Aboriginal and Torres Strait Islander communities continue. All findings will be shared with peak Aboriginal research bodies and Aboriginal and Torres Strait Islander communities in ways that are meaningful to them.
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Henson, Connie, Boe Rambaldini, Bronwyn Carlson, Monika Wadolowski, Carol Vale, and Kylie Gwynne. "A new path to address health disparities: How older Aboriginal & Torres Strait Islander women use social media to enhance community health (Protocol)." DIGITAL HEALTH 8 (January 2022): 205520762210844. http://dx.doi.org/10.1177/20552076221084469.
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Background Digital health offers a fresh avenue to address health disparities experienced by Aboriginal and Torres Strait Islanders. Despite the scant evidence about how Aboriginal and Torres Strait Islanders access and use health technology, the Australian government has prioritised research that uses technology to enable people to manage their health and promote better health outcomes. Older Aboriginal and Torres Strait Islander women are cultural leaders in their communities, enabling them to provide valuable insights about the safety and efficacy of health care messaging. However, no research has engaged older Aboriginal and Torres Strait Islander, women as partners in digital health research. Objective This paper provides a protocol for co-designed translational research that privileges older Aboriginal & Torres Strait Islander women’s cultural expertise to design and test a framework for accessible, culturally safe and feasible digital health technologies. Methods This mixed-methods research project will use the collective impact approach, a user-centred, co-design methodology and yarning circles, a recognised Indigenous research methodology. A series of yarning circles with three different communities will elucidate enablers and barriers to access health information; co-create a framework clarifying what works and does not work for digital health promotion in their communities; and test the framework by co-creating three digital health information programs. Conclusions Privileging the cultural expertise of older Aboriginal and Torres Strait Islander women will provide a novel perspective and vital guidance that end users and developers can trust and rely upon to create and evaluate culturally safe and efficacious digital health promotion programs.
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Brinckley, Makayla-May, Sarah Bourke, Felecia Watkin Lui, and Raymond Lovett. "Knowledge translation in Aboriginal and Torres Strait Islander research contexts in Australia: scoping review protocol." BMJ Open 12, no. 7 (July 2022): e060311. http://dx.doi.org/10.1136/bmjopen-2021-060311.
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IntroductionKnowledge translation (KT) involves bridging the gaps between research knowledge and research application or practice, by sharing this knowledge with knowledge-users. KT is increasingly being used in research with Indigenous peoples globally to address the top-down and inappropriate research approaches commonly used in Indigenous research. Employing KT in Indigenous research in Australia is an emergent field, despite Aboriginal and Torres Strait Islander peoples having conducted KT for generations.There is limited evidence which demonstrates how KT is applied in the Aboriginal/Torres Strait Islander context. Results will benefit researchers by demonstrating ways of appropriately translating research findings to knowledge-users, including Aboriginal and Torres Strait Islander communities, researchers and policy makers. The scoping review will also inform a KT definition, method and practices used in a large-scale, longitudinal cohort study of Aboriginal and Torres Strait Islander adults: the Mayi Kuwayu Study.Methods and analysisUnder guidance of an Aboriginal and Torres Strait Islander governance committee, we will conduct a scoping review on KT in Aboriginal/Torres Strait Islander research. We will follow the scoping review method outlined by the Joanna Briggs Institute. We will search the ANU SuperSearch, and grey and hard to find literature in June 2022. Abstracts and full-text articles will be screened by two independent reviewers. We will include studies that relate to KT in Aboriginal/Torres Strait Islander research, regardless of the research topic. Results will be used to inform the KT definition, method and practices that can be used in Aboriginal/Torres Strait Islander research contexts in Australia.Ethics and disseminationThe Mayi Kuwayu Study has ethics approvals from the Australian Institute of Aboriginal and Torres Strait Islander Studies, 12 Aboriginal/Torres Strait Islander organisations, and the Australian National University Human Research Ethics Committee. Results will be disseminated through peer-review publication and community workshops. Protocol registration is available online (10.17605/OSF.IO/JMFQ3).
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Garvey, Gail, Kate Anderson, Alana Gall, Tamara L. Butler, Joan Cunningham, Lisa J. Whop, Michelle Dickson, et al. "What Matters 2 Adults (WM2Adults): Understanding the Foundations of Aboriginal and Torres Strait Islander Wellbeing." International Journal of Environmental Research and Public Health 18, no. 12 (June 8, 2021): 6193. http://dx.doi.org/10.3390/ijerph18126193.
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Aboriginal and Torres Strait Islander people experience a greater range of health and social disadvantages compared to other Australians. Wellbeing is a culturally-bound construct, and to date, a national evidence base around the components of wellbeing for Aboriginal and Torres Strait Islander people is lacking. Understanding and measurement of wellbeing for this population is critical in achieving health equity. This paper aims to identify and describe the foundations of wellbeing for Aboriginal and Torres Strait Islander adults. This national qualitative study was underpinned by an Indigenist research approach which privileges the voices of Aboriginal and Torres Strait Islander people. Aboriginal and Torres Strait Islander adults were purposively recruited from around Australia between September 2017 and September 2018 to participate in Yarning Circles, led by Aboriginal and Torres Strait Islander researchers. Yarning Circles were audio recorded, transcribed and analyzed. A Collaborative Yarning Methodology was used, which incorporated reflexive thematic analysis to identify and describe the foundations of wellbeing reported by participants. A total of 359 Aboriginal and Torres Strait Islander adults participated. Our analysis revealed five foundations of wellbeing: belonging and connection; holistic health; purpose and control; dignity and respect; and basic needs. These foundations were deeply interwoven by three interconnected aspects of Aboriginal and Torres Strait Islander life: family, community and culture. The findings of this study will substantially aid our efforts to develop a new wellbeing measure for Aboriginal and Torres Strait Islander adults. The iterative Indigenist methods used in this study provide a robust research methodology for conducting large-scale, nationally-relevant qualitative research with Aboriginal and Torres Strait Islander people. Policies and practices that are informed by our results have the potential to address outcomes that are meaningful for Aboriginal and Torres Strait Islander people.
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Gooda, Mick. "The research road less travelled." Microbiology Australia 30, no. 5 (2009): 169. http://dx.doi.org/10.1071/ma09169.
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If there is one thing that should be clear by now to anyone working in the area of Aboriginal and Torres Strait Islander health, it is that biomedical research carried out in isolation from the Aboriginal and Torres Strait Islander community will not significantly improve health outcomes for Australia?s Indigenous peoples.
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Wells, Shavaun, Makayla-May Brinckley, Katherine Ann Thurber, Emily Banks, Lisa J. Whop, Raglan Maddox, and Raymond Lovett. "Kulay Kalingka, a national cohort study of Aboriginal and Torres Strait Islander peoples’ cancer experiences: a study protocol." BMJ Open 13, no. 5 (May 2023): e072045. http://dx.doi.org/10.1136/bmjopen-2023-072045.
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IntroductionAboriginal and Torres Strait Islander peoples are the First Peoples of Australia. Since settler colonisation, Aboriginal and Torres Strait Islander peoples have experienced disparities in health outcomes, including cancer, when compared with non-Indigenous Australians, including higher cancer incidence and mortality rates, and lower participation in cancer screening programmes. Data to monitor and improve outcomes are limited.Aims, method and analysisThe Kulay Kalingka Study will be a national cohort study aiming to understand Aboriginal and Torres Strait Islander people’s beliefs about cancer and experiences with cancer care and treatment, and to improve experiences and outcomes. It will be nested within the Mayi Kuwayu Study, a national community-controlled cohort study of Aboriginal and Torres Strait Islander people (n>11 000), with supplementary in-community recruitment.Mayi Kuwayu Study participants aged ≥18 years who consented to being recontacted, and a diversity of local community members will be invited to participate through completing a questionnaire relevant to their cancer status, aiming to recruit 2800 participants without prior doctor-diagnosed cancer and 700 with a cancer diagnosis.This community-driven data will enable monitoring and reporting of national trends over time and will guide national cancer control research, policy and clinical care, to improve outcomes for Aboriginal and Torres Strait Islander peoples.Ethics and disseminationThe Kulay Kalingka Study has ethics approval from Australian Institute of Aboriginal and Torres Strait Islander Studies (#EO324-20220414 and REC-0121) and the Australian National University (#2022/465). The Kulay Kalingka Study is being developed with Aboriginal and Torres Strait Islander communities, following the Maiam nayri Wingara Indigenous Data Sovereignty Collective principles. Meaningful, accessible and culturally adapted study findings will be disseminated to Aboriginal and Torres Strait Islander communities through activities including community workshops, reports and feedback sheets, and in other ways as determined by the community. We will also return data to participating communities.
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Pearce, Leilani, and Bronwyn Fredericks. "Establishing a Community-Controlled Multi-Institutional Centre for Clinical Research Excellence in Aboriginal and Torres Strait Islander Health." Australian Journal of Indigenous Education 36, S1 (2007): 121–28. http://dx.doi.org/10.1017/s1326011100004798.
