Academic literature on the topic 'Aboriginal and Torrres Strait Islander community'

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.

The Aboriginal and Torres Strait Islander Child Placement Principle has been the policy guiding the placement of indigenous children in most Australian child protection jurisdictions for around fifteen years. The Principle requires the involvement of Aboriginal and Torres Strait Islander community representatives in decision making concerning indigenous children, and ensuring that alternative care placements of Aboriginal and Torres Strait Islander children are with Aboriginal and Torres Strait Islander careproviders.Most Jurisdictions still have a significant number of Aboriginal and Torres Strait Islander children placed with non-indigenous careproviders, and community based Aboriginal and Islander child care agencies continue to express dissatisfaction about the nature and level of consultation which occurs when welfare departments are taking action to protect indigenous children.This paper, which was presented at the IFCO conference in Melbourne in July 1999, examines why there has been such limited improvement in Child Placement Principle outcomes. Work undertaken in Queensland to address the over representation of Aboriginal and Torres Strait Islander children in the child protection system will be outlined from both a departmental and community perspective. The paper argues that if strategies for addressing these issues are not located within a framework of self determination for Aboriginal and Torres Strait Islander people, then they will not work.

IntroductionConducting ethical and high-quality health research is crucial for informing public health policy and service delivery to reduce the high and inequitable burden of disease experienced by Aboriginal and Torres Strait Islander people. Ethical guidelines and principles specifically for health research with Aboriginal and Torres Strait Islander people have been developed for use since 1987. However, there has been limited examination of how these are being applied to the conduct of research.Methods and analysisMurru Minyawill be a large-scale national study to examine the implementation of ethical processes in Aboriginal and Torres Strait Islander health research. A mixed-methods design will be used in fourbaarra(steps). The first threebaarrawill collect knowledge, experiences and wisdom from three key groups: Aboriginal and Torres Strait Islander communities, research academics, and Human Research Ethics Committees using online surveys, yarning, and semistructured interviews. This knowledge will inform the finalbaarraof developing a set of practical recommendations to support ethical conduct in Aboriginal and Torres Strait Islander health research into the future.Ethics and disseminationEthical approval for this research project has been granted by National, State and Territory Human Research Ethics Committees. This research has been developed in collaboration with Aboriginal and Torres Strait Islander researchers, Aboriginal Community Controlled Health Organisation representatives, Aboriginal community members, the National Health Leadership Forum, and Aboriginal and Torres Strait Islander research team. The knowledge translation plan will be integrated and revised throughout the project as partnerships and engagement with Aboriginal and Torres Strait Islander communities continue. All findings will be shared with peak Aboriginal research bodies and Aboriginal and Torres Strait Islander communities in ways that are meaningful to them.

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.

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.

Background Digital health offers a fresh avenue to address health disparities experienced by Aboriginal and Torres Strait Islanders. Despite the scant evidence about how Aboriginal and Torres Strait Islanders access and use health technology, the Australian government has prioritised research that uses technology to enable people to manage their health and promote better health outcomes. Older Aboriginal and Torres Strait Islander women are cultural leaders in their communities, enabling them to provide valuable insights about the safety and efficacy of health care messaging. However, no research has engaged older Aboriginal and Torres Strait Islander, women as partners in digital health research. Objective This paper provides a protocol for co-designed translational research that privileges older Aboriginal & Torres Strait Islander women’s cultural expertise to design and test a framework for accessible, culturally safe and feasible digital health technologies. Methods This mixed-methods research project will use the collective impact approach, a user-centred, co-design methodology and yarning circles, a recognised Indigenous research methodology. A series of yarning circles with three different communities will elucidate enablers and barriers to access health information; co-create a framework clarifying what works and does not work for digital health promotion in their communities; and test the framework by co-creating three digital health information programs. Conclusions Privileging the cultural expertise of older Aboriginal and Torres Strait Islander women will provide a novel perspective and vital guidance that end users and developers can trust and rely upon to create and evaluate culturally safe and efficacious digital health promotion programs.

