Dissertations / Theses on the topic 'Aboriginal health'
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1
Craig, Barbara. "Jurisdiction for Aboriginal health in Canada." Thesis, University of Ottawa (Canada), 1992. http://hdl.handle.net/10393/7706.
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The purpose of this thesis is to determine which level of government has jurisdiction for Aboriginal$\sp1$ health in Canada--the federal or the provincial. As background to the consideration of jurisdiction for Aboriginal health in Canada, three things are examined: the existing legal and policy frameworks for Aboriginal health; the development of the delivery of health services to Aboriginal people; and the current health status of Aboriginal people in Canada. The distribution of exclusive legislative powers between the federal and provincial legislatures contained in sections 91 and 92 of the Constitution Act, 1987 is examined and the "peace, order and good government" power of the federal Parliament is considered. Legislative jurisdiction over health is considered. The extent of the federal power over "Indians, and Lands reserved for the Indians" as a result of subsection 91(24) of the Constitution Act, 1867 is explored. Parallels are drawn between labour relations and health jurisdictional issues, in an attempt to determine where legislative jurisdiction for Aboriginal health rests. The spending power of Parliament, the Crown-Indian treaty process and the nature of Indian treaties, and the fiduciary relationship between First Nations and the federal and provincial governments is examined. The final conclusion is that Aboriginal health is a double aspect matter, to which valid legislation of both levels of government can apply. Although there are spheres of exclusive provincial jurisdiction, e.g. regulation of health practitioners and hospitals, there is no exclusive federal sphere. However, the federal government does have concurrent jurisdiction with the provinces over the public health of Aboriginal people. The doctrine of paramountcy applies to give valid federal legislation pre-eminence over inconsistent provincial legislation. (Abstract shortened by UMI.) ftn$\sp1$In this thesis, the term "Aboriginal" is intended to have the same meaning it does in the Constitution Act, 1982, section 35. Section 35(2) states: "In this Act, "aboriginal peoples of Canada" includes the Indian, Inuit and Metis peoples of Canada." It is my submission that "Indian" as it is used in section 35 includes both status and non-status Indians.
2
Wisener, Katherine Marie. "Aboriginal health education programs : examining sustainability." Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/33830.
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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.
3
Jackson, Pulver Lisa Rae. "An argument on culture safety in health service delivery towards better health outcomes for Aboriginal peoples /." University of Sydney. Public Health and Community Medicine, 2003. http://hdl.handle.net/2123/609.
Full textAbstract:
The bureaucratic measure of health service, health performance indicators, suggest that we are not effective in our legislative responsibility to deliver suitable health care to some of the populations we are meant to serve. Debate has raged over the years as to the reasons for this, with no credible explanation accepted by those considered stakeholders. One thing is clear though, we have gone from being a culture believing that the needs of the many far outweigh those of the few, to one where we are barely serving the needs of the 'any'. This is most evident in the care delivered to the Aboriginal and Torres Strait Islander people of Australia.
4
Jackson, Pulver Lisa Rae. "An argument on culture safety in health service delivery: towards better health outcomes for Aboriginal peoples." Thesis, The University of Sydney, 2003. http://hdl.handle.net/2123/609.
Full textAbstract:
The bureaucratic measure of health service, health performance indicators, suggest that we are not effective in our legislative responsibility to deliver suitable health care to some of the populations we are meant to serve. Debate has raged over the years as to the reasons for this, with no credible explanation accepted by those considered stakeholders. One thing is clear though, we have gone from being a culture believing that the needs of the many far outweigh those of the few, to one where we are barely serving the needs of the 'any'. This is most evident in the care delivered to the Aboriginal and Torres Strait Islander people of Australia.
5
Bartlett, William Bennett. "Origins of Persisting Poor Aboriginal Health: An Historical Exploration of Poor Aboriginal Health and the Continuity of the Colonial Relationship as an Explanation of the Persistence of Poor Aboriginal Health." University of Sydney, Public Health & Community Medicine, 1999. http://hdl.handle.net/2123/386.
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The thesis examines the history of Central Australia and specifically the development of health services in the Northern Territory. The continuing colonial realtionships between Aboriginal and non-Aboriginal Australia are explored as a reason for the peristence of poor Aboriginal health status, including the cycle of vself destructive behaviours. It rovides an explanation of the importance of community agency to address community problems, and the potential of community controlled ABoriginal health services as vehicles for such community action.
6
Bartlett, Ben. "Origins of persisting poor Aboriginal health an historical exploration of poor Aboriginal health and the continuities of the colonial relationship as an explanation of the persistence of poor Aboriginal health /." Connect to full text, 1998. http://setis.library.usyd.edu.au/~thesis/adt-NU/public/adt-NU1999.0016/index.html.
Full textAbstract:
Thesis (M.P.H.)--Dept. of Public Health & Community Medicine, Faculty of Medicine, University of Sydney, 1999."An historical exploration of poor aboriginal health and the continuities of the colonial relationship as an explanation of the persistence of poor aboriginal health " Includes bibliographical references (leaves 334-349).
7
Bartlett, William Bennett. "Origins of Persisting Poor Aboriginal Health: An Historical Exploration of Poor Aboriginal Health and the Continuity of the Colonial Relationship as an Explanation of the Persistence of Poor Aboriginal Health." Thesis, The University of Sydney, 1998. http://hdl.handle.net/2123/386.
Full textAbstract:
The thesis examines the history of Central Australia and specifically the development of health services in the Northern Territory. The continuing colonial realtionships between Aboriginal and non-Aboriginal Australia are explored as a reason for the peristence of poor Aboriginal health status, including the cycle of vself destructive behaviours. It rovides an explanation of the importance of community agency to address community problems, and the potential of community controlled ABoriginal health services as vehicles for such community action.
8
Saville, Deborah M. "Language and language disabilities : aboriginal and non-aboriginal perspectives." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape11/PQDD_0002/MQ44273.pdf.
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Spark, Ross L. "Developing health promotion methods in remote Aboriginal communities." Thesis, Curtin University, 1999. http://hdl.handle.net/20.500.11937/969.
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This thesis investigates the development and implementation of health promotion strategies and methods in remote Aboriginal communities via the Kimberley Aboriginal Health Promotion Project (KAHPP), a project funded under a grant from the Commonwealth Department of Health and Family Services and conducted by the School of Public Health at Curtin University of Technology. The aim of the project was to investigate the effectiveness of health promotion strategies and methods in remote Aboriginal communities and to develop structures for implementing effective Aboriginal health promotion programs.There were three main research components in this study: an assessment of health indicators; an assessment of the intervention impact; and an assessment of the media component of the intervention. The research methodology included the development of a culturally appropriate survey instrument and the conduct of cross-sectional surveys of three remote Aboriginal communities with differing historical circumstances in the Kimberley region. The questionnaire and field study methods were piloted in 1990 and the main study conducted in 1991 1[superscript].A health promotion intervention was conducted based on an approach originally developed in the Northern Territory 2[superscript]. The intervention employed community development and mass media strategies. Community members nominated health issues that they wished to address, from which 'storyboards' were created for health promotion advertisements to appear on remote television on a paid schedule 3[superscript]. Representative random samples of adult males and females from three remote Aboriginal communities were surveyed according to a range of attitudinal and behavioural health indicators. A post-test survey assessed media reach and impact and pre-post surveys assessed relevant changes in the communities.The cross-sectional survey of health indicators found differences between communities in terms of self-assessed health and risk behaviours. These are discussed in terms of the historical differences between communities and with respect to each community's current situation. Respondents from all communities rated environmental factors as important in their contribution to health, and generally more so than individual lifestyle behaviours.The study demonstrated that television has the potential to reach the vast majority of Aboriginal people in remote communities in the Kimberley. There was some indication that participation in the development of advertisements was associated with higher recognition and more positive assessments of that advertisement. No significant differences in selected indicators of community 'empowerment' were detected following the intervention.The thesis methodology has contributed to the development of a set of guidelines for the conduct of survey research in remote Aboriginal communities, 4[superscript] and has guided the formation of Aboriginal health promotion units in Western Australia and elsewhere.1. Spark R, Binns C, Laughlin D, Spooner C, Donovan RJ. Aboriginal people's perceptions of their own and their community's health: results of a pilot study. Health Promotion Journal of Australia 1992; 2(2):60-61.2. Spark R, Mills P. Promoting Aboriginal health on television in the Northern Territory: a bicultural approach. Drug Education Journal of Australia 1988; 2 (3):191-198.3. Spark R, Donovan RJ, Howat P. Promoting health and preventing injury in remote Aboriginal communities: a case study. Health Promotion Journal of Australia 1991; 1(2):10-16.4. Donovan RJ, Spark. R. Towards guidelines for conducting survey research in remote Aboriginal communities. Australian and New Zealand Journal of Public Health 1997; 21:89-94.