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AbstractThe Queensland Aboriginal and Islander Health Council (QAIHC) lead and govern the Centre for Clinical Research Excellence (CCRE), which has a focus on circulatory and associated conditions in urban Aboriginal and Torres Strait Islander communities. The CCRE is a partnership between QAIHC and Monash University, the Queensland University of Technology, the University of Queensland, James Cook University, the National Heart Foundation, and the University of Wollongong. The establishment of the CCRE under the community-controlled model of governance is unique and presents both opportunities and challenges for innovative partnerships between universities and Aboriginal and Torres Strait Islander community organisations. This paper outlines the processes and strategies used to establish a multi-institutional research centre that is governed by the Aboriginal and Torres Strait Islander community-controlled health sector.
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McGuffog, Romany, Jamie Bryant, Kade Booth, Felicity Collis, Alex Brown, Jaquelyne T. Hughes, Catherine Chamberlain, Alexandra McGhie, Breanne Hobden, and Michelle Kennedy. "Exploring the Reported Strengths and Limitations of Aboriginal and Torres Strait Islander Health Research: A Narrative Review of Intervention Studies." International Journal of Environmental Research and Public Health 20, no. 5 (February 23, 2023): 3993. http://dx.doi.org/10.3390/ijerph20053993.
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High quality intervention research is needed to inform evidence-based practice and policy for Aboriginal and Torres Strait Islander communities. We searched for studies published from 2008–2020 in the PubMed database. A narrative review of intervention literature was conducted, where we identified researcher reported strengths and limitations of their research practice. A total of 240 studies met inclusion criteria which were categorised as evaluations, trials, pilot interventions or implementation studies. Reported strengths included community engagement and partnerships; sample qualities; Aboriginal and Torres Strait Islander involvement in research; culturally appropriate and safe research practice; capacity building efforts; providing resources or reducing costs for services and communities; understanding local culture and context; and appropriate timelines for completion. Reported limitations included difficulties achieving the target sample size; inadequate time; insufficient funding and resources; limited capacity of health workers and services; and inadequate community involvement and communication issues. This review highlights that community consultation and leadership coupled with appropriate time and funding, enables Aboriginal and Torres Strait Islander health intervention research to be conducted. These factors can enable effective intervention research, and consequently can help improve health and wellbeing outcomes for Aboriginal and Torres Strait Islander people.
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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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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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Abbott, Penelope, Deborah Askew, Chelsea Watego, Wendy CY Hu, Letitia Campbell, Claudette Tyson, Robyn Walsh, et al. "Randomised clinical trial research within Aboriginal and Torres Strait Islander primary health services: a qualitative study." BMJ Open 11, no. 12 (December 2021): e050839. http://dx.doi.org/10.1136/bmjopen-2021-050839.
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ObjectiveTo better understand how to undertake valuable, ethical and sustainable randomised controlled clinical trial (RCT) research within Aboriginal and Torres Strait Islander primary health services.DesignIn a qualitative approach, we utilised data collected between 2013 and 2020 during the planning and implementation of two RCTs. The data comprised agreed records of research meetings, and semistructured interviews with clinical trial stakeholders. The stakeholders were parents/carers of child participants, and site-based research officers, healthcare providers and community advisory groups. Our thematic analysis was informed by constructivist grounded theory.SettingThe RCTs investigated the management of otitis media in Aboriginal and Torres Strait Islander children, with the first RCT commencing recruitment in 2014 and the second in 2017. They took place in Aboriginal Medical Services (AMSs), large primary health services for Aboriginal and Torres Strait Islander people, based in urban and regional communities across two Australian states and one territory.ResultsWe analysed data from 56 meetings and 67 interviews, generating themes on making research valuable and undertaking ethical and sustainable RCTs. Aboriginal and Torres Strait Islander leadership, and support of AMSs in their service delivery function were critical. The broad benefits of the trials were considered important to sustainability, including workforce development, enhanced ear healthcare and multidirectional research capacity building. Participants emphasised the long-term responsibility of research teams to deliver benefits to AMSs and communities regardless of RCT outcomes, and to focus on relationships, reciprocity and creating positive experiences of research.ConclusionWe identify principles and strategies to assist in undertaking ethical and sustainable RCTs within Aboriginal and Torres Strait Islander primary health services. Maintaining relationships with AMSs and focusing on mutual workforce development and capacity building creates opportunities for long-term benefits so that health research and RCTs work for Aboriginal and Torres Strait Islander peoples, services, communities and researchers.Trial registration numberACTRN12613001068752 (Pre-results); ACTRN12617001652369 (Pre-results).
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Bovill, Michelle, Catherine Chamberlain, Jessica Bennett, Hayley Longbottom, Shanell Bacon, Belinda Field, Paul Hussein, Robert Berwick, Gillian Gould, and Peter O’Mara. "Building an Indigenous-Led Evidence Base for Smoking Cessation Care among Aboriginal and Torres Strait Islander Women during Pregnancy and Beyond: Research Protocol for the Which Way? Project." International Journal of Environmental Research and Public Health 18, no. 3 (February 2, 2021): 1342. http://dx.doi.org/10.3390/ijerph18031342.
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Strong and healthy futures for Aboriginal and Torres Strait Islander people requires engagement in meaningful decision making which is supported by evidence-based approaches. While a significant number of research publications state the research is co-designed, few describe the research process in relation to Indigenous ethical values. Improving the health and wellbeing of Aboriginal and Torres Strait Islander mothers and babies is crucial to the continuation of the oldest living culture in the world. Developing meaningful supports to empower Aboriginal and Torres Strait Islander mothers to quit smoking during pregnancy is paramount to addressing a range of health and wellbeing outcomes. Aboriginal and Torres Strait Islander women have called for non-pharmacological approaches to smoking cessation during pregnancy. We describe a culturally responsive research protocol that has been co-designed and is co-owned with urban and regional Aboriginal communities in New South Wales. The project has been developed in line with the AH&MRC’s (Aboriginal Health & Medical Research Council) updated guidelines for ethical research with Aboriginal and Torres Strait Islander communities. Ethics approvals have been granted by AH&MRC #14541662 University of Newcastle HREC H-2020-0092 and the Local Health District ethics committee 2020/ETH02095. Results will be disseminated through peer reviewed articles, community reports, infographics, and online social media content.
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Lee, Grace Yeeun, Julie Robotham, Yun Ju C. Song, Jo-An Occhipinti, Jakelin Troy, Tanja Hirvonen, Dakota Feirer, et al. "Partnering with Aboriginal and Torres Strait Islander Peoples: An Evaluation Study Protocol to Strengthen a Comprehensive Multi-Scale Evaluation Framework for Participatory Systems Modelling through Indigenous Paradigms and Methodologies." International Journal of Environmental Research and Public Health 20, no. 1 (December 21, 2022): 53. http://dx.doi.org/10.3390/ijerph20010053.
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The social and emotional wellbeing of young Aboriginal and Torres Strait Islander peoples should be supported through an Indigenous-led and community empowering approach. Applying systems thinking via participatory approaches is aligned with Aboriginal and Torres Strait Islander research paradigms and can be an effective method to deliver a decision support tool for mental health systems planning for Indigenous communities. Evaluations are necessary to understand the effectiveness and value of such methods, uncover protective and healing factors of social and emotional wellbeing, as well as to promote Aboriginal and Torres Strait Islander self-determination over allocation of funding and resources. This paper presents modifications to a published evaluation protocol for participatory systems modelling to align with critical Aboriginal and Torres Strait Islander guidelines and recommendations to support the social and emotional wellbeing of young people. This paper also presents a culturally relevant participatory systems modelling evaluation framework. Recognizing the reciprocity, strengths, and expertise Aboriginal and Torres Strait Islander methodologies can offer to broader research and evaluation practices, the amended framework presented in this paper facilitates empowering evaluation practices that should be adopted when working with Aboriginal and Torres Strait Islander peoples as well as when working with other diverse, non-Indigenous communities.
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Miller, Jenna, and Emily Berger. "A review of school trauma-informed practice for Aboriginal and Torres Strait Islander children and youth." Educational and Developmental Psychologist 37, no. 1 (May 11, 2020): 39–46. http://dx.doi.org/10.1017/edp.2020.2.
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AbstractAboriginal and Torres Strait Islander people in Australia are especially vulnerable to traumatic and discriminatory experiences. However, limited literature and research has implemented and evaluated school-based interventions designed to assist Aboriginal and Torres Strait Islander children and young people to overcome their adversity and achieve their potential at school. This article reviews the literature and frameworks on school programs designed for Aboriginal and Torres Strait Islander students who have experienced trauma. The key aspects of trauma-informed programs in schools for Aboriginal and Torres Strait Islander students is explored and recommendations made for further research and greater acknowledgement of cultural and historical issues for Aboriginal and Torres Strait Islander students when implementing culturally informed and trauma-informed practices in schools.
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Lyall, Vivian, Sonya Egert, Natasha Reid, Karen Moritz, and Deborah Askew. "“Our Mothers Have Handed That to Us. Her Mother Has Handed That to Her”: Urban Aboriginal and Torres Strait Islander Yarning about Community Wellbeing, Healthy Pregnancies, and the Prevention of Fetal Alcohol Spectrum Disorder." International Journal of Environmental Research and Public Health 20, no. 9 (April 23, 2023): 5614. http://dx.doi.org/10.3390/ijerph20095614.
