Journal articles: 'Aboriginal and Torres Strait Islander public health and wellbeing'

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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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Garvey, Gail, Kate Anderson, Alana Gall, Tamara L. Butler, Lisa J. Whop, Brian Arley, Joan Cunningham, et al. "The Fabric of Aboriginal and Torres Strait Islander Wellbeing: A Conceptual Model." International Journal of Environmental Research and Public Health 18, no. 15 (July 21, 2021): 7745. http://dx.doi.org/10.3390/ijerph18157745.

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Wellbeing is culturally bound and is shaped by many aspects of life, including experiences, beliefs and values. As such, in order to accurately measure wellbeing for a specific cultural group, it is necessary to understand the experiences, beliefs and values that influence the conception and experience of wellbeing of that group. This paper presents a conceptual model of wellbeing for Aboriginal and Torres Strait Islander people, which was developed from a large national qualitative study that explored the views of 359 Aboriginal and Torres Strait Islander adults. An Aboriginal- and Torres Strait Islander-led research team used an Indigenist research approach to iteratively develop this conceptual model, called the Fabric of Aboriginal and Torres Strait Islander Wellbeing model, which takes inspiration from Aboriginal and Torres Strait Islander weaving traditions whereby individual strands are twined to create fabrics that are both beautiful and strong. This reflects our findings that the parts of life that are most important to wellbeing for many Aboriginal and Torres Strait Islander people are interwoven with their families, communities and culture.

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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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Kennedy, Michelle, Tess Bright, Simon Graham, Christina Heris, Shannon K. Bennetts, Renee Fiolet, Elise Davis, et al. "“You Can’t Replace That Feeling of Connection to Culture and Country”: Aboriginal and Torres Strait Islander Parents’ Experiences of the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 19, no. 24 (December 13, 2022): 16724. http://dx.doi.org/10.3390/ijerph192416724.

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This Aboriginal-led study explores Aboriginal and Torres Strait Islander parents’ experiences of COVID-19. 110 Aboriginal and Torres Strait Islander parents were interviewed between October 2020 and March 2022. Participants were recruited through community networks and partner health services in South Australia, Victoria, and Northern Territory, Australia. Participants were predominantly female (89%) and based in Victoria (47%) or South Australia (45%). Inductive thematic analysis identified three themes: (1) Changes to daily living; (2) Impact on social and emotional wellbeing; and (3) Disconnection from family, community, and culture. COVID-19 impacted Aboriginal and Torres Strait Islander families. Disruption to cultural practice, and disconnection from country, family, and community was detrimental to wellbeing. These impacts aggravated pre-existing inequalities and may continue to have greater impact on Aboriginal and Torres Strait Islander parents and communities due to intergenerational trauma, stemming from colonisation, violence and dispossession and ongoing systemic racism. We advocate for the development of a framework that ensures an equitable approach to future public health responses for Aboriginal and Torres Strait Islander people.

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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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Dudgeon, Patricia, Jemma R. Collova, Kate Derry, and Stewart Sutherland. "Lessons Learned during a Rapidly Evolving COVID-19 Pandemic: Aboriginal and Torres Strait Islander-Led Mental Health and Wellbeing Responses Are Key." International Journal of Environmental Research and Public Health 20, no. 3 (January 25, 2023): 2173. http://dx.doi.org/10.3390/ijerph20032173.

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As the world journeys towards the endemic phase that follows a pandemic, public health authorities are reviewing the efficacy of COVID-19 pandemic responses. The responses by Aboriginal and Torres Strait Islander communities in Australia have been heralded across the globe as an exemplary demonstration of how self-determination can achieve optimal health outcomes for Indigenous peoples. Despite this success, the impacts of pandemic stressors and public health responses on immediate and long-term mental health and wellbeing require examination. In December 2021, Aboriginal and Torres Strait Islander mental health and wellbeing leaders and allies (N = 50) attended a virtual roundtable to determine the key issues facing Aboriginal and Torres Strait Islander peoples and communities, and the actions required to address these issues. Roundtable attendees critically reviewed how the rapidly evolving pandemic context has impacted Aboriginal and Torres Strait Islander mental health and social and emotional wellbeing (SEWB). This paper presents an overview of this national collaborative consultation process, and a summary of the key issues and actions identified. These results build on evidence from other roundtables held in Australia during 2020, and the emerging consensus across the globe that Indigenous self-determination remains essential to Indigenous SEWB, especially during and following a pandemic.

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Graham, Simon, Ilias Kamitsis, Michelle Kennedy, Christina Heris, Tess Bright, Shannon K. Bennetts, Kimberley A. Jones, et al. "A Culturally Responsive Trauma-Informed Public Health Emergency Framework for Aboriginal and Torres Strait Islander Communities in Australia, Developed during COVID-19." International Journal of Environmental Research and Public Health 19, no. 23 (November 24, 2022): 15626. http://dx.doi.org/10.3390/ijerph192315626.

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The Coronavirus Disease 2019 (COVID-19) pandemic impacted peoples’ livelihoods and mental wellbeing. Aboriginal and Torres Strait Islander peoples in Australia continue to experience intergenerational trauma associated with colonization and may experience trauma-related distress in response to government responses to public health emergencies. We aimed to develop a culturally responsive trauma-informed public health emergency response framework for Aboriginal and Torres Strait Islander peoples. This Aboriginal and Torres Strait Islander-led study involved: (i) a review of trauma-informed public health emergency responses to develop a draft framework (ii) interviews with 110 Aboriginal and Torres Strait Islander parents about how COVID-19 impacted their lives, and (iii) a workshop with 36 stakeholders about pandemic experiences using framework analysis to refine a culturally responsive trauma-informed framework. The framework included: an overarching philosophy (cultural humility, safety and responsiveness); key enablers (local leadership and Eldership); supporting strategies (provision of basic needs and resources, well-functioning social systems, human rights, dignity, choice, justice and ethics, mutuality and collective responsibility, and strengthening of existing systems); interdependent core concepts (safety, transparency, and empowerment, holistic support, connectedness and collaboration, and compassion, protection and caring); and central goals (a sense of security, resilience, wellbeing, self- and collective-efficacy, hope, trust, resilience, and healing from grief and loss).

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Bell, Lorraine, Kate Anderson, Afaf Girgis, Samar Aoun, Joan Cunningham, Claire E. Wakefield, Shaouli Shahid, et al. "“We Have to Be Strong Ourselves”: Exploring the Support Needs of Informal Carers of Aboriginal and Torres Strait Islander People with Cancer." International Journal of Environmental Research and Public Health 18, no. 14 (July 7, 2021): 7281. http://dx.doi.org/10.3390/ijerph18147281.

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Informal carers provide an important role in supporting people with cancer. Aboriginal and Torres Strait Islander peoples experience higher cancer mortality than other Australians. To date, very little is known about the support needs of carers of Aboriginal and Torres Strait Islander adults with cancer. This article explored these needs through a qualitative study. Twenty-two semi-structured qualitative interviews and one focus group were conducted with carers of Aboriginal and Torres Strait Islander adults with cancer (n = 12) and Aboriginal and Torres Strait Islander cancer survivors (n = 15) from Queensland, Australia. Half of the carers interviewed were Aboriginal or Torres Strait Islander Australians. Interviews were transcribed, coded and thematically analysed following an interpretive phenomenological approach. Thematic analysis of carer and survivor interviews revealed four key themes relating to carers’ needs: managing multiple responsibilities; maintaining the carer’s own health and wellbeing; accessing practical support and information; and engaging with the health system. Within these overarching themes, multiple needs were identified including specific needs relevant for carers of Aboriginal and Torres Strait Islander peoples, such as advocating for the patient; accessing Indigenous support services and health workers; and ensuring that the cultural needs of the person are recognised and respected. Identifying the needs of informal carers of Aboriginal and Torres Strait Islander cancer patients will enable greater understanding of the support that carers require and inform the development of strategies to meet these areas of need.