10
Spark, Ross L. "Developing health promotion methods in remote Aboriginal communities." Curtin University of Technology, School of Public Health, 1999. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=9501.
Full textAbstract:
This thesis investigates the development and implementation of health promotion strategies and methods in remote Aboriginal communities via the Kimberley Aboriginal Health Promotion Project (KAHPP), a project funded under a grant from the Commonwealth Department of Health and Family Services and conducted by the School of Public Health at Curtin University of Technology. The aim of the project was to investigate the effectiveness of health promotion strategies and methods in remote Aboriginal communities and to develop structures for implementing effective Aboriginal health promotion programs.There were three main research components in this study: an assessment of health indicators; an assessment of the intervention impact; and an assessment of the media component of the intervention. The research methodology included the development of a culturally appropriate survey instrument and the conduct of cross-sectional surveys of three remote Aboriginal communities with differing historical circumstances in the Kimberley region. The questionnaire and field study methods were piloted in 1990 and the main study conducted in 1991 1[superscript].A health promotion intervention was conducted based on an approach originally developed in the Northern Territory 2[superscript]. The intervention employed community development and mass media strategies. Community members nominated health issues that they wished to address, from which 'storyboards' were created for health promotion advertisements to appear on remote television on a paid schedule 3[superscript]. Representative random samples of adult males and females from three remote Aboriginal communities were surveyed according to a range of attitudinal and behavioural health indicators. A post-test survey assessed media reach and impact and pre-post surveys assessed relevant changes in the communities.The cross-sectional survey ++of health indicators found differences between communities in terms of self-assessed health and risk behaviours. These are discussed in terms of the historical differences between communities and with respect to each community's current situation. Respondents from all communities rated environmental factors as important in their contribution to health, and generally more so than individual lifestyle behaviours.The study demonstrated that television has the potential to reach the vast majority of Aboriginal people in remote communities in the Kimberley. There was some indication that participation in the development of advertisements was associated with higher recognition and more positive assessments of that advertisement. No significant differences in selected indicators of community 'empowerment' were detected following the intervention.The thesis methodology has contributed to the development of a set of guidelines for the conduct of survey research in remote Aboriginal communities, 4[superscript] and has guided the formation of Aboriginal health promotion units in Western Australia and elsewhere.1. Spark R, Binns C, Laughlin D, Spooner C, Donovan RJ. Aboriginal people's perceptions of their own and their community's health: results of a pilot study. Health Promotion Journal of Australia 1992; 2(2):60-61.2. Spark R, Mills P. Promoting Aboriginal health on television in the Northern Territory: a bicultural approach. Drug Education Journal of Australia 1988; 2 (3):191-198.3. Spark R, Donovan RJ, Howat P. Promoting health and preventing injury in remote Aboriginal communities: a case study. Health Promotion Journal of Australia 1991; 1(2):10-16.4. Donovan RJ, Spark. R. Towards guidelines for conducting survey research in remote Aboriginal communities. Australian and New Zealand Journal of Public Health 1997; 21:89-94.
11
Lansingh, Van Charles. "Primary health care approach to trachoma control in Aboriginal communities in Central Australia." Connect to thesis, 2005. http://repository.unimelb.edu.au/10187/984.
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This study concerned a primary health care approach to trachoma control in two Central Australian Aboriginal communities. The World Health Organization (WHO) has advocated that the best method to control trachoma is the SAFE strategy (Surgery, Antibiotics, Facial hygiene, and Environmental improvements), and this approach was adopted.The communities, Pipalyatjara and Mimili, with populations slightly less than 300 each, are located in the Anangu Pitjantjatjara (AP) lands of Central Australia, in the northwest corner of the South Australia territory. At Pipalyatjara, a full SAFE-type intervention was undertaken, with the ‘E’ component designed and implemented by the NHC (Nganampa Health Council Inc.). At Mimili, only a SAF-type of intervention was implemented.
Baseline data was gathered for 18 months from March 1999 through September 2000 (five visits to Pipalyatjara and four at Mimili), and included determining trachoma prevalence levels using the WHO system, facial cleanliness, and nasal discharge parameters. A trachoma health program was implemented at the end of this period and a one-time dose of azithromycin was given in September of 2000. The chief focus of the study was children under 15 years of age.
Improvements in road sealing, landscaping, and the creation of mounds were started to improve dust control. Concurrently, efforts were made in the houses of the residents to improve the nine healthy living practices, which were scored in two surveys, in March 1999 and August 2001. Trachoma prevalence, and levels of facial cleanliness and nasal discharge were determined at 3, 6, and 12 months following antibiotic administration.
In children less than 15 years of age, the pre-intervention prevalence level of TF (Trachoma Follicular) was 42% at Pipalyatjara, and 44% at Mimili. For the 1-9 year age group, the TF prevalence was 47% and 54% respectively. For TI (Trachoma Intense), the pre-intervention prevalence was 8% for Pipalyatjara, and 9% for Mimili. The TF prevalence, adjusted for clustering, and using only individuals present at baseline and follow-up (3, 6, and 12 months post-intervention), was 41.5%, 21.2%, 20.0%, and 20.0% at Pipalyatjara respectively. For Mimili, the corresponding prevalence figures were 43.5%, 18.2%, 18.2%, and 30%.
In the 1-9 year age group, a lower TF prevalence existed between the pre-intervention and 12-month post-intervention points at Pipalyatjara compared to Mimili. The TF prevalence after the intervention was also lower for males compared to females, when the cohorts were grouped by gender, rather than community. It is posited that reinfection was much higher at Mimili within this age group, however, in both communities, there appeared to be a core of females whose trachoma status did not change. This is speculated as mainly being caused by prolonged inflammation, though persistent infection C. Trachomatis cannot be ruled out.
Facial cleanliness and nasal discharge continued to improve throughout the intervention at both communities, but at the 3-month post-intervention point no longer became a good predictor of trachoma.
It is not known whether the improvements in the environment at Pipalyatjara were responsible for the reduction in trachoma prevalence 12 months after the intervention, relative to Mimili.
12
Hughes, Ian. "Self-Determination: Aborigines and the State in Australia." Thesis, The University of Sydney, 1997. http://hdl.handle.net/2123/931.
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This thesis is an inquiry into the possibility of Aboriginal autonomy under the regime of a state policy which commands self determination. Debate about policy has been dominated by Western scientific, political and professional knowledge, which is challenged by indigenous paradigms grounded in the Dreaming. A recognition of the role of paradox leads me to an attempt at reconciliation between the old and the new Australian intellectual traditions. The thesis advances the theory of internal colonialism by identifying self-determination as its current phase. During more than 200 years of colonial history the relationship between Aborigines and the state has been increasingly contradictory. The current policy of self-determination is a political paradox. Aboriginal people must either conform to the policy by disobeying it, or reject the policy in obedience to it. Through the policy of self-determination the state constructs a relationship of dependent autonomy with Aboriginal people. In a two-year (1994-95) action research project Kitya Aboriginal Health Action Group was set up to empower a local community to establish an Aboriginal health service despite opposition from the Government Health Service. In collaboration with local general practitioners and volunteers the action group opened a health centre. After the end of formal field work government funding and support for the health service was granted. The project illustrated the paradox of dependent autonomy. What appeared as successful community development was not development, and what appeared as destructive factionalism was empowering. Strategies for change made use of contradictions and paradoxes within the state. As an innovation in the practice of social change, the thesis begins the construction of a model for indigenous community action for self-determination in health.
