Journal articles on the topic 'Brisbane Aboriginal and Islander Community Health Service'
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1
Spurling, Geoffrey K. P., Deborah A. Askew, Philip J. Schluter, Fiona Simpson, and Noel E. Hayman. "Household number associated with middle ear disease at an urban Indigenous health service: a cross-sectional study." Australian Journal of Primary Health 20, no. 3 (2014): 285. http://dx.doi.org/10.1071/py13009.
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Few epidemiological studies of middle ear disease have been conducted in Aboriginal and Torres Strait Islander populations, yet the disease is common and causes hearing impairment and poorer educational outcomes. The objective of this study is to identify factors associated with abnormal middle ear appearance, a proxy for middle ear disease. Aboriginal and Torres Strait Islander children aged 0–14 years receiving a Child Health Check (CHC) at an urban Indigenous Health Service, Brisbane, Australia were recruited from 2007 to 2010. Mixed-effects models were used to explore associations of 10 recognised risk factors with abnormal middle ear appearance at the time of the CHC. Ethical approval and community support for the project were obtained. Four hundred and fifty-three children were included and 54% were male. Participants were Aboriginal (92%), Torres Strait Islander (2%) or both (6%). Abnormal middle ear appearance was observed in 26 (6%) children and was significantly associated with previous ear infection (odds ratio (OR), 8.8; 95% confidence interval (CI), 3.2–24.0) and households with eight or more people (OR, 3.8; 95% CI, 1.1–14.1) in the imputed multivariable mixed-effects model. No significant associations were found for the other recognised risk factors investigated. Overcrowding should continue to be a core focus for communities and policy makers in reducing middle ear disease and its consequences in Aboriginal and Torres Strait Islander peoples.
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Kildea, Sue, Sophie Hickey, Carmel Nelson, Jody Currie, Adrian Carson, Maree Reynolds, Kay Wilson, et al. "Birthing on Country (in Our Community): a case study of engaging stakeholders and developing a best-practice Indigenous maternity service in an urban setting." Australian Health Review 42, no. 2 (2018): 230. http://dx.doi.org/10.1071/ah16218.
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Developing high-quality and culturally responsive maternal and infant health services is a critical part of ‘closing the gap’ in health disparities between Aboriginal and Torres Strait Islander people and other Australians. The National Maternity Services Plan led work that describes and recommends Birthing on Country best-practice maternity care adaptable from urban to very remote settings, yet few examples exist in Australia. This paper demonstrates Birthing on Country principles can be applied in the urban setting, presenting our experience establishing and developing a Birthing on Country partnership service model in Brisbane, Australia. An initial World Café workshop effectively engaged stakeholders, consumers and community members in service planning, resulting in a multiagency partnership program between a large inner city hospital and two local Aboriginal Community-Controlled Health Services (ACCHS). The Birthing in Our Community program includes: 24/7 midwifery care in pregnancy to six weeks postnatal by a named midwife, supported by Indigenous health workers and a team coordinator; partnership with the ACCHS; oversight from a steering committee, including Indigenous governance; clinical and cultural supervision; monthly cultural education days; and support for Indigenous student midwives through cadetships and placement within the partnership. Three years in, the partnership program is proving successful with clients, as well as showing early signs of improved maternal and infant health outcomes. What is known about the topic? Birthing on Country has been described as a metaphor for the best start in life for Aboriginal and Torres Strait Islander babies, and services that incorporate Birthing on Country principles can improve outcomes for mothers and babies. Currently, few such models exist in Australia. What does this paper add? This paper demonstrates that Birthing on Country principles can be successfully applied to the urban context. We present a real case example of the experience of setting up one such best-practice, community-engaged and informed partnership model of maternity and child healthcare in south-east Queensland. We share our experience using a World Café to facilitate community engagement, service delivery and workforce planning. What are the implications for practitioners? Health professionals providing maternity care for Aboriginal and Torres Strait Islander families are encouraged to incorporate Birthing on Country principles into their model of care to address the specific needs and demands of the local Indigenous community and improve maternal and infant health outcomes.
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Malseed, Claire, Alison Nelson, Robert Ware, Ian Lacey, and Keiron Lander. "Deadly Choices™ community health events: a health promotion initiative for urban Aboriginal and Torres Strait Islander people." Australian Journal of Primary Health 20, no. 4 (2014): 379. http://dx.doi.org/10.1071/py14041.
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The present study was an evaluation of the effectiveness of Deadly Choices™ community events for improving participants’ short-term knowledge of chronic disease and risk factors, and increasing community engagement with local health services. Surveys were completed directly before and after participating in health education activities (pre and post surveys, respectively) assessing knowledge of chronic diseases and risk factors at three Deadly Choices community events and four National Aboriginal and Islander Day Observance Committee (NAIDOC) events in south-east Queensland where Deadly Choices health education activities took place. An audit trail was conducted at two Deadly Choices community events in Brisbane to identify the proportion of participants who undertook a health screen at the event who then followed up for a Medicare-funded health check (MBS item 715) or other appointment at an Aboriginal and Torres Strait Islander clinic in the local area within 2 months. Results were compared with a sample of participants who attended one Deadly Choices community event but did not complete a health screen. There were 472 community members who completed a pre and post survey. All knowledge scores significantly improved between baseline and follow up. Although based on a small sample, the audit trail results suggest individuals who participated in a health screen at the community day were approximately twice as likely to go back to a clinic to receive a full health check or have an alternative appointment compared with attendees who did not participate in a screen. Community events that include opportunities for health education and health screening are an effective strategy to improve chronic disease health literacy skills and appear to have the potential to increase community engagement with local Aboriginal and Torres Strait Islander health services.
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Salisbury, Christine, and Sue Follent. "Bicultural Stress: An Aboriginal Community Perspective." Australian Journal of Primary Health 2, no. 2 (1996): 78. http://dx.doi.org/10.1071/py96032.
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A survey was designed to assess and to compare the levels of stress being experienced by Aboriginal and Torres Strait Islander and non-Aboriginal respondents. The survey covered a range of areas including demographics, access to transport, drug and alcohol use, use of public services, identification of stressful events in the past 12 months and a self evaluation of stress symptoms. The groups were matched by age, sex and income. The results showed differences between the stressful events and stress symptoms reported by the two groups, with the Aboriginal and Torres Strait Islander group reporting considerably higher levels. There were significant differences in access to transport and use of public health facilities. The barriers to the use of public health services were identified. A major finding was that 69% of the Aboriginal and Torres Strait Islander sample experienced more than one loss through death compared to 5% of the non-Aboriginal sample in the previous 12 months. It was concluded that the Aboriginal and Torres Strait Islander sample experienced more stressful events, had more stress related symptoms and used public mental health services less than the non-Aboriginal sample. The barriers to use of services were a lack of cultural sensitivity and the discomfort experienced by the Aboriginal and Torres Strait Islander sample when accessing services. A partnership with the Aboriginal and Torres Strait Islander community is required to develop a public health service that is acceptable and useful to the Aboriginal and Torres Strait Islander sample.
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Salisbury, Christine. "A Health Service and Aboriginal & Torres Strait Islander Partnership to Develop and Plan Mental Health Services." Australian Journal of Primary Health 4, no. 4 (1998): 18. http://dx.doi.org/10.1071/py98058.