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Bramwell, Leigh, Wendy Foley, and Tanya Shaw. "Putting urban Aboriginal and Torres Strait Islander food insecurity on the agenda." Australian Journal of Primary Health 23, no. 5 (2017): 415. http://dx.doi.org/10.1071/py17073.

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Food insecurity adversely affects diet quality, physical, mental and social wellbeing and the capacity to act on health advice recommended by primary healthcare providers. In this article, an overview of the neglected issue of food insecurity in urban Aboriginal and Torres Strait Islander communities is provided. Policy and action on food security for urban Aboriginal and Torres Strait Islander people is reviewed, and it is argued that for primary health care to better address food insecurity, an evidence base is needed to understand the experiences of individuals and households and how to work effectively to support food insecure clients.

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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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Tsey, Komla, Philemon Chigeza, Carol A. Holden, Jack Bulman, Hilton Gruis, and Mark Wenitong. "Evaluation of the pilot phase of an Aboriginal and Torres Strait Islander Male Health Module." Australian Journal of Primary Health 20, no. 1 (2014): 56. http://dx.doi.org/10.1071/py12033.

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This article evaluates the pilot phase of an Aboriginal and Torres Strait Islander Male Health Module. Although men experience higher levels of illness and die younger than women, educational programs to support health workers utilise a gender-based approach to increase participation of Aboriginal and Torres Strait Islander males in health care are rare and lack appropriate content. Recognising this gap in service provision, and under the guidance of a Reference Group comprising community leaders in Aboriginal and Torres Strait male health, a comprehensive and culturally appropriate Male Health Module has been developed to enhance the capacity of health workers to improve access to services for Aboriginal and Torres Strait Islander males. Methods used were: in-depth interviews with Module developers, pilot workshops for trainers and health workers, questionnaires and focus group discussions with workshop participants, and participant observations. As well as enhancing capacity to facilitate access to health services for men, the Module was deemed relevant because of its potential to promote health worker empowerment and wellbeing. Findings revealed that improving access to services for men required male and female health workers working in partnership. Despite overall enthusiasm for the Module, the findings also revealed deep fear that it would end up ‘collecting dust on shelves’. Strategies to improve the Module quality and accessibility are highlighted.

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Thurber, Katherine, Emily Colonna, Roxanne Jones, Gilbert Gee, Naomi Priest, Rubijayne Cohen, David Williams, Joanne Thandrayen, Tom Calma, and Raymond Lovett. "Prevalence of Everyday Discrimination and Relation with Wellbeing among Aboriginal and Torres Strait Islander Adults in Australia." International Journal of Environmental Research and Public Health 18, no. 12 (June 18, 2021): 6577. http://dx.doi.org/10.3390/ijerph18126577.

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Discrimination is a fundamental determinant of health and health inequities. However, despite the high prevalence of discrimination exposure, there is limited evidence specific to Indigenous populations on the link between discrimination and health. This study employs a validated measure to quantify experiences of everyday discrimination in a national sample of Aboriginal and Torres Strait Islander (Australia’s Indigenous peoples) adults surveyed from 2018 to 2020 (≥16 years, n = 8108). It quantifies Prevalence Ratios (PRs) and 95% Confidence Intervals (CIs) for wellbeing outcomes by level of discrimination exposure, and tests if associations vary by attribution of discrimination to Indigeneity. Of the participants, 41.5% reported no discrimination, 47.5% low, and 11.0% moderate-high. Discrimination was more commonly reported by younger versus older participants, females versus males, and those living in remote versus urban or regional areas. Discrimination was significantly associated in a dose-response manner, with measures of social and emotional wellbeing, culture and identity, health behaviour, and health outcomes. The strength of the association varied across outcomes, from a 10–20% increased prevalence for some outcomes (e.g., disconnection from culture (PR = 1.08; 95% CI: 1.03, 1.14), and high blood pressure (1.20; 1.09, 1.32)), to a five-fold prevalence of alcohol dependence (4.96; 3.64, 6.76), for those with moderate-high versus no discrimination exposure. The association was of consistent strength and direction whether attributed to Indigeneity or not—with three exceptions. Discrimination is associated with a broad range of poor wellbeing outcomes in this large-scale, national, diverse cohort of Aboriginal and Torres Strait Islander adults. These findings support the vast potential to improve Aboriginal and Torres Strait Islander peoples’ wellbeing, and to reduce Indigenous-non-Indigenous inequities, by reducing exposure to discrimination.

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Ring, Ian, and Kalinda Griffiths. "Australian Aboriginal and Torres Strait Islander Health Information: Progress, Pitfalls, and Prospects." International Journal of Environmental Research and Public Health 18, no. 19 (September 29, 2021): 10274. http://dx.doi.org/10.3390/ijerph181910274.

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Despite significant developments in Aboriginal and Torres Strait Islander Health information over the last 25 years, many challenges remain. There are still uncertainties about the accuracy of estimates of the summary measure of life expectancy, and methods to estimate changes in life expectancy over time are unreliable because of changing patterns of identification. Far too little use is made of the wealth of information that is available, and formal systems for systematically using that information are often vestigial to non-existent. Available information has focussed largely on traditional biomedical topics and too little on access to, expenditure on, and availability of services required to improve health outcomes, and on the underpinning issues of social and emotional wellbeing. It is of concern that statistical artefacts may have been misrepresented as indicating real progress in key health indices. Challenges and opportunities for the future include improving the accuracy of estimation of life expectancy, provision of community level data, information on the availability and effectiveness of health services, measurement of the underpinning issues of racism, culture and social and emotional wellbeing (SEWB), enhancing the interoperability of data systems, and capacity building and mechanisms for Indigenous data governance. There is little point in having information unless it is used, and formal mechanisms for making full use of information in a proper policy/planning cycle are urgently required.

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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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Wright, Alyson, Mandy Yap, Roxanne Jones, Alice Richardson, Vanessa Davis, and Raymond Lovett. "Examining the Associations between Indigenous Rangers, Culture and Wellbeing in Australia, 2018–2020." International Journal of Environmental Research and Public Health 18, no. 6 (March 16, 2021): 3053. http://dx.doi.org/10.3390/ijerph18063053.

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The centrality of culture to Indigenous peoples’ health and wellbeing is becoming increasingly acknowledged in government policy. In Australia, the Indigenous Ranger program is a leading example of employment that supports increased cultural participation. In 2017, we demonstrated higher life satisfaction and family wellbeing among Indigenous Rangers compared to non-Rangers in Central Australia. Using an expanded national dataset, this present study aimed to: examine if associations between Ranger status and wellbeing continued to be observed in Central Australia; assess if these associations were observed among non-Central Australian Rangers; and, quantify the effect of mediating variables (Rangers status, cultural factors) on wellbeing outcomes. We analyzed Mayi Kuwayu baseline data (n = 9691 Aboriginal and Torres Strait Islander people) and compared participants who identified as past or currently employed Rangers compared to non-Rangers across two geographic locations (Central Australia, non-Central Australia). Ranger participation was significantly associated with very high life satisfaction and family wellbeing in Central Australia (high life satisfaction PR 1.31, 95% CI 1.09–1.57, and family wellbeing (PR 1.17, 95% CI 1.01–1.36) and non-Central Australia (high life satisfaction PR 1.29, 95% CI 1.06–1.57), family wellbeing (PR 1.37, 95% CI 1.14–1.65). These findings concord with those observed in the 2017 proof-of-concept study. Additionally, we found that Ranger status partially mediated the relationships between existing cultural practices (first language as your Indigenous language and living on your country) and the two wellbeing outcomes. Current cultural practices, spending time on country and speaking your Aboriginal language, also partially mediated the associations between Ranger status and high life satisfaction, and between Ranger status and high family wellbeing. This analysis supports evidence that both Ranger employment and cultural participation are contributors to wellbeing. Ranger work is not only good for land, but it is good for people. As such, determining policies that mutually acknowledge and enhance culture, health and wellbeing will likely have additional benefits for the broader Aboriginal and Torres Strait Islander population.