13
McCoy, Brian Francis. "Kanyirninpa : health, masculinity and wellbeing of desert Aboriginal men." Access full text, 2004. http://repository.unimelb.edu.au/10187/2416.
Full textAbstract:
Kanyirninpa, or holding, exists as a deeply embedded value amongst desert Aboriginal peoples (Puntu). It is disclosed as authority with nurturance, where older generations assume the responsibility to care for and look after younger people. Kanyirninpa also holds in balance two other key cultural patterns of desert life, autonomy and relatedness. These values are transmitted across generations where they provide desert society with identity, cohesion and strength. While kanyirninpa can be identified in the nurturance provided a child after birth, its presence and power is particularly disclosed at ceremonial time. Here, the meanings of the ancestral tjukurrpa (dreaming) are celebrated and renewed. Desert society is reproduced as the deeper, social and cosmic meanings around ngurra (land), walytja (family) and tjukurrpa are gathered, ritualised and re-enacted. The older generations of men and women enable this holding to occur. When boys (marnti) become men (wati) the manner of kanyirninpa changes. No longer do young men seek to be held by their mothers and female relations. Instead, they seek to be held by older men: brothers, uncles and other males. By holding them older men induct younger men into the social meanings and behaviours of desert, male adulthood. A generative and generational male praxis is disclosed.
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Parsons, Meg. "Spaces of disease the creation and management of Aboriginal health and disease in Queensland 1900-1970 /." Connect to full text, 2008. http://hdl.handle.net/2123/5572.
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Thesis (Ph. D.)--University of Sydney, 2009.Degree awarded 2009; thesis submitted 2008. Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept.of History, Faculty of Arts. Title from title screen (viewed 3 December, 2009). Includes graphs and tables. List of tables: leaf 9. List of illustrations: leaves 10-12. Includes bibliographical references. Also available in print form.
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Sevo, Goran. "A multidimensional assessment of health and functional status in older Aboriginal Australians from Katherine and Lajamanu, Northern Territory /." View thesis entry in Australian Digital Theses Program, 2003. http://thesis.anu.edu.au/public/adt-ANU20051021.144853/index.html.
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Thomas, William. ""The social determinants of Aboriginal Health: A literature review"." School of Native Human Services, 2003. http://142.51.24.159/dspace/handle/10219/416.
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The Assembly of First Nations has identified "the need to develop an integrated, holistic,
inter-departmental and inter organizational organism to address the inequities and gaps in
health and social service delivery to First Nations" (AFN, 2002). However, there is much work to
be done in efforts to reach this goal, as there are many factors that one must
take into consideration when examining Aboriginal health from a holistic perspective. For
example, it has been reported that in British Columbia (BC) that 20% of Aboriginal people
are below the provincial average based on income, employment, and educational attainment and
housing (Kendell and Hull, 2002).
In addition to national reports, the BC Ministry of Health advocates that there is the need to
look at the broad spectrum of health and social determinants to come up with solutions that
will improve the health and well being of Aboriginal people. These determinants are comprised
of health, gender, biology, culture, coping skills, social environments, social support
networks, income and social status, employment and working conditions, education, child
development and physical environments. The determinants are interdependent, cannot be examined
individually and a holistic approach needs to be utilized when dealing with
Aboriginal health issues. It is important for non-aboriginals to observe the difference
in fundamental viewpoints of Aboriginal people in their relationship with the natural
surroundings, other races, flora and fauna (Driben and Simpson, 2000). The lack of control over
one's life plays an important factor in their well-being.
17
Devries, Karen Maria. "Condom use and sexual health among Canadian Aboriginal Youth." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.582545.
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Background Aboriginal youth are more likely to contract a variety of STIs versus other Canadian youth, but the determinants of sexual health in this group are seldom researched. This thesis explores condom use and sexual health among Aboriginal youth and generates recommendations for interventions. Methods Two systematic reviews were conducted examining relationships between different factors and condom use, among indigenous peoples and other diverse groups of youth. Next, qualitative interviews were conducted with 30 Aboriginal youth in British Columbia, Canada. Finally, a secondary analysis of cross-sectional data from a large, representative survey was performed to model relationships between various exposures and ever having sex, having more than one sexual partner, condom use, STI diagnosis and pregnancy involvement. Results The two systematic reviews revealed serious potential bias in studies assessing condom use among indigenous peoples and other diverse groups. Few factors were tested across populations, and little insight was gained as to which factors may differ in their relative importance. In the qualitative study, youth with less stable family relationships and negative life experiences described more risky sexual behaviour than those who did not. Both genders engaged in coercive sexual negotiation, and sometimes young women insisted on condom non-use. Youth also described concurrent/serially monogamous relationships with rapid rates of partner change. These relationships could be 'serious', and 'serious' relationships could denote an acceptable context for pregnancy. In the cross-sectional study, substance use, unwanted sex, and living on reserve increased risk of multiple outcomes. Feeling more connected to family was strongly protective for both genders, and for girls, helping out in the community was also protective. Conclusions Interventions addressing substance use, sexual communication and family relationships may be efficacious for improving sexual health among Aboriginal youth. Building on youth's own ideas about positive lifestyles could be an effective method of tailoring.
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Winch, Marie Joan. "Marr Mooditj Foundation : three decades of aboriginal health education." Thesis, Curtin University, 2010. http://hdl.handle.net/20.500.11937/2541.
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This thesis presents a history of Marr Mooditj Foundation, the Aboriginal health worker training college that has for the past thirty years provided culturally appropriate education in primary health care and training for Indigenous staff involved in delivering and managing health care and community service programs. It traces the development of Marr Mooditj from its origins in the context of Indigenous health in the 1970s through to its current achievements and challenges.This auto-ethnographic study, which focuses on my central positioning as an advocate and leader of Marr Mooditj, documents the history of how Marr Mooditj emerged from a context of ‘dis-ease’, where government legislation and the introduction of strict and repressive policies and practices regarding Indigenous people determined an outcome that resulted in a disruption of lifestyle, separation of children from families, serious illness, and an on-going, poverty-stricken separation from the rest of the population. It explores the wide-ranging ramifications of the appalling state of Indigenous health in Western Australia, and the part played by all those involved in establishing and running Marr Mooditj and the Perth Aboriginal Medical Service in working at changing this for the better. The thesis argues that Marr Mooditj Foundation is now deeply embedded within Aboriginal culture, is responsible for delivering culturally safe programs, and can be proud of its contribution to closing the gap between Aboriginal and mainstream health care in Australia.
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Hummelle, Laura. "Exploring the mental health needs of aboriginal people in the Capital Health Region." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/MQ62019.pdf.
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Nilson, Caroline. "Bindjareb Yorgas Health Program: Promoting Aboriginal women's health in a regional community setting." Thesis, Nilson, Caroline ORCID: 0000-0003-3975-3862 (2016) Bindjareb Yorgas Health Program: Promoting Aboriginal women's health in a regional community setting. PhD thesis, Murdoch University, 2016. https://researchrepository.murdoch.edu.au/id/eprint/31360/.
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This study addresses the self-identified health issues experienced by yorgas (women) in an Aboriginal Bindjareb (region) community in the Nyungar nation of south west Western Australia. In collaboration with yorga Elders and Leaders from the Murray Districts Aboriginal Association (MDAA), Caroline Nilson, a non-Indigenous researcher, academic and health professional, developed, coordinated, facilitated, and implemented a culturally appropriate health promotion initiative, the Bindjareb Yorgas Health Program [BYHP], which was the topic of Caroline's PhD research project.
The BYHP aims were to foster the development of personal knowledge and skills in achieving and maintaining wellness, and the strengthening of community actions towards improving health by facilitating improved individual and group health literacy. Further, the study sought an understanding of the ways in which the BYHP facilitated healthy lifestyle change in the Bindjareb yorgas and their families and whether the structure and delivery of the program provided a supportive environment for the women to engage in sustainable health promotion activities.
The BYHP was underpinned by the ideals of the Aboriginal model of health, which encompasses all aspects of a person's life (Lock, 2007). This concept places significant emphasis on social and emotional components and is linked to the sense of being Aboriginal, through connection with the environment (social and economic), community, relationships, land, the physical body and the mind, and traditional cultural lore (law) and knowledge (Nyungar kaartdijin). The BYHP study consisted of four components: nutrition and cooking classes, group fitness classes (including walking group sessions), a community vegetable garden project and health 'yarning' sessions (a culturally appropriate method of communicating about important matters), which comprised informal and formal discussions.