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The aim of this study was to examine the effects of an action research partnership between the Tweed Valley Health Service (TVHS) and the Aboriginal & Torres Strait Islander community for the development and delivery of Aboriginal & Torres Strait Islander Mental Health Services. This partnership was based upon Labonte's (1989) view of empowerment where it is suggested that to be empowered means to have increased capacity to define, analyse and act upon one's problems. It was proposed that the establishment of a 'partnership' based upon these principles would assist in operationalising Indigenous community participation in TVHS planning. To achieve this type of 'partnership', the health service had to be willing to enter the partnership and to give the authority to the Aboriginal & Torres Strait Islander Health Outcome Council to seek and trial solutions on Aboriginal & Torres Strait Islander Mental Health matters. Key outcomes were defined as the extent to which the re-organised services proved to be acceptable and utilised by the local Aboriginal & Torres Strait Islander population. Outcomes were operationalised through measures of service utilisation and consumer satisfaction with accessibility, process and outcomes. The study trialed participatory action research as a method for Indigenous participation in Mental Health Service planning and development and concludes that it is a valid model for cross cultural research and health service development in a complex medical setting.
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Bartlett, Ben, and John Boffa. "The impact of Aboriginal community controlled health service advocacy on Aboriginal health policy." Australian Journal of Primary Health 11, no. 2 (2005): 53. http://dx.doi.org/10.1071/py05022.
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This paper reviews the advocacy role of Aboriginal community controlled health services (ACCHSs) in the development of Aboriginal health policy over the past 30 years, with a specific focus on the recent changes in Commonwealth funding and administrative responsibility - the transfer of Aboriginal health service funding from the Aboriginal and Torres Strait Islander Commission (ATSIC) to the Office of Aboriginal and Torres Strait Islander Health Services (OATSIHS) within the Commonwealth Department of Health and Ageing (DoHA), and the development of policies aimed at Aboriginal health services accessing mainstream (Medical Benefits Scheme [MBS]) funds. The outcomes of this policy change include a significant increase in funding to Aboriginal primary health care (PHC), the inclusion of ACCHSs in collaborative strategic relationships, and the development of new arrangements involving regional planning and access to per capita funds based on MBS equivalents. However, the community sector remains significantly disadvantaged in participating in this collaborative effort, and imposed bureaucratic processes have resulted in serious delays in releasing funds for actual services in communities. Government agencies need to take greater heed of community advocacy, and provide appropriate resourcing to enable community organisations to better direct government effort, especially at the implementation phase. These remain major concerns and should be considered by non-health sectors in the development of new funding and program development mechanisms in the wake of the abolition of ATSIC.
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Cuthbert, Kiarah E., Clare Brown, Melinda Hammond, Tiffany A. Williams, Desmond Tayley, Eileen Deemal-Hall, and David P. Thomas. "Engaging with Aboriginal Shire Councils in remote Cape York communities to address smoke-free environments." Australian Journal of Primary Health 25, no. 5 (2019): 419. http://dx.doi.org/10.1071/py19023.
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The high prevalence and health effect of tobacco smoking and secondhand smoke exposure among Aboriginal and Torres Strait Islander people is well known. Due to its significance, the responsibility of tackling smoking among Aboriginal and Torres Strait Islander people should not remain solely with health service providers. The creation of supportive environments and collaboration beyond the health sector are critical elements of comprehensive primary health care practised by Aboriginal Community Controlled Health Services. This paper discusses how Apunipima Cape York Health Council worked with three Aboriginal Shire Councils to create more smoke-free places, using local working groups, information sessions and community-based health promotion. The flexibility and the time allocated to the engagement process with councils, community leaders, organisations and community members were important. All three communities acknowledged the benefits of role modelling and working together to improve health, with addressing tobacco smoking seen as ‘everyone’s business’ and ‘not just service providers’. Aboriginal Shire Councils can play a critical role, in partnership with Aboriginal Community Controlled Health Services, in creating healthy places that enable healthy choices.
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Coombes, Julieann, Patricia Cullen, Keziah Bennett-Brook, Marlene Longbottom, Tamara Mackean, Belinda Field, and Vickie Parry. "Culturally Safe and Integrated Primary Health Care: A Case Study of Yerin Eleanor Duncan Aboriginal Health Services’ Holistic Model." Journal of the Australian Indigenous HealthInfoNet 3, no. 1 (2022): 1–9. http://dx.doi.org/10.14221/aihjournal.v3n1.5.
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Objective To understand the importance of culturally safe integrated primary health care for Aboriginal families in the Central Coast of New South Wales, where their social and emotional wellbeing is impacted through a range of health issues related to domestic and family violence. Methods An Indigenous methodology of yarning through conversational semi-structured interviews with seven primary health care workers at Yerin, an Aboriginal Community Controlled Health Service (ACCHS) in New South Wales. Yarning sessions explored factors that enable and/or inhibit the provision of holistic and comprehensive trauma and culturally informed responses to Aboriginal and Torres Strait Islander women who experience violence. Results Five key themes were identified: 1) The importance of integrated primary health to support women and families; 2) Soft entry pathways; 3) Culturally safe care delivered by health workers experienced in trauma informed care; 4) Community partnerships; and 5) Funding sustainable programs that are community led and delivered by Aboriginal and Torres Strait Islander people. Lessons Learned Culturally safe and trauma informed and responsive care that is integrated within primary health care is important in comprehensively meeting the needs of Aboriginal and Torres Strait Islander women who experience domestic and family violence. The provision of soft entry pathways creates rapport and trust through an integrated team approach, highlighting the importance of more holistic service provision focusing on recovery and healing.
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McGuffog, Romany, Catherine Chamberlain, Jaqui Hughes, Kelvin Kong, Mark Wenitong, Jamie Bryant, Alex Brown, et al. "Murru Minya–informing the development of practical recommendations to support ethical conduct in Aboriginal and Torres Strait Islander health research: a protocol for a national mixed-methods study." BMJ Open 13, no. 2 (February 2023): e067054. http://dx.doi.org/10.1136/bmjopen-2022-067054.
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IntroductionConducting ethical and high-quality health research is crucial for informing public health policy and service delivery to reduce the high and inequitable burden of disease experienced by Aboriginal and Torres Strait Islander people. Ethical guidelines and principles specifically for health research with Aboriginal and Torres Strait Islander people have been developed for use since 1987. However, there has been limited examination of how these are being applied to the conduct of research.Methods and analysisMurru Minyawill be a large-scale national study to examine the implementation of ethical processes in Aboriginal and Torres Strait Islander health research. A mixed-methods design will be used in fourbaarra(steps). The first threebaarrawill collect knowledge, experiences and wisdom from three key groups: Aboriginal and Torres Strait Islander communities, research academics, and Human Research Ethics Committees using online surveys, yarning, and semistructured interviews. This knowledge will inform the finalbaarraof developing a set of practical recommendations to support ethical conduct in Aboriginal and Torres Strait Islander health research into the future.Ethics and disseminationEthical approval for this research project has been granted by National, State and Territory Human Research Ethics Committees. This research has been developed in collaboration with Aboriginal and Torres Strait Islander researchers, Aboriginal Community Controlled Health Organisation representatives, Aboriginal community members, the National Health Leadership Forum, and Aboriginal and Torres Strait Islander research team. The knowledge translation plan will be integrated and revised throughout the project as partnerships and engagement with Aboriginal and Torres Strait Islander communities continue. All findings will be shared with peak Aboriginal research bodies and Aboriginal and Torres Strait Islander communities in ways that are meaningful to them.
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Spurling, Geoffrey K., Chelsea J. Bond, Philip J. Schluter, Corey I. Kirk, and Deborah A. Askew. "'I'm not sure it paints an honest picture of where my health's at' – identifying community health and research priorities based on health assessments within an Aboriginal and Torres Strait Islander community: a qualitative study." Australian Journal of Primary Health 23, no. 6 (2017): 549. http://dx.doi.org/10.1071/py16131.