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Snijder, Mieke, Lexine Stapinski, James Ward, Briana Lees, Cath Chapman, Katrina Champion, Michael Doyle, et al. "Strong and Deadly Futures: Co-Development of a Web-Based Wellbeing and Substance Use Prevention Program for Aboriginal and Torres Strait Islander and Non-Aboriginal Adolescents." International Journal of Environmental Research and Public Health 18, no. 4 (February 23, 2021): 2176. http://dx.doi.org/10.3390/ijerph18042176.

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School-based programs can effectively prevent substance use; however, systematic reviews and consultation with stakeholders identified a need for effective, culturally inclusive programs for Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) youth. This paper describes the development of Strong & Deadly Futures, a six-lesson, curriculum-aligned wellbeing and substance use prevention program that was designed for, and with, the Aboriginal youth. Formative reviews and consultation recommended that the program (i) combine effective components of mainstream prevention with cultural elements, highlighting Aboriginal cultural strengths; (ii) avoid stigma and celebrates the cultural diversity by catering to both Aboriginal and non-Aboriginal students; and (iii) use digital technology to enhance engagement, implementation and scalability. Guided by an Appreciative Inquiry approach, the program was developed in partnership with an Indigenous Creative Design Agency, and four schools in New South Wales and Queensland, Australia. Aboriginal (n = 41) and non-Aboriginal students (n = 36) described their role models, positive aspects of their community and reasons to avoid substance use; these formed the basis of an illustrated story which conveyed the key learning outcomes. Feedback from teachers, students and content experts supported the acceptability of the program, which will be evaluated in a subsequent randomised controlled trial.

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Bovill, Michelle, Catherine Chamberlain, Yael Bar-Zeev, Maree Gruppetta, and Gillian S. Gould. "Ngu-ng-gi-la-nha (to exchange) knowledge. How is Aboriginal and Torres Strait Islander people's empowerment being upheld and reported in smoking cessation interventions during pregnancy: a systematic review." Australian Journal of Primary Health 25, no. 5 (2019): 395. http://dx.doi.org/10.1071/py18186.

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Smoking during pregnancy is a national priority to improve Aboriginal health. Empowerment approaches underpin the priorities set by the government to improve Aboriginal health and wellbeing; however, empowerment is seldom evaluated within interventions for Aboriginal people. Literature was searched to April 2018 and data was extracted using an assessment tool with domains of individual and community empowerment in smoking cessation during pregnancy studies with Aboriginal women. Three interventions were found in published and grey literature. Elements of individual empowerment were embedded in all interventions. Interventions considered barriers for Aboriginal women to quit smoking and areas for capacity building. Interventions used health education resources. There was limited reporting of community empowerment domains. Aboriginal ethics and capacity building was the only criterium addressed by all studies. Interventions are incorporating individual empowerment, but seldom report community empowerment. The development of reporting guidelines or extensions of current guidelines would be beneficial to set a consistently high standard reporting across Aboriginal health interventions, similar to the work conducted to develop the extension of Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity (PRISMA-E) for health equity in systematic review reporting. Reporting empowerment domains would reflect the government priority of empowerment to improve Aboriginal health, as well as enhancing knowledge translation into practice.

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Blewitt, Claire, Melissa Savaglio, Seonad K. Madden, Donna Meechan, Amanda O’Connor, Helen Skouteris, and Briony Hill. "Using Intervention Mapping to Develop a Workplace Digital Health Intervention for Preconception, Pregnant, and Postpartum Women: The Health in Planning, Pregnancy and Postpartum (HiPPP) Portal." International Journal of Environmental Research and Public Health 19, no. 22 (November 16, 2022): 15078. http://dx.doi.org/10.3390/ijerph192215078.

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Digital health interventions that specifically target working women across the preconception, pregnancy and postpartum (PPP) life stages may address the unique barriers to engaging in healthy lifestyle behaviours and self-care during this life phase. This paper describes the development of a workplace digital health intervention to promote healthy lifestyles and wellbeing for PPP women working at a community service organization in Australia. Intervention Mapping is a framework that guides program development, implementation, and evaluation. Steps 1 to 5 of Intervention Mapping methodology (needs assessment through to program implementation) were used, including identification of determinants and change objectives across socioecological levels (i.e., individual, interpersonal, and organisational) and iterative co-design and stakeholder engagement processes. The workplace digital health intervention was successfully developed and implemented as an online portal. Content included key strategies, information, and supports to promote health and wellbeing across PPP, including supporting the return to work in the postpartum period. Examples of resource pages included a parental leave checklist, process flows, Pride resources, and Aboriginal and Torres Strait Islander resources. Findings from a pilot feasibility study indicate the portal was accessible and beneficial for women in PPP life stages. The Intervention Mapping protocol may offer a valuable roadmap for collaborative design of interventions targeting PPP women’s behaviour and organisational work culture. Future work is needed to evaluate whether such interventions lead to improvements in women’s health and wellbeing.

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McCalman, Janya Robyn, Ruth Fagan, Tina McDonald, Semara Jose, Paul Neal, Ilse Blignault, Deborah Askew, and Yvonne Cadet-James. "The Availability, Appropriateness, and Integration of Services to Promote Indigenous Australian Youth Wellbeing and Mental Health: Indigenous Youth and Service Provider Perspectives." International Journal of Environmental Research and Public Health 20, no. 1 (December 26, 2022): 375. http://dx.doi.org/10.3390/ijerph20010375.

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Concerns about the complexity, fragmentation and inefficiency of Australia’s current youth mental health service systems have led policy makers to seek improvements through a shift to community-based solutions. However, there is little evidence of how communities can make this shift. This paper examines the efforts of one Aboriginal and Torres Strait Islander (hereafter, respectfully, Indigenous) community—Yarrabah in north Queensland—to develop strategies for mental health and wellbeing service system improvements for school-aged youth (5–18 years). The research was co-designed with Yarrabah’s community-controlled health service and explores the perceptions of Yarrabah youth and service providers. Iterative grounded theory methods were used to collect and analyse data from 32 youth aged 11–24 years and 24 service providers. Youth were reluctant to seek help, and did so only if they felt a sense of safety, trust, relationality and consistency with providers. Young people’s four suggestions for improvement were access to (1) information and awareness about mental health; (2) youth facilities, spaces and activities; (3) safe and available points of contact; and (4) support for recovery from mental illness. Service providers highlighted an appetite for youth-guided community change and recommended five improvement strategies: (1) listening to youth, (2) linking with community members, (3) providing wellbeing promotion programs, (4) intervening early, and (5) advocating to address the determinants of youth mental health. Overall, both groups realised a disjunct between youth need and service provision, but a willingness to work together for systems change. This study demonstrates the importance of community-driven efforts that harness both youth and service providers’ perspectives, and suggests a need for ongoing dialogue as the basis for co-designing and implementing improvements to wellbeing supports and mental health services for Indigenous youth.