Twenty-two women from the two kinship groups in two towns in the research setting were invited to take part in the project. Purposive and snowball sampling were used to recruit the yorga participants and the consent processes were conducted by the yorga Elders and Leaders and resulted in 17 Bindjareb yorgas consenting to participate.
There were a total of 24 cooking and nutrition classes and all 17 participants each took part in between 3 and 22 classes. Attendance at the 33 group fitness classes varied, with 16 of the 17 participants taking part in between 1 and 29 classes; as did attendance at the 24 walking group sessions where 13 yorgas participated in between 3 and 22 sessions each. Six participants volunteered to share the vegetable garden management over a 24 week period resulting in an average weekly attendance of 5.5 visits between them. A number of yarning sessions (individual and group) were also facilitated by Caroline in collaboration with Karrie-Anne Kearing-Salmon, an Aboriginal woman Leader appointed as the research assistant.
An ethnographic action research [EAR] approach was used in the research, which combines the methodologies of ethnography, participatory techniques and action research (Tacchi, Slater & Hearn, 2003; Tacchi, et al., 2007). The data was collected with the assistance of the yorga Elders and Leaders during which time Caroline was also mentored by Gloria Kearing, a yorga Elder. Data sources included audio recorded yarning groups, audio recorded individual yarning, direct observations and participant-observations, and Caroline's personal diary notes audio recorded during fieldwork.
A narrative art project was also conducted as a culturally appropriate method of gathering data and was used as an opportunity to facilitate informal health yarning. The works of art were shared with the wider community in a public gallery exhibition, which ran for six weeks during August and September 2013.
Thematic analysis of the data was undertaken in consultation and collaboration with the selected yorga Elders and Leaders for each component of the research, and was assisted using Artichoke ™ (Fetherston, 2013), a computer-based program.
Results that have captured the main findings are presented in the thesis in a number of peer-reviewed published and under review articles and other manuscripts have been prepared and are in the process of submission.
The themes identified from the cooking and nutrition component related to experiences of overwhelming loss, acknowledging collective shame, finding change too hard, being crippled by the lack of resources, mistrust, and tensions, community control empowering individuals through engagement, learning for life purpose, and planning for community determination.
The themes derived from the group fitness component related to the loss of traditional knowledge and practices, withdrawal due to shame, community facilitation enabling enjoyment in engagement, and experiencing a sense of place and connection to land and culture.
The community vegetable garden component themes related to feelings of ownership: "deadly, unna?" (very good, isn’t it?), "ngnaailak" (belongs to us); a sense of place: "nalaru boodjar" (our own country), "kwobbrup" (a good place); reconnection to traditional land: "boodjar, mundak and ponar" (land, the bush and the seasons); pride in learning new skills: "djinanginy kaartdijin" (seeing, learning, and understanding); and hoping for continued community engagement and partnership support: "patpatan mila" (worried for the future).
The health yarning component themes related to patience in the ways of talking with the yorgas "moorditj bandjar tarwagin" (patient way of talking with us), feelings of safety to talk about health issues and coming together as equals to become strong in health; "djaliny moordidjabiny kootamiara quab" (listening to become strong in health).
The narrative art project themes related to the overall connectedness and the mobilisation of community members in coming together to consolidate relationships for their health and wellbeing; individuals coming together for their health and wellbeing, and processes in mobilising community social relationships. The additional themes related to the yorgas developing self-identity through painting their experiences and their creativity contributing to community empowerment.
In regards to sustainable lifestyle change, themes from the group fitness and cooking and nutrition components around the real challenges and barriers also emerged. The acknowledgement of shame was identified as a psychosocial barrier and previously experienced reduced health literacy was seen as having a negative impact on food security and healthy lifestyle choices. Several themes relating to the importance of a 'sense of place' and 'feelings of safety', and the 'rekindled connection to land' were threaded through all the components, particularly the vegetable garden project. These themes were critical in answering the research questions regarding community ownership and the culturally appropriate structure and delivery of the BYHP. Themes from the cooking and nutrition component also related to the impact of historical events on nutritional health of Indigenous Australians, and on the undermining effect of mistrust within the community and towards outsiders and the need to plan to achieve a real sense of community determination and address issues of limited resources. These themes were pertinent in answering the research question regarding the required community action to lead to the sustainability of the program.
The findings suggest that historical colonisation processes greatly influence current Aboriginal health and wellbeing. It has impacted on individual and community esteem and determination, resulting in feelings of inadequacy, racial demoralisation and mistrust, towards others and within their own groups. Feelings of a sense of place, the reconnection to land and culture, and a sense of safety were a common thread to have emerged from the BYHP. These correlated with further findings that identify the need for community collaboration and control. The acknowledgement of shame was identified as a psychosocial barrier influencing health literacy, food security and healthy lifestyle choices. The real challenges of change around healthy eating and physical activity were highlighted, however the sense of purpose gained through learning new skills and knowledge was found to be a key driver towards change. To achieve sustainability the findings highlighted the need for continued partnership development and ongoing planning for skills and employment opportunity and these were identified as important to achieving a real sense of community determination.
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Lee, Vanessa Sharon. "Aboriginal Community Controlled Health Services: Controlled or Controlling their own Destinies?" Thesis, Griffith University, 2016. http://hdl.handle.net/10072/367501.
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The Indigenous people in Australia are the Aboriginal and Torres Strait Islanders. Since colonisation in 1788 this population has diminished significantly. Following years of advocacy addressing inequitable government policies towards Aboriginal and Torres Strait Islanders, the first Aboriginal Medical Service was established in Redfern, New South Wales, in 1971. From this one Aboriginal Medical Service there grew many more across Australia; in some jurisdictions they are referred to as Aboriginal Community Controlled Health Services (ACCHS). This study was designed to examine the bureaucratic and organisational structures, functions and operations of these ACCHS, and how these services meet both the organisation’s requirements and the community’s expectations when delivering a culturally-appropriate health service to Aboriginal and Torres Strait Islander people.
This research applies a case study method within a qualitative paradigm for the depth needed to explore the research aims. Following discussions with the Queensland Aboriginal and Islander Health Council, the sites for this research were identified in central and southern Queensland. The three sites were vastly separated by distance but at the same time subjected to similar historical abuse. The participants drawn from these sites were Aboriginal and Torres Strait Islanders and the research attempted to capture their perceptions. Each case was subjected to a conceptual and thematic analysis to draw out the key themes and concepts and thence to develop a theoretical model of how the ACCHS balance their organisational requirements and community expectations.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medical Science
Griffith Health
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Paradies, Yin Carl. "Race, racism, stress and indigenous health /." Connect to thesis, 2006. http://eprints.unimelb.edu.au/archive/00002514.
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Hunter, Linda M. "Traditional Aboriginal healing practices: An ethnographic approach." Thesis, University of Ottawa (Canada), 2004. http://hdl.handle.net/10393/26662.
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This thesis explores traditional Aboriginal healing practices as they relate to health issues by asking the research question "How do urban-based First Nations peoples use healing traditions to address their health issues?" The purpose of this thesis was to explore the healing traditions of urban-based First Nations peoples. The objectives were to describe the use of Aboriginal healing traditions, discuss how these traditions addressed health issues, and explore the link between such traditions and holism in nursing practice.
Critical ethnography was the qualitative research method used for this thesis. Data collection consisted of eight individual interviews, participant observations over a period of four months, and field notes. The three major categories that emerged from the data analysis were (a) the following of a cultural path, (b) the gaining of balance, and (c) the circle of life. The theme of healing holistically emerged. Healing holistically includes following a cultural path by regaining culture through the use of healing traditions; gaining balance in the four realms of the spiritual, emotional, mental, and physical self, and sharing culture between Aboriginal peoples and non-Aboriginal health professionals, as part of the circle of life.
Implications for practice include incorporating the concepts of balance, a holistic outlook, and healing and culture into the health care of diverse First Nations groups. Healing holistically is an ongoing process that continues throughout the lifespan. This process can contribute to empowerment for Aboriginal peoples through an enhanced state of health reached by using traditional healing and understood through a critical ethnography approach.
