Dissertations / Theses on the topic 'Aboriginal and Torrres Strait Islander community'

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.

My thesis consists of a creative work plus an exegesis. This exegesis uses case study research to investigate three Brisbane-based media organisations and the role they play in encouraging social inclusion and other positive social change for specific disadvantaged and stigmatised minority groups. Bailey, Cammaerts and Carpentier’s theoretical approach to alternative media forms the basis of this research. Bailey et al. (2008, p. 156) view alternative media organisations as having four important roles, two media-centred and two society-centred, which must all be considered to best understand them: • serving their communities • acting as an alternative to mainstream media discourses • promoting and advocating democratisation in the media and through the media in society • functioning as a crossroads in civil society. The first case study, about community radio station 4RPH (Radio for the Print Handicapped), centres on promoting social inclusion for people with a print disability through access to printed materials (primarily mainstream print media) in an audio format. The station also provides important opportunities for members of this group to produce media and, to a lesser extent, provides disability-specific information and discussions. The second case study, about gay print and online magazine Queensland Pride, focuses on promoting social inclusion and combating the discrimination and repression of people who identify as lesbian, gay, bisexual or transgender. Central issues include the representation (including sexualised representation) of a subculture and niche target market, and the impact of commercialisation on this free publication. The third case study, about community radio station 98.9FM, explores the promotion of social inclusion for peoples whose identity, cultures, issues, politics and contributions are often absent or misrepresented in the mainstream media. This radio station provides “a first level of service” (Meadows & van Vuuren, 1998, p. 104) to these people, but also informs and entertains those in the majority society. The findings of this research suggest that there are two key mechanisms that help these media organisations to effect social change: first, strengthening the minority community and serving its needs, and second, fostering connections with the broader society.

Thesis (Ph.D.) -- University of Western Sydney, 2004.
Title from electronic document (viewed 15/6/10) Presented for the degree of Doctor of Philosophy, University of Western Sydney, 2004. Includes bibliography.