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Gall, Alana, Abbey Diaz, Gail Garvey, Kate Anderson, Daniel Lindsay, and Kirsten Howard. "Self‐reported wellbeing and health‐related quality of life of Aboriginal and Torres Strait Islander people pre and post the first wave of the COVID‐19 2020 pandemic." Australian and New Zealand Journal of Public Health 46, no. 2 (December 23, 2021): 170–76. http://dx.doi.org/10.1111/1753-6405.13199.

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English, Madeleine, Lee Wallace, John Evans, Samantha Diamond, and Cristina M. Caperchione. "The impact of sport and physical activity programs on the mental health and social and emotional wellbeing of young Aboriginal and Torres Strait Islander Australians: A systematic review." Preventive Medicine Reports 25 (February 2022): 101676. http://dx.doi.org/10.1016/j.pmedr.2021.101676.

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Adams, Mick, Kootsy (Justin) Canuto, Neil Drew, and Jesse John Fleay. "Postcolonial Traumatic Stresses among Aboriginal and Torres Strait Islander Australians." ab-Original 3, no. 2 (September 1, 2020): 233–63. http://dx.doi.org/10.5325/aboriginal.3.2.233.

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Abstract The mental health of Aboriginal and Torres Strait Islander males in Australia is often misunderstood, mainly because it has been poorly researched. When analyzing the quality of life of Aboriginal and Torres Strait Islander males, it is crucial to consider the associated factors that have directly and indirectly contributed to their poor health and wellbeing, that is, the effects of colonization, the interruption of cultural practices, displacement of societies, taking away of traditional homelands and forceful removal of children (assimilation and other policies). The displacement of families and tribal groups from their country broke up family groups and caused conflict between the original inhabitants of the lands and dislocated Aboriginal and Torres Strait Islander tribal groups. These dislocated Aboriginal and Torres Strait Islander people were forced to reside on the allocated government institutions where they would be (allegedly) protected. Whilst in the institutions they were made to comply with the authority rules and were forbidden to practice or participate in their traditional rituals or customs or speak their own tribal languages. Additionally, the dispossession from Aboriginal and Torres Strait Islander traditional lands and the destruction of culture and political, economic, and social structures have caused many Aboriginal and Torres Strait Islander people to have a pervading sense of hopelessness for the future. The traditional customs and life cycles of Aboriginal and Torres Strait Islander males were permanently affected by colonization adversely contributing to mental health problems in Aboriginal and Torres Strait Islander communities. In this article we aim to provide a better understanding of the processes impacting on Aboriginal and Torres Strait Islander males' social and emotional wellbeing.

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Thomas, David P., Nadia Lusis, Anke E. Van der Sterren, and Ron Borland. "Electronic Cigarette Use and Understanding Among a National Sample of Australian Aboriginal and Torres Strait Islander Smokers." Nicotine & Tobacco Research 21, no. 10 (July 19, 2018): 1434–40. http://dx.doi.org/10.1093/ntr/nty154.

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Abstract Introduction Adult daily smoking prevalence in the Aboriginal and Torres Strait Islander population is 2.8 times that of other Australians. There is little data on prevalence of electronic cigarette (e-cigarette) use among Aboriginal and Torres Strait Islander peoples. We measured e-cigarette use and beliefs about their harmfulness in national samples of Aboriginal and Torres Strait Islander smokers and of all Australian smokers. Methods The Talking About the Smokes project interviewed a nationally representative quota sample of 1301 Aboriginal and Torres Strait Islander smokers between August 2013 and August 2014. The Australian Wave 9 survey of the long-running International Tobacco Control Project interviewed 1093 smokers between February and May 2013. Estimates for all Australian smokers were standardized to the age and sex distribution of Aboriginal and Torres Strait Islander smokers. Results Fewer Aboriginal and Torres Strait Islander than all Australian smokers had tried an e-cigarette (21% vs. 30%). This was in part because of more Aboriginal and Torres Strait Islander smokers having not heard of e-cigarettes. Fewer Aboriginal and Torres Strait Islander smokers than all Australian smokers agreed that e-cigarettes are less harmful than conventional cigarettes (22% vs. 50%). Conclusions Many Aboriginal and Torres Strait Islander smokers have used e-cigarettes. However, there is considerable misunderstanding about the relative harm of e-cigarettes compared with conventional cigarettes, in part because of the tight regulatory environment in Australia. Implications The study describes e-cigarette use and understanding in national samples of Aboriginal and Torres Strait Islander smokers and of all Australian smokers. Only small studies have reported on e-cigarette use in this high smoking prevalence population. Fewer Aboriginal and Torres Strait Islander smokers than all Australian smokers had tried an e-cigarette and fewer agreed that e-cigarettes are less harmful than conventional cigarettes. Australian governments, health authorities, health professionals, and e-cigarette regulations should provide clearer messages that e-cigarettes are less harmful.

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Salisbury, Christine, and Sue Follent. "Bicultural Stress: An Aboriginal Community Perspective." Australian Journal of Primary Health 2, no. 2 (1996): 78. http://dx.doi.org/10.1071/py96032.

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A survey was designed to assess and to compare the levels of stress being experienced by Aboriginal and Torres Strait Islander and non-Aboriginal respondents. The survey covered a range of areas including demographics, access to transport, drug and alcohol use, use of public services, identification of stressful events in the past 12 months and a self evaluation of stress symptoms. The groups were matched by age, sex and income. The results showed differences between the stressful events and stress symptoms reported by the two groups, with the Aboriginal and Torres Strait Islander group reporting considerably higher levels. There were significant differences in access to transport and use of public health facilities. The barriers to the use of public health services were identified. A major finding was that 69% of the Aboriginal and Torres Strait Islander sample experienced more than one loss through death compared to 5% of the non-Aboriginal sample in the previous 12 months. It was concluded that the Aboriginal and Torres Strait Islander sample experienced more stressful events, had more stress related symptoms and used public mental health services less than the non-Aboriginal sample. The barriers to use of services were a lack of cultural sensitivity and the discomfort experienced by the Aboriginal and Torres Strait Islander sample when accessing services. A partnership with the Aboriginal and Torres Strait Islander community is required to develop a public health service that is acceptable and useful to the Aboriginal and Torres Strait Islander sample.

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Atkinson-Briggs, Sharon, Alicia Jenkins, Christopher Ryan, and Laima Brazionis. "Prevalence of Health-Risk Behaviours Among Indigenous Australians With Diabetes: A Review." Journal of the Australian Indigenous HealthInfoNet 3, no. 4 (2022): 1–30. http://dx.doi.org/10.14221/aihjournal.v3n4.6.

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Aboriginal and Torres Strait Islander Australians are at high risk of Type 2 diabetes and its complications. Optimal lifestyle choices can improve health outcomes. A thematic review of original research publications related to smoking, nutrition, alcohol intake, physical activity and emotional wellness in Aboriginal and Torres Strait Islander Australians with diabetes was performed. Overall, 7118 English-language publications were identified by search engines (PubMed, CINAHL, Scopus, Medline-Web of Science, and Google Scholar) with search terms Indigenous Australians OR Aboriginal and Torres Strait Islanders AND diabetes AND lifestyle OR smoking OR nutrition OR alcohol OR physical activity OR emotional wellbeing and their common synonyms. After review of abstracts and publication reference lists, 36 articles met inclusion criteria and were reviewed. In general, the self-reported health-related behaviours of Aboriginal and Torres Strait Islander Australian adults with diabetes, which is predominantly Type 2 diabetes, was suboptimal. An important clinical challenge in diabetes care is to sustainably reduce smoking, improve nutrition (including alcohol use), increase physical activity, reduce sedentary time, and improve emotional wellbeing, which should lead to reduced rates of diabetes complications. Regular assessments and multi-stakeholder input, including individuals, communities, clinical, health policy, societal and government inputs and partnerships, are desirable to facilitate closing the gap in health between Aboriginal and Torres Strait Islander and non-Indigenous Australians.