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Aboriginal and Torres Strait Islander health assessments are conducted annually in Australian primary care to detect risk factors, chronic diseases and implement preventive health measures. At the Inala Indigenous Health Service, health assessment data have also been used for research purposes. This research has been investigator-driven, which risks misinterpreting or ignoring community priorities compared with community-led research. The objective of this research was to learn about the Aboriginal and Torres Strait Islander community’s health priorities that could be translated into research themes, and investigate these using health assessment data. A thematic analysis of data was conducted from 21 semi-structured interviews with purposively selected key informants from an urban Aboriginal and Torres Strait Islander community. Key informants articulated an authoritative understanding of how interrelated, inter-generational, social, cultural and environmental determinants operated in a ‘cycle’ to influence the community’s health. Key informant views supported the inclusion of these determinants in health assessments, reinforced the importance of comprehensive primary healthcare and strengthened referral pathways to community resources. Some key informants were ambivalent about Aboriginal and Torres Strait Islander health assessments because of their biomedical emphasis. This research also revealed limitations of health assessment-based research and the biomedical emphasis of the health system more broadly.
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Fitzgerald, Xavier, Ana Herceg, Kirsty Douglas, and Nadeem Siddiqui. "Cardiovascular disease risk assessment in an Aboriginal community-controlled health service: comparing algorithms." Australian Journal of Primary Health 26, no. 4 (2020): 281. http://dx.doi.org/10.1071/py19216.
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Aboriginal and Torres Strait Islander people have high rates of cardiovascular disease (CVD). The National Vascular Disease Prevention Alliance (NVDPA) CVD risk assessment algorithm is used for all Australians. The Central Australian Rural Practitioners Association (CARPA) algorithm used in the Northern Territory adds five percentage points to all NVDPA risk scores for Indigenous Australians. Information was extracted from an Aboriginal Community-Controlled Health Service for all Aboriginal and Torres Strait Islander regular clients aged 35–74 years without known CVD (n=1057). CVD risk scores were calculated using both algorithms. Prescription of lipid-lowering medications was assessed. Clients with high-risk scores were reviewed and recalled if required. CVD risk scores were calculated for 362 (34.4%) clients. Clients with high CVD risk comprised 17.7% (NVDPA) or 23.8% (CARPA), with most determined clinically. Clients with low CVD risk comprised 73.7% (NVDPA) or 47.2% (CARPA). More than 30% of those with high risk were not on lipid-lowering medications. Significant health and social issues affected treatment uptake. It is unclear which algorithm is most applicable; however, this service has decided to continue to use the NVDPA algorithm. Use of CVD risk assessment and management of high-risk clients could be increased in primary care.
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Dennis, Sarah, Iqbal Hasan, Lisa Jackson Pulver, Ian Wilson, and Nicholas Zwar. "Experiences and views of a brokerage model for primary care for Aboriginal people." Australian Health Review 39, no. 1 (2015): 26. http://dx.doi.org/10.1071/ah13205.
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Objective A mixed methods study was conducted to determine the views of Aboriginal people on their experiences of a brokerage model for access to community-based health services in an urban setting. Methods A broad range of approaches, using surveys, semi-structured interviews and community forums with Aboriginal people were used to find out people’s views and experiences of using the brokerage service. Results Of the 1304 people invited to participate, only 127 people provided feedback on the brokerage service model for Aboriginal people. Of these, 120 people identified as being Aboriginal. Participants said that the service helped them to navigate the system and access health care. Participants felt that the health professionals involved with the service were respectful of their needs. The service was not able to improve access to dental care. Conclusions The brokerage model implemented in this area appears to have been well received and is supporting urban Aboriginal people to access some of the health care needed. What is known about the topic? Aboriginal and Torres Strait Islander people often experience difficulty accessing health services. Urban brokerage models of care were funded by the Office for Aboriginal and Torres Strait Islander Health (OATSIH) under the Improving Indigenous Access to Health Care Services initiative and aimed to increase access to mainstream health services. What does this paper add? The brokerage model of care in South West Sydney has been well-received by the Aboriginal people receiving the service and participants are positive about the role of the service in increasing access to mainstream health care. What are the implications for practitioners? Navigating the healthcare system is difficult for some and a brokerage service with supportive Aboriginal health workers increases access.
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Pandeya, Neha A., Philip J. Schluter, Geoffrey K. Spurling, Claudette Tyson, Noel E. Hayman, and Deborah A. Askew. "Factors Associated with Thoughts of Self-Harm or Suicide among Aboriginal and Torres Strait Islander People Presenting to Urban Primary Care: An Analysis of De-Identified Clinical Data." International Journal of Environmental Research and Public Health 19, no. 1 (December 23, 2021): 153. http://dx.doi.org/10.3390/ijerph19010153.
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Suicide amongst Aboriginal and Torres Strait Islander people is a major cause of premature mortality and a significant contributor to the health and life expectancy gap. This study aimed to estimate the prevalence of thoughts of self-harm or suicide in Aboriginal and Torres Strait Islander people attending an urban primary health care service and identify factors associated with these thoughts. Multilevel mixed-effects modified Poisson regression models were employed to analyse three years of data gathered during the annual Aboriginal and Torres Strait Islander health assessments. At their first health assessment, 11.5% (191/1664) of people reported thoughts of suicide or self-harm in the prior two weeks. Having children, participating in sport or community activities or being employed full-time decreased the risk of such thoughts. Conversely, factors relating to social exclusion including homelessness, drug use, unemployment and job insecurity increased the risk of thoughts of self-harm or suicide. Individual clinicians, health services, and policy-makers all have a role in suicide prevention. Clinicians need appropriate training to be able to respond to people expressing these thoughts. Aboriginal and Torres Strait Islander community organisations need sovereignty and self-determination over resources to provide programs that promote cultural connectivity and address social exclusion, thereby saving lives.
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Kennedy, Michelle, Amanual Getnet Mersha, Raglan Maddox, Catherine Chamberlain, Sian Maidment, Peter O'Mara, Cathy Segan, et al. "Koori Quit Pack mailout smoking cessation support for Aboriginal and Torres Strait Islander people who smoke: a feasibility study protocol." BMJ Open 12, no. 10 (October 2022): e065316. http://dx.doi.org/10.1136/bmjopen-2022-065316.
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IntroductionSmoking remains the leading preventable cause of death for Aboriginal and Torres Strait Islander people in Australia. Aboriginal and Torres Strait Islander people who smoke are more likely to make a quit attempt than their non-Aboriginal counterparts but less likely to sustain the quit attempt. There is little available evidence specifically for and by Indigenous peoples to inform best practice smoking cessation care.The provision of a free Koori Quit Pack with optional nicotine replacement therapy sent by mail may be a feasible, acceptable and effective way to access stop smoking support for Aboriginal and Torres Strait Islander peoples.Methods and analysisAn Aboriginal-led, multisite non-randomised single-group, pre–post feasibility study across three states in Australia will be conducted. Participants will be recruited via service-targeted social media advertising and during usual care at their Aboriginal Community Controlled Health Services. Through a process of self-referral, Aboriginal and Torres Strait Islander people who smoke daily will complete a survey and receive mailout smoking cessation support. Data will be collected over the phone by an Aboriginal Research Assistant. This pilot study will inform the development of a larger, powered trial.Ethics and disseminationEthics approval has been obtained from the Aboriginal Health & Medical Research Council Ethics Committee of New South Wales (NSW) (#1894/21) and the University of Newcastle (#H-2022-0174). Findings will be reported through peer-reviewed journals and presentations at relevant local, national and international conferences. The findings will be shared with the NSW and Victoria Quitline, Aboriginal Health and Medical Research Council and Victorian Aboriginal Community Controlled Organisation and the National Heart Foundation.Trial registration numberACTRN12622000654752.