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In Australia, fetal alcohol spectrum disorder (FASD) is a largely hidden disability that is currently under-recognized, under-resourced, and under- or misdiagnosed. Unsurprisingly, efforts to prevent FASD in urban Aboriginal and Torres Strait Islander communities are lacking. Further, mainstream approaches are not compatible with diverse and distinct Aboriginal and Torres Strait Islander ways of approaching family, pregnancy, and parenting life. To support the creation of culturally appropriate urban Aboriginal and Torres Strait Islander FASD prevention strategies, we sought to understand local perspectives, experiences, and priorities for supporting healthy and alcohol-free pregnancies. Using a narrative methodology, we undertook research yarns with eight female and two male community participants. Data were analyzed using a narrative, thematic analysis and guided by an Indigenist research practice of reflexive listening. Participant yarns provided important insights into local urban Aboriginal and Torres Strait Islander cultural, social, and structural determinants that support family and child health, alcohol-free pregnancies, and the prevention of FASD. The results provide critical guidance for Indigenizing and decolonizing FASD prevention strategies to support culturally safe, relevant, and strengths-based services. This approach has critical implications for all health and social professionals and can contribute to Aboriginal and Torres Strait Islander peoples’ justice, recovery, and healing from colonization.
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Guenther, John, Samantha Disbray, and Sam Osborne. "Building on ‘Red Dirt’ Perspectives: What Counts as Important for Remote Education?" Australian Journal of Indigenous Education 44, no. 2 (November 3, 2015): 194–206. http://dx.doi.org/10.1017/jie.2015.20.
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The Remote Education Systems (RES) project within the Cooperative Research Centre for Remote Economic Participation (CRC-REP) has, over the last four years, gathered and analysed qualitative data directly from over 230 remote education stakeholders and from more than 700 others through surveys. The research was designed to answer four questions: (1) What is education for in remote Aboriginal and Torres Strait Islander communities?; (2) What defines ‘successful’ educational outcomes from the remote Aboriginal and Torres Strait Islander standpoint?; (3) How does teaching need to change in order to achieve ‘success’ as defined by the Aboriginal and Torres Strait Islander standpoint?; and (4) What would an effective education system in remote Australia look like? Based on this data, the paper reveals how perceptions differ for Aboriginal and Torres Strait Islander people from remote communities compared with people who come from elsewhere. The analysis points to the need for some alternative indicators of ‘success’ to match the aspirations of local people living in remote communities. It also points to the need for school and system responses that resonate with community expectations of education, and to develop narratives of aspiration and success alongside community views.
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Nash, Kai, Kylie Gwynne, Yvonne Dimitropoulos, Mark Fitzpatrick, Hasantha Gunasekera, Luke Halvorsen, Kelvin Kong, et al. "INdigenous Systems and Policies Improved and Reimagined for Ear and hearing care (INSPIRE): a multi-method study protocol." BMJ Open 14, no. 1 (January 2024): e079850. http://dx.doi.org/10.1136/bmjopen-2023-079850.
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IntroductionOtitis media (middle ear disease) severity and chronicity among Aboriginal and Torres Strait Islander people, as well as gaps in socioeconomic outcomes related to hearing loss, indicates a breakdown in the current ear and hearing care system. The ear and hearing care system spans multiple sectors due to long-term impacts of otitis media and hearing loss in health, education and employment, necessitating a multi-disciplinary cross-sectorial approach to ear and hearing care. Public policies shape the current ear and hearing care system and here it is argued that a critical public policy analysis across different sectors is needed, with strong Aboriginal and Torres Strait Islander leadership and guidance. The current study aims to establish consensus-based ear and hearing care policy solutions for Aboriginal and Torres Strait Islander people in Australia.Methods and analysisThis multi-method study will be guided by a Brains Trust with strong Aboriginal and Torres Strait Islander leadership. Public policies in hearing health, social services, and education will be scoped to identify policy gaps, using the World Health Organization framework. Qualitative data will be collected through a culturally specific process of yarning circles to identify policy challenges and/or limitations in enabling accessible ear and hearing care programs/services for Aboriginal and Torres Strait Islander people, using dimensions of Morestin’s public policy appraisal tool as an interview guide for stakeholders. Themes from the yarning circles will be used to inform an expert Delphi process to establish consensus-based policy solutions for optimising the ear and hearing care system for Aboriginal and Torres Strait Islander people.Ethics and disseminationThis study has approval from the Australian Institute of Aboriginal and Torres Strait Islander Studies Ethics Committee. Study findings will be disseminated to community through Brains Trust members and study participants, as well as through publications in peer-reviewed journals and research forum presentations.
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McKay, Fiona H., and Stephanie L. Godrich. "Interventions to address food insecurity among Aboriginal and Torres Strait Islander people: a rapid review." Applied Physiology, Nutrition, and Metabolism 46, no. 12 (December 2021): 1448–58. http://dx.doi.org/10.1139/apnm-2020-1075.
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Food insecurity disproportionately impacts Aboriginal and Torres Strait Islander Australians. This review sought to investigate research and evaluations of programs and interventions implemented to address food insecurity among Aboriginal and Torres Strait Islander communities. A rapid review was conducted to collate the available research from 6 databases. The search was conducted in May 2020. Search constructs related to food insecurity, Aboriginal and Torres Strait Islander people, and Australia. Twenty-five publications were included in this review, 24 reported on an intervention, while 9 were evaluations of an intervention. Interventions included behaviour change projects, including projects that sought to change purchasing and cooking behaviours, school-based education programs, and gardening programs. In general, the studies included in this sample were small and lacked a systematic consideration of the factors that shape the experience of food insecurity among Aboriginal and Torres Strait Islander people specifically. Based on the findings of this review, authors suggest greater consideration to the systematic determinants of food insecurity among Aboriginal and Torres Strait Islander communities to have lasting and sustainable impact on food insecurity. This review has been registered with the international prospective register of systematic reviews (PROSPERO: CRD42020183709). Novelty: Food insecurity among Aboriginal and Torres Strait Islander people poses significant risk to health and wellbeing. Small-scale food security interventions may not provide ongoing and sustained impact. Any intervention to promote food security will need to involve Aboriginal and Torres Strait Islander people and be sustained once external parties have left.
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Jacobsen, Damien. ""Hot Issue" Critical Review: The Aboriginalization of Inquiry: Tourism Research by and for Aboriginal and Torres Strait Islander People." Tourism Culture & Communication 20, no. 1 (March 27, 2020): 51–56. http://dx.doi.org/10.3727/194341419x15554157596236.
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In this "hot issue" article, Jacobsen argues that even after decades of inquiry the level of Tourism Studies disconnect from Aboriginal and Torres Strait Islander people is troubling. He maintains that (relieved of Aboriginal or Torres Strait Islander voices for so long) the received literature on tourism is still dominated by non-indigenous academics who continue to forge a discourse based on "Othering." The purpose of his critical review article is to substantively engage with the disconnect that seemingly plagues inquiry about tourism for Aboriginal and Torres Strait Islander people in Australia. This Jacobsen piece thereby exposes subtle, overarching misgivings observable in the literature underscored by the presupposed "Othering" of Aboriginal and Torres Strait Islander people as "inferior people." This hot issue article therefore moves away from discourses of deficit, inertia, imposed Western-centric theorization, and superficial inquiry towards the Aboriginalization of research-intotourism as inquiry that is emancipative and situated within and emanating from Aboriginal and Torres Strait Islander worldviews. In providing a number of outcomes from a 6-year national research program in remote Australia, Jacobson reflects on their value as the basis for "leadership" and for "future broad directions." To Jacobsen, the Aboriginalization of tourism inquiry must be based on cultural integrity in order to drive the discourse of enabling, cultural ways of business, and appropriate leadership. This hot issue article thus draws attention to the urgent need for Tourism Studies practice to be genuinely committed to the well-being of Aboriginal and Torres Strait Islander people, cultures, country, and knowledge. [Abstract by the Reviews Editor]
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Townsend, Philip. "Mobile Devices for Tertiary Study – Philosophy Meets Pragmatics for Remote Aboriginal and Torres Strait Islander Women." Australian Journal of Indigenous Education 44, no. 2 (September 30, 2015): 139–49. http://dx.doi.org/10.1017/jie.2015.26.
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This paper outlines PhD research which suggests mobile learning fits the cultural philosophies and roles of Aboriginal and Torres Strait Islander women who are preservice teachers in the very remote Australian communities where the research was conducted. The problem which the research addresses is the low completion rates for two community-based Initial Teacher Education (ITE) programs in South Australia (SA) and Queensland (Qld). Over the past decade, the national completion rate of Aboriginal and Torres Strait Islander students in teacher training was 36 per cent, and in these two community-based programs it was less than 15 per cent. This paper identifies the perceptions of the benefits of using mobile devices by Aboriginal and Torres Strait Islander women who are preservice teachers in very remote communities. They report ways in which mobile learning supports their complex roles and provides pragmatic positive outcomes for their tertiary study in remote locations. The paper describes the apparent alignment between mobile learning and cosmology, ontology, epistemology and axiology, which may underpin both the popularity of mobile devices and the affordances of mobile learning.