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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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Canuto, Kootsy, Stephen G. Harfield, Karla J. Canuto, and Alex Brown. "Aboriginal and Torres Strait Islander men and parenting: a scoping review." Australian Journal of Primary Health 26, no. 1 (2020): 1. http://dx.doi.org/10.1071/py19106.

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Aboriginal and Torres Strait Islander men rarely rate a mention within discussions of parenting unless framed in the negative, or as the cause of dysfunctional family life. Consequently, the roles and responsibilities of Aboriginal and Torres Strait Islander men within parenting have largely been neglected or ignored. This scoping review aimed to identify and describe Aboriginal and Torres Strait Islander parenting programs that focused on male parents. A comprehensive search was conducted of databases, PubMed and Informit ATSIhealth, to identify peer-review publications, while relevant websites were also searched for grey literature. The review identified eight programs that met the inclusion criteria. The review highlights the lack of rigorously researched and published literature on parenting programs that focus on Aboriginal and Torres Strait Islander male parents. The programs all reported positive outcomes and demonstrate that given the opportunity, Aboriginal and Torres Strait Islander male parents are ready and determined to fulfil their roles and responsibilities as parents to the best of their ability for the benefit of their families and communities. The provision of inclusive parenting programs and services will equip Aboriginal and Torres Strait Islander male parents to better support their families during these important times.

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Castles, Simon, Zoe Wainer, and Harindra Jayasekara. "Risk factors for cancer in the Australian Aboriginal and Torres Strait Islander population: a systematic review." Australian Journal of Primary Health 22, no. 3 (2016): 190. http://dx.doi.org/10.1071/py15048.

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Cancer incidence in the Australian Aboriginal and Torres Strait Islander population is higher and survival lower compared with non-Indigenous Australians. A proportion of these cancers are potentially preventable if factors associated with carcinogenesis are known and successfully avoided. We conducted a systematic review of the published literature to examine risk factors for cancer in the Australian Aboriginal and Torres Strait Islander population. Electronic databases Medline, Web of Science and the Australian Aboriginal and Torres Strait Islander Health Bibliographic Index were searched through August 2014 using broad search terms. Studies reporting a measure of association between a risk factor and any cancer site in the Australian Aboriginal and Torres Strait Islander population were eligible for inclusion. Ten studies (1991–2014) were identified, mostly with small sample sizes, showing marked heterogeneity in terms of methods used to assess exposure and capture outcomes, and often using descriptive comparative analyses. Relatively young (as opposed to elderly) and geographically remote Aboriginal and Torres Strait Islanders were found to be at increased risk for selected cancers while most modifiable lifestyle and behavioural risk factors were rarely assessed. Further studies examining associations between potential risk factors and cancer will help define public health policy for cancer prevention in the Australian Aboriginal and Torres Strait Islander population.

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Laccos-Barrett, Keera, Angela Elisabeth Brown, Vicki Saunders, Katherine Lorraine Baldock, and Roianne West. "Are We Teaching Nurses to Be Racist towards Aboriginal and Torres Strait Islander Peoples? A Critical Race Document Analysis of Discrete Aboriginal and Torres Strait Islander Health Courses." International Journal of Environmental Research and Public Health 19, no. 18 (September 12, 2022): 11455. http://dx.doi.org/10.3390/ijerph191811455.

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Background: Racism is responsible for health inequity and the harm perpetrated upon Aboriginal and Torres Strait Islander peoples by white institutions, building on attitudes and beliefs dominated by assumptions of white superiority. The National Aboriginal and Torres Strait Islander Health Curriculum Framework ‘Curriculum Framework’, released in 2014, was introduced to provide a framework for nursing programs and included the introduction of discrete Aboriginal and Torres Strait Islander health courses to draw attention to the relationship between racism health outcomes of Aboriginal and Torres Strait Islander peoples within health care settings. Methods: Using an Indigenist research paradigm with Colonial Critical Race Theory as the methodology and framework, this study presents a document analysis of discrete Aboriginal and Torres Strait Islander health courses taught in undergraduate nursing programs at 31 Australian Universities. Results: This work draws on the collective activism of Aboriginal and Torres Strait Islander nurses in challenging the systemic racism embedded in the Australian nursing curriculum. We demonstrate the utility of the Racial Segregation Audit Tool (RSAT), as an innovative approach to identify and respond to racism embedded in course learning outcomes. Conclusions: This study explores and uncovers how the learning outcomes assert the social construction of race as a tool of oppressive segregation.

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Liddelow-Hunt, Shakara, Ashleigh Lin, James Hector Laurent Hill, Kate Daglas, Braden Hill, Yael Perry, Mirella Wilson, and Bep Uink. "Conceptualising Wellbeing for Australian Aboriginal LGBTQA+ Young People." Youth 3, no. 1 (January 12, 2023): 70–92. http://dx.doi.org/10.3390/youth3010005.

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It is likely that young people who are both Aboriginal and Torres Strait Islander and LGBTQA+ would be at increased risk for poor mental health outcomes due to the layered impacts of discrimination they experience; however, there is very little empirical evidence focused on the mental health and wellbeing of Aboriginal and Torres Strait Islander LGBTQA+ young people. The current study represents a qualitative exploration of wellbeing among Aboriginal LGBTQA+ young people. This study consisted of semi-structured interviews and focus groups with Aboriginal LGBTQA+ young people aged 14–25 years old in the Perth metropolitan area of Western Australia. Thematic analysis identified seven major themes that were significant to participants’ wellbeing: identity, family, community, visibility, services, stigma and navigating.

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Bernardes, Christina M., Stuart Ekberg, Stephen Birch, Renata F. I. Meuter, Andrew Claus, Matthew Bryant, Jermaine Isua, et al. "Clinician Perspectives of Communication with Aboriginal and Torres Strait Islanders Managing Pain: Needs and Preferences." International Journal of Environmental Research and Public Health 19, no. 3 (January 29, 2022): 1572. http://dx.doi.org/10.3390/ijerph19031572.

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Poor communication is an important factor contributing to health disparity. This study sought to investigate clinicians’ perspectives about communicating with Aboriginal and Torres Strait Islander patients with pain. This multi-site and mixed-methods study involved clinicians from three pain management services in Queensland, Australia. Clinicians completed a survey and participated in focus groups. Clinicians rated the importance of communication training, their knowledge, ability, and confidence in communicating with Aboriginal and Torres Strait Islander patients using a 5-point Likert scale. Rating scores were combined into low (scores 1–2); moderate (score 3) and high (scores 4–5). Informed by an interpretive description methodology, thematic analysis of focus group data was used to identify the communication needs and training preferences of clinicians. Overall (N = 64), 88% of clinicians rated the importance of communication training when supporting Aboriginal and Torres Strait Islander patients as “high”. In contrast, far fewer clinicians rated as “high” their knowledge (28%), ability (25%) and confidence (28%) in effectively communicating with Aboriginal and Torres Strait Islander patients. Thematic analysis identified three areas of need: knowledge of Aboriginal and Torres Strait Islander cultures, health beliefs, and understanding cross-cultural cues. Communication skills can be learned and training, in the form of a tailored intervention to support quality engagement with Aboriginal and Torres Strait Islander patients, should combine cultural and communication aspects with biomedical knowledge.