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Abbott, Penelope, Deborah Askew, Chelsea Watego, Wendy CY Hu, Letitia Campbell, Claudette Tyson, Robyn Walsh, et al. "Randomised clinical trial research within Aboriginal and Torres Strait Islander primary health services: a qualitative study." BMJ Open 11, no. 12 (December 2021): e050839. http://dx.doi.org/10.1136/bmjopen-2021-050839.
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ObjectiveTo better understand how to undertake valuable, ethical and sustainable randomised controlled clinical trial (RCT) research within Aboriginal and Torres Strait Islander primary health services.DesignIn a qualitative approach, we utilised data collected between 2013 and 2020 during the planning and implementation of two RCTs. The data comprised agreed records of research meetings, and semistructured interviews with clinical trial stakeholders. The stakeholders were parents/carers of child participants, and site-based research officers, healthcare providers and community advisory groups. Our thematic analysis was informed by constructivist grounded theory.SettingThe RCTs investigated the management of otitis media in Aboriginal and Torres Strait Islander children, with the first RCT commencing recruitment in 2014 and the second in 2017. They took place in Aboriginal Medical Services (AMSs), large primary health services for Aboriginal and Torres Strait Islander people, based in urban and regional communities across two Australian states and one territory.ResultsWe analysed data from 56 meetings and 67 interviews, generating themes on making research valuable and undertaking ethical and sustainable RCTs. Aboriginal and Torres Strait Islander leadership, and support of AMSs in their service delivery function were critical. The broad benefits of the trials were considered important to sustainability, including workforce development, enhanced ear healthcare and multidirectional research capacity building. Participants emphasised the long-term responsibility of research teams to deliver benefits to AMSs and communities regardless of RCT outcomes, and to focus on relationships, reciprocity and creating positive experiences of research.ConclusionWe identify principles and strategies to assist in undertaking ethical and sustainable RCTs within Aboriginal and Torres Strait Islander primary health services. Maintaining relationships with AMSs and focusing on mutual workforce development and capacity building creates opportunities for long-term benefits so that health research and RCTs work for Aboriginal and Torres Strait Islander peoples, services, communities and researchers.Trial registration numberACTRN12613001068752 (Pre-results); ACTRN12617001652369 (Pre-results).
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Jennings, Warren, Geoffrey K. Spurling, and Deborah A. Askew. "Yarning about health checks: barriers and enablers in an urban Aboriginal medical service." Australian Journal of Primary Health 20, no. 2 (2014): 151. http://dx.doi.org/10.1071/py12138.
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The annual health check for Aboriginal and Torres Strait Islander People has been welcomed as a means of conducting a comprehensive assessment to address preventive health care delivery, identify new diagnoses and initiate new treatments. Rates of health check uptake across Australia have been poor with less than 12% of the eligible population receiving one during 2009/10. This qualitative study sought to identify barriers and enablers to undertaking health checks in an urban Aboriginal Medical Service through semistructured interviews with 25 clinical staff (doctors, nurses and Aboriginal and Torres Strait Islander health workers). Clinical systems for conducting health checks were unclear to staff, with barriers relating to time pressures for both patients and clinic staff, and lack of clarity about staff responsibilities for initiating and conducting the health check. Additionally some staff perceived some content as sensitive, invasive, culturally inappropriate and of questionable value. Other barriers included concerns about community health literacy, disengagement with preventative health care, and suspicion about confidentiality and privacy. The development of clear service-wide systems that support the conduct of health checks are required to increase uptake, combined with supportive local clinical leadership and audit and feedback systems. Staff training, consideration of culture and roles, and critical review of health check content may improve staff confidence and community acceptance. Community-based health education and promotion is strongly supported by staff to increase client engagement, knowledge and acceptance of the health check.
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Dorrington, Melanie S., Ana Herceg, Kirsty Douglas, Julie Tongs, and Marianne Bookallil. "Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement." Australian Journal of Primary Health 21, no. 4 (2015): 417. http://dx.doi.org/10.1071/py14088.
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This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.
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Tieman, Jennifer J., Mikaela A. Lawrence, Raechel A. Damarell, Ruth M. Sladek, and Arwen Nikolof. "LIt.search: fast tracking access to Aboriginal and Torres Strait Islander health literature." Australian Health Review 38, no. 5 (2014): 541. http://dx.doi.org/10.1071/ah14019.
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Objective To develop and validate a PubMed search filter, LIt.search, that automatically retrieves Aboriginal and Torres Strait Islander health literature and to make it publicly accessible through the Lowitja Institute website. Methods Search filter development phases included: (1) scoping of the publication characteristics of Aboriginal and Torres Start Islander literature; (2) advisory group input and review; (3) systematic identification and testing of MeSH and text word terms; (4) relevance assessment of the search filter’s retrieved items; and (5) translation for use in PubMed through the web. Results Scoping study analyses demonstrated complexity in the nature and use of possible search terms and publication characteristics. The search filter achieved a recall rate of 84.8% in the full gold standard test set. To determine real-world performance, post-hoc assessment of items retrieved by the search filter in PubMed was undertaken with 87.2% of articles deemed as relevant. The search filter was constructed as a series of URL hyperlinks to enable one-click searching. Conclusion LIt.search is a search tool that facilitates research into practice for improving outcomes in Aboriginal and Torres Strait Islander health and is publicly available on the Lowitja Institute website. What is known about this topic? Health professionals, researchers and decision makers can find it difficult to retrieve published literature on Aboriginal and Torres Strait Islander health easily, effectively and in a timely way. What does this paper add? This paper describes a new web-based searching tool, LIt.search, which facilitates access to the relevant literature. What are the implications for practice? Ready access to published literature on Aboriginal and Torres Strait Islander health reduces a barrier to the use of this evidence in practice. LIt.search encourages the use of this evidence to inform clinical judgement and policy and service decision-making as well as reducing the burdens associated with searching for community practitioners, academics and policy makers.
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Tsey, Komla, Philemon Chigeza, Carol A. Holden, Jack Bulman, Hilton Gruis, and Mark Wenitong. "Evaluation of the pilot phase of an Aboriginal and Torres Strait Islander Male Health Module." Australian Journal of Primary Health 20, no. 1 (2014): 56. http://dx.doi.org/10.1071/py12033.
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This article evaluates the pilot phase of an Aboriginal and Torres Strait Islander Male Health Module. Although men experience higher levels of illness and die younger than women, educational programs to support health workers utilise a gender-based approach to increase participation of Aboriginal and Torres Strait Islander males in health care are rare and lack appropriate content. Recognising this gap in service provision, and under the guidance of a Reference Group comprising community leaders in Aboriginal and Torres Strait male health, a comprehensive and culturally appropriate Male Health Module has been developed to enhance the capacity of health workers to improve access to services for Aboriginal and Torres Strait Islander males. Methods used were: in-depth interviews with Module developers, pilot workshops for trainers and health workers, questionnaires and focus group discussions with workshop participants, and participant observations. As well as enhancing capacity to facilitate access to health services for men, the Module was deemed relevant because of its potential to promote health worker empowerment and wellbeing. Findings revealed that improving access to services for men required male and female health workers working in partnership. Despite overall enthusiasm for the Module, the findings also revealed deep fear that it would end up ‘collecting dust on shelves’. Strategies to improve the Module quality and accessibility are highlighted.
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McFarlane, Kathryn, Sue Devine, Jenni Judd, Nina Nichols, and Kerrianne Watt. "Workforce insights on how health promotion is practised in an Aboriginal Community Controlled Health Service." Australian Journal of Primary Health 23, no. 3 (2017): 243. http://dx.doi.org/10.1071/py16033.