IntroductionKnowledge translation (KT) involves bridging the gaps between research knowledge and research application or practice, by sharing this knowledge with knowledge-users. KT is increasingly being used in research with Indigenous peoples globally to address the top-down and inappropriate research approaches commonly used in Indigenous research. Employing KT in Indigenous research in Australia is an emergent field, despite Aboriginal and Torres Strait Islander peoples having conducted KT for generations.There is limited evidence which demonstrates how KT is applied in the Aboriginal/Torres Strait Islander context. Results will benefit researchers by demonstrating ways of appropriately translating research findings to knowledge-users, including Aboriginal and Torres Strait Islander communities, researchers and policy makers. The scoping review will also inform a KT definition, method and practices used in a large-scale, longitudinal cohort study of Aboriginal and Torres Strait Islander adults: the Mayi Kuwayu Study.Methods and analysisUnder guidance of an Aboriginal and Torres Strait Islander governance committee, we will conduct a scoping review on KT in Aboriginal/Torres Strait Islander research. We will follow the scoping review method outlined by the Joanna Briggs Institute. We will search the ANU SuperSearch, and grey and hard to find literature in June 2022. Abstracts and full-text articles will be screened by two independent reviewers. We will include studies that relate to KT in Aboriginal/Torres Strait Islander research, regardless of the research topic. Results will be used to inform the KT definition, method and practices that can be used in Aboriginal/Torres Strait Islander research contexts in Australia.Ethics and disseminationThe Mayi Kuwayu Study has ethics approvals from the Australian Institute of Aboriginal and Torres Strait Islander Studies, 12 Aboriginal/Torres Strait Islander organisations, and the Australian National University Human Research Ethics Committee. Results will be disseminated through peer-review publication and community workshops. Protocol registration is available online (10.17605/OSF.IO/JMFQ3).

AbstractThe Queensland Aboriginal and Islander Health Council (QAIHC) lead and govern the Centre for Clinical Research Excellence (CCRE), which has a focus on circulatory and associated conditions in urban Aboriginal and Torres Strait Islander communities. The CCRE is a partnership between QAIHC and Monash University, the Queensland University of Technology, the University of Queensland, James Cook University, the National Heart Foundation, and the University of Wollongong. The establishment of the CCRE under the community-controlled model of governance is unique and presents both opportunities and challenges for innovative partnerships between universities and Aboriginal and Torres Strait Islander community organisations. This paper outlines the processes and strategies used to establish a multi-institutional research centre that is governed by the Aboriginal and Torres Strait Islander community-controlled health sector.

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.

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.

Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.

Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.

This study is a critical reflection on two music projects that I conducted in my home area of Ipswich, Australia, prior to undertaking this research. The music projects involved participatory action research to investigate the music heritage and culture of the rural Ipswich region. The purpose of this study is to review and analyse the creative processes that I used in the rural Ipswich music projects in order to develop suitable practice frameworks for similar projects in future. The first music project was a collaborative investigation of the music history of Purga in rural Ipswich (2003-2005). Local people and those who used to live in the area were invited to come back to share memories of the music from the area with one another. People collaborated creatively: This allowed me to write The Purga Music Story and Harold Blair (2005), an inter-generational community education package. In 2003, we established the Purga Music Museum as a meeting place where the music heritage and culture of our neighbourhood is performed and displayed. The second music project (2006) was a study of contemporary music in rural Ipswich that resulted in community consultation and the development of a Music Action Plan for the area. I continued facilitating community music in rural Ipswich, as the curator of the Purga Music Museum, until 2008. Both music projects presented different challenges in the establishment of processes that would be effective for the needs and interests of people from various cultural groups. The work was fraught with complex decisions and ethical dilemmas about representation and music cultural heritage management because our neighbourhood previously contained the Purga Aboriginal Mission (1915-1948). The findings therefore relate to the struggles of the ‘Stolen Generation’-- Aboriginal and Torres Strait Islander people who were taken away from their families and forced to live in government-controlled residential situations. New, respectful approaches had to be found, conducive to the health and well-being of all concerned. For this reason, participatory action research methods were developed and a ‘Community of Discovery’ approach was used. Throughout this study, I investigate issues that arose as people told their music stories, and passed on music heritage and culture from one generation to the next. The key question is “What are appropriate frameworks of culturally engaged community music practice for rural Ipswich?” This study also draws on findings from the music projects to address the sub-questions, “How did community music practice function in the past in rural Ipswich?” “What is the current situation regarding contemporary community music practice in rural Ipswich?” and “What can be done to enhance future community music practice for rural Ipswich?” Aspects of music and health practice complement each other in this study. As a dual qualified music and health professional, I draw on expertise from both of these areas. Ethnographic methods were used to record and review the findings from each music project. The analysis is grounded in review of literature and other sources, creative display and performance, analysis of music history, community consultation, and critical reflection on my own community music practice. Finally, this evidence-based process of professional reasoning leads to the development of appropriate practice frameworks that transform the way that I intend to deliver services in future, and will hopefully inspire others. The thesis has five parts. The context and rationale for the research are outlined in Part 1. This is followed by description of the two music projects in Part 2. Part 3 is an exploration of how my music practice is situated in relation to scholarly literature (and other sources) and outlines the chosen theoretical constructs or models. This prepares for critical analysis and discussion of specific issues that arose from reflection on practice in Part 4. The conclusions of the research, presented in chapter 9, outline the creative processes, underlying principles, and the philosophy of my practice. The study concludes with an epilogue, which is a consideration of the present situation and suggested future directions for service provision and research.