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Spurling, Geoffrey K., Claudette ‘Sissy' Tyson, Deborah Askew, and Jennifer Reath. "Mixed-methods evaluation of screening for hearing loss using the hearScreen™ mobile health application in Aboriginal and Torres Strait Islander children presenting to an urban primary healthcare service." Australian Journal of Primary Health 27, no. 5 (2021): 371. http://dx.doi.org/10.1071/py21059.

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Recommendations for hearing screening for Aboriginal and Torres Strait Islander children aged 4 years have a limited evidence base. Using the hearScreen™ (HearX, Camden, DE, USA) mobile health application as part of a mixed-methods study, the aim of this study was to assess the proportion of 4-year-old Aboriginal and Torres Strait Islander children with hearing difficulties, as well as the feasibility and acceptability of the test itself. Of the 145 4-year-old Aboriginal and Torres Strait Islander children who were regular patients of the service during the recruitment period, 50 were recruited to the present study. Of these 50 children, 42 (84%) passed the hearing screening test, 4 (8%) did not and 4 (8%) were unable to complete the test. Nine caregivers were interviewed. Themes included the priority given to children’s health by caregivers, positivity and trust in the test, preference for having the test conducted in primary care and the importance of an Aboriginal and Torres Strait Islander person providing the screening test. These findings lend support to hearing screening for school-age children in primary care provided by an Aboriginal and Torres Strait Islander healthcare worker using the hearScreen™ test.

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Spurling, Geoffrey, Catrina Felton-Busch, and Sarah Larkins. "Aboriginal and Torres Strait Islander health." Australian Journal of Primary Health 24, no. 5 (2018): i. http://dx.doi.org/10.1071/pyv24n5_ed.

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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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Mersha, Amanual Getnet, Raglan Maddox, Sian Maidment, Kade Booth, Karl Briscoe, Paul Hussein, Hayley Longbottom, Yael Bar-Zeev, and Michelle Kennedy. "“It Needs a Full-Time Dedicated Person to Do This Job in Our Local Communities with Our Aboriginal Health Services”—Aboriginal and Torres Strait Islander Health Workers and Practitioners Perspectives on Supporting Smoking Cessation during Pregnancy." International Journal of Environmental Research and Public Health 20, no. 1 (December 20, 2022): 28. http://dx.doi.org/10.3390/ijerph20010028.

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Background: Aboriginal and Torres Strait Islander women deserve improved smoking cessation support. Aboriginal health workers (AHW) and practitioners (AHP) can be central to the provision of culturally safe smoking cessation care (SCC). The objective of this study is to explore attitudes and the perceived role of AHWs/AHPs toward providing SCC to Aboriginal and Torres Strait Islander pregnant women. Method: A mixed-method study using quantitative and qualitative data was conducted among AHW/AHPs in 2021 across Australia. Descriptive and analytical statistics were used to characterise AHWs’/AHPs’ attitudes towards SCC and to evaluate the factors associated with perceptions of who is best placed to provide SCC. Results: From the total AHW/AHP workforce, 21.2% (223) completed the survey. Less than half (48.4%) believed that AHW/AHP were best placed to provide SCC for pregnant women. The majority believed that group-based supports (82.5%) and cultural support programs (63.7%) were the best strategies to support Aboriginal and Torres Strait Islander pregnant women to quit smoking. Conclusion: This study highlights the need to enhance SCC offered to Aboriginal and Torres Strait Islander pregnant women. A targeted workforce dedicated to smoking cessation should be resourced, including funding, standardised training, and ongoing SCC support tailored to Aboriginal and Torres Strait Islander pregnant women.

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Browne, Jennifer, Deborah Gleeson, Karen Adams, Deanne Minniecon, and Rick Hayes. "Strengthening Aboriginal and Torres Strait Islander health policy: lessons from a case study of food and nutrition." Public Health Nutrition 22, no. 15 (May 22, 2019): 2868–78. http://dx.doi.org/10.1017/s1368980019001198.

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AbstractObjective:To examine key factors influencing the prioritisation of food and nutrition in Aboriginal and Torres Strait Islander health policy during 1996–2015.Design:A qualitative policy analysis case study was undertaken, combining document analysis with thematic analysis of key informant interviews.Setting:Australia.Participants:Key actors involved in Aboriginal and Torres Strait Islander health policy between 1996 and 2015 (n 38).Results:Prioritisation of food and nutrition in policy reduced over time. Several factors which may have impeded the prioritisation of nutrition were identified. These included lack of cohesion among the community of nutritionists, Aboriginal and Torres Strait Islander leaders and civil society actors advocating for nutrition; the absence of an institutional home for nutrition policy; and lack of consensus and a compelling policy narrative about how priority nutrition issues should be addressed. Political factors including ideology, dismantling of public health nutrition governance structures and missing the opportunities presented by ‘policy windows’ were also viewed as barriers to nutrition policy change. Finally, the complexity and multifaceted nature of nutrition as a policy problem and perceived lack of evidence-based solutions may also have constrained its prioritisation in Aboriginal and Torres Strait Islander health policy.Conclusions:Future advocacy should focus on embedding nutrition within holistic approaches to health and building a collective voice through advocacy coalitions with Aboriginal and Torres Strait Islander leadership. Strategic communication and seizing political opportunities may be as important as evidence for raising the priority of Aboriginal and Torres Strait Islander health issues.

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Kum Sing, Selma, Daniel McDonough, and James Charles. "Health Website Evaluation - An Aboriginal and Torres Strait Islander Perspective: Assessing Quality and Cultrability of Health Websites in a Covid-19 Pandemic: A Literature Review." Journal of the Australian Indigenous HealthInfoNet 2, no. 3 (2021): 1–19. http://dx.doi.org/10.14221/aihjournal.v2n3.6.

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Introduction Health Websites have been used to improve the health and wellbeing of people since the internet was widely available to the world’s populations. The development of websites by health practitioners, hospitals, and governments has continued to grow over the past 20 years. Due to the restriction of movement and gatherings for populations globally caused by Covid-19, there has been a reliance on health information being disseminated via health websites. However, there has been little investigation into the appropriateness of health websites for Aboriginal and Torres Strait Islander communities. Aim Review literature on digital resources and evaluate health websites based on functionality, navigation, and usability. Assess the cultrability of the website design from an Aboriginal and Torres Strait Islander perspective and develop some evidence-based principles that can be used when designing and developing health websites for Aboriginal and Torres Strait Islander Peoples. Method The literature review explores essential website evaluation criteria and frameworks for assessing design, functionality, navigation, and usability. In addition, literature search for website evaluations of global Indigenous cultural appropriate design and content. The literature search accessed several databases i.e., Emerald, EBSCOhost, Medline Ovid, CINHAL and Google Scholar. Additional searches using Clinical Knowledge Networks Federation accessed through the Townsville Hospital Health Library. The search produced a total of 534 articles, and 14 were deemed relevant for inclusion. Discussion The thematic analysis identified that Indigenous global presence on the Internet has been extensive, and the most successful examples were developed in collaboration with Indigenous Peoples. A comprehensive evaluation of website content is paramount in validating the appropriateness of communication and engagement with Aboriginal and Torres Strait Islander People. A customer/end user model of evaluation is the recommended type of evaluation for websites intending to target Aboriginal and Torres Strait Islander People. There are significant challenges for Aboriginal and Torres Strait Islander People navigating digital technology and websites, especially families living in rural and remote areas. These difficulties are not being addressed by services or governments to alleviate these barriers. Conclusion Aboriginal and Torres Strait Islander Peoples are actively involved in digital technology and websites, however their experience on the internet has been challenging and disempowering. The evidence provided alluded to negative experiences and constant challenges to have a growing presence in the digital space. The studies showed no evidence of Aboriginal and Torres Strait Islander People’s experience of website design, or development, which demonstrated positive outcomes or future developments in this area. Improving health, health literacy and health services will take a collaborative effort across all areas of health and education. Indigenous knowledges in all its forms must be protected and respected through intellectual property and reciprocity with websites and digital resources.