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Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care; however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts; (2) the attitude towards health promotion was very positive; and (3) health promotion capacity can be enhanced at both individual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.
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Dossetor, Phillipa J., Joseph M. Freeman, Kathryn Thorburn, June Oscar, Maureen Carter, Heather E. Jeffery, David Harley, Elizabeth J. Elliott, and Alexandra L. C. Martiniuk. "Health services for aboriginal and Torres Strait Islander children in remote Australia: A scoping review." PLOS Global Public Health 3, no. 2 (February 13, 2023): e0001140. http://dx.doi.org/10.1371/journal.pgph.0001140.
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In Australia, there is a significant gap between health outcomes in Indigenous and non-Indigenous children, which may relate to inequity in health service provision, particularly in remote areas. The aim was to conduct a scoping review to identify publications in the academic and grey literature and describe 1) Existing health services for Indigenous children in remote Australia and service use, 2) Workforce challenges in remote settings, 3) Characteristics of an effective health service, and 4) Models of care and solutions. Electronic databases of medical/health literature were searched (Jan 1990 to May 2021). Grey literature was identified through investigation of websites, including of local, state and national health departments. Identified papers (n = 1775) were screened and duplicates removed. Information was extracted and summarised from 116 papers that met review inclusion criteria (70 from electronic medical databases and 45 from the grey literature). This review identified that existing services struggle to meet demand. Barriers to effective child health service delivery in remote Australia include availability of trained staff, limited services, and difficult access. Aboriginal and Community Controlled Health Organisations are effective and should receive increased support including increased training and remuneration for Aboriginal Health Workers. Continuous quality assessment of existing and future programs will improve quality; as will measures that reflect aboriginal ways of knowing and being, that go beyond traditional Key Performance Indicators. Best practice models for service delivery have community leadership and collaboration. Increased resources with a focus on primary prevention and health promotion are essential.
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Cox, Adele, Pat Dudgeon, Christopher Holland, Kerrie Kelly, Clair Scrine, and Roz Walker. "Using participatory action research to prevent suicide in Aboriginal and Torres Strait Islander communities." Australian Journal of Primary Health 20, no. 4 (2014): 345. http://dx.doi.org/10.1071/py14043.
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The National Empowerment Project is an innovative Aboriginal-led community empowerment project that has worked with eight Aboriginal and Torres Strait Islander communities across Australia over the period 2012–13. The aim of the Project was to develop, deliver and evaluate a program to: (1) promote positive social and emotional well-being to increase resilience and reduce the high reported rates of psychological distress and suicide among Aboriginal and Torres Strait Islander people; and (2) empower communities to take action to address the social determinants that contribute to psychological distress, suicide and self-harm. Using a participatory action research approach, the communities were supported to identify the risk factors challenging individuals, families and communities, as well as strategies to strengthen protective factors against these challenges. Data gathered during Stage 1 were used to develop a 12-month program to promote social and emotional well-being and build resilience within each community. A common framework, based on the social and emotional well-being concept, was used to support each community to target community-identified protective factors and strategies to strengthen individual, family and community social and emotional well-being. Strengthening the role of culture is critical to this approach and marks an important difference between Aboriginal and Torres Strait Islander and non-Indigenous mental health promotion and prevention activities, including suicide prevention. It has significant implications for policy makers and service providers and is showing positive impact through the translation of research into practice, for example through the development of a locally run empowerment program that aims to address the social determinants of health and their ongoing negative impact on individuals, families and communities. It also provides a framework in which to develop and strengthen culture, connectedness and foster self-determination, through better-informed policy based on community-level holistic responses and solutions as opposed to an exclusive focus on single-issue deficit approaches.
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Gilles, Marisa T., John Wakerman, and Angela Durey. ""If it wasn't for OTDs, there would be no AMS": overseas-trained doctors working in rural and remote Aboriginal health settings." Australian Health Review 32, no. 4 (2008): 655. http://dx.doi.org/10.1071/ah080655.
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Australian-trained doctors are often reluctant to work in rural and remote areas and overseastrained doctors (OTDs) are recruited to practise in many rural Aboriginal medical services. This paper focuses on recent research carried out in Australia to analyse factors affecting OTDs? professional, cultural and social integration and examine their training and support needs. Ten case studies were conducted throughout Australia with OTDs, which also included interviews with spouses/partners, professional colleagues, co-workers, and Aboriginal and Torres Strait Islander community members associated with the health service. Key themes emerging from the data across all informants included the need to better address recruitment, orientation and cross-cultural issues; the importance of effective communication and building community and institutional relationships, both with the local health service and the broader medical establishment.
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Gotis-Graham, Anna, Rona Macniven, Kelvin Kong, and Kylie Gwynne. "Effectiveness of ear, nose and throat outreach programmes for Aboriginal and Torres Strait Islander Australians: a systematic review." BMJ Open 10, no. 11 (November 2020): e038273. http://dx.doi.org/10.1136/bmjopen-2020-038273.
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ObjectiveTo examine the ability of ear, nose and throat (ENT) outreach programmes to improve health outcomes among Aboriginal and Torres Strait Islander people.MethodsWe conducted a systematic literature search of nine databases (Medline, CINAHLS, PsycINFO, Embase, Cochrane, Scopus, Global health, Informit Rural health database and Indigenous collection) and grey literature sources for primary studies evaluating ENT outreach services for Aboriginal and Torres Strait Islander people. This review included English language studies of all types, published between 2000 and 2018, that supplied ENT outreach services to Aboriginal and Torres Strait Islander Australians and provided data to evaluate their aims. Two authors independently evaluated the eligible articles and extracted relevant information. Risk of bias was assessed using the Mixed Methods Assessment Tool.ResultsOf the 506 studies identified, 15 were included in this review. These 15 studies evaluated eight different programs/activities. Studies were heterogeneous in design so a meta-analysis could not be conducted. Seven studies measured health-related outcomes in middle ear or hearing status; six reported overall positive changes one reported no clinically significant improvements. Five programmes/activities and their corresponding studies involved Aboriginal and Torres Strait Islander people and organisations in delivery and evaluation, but involvement in programme or study design was unclear.ConclusionWhile some studies demonstrated improved outcomes, the overall ability of ENT programmes to improve health outcomes for Aboriginal and Torres Strait Islander children is unclear. The impact of ENT outreach may be limited by a lack of quality evidence, service coordination and sustainability. Community codesign and supporting and resourcing local capacity must be a component of outreach programmes and ongoing evaluation is also recommended. Improvements in these areas would likely improve health outcomes.PROSPERO registration numberCRD42019134757.
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Tracy, Marguerite, Bradley Freeburn, Kylie Lee, Julie Woods, and Kate Conigrave. "Review of alcohol and drug treatment for Aboriginal and Torres Strait Islander peoples." Journal of the Australian Indigenous HealthInfoNet 4, no. 1 (2023): 1–32. http://dx.doi.org/10.14221/aihjournal.v4n1.1.
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This review provides an overview of treatments for problem alcohol and other drug (AOD) use for Aboriginal and Torres Strait Islander people. It includes information on the available research and discusses core principles for providing treatment. The review outlines how effective mainstream treatment approaches can be adapted to be more suitable for Aboriginal and Torres Strait Islander ways of being or worldview. It also highlights that services, such as those offered by Aboriginal community controlled health organisations are in a unique position to offer culturally secure treatment approaches. The barriers to accessing treatment are discussed as well as recommendations for future strategic directions in service delivery such as collaboration and two-way learning. This review is part of a suite of knowledge exchange products that includes a summary, video, and factsheet.