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Mundel, Erika. "Story-gathering with the Urban Aboriginal Community Kitchen Garden Project." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/2527.
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This research focuses on the work of the Urban Aboriginal Community Kitchen Garden Project (the Garden Project). The Garden Project aims to be a culturally appropriate health promotion project with urban Aboriginal people, drawing on traditional Indigenous approaches to health and healing, and rooted in community food work. The project is situated within the context of colonialism, the destruction of traditional foodways, and subsequent increased need for Indigenous people to rely on a dominant food system that is seen as destructive to human and ecological health.
The purpose of my research is to describe the Garden Project’s main goals and achievements from the perspective of project leaders, project participants as well as through my own observations and experiences. The research methodology was guided by participatory and community based approaches to research and qualitative methods were employed, focusing primarily on semi-structured interviews with project participants and project leaders. I also participated in and observed the project for two years, from September 2006-September 2008. Data collection and analysis happened through an iterative process of action and reflection.
Based on my time with the Garden Project, I suggest that it can be seen simultaneously as a community food security, health promotion, and Indigenous health project. It connects participants with food as a natural product, builds skills around cooking and growing food, and increases knowledge about food system issues. Drawing on the health promotion discourse, it can be seen building community and social support networks, treating the whole person, and empowering participants to take actions around their own health needs. It is rooted in Indigenous approaches to health and healing in the way it promotes individuals’ physical, mental/emotional and spiritual health, the health of the community through cultural revitalization, and the health of the Universe through the opportunity it provides for awareness about ecosystem health.
This research project was very site specific. Nevertheless, the findings suggest that food work with urban Indigenous people, carried out in a culturally sensitive manner, may be a powerful leverage point for promoting health with this population. These types of projects can also be vehicles for social change.
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Schultz, Clinton. "Factors of holistic wellbeing for members of the Aboriginal health and community workforce." Thesis, Griffith University, 2020. http://hdl.handle.net/10072/392019.
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The following thesis is an explanation of a lore and culture informed perspective of worker wellbeing for the Aboriginal health and community workforce derived from the lived experiences of such workers. The entirety of this perspective required the furthering of current understandings or explanations of social and emotional wellbeing that were further removed from western understandings of being, particularly organisational wellbeing and more inclusive of notions of lore and culture. For the modelling to blossom a bricolage Indigenist methodology was required.
A qualitative methodology incorporating elements of Indigenous standpoint theory, grounded theory, critical theory, autobiographical ethnicity and yarning was used to form a bricolage for this study. This bricolage was developed after acknowledging that none of the above-mentioned approaches on their own quite fit the purposes of the current study however elements of each were considered integral. For the purposes of this study, this bricolage was labelled: Critical Aboriginal Bricolage (CAB).
Critical Aboriginal Bricolage (CAB) offers a culturally responsive research methodology that fits with the need to protect Aboriginal knowledge production and to meet academic rigour. It is an approach that promotes the active search for pieces of methodology that most fit the situation under investigation and for those for whom the investigation is occurring. The aim of CAB is to empower the voice of the subject from the culturally informed and involved perspective of the investigator.
For the knowledge produced to be most relevant to those it was produced for and from whom the knowledge came, the importance of Aboriginal ways of sharing knowledge had to be respected and used. This leads to more weight being applied to knowledge transfer through story rather than strict Western academic expectation. The author of this thesis is unforgiving in this pursuit and considers relevance to the target audience and acceptance of the themes from Aboriginal Elders to be of more value than
Western academic ‘excellence’. The author questions the status of power and authority of and over knowledge by western institutions and the legitimacy of such claims particularly with reference to Indigenist knowledges.
Australia has both an internationally recognised (through being a signatory to the United Nations Declaration of the Rights of Indigenous Peoples (UNDRIP)) and a moral obligation to ensure the wellbeing of Australia’s Aboriginal populations is improved as a national priority. Improvements in health outcomes and well–being are dependent on providing self-determination and sovereignty for Aboriginal peoples. This requires allowing Aboriginal people to utilise their own ontologies and epistemologies at all levels of the lived experience, be those education, work, healing, policy, child rearing, living and even dying. It also requires opportunity for Aboriginal peoples to know and to practice their own law as law is intrinsically linked to self–determination. Lore and culture have always provided Aboriginal peoples with the frameworks required to live well with each other and with place on the Australian continent. Looking at lore and culture to inform future policy and procedure is likely to lead to positive outcomes for Aboriginal peoples.
Aboriginal people as a population group experience far greater burden of disease than other Australians. This is the case across all physical and mental health indicators. There is therefore a greater need for service provision for Aboriginal peoples and communities yet engagement and adherence remain low. Access to culturally informed and appropriate health provision is often mentioned as a barrier to Aboriginal health. One identified effective strategy for increasing engagement with health and community services and further improving adherence to health and community service interventions has been to increase the number of Aboriginal workers within the fields of health and community service work.
Increasing the workforce is only a viable strategy if the workforce is stable. Aboriginal health and community service workers experience high levels of stress driven by multiple and at times unique stressors associated with the work they undertake and the communities in which they live or are from. This culminative stress impacts on the overall wellbeing of workers. Negatively impacted wellbeing is likely to be a factor influencing the high turnover and burnout rates experienced by Aboriginal people employed in health and community service work. Given the unique mix of cultural,
historical, professional and social influences of wellbeing present for Aboriginal health and community service providers it is unlikely that western explanations of workplace stress and worker wellbeing such as those offered around burnout or compassion fatigue for instance will be a true and complete fit for this workforce. Currently there is little work investigating the wellbeing of this particular workforce from a culturally rooted standpoint. As Aboriginal workers are themselves Aboriginal people and community members, if we are to be guided by the UN Declaration then culturally informed and appropriate strategies should be developed to assist with the maintenance of their wellbeing. It is therefore pertinent that strategies are developed to better maintain the wellbeing of Aboriginal workers that are developed from Aboriginal ontologies and epistemologies.
The theories offered in this thesis have come from the knowledge and experience of the workers themselves and may support this important work force in staying strong, supported, resilient and empowered in their work. Notions of lore and culture are prominent and are the basis for the theories offered as they have since the beginning of time kept us strong while caring for each other and caring for country.
A new model of holistic being, highlighting the importance of spirit is offered. This model incorporates lore as paramount in the wellbeing experience for Aboriginal people. It is further suggested that this model could be utilised with any population group as humans, in our great diversity of understandings of well-being and healthcare, all share the same basic structure of being. This involves spirit as core; mind, body and soul (as genetic memory) as a basic framework; and multiple connections influencing our story of self and other. This is all surrounded by a constant flow of positive and negative experiences that influence the choices we make and the expressions of being we create at any given time.Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medicine
Griffith Health
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Knight, Michele Therese. "Growing the Aboriginal and Torres Strait Islander." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/13789.
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The current study consisted of two initiatives. The first initiative was to qualitatively explore the perceptions and attitudes of Career Advisers in New South Wales secondary schools regarding health career pathways for Aboriginal and Torres Strait Islander secondary school students. The second initiative was to explore strategies for raising awareness and stimulating interest in health career pathways for Aboriginal and Torres Strait Islander secondary school students. Fifteen Career Advisers from fifteen secondary schools across metropolitan and regional New South Wales participated in the study. At three separate data collection sites, and at the express request of the participant, the school Aboriginal Education Assistant also contributed primary data to the study. It was the express wish of Career Advisers at these schools that an Indigenous perspective be included in the study. At one data collection site, the Deputy School Principal also expressed the wish to be included in the study. In total nineteen participants contributed toward the study. Findings from the current study suggest that Career Advisers work within a challenging world-of-work context which is constantly changing in order to meet the demands of globalisation. Furthermore, it is evident that within this world-of-work context Aboriginal and Torres Strait Islander students face significant barriers and socio-economic disadvantage. This disadvantage severely impacts upon and restricts these students’ access to career education within the schooling environment. Additionally, the opportunity to engage with and foster lifelong learning in conjunction with ongoing career development is also negatively impacted upon. Other than with medicine and nursing, Career Advisers were found to have limited knowledge regarding both the diversity and range of allied health careers that are currently available to Aboriginal and Torres Strait Islander students. Career Advisers noted they work collaboratively with Aboriginal Education Assistants, who are a core component of the learning and teaching environment for Aboriginal and Torres Strait Islander students. In spite of the critical role they play in holistically integrating the schooling environment and the Aboriginal and Torres Strait Islander community, it was noted that of those schools that did employ Aboriginal Education Assistants, did so on a part-time or casual basis. It was also noted by some participants that despite the necessity for Aboriginal Education Assistants to be on staff in their school, and to be available to themselves and to Aboriginal and Torres Strait Islander students, there was no Aboriginal and Torres Strait Islander person employed in that capacity. Notwithstanding these significant challenges, research outcomes from the current study will recommend that Career Advisers and Aboriginal Education Assistants be supported in their roles. This is particularly important if they are to raise awareness and stimulate interest in health career pathways for Aboriginal and Torres Strait Islander students. Furthermore, it is recommended that additional research be conducted in order to determine how the Commonwealth Department of of Education Science and Training can best provide this support.