The health inequalities between Indigenous and non-Indigenous Australians, and the benefits of physical activity in the prevention and treatment of chronic diseases are well known. Yet, little research has been conducted on physical activity and health outcomes for Aboriginal and Torres Strait Islander people. The Australian physical activity guidelines, recommend that adults should accumulate 150-300 minutes per week of moderate activity or 75-150 minutes of vigorous activity or equivalent combinations of both. Currently, 47% of Aboriginal and Torres Strait Islanders in non-remote locations are sufficiently physically active, 0.9 times that of non-Indigenous Australians. The purpose of this thesis was to investigate ways to improve the health of Indigenous Australians through a physical activity program. The first major aim (Study 1) was to synthesise previous evaluations of physical activity interventions implemented with Indigenous people in Australia and New Zealand and, based on this, to identify gaps in the literature and to recommend an agenda for future research in this field. The second aim (Study 2) was to assess the reliability and validity of the Fitbit Flex for measuring physical activity levels, as this device would be used in the succeeding study. The Fitbit Flex was selected as the comparative device as it is a waterproof accelerometer that can be worn 24 hours a day as a wristband, which may be more convenient for users and was hypothesised to lead to higher compliance in wearing time than the waist worn Actigraph GTX3+. The third aim was to implement and evaluate an 8-week community-tailored physical activity program in a rural and regional setting. The quantitative part of the evaluation of the program (Study 3) involved assessing changes in functional capacity for exercise, physical activity and various health outcomes. In a qualitative study (Study 4) barriers and enablers to participating in the program were examined. Study 1: The systematic review was registered with the PROSPERO network and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of the literature identified 13 studies which met the inclusion criteria. Due to the heterogeneity of the data and the contexts in which they were collected a meta-analysis was not feasible, so a narrative synthesis of the results was conducted. Only six studies measured physical activity objectively (n=2) or via self-report (n=4) and only five studies measured a component of fitness such as strength or sub-maximal aerobic capacity. There was no clear evidence that the interventions had increased activity levels in the shortterm. However, 11 out of 13 studies reported improvements in fitness and other physical activity-related health outcomes such as reductions in weight and blood pressure. Study 2: A gap identified in the systematic review (Study 1) was the lack of objective measurements of physical activity, where only two out of the 13 studies had used pedometers. Therefore, in Study 2 the Fitbit Flex, a novel accelerometer, was validated against direct observation and a research-grade accelerometer (Actigraph GTX3+) under laboratory and free-living conditions. The validity of the Fitbit Flex was found to be dependent on the type of activity, where the number of steps taken during jogging and stair stepping were more accurate, compared to slow walking activities which were undercounted. The Fitbit Flex had overall moderate validity, was deemed more cost-effective and, due to the lower participant burden was expected to lead to higher compliance in wearing time. Consequently, the Fitbit Flex was selected as the method for objectively measuring activity levels of the participants in the planned physical activity program (Study 3). Study 3: In line with the recommendations from the systematic review, objective measures of activity with the Fitbit Flex were attempted in the evaluation of the physical activity intervention (Study 3). The primary outcome measure for the community-tailored 8-week physical activity program was the change in functional capacity, which was assessed by the six-minute walk test (6MWT). The physical activity program was implemented in both a rural (n=12) and regional community (n=22) in Far North Queensland. An attempt was made to use a wait-listed control group, however, the intended site withdrew shortly before the intervention was to begin due to a lack of staff availability. Due to an insufficient number of participants and therefore lack of statistical power, the original plan to run the evaluation with a waitlisted control group had to be replaced with a pre-post study design. An intention to treat analysis was undertaken due to low program attendance. In the rural community, there was a 50% attrition rate, where six of the 12 participants completed follow-up assessment. There was a significant improvement in the 6MWT distance from 467.3 metres±56 to 557.8 metres±108 (p=0.01) and significant decreases in body fat (34.98±6.6% to 30.61%±6.92, p=0.009) and hip circumference (106.6cm±4.0 to 104cm±5.3, p=0.005). Attendance to the program was low. Eight participants did not attend a single training session, and four attended an average of seven out of 26 sessions. Six sessions were cancelled due to rain which affected the implementation of the program. In the regional city, 18 of the 22 participants attended post-program assessments. There was an increase in the 6MWT distance, but this was not clinically significant (p=0.287). There were no significant reductions in weight (p=0.25), BMI (p=0.19) or body fat percentage (p=0.85). Significant reductions were measured in waist circumference (from 99.11cm±11.95 to 96.07cm±11.46 (p=0.006) and hip circumference (from 105.41cm±11.32 to 101.97cm±8.83 (p=0.019)). Reductions in both systolic (p=0.0002) and diastolic blood pressure (p=0.0002) were also evident. No significant improvements in pathology markers, such as HbA1c or cholesterol, were evident. Unfortunately, the objectively measured physical activity data could not be used for the evaluation of the intervention due to poor compliance in wearing the Fitbit Flex accelerometres. Self-reported daily minutes of moderate to vigorous physical activity increased from 28.2 minutes ± 13.3 to 40 minutes ± 20.2 (p=0.09), but this was not significant. Study 4: After observing low attendance to the physical activity program, a qualitative evaluation was undertaken to better understand the factors that were influencing the attendance rate. Semi-structured interviews were conducted with twelve participants at the follow-up health assessments for Study 3. The interview guide was loosely based on the Health Belief Model. It was theorised that individuals would be more likely to voluntarily engage in the physical activity program if their current behaviour is perceived as a threat to their health. The findings from the interviews confirmed that despite low program attendance, there were positive attitudes and high levels of motivation towards the physical activity program. The enablers to participation were the inclusion of family members, no financial cost and a good relationship with the principal investigator, which was strengthened by the community-based participatory approach to the program design. Barriers to program attendance were mostly beyond the control of the individuals, such as sorry business, needing to travel away from the community and lack of community infrastructure. Conclusion: The purpose of this thesis was to investigate ways to improve the health of Indigenous Australians through a physical activity program. Based on the findings from the systematic review of the literature and the validation study, an 8-week physical activity program was implemented. The results of the program suggest that those who participated in physical activity during the study period had improvements in clinical health outcomes. However, more consideration of community-specific barriers and enablers is needed prior to implementation of programs to understand how they will affect attendance to the program. More work is needed to better understand how to improve participation rates in physical activity programs for Aboriginal and Torres Strait Islander people in rural and regional settings.