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Fitts, Michelle S., Jennifer Cullen, Gail Kingston, Elaine Wills, and Karen Soldatic. "“I Don’t Think It’s on Anyone’s Radar”: The Workforce and System Barriers to Healthcare for Indigenous Women Following a Traumatic Brain Injury Acquired through Violence in Remote Australia." International Journal of Environmental Research and Public Health 19, no. 22 (November 9, 2022): 14744. http://dx.doi.org/10.3390/ijerph192214744.
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Aboriginal and Torres Strait Islander women experience high rates of traumatic brain injury (TBI) as a result of violence. While healthcare access is critical for women who have experienced a TBI as it can support pre-screening, comprehensive diagnostic assessment, and referral pathways, little is known about the barriers for Aboriginal and Torres Strait Islander women in remote areas to access healthcare. To address this gap, this study focuses on the workforce barriers in one remote region in Australia. Semi-structured interviews and focus groups were conducted with 38 professionals from various sectors including health, crisis accommodation and support, disability, family violence, and legal services. Interviews and focus groups were audiotaped and transcribed verbatim and were analysed using thematic analysis. The results highlighted various workforce barriers that affected pre-screening and diagnostic assessment including limited access to specialist neuropsychology services and stable remote primary healthcare professionals with remote expertise. There were also low levels of TBI training and knowledge among community-based professionals. The addition of pre-screening questions together with professional training on TBI may improve how remote service systems respond to women with potential TBI. Further research to understand the perspectives of Aboriginal and Torres Strait Islander women living with TBI is needed.
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Munns, Ailsa. "Community midwifery: a primary health care approach to care during pregnancy for Aboriginal and Torres Strait Islander women." Australian Journal of Primary Health 27, no. 1 (2021): 57. http://dx.doi.org/10.1071/py20105.
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Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers’ perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations.
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Fitts, Michelle S., Jennifer Cullen, Gail Kingston, Yasmin Johnson, Elaine Wills, and Karen Soldatic. "Understanding the Lives of Aboriginal and Torres Strait Islander Women with Traumatic Brain Injury from Family Violence in Australia: A Qualitative Study Protocol." International Journal of Environmental Research and Public Health 20, no. 2 (January 16, 2023): 1607. http://dx.doi.org/10.3390/ijerph20021607.
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Globally, there is growing recognition of the connection between violence and head injuries. At present, little qualitative research exists around how surviving this experience impacts everyday life for women, particularly Aboriginal and Torres Strait Islander women. This project aims to explore the nature and context of these women’s lives including living with the injury and to identify their needs and priorities during recovery. This 3-year exploratory project is being conducted across three Australian jurisdictions (Queensland, Northern Territory, and New South Wales). Qualitative interviews and discussion groups will be conducted with four key groups: Aboriginal and Torres Strait Islander women (aged 18+) who have acquired a head injury through family violence; their family members and/or carers; and hospital staff as well as government and non-government service providers who work with women who have experienced family violence. Nominated staff within community-based service providers will support the promotion of the project to women who have acquired a head injury through family violence. Hospital staff and service providers will be recruited using purposive and snowball sampling. Transcripts and fieldnotes will be analysed using narrative and descriptive phenomenological approaches. Reflection and research knowledge exchange and translation will be undertaken through service provider workshops.
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Wallace, Jack, Bev Hanley, Mary Belfrage, Sandra Gregson, Niall Quiery, and Jayne Lucke. "Delivering the hepatitis C cure to Aboriginal people: documenting the perspectives of one Aboriginal Health Service." Australian Journal of Primary Health 24, no. 6 (2018): 491. http://dx.doi.org/10.1071/py18024.
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Aboriginal and Torres Strait Islander peoples are disproportionately affected by hepatitis C, an infection that is curable with direct acting antivirals (DAAs). The Australian Government funded access to DAAs from March 2016 for all people with hepatitis C, with primary care physicians, along with clinical specialists, permitted to prescribe these treatments. The Victorian Aboriginal Health Service, in recognising the effect of liver disease from viral hepatitis within their community, and of the increased availability to DAAs, established a Liver Clinic to facilitate access to treatment for people attending the service. This study conducted semi-structured interviews to document the health service provider perspectives on the barriers and enablers to treatment; explored patients’ experiences of hepatitis C treatment and cure; and sought to identify possible health system-level changes to facilitate increased access and uptake of treatment by Aboriginal people. The study found the success of the clinic was supported by the multidisciplinary and accessible nature of the health service, and the relationships built over time between clinic staff and people with, or at risk of, hepatitis C. For those treated, the individual effect of the cure not only eliminated the hepatitis C virus, but reduced shame and increased broader social participation.
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Coombe, Leanne L., Melissa R. Haswell-Elkins, and Peter S. Hill. "Community-governed health services in Cape York: does the evidence point to a model of service delivery?" Australian Health Review 32, no. 4 (2008): 605. http://dx.doi.org/10.1071/ah080605.
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Health service delivery model reforms are currently underway in Cape York in an effort to improve health outcomes for the Aboriginal and Torres Strait Islander communities. These reforms include the transition of the Apunipima Cape York Health Council from an advocacy agency to a community-controlled health service provider. This paper investigates the literature on existing community governance models and communitycontrolled health service delivery models, to guide the choice of the most appropriate model for the Cape York health reforms. The evidence collected suggests a new innovative health service delivery model is emerging that will not only improve Indigenous health status, but may also present a more appropriate model for the health care sector than the existing mainstream health service delivery model provided for other sections of the collective Australian population.
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Panaretto, K. S., A. Dellit, A. Hollins, G. Wason, C. Sidhom, K. Chilcott, D. Malthouse, et al. "Understanding patient access patterns for primary health-care services for Aboriginal and Islander people in Queensland: a geospatial mapping approach." Australian Journal of Primary Health 23, no. 1 (2017): 37. http://dx.doi.org/10.1071/py15115.
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This paperexplores the patterns ofpatients’accessingsix Aboriginal and Islander CommunityControlled Health Services (AICCHSs) in Queensland. Between August 2011 and February 2014, 26199 patients made at least one visit over a 2-year period prior to at least one of six Queensland AICCHS – one urban service (RA 1) in south-east Queensland, and five services in regional towns (RA 3) in Far North Queensland. Geospatial mapping of addresses for these registered patients was undertaken. The outcomes analysed included travel times to, the proportion of catchment populations using each AICCHS and an assessment of alternative mainstream general practice availability to these patients was made. In brief, the use of AICCHS was higher than Australian Bureau of Statistics census data would suggest. Approximately 20% of clients travel more than 30min to seek Aboriginal Health services, but only 8% of patients travelled longer than 60min. In the major city site, many other general practitioner (GP) services were bypassed. The data suggest Aboriginal and Islander patients in Queensland appear to value community-controlled primary care services. The number of Indigenous clients in regional locations in the Far North Queensland registered with services is often higher than the estimated resident population numbers.
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Flood, Louise, Matthew McConnell, Luda Molchanoff, Zell Dodd, Jana Sisnowski, Melissa Fidock, Tina Miller, Karli Borresen, Hannah Vogt, and Andrew Lane. "Lessons from a community vaccination programme to control a meningococcal disease serogroup W outbreak in remote South Australia, 2017." Western Pacific Surveillance and Response Journal 12, no. 1 (March 31, 2021): 26–31. http://dx.doi.org/10.5365/wpsar.2019.10.2.002.