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Riese, Nichole Margaret Marie. "Perceptions of care, Aboriginal patients at the Winnipeg Health Sciences Centre." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/MQ62834.pdf.
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Brummitt, Rosalind Barbara. "Two health worlds : Aboriginal medical transfers from Central Australia to Adelaide /." Title page, contents and abstract only, 1987. http://web4.library.adelaide.edu.au/theses/09AR/09arb893.pdf.
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Macdonald, Mary Ellen 1969. "Hearing (unheard) voices : aboriginal experiences of mental health policy in Montreal." Thesis, McGill University, 2003. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=84525.
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The focus of this dissertation is the mental health experiences of Aboriginal people in Montreal as they interface with health policy, and lack thereof, for this population.Drawing on anthropological fieldwork from Montreal, Eastern Quebec, and Ontario, this thesis endeavours to unravel the jurisdictional tapestry that Aboriginal clients must negotiate when seeking services in Montreal. Using an ethnographic methodology, this project provides an understanding of the ordering of health services for Aboriginal clients from street-level to policy offices.
This thesis draws on three theoretical areas (theories of illness, aboriginality, and public policy) to explicate four themes that emerge from the data. Analysis moves along a continuum between the illness experience and the macro-social determinants of politics and bureaucracy that impact the health of the individual as well as support and organize systems of care.
Discussion of Theme #1 (evolution of mental health and wellness categories in health theory, policy and practice) and Theme #2 ( the culture concept in health policy) demonstrates that despite the progressive evolution of concepts in health theory and policy, Aboriginal people generally do not find services in Montreal that provide culturally-sensitive, holistic care. Discussion of Theme #3 (barriers to wellness created by jurisdiction) argues that jurisdictional barriers prevent clients' access to even the most basic and rudimentary services and that such barriers can actually disable and increase distress. Discussion of Theme #4 ( Aboriginal-specific services) looks at the pros and cons of creating an Aboriginal-specific health centre in Montreal.
Together, these four themes show that understanding Aboriginal people in Montreal requires contextualizing their embodied experience within the colonial history and institutional racism which characterizes many healthcare interactions, and clarifying the bureaucracy that complicates the search for well-being. Montreal's Aboriginal problematic is located in a system characterized by entrenched bureaucracy, jurisdictional complexity and injustice, these elements mapping onto Aboriginal reality with serious repercussions for individual identity and well-being.
Hearing the voices of Aboriginal people in Montreal as they seek out care for mental health problems requires the resolution of jurisdictional and policy clashes that currently silence their suffering. This thesis endeavours to advance this crucial social agenda.
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Haining, Anna. "Sexual health for New South Wales Aboriginal people: A literature review." Thesis, Indigenous Heath Studies, 2004. http://hdl.handle.net/2123/5695.
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During the past 16 years I have worked in the area of needle and syringe programs 'harm minimisation' and sexual health strategies, targeting different populations of injecting drug users in the Canterbury and Redfern area. My expertise in the field was delivering safe sex education and safe using practices to people who were at risk of HIV or sexually transmitted infections due to their using or sexual choices. Because of the nature of their using, it was not appropriate to provide extensive safe sex and safe using education, as contact with clients was usually less than 5 minutes. In this situation, each worker had to develop short and precise safe sex messages to this population while they were virtually walking out the door. Sexual health for me is such an important part of peoples' lives no matter who they are or what they do, but, there is also a down side in this area of health as many individuals have, in the past experienced many barriers and stigmatization that has influenced them in accessing sexual health services. These barriers and stigmatization from health professionals include inappropriate comments and cultural ignorance towards Aboriginal people. During the first year of my employment as a sexual health worker, women from the local communities contacted me to discuss their concerns about the limited education that families have on sexual health. The women expressed the need and importance of having Aboriginal men and women's sexual health clinics in the area that would provide clinical, education and support to community, as there was a growing concern of young girls falling pregnant and dropping out of school. In addition, the women spoke about their past (usually, not very good) experiences in attending health clinics, and identified what they saw as the main barriers which disabled them from attending sexual health clinics. These were: lack of transport to Sexual Health Services; little cultural acceptance of Sexual Health Services; Aboriginal Workers in the service; lack of availability of culturally appropriate resources, such as men and women's business being separated; and the community's lack of awareness of sexually transmitted infections. Three important themes emerged from these talks: the need for indigenous Sexual Health clinics, male and female, in a Primary Health setting that take into account the diversity of Aboriginal/Torres Strait Islander's culture and protocols; the need for an increase of Aboriginal/Torres Strait Islander Health Workers in Primary Health Care settings; and Holistic Health for Aboriginal and Torres Strait Islander People. Central Sydney Area Sexual Health Service has now taken positive steps towards establishing culturally effective and efficient sexual health clinics for Aboriginal men and women. Funding has been approved and these clinics will commence in 2004. Thus, the choice of this topic for my literature review is a timely one. Undertaking this literature review will provide information that identifies the scope of Aboriginal sexual health issues and, in a broader sense, identifies those issues of main concern - all of which may help inform the establishment of culturally appropriate sexual health programs/projects in CSAHS. Identifying key concerns and recommendations that relate to Aboriginal sexual health will provide an appropriate framework for the formulation of a set of principles that may guide the sexual health planning, development and implementation of sexual health projects/programs in the Central Sydney Area Health Service. in addition, Central Sydney Sexual Health Services in partnership with the Aboriginal Health Service, Redfern are currently developing an Aboriginal Sexual Health Strategy for future men and women's sexual health clinics in this area. In summary, this chapter provides an overview of the future direction of the Central Sydney Area Sexual Health Services and how the findings of this thesis will help to provide a more supportive pathway to the establishing of Aboriginal men and women's sexual health clinics in the local communities.
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Fredericks, Bronwyn L. "Us Speaking about Women's Health: Aboriginal women's perceptions and experiences of health, well-being, identity, body and health services." Thesis, Central Queensland University, 2003. https://eprints.qut.edu.au/13909/1/FREDERICKS%2C_B.L._PHD.pdf.
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When compared to other women in Australia Aboriginal women are considered the most socially and economically disadvantaged and have the poorest health status. Aboriginal women in Rockhampton, Central Queensland are not excluded from this lived reality. This research has explored Aboriginal women’s perceptions and experiences of health and health services in Rockhampton. Drawing on these experiences, and centring the voices of these women, the study reports on findings concerning cross-cultural issues, communication, policy, practice and service delivery. Importantly, the study has built new knowledge identifying the complex relationship between identity, body and well-being.
In undertaking this study, I have developed a ‘talkin’ up’ research process in collaboration with other Aboriginal women. That is, by asking what Aboriginal women in Rockhampton wanted me as an Aboriginal woman researcher to explore and what type of process I would work through with Aboriginal women as the participants. The research has been informed and guided by these Aboriginal women and thus has witnessed the articulations of a more accurate portrayal of Aboriginal women’s perceptions and experiences of health services. I take the witnessing to be partly personally empowering, partly sharing and partly a taking of ownership of experience. As those women interviewed explained, our story here is told ‘by us’. In undertaking such a research process, I needed to ask what it means to be an Indigenous researcher and what is a good Indigenous research process? These are addressed at length within the thesis.