This thesis explored how six teachers of mathematics embedded Aboriginal and Torres Strait Islander Peoples’ Histories and Cultures into the core mathematics curriculum. Semi-structured interviews were conducted, then written transcripts were analysed through the use of Bernstein’s Theory of Pedagogic Discourse. Teachers shared their perspectives on how they have developed their cultural capabilities, and how this has informed culturally responsive teaching of mathematics. Recommendations are made for how to support in-service teachers with their personal cultural capabilities to authentically embed Aboriginal and Torres Strait Islander Peoples’ Histories and Cultures in mathematics curriculum.

The research problem underlying this study concerns the potential of a mainstream secondary school to offer an inclusive and equitable experience of education for Aboriginal and Torres Strait Islander (Indigenous) students. The research explores how Indigenous students experience education at St Mary’s Catholic College, Cairns. Three specific research questions frame the organisation of this study: - How do Indigenous students experience teaching and learning at St Mary’s? - How do Indigenous parents experience the education of their children at St Mary’s? - How do Indigenous students and their parents experience the implementation of inclusivity policies at St Mary’s? This study adopts an interpretivist paradigm that is underpinned by constructionist epistemology. Data are analysed from the theoretical standpoint of symbolic interactionism. A case study methodology organises the choice of data-gathering strategies. These are document analysis, focus group interviews and in-depth, individual interviews. This study’s participants are purposively selected from four stakeholder groups: Indigenous students, Indigenous parents, Indigenous support staff and non-Indigenous teachers. In total, 54 stakeholders were participants. The research generates seven conclusions that add to new knowledge, practice and policy concerning how Indigenous students experience education at St Mary’s. First, St Mary’s Indigenous students consider their identification as Indigenous to be irrelevant to their engagement in the learning process or to their achievement of learning outcomes. Further, they argue that a serious focus on school academic work is not inconsistent with honouring Indigenous culture and values. Second, St Mary’s Indigenous students consider teachers’ non-Indigenous backgrounds to be no disadvantage to their learning. Instead, Indigenous students value the presence of differing cultural identities in the classroom for what they contribute to the learning experience. Similarly, Indigenous parents consider a paucity in the number of Indigenous teachers at St Mary’s will not negatively influence their children’s academic outcomes. Instead, they believe interactions with non-Indigenous teachers to be beneficial learning experiences for their children. Third, Indigenous parents believe that their decision to enrol their children at St Mary’s is a way of ensuring their positive futures. This decision may incur criticism that is supposedly justified by cultural identification values, from extended family members. St Mary’s Indigenous parents consider the defining and dividing of closely related people in order to maintain boundaries of inclusion and exclusion to be harmful for and divisive of Indigenous people. Fourth, Indigenous families consider St Mary’s to be an authentic, supportive and engaging place for all school community members. Parents noted that the school’s respect of Indigenous peoples and cultures reflected a fundamental characteristic of Catholic education. They value the policies and practices of inclusive education that honour their cultural identities and enable them to experience belonging to an authentic community. Fifth, Indigenous students consider it more educationally advantageous that teachers identify and address their individual learning needs rather than employ specific pedagogies considered to be preferred by Indigenous students in general. They are appreciative of reflective educators who adopt a variety of pedagogies in order to communicate authentically with all students. Sixth, ongoing professional development that challenges teachers to become knowledgeable about the different ways of learning that are equally legitimate and appropriate in diverse teaching contexts is needed at St Mary’s. This professional development would encourage teachers to employ a wide range of pedagogies that ensures quality relationships and communication with Indigenous students. Seventh, St Mary’s Indigenous support staff form an essential relationship between Indigenous students and their families, non-Indigenous teachers and the College leadership. This relationship allows for a better understanding of cultural differences that encourages positive learning outcomes for all students. Non-Indigenous teachers’ valuing of Indigenous aides and elders as co-educators in the classroom is essential for the successful implementation of inclusive education policies.

