Academic literature on the topic 'Aboriginal education'

The Director-General of Education in 1982, Mr. D.Swan, stated that Aboriginal education had two purposes: to enhance the development and learning of Aboriginal students and to enable all students to have some knowledge, understanding and appreciation of Aborigines and their cultural heritage (Aboriginal Education Unit, 1982, p.5). Unfortunately, today Aboriginal students still do not enjoy compatible success and participation rates to those of non-Aboriginal students. They are predominantly taught irrelvant curriculums and faced with inappropriate teacher classroom management and discipline styles. Subsequently, many Aboriginal students view schools as alien and hostile places. Schools do not meet Aboriginal students’ needs and problems of low self-esteem, motivation, academic achievement and a sense of safety and belonging often occur. Aboriginal students often do not behave in the same manner as non-Aboriginal students and teachers should be aware of the purposes of Aboriginal students’ behaviour and of the family and cultural influences which shape Aboriginals’ feelings, attitudes and values. There is a need in our schools for the inclusion of more Aboriginal perspectives in curriculums and for teachers to become aware of the need to change the way they teach and interact with Aboriginal students.

Education as a form of initiation has severely affected Aboriginal children as they endeavour to live in ‘two worlds’.Education involves the initiation of a child into society. At an early age a child attends school where he or she learns attitudes, values and beliefs that are seen as desirable.Australia’s early white settlers saw that the Aborigines had no buildings and no formal institutions, this led them to draw a distorted view of Aboriginal education. Coming from the European situation where classrooms, boarding schools, and university buildings represented learning, they concluded that Aborigines were completely without any system of education.

In 1988 the Aboriginal Education Policy Task Force called for broad equity between Aboriginal people and other Australians in access, participation, and outcomes at all stages of education. Aboriginals are not achieving a comparative level of success at school compared to non-Aboriginals. Symptomatic of problems in our schools are, the over representation of Aboriginals in lower classes, the high drop-out rate of Aboriginal children and their low participation rates in the senior years of high school. Some 17% of Aboriginal youth continue their schooling to year 12 compared to 49% of all students (Department of Employment, Education and Training, 1988, p.7). The failure of Aboriginal children to achieve at school has been widely interpreted as an individual failure on the part of Aboriginal children. Poor attainment has been attributed to lower I.Q. and ability, inadequate home environments, and poor parenting and not to the inadequacies of the education provided, to prejudices Aboriginal children face or to the active resistance by Aboriginal people to the cultural destruction implicit in many educational programs (McConnochie, 1982, p.20). An examination of the determinants of school success shows that Aboriginal children’s cultural values, beliefs and practices and Australian schools are often in conflict. To improve the outcomes for Aboriginal children schools are required to assess whether or not they are catering for the inherent needs and talents of individual Aboriginal children.

In our society education is a key factor in determining social and economic status (work opportunities derived from recognised training and accredited qualifications). The educational system appears to alienate many Aborigines. This is attributed to the interplay of poverty, communication or cultural differences, low expectations of school children, attitudes of teachers and parents (and the community in general), large unemployment and the limited scope of school curricula covering Aboriginal history or culture. This had led to an upsurge of pride (in recent years) in Aboriginal traditions and a promotion of the cultural inheritance stemming from the past. The notion of ‘cultural pride’, clearly influences the black community and the wider society wherein non-Aborigines are increasingly being exposed to ‘Aboriginality’ in a social and educational environment.

1988, the year of the Bicentenary, was considered by some as the start of a new era for Aborigines. However, despite excellent media exposure on Aboriginal issues, the bicentennial year concluded with just memories of various celebrations.We enter the 1990s at a time of increasing change throughout the world. I believe that it is necessary for everyone involved in Aboriginal education to focus on some important issues that encompass this delicate area.

The Aboriginal consultative group to the Schools Commission in their report. Education for Aborigines, made the following statement about the involvement of parents in the education of their children.