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Henson, Connie, Felicity Chapman, Gina Shepherd, Bronwyn Carlson, Josephine Y. Chau, Josephine Gwynn, Deb McCowen, Boe Rambaldini, Katrina Ward, and Kylie Gwynne. "Mature aged Aboriginal and Torres Strait Islander adults are using digital health technologies (original research)." DIGITAL HEALTH 8 (January 2022): 205520762211458. http://dx.doi.org/10.1177/20552076221145846.
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Background Aboriginal and Torres Strait Islander people avidly use technology for a variety of purposes. Digital health technologies offer a new way to build on Aboriginal and Torres Strait Islander peoples propensity for early adoption and innovation with technology. Only limited research has focused on mature aged adults in non-urban locations as partners in digital health research and there is no research related to wearables for health tracking for this cohort. Objective This paper provides insights into mature aged Aboriginal and Torres Strait Islander adults interest, use and trust of social media, apps and wearables to gain health information and manage health. Methods This cross-sectional survey study was co-designed and co-implemented with Aboriginal Community Controlled Health Services (ACCHS) in three locations in New South Wales, Australia. The 13-item survey was administered via a semi-structured interview. Results Aboriginal and Torres Strait Islander adults ( n = 78), in regional, rural and remote locations indicated their interest in and use of apps and wearables for health purposes. Mature aged participants, particularly women, used Facebook, ACCHS websites and YouTube for acquiring health-related information which they then shared online and in real life with a diversity of family, friends and colleagues. Conclusions Aboriginal and Torres Strait Islander people are using digital health technologies to acquire and share health information and want to use apps and wearables for health management. Co-designed research enables a greater understanding of the diverse needs for different cohorts and informs culturally responsible design. Broader use of co-design will foster effective user-focused digital health communication and health-management.
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Ryder, Courtney, Jacqueline H. Stephens, Shahid Ullah, Julieann Coombes, Nayia Cominos, Patrick Sharpe, Shane D’Angelo, et al. "Community Engagement and Psychometric Methods in Aboriginal and Torres Strait Islander Patient-Reported Outcome Measures and Surveys—A Scoping Review and Critical Analysis." International Journal of Environmental Research and Public Health 19, no. 16 (August 19, 2022): 10354. http://dx.doi.org/10.3390/ijerph191610354.
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(1) Background: In healthcare settings, patient-reported outcome measures (PROMs) and surveys are accepted, patient-centered measures that provide qualitative information on dimensions of health and wellbeing. The level of psychometric assessment and engagement with end users for their design can vary significantly. This scoping review describes the psychometric and community engagement processes for PROMs and surveys developed for Aboriginal and Torres Strait Islander communities. (2) Methods: The PRISMA ScR guidelines for scoping reviews were followed, aimed at those PROMs and surveys that underwent psychometric assessment. The Aboriginal and Torres Strait Islander Quality Appraisal Tool and a narrative synthesis approach were used. (3) Results: Of 1080 articles, 14 were eligible for review. Most articles focused on a validity assessment of PROMs and surveys, with reliability being less common. Face validity with Aboriginal and Torres Strait Islander communities was reported in most studies, with construct validity through exploratory factor analyses. Methodological design risks were identified in the majority of studies, notably the absence of explicit Indigenous knowledges. Variability existed in the development of PROMs and surveys for Aboriginal and Torres Strait Islander communities. (4) Conclusions: Improvement in inclusion of Indigenous knowledges and research approaches is needed to ensure relevance and appropriate PROM structures. We provide suggestions for research teams to assist in future design.
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Kennedy, Michelle, Amanual Getnet Mersha, Raglan Maddox, Catherine Chamberlain, Sian Maidment, Peter O'Mara, Cathy Segan, et al. "Koori Quit Pack mailout smoking cessation support for Aboriginal and Torres Strait Islander people who smoke: a feasibility study protocol." BMJ Open 12, no. 10 (October 2022): e065316. http://dx.doi.org/10.1136/bmjopen-2022-065316.
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IntroductionSmoking remains the leading preventable cause of death for Aboriginal and Torres Strait Islander people in Australia. Aboriginal and Torres Strait Islander people who smoke are more likely to make a quit attempt than their non-Aboriginal counterparts but less likely to sustain the quit attempt. There is little available evidence specifically for and by Indigenous peoples to inform best practice smoking cessation care.The provision of a free Koori Quit Pack with optional nicotine replacement therapy sent by mail may be a feasible, acceptable and effective way to access stop smoking support for Aboriginal and Torres Strait Islander peoples.Methods and analysisAn Aboriginal-led, multisite non-randomised single-group, pre–post feasibility study across three states in Australia will be conducted. Participants will be recruited via service-targeted social media advertising and during usual care at their Aboriginal Community Controlled Health Services. Through a process of self-referral, Aboriginal and Torres Strait Islander people who smoke daily will complete a survey and receive mailout smoking cessation support. Data will be collected over the phone by an Aboriginal Research Assistant. This pilot study will inform the development of a larger, powered trial.Ethics and disseminationEthics approval has been obtained from the Aboriginal Health & Medical Research Council Ethics Committee of New South Wales (NSW) (#1894/21) and the University of Newcastle (#H-2022-0174). Findings will be reported through peer-reviewed journals and presentations at relevant local, national and international conferences. The findings will be shared with the NSW and Victoria Quitline, Aboriginal Health and Medical Research Council and Victorian Aboriginal Community Controlled Organisation and the National Heart Foundation.Trial registration numberACTRN12622000654752.
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Kairuz, Camila, Kate Hunter, Keziah Bennett-Brook, Courtney Ryder, Andrew J. A. Holland, Tamara Mackean, Madeleine Jacques, et al. "Codesigning informative resources for families of Aboriginal and Torres Strait Islander children who sustained a burn injury: a protocol for a participatory action research study." BMJ Open 13, no. 5 (May 2023): e068530. http://dx.doi.org/10.1136/bmjopen-2022-068530.
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IntroductionParents of children hospitalised in a burn unit experience psychological trauma and later post-traumatic stress. Aboriginal and Torres Strait Islander families whose child has been admitted to a burn unit encounter additional burdens through a culturally unsafe healthcare system. Psychosocial interventions can help reduce anxiety, distress and trauma among children and parents. There remains a lack of interventions or resources that reflect Aboriginal and Torres Strait Islander people’s perspective of health. The objective of this study is to codevelop a culturally appropriate informative resource to assist Aboriginal and Torres Strait Islander parents whose child has been hospitalised in a burn unit.MethodsIn this participatory research study, the development of a culturally safe resource will build on Aboriginal and Torres Strait Islander families’ experiences and voices, complemented by the knowledge and expertise of an Aboriginal Health Worker (AHW) and burn care experts. Data will be collected through recorded yarning sessions with families whose child has been admitted to a burn unit, the AHW and burn care experts. Audiotapes will be transcribed and data will be analysed thematically. Analysis of yarning sessions and resource development will follow a cyclical approach.Ethics and disseminationThis study has been approved by the Aboriginal Health and Medical Research Council (AH&MRC) (1690/20) and the Sydney Children’s Hospitals Network ethics committee (2020/ETH02103). Findings will be reported to all participants and will be disseminated with the broader community, the funding body and health workers at the hospital. Dissemination with the academic community will be through peer-reviewed publications and presentations in relevant conferences.
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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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Garvey, Gail, Kirsten Howard, Darren Garvey, Michelle Dickson, M. Howell, Tamara L. Butler, Yvonne Cadet-James, et al. "What Matters to Aboriginal and Torres Strait Islander Youth (WM2Y): a study protocol to develop a national youth well-being measure." BMJ Open 14, no. 3 (March 2024): e076119. http://dx.doi.org/10.1136/bmjopen-2023-076119.
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IntroductionAdolescents face challenges associated with unprecedented environmental, social and technological changes. The impacts of colonisation, intergenerational trauma, racism and socioeconomic disadvantage intensify these challenges for many Aboriginal and Torres Strait Islander adolescents. However, Aboriginal and Torres Strait Islander adolescents also have cultural, spiritual, family and community capital that fosters their well-being.To date, little research has focused on understanding and appropriately measuring the well-being of Aboriginal and Torres Strait Islander adolescents, a pivotal factor in informing and guiding programmes and interventions that support them. This study will identify the domains of well-being and develop a new preference-based well-being measure based on the values and preferences of Aboriginal and Torres Strait Islander youth (aged 12–17 years).Methods and analysisThis project will be conducted across three research phases: (1) qualitative exploration of well-being using PhotoYarning and yarns with adult mentors to develop candidate items; (2) Think Aloud study, quantitative survey, psychometric analysis, validity testing of candidate items and finalisation of the descriptive system; and (3) scoring development using a quantitative preference-based approach. A multinomial (conditional) logit framework will be used to analyse responses and generate a scoring algorithm for the new preference-based well-being measure.Ethics and disseminationEthics approvals have been obtained from: the Human Research Ethics Committees for each state and territory where data are being collected, the institutions where the research is being conducted and from the relevant Departments of Education. The new well-being measure will have wide applicability and can be used in assessing the effectiveness of programmes and services. This new national measure will ensure benefit and positive impact through the ability to identify and measure the aspects of well-being important to and valued by Aboriginal and Torres Strait Islander youth. Results will be published in international peer-reviewed journals and presented at conferences, and summaries will be provided to the study partner organisations and other relevant organisations.