Research Doctorate - Doctor of Philosophy (PhD)
This doctoral thesis by publication provides new knowledge in two important and related areas in Aboriginal and Torres Strait Islander health. Firstly, the thesis investigates opportunities in primary health care for reducing some of the major contributors to the health disparity between Aboriginal and Torres Strait Islander people and non-Indigenous Australians. It suggests that strategies are needed to better support patients and GPs in accurately identifying patients at risk and also support the need for a continued policy commitment towards these activities. Secondly, where evidence is lacking of effective primary health care interventions, the research aims to inform health and medical research policy to support research that will maximise health improvements for Aboriginal and Torres Strait Islander people. It aims to inform policy-makers, health practitioners, researchers and Aboriginal and Torres Strait Islander communities on opportunities for health gains that are evident in primary health care and through more targeted health and medical research. One of the key findings of this doctoral research is the lack of intervention research being conducted specifically in Aboriginal and Torres Strait Islander health. It identifies the lack of research outputs that can be used to inform clinical practice as well as health policy and programs. The findings offer strategies that may be able to be implemented into policy to address barriers to increasing the amount of high quality intervention research being conducted in Australia. Another key finding is that research funding disproportionally funds descriptive research rather than measurement and intervention research. The findings aim to inform future health and medical research funding allocation in a way that targets specific health topics, types of research, as well as disciplines that may result in health gains more quickly due to their ability to more rapidly translate findings into policy and practice. The implications of the research aim to be practical and achievable. In primary health care, improving screening according to evidence-based guidelines will greatly improve the health of Aboriginal and Torres Strait Islander people. Where the evidence is lacking on effective health care strategies specifically targeting Aboriginal and Torres Strait Islander people, strategic research is needed that will create evidence to address the major causes of the health gap between Aboriginal and Torres Strait Islander people and non-Indigenous Australians.

Research Doctorate - Doctor of Philosophy (PhD)
Aboriginal and Torres Strait Islander Australians have a substantially lower life expectancy and greater burden of chronic disease than their non-Indigenous Australian counterparts. The current health status of Indigenous Australians can be linked to a history of colonization and dispossession, as well as to past and ongoing racism and discrimination. While acknowledging the need to address such broader social determinants of health, there is also significant potential to improve the health of Aboriginal and Torres Strait Islander Australians through reducing the disproportionate prevalence of key health risk behaviours among this population, such as smoking, poor diet, excess alcohol and physical inactivity. Primary care is an important setting for the delivery of preventive health care, and Aboriginal Community Controlled Health Services (ACCHSs) are well placed to provide primary care for Aboriginal communities. A range of preventive care interventions have shown success in modifying health risk behaviours in non-Indigenous healthcare settings. However, such strategies are not well tested in Aboriginal health. Therefore this thesis aimed to explore the acceptability of strategies including point-of-care screening, and the provision of patient feedback, in the ACCHS setting. The need for primary care to address ‘lifestyles’ or patterns of interrelated health risks is also being increasingly recognized. In order to inform the provision of more holistic preventive care, this thesis also explored the clustering patterns of key health risk behaviours among ACCHS clients. Patient preferences for addressing their health risks, including whether health risks should be addressed individually, sequentially or simultaneously, and the types of support that would be most helpful, were examined. Implications of the results of these studies for the delivery of appropriate and effective primary care for Aboriginal and Torres Strait Islander Australians are discussed. Based on these findings and drawing on the existing literature, a multi-component, community-based intervention aimed at reducing multiple health risk behaviours is also proposed.