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Wenitong, Mark. "Aboriginal and Torres Strait Islander male health, wellbeing and leadership." Medical Journal of Australia 185, no. 8 (October 2006): 466–67. http://dx.doi.org/10.5694/j.1326-5377.2006.tb00652.x.

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Poirier, Brianna F., Joanne Hedges, Gustavo Soares, and Lisa M. Jamieson. "Aboriginal Community Controlled Health Services: An Act of Resistance against Australia’s Neoliberal Ideologies." International Journal of Environmental Research and Public Health 19, no. 16 (August 15, 2022): 10058. http://dx.doi.org/10.3390/ijerph191610058.

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The individualistic and colonial foundations of neoliberal socio-political ideologies are embedded throughout Australian health systems, services, and discourses. Not only does neoliberalism undermine Aboriginal and Torres Strait Islander collectivist values by emphasizing personal autonomy, but it has significant implications for Aboriginal and Torres Strait Islander health. Aboriginal Community Controlled Health Services (ACCHS) operate within Community-oriented holistic understandings of well-being that contradict neoliberal values that Western health services operate within. Therefore, this paper aims to explore the role of ACCHS in resisting the pervasive nature of neoliberalism through the prioritization of self-determination for Aboriginal and Torres Strait Islander Peoples. Utilizing a critical evaluative commentary, we reflect on Aboriginal political leadership and advocacy during the 1970s and 1980s and the development of neoliberalism in Australia in the context of ACCHS. Community controlled primary health services across Australia are the only remaining government-funded and Aboriginal-controlled organizations. Not only do ACCHS models resist neoliberal ideologies of reduced public expenditure and dominant individualistic models of care, but they also incontrovertibly strengthen individual and Community health. ACCHS remain the gold standard model by ensuring Aboriginal and Torres Strait Islander rights to the self-determination of health in accordance with the United Nations Declaration of the Rights of Indigenous Peoples.

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Griffiths, Kalinda, Ian Ring, Richard Madden, and Lisa Jackson Pulver. "In the pursuit of equity: COVID-19, data and Aboriginal and Torres Strait Islander people in Australia." Statistical Journal of the IAOS 37, no. 1 (March 22, 2021): 37–45. http://dx.doi.org/10.3233/sji-210785.

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Since March 2020 in Australia, there has been decisive national, and state and territory policy as well as community led action involving Aboriginal and Torres Strait Islander people as information about COVID-19 arose. This has resulted in, what could only be framed as a success story in self-determination. However, there continues to be issues with the quality of data used for the surveillance and reporting of Aboriginal and Torres Strait Islander people during the pandemic. This article discusses some of the important events in pandemic planning regarding Aboriginal and Torres Strait Islander people and how this relates to surveillance and monitoring in the emerging and ongoing threat of COVID-19 within Aboriginal and Torres Strait Islander communities. The authors also identify some of the data considerations required in the future to monitor and address public health.

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Coombes, Julieann, Patricia Cullen, Keziah Bennett-Brook, Marlene Longbottom, Tamara Mackean, Belinda Field, and Vickie Parry. "Culturally Safe and Integrated Primary Health Care: A Case Study of Yerin Eleanor Duncan Aboriginal Health Services’ Holistic Model." Journal of the Australian Indigenous HealthInfoNet 3, no. 1 (2022): 1–9. http://dx.doi.org/10.14221/aihjournal.v3n1.5.

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Objective To understand the importance of culturally safe integrated primary health care for Aboriginal families in the Central Coast of New South Wales, where their social and emotional wellbeing is impacted through a range of health issues related to domestic and family violence. Methods An Indigenous methodology of yarning through conversational semi-structured interviews with seven primary health care workers at Yerin, an Aboriginal Community Controlled Health Service (ACCHS) in New South Wales. Yarning sessions explored factors that enable and/or inhibit the provision of holistic and comprehensive trauma and culturally informed responses to Aboriginal and Torres Strait Islander women who experience violence. Results Five key themes were identified: 1) The importance of integrated primary health to support women and families; 2) Soft entry pathways; 3) Culturally safe care delivered by health workers experienced in trauma informed care; 4) Community partnerships; and 5) Funding sustainable programs that are community led and delivered by Aboriginal and Torres Strait Islander people. Lessons Learned Culturally safe and trauma informed and responsive care that is integrated within primary health care is important in comprehensively meeting the needs of Aboriginal and Torres Strait Islander women who experience domestic and family violence. The provision of soft entry pathways creates rapport and trust through an integrated team approach, highlighting the importance of more holistic service provision focusing on recovery and healing.

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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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Pandeya, Neha A., Philip J. Schluter, Geoffrey K. Spurling, Claudette Tyson, Noel E. Hayman, and Deborah A. Askew. "Factors Associated with Thoughts of Self-Harm or Suicide among Aboriginal and Torres Strait Islander People Presenting to Urban Primary Care: An Analysis of De-Identified Clinical Data." International Journal of Environmental Research and Public Health 19, no. 1 (December 23, 2021): 153. http://dx.doi.org/10.3390/ijerph19010153.

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Suicide amongst Aboriginal and Torres Strait Islander people is a major cause of premature mortality and a significant contributor to the health and life expectancy gap. This study aimed to estimate the prevalence of thoughts of self-harm or suicide in Aboriginal and Torres Strait Islander people attending an urban primary health care service and identify factors associated with these thoughts. Multilevel mixed-effects modified Poisson regression models were employed to analyse three years of data gathered during the annual Aboriginal and Torres Strait Islander health assessments. At their first health assessment, 11.5% (191/1664) of people reported thoughts of suicide or self-harm in the prior two weeks. Having children, participating in sport or community activities or being employed full-time decreased the risk of such thoughts. Conversely, factors relating to social exclusion including homelessness, drug use, unemployment and job insecurity increased the risk of thoughts of self-harm or suicide. Individual clinicians, health services, and policy-makers all have a role in suicide prevention. Clinicians need appropriate training to be able to respond to people expressing these thoughts. Aboriginal and Torres Strait Islander community organisations need sovereignty and self-determination over resources to provide programs that promote cultural connectivity and address social exclusion, thereby saving lives.

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Allen, Bridget, Karla Canuto, John Robert Evans, Ebony Lewis, Josephine Gwynn, Kylie Radford, Kim Delbaere, et al. "Facilitators and Barriers to Physical Activity and Sport Participation Experienced by Aboriginal and Torres Strait Islander Adults: A Mixed Method Review." International Journal of Environmental Research and Public Health 18, no. 18 (September 20, 2021): 9893. http://dx.doi.org/10.3390/ijerph18189893.