This research process has not involved examining health services with regards to their service provision or their implementation of more empowering practices to improve health outcomes for Aboriginal women. This remains to be done. This research, has instead attempted to answer the question ‘how the relationship between health services and Aboriginal women can be more empowering from the viewpoints of Aboriginal women?’ The assumption underpinning this study is that empowering and re-empowering practices for Aboriginal women can lead to improved health outcomes.
The study found :
Aboriginal women had requirements of health services relating to cultural
comfort of health service environments
Aboriginal women did not access one health provider for all their health
needs, they ‘shopped around’ to meet their general health, Women’s
Business and relationship and privacy requirements
Aboriginal women’s health is impacted upon by stereotypes held of
Aboriginal women around skin colour and Aboriginality
Aboriginal women have an understanding of what is required to improve the
interactions between health service providers and Aboriginal women
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Quantz, Darryl. "Public participation in health policy, a case study of the Region 4 Aboriginal Community Health Council." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/mq65131.pdf.
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Van, Herk Kimberley A. "Intersecting Identities: Exploring Urban Aboriginal Women's Experiences of Accessing Care." Thesis, University of Ottawa (Canada), 2010. http://hdl.handle.net/10393/28782.
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The purpose of this master's thesis is to explore intersections within Aboriginal womens' descriptions of their experiences of accessing care in an urban context, and to explicate how service provider's perceptions of women's identity featured in their care encounters. This thesis is divided into three chapters. The first chapter provides a background on access to care for Aboriginal women living in urban contexts, outlines the methodology of the primary study, and explores the intersectionality paradigm used to complete the secondary analysis done for this study. The second chapter describes the results of the study. It begins by providing a general overview of the major themes and subthemes, followed by two manuscripts that have been written for submission for publication in scholarly journals. The third chapter discusses how this study has contributed to new knowledge for nursing, as well as the implications for nursing education, research and policy.
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Grootjans, John. "Both ways and beyond : in Aboriginal and Torres Strait Islander health worker education." Thesis, View thesis, 1999. http://handle.uws.edu.au:8081/1959.7/445.
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During 1987 my essential beliefs about the nature of the world were challenged by a chance event which led to my arrival in Arnhemland. Working with Aboriginal people allowed me to see first hand the failings of Western ideas in Aboriginal education and health. This is how a 12 year collaboration with Aboriginal people began. The aim was to search for answers to the question, 'Why so many ideas that had been successfully used in the Western world, fail to meet the needs of aboriginal people? My experiences prior to 1995 had led me to believe that Both Ways, an education pedagogy developed in teacher education, was the best approach for empowering Aboriginal Health Workers. I believed Both Ways gave Aboriginal Health Workers a means to develop solutions to aboriginal health issues which valued and respected their aboriginal knowledge. I needed to describe and evaluate the practice of both ways with Aboriginal Health workers for the purpose of proving the benefit of this pedagogy for other educators in this field. This thesis describes how I came to think Both Ways was a good idea; how I defined Both ways; and how I put it into practice. It also provides a description of the issues raised in my critique of Both Ways and in my attempts to provide answers to these issues. Several years of collecting data, including records from action research group discussions, participant observation, interviews with peers and students, and formal evaluations left me with many concerns about Both Ways. As educators follow my journey of discovery I hope that they will recognise experiences and insights that they themselves have shared. The descriptions and discussions in this thesis will add significantly to the overall discourse about health worker education. Similarly, the exploration of ideas beyond Both Ways will add significantly to the overall body knowledge about the power relationships involved in teaching in a cross cultural setting
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Jacobs, Kahá:wi Joslyn. "Mental health issues in an urban Aboriginal population, focus on substance abuse." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0029/MQ64375.pdf.
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Paul, David. "Casting shadows and struggling for control : silence, resistance and negotiation in Australian Aboriginal health." University of Western Australia. School of Primary, Aboriginal and Rural Health Care, 2007. http://theses.library.uwa.edu.au/adt-WU2008.0015.
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Self determination has been recognised as a basic human right both internationally and, to an extent, locally, but it is yet to be fully realised for Aboriginal Peoples in Australia. The assertion of Aboriginal community control in Aboriginal health has been at the forefront of Aboriginal peoples' advocacy for self determination for more than thirty years. Aboriginal Community Controlled Health Services and their representative organisations have been the site of considerable resistance and contestation in the struggles involved in trying to improve Aboriginal health experiences. Drawing on some of these experiences I explore the apparent inability of policy and decision makers to listen to systematic voices calling for change from the Aboriginal Community Controlled Health sector. It is government inability to act more fully on clear and repeated messages that is a source of much disquiet within representative Aboriginal organisations. Such disquiet is grounded in a belief that colonial notions continue to influence decision making at policy, practice and research levels resulting in a significant impediment to the realisation of self determination and associated human rights in Aboriginal health matters and Aboriginal Affairs more broadly.
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Lee, Amanda (Amanda Joan). "Survival tucker : aboriginal dietary intake and a successful community-based nutrition intervention project." Thesis, The University of Sydney, 1992. http://hdl.handle.net/2123/9463.
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Jalla, Caris Lae. "Talking about health, wellbeing and disability in young people: An Aboriginal perspective." Thesis, Curtin University, 2016. http://hdl.handle.net/20.500.11937/48702.
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Disability in Australian Indigenous populations is twice as high compared to non-Indigenous populations. This study explores the perceptions of health and disability from the viewpoint of Indigenous children and young people with and without disabilities. A total of 24 Perth youths aged 9 to 26 years participated. Findings outline the facilitators and barriers to health and beliefs around the causes of disability. These results have important implications for disability service providers working with Indigenous communities.
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Adams, Michael John. "Sexual and reproductive health problems among Aboriginal and Torres Strait Islander males." Thesis, Queensland University of Technology, 2007. https://eprints.qut.edu.au/16599/1/Michael_John_Adams_Thesis.pdf.
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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.
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Adams, Michael John. "Sexual and reproductive health problems among Aboriginal and Torres Strait Islander males." Queensland University of Technology, 2007. http://eprints.qut.edu.au/16599/.
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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.
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Winsor-Dahlstrom, Josephine. "Aboriginal health workers: Role, recognition, racism and horizontal violence in the workplace." Thesis, Indigenous Heath Studies, 2000. http://hdl.handle.net/2123/5708.
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The aim of this project is to explore the role of the Aboriginal Health Worker, their recognition as a legitimate profession and the current racism most will face in the current New South Wales Health System. The position of the Aboriginal Health Worker was introduced to improve the consultation process with Aboriginal people about their health. It was also introduced to address their specific cultural needs around health. Anecdotal reports from the field by various Aboriginal Health Workers show that these objectives have, in large, not been met. A preliminary review into the literature was conducted which includes important discussions and studies into the history and development of the Aboriginal Health Worker role. This review is not placed in a single chapter, but is strategically placed throughout the thesis to demonstrate the impact of this development and history upon the different issues of role, recognition, racism and horizontal violence. This project uses a qualitative approach using a descriptive study design. A sample of five selected participants of who were all ex-Aboriginal Health Workers joined the research project. The qualitative method of theme extraction was employed for data analysis which led to the emergence of themes which were grouped and compared to each other. The findings were contrasted with relevant literature in the field to fully understand the phenomenon under study and explore why objectives regarding Aboriginal Health Workers continue not to be met, despite Health Service Management rhetoric. The five ex-Aboriginal Health Workers were interviewed, in-depth, to provide information on the recognition, role and racism difficulties they faced at work. They were selected from five different Area Health Services so that the sample remains relatively heterogeneous. This ensures a record experiences from as wide a variety of work environments as possible in the sample. The interviews reveal a deep sense of shame and hurt experienced by the Aboriginal Health Workers caused by both their communities and their employers. The paper presents the story of the despair experienced by those interviewed and shows examples of promised recommendations to facilitate the future recognition and contribution of the Aboriginal Health Worker. Limitations of the methodology and implications for further study are also discussed.
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Young, Christian Ronald Phillip. "The resilience of urban Aboriginal children and their caregivers." Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20120.