"Shut the Gate" was a project initiated and sponsored by the Beef Cattle sub-Committee of the Mackay and District Agricultural, Pastoral and Industrial Association Inc., in collaboration with Central Queensland University. Its goal was to research, write and publish an attractive, engaging and informative account of the history of cattle showing in Mackay, with particular emphasis on the relationship between the regional industry and the 123 year old annual Mackay Show. While the project throws considerable light on the influence that cattle showing has had on the development ofthe beef industry, and the important role it plays in generating and maintaining a positive awareness of the industry among town folk, it is essentially about people. The book celebrates the trials, tribulations and triumphs of those who breed, raise, and compete with beef cattle in the Mackay district. "Shut the Gate" was a commissioned work, with the Beef Cattle sub-Committee its primary sponsor. The essential brief was to prepare 'a readable social history' for possible publication. This in effect meant that the book needed to be written in a style accessible to its anticipated target audience, such as participants in the beef industry, rural primary producers, regular patrons of the Mackay Show, and local history enthusiasts. Its content and tone therefore, reflects this audience. It is a work ofacademic scholarship presented in the form of a textually accessible local history that is not only informative but also a pleasurable experience for the intended reader. The book is introduced by a dissertation that reflects on the research and writing process.

"In spite of various health care initiatives, diabetes self-management among culturally and linguistically diverse (CALD) migrant Australians is poor. This improper diabetes self-management is becoming a burden on the Australian economy. The literature review of this thesis also suggests that while individual attributes such as knowledge, beliefs, attitudes and demographics impact on self-management of diabetes, collaboration of different levels of influences, from immediate family members to health policy makers are mandatory. Such a collaborative effort can be supported by existing models of health promotion based on socio-ecological theory. In Australia very few socio-ecological theory based studies were reported in terms of the knowledge, self-care activities and experiences about diabetes self-management among CALD people. Particularly, to date no such study has conveyed the voices of the CALD people living with diabetes in regional Australia. Therefore, this study has been conducted in a regional setting and twenty-nine (29) CALD males and females from a regional area participated in this study. For the data collection and data analysis of this study I have chosen a mixed methods approach under the interpretive-constructivist paradigm. The study found that demographics such as age, education, level of English proficiency, and cultural factors such as traditional food, values, beliefs, language and socio-structural factors such as provision of health education, play a significant role in diabetes self-management among this cohort. Further, the socio-culturally constructed role of gender is found to be an overarching issue in diabetes self-management which determines the efficiency of diabetes self-management among the CALD women in this study. It is recommended that health service providers should be sensitive to the needs and barriers of CALD female individuals living with diabetes. Moreover, the study suggests that the problem of diabetes self-management need to be addressed by health care services, in terms of social, cultural and environmental influences surrounding an individual. However, these health service consumers also need to be informed of the culture and health care service system in the host1 country. Therefore, in addition to multi-level support, this study advocates that reciprocal knowing between health service providers and the consumers is an essential element for successful self-management of diabetes among these people. Particularly, this reciprocal knowing is vital in a regional context, where absolutely culturally competent health service provision is not feasible for a small but heterogeneous CALD migrant population. The sample size and time within which the study was undertaken, did not allow significant quantitative explorations as well as further qualitative inquiries about different levels of influence for diabetes self-management. The mixed methods approach and use of participants’ actual voices as data provide an evidentiary basis for further research opportunities in this area."--Abstract.