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Atkinson, Petah, Marilyn Baird, and Karen Adams. "Intersectionality Based Policy Analysis of How Racism is Framed in Medical Education Policies Guiding Aboriginal Health Curriculum." Journal of the Australian Indigenous HealthInfoNet 4, no. 2 (2023): 1–28. http://dx.doi.org/10.14221/aihjournal.v4n2.4.
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Introduction: Racism has a profound impact on health inequities for Aboriginal and Torres Strait Islander people. Australian medical schools are required to include Aboriginal and Torres Strait Islander health curriculum in their medical courses and policies have been developed to support this work. Methods: The research question was: how is racism framed in medical education policies guiding Aboriginal and Torres Strait Islander health curriculum for entry-level medical courses? Applying an Indigenous Research Paradigm and Intersectionality Based Policy Analysis, three key policies were analysed: Australian Medical Council (AMC) Standards for Assessment and Accreditation of Primary Medical programs; Aboriginal and Torres Strait Islander Health Curriculum Framework (ATSIHCF); Committee of Deans of Australasian Medical Schools Indigenous Health Curriculum Framework (CDAMS). Results: The AMC standards did not refer to racism, while CDAMS and ATSICF supported the notion that teaching students about racism would lead to reduced racism or increased anti-racism in healthcare practice. However, both policies’ learning objectives lacked inclusion of critical reflection required to inform responsive action to racism. As the CDAMS and ATSIHCF were not mandated, there is little accountability for medical schools to implement either of the curriculum policies. Conclusion: Realising the goal of medical practitioners who understand racism and practice anti-racism requires a multi-layered approach. This involves evidence-based teaching about racism and anti-racism, Aboriginal and Torres Strait Islander leadership in curriculum development, inclusion of racism and anti-racism in medical school accreditation standards, and development of student critical reflection skills. Importantly, education and health institutions need to value and model anti-racism.
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Harrod, Mary Ellen, Sophia Couzos, James Ward, Mark Saunders, Basil Donovan, Belinda Hammond, Dea Delaney-Thiele, et al. "Gonorrhoea testing and positivity in non-remote Aboriginal Community Controlled Health Services." Sexual Health 14, no. 4 (2017): 320. http://dx.doi.org/10.1071/sh16046.
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Background Gonorrhoea occurs at high levels in young Aboriginal and Torres Strait Islander people living in remote communities, but there are limited data on urban and regional settings. An analysis was undertaken of gonorrhoea testing and positivity at four non-remote Aboriginal Community Controlled Health Services participating in a collaborative research network. Methods: This was a retrospective analysis of clinical encounter data derived from electronic medical records at participating services. Data were extracted using the GRHANITE program for all patients aged 15–54 years from 2009 to 2013. Demographic characteristics and testing and positivity for gonorrhoea were calculated for each year. Results: A total of 2971 patients (2571 Aboriginal and/or Torres Strait Islander) were tested for gonorrhoea during the study period. Among Aboriginal and/or Torres Strait Islander patients, 40 (1.6%) tested positive. Gonorrhoea positivity was associated with clinic location (higher in the regional clinic) and having had a positive chlamydia test. By year, the proportion of patients aged 15–29 years tested for gonorrhoea increased in both men (7.4% in 2009 to 15.9% in 2013) and women (14.8% in 2009 to 25.3% in 2013). Concurrent testing for chlamydia was performed on 86.3% of testing occasions, increasing from 75% in 2009 to 92% in 2013. Factors related to concurrent testing were sex and year of test. Conclusions: The prevalence of gonorrhoea among young Aboriginal and/or Torres Strait Islander people in non-remote settings suggests that the current approach of duplex testing for chlamydia and gonorrhoea simultaneously is justified, particularly for women.
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Kaladharan, Sid, Miranda E. Vidgen, John V. Pearson, Victoria K. Donoghue, David C. Whiteman, Nicola Waddell, and Gregory Pratt. "Ask the people: developing guidelines for genomic research with Aboriginal and Torres Strait Islander peoples." BMJ Global Health 6, no. 11 (November 2021): e007259. http://dx.doi.org/10.1136/bmjgh-2021-007259.
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In health and medical research, guidelines are a set of statements and recommendations, whereby experts or stakeholders assess published literature to generate practical advice for a specific audience. This emphasis on guidelines development with expert consultation and published literature is not practical or inclusive when working in disciplines with minimal data and addressing issues that concern under-represented communities. Here we describe the process used for developing guidelines for the conduct of genomic research projects in partnership with Aboriginal and Torres Strait Islander peoples. A new technology with individual and community level ethical and social implications, and First Nations peoples with cultural and community expectations for research. We developed the guidelines through a consultation process that used participatory action research to engage with various stakeholders during multiple rounds of tailored activities. The end product, ‘Genomic Partnerships: Guidelines for Genomics Research with Aboriginal and Torres Strait Islander peoples of Queensland’ reflects the needs of the end-users and perspectives of the Aboriginal and Torres Strait Islander peoples, communities and organisations that participated. Through this process, we have identified recommendations for developing guidelines with other under-represented communities.
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Wotherspoon, Craig, and Cylie M. Williams. "Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service." Australian Health Review 43, no. 2 (2019): 217. http://dx.doi.org/10.1071/ah17096.
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Objective There continue to be disparate health outcomes for people who are Aboriginal and Torres Strait Islander. The aim of the present study was to measure whether there were any differences in in-patient experiences between Aboriginal and Torres Strait Islander people and those without an Aboriginal or Torres Strait Islander background. Methods Random samples of people were invited to complete a survey following admission at the hospitals at Peninsula Health, Victoria, Australia. This survey was based on the Victorian Patient Satisfaction Monitor. Open-ended questions were also asked to gauge perspectives on how the services could better meet needs of Aboriginal and Torres Strait Islander patients. Results A total of 154 responses was obtained. There were differences between the two groups of participants in the following variables: respect of privacy, representation of culture, assistance with meals and access to a culturally specific worker if needed. This was reflected in thematic analysis, with three main themes identified: (1) interactions with staff; (2) the challenging environment; and (3) not just about me, but my family too. Conclusion There were systemic differences in in-patient experiences. Healthcare services have a responsibility to make systemic changes to improve the health care of all Australians by understanding and reforming how services can be appropriately delivered. What is known about the topic? There is a disparity in health outcomes between Aboriginal and Torres Strait Islander Australians and those who do not identify as Aboriginal and/or Torres Strait Islander. In addition, Aboriginal and Torres Strait Islanders have different interactions within healthcare services. Many rural health services have models that aim to deliver culturally appropriate services, but it is unknown whether the same challenges apply for this group of Australians within metropolitan health services. What does this paper add? This paper identifies the structural supports that are required to help close the gap in health care provision inequality. Many of the key issues identified are not people but system based. Healthcare administrators should consider the factors identified and address these at a whole-of-service level. What are the implications for practitioners? Many practitioners are aware of the challenges of providing culturally appropriate services. This research raises awareness of how traditional healthcare is not a one size fits all and flexibility is required to improve health outcomes.
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Whop, Lisa J., Tamara L. Butler, Julia M. L. Brotherton, Kate Anderson, Joan Cunningham, Allison Tong, and Gail Garvey. "Study protocol: Yarning about HPV Vaccination: a qualitative study of factors influencing HPV vaccination among Aboriginal and Torres Strait Islander adolescents in Australia." BMJ Open 11, no. 8 (August 2021): e047890. http://dx.doi.org/10.1136/bmjopen-2020-047890.
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IntroductionAboriginal and Torres Strait Islander women experience a higher burden of cervical cancer than non-Indigenous women in Australia. Cervical cancer is preventable partly through human papillomavirus (HPV) vaccination; in Australia, this is delivered through the national school-based immunisation programme. While HPV vaccination uptake is high among Australian adolescents, there remain gaps in uptake and completion among Aboriginal and Torres Strait Islander adolescents. This study aims to gain a comprehensive understanding of the barriers and facilitators to HPV vaccination uptake and completion among Aboriginal and Torres Strait Islander adolescents in Queensland, Australia.Methods and analysisThe study will be guided by an Indigenist research approach and an ecological model for health promotion. Yarning, a qualitative Indigenous research method, will be conducted in up to 10 schools. Participants will include Year 7 (12/13 years old) Aboriginal and Torres Strait Islander adolescents; parents/caregivers; and local key informants and immunisation programme partners involved in the delivery of school-based HPV immunisation programme. Participants will be recruited through school representatives and investigator networks using purposive and snowball sampling and samples of convenience. Field notes, HPV vaccination clinic observations and sequential diagramming of the HPV vaccination process will be conducted. Thematic analysis of data will be led by Aboriginal and Torres Strait Islander researchers. Synthesised sequential diagrams of the process of HPV vaccination and qualitative themes summarising key findings will be produced.Ethics and disseminationThe Aboriginal Health and Medical Research Council of New South Wales Ethics Committee (1646/20), the Australian National University Human Research Ethics Committee (HREC, 2020/478), the HREC of the Northern Territory Department of Health and Menzies School of Health Research (19-3484) and the Townsville Hospital and Health Service HREC (HREC/QTHS/73789) have approved the study. Dissemination will occur via conferences and peer-reviewed publications. Further dissemination will be determined in partnership with the Aboriginal and Torres Strait Islander Steering Committee, including Youth Representatives and Consultation Network.