Within Australia, data on the oral health and health-related quality of life experiences of Aboriginal and Torres Strait Islander children living in urban areas are lacking. This project utilised a mixed-methods approach to contribute new epidemiological and life experience data to the field of oral health and create a culturally specific, parent-proxy tool to measure the health-related quality of life of Aboriginal and Torres Strait Islander children. These findings provide contemporary oral health data to inform policy and a foundation for the development of other culturally specific health-related quality of life measures for Aboriginal and Torres Strait Islander peoples.

This program of research investigated the factors facilitating drink driving in Indigenous communities in Far North Queensland. Drink driving-related road crashes are a significant health burden for Indigenous people, as they die in road crashes at three times the rate of other Australians and are 30% more likely to be seriously injured. This research provided information to develop and pilot a culturally-specific program, 'Hero to Healing'. The main motivation to drink drive was related to 'kinship pressure; where drivers were pressured by family members to drive after drinking. The underlying responsibility for transporting family members was related to cultural values and involved responding to family needs as a priority. Exposure to older family members drink driving was considered to play a role in normalising the behaviour, leading to imitation into adulthood. The research highlighted the need to treat drink driving as a community issue, rather than an individual phenomenon.

Aboriginal and Torres Strait Islander art centres across regional and remote Australia support the contemporary cultural expression of more than 14,000 artists and are a significant part of the local economies in their communities. This thesis explores how government policies and programs have impacted on art centres, with the aim of better understanding the enabling environment in which art centres operate and why they have succeeded to the degree they have.

This thesis contributes to the decolonisation of health promotion by examining Indigenous-led health promotion practice in an urban setting. Using critical ethnography, the study revealed dialogical, identity-based approaches that centred relationship, community control and choice. Based on the findings, the thesis proposes four interrelated principles for decolonising health promotion and argues that Indigenous-led health promotion presents a way to bridge the rhetoric and practice of empowerment in Australian mainstream health promotion practice.

AbstractConnection with Country, community, and culture lies at the heart of Aboriginal and Torres Strait Islander peoples’ health and wellbeing. Although there is some evidence on the role of cultural identity on the mental health of Indigenous adults, this relationship is relatively unexplored in the context of Indigenous Australian children. Robust empirical evidence on the role of cultural identity for social and emotional wellbeing is necessary to design and develop effective interventions and approaches for improving the mental health outcomes for Indigenous Australian children. Drawing on data from the Longitudinal Study of Indigenous Children (LSIC), we explore social and emotional wellbeing in Indigenous Australian children and assesses whether cultural identity protects against social-emotional problems in Indigenous children. The results show that Indigenous children with strong cultural identity and knowledge are less likely to experience social and emotional problems than their counterparts. Our work provides further evidence to support the change from a deficit narrative to a strengths-based discourse for improved health and wellbeing of Indigenous Australian children.