Indigenous people worldwide face complex historical, social and cultural circumstances that impair their ability to live in safety. In Australia, two in three Aboriginal and Torres Strait Islander women have experienced spousal violence, and Indigenous children are seven times more likely than non-Indigenous children to experience substantiated abuse or neglect. Indigenous community safety is a complex concept that should be based on the self-identified concerns of Indigenous people. Few studies thus far have enquired how Indigenous Australians in rural and remote areas visualise safety in their own neighbourhoods. This study investigates how Kunwinjku Aboriginal people and service providers understand and operationalise community safety in Gunbalanya, Northern Territory. It enquires about the values, behaviours, social norms and controls that influence participants’ perceptions and experiences of harm and safety. An intercultural and strengths-based approach is needed to understand these multifaceted issues beyond simply measuring crime and violence. The study uses social disorganisation and ecological systems theories to understand how community members and service providers manage harmful behaviours and leverage values, attitudes and beliefs which are perceived to enhance safety. This mixed methods research involves long-term fieldwork, undertaken from September 2015 to October 2017 where the majority of residents are Indigenous. Data collection includes 19 semi-structured interviews and 55 questionnaires involving 78 Indigenous and non-Indigenous participants. This intercultural concept of Indigenous community safety: 1) identifies neighbourhood problems which need to be addressed for the community to reduce harm and improve safety; 2) embraces the strengths-based elements of kinship, law and ceremonies; and 3) develops a practical approach to understand how services could better enable positive behaviour change in Gunbalanya. In Gunbalanya, harmful behaviours are multi-layered and intimately interlinked. This concept of community safety has three main dimensions: interpersonal and community harm and the strengths-based values of Aboriginal Law. At the interpersonal level, neighbourhood problems occur amongst close kin relationships where children and elderly persons are most vulnerable. Interpersonal neighbourhood problems include alcohol and substance misuse, interpersonal and family violence, gambling, mental health issues and dangerous driving. These reoccurring patterns of behaviour at the interpersonal level have flow-on effects across the community and articulate in broader social issues. At the community level, distal neighbourhood problems include youth delinquency and fractured parent-child relationships, collective trauma, and intergenerational transmission of violence. Findings from this research suggest that future strategies for addressing these challenges need to build on Kunwinjku values as the foundation for enabling healthy and respectful relationships. At the third level, the values and beliefs in Kunwinjku society promote positive relationships through mutual respect including listening, helping and sharing with each other. These values are practiced through Aboriginal dispute resolution strategies and have the potential for use in formal service delivery. However, ongoing patterns of harmful behaviours are fracturing respect and belief in Aboriginal Law as social norms and controls are less able to manage delinquent and other harmful behaviours. Strengths-based solutions are required to engage elders and young people in a process of transgenerational learning according to the practices of Aboriginal Law.

 "Treat a man as he is and he will remain as he is. Treat a man as he can and should be, and he will become as he can and should be" (Covey, 1998, p 62) 

The study 'Through the Eyes of Blackfellas' identified, examined and documented Queensland Aboriginal and Tones Strait Islander men's groups and their respective attempts to improve individual, family and community well-being. The study had a particular focus on how men's groups worked towards reducing family violence. The study explored proactive activities by groups to restore resilience and to reduce family violence. Men's groups activities that were not directly focused on reducing family violence, such as health and education, also arose as significant in the course of the study. I took the view that all group activities have interrelated benefits, and therefore they have the potential to reduce violence in communities through the benefits of group participation for individual men, and by strengthening, empowering and building skills in communities as a result of community based initiatives. The research found that men's groups target one or two social problems to focus on depending on the particular social and economic context, history and existing identified areas for change. Nevertheless, the general prevalence of family violence in communities ensured that it consistently emerged as an issue in most activities or considerations of men involved in groups. It must be made clear that although all men must take responsibility for their violence against women, this thesis is not intended to, and will not, identify or demonise Aboriginal and Tones Strait Islander male wrongdoers of violence or any other crime. 

The research incorporated a qualitative methodology and a critical theoretical framework. An action research framework encouraged participant observation and provided me with an opportunity to work collaboratively and reflectively with men's groups. As a researcher I was engaged in activities that included brainstorming community issues such as family violence, which did in some cases inform a strategy that could be implemented and driven by the group. 

The qualitative methodology included a semi -structured interview schedule for men's groups' participants, the collection of organisational data, and participatory observation. This methodological process allowed the participants of the research (`Murri and Torres Strait Islander men') to interpret and give meaning from their perspectives as to the significance of Indigenous men's issues and men's groups. Critical theory, particularly a Native American critical theory framework (Pulitano, 2003), supported an analysis which is structural and contextualises Murri men's issues within a broader social and historical framework of oppression and marginalisation from an Indigenous perspective. 

An analysis of the data established that there are diverse structures and manifestations of Aboriginal and Tones Strait Islander men's groups in Queensland. The groups are actively and proactively addressing social issues and providing individual support, and are either formal or informal in terms of their composition. Issues which arose predominantly in the study included the role of men's groups in addressing family violence, the significance of self esteem and empowerment, the interrelationships between men's groups and family and community wellbeing, the importance of the role of men as mentors, and an enduring respect for elders which is nurtured by the existence of men's groups.  

The groups are consistently committed to re-establishing strong and safe communities as a focus of their activities. Furthermore the study found that men's groups need to be recognised and supported by governments as a strategy for constructive change towards the betterment of Aboriginal and Torres Strait Islander communities. 