The article analyzes the process of transformation of the educational system of the Indigenous peoples, the key factor of which is the policy of the Canadian government. Based on the analysis of documents and materials of the federal government of Canada and regional authorities, qantitative and qualitative characteristics of the modern educational status of Aboriginal peoples have been identified. Canada's Aboriginal education system has gone through a difficult path from destructive forms of education for culture, family and personality, to humane and careful attitude towards students, their national roots and traditions. The policy of compensating for the damage done in the past and supporting the Indigenous peoples in the field of education goes in several directions. Among them there are payments to those Aborigines who have suffered physically or mentally in boarding schools in the past; equalization of education levels of Indigenous peoples and other Canadians, support of Aboriginal languages and culture. The main tools in the implementation of modern government policy are increased funding for the education of the Indigenous population and the collaboration of the authorities with public organizations and Aboriginal communities.

Aboriginal children attending school have special needs that should be recognised and catered for by the school system. This paper will deal with the practical aspects of Aboriginal education. In particular the focus will be on Aboriginal Primary education within Western Australia. The paper also limits itself by addressing issues related to more traditionally oriented Aboriginal groups living in remote communities. However, while the main emphasis is given to more traditionally oriented Aboriginal groups, many aspects can be usefully employed and extended to Aboriginal education in general. Therefore the aim of this paper is to give teachers and educators basic information about Aboriginal education so that they can develop appropriate education programs to meet the needs of the Aboriginal children within their schools.

There has been little research conducted on Taiwanese Aboriginal music education in comparison to Aboriginal education. C. Hsu's Taiwanese Music History (1996) presents information on Aboriginal music including instruments, dance, ritual music, songs and singing, but information on music education practices is lacking. The examination of historical documentation shows that music education was used by both the Japanese government and Christian missionaries to advance their political and religious agendas. This paper will examine the development of the music education of Aborigines in Taiwan from the mid nineteenth century, when Christian missionaries first came to Taiwan, until the end of the Japanese protectorate (1945). I shall discuss how the missionaries from Britain and Canada successfully introduced Western religious music to Aboriginal communities by promoting various activities such as hymn singing and religious services. The paper will then look at the influence of government policy on Aboriginal music education during the colonial periods. These policies affected both the music taught in elementary schools and the teaching materials.

Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, constructivist theories, and Indigenous methods, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? A university-community partnership titled the Community Learning Centres (CLC) provided the context for the collective cases. CLC involved the development of three learning centres (CLCs), each of which provided community members with a physical space and online resources pertaining to culturally relevant health education. Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Document review served to verify information described by participants. Analysis included a description of each case (within-case analysis) and a thematic analysis across cases (cross-case analysis). Seven factors were identified to either promote or inhibit CLC sustainability, including: 1) community uptake (if and how users access the CLC); 2) environmental factors (conditions within the CLC and the community); 3) stakeholder awareness and support (presence and extent of support exhibited by stakeholder groups); 4) presence of a champion (passionate leaders dedicated to CLC success); 5) availability of funding (ability to identify and allocate program funding); 6) fit and flexibility (CLCs’ ability to address user needs and community priorities), and; 7) capacity and capacity building (capacity to sustain the CLC and use learned skills to address other health education issues). These findings were integrated into practical sustainability tools where each factor was provided a working definition, influential moderators, key evaluation questions, and their relationship to other factors. These tools represent the development of a sustainability framework that is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education intervention.