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Porykali, Bobby, Alyse Davies, Cassandra Brooks, Hannah Melville, Margaret Allman-Farinelli, and Julieann Coombes. "Effects of Nutritional Interventions on Cardiovascular Disease Health Outcomes in Aboriginal and Torres Strait Islander Australians: A Scoping Review." Nutrients 13, no. 11 (November 15, 2021): 4084. http://dx.doi.org/10.3390/nu13114084.
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Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.
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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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Cox, Adele, Pat Dudgeon, Christopher Holland, Kerrie Kelly, Clair Scrine, and Roz Walker. "Using participatory action research to prevent suicide in Aboriginal and Torres Strait Islander communities." Australian Journal of Primary Health 20, no. 4 (2014): 345. http://dx.doi.org/10.1071/py14043.
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The National Empowerment Project is an innovative Aboriginal-led community empowerment project that has worked with eight Aboriginal and Torres Strait Islander communities across Australia over the period 2012–13. The aim of the Project was to develop, deliver and evaluate a program to: (1) promote positive social and emotional well-being to increase resilience and reduce the high reported rates of psychological distress and suicide among Aboriginal and Torres Strait Islander people; and (2) empower communities to take action to address the social determinants that contribute to psychological distress, suicide and self-harm. Using a participatory action research approach, the communities were supported to identify the risk factors challenging individuals, families and communities, as well as strategies to strengthen protective factors against these challenges. Data gathered during Stage 1 were used to develop a 12-month program to promote social and emotional well-being and build resilience within each community. A common framework, based on the social and emotional well-being concept, was used to support each community to target community-identified protective factors and strategies to strengthen individual, family and community social and emotional well-being. Strengthening the role of culture is critical to this approach and marks an important difference between Aboriginal and Torres Strait Islander and non-Indigenous mental health promotion and prevention activities, including suicide prevention. It has significant implications for policy makers and service providers and is showing positive impact through the translation of research into practice, for example through the development of a locally run empowerment program that aims to address the social determinants of health and their ongoing negative impact on individuals, families and communities. It also provides a framework in which to develop and strengthen culture, connectedness and foster self-determination, through better-informed policy based on community-level holistic responses and solutions as opposed to an exclusive focus on single-issue deficit approaches.
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Bailey, Benjamin, and Joanne Arciuli. "Indigenous Australians with autism: A scoping review." Autism 24, no. 5 (January 13, 2020): 1031–46. http://dx.doi.org/10.1177/1362361319894829.
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Aboriginal and Torres Strait Islander people with autism spectrum disorder, used interchangeably with the term autism, are among the most marginalised people in Australian society. This review maps out existing and emerging themes in the research involving Indigenous Australians with autism based on a search of the peer-reviewed and grey literature. Our search identified 1457 potentially relevant publications. Of these, 19 publications met our inclusion criteria and focused on autism spectrum disorder diagnosis and prevalence, as well as carer and service provider perspectives on autism, and autism support services for Indigenous Australians. We were able to access 17 publications: 12 journal articles, 3 conference presentations, 1 resource booklet and 1 dissertation. Findings suggest similar prevalence rates for autism among Indigenous and non-Indigenous Australians, although some Aboriginal and Torres Strait Islander people with autism may not receive a diagnosis or may be misdiagnosed. Research on the perspectives of Aboriginal and Torres Strait Islander carers and Indigenous and non-Indigenous service providers is discussed in relation to Indigenous perspectives on autism, as well as barriers and strategies to improve access to diagnosis and support services. Although not the focus of our review, we briefly mention studies of Indigenous people with autism in countries other than Australia. Lay Abstract Aboriginal and Torres Strait Islander people with developmental disabilities such as autism are among the most marginalised people in Australian society. We reviewed research involving Indigenous Australians with autism based on a search of the peer-reviewed and grey literature. Our search identified 1457 potentially relevant publications. Of these, 19 publications were in line with our main areas of inquiry: autism spectrum disorder diagnosis and prevalence, carer and service provider perspectives on autism, and autism support services. These included 12 journal publications, 3 conference presentations, 1 resource booklet and 1 thesis dissertation. Findings suggest similar prevalence rates for autism among Indigenous and non-Indigenous Australians, although some Aboriginal and Torres Strait Islander people with autism may not receive a diagnosis or may be misdiagnosed. We also discuss research on the perspectives of Aboriginal and Torres Strait Islander carers and Indigenous and non-Indigenous service providers, as well as barriers and strategies for improving access to diagnosis and support services.
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Leckning, Bernard, Tanja Hirvonen, Gregory Armstrong, Timothy A. Carey, Mark Westby, Alix Ringbauer, and Gary Robinson. "Developing best practice guidelines for the psychosocial assessment of Aboriginal and Torres Strait Islander people presenting to hospital with self-harm and suicidal thoughts." Australian & New Zealand Journal of Psychiatry 54, no. 9 (May 26, 2020): 874–82. http://dx.doi.org/10.1177/0004867420924082.
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Objective: To develop guidelines for the culturally responsive psychosocial assessment of Aboriginal and Torres Strait Islander people presenting to hospital with self-harm and suicidal thoughts. Method: The Delphi method was used to establish expert consensus. A systematic search and review of relevant research literature, existing guidelines and grey literature was undertaken to develop a 286-item questionnaire. The questionnaire contained best practice statements to guide clinicians undertaking psychosocial assessment of Aboriginal and Torres Strait Islander people presenting to hospital with self-harm and suicidal thoughts. An expert panel comprising 28 individuals with clinical, community-based and lived experience in Aboriginal and Torres Strait Islander mental health and/or suicide prevention were recruited and independently rated the items over three rounds. Statements endorsed as essential or important by 90% or more of the expert panel were then synthesised into recommendations for the best practice guideline document. Results: A total of 226 statements across all relevant areas of clinical practice were endorsed. No statements covering the use of structured assessment tools were endorsed. The endorsed statements informed the development of a set of underlying principles of culturally competent practice and recommendations for processes of effective and appropriate engagement; risks, needs and strengths to be assessed; formulation of psychosocial assessment; and recommendations specific to children and young people. Conclusion: The guidelines are based on recommendations endorsed across a range of expertise to address an important gap in the evidence-base for clinically effective and culturally responsive assessment of self-harm and suicidal thoughts by Aboriginal and Torres Strait Islander people in hospital settings. Further work is needed to develop an implementation strategy and evaluate the recommendations in practice.
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Kurji, Jaameeta, India Shackleford, Daniel McDonough, Brittney Andrews, Felicity Andrews, Sally Cooke, Mahlia Garay, et al. "Generating evidence to inform responsive and effective actions for Aboriginal and Torres Strait Islander adolescent health and well-being: a mix method protocol for evidence integration ‘theRoadmap Project’." BMJ Open 14, no. 7 (July 2024): e085109. http://dx.doi.org/10.1136/bmjopen-2024-085109.
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BackgroundAustralia does not have a national strategy for Aboriginal and Torres Strait Islander adolescent health and as a result, policy and programming actions are fragmented and may not be responsive to needs. Efforts to date have also rarely engaged Aboriginal and Torres Strait Islander people in co-designing solutions. The Roadmap Project aims to work in partnership with young people to define priority areas of health and well-being need and establish the corresponding developmentally appropriate, evidence-based actions.Methods and analysisAll aspects of this project are governed by a group of Aboriginal and Torres Strait Islander young people. Needs, determinants and corresponding responses will be explored with Aboriginal and Torres Strait Islander adolescents (aged 10–24 years) across Australia through an online qualitative survey, interviews and focus group discussions. Parents, service providers and policy makers (stakeholders) will share their perspectives on needs and support required through interviews. Data generated will be co-analysed with the governance group and integrated with population health data, policy frameworks and evidence of effective programmes (established through reviews) to define responsive and effective actions for Aboriginal and Torres Strait Islander adolescent health and well-being.Ethics and disseminationEthical approval for this study has been obtained from the Aboriginal Health Council of South Australia (Ref: 04-21-956), the Aboriginal Health and Medical Research Council of New South Wales (Ref: 1918/22), the Western Australian Aboriginal Health Ethics Committee (Ref: HREC1147), the Northern Territory Health and Menzies School of Health Research (Ref: 2022–4371), ACT Health Human Research Ethics Committee (Ref: 2022.ETH.00133), the St. Vincent’s Hospital, Victoria (Ref: HREC 129/22), University of Tasmania (Ref: 28020), Far North Queensland Human Research Ethics Committee (Ref: HREC/2023/QCH/89911) and Griffith University (Ref: 2023/135). Prospective adolescent participants will provide their own consent for the online survey (aged 13–24 years) and, interviews or focus group discussions (aged 15–24 years); with parental consent and adolescent assent required for younger adolescents (aged 10–14 years) participating in interviews.Study findings (priority needs and evidence-based responses) will be presented at a series of co-design workshops with adolescents and stakeholders from relevant sectors. We will also communicate findings through reports, multimedia clips and peer-reviewed publications as directed by the governance group.