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The current health and social disparities between Australian Aboriginal and non-Aboriginal people pose significant challenges for Aboriginal communities. These disparities are widely attributed to the historical and ongoing trauma associated with European colonisation, including catastrophic population loss, institutionalised discrimination, dispossession of land, loss of culture and language, and the removal of children. In the face of these challenges Aboriginal people have shown remarkable resilience. Resilience is commonly described as ‘positive adaption in the context of adversity’. Despite a rich history of resilience research, the scientific literature describing Aboriginal resilience is sparse. The aim of this research is to investigate resilience within an urban Aboriginal context and identify factors that promote it. This thesis includes a systematic review of the psychosocial correlates of mental health and resilience among Indigenous children from high-income countries, a mixed methods investigation of the resilience of children from four urban Australian communities, a cross-sectional assessment of the resilience of caregivers of Aboriginal children, and a systematic review of peer reviewed studies that evaluated social and emotional wellbeing (SEWB) programs for Aboriginal young people. For children, the presence of stable home environments, supportive social networks, connection to culture, regular exercise and the opportunity to set and attain positive goals were all seen to be associated with resilience. Caregivers who lived in stable home environments were more likely to be resilient; however, the poor physical health of caregivers and their families posed a significant threat to resilience. The number of evaluated SEWB programs was small, and the quality of evidence was predominantly low, reflecting the nascent stage of Aboriginal SEWB and resilience research. For Aboriginal families, this thesis highlights risks that are associated with higher order determinants of poor health. Greater provision of initiatives that can promote stable, strong, cohesive and physically healthy Aboriginal families are needed to build resilience. More rigorous program evaluations that have the power to inform large-scale strategies to enhance resilience are warranted.
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Priestly, Jacqueline Rita. "Growing stronger together : cross-cultural nutrition partnerships in the Northern Territory 1974-2000 /." View thesis, 2003. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031219.105829/index.html.
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Constable, S. E. "Knowledge-sharing education and training to enhance dog health initiatives in remote and rural indigenous communities in Australia." Thesis, The University of Sydney, 2012. http://hdl.handle.net/2123/9270.
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Richmond, Chantelle Anne Marie. "Social support, material circumstance and health : understanding the links in Canada's aboriginal population." Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=103286.
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Societies that foster high quality social environments and integration produce healthier populations. The mechanisms underlying the protective effect of social integration appear to be through various forms of social support. In the Canadian Aboriginal context, few authors have explored the relationship between health and social support. This gap in understanding is significant because Aboriginal frameworks of health point to the salience of larger social structures (i.e., family), yet patterns of population health point to distinctly social causes of morbidity and mortality (e.g., violence, alcoholism). An interesting paradox emerges: patterns of Aboriginal health suggest that social support is not working to promote health. This dissertation explores this paradox through a mixed-methods approach to describe the value of social support for Aboriginal health, and to critically examine the social-structural processes and mechanisms through which social support influences Aboriginal health at the community level.Principal components analyses of the 2001 Aboriginal Peoples Survey (APS) identified social support as a consistent dimension of Metis and Inuit health, and multivariable logistic regression modelling of the 2001 APS identified social support to be a significant determinant of thriving health among Indigenous men and women (e.g., those reporting their health as excellent/very good versus good/fair/poor). The results also indicate a distinct social gradient in thriving health status and social support among Aboriginal Canadians.
Narrative analyses of 26 interviews with Aboriginal Community Health Representatives point to two key explanations for the health-support paradox: (i) social support is not a widely accessible resource; and (ii) the negative health effects of social support can outweigh the positive ones. The formation of health behaviours and cultural norms - which underpin social supports - are inextricably tied to the poor material circumstances that characterize Canada's Aboriginal communities. The thesis concludes with a critical examination of the processes through which environmental dispossession has influenced the determinants of Aboriginal health, broadly speaking. Effects are most acute within the material and social environments of Aboriginal communities. More research attention should focus on identifying the pathways through which the physical, material and social environments interact to influence the health of Aboriginal Canadians.
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Suggit, Daniel Richard. "A Clever People: Indigenous healing traditions and Australian mental health futures." Thesis, Canberra, ACT : The Australian National University, 2008. http://hdl.handle.net/1885/12051.
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Indigenous Australians are currently hospitalised for mental health disorders at significantly higher rates than members of the non-Indigenous population. In this context, the development of effective Indigenous mental health service delivery models in remote, rural and urban areas continues to be a national priority.
Traditional forms of healing are fundamental to Indigenous societies across Australia. Anthropologists, linguists, psychiatrists, psychologists, psycho-analysists and Indigenous healers themselves have recorded and discussed many localised traditions of healing over the last 100 years.
This paper presents an overview of this significant Australian heritage and proposes that the challenges which face mental health service delivery within many Indigenous communities may be addressed in part through the recognition of the intellectual, religious and therapeutic bases of Indigenous healing traditions.
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Grootjans, John, of Western Sydney Hawkesbury University, and of Health Humanities and Social Ecology Faculty. "Both ways and beyond : in Aboriginal and Torres Strait Islander health worker education." THESIS_FHHSE_SEL_Grootjans_J.xml, 1999. http://handle.uws.edu.au:8081/1959.7/445.
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During 1987 my essential beliefs about the nature of the world were challenged by a chance event which led to my arrival in Arnhemland. Working with Aboriginal people allowed me to see first hand the failings of Western ideas in Aboriginal education and health. This is how a 12 year collaboration with Aboriginal people began. The aim was to search for answers to the question, 'Why so many ideas that had been successfully used in the Western world, fail to meet the needs of aboriginal people? My experiences prior to 1995 had led me to believe that Both Ways, an education pedagogy developed in teacher education, was the best approach for empowering Aboriginal Health Workers. I believed Both Ways gave Aboriginal Health Workers a means to develop solutions to aboriginal health issues which valued and respected their aboriginal knowledge. I needed to describe and evaluate the practice of both ways with Aboriginal Health workers for the purpose of proving the benefit of this pedagogy for other educators in this field. This thesis describes how I came to think Both Ways was a good idea; how I defined Both ways; and how I put it into practice. It also provides a description of the issues raised in my critique of Both Ways and in my attempts to provide answers to these issues. Several years of collecting data, including records from action research group discussions, participant observation, interviews with peers and students, and formal evaluations left me with many concerns about Both Ways. As educators follow my journey of discovery I hope that they will recognise experiences and insights that they themselves have shared. The descriptions and discussions in this thesis will add significantly to the overall discourse about health worker education. Similarly, the exploration of ideas beyond Both Ways will add significantly to the overall body knowledge about the power relationships involved in teaching in a cross cultural settingDoctor of Philosophy (PhD)
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Grootjans, John. "Both ways and beyond : in Aboriginal and Torres Strait Islander health worker education /." View thesis, 1999. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030725.103057/index.html.
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Priestly, Jacqueline Rita, University of Western Sydney, College of Social and Health Sciences, and School of Sociology and Justice Studies. "Growing stronger together : cross-cultural nutrition partnerships in the Northern Territory 1974-2000." THESIS_CSHS_SJS_Priestly_J.xml, 2003. http://handle.uws.edu.au:8081/1959.7/266.
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This thesis incorporates social history and consultative action research to analyse the development of cross-cultural nutrition services for Indigenous communities in the Northern Territory from 1974-2000 and promote the development of stronger partnerships in 1999-2001.The historical development of nutrition services is analysed against current theory and a model of capacity building for health promotion. Nutrition infrastructure and services have developed systematically, incrementally and substantially. Strengths include the development of enduring and successful inter-cultural partnerships and leadership.Two facilitative narratives which aim to improve inter-cultural knowledge sharing, strengthen capacity and promote participatory action in community based projects were developed, implemented and partially evaluated. Services can be further strengthened by long-term commitments to examining power issues, promoting improved Indigenous control and problem solving and comprehensive bi cultural evaluation that identifies significant indicators to improving outcomes. Participatory action research, facilitative story telling, capacity building, Indigenous education theory and critical social science can inform and guide these efforts in complementary ways.Master of Arts (Hons) (Critical Social Science)
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Peiris, Priyajit David. "Building better primary care systems for indigenous peoples : a multimethods analysis." Thesis, The University of Sydney, 2010. http://hdl.handle.net/2123/12717.
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