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Physical activity has cultural significance and population health benefits. However, Aboriginal and Torres Strait Islander adults may experience challenges in participating in physical activity. This mixed methods systematic review aimed to synthetize existing evidence on facilitators and barriers for physical activity participation experienced by Aboriginal and Torres Strait Islander adults in Australia. The Joanna Briggs Institute methodology was used. A systematic search was undertaken of 11 databases and 14 grey literature websites during 2020. The included studies reported physical activity facilitators and barriers experienced by Aboriginal or Torres Strait Islander participants aged 18+ years, living in the community. Twenty-seven studies met the inclusion criteria. Sixty-two facilitators were identified: 23 individual, 18 interpersonal, 8 community/environmental and 13 policy/program facilitators. Additionally, 63 barriers were identified: 21 individual, 17 interpersonal, 15 community/environmental and 10 policy/program barriers. Prominent facilitators included support from family, friends, and program staff, and opportunities to connect with community or culture. Prominent barriers included a lack of transport, financial constraints, lack of time, and competing work, family or cultural commitments. Aboriginal and Torres Strait Islander adults experience multiple facilitators and barriers to physical activity participation. Strategies to increase participation should seek to enhance facilitators and address barriers, collaboratively with communities, with consideration to the local context.

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Spurling, Geoffrey K. P., Deborah A. Askew, Philip J. Schluter, Fiona Simpson, and Noel E. Hayman. "Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study." Australian Journal of Primary Health 20, no. 3 (2014): 285. http://dx.doi.org/10.1071/py13009.

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Few epidemiological studies of middle ear disease have been conducted in Aboriginal and Torres Strait Islander populations, yet the disease is common and causes hearing impairment and poorer educational outcomes. The objective of this study is to identify factors associated with abnormal middle ear appearance, a proxy for middle ear disease. Aboriginal and Torres Strait Islander children aged 0–14 years receiving a Child Health Check (CHC) at an urban Indigenous Health Service, Brisbane, Australia were recruited from 2007 to 2010. Mixed-effects models were used to explore associations of 10 recognised risk factors with abnormal middle ear appearance at the time of the CHC. Ethical approval and community support for the project were obtained. Four hundred and fifty-three children were included and 54% were male. Participants were Aboriginal (92%), Torres Strait Islander (2%) or both (6%). Abnormal middle ear appearance was observed in 26 (6%) children and was significantly associated with previous ear infection (odds ratio (OR), 8.8; 95% confidence interval (CI), 3.2–24.0) and households with eight or more people (OR, 3.8; 95% CI, 1.1–14.1) in the imputed multivariable mixed-effects model. No significant associations were found for the other recognised risk factors investigated. Overcrowding should continue to be a core focus for communities and policy makers in reducing middle ear disease and its consequences in Aboriginal and Torres Strait Islander peoples.

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Kong, Ariana, Michelle Dickson, Lucie Ramjan, Mariana S. Sousa, Joanne Goulding, Jemma Chao, and Ajesh George. "A Qualitative Study Exploring the Experiences and Perspectives of Australian Aboriginal Women on Oral Health during Pregnancy." International Journal of Environmental Research and Public Health 18, no. 15 (July 29, 2021): 8061. http://dx.doi.org/10.3390/ijerph18158061.

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The aim of this study was to explore whether oral health was an important consideration for Aboriginal and Torres Strait Islander women during pregnancy, whether oral health could be promoted by Aboriginal health staff, and strategies that would be appropriate to use in a new model of care. A qualitative descriptive methodology underpinned the study. All participants in this study identified as Aboriginal, with no Torres Strait Islander participants, and were from New South Wales, Australia. The interviews were analysed using inductive thematic analysis. From the data, two themes were constructed. The first theme identified that oral health was not always the first priority for participants as poor accessibility alongside other competing commitments were challenges to accessing oral health services. The second theme highlighted how relationships with personal networks and healthcare providers were essential and could be used to support maternal oral health during pregnancy. Effective strategies to promote oral health during pregnancy for Aboriginal and Torres Strait Islander women should involve key stakeholders and health care providers, like Aboriginal Health Workers, to facilitate culturally safe support and tailored oral health advice.

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Jones, Roxanne, Katherine Thurber, Alyson Wright, Jan Chapman, Peter Donohoe, Vanessa Davis, and Raymond Lovett. "Associations between Participation in a Ranger Program and Health and Wellbeing Outcomes among Aboriginal and Torres Strait Islander People in Central Australia: A Proof of Concept Study." International Journal of Environmental Research and Public Health 15, no. 7 (July 12, 2018): 1478. http://dx.doi.org/10.3390/ijerph15071478.

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Culture can be viewed as an integral part of Aboriginal and Torres Strait Islander health and wellbeing. This study explores the association between caring for country, through participation in a Ranger program, and wellbeing. We analyzed cross-sectional data collected in Central Australia in 2017, comparing health and wellbeing (life satisfaction, general health, psychological wellbeing and family wellbeing) among Aboriginal and Torres Strait Islander peoples employed as Rangers (n = 43) versus not employed as Rangers (n = 160). We tested if any differences in outcomes were explained by differences in key demographic or health factors. Ranger participation was significantly associated with very high life satisfaction (PR = 1.69, 95% CI: 1.29, 2.20) and high family wellbeing (PR = 1.47, 95% CI: 1.13, 1.90); associations remained significant after individual adjustment for education, income, employment, health risk factors and health conditions. The magnitude and direction of associations were similar for very good general health, but results were not significant. We did not identify an association between Ranger participation and psychological wellbeing. While based on a small sample, these findings support the assertion that participation in the Ranger program is associated with positive health and wellbeing outcomes. This supports the continuation of cultural participation and practice through the Ranger program and has implications for funding, program and policy development.

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Briggs, V. L. "Aboriginal and Torres Strait Islander Australians and tobacco." Tobacco Control 12, no. 90002 (September 1, 2003): 5ii—8. http://dx.doi.org/10.1136/tc.12.suppl_2.ii5.

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Luke, Joanne, Ebony Verbunt, Angela Zhang, Muriel Bamblett, Gabrielle Johnson, Connie Salamone, David Thomas, et al. "Questioning the ethics of evidence-based practice for Indigenous health and social settings in Australia." BMJ Global Health 7, no. 6 (June 2022): e009167. http://dx.doi.org/10.1136/bmjgh-2022-009167.

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Australian government planning promotes evidence-based action as the overarching goal to achieving health equality for Aboriginal and Torres Strait Islander populations. However, an inequitable distribution of power and resources in the conduct of evidence-based practice produces a policy environment counterintuitive to this goal. This context of contemporary evidence-based practice gives legitimacy to ‘expert practitioners’ located in Australian governments and universities to use Western guidelines and tools, embedded in Western methodology, to make ‘evidence’ informed policy and programming decisions about Aboriginal and Torres Strait Islander populations. This method for decision making assumes a positional superiority that can marginalise the important perspectives, experiences and knowledge of Aboriginal Community Controlled Organisations and their processes for decision making. Here we consider the four steps of an evidence review: (1) developing a review question; (2) acquiring studies; (3) appraising the evidence and (4) assessing the evidence, as components of wider evidence-based practice. We discuss some of the limitations across each step that arise from the broader context within which the evidence review is produced. We propose that an ethical and just approach to evidence-based review can be achieved through a well-resourced Aboriginal community controlled sector, where Aboriginal organisations generate their own evidence and evidence is reviewed using methods and tools that privilege Aboriginal and Torres Strait Islander ways of knowing, doing and being.

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Calma, Tom, Pat Dudgeon, and Abigail Bray. "Aboriginal and Torres Strait Islander Social and Emotional Wellbeing and Mental Health." Australian Psychologist 52, no. 4 (July 19, 2017): 255–60. http://dx.doi.org/10.1111/ap.12299.

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Journal articles on the topic 'Aboriginal and Torres Strait Islander public health and wellbeing'

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