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Fitts, Michelle S., Jennifer Cullen, Gail Kingston, Elaine Wills, and Karen Soldatic. "“I Don’t Think It’s on Anyone’s Radar”: The Workforce and System Barriers to Healthcare for Indigenous Women Following a Traumatic Brain Injury Acquired through Violence in Remote Australia." International Journal of Environmental Research and Public Health 19, no. 22 (November 9, 2022): 14744. http://dx.doi.org/10.3390/ijerph192214744.
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Aboriginal and Torres Strait Islander women experience high rates of traumatic brain injury (TBI) as a result of violence. While healthcare access is critical for women who have experienced a TBI as it can support pre-screening, comprehensive diagnostic assessment, and referral pathways, little is known about the barriers for Aboriginal and Torres Strait Islander women in remote areas to access healthcare. To address this gap, this study focuses on the workforce barriers in one remote region in Australia. Semi-structured interviews and focus groups were conducted with 38 professionals from various sectors including health, crisis accommodation and support, disability, family violence, and legal services. Interviews and focus groups were audiotaped and transcribed verbatim and were analysed using thematic analysis. The results highlighted various workforce barriers that affected pre-screening and diagnostic assessment including limited access to specialist neuropsychology services and stable remote primary healthcare professionals with remote expertise. There were also low levels of TBI training and knowledge among community-based professionals. The addition of pre-screening questions together with professional training on TBI may improve how remote service systems respond to women with potential TBI. Further research to understand the perspectives of Aboriginal and Torres Strait Islander women living with TBI is needed.
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Tracy, Marguerite, Bradley Freeburn, Kylie Lee, Julie Woods, and Kate Conigrave. "Review of alcohol and drug treatment for Aboriginal and Torres Strait Islander peoples." Journal of the Australian Indigenous HealthInfoNet 4, no. 1 (2023): 1–32. http://dx.doi.org/10.14221/aihjournal.v4n1.1.
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This review provides an overview of treatments for problem alcohol and other drug (AOD) use for Aboriginal and Torres Strait Islander people. It includes information on the available research and discusses core principles for providing treatment. The review outlines how effective mainstream treatment approaches can be adapted to be more suitable for Aboriginal and Torres Strait Islander ways of being or worldview. It also highlights that services, such as those offered by Aboriginal community controlled health organisations are in a unique position to offer culturally secure treatment approaches. The barriers to accessing treatment are discussed as well as recommendations for future strategic directions in service delivery such as collaboration and two-way learning. This review is part of a suite of knowledge exchange products that includes a summary, video, and factsheet.
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Gwynn, Josephine, Kyra Sim, Tania Searle, Alistair Senior, Amanda Lee, and Julie Brimblecombe. "Effect of nutrition interventions on diet-related and health outcomes of Aboriginal and Torres Strait Islander Australians: a systematic review." BMJ Open 9, no. 4 (April 2019): e025291. http://dx.doi.org/10.1136/bmjopen-2018-025291.
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ObjectiveTo review the literature on nutrition interventions and identify which work to improve diet-related and health outcomes in Australian Aboriginal and Torres Strait Islander people.Study designSystematic review of peer-reviewed literature.Data sourcesMEDLINE, PubMed, Embase, Science Direct, CINAHL, Informit, PsychInfo and Cochrane Library, Australian Indigenous Health InfoNet.Study selectionPeer-reviewed article describing an original study; published in English prior to December 2017; inclusion of one or more of the following outcome measures: nutritional status, food/dietary/nutrient intake, diet-related biomedical markers, anthropometric or health measures; and conducted with Australian Aboriginal and Torres Strait Islander people.Data extraction and synthesisTwo independent reviewers extracted data and applied the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project. A purpose designed tool assessed community engagement in research, and a framework was applied to interventions to report a score based on numbers of settings and strategies. Heterogeneity of studies precluded a meta-analysis. The effect size of health outcome results were estimated and presented as forest plots.ResultsThirty-five articles (26 studies) met inclusion criteria; two rated moderate in quality; 12 described cohort designs; 18 described interventions in remote/very remote communities; none focused solely on urban communities; and 11 reported moderate or strong community engagement. Six intervention types were identified. Statistically significant improvements were reported in 14 studies of which eight reported improvements in biochemical/haematological markers and either anthropometric and/or diet-related outcomes.ConclusionsStore-based intervention with community health promotion in very remote communities, fiscal strategies and nutrition education and promotion programmes show promise. Future dietary intervention studies must be rigorously evaluated, provide intervention implementation details explore scale up of programmes, include urban communities and consider a multisetting and strategy approach. Strong Aboriginal and Torres Strait Islander community engagement is essential for effective nutrition intervention research and evaluation.PROSPERO registration numberCRD42015029551.
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Butler, Danielle, Anton Clifford-Motopi, Saira Mathew, Carmel Nelson, Renee Brown, Karen Gardner, Lyle Turner, et al. "Study protocol: primary healthcare transformation through patient-centred medical homes—improving access, relational care and outcomes in an urban Aboriginal and Torres Strait Islander population, a mixed methods prospective cohort study." BMJ Open 12, no. 9 (September 2022): e061037. http://dx.doi.org/10.1136/bmjopen-2022-061037.
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IntroductionFor over 40 years, Aboriginal and Torres Strait Islander Community-Controlled Health Services (ACCHS) in Australia have led strategic responses to address the specific needs of Aboriginal and Torres Strait Islander populations. Globally, there has been rapid growth in urban Indigenous populations requiring an adaptive primary healthcare response. Patient-centred medical homes (PCMH) are an evidenced-based model of primary healthcare suited to this challenge, underpinned by principles aligned with the ACCHS sector—relational care responsive to patient identified healthcare priorities. Evidence is lacking on the implementation and effectiveness of the PCMH model of care governed by, and delivered for, Aboriginal and Torres Strait Islander populations in large urban settings.Method and analysisOur multiphased mixed-methods prospective cohort study will compare standard care provided by a network of ACCHS to an adapted PCMH model of care. Phase 1 using qualitative interviews with staff and patients and quantitative analysis of routine primary care health record data will examine the implementation, feasibility and acceptability of the PCMH. Phase 2 using linked survey, primary care and hospitalisation data will examine the impact of our adapted PCMH on access to care, relational and quality of care, health and wellbeing outcomes and economic costs. Phase 3 will synthesise evidence on mechanisms for change and discuss their implications for sustainability and transferability of PCMHs to the broader primary healthcare systemEthics and disseminationThis study has received approval from the University of Queensland Human Research Ethics Committee (2021/HE00529). This research represents an Aboriginal led and governed partnership in response to identified community priorities. The findings will contribute new knowledge on how key mechanisms underpinning the success and implementation of the model can be introduced into policy and practice. Study findings will be disseminated to service providers, researchers, policymakers and, most importantly, the communities themselves.
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Farnbach, Sara, John Evans, Anne-Marie Eades, Graham Gee, Jamie Fernando, Belinda Hammond, Matty Simms, Karrina DeMasi, and Maree Hackett. "Process evaluation of a primary healthcare validation study of a culturally adapted depression screening tool for use by Aboriginal and Torres Strait Islander people: study protocol." BMJ Open 7, no. 11 (November 2017): e017612. http://dx.doi.org/10.1136/bmjopen-2017-017612.
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IntroductionProcess evaluations are conducted alongside research projects to identify the context, impact and consequences of research, determine whether it was conducted per protocol and to understand how, why and for whom an intervention is effective. We present a process evaluation protocol for the Getting it Right research project, which aims to determine validity of a culturally adapted depression screening tool for use by Aboriginal and Torres Strait Islander people. In this process evaluation, we aim to: (1) explore the context, impact and consequences of conducting Getting It Right, (2) explore primary healthcare staff and community representatives’ experiences with the research project, (3) determine if it was conducted per protocol and (4) explore experiences with the depression screening tool, including perceptions about how it could be implemented into practice (if found to be valid). We also describe the partnerships established to conduct this process evaluation and how the nationalValues and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Researchis met.Methods and analysisRealist and grounded theory approaches are used. Qualitative data include semistructured interviews with primary healthcare staff and community representatives involved with Getting it Right. Iterative data collection and analysis will inform a coding framework. Interviews will continue until saturation of themes is reached, or all participants are considered. Data will be triangulated against administrative data and patient feedback. An Aboriginal and Torres Strait Islander Advisory Group guides this research. Researchers will be blinded from validation data outcomes for as long as is feasible.Ethics and disseminationThe University of Sydney Human Research Ethics Committee, Aboriginal Health and Medical Research Council of New South Wales and six state ethics committees have approved this research. Findings will be submitted to academic journals and presented at conferences.Trial registration numberACTRN12614000705684.
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Baird, Mercy. "Perspectives of my lived experiences for addressing suicides among aboriginal communities in the North Queensland tropics." AlterNative: An International Journal of Indigenous Peoples 16, no. 3 (September 2020): 211–19. http://dx.doi.org/10.1177/1177180120952895.