This research explores the experiences and perceptions of nine Aboriginal and ally early career teachers (1-5 years experience) who have completed university coursework and/or extended professional development on the topic of Aboriginal education. The inquiry places focus on how targeted teacher education, and transitions into educational work settings, shape teacher identity and practice. Over an eight-month period, teachers participated in a series of three or four individual, semi-structured interviews on topics related to professional identity and engagement in Aboriginal education across institutions. Data fragments elicited from the research reveal ongoing, relational processes of momentarily occupying, exceeding, resisting, and/or reforming subject positions of teacher made available through discourse. The fragments are used to identify and trace significant forces that direct how participants become, and become undone as, teachers of school-based Aboriginal education. Analysis concentrates on four key relationships between teachers and sources of knowledge about Aboriginal education that formed, reinforced, and challenged teachers’ emerging professional identities and associated practices as they navigated Faculties of Education, schools, and areas between (e.g., teaching practicum). They include: (un)becoming teacher and a) school-based sources of Aboriginality, b) pedagogical pathways for Aboriginal education with/in teacher education, c) significant place, and d) supports used for engaging Aboriginal education. Contributions are made to the fields of teacher education, Aboriginal education, and decolonizing education and research. The research reveals the benefits and difficulties that coursework and professional development afford in preparing, and providing ongoing assistance to, teachers who foreground Aboriginal content and approaches. Learning from teachers’ processes, preparedness, and priorities enhances understanding about identity negotiation and movement of knowledge-practice across institutions. Further, theory building presents a decolonizing methodology for analyzing the construction of teacher identity that accounts for teachers’ complex and shifting positions beyond the binary opposition Aboriginal/non-Aboriginal. A decolonizing theory of (un)becoming teacher of Aboriginal education, alongside early career teachers’ recommendations to improve university and school-based Aboriginal education, hold potential to shift Aboriginal education research beyond a discourse of transformation/resistance. This opens space to reconfigure Aboriginal education and teacher education, as well as subject positions therein, to support the needs and prerogatives of Aboriginal students and communities.
Education, Faculty of
Graduate

In Queensland, there is little research that speaks to the historical experiences of schooling. Aboriginal education remains a part of the silenced history of Aboriginal people. This thesis presents stories of schooling from Aboriginal people across three generations of adult storytellers. Elders, grandparents, and young parents involved in an early childhood urban playgroup were included. Stories from the children attending the playgroup were also welcomed. The research methodology involved narrative storywork. This is culturally appropriate because Aboriginal stories connect the past with the present. The conceptual framework for the research draws on decolonising theory. Typically, reports of Aboriginal schooling and outcomes position Aboriginal families and children within a deficit discourse. The issues and challenges faced by urban Murri families who have young children or children in school are largely unknown. This research allowed Aboriginal families to participate in an engaged dialogue about their childhood and offered opportunities to tell their stories of education. Key research questions were: What was the reality of school for different generations of Indigenous people? What beliefs and values are held about mainstream education for Indigenous children? What ideas are communicated about school across generations? Narratives from five elders, five grandparents, and five (urban) mothers of young Indigenous children are presented. The elders offer testimony on their recollected experiences of schooling in a mission, a Yumba school (fringe-dwellers’ camp), and country schools. Their stories also speak to the need to pass as non-indigenous and act as “white”. The next generation of storytellers are the grandparents and they speak to their lives as “stolen children”. The final story tellers are the Murri parents. They speak to the current and recent past of education, as well as their family experiences as they parent young children who are about to enter school or who are in the early years of school.

This thesis is an interpretive case study, drawing upon feminist and Aboriginal perspectives, about working in an educational environment described as a border world comprised of overlapping cultures. It is a chronological account of the delivery of a university programme in a First Nations community. The study seeks to explore the reasons why Aboriginal women enter and successfully complete post-secondary study, and whether their roles in traditional Aboriginal culture facilitate this process. This first portion of the study involved semi-structured interviews with three female Aboriginal educators, focusing on the traditional roles of women within Cree culture, and the relationship of these traditional roles to their roles in contemporary Cree society. The second portion of the study involves a series of group and personal interviews with female Aboriginal learners involved in a community-based programme in a Northern Cree community. The interviews, which encompassed a three-year period, sought to provide a chronological account of the learners' experiences in the programme. In addition, interviews were conducted with faculty members teaching within the programme. The interviews provided the data for an operation model entitled Community-Controlled Education that suggests criteria for the delivery of an inclusive learning experience for Aboriginal learners.