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Problem: From December 2016 to February 2017, two cases of invasive meningococcal disease and one case of meningococcal conjuctivitis, all serogroup W, occured in Aboriginal children in the Ceduna region of South Australia. The clustering of cases in time and place met the threshold for a community outbreak. Context: The Ceduna region is a remote part of South Australia, with more than 25% of the population identifying as Aboriginal or Torres Strait Islander. Action: As part of the outbreak response, a community-wide meningococcal vaccination programme against serogroups A, C, W and Y was implemented in a collaboration among different agencies of the South Australian Department for Health and Wellbeing, Aboriginals health and community services providers, and other local service providers and government agencies. Outcome: Between March and June 2017, 3383 persons were vaccinated, achieving an estimate coverage of 71-85% of the target population, with 31% (n = 1034) of those vaccinated identifying as Aboriginal or Torres Strait Islander. No local cases of serogroup W occurred during the vaccination programme, but two further cases were notified by the end of 2018. Discussion: The participation of a large number of local and non-health-sector stakeholders in programme planning and implementation, a clear response management structure and high community acceptability were identified as key factors that contributed to the programme achieving high vaccination coverage. The need to develop standard procedures for community-based outbreak response interventions to ease logistical challenges was considered an important lessons learnt.
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STEWART, JESSICA M., ROB W. SANSON-FISHER, SANDRA EADES, and MICHAEL FITZGERALD. "The risk status, screening history and health concerns of Aboriginal and Torres Strait Islander people attending an Aboriginal Community Controlled Health Service." Drug and Alcohol Review 31, no. 5 (April 26, 2012): 617–24. http://dx.doi.org/10.1111/j.1465-3362.2012.00455.x.
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Visser, Hannah, Megan Passey, Emma Walke, and Sue Devlin. "Screening for latent tuberculosis infection by an Aboriginal Community Controlled Health Service, New South Wales, Australia, 2015." Western Pacific Surveillance and Response Journal 10, no. 4 (December 30, 2019): 24–30. http://dx.doi.org/10.5365/wpsar.2018.9.2.010.
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Objective: Ongoing transmission of tuberculosis (TB) continues in Indigenous communities in New South Wales (NSW), Australia. In a pilot project, a Public Health Unit TB team partnered with an Aboriginal Community Controlled Health Service (ACCHS) in a community with a cluster of TB to augment screening for latent TB infection (LTBI) using interferongamma release assay (IGRA). This study examined screening data and programme outcomes at 12 months post hoc to advise practice and policy formulation. Methods: We conducted a retrospective, cross-sectional analysis of demographic and clinical data of ACCHS patients, stratified by IGRA testing status. Differences in sex and age distribution between the groups and cases of a genetically and epidemiologically linked TB cluster in Aboriginal people in NSW were assessed using non-parametric tests. Results: Of 2019 Aboriginal and Torres Strait Islander people seen by general practitioners during the study period, 135 (6.7%) participated in the screening. Twenty-four (17.8%) participants were IGRA positive. One person was diagnosed with active TB. Twelve participants received a chest X-ray at the time of the positive test, and six participants had an additional chest X-ray within 12 months. None commenced preventive treatment for LTBI. Discussion: ACCHS screening for LTBI reached individuals in the age group most commonly affected by TB in these Aboriginal communities. No conclusions can be made regarding the population prevalence due to the low screening rate. Further strategies need to be developed to increase appropriate follow-up and preventive treatment.
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Arthur, Lachlan, Ana Herceg, Heidi Shukralla, and Jason Payne. "Evaluating Patient Experience at a Novel Health Service for Aboriginal and Torres Strait Islander Prisoners: A Pilot Study." Journal of the Australian Indigenous HealthInfoNet 3, no. 1 (2022): 1–14. http://dx.doi.org/10.14221/aihjournal.v3n1.4.
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Background The Winnunga Alexander Maconochie Centre Health and Wellbeing Service (AMCHWS) is the first prison health service operated by an Aboriginal Community Controlled Health Organisation in Australia. This pilot study developed and implemented a patient experience survey to evaluate the novel model of healthcare delivered by the Winnunga AMCHWS to Aboriginal and Torres Strait Islander prisoners. Methods Patients accessing the Winnunga AMCHWS between February and May 2020 were invited to participate in the study. Descriptive data were analysed and compiled for demographics, patient satisfaction, patient perception of care quality, cultural safety, and patient thoughts on the Winnunga AMCHWS. Findings Sixteen of 26 eligible patients participated in the survey (62% response rate). At least 75% of patients were satisfied with the waiting time to see staff at the Winnunga AMCHWS most or all of the time. All 16 patients reported that Winnunga AMCHWS staff always treated them with dignity and respect. Of 14 patients who identified as Aboriginal, nine felt that they were treated better by staff because of their Aboriginal identity while the other five felt their Aboriginal identity made no difference to their treatment by the staff. Interpretation This patient experience survey of the Winnunga AMCHWS found that it has provided highly satisfactory, timely, respectful, and culturally safe care to patients. Due to the limitations of this study, continual evaluation of the Winnunga AMCHWS and future studies to evaluate the continuity of care, health, and re-offending rates of released patients are needed to fully evaluate the Winnunga AMCHWS model.
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Graham, Simon, Megan Blaxland, Reuben Bolt, Mitchell Beadman, Kristy Gardner, Kacey Martin, Michael Doyle, et al. "Aboriginal peoples’ perspectives about COVID-19 vaccines and motivations to seek vaccination: a qualitative study." BMJ Global Health 7, no. 7 (July 2022): e008815. http://dx.doi.org/10.1136/bmjgh-2022-008815.
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IntroductionAboriginal and Torres Strait Islander (Aboriginal) people compared with non-Aboriginal people in Australia have higher rates of chronic conditions. These conditions increase the risk of poorer health outcomes if infected with COVID-19, highlighting the importance of COVID-19 vaccination. This study examined what Aboriginal people think about COVID-19 vaccines, reasons why they were vaccinated or not vaccinated and factors involved in receiving COVID-19 vaccination.MethodsWe used a participatory peer researcher method to interview 35 Aboriginal people aged 15–80 years living in Western Sydney, Australia. Local Aboriginal people who had ties with the community conducted the interviews. The questions and analyses were framed using the WHO’s Behavioural and Social Drivers of COVID-19 model. Interviews occurred between February 2021 and March 2021. Peer researchers were paid for their time in training and to conduct the interviews and each participant received $50.ResultsReasons why participants would seek vaccination included: to protect themselves from infection and severe illness, to protect others in their community, to travel again and to return to ‘normal life’. Reasons why some participants were hesitant about being vaccinated included: fear of vaccine side effects; negative stories on social media; and distrust in Australian governments and medical institutions. Aboriginal people preferred to access COVID-19 vaccination through their local Aboriginal Health Service or a general practitioner they already knew.ConclusionAchieving high vaccination rates in Aboriginal communities is possible if vaccination programmes are delivered through trusted general practitioners or Aboriginal Health Services.
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Dwyer, Judith, Kim O'Donnell, Eileen Willis, and Janet Kelly. "Equitable Care for Indigenous People: every health service can do it." Asia Pacific Journal of Health Management 11, no. 3 (October 1, 2016): 11–17. http://dx.doi.org/10.24083/apjhm.v11i3.143.
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Problem and its context: Indigenous peoples in many countries suffer poorer health and poorer access to good healthcare than their non-Indigenous counterparts. In Australia, enduring barriers to good health and good healthcare remain, in spite of long-standing policy priorities. These barriers include the ongoing reality of colonisation, and silence about its implications. People working in and using the health system need to relate across cultures, but they approach this endeavour witha complex mixture of goodwill, defensiveness, guilt and anxiety.
Methods: We analysed what is known in Australia about differentials in access to good care, and the underlying factors that entrench them, as well as strategies for developing mainstream competence in care for Aboriginal and Torres Strait Islander patients and communities.