This chapter describes work with an Aboriginal community group using an approach described as structural community development, a ‘bottom-up, citizen-led and -owned approach that seeks to challenge racism at its source in systems, laws, and policies based on white privilege’. Because the Benarrawa group owned this approach, the authors argue that it provides an excellent example of how grounded practice by community groups can inform the theorising of community development. The work of the group involved a range of activities, including workshops, cultural events, commemorative gatherings, and social activities, all designed to affirm the ownership of land by Aboriginal groups and strengthen their determination to assert that ownership against the depredations of the Australian state.

This chapter examines the importance of culturally responsive relationships-focused pedagogical approaches in engaging Aboriginal students in their learning and the significance of this to improving their educational outcomes. Significantly, the themes and issues raised in this chapter reflect much of the international literature on Indigenous, minority and marginalised students. The following enablers are necessary when implementing culturally responsive relationships focused pedagogies: Engaging with Aboriginal families and community members; Harnessing Aboriginal students' backgrounds, lived experiences and interests as classroom resources; Implementing innovative place-based curriculum approaches, and Exploring holistic teacher professional learning opportunities. The combination of these factors creates quality learning environments as places of belonging and socio-cultural support underpinned by mobilising Aboriginal family and community social and cultural capital in the educational process. Once schools and teachers realise the potential of this approach, conditions are created to improve the academic, social and cultural outcomes of Aboriginal and Torres Strait Islander students.

This chapter examines the importance of culturally responsive relationships-focused pedagogical approaches in engaging Aboriginal students in their learning and the significance of this to improving their educational outcomes. Significantly, the themes and issues raised in this chapter reflect much of the international literature on Indigenous, minority and marginalised students. The following enablers are necessary when implementing culturally responsive relationships focused pedagogies: Engaging with Aboriginal families and community members; Harnessing Aboriginal students' backgrounds, lived experiences and interests as classroom resources; Implementing innovative place-based curriculum approaches, and Exploring holistic teacher professional learning opportunities. The combination of these factors creates quality learning environments as places of belonging and socio-cultural support underpinned by mobilising Aboriginal family and community social and cultural capital in the educational process. Once schools and teachers realise the potential of this approach, conditions are created to improve the academic, social and cultural outcomes of Aboriginal and Torres Strait Islander students.

Australian palliative social work is dynamic, responding to changing contexts and system challenges. Work in Australia requires an understanding of the history and experience of Aboriginal and Torres Strait Islander Australians, along with the many other cultural groups who have arrived since 1788 to make up Australia’s multicultural community. Palliative care and bereavement service delivery varies across the country, meaning social workers must be flexible and able to adapt in their roles, while assisting patients and their families to navigate systems in their local context. Therapeutic knowledge and interventions underpin the work of palliative social work in Australia; counseling and therapeutic work are often delivered alongside skilled practical resourcing, care planning, and provision.

There is a need to increase access to evidence-based parenting support in disadvantaged and marginalized communities; however, cultural fit of a mainstream program may be a significant barrier to program adoption. Tailoring existing programs to local family and community needs is the most cost-effective route to achieve broader population reach, rather than creating a new program for each culturally diverse community. This chapter presents a collaborative partnership adaptation model that considers cultural fit and presents a process for tailored cultural adaptation of the implementation of parenting programs, including variations relating to both content and process that may be required for different cultural groups. The examples of Indigenous Triple P, developed with Australian Aboriginal and Torres Strait Islander community consultation, and Te Whānau Pou Toru (Three Pillars of Positive Parenting), developed with New Zealand Māori community consultation, are discussed as examples.

This article details the construction of a Grounded Theory to explain the concept of enhancing professional learning through mobile devices. The research data was delimited to the behaviours and beliefs of Aboriginal and Torres Strait Islander pre-service teachers enrolled in two community-based initial teacher education programs in very remote communities in Australia. Four educational uses of mobile devices were identified: accessing content, handling administration, collaborating for academic support and sharing personal encouragement. The use of mobile devices enabled adults to choose times of study, choose places of study, complete assessment relevant to their course and achieve a career goal. Three elements that impact the educational use of mobile devices were identified (i.e. context, precursors and catalyst). Seven categories underlie the concept of enhancing professional learning through mobile devices: fostering access, facilitating customisation, promoting collaboration, supporting relevance, completing the course, empowering agency and enabling networking.

Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.