This study investigates the beliefs of Aboriginal children, their parents, Aboriginal educators and non-Aboriginal teachers towards the learning and teaching of mathematics in years 5 and 6 in a rural community in New South Wales. Areas explored include the beliefs expressed by the students, their parents and educators about mathematics education, how these sets of beliefs compare and contrast, and what the pedagogical consequences are for mathematics education based on these beliefs. The study was conducted in a rural school following trials in other sites. Conversational interviews were conducted and from the transcript sixteen core categories of beliefs across all participant groups were identified. The belief statements demonstrate the complex nature of the social, cultural, economic, historical and political contexts in which the learning of mathematics takes place. A number of actions intended to enhance Aboriginal children's learning of mathematics are proposed. Non-Aboriginal teachers need to share their beliefs with the Aboriginal community, and conversations need to occur between Aboriginal and non-Aboriginal people about mathematics education. Teachers require pedagogical strategies that address Aboriginal children's learning of mathematics, and educational systems need to include an Aboriginal perspective in mathematics curricula. Future collaborative research in mathematics education has to be based on the premise of researchers working in close co-operation with Aboriginal people
Doctor of Philosophy (PhD)

In Australia, non-Aboriginal people have been involved in Aboriginal education since the end of the 19th century. There has been ongoing criticism of non-Aboriginal involvement in Aboriginal education and a movement towards Aboriginalisation in education. This study addresses the issues faced by six non-Aboriginal teachers in remote Aboriginal communities in the 1990's. The purpose of this study is to explore the experiences and perceptions of non-Aboriginal teachers living and working in remote Aboriginal communities in the 1990's. Through this research I found that the non-Aboriginal teachers faced difficulties living and working in remote Aboriginal communities. They talked about the distinctive lifestyle and living conditions. They reported a need for pre-service and ongoing professional development focusing on aspects influencing their lives. The discussion topics included: their living circumstances; Aboriginal world view; Aboriginal health issues; community issues; Aboriginal teaching and learning styles and school policies. The study is consistent with previous research about non-Aboriginal teachers living and working in remote Aboriginal communities. It argues that pre-service and ongoing professional development is vital for the success of non-Aboriginal teacher in remote communities. Community based educational programs for non-Aboriginal teachers are needed. These programs should include non-Aboriginal teachers learning about Aboriginal culture, Aboriginal learning and teaching styles and the development and implementation of educational policies. These programmes need to include discussion of aspects of living in isolated settings. Schools and governing bodies involved need to develop closer liaison with non-Aboriginal teachers to support their living in this setting. It is also important that policies in place address the problem of the high turnover of non-Aboriginal staff experienced by remote community schools. This study also poses the question what is the future for non-Aboriginal teachers in remote Aboriginal communities? Aboriginalisation in remote Aboriginal communities is highly recommended.

In this thesis, memories and forgetting in Aboriginal youths’ recounting of experiences in contemporary Aboriginal education programs were traced back to the Indian residential school system and colonial policy. By focusing on Aboriginal Education Enhancement Agreements—policies intended to address the poor educational outcomes of Aboriginal students, within their broader social, political and historical context, the supposed “problem” of educating Aboriginal students is viewed from a decolonizing perspective. I argue that the effects of the Indian residential school system are productive across generations and continue into the present. Practicing a “critical pedagogy of decolonization” (L. T. Smith, 1999, p. 34) means listening to Aboriginal students’ memories of Aboriginal/Indian education policies in order to decolonize education, history and research. This study is aimed at informing/influencing/shaping current policy and practices and at improving the quality and outcome of Aboriginal students’ education. The complexity of this research is reflected in the metaphorical use of the term montage, a film technique, to represent the decolonizing epistemological and methodological frames that focus on narrative analysis, textual analysis, photograph analysis, and policy analysis. Listening to Indigenous students’ memories and forgetting of public schooling practices, and analyzing visual and textual representations of Aboriginal students, Aboriginal education and history, in past and present policy were framed and captured by decolonizing methodologies. Further, fiction was used to highlight haunted memories of Indian residential schooling and to trace colonial policies and practices back to a violent and traumatic past. By listening to counter memories of educational policy across generations of Indigenous actors, the relevance of these memories for understanding the effects of Aboriginal Education Enhancement Agreement policy today as they relate to historical, present and future manifestations of self-determination, re-birth and a decolonizing renaissance among Indigenous peoples in Canada is highlighted as a decolonizing strategy. This thesis represents an attempt at practicing a critical pedagogy of decolonization by linking notions of race and iconic myths of frontier history to perceptions of Indigenous peoples, cultures and histories that are disciplined by a colonial archive of photographs, policies, curricula, and texts.
Education, Faculty of
Educational Studies (EDST), Department of
Graduate