The research was undertaken to provide a descriptive account of Aboriginal and Torres Strait Islander Men's groups in Queensland. It is written primarily as a document for and by Indigenous men, as a way of acknowledging the activities of men, their perspectives and what is needed to ensure that men are empowered and supported to protect and cultivate their communities in self -identified, positive and beneficial ways.  

The concept of ‘artistic terra nullius’ refers to the violent erasure of First Nations peoples in colony Australia and highlights their absence – particularly Aboriginal Women – in the white-dominated arts world. This doctoral research by creative project and exegesis sets out to document and respond to the work of Aboriginal women in art and community. I have used practice-led inquiry as the main methodology, informed by my own roles as artist, writer, curator, community researcher and as a Wemba-Wemba & Gunditjmara, matriarchal and sovereign woman. Practising community ways of 'being, knowing and doing' to witness, participate and respond to Aboriginal women's art making and activism, I developed a new body of visual works and a series of essays, together with an exegesis relating to the project as a whole. The exhibition in December 2019 at Footscray Community Arts Centre held two bodies of work in two spaces. The ontological (or Being) space was a healing space of unconditional love, one of memory, timelessness, and respite. It has been created as 'daily acts of repair' in collaboration with other Aboriginal women and family members in a new process of bush dyeing fabrics, clothing and rags to become 'healing cloths”, dyed with gathered gum leaves, bush flowers, plants and Wemba-Wemba family bush medicine gifted to me from my Aunties. As a three-dimensional space, it makes visible trauma trails and stains and visualises what respite and healing could look and feel like. Under the 1961 flickering Super-8 image of my great-grandmother, this space also recreates ‘home’, particularly resonating with Aboriginal women’s curation of ‘home’ even in Mission housing. The second space, an epistemological (or Knowing) space, was an active studio of photographic based works drawn from matriarchal family stories, both past, present and future, and archival research. It included scholarly and other literature on Blak art and representation, in a recreation of my home studio and office. These bodies of work were made over a four-year project, drawing on concepts of de-colonising, Aboriginal feminist standpoint theory (Moreton- Robinson) and sovereignty. In emphasising making art as both research and artistic outcomes, I demonstrate art as a sovereign act, based in cultural practice and sovereign values. Both the exhibition spaces and the exegesis weave across past, present and future, across research in family, community and the Aboriginal women’s arts-work, across multiple creative media and stories – in the process here called ‘Ghost Weaving’. Responding to various modes of oppression, patriarchy and racism, Blak women’s art is not only a form of resistance to colonising, to violence, to academia and the white art world. It is also an ethical foregrounding of other forms of knowing and being. The exegesis is in two main parts: the written, thesis-element and a series of appendices which include a pictorial record of the exhibition, links and lists of related works, including relevant essays.

This thesis explores how policy is enacted – in this case, the Australian Government’s labour market program for remote unemployed people, initially known as the Remote Jobs and Communities Program (RJCP) and then the Community Development Programme (CDP). It outlines the development and delivery of the program from 2011, when the then Labor Government identified the need for a specific remote employment program, placing the employment participation of remote Indigenous people (who made up over 80% of the remote unemployed) at centre stage. It examines the changes that occurred to the program following the 2013 election of a Coalition Government, including the introduction of ‘continuous’ Work for the Dole. The focus of the thesis is on how patterns of practice have emerged in these programs, in particular: how providers have responded; how frontline workers navigate their roles; and how ‘Work for the Dole’ actually operates. What emerges is a gulf between bureaucratic and political ambitions for these programs and the ways in which participants and frontline workers view and enact them. This is more than a problem of poor implementation or the subversions of street-level bureaucrats and clients. There is evidence of a more fundamental failure of technologies of settler-state government as they are applied to remote Indigenous peoples. On the remote, intercultural frontiers of the labour market, the limits of centralised attempts at ‘reform’ become clear. Practices intended to tutor Indigenous people in the ways of the labour market are emptied of meaning. The Indigenous people who are the targets of governing efforts fail to conform with desired behaviours of ‘self-governing’ citizens, even in the face of escalating penalties. As a result, government ambitions to transform the behaviours and subjectivities of Indigenous people are reduced to bureaucratic rituals, represented in numbers and graphs on computer screens in Canberra.