Analysis and Conclusions: The available evidence of differentials in access and quality that are not explained by clinical or demographic variables is unequivocal. Official policy needs to be implemented at the system and organisation level through operational policies, programs and protocols, and through relationships with Aboriginal healthcare providers and community organisations. The concept of racism anxiety provides a way of making one important barrier visible, and moving beyond it can enable people of goodwill to ‘see’ where change is needed, and to see themselves as part of the solution. It is time to get beyond the barriers and attend to practical improvements in care, focused on the care system, not simply on the skills and knowledge of individuals within it.
Abbreviations: ACCHO – Aboriginal Community Controlled Health Organisation; CC – Cultural Competence.
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Lovett, Ray, Phyll Dance, Jill Guthrie, Roxie Brown, and Julie Tongs. "Walan Girri: developing a culturally mediated case management model for problematic alcohol use among urban Indigenous people." Australian Health Review 38, no. 4 (2014): 440. http://dx.doi.org/10.1071/ah13148.
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Objective To describe the design and implementation of a culturally mediated case management model at Winnunga Nimmityjah Aboriginal Health Service (Winnunga) for Indigenous clients who consume alcohol at problematic levels. Methods Our research took place from March 2008 to March 2010 in the Australian Capital Territory and built on previous research partnerships between Winnunga and The Australian National University’s National Centre for Epidemiology and Population Health. We conducted a review of existing models to determine elements for consideration in the community controlled setting, and conducted staff surveys to assess current levels of skill and confidence around alcohol screening, brief intervention and care planning. Using the information from the review and staff surveys, we then undertook staff capacity building to build confidence and skills in conducting alcohol screening, brief intervention and care planning. This process was driven by Winnunga’s social health team. To meet Medicare benefits schedule requirements, and frame the study within the Aboriginal and Torres Strait Islander Chronic Disease Package framework, we included team care arrangements, care planning and health checks. Results Elements of case management were suggested by staff and incorporated into the final model. Forty staff in the health service participated in identifying training needs for the development of the case management model and undertook a range of training before the model was implemented. Staff working within the social health team decided that the focus of the case management was to build a stronger future for their clients, hence the name of the case management model ‘Walan Girri’ (Wiradjuri language for strong future). The model included a package of screening instruments and brief intervention, related polices and discussion of ‘mob’ and ‘country.’ Changes in Winnunga management and staff, the composition of the research team and the way Walan Girri evolved led to protracted development and implementation. Conclusions This project highlights considerations for implementing a case management model in a dynamic health service environment. Capacity building for Winnunga staff and for an Indigenous PhD scholar were part of the process and were integral in maintaining momentum in the project. What is known about the topic? Case management for chronic disease and other health conditions is currently recommended in assisting to resolve those issues. Case management aims to involve a range of healthcare practitioners (general practitioners, nurses and Aboriginal health workers) and providers in conjunction with the client to improve their health status. Currently, there is limited description of how case management models are used within the Aboriginal community controlled context. What does this paper add? This paper adds to the knowledge base in this field by describing the results of a method of case management driven by the community controlled health sector. It also introduces a simple approach that may be useful in a range of contexts in the health setting in building trust and rapport with clients, while engaging the healthcare practitioner in the Aboriginal and Torres Strait Islander cultural contexts of relationships to country and family (mob). What are the implications for practitioners? The implication may be that healthcare practitioners working in Aboriginal and/or Torres Strait Islander Health Services adopt Aboriginal and Torres Strait Islander cultural protocols, such as talking with clients about ‘mob’ and ‘country’, to build trust and rapport.
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Kerrigan, Vicki, Rarrtjiwuy Melanie Herdman, David P. Thomas, and Marita Hefler. "'I still remember your post about buying smokes': a case study of a remote Aboriginal community-controlled health service using Facebook for tobacco control." Australian Journal of Primary Health 25, no. 5 (2019): 443. http://dx.doi.org/10.1071/py19008.
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Many Aboriginal Community Controlled Health Services (ACCHS) embrace Facebook as an organisational tool to share positive stories, which counter the negative narrative surrounding Aboriginal issues. However, the Facebook algorithm prioritises posts on personal pages over organisations. To take advantage of the algorithm, this project paid three Yolŋu employees of a north-east Arnhem Land ACCHS to share quit smoking messages on their personal Facebook pages. Smoking prevalence among Aboriginal and Torres Strait Islander Australians is nearly three-fold higher than non-Indigenous Australians, and previous research has identified the need for culturally appropriate communication approaches to accelerate the decline in Indigenous smoking. This research found Yolŋu participants nurtured healthy behaviours through compassionate non-coercive communications, in contrast to fear-inducing health warnings prevalent in tobacco control. Cultural tailoring of tobacco control messages was achieved by having trusted local health staff sharing, and endorsing, messages regardless of whether the content was Indigenous specific. This research also revealed online Facebook activity does not reflect the reach of posts, which may extend beyond social media users to individuals who do not have a Facebook profile.
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Butler, Danielle, Anton Clifford-Motopi, Saira Mathew, Carmel Nelson, Renee Brown, Karen Gardner, Lyle Turner, et al. "Study protocol: primary healthcare transformation through patient-centred medical homes—improving access, relational care and outcomes in an urban Aboriginal and Torres Strait Islander population, a mixed methods prospective cohort study." BMJ Open 12, no. 9 (September 2022): e061037. http://dx.doi.org/10.1136/bmjopen-2022-061037.
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IntroductionFor over 40 years, Aboriginal and Torres Strait Islander Community-Controlled Health Services (ACCHS) in Australia have led strategic responses to address the specific needs of Aboriginal and Torres Strait Islander populations. Globally, there has been rapid growth in urban Indigenous populations requiring an adaptive primary healthcare response. Patient-centred medical homes (PCMH) are an evidenced-based model of primary healthcare suited to this challenge, underpinned by principles aligned with the ACCHS sector—relational care responsive to patient identified healthcare priorities. Evidence is lacking on the implementation and effectiveness of the PCMH model of care governed by, and delivered for, Aboriginal and Torres Strait Islander populations in large urban settings.Method and analysisOur multiphased mixed-methods prospective cohort study will compare standard care provided by a network of ACCHS to an adapted PCMH model of care. Phase 1 using qualitative interviews with staff and patients and quantitative analysis of routine primary care health record data will examine the implementation, feasibility and acceptability of the PCMH. Phase 2 using linked survey, primary care and hospitalisation data will examine the impact of our adapted PCMH on access to care, relational and quality of care, health and wellbeing outcomes and economic costs. Phase 3 will synthesise evidence on mechanisms for change and discuss their implications for sustainability and transferability of PCMHs to the broader primary healthcare systemEthics and disseminationThis study has received approval from the University of Queensland Human Research Ethics Committee (2021/HE00529). This research represents an Aboriginal led and governed partnership in response to identified community priorities. The findings will contribute new knowledge on how key mechanisms underpinning the success and implementation of the model can be introduced into policy and practice. Study findings will be disseminated to service providers, researchers, policymakers and, most importantly, the communities themselves.
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Wheeler, Amanda J., Jean Spinks, Fiona Kelly, Robert S. Ware, Erica Vowles, Mike Stephens, Paul A. Scuffham, and Adrian Miller. "Protocol for a feasibility study of an Indigenous Medication Review Service (IMeRSe) in Australia." BMJ Open 8, no. 11 (November 2018): e026462. http://dx.doi.org/10.1136/bmjopen-2018-026462.
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IntroductionThe age-adjusted rate of potentially preventable hospitalisations for Aboriginal and Torres Strait Islander people is almost five times the rate of other Australians. Quality use of medicines has an important role