"Many Australian universities have recently incorporated Indigenous graduate attributes into their programs, and the University of Technology Sydney (UTS) is no exception. This project aimed to investigate students’ perceptions and experiences of learning about Indigenous Knowledge systems and culture while developing science communication skills. Advanced Communication Skills in Science is a core subject in the Master of Science program at UTS. An existing assessment task, a three-minute thesis style oral presentation, was reworked to include the Indigenous Graduate Attribute (IGA) developed for the Faculty of Science. Students researched an aspect of Indigenous Science, an area of emerging interest for cultural and scientific understanding, and a mechanism for empowering Australia’s diverse first nations peoples. They then presented their key message in three minutes using a single PowerPoint slide. This task allowed students to demonstrate an awareness and appreciation of multiple ways of developing understandings of nature while enhancing their ability to understand the role of science communication in the modern world. Students were surveyed at the beginning and end of the semester to establish their Indigenous Science conceptions and reflect on their experiences. Students demonstrated an outstanding ability to integrate appropriate Aboriginal and Torres Strait Islander knowledges, experience, and analysis into a key message. Most students reported greater familiarity with concepts such as Indigenous Science and provided richer definitions of what this means. When asked if understanding Aboriginal and Torres Strait Islander knowledges and cultural practices might impact their practice as a scientist, many felt their perspective had changed and that reflecting on their cultural values and beliefs had improved their cultural capability. Most students responded that this subject challenged (at least to a degree) some firmly held assumptions, ideas, and beliefs."

The Longitudinal Study of Indigenous Children (LSIC; also called Footprints in Time) is the only longitudinal study of developmental outcomes for Aboriginal and Torres Strait Islander children globally. Footprints in Time follows the development of Australian Aboriginal and Torres Strait Islander children to understand what Indigenous children need to grow up strong. LSIC involves annual waves of data collection (commenced in 2008) and follows approximately 1,700 Aboriginal and Torres Strait Islander children living in urban, regional, and remote locations. This LSIC Primary School report has been produced following the release of the twelfth wave of data collection, with the majority of LSIC children having completed primary school (Preparatory [aged ~5 years] to Year 6 [aged ~12 years]). Primary schools play a central role in supporting student learning, wellbeing, and connectedness, and the Footprints in Time study provides a platform for centring Indigenous voices, connecting stories, and exploring emerging themes related to the experience of Indigenous children and families in the Australian education system. This report uses a mixed-methods approach, analysing both quantitative and qualitative data shared by LSIC participants, to explore primary school experiences from the perspective of children, parents and teachers. Analyses are framed using a strengths-based approach and are underpinned by the understanding that all aspects of life are related. The report documents a range of topics including teacher cultural competence, racism, school-based Aboriginal and Torres Strait Islander education activities, parental involvement, engagement, attendance, and academic achievement.

Coffs Harbour on the north coast of NSW is a highway city sandwiched between the Great Dividing Range and the Pacific Ocean. For thousands of years it was the traditional land of the numerous Gumbaynggirr peoples. Tourism now appears to be the major industry, supplanting agriculture and timber getting, while a large service sector has grown up around a sizable retirement community. It is major holiday destination. Located further away from the coast in the midst of a dairy farming community, Bellingen has become a centre of alternative culture which relies heavily on a variety of festivals activated by energetic tree changers and numerous professionals who have relocated from Sydney. Both communities rely on the visitor economy and there have been considerable changes to how local government in this region approach strategic planning for arts and culture. The newly built Coffs Harbour Education Campus (CHEC) is an experiment in encouraging cross pollination between innovative businesses and education and incorporates TAFE NSW, Coffs Harbour Senior College and Southern Cross University as well as the Coffs Harbour Technology Park and Coffs Harbour Innovation Centre all on one site. The 250 seat Jetty Memorial Theatre is the main theatre in Coffs Harbour for local and touring productions while local halls and converted theatres are the mainstay of smaller communities in the region. As peak body Arts Mid North Coast reports, there is a good record of successful arts related events which range across all genres of music, art, sculpture, Aboriginal culture, street art, literature and even busking and opera. These are mainly managed by passionate local volunteers.

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.