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This article contextualises my perspectives of Indigenous knowledge within a cultural cosmology, used to address the suicide epidemic in an Indigenous Community in the Far North Queensland Tropics of Australia. I use my personal narrative from the philosophical standpoint theory of an Indigenous female with first-hand experience of living under the residues of the Queensland Government Act (1897). Through the lens of a social constructivist worldview and theoretical underpinnings of Indigenist research, I give honour to Indigenous knowledge, cultural values and privilege the voices of local people. As a PhD researcher at James Cook University, I apply to my research, “Healing after experiencing the suicide of a young person—Aboriginal and Torres Strait Islander perspectives informed by Indigenous Knowledges” with three Aboriginal and Torres Strait Islander Communities. This research also aligns itself to the JCU Strategic Intent, Peoples and Society in the Tropics.
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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.
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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.
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Flemington, Tara, Gina La Hera-Fuentes, Michelle Bovill, Allison Hart, Jessica Bennett, Nicole M. Ryan, and Gillian Sandra Gould. "Smoking Cessation Messages for Pregnant Aboriginal and Torres Strait Islander Women: A Rapid Review of Peer-Reviewed Literature and Assessment of Research Translation of Media Content." International Journal of Environmental Research and Public Health 18, no. 17 (September 4, 2021): 9341. http://dx.doi.org/10.3390/ijerph18179341.
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This review summarized literature about knowledge, attitudes, and beliefs of Aboriginal and Torres Strait Islander women from Australia who smoke during pregnancy, then examined the extent that existing health promotion materials and media messages aligned with evidence on smoking cessation for pregnant Aboriginal and Torres Strait Islander women. Knowledge, attitudes, and beliefs of pregnant Aboriginal women who smoke tobacco were identified in the literature. Health promotion campaigns were retrieved from a grey literature search with keywords and social and professional networks. Key themes from peer-reviewed papers were compared against the content of health promotion campaigns using the Aboriginal Social and Emotional Wellbeing Model, the Behavior Change Wheel and thematic analysis. Eleven empirical studies and 17 campaigns were included. Empirical studies highlighted women sought holistic care that incorporated nicotine replacement therapy, engaged with their family and community and the potential for education about smoking cessation to empower a woman. Health promotion campaigns had a strong focus on ‘engagement with family and community’, ‘knowledge of risks of smoking,’ ‘giving up vs cutting down’ and ‘culture in language and arts’. There were similarities and variances in the key themes in the research evidence and promotion materials. Topics highly aligned included risks from smoking and quitting related issues.
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Hornby-Turner, Yvonne C., Sarah G. Russell, Rachel Quigley, Veronica Matthews, Sarah Larkins, Noel Hayman, Prabha Lakhan, et al. "Safeguarding against Dementia in Aboriginal and Torres Strait Islander Communities through the Optimisation of Primary Health Care: A Project Protocol." Methods and Protocols 6, no. 5 (October 19, 2023): 103. http://dx.doi.org/10.3390/mps6050103.
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This protocol describes the methodology and methods for a collaborative project with eight Aboriginal and Torres Strait Islander primary health care (PHC) organisations, across three Australian states and one territory, to increase clinical service performance and access to preventive health and health promotion services for preventing, identifying, treating, and managing dementia risk in Aboriginal and Torres Strait Islander communities. Aboriginal participatory action research (APAR) methodology will be the framework for this project, incorporating continuous quality improvement (CQI), informed by research yarning with stakeholder groups, comprising community members and PHC staff and service providers and data collected from the auditing of client health records and the mapping of existing clinical processes and health services at each partnering PHC organisation. The qualitative and quantitative data will be summarised and discussed with stakeholder groups. Priorities will be identified and broken down into tangible PHC organisation deliverable strategies and programs, which will be co-developed with stakeholder groups and implemented cyclically over 24 months using the Plan, Do, Study, Act model of change. Key project outcome measures include increased clinical service performance and availability of preventive health and health promotion services for safeguarding against dementia. Project implementation will be evaluated for quality and transparency from an Indigenous perspective using an appropriate appraisal tool. The project processes, impact, and sustainability will be evaluated using the RE-AIM framework. A dementia safeguarding framework and accompanying tool kit will be developed from this work to support Aboriginal and Torres Strait Islander PHC organisations to identify, implement, and evaluate dementia safeguarding practice and service improvements on a broader scale.
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Gould (Judean), Gillian Sandra, Ratika Kumar, Nicole M. Ryan, Leah Stevenson, Christopher Oldmeadow, Gina La Hera Fuentes, Simon Deeming, et al. "Protocol for iSISTAQUIT: Implementation phase of the supporting indigenous smokers to assist quitting project." PLOS ONE 17, no. 11 (November 9, 2022): e0274139. http://dx.doi.org/10.1371/journal.pone.0274139.
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Introduction About 44% of Aboriginal and/or Torres Strait Islander women smoke during pregnancy compared to 12% of their general population counterparts. Evidence-based quit smoking advice received from health care professionals (HCPs) can increase smoking cessation rates. However, HCPs lack culturally appropriate smoking cessation training, which is a major barrier to provision of smoking cessation care for this population. Methods and analysis iSISTAQUIT is a multicentre, single arm study aiming to implement and evaluate the evidence-based, culturally competent iSISTAQUIT smoking cessation training among health practitioners who provide support and assistance to pregnant, Aboriginal and Torres Strait Islander women in Australia. This project will implement the iSISTAQUIT intervention in Aboriginal Medical Services and Mainstream Health Services. The proposed sample size is 10 of each of these services (total N = 20), however if the demand is higher, we will aim to accommodate up to 30 services for the training. Participating sites and their HCPs will have the option to choose one of the two iSISTAQUIT packages available: a) Evaluation- research package b) Training package (with or without continued professional development points). Training will be provided via an online eLearning platform that includes videos, text, interactive elements and a treatment manual. A social media campaign will be conducted from December 2021 to September 2022 to raise brand and issue awareness about smoking cessation for Aboriginal and Torres Strait Islander women in pregnancy. This national campaign will consist of systematic advertising and promotion of iSISTAQUIT and video messages through various social media platforms. Analysis We will use the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation and Maintenance) to plan, evaluate and report the intervention impact of iSISTAQUIT. Effectiveness of social media campaign will be assessed via social media metrics, cross-sectional surveys, and interviews. Discussion This innovative research, using a multi-component intervention, aims to practically apply and integrate a highly translatable smoking cessation intervention in real-world primary care settings in Aboriginal Medical Services and Mainstream services. The research benefits Aboriginal women, babies and their family and community members through improved support for smoking cessation during pregnancy. The intervention is based on accepted Australian and international smoking cessation guidelines, developed and delivered in a culturally appropriate approach for Aboriginal communities.
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Boughton, Bob. "Popular EducationforAdult LiteracyandHealth DevelopmentinIndigenous Australia." Australian Journal of Indigenous Education 38, no. 1 (January 2009): 103–9. http://dx.doi.org/10.1375/s1326011100000648.
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AbstractThe focus of this paper is adult literacy, and the impact this has on Aboriginal and Torres Strait Islander individual and community health. It directs attention to those Aboriginal and Torres Strait Islander young people and adults who have not benefited from the formal school education system, and who, as a consequence, have very low levels of basic English language literacy. Analysing data from a range of sources, I suggest that these people comprise as much as 35% of the Aboriginal and Torres Strait Islander adult population nationally, and a much bigger proportion in some communities and regions. Moreover, they are key to improving overall health outcomes in the population as a whole, because they are among the people most at risk. Drawing on research in countries of the global South over recent decades, the paper then suggests that one of the most effective ways to improve health outcomes and foster health development is through a popular mass adult literacy campaign. Popular education is not formal education, of the kind provided by schools, TAFEs and universities. It is “non-formal” education, provided on a mass scale, to people in marginalised and disadvantaged communities, as part of wider social and political movements for equality. The paper concludes that this is the most appropriate form of education to deal with the massive social and economic inequality at the heart of the social determinants of Indigenous health.
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Mackinlay, Elizabeth, Kristy Thatcher, and Camille Seldon. "Understanding Social and Legal Justice Issues for Aboriginal Women within the Context of an Indigenous Australian Studies Classroom: a Problem-based Learning Approach." Australian Journal of Indigenous Education 33 (2004): 23–30. http://dx.doi.org/10.1017/s1326011100600832.
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AbstractProblem-based learning (PBL) is a pedagogical approach in which students encounter a problem and systematically set about finding ways to understand the problem through dialogue and research. PBL is an active process where students take responsibility for their learning by asking their own questions about the problem and in this paper we explore the potential of PBL as a “location of possibility” (hooks, 1994, p. 207) for an engaged, dialogic, reflective and critical classroom. Our discussion centres on a course called ABTS2010 Aboriginal Women, taught by the Aboriginal and Torres Strait Islander Studies Unit at the University of Queensland where PBL is used frequently, and a specific PBL package entitled Kina v R aimed at exploring social and legal justice issues for Indigenous Australian women. From both a historical and contemporary perspective, we consider the types of understandings made possible about justice for Aboriginal and Torres Strait Islander women for students in the course through the use of a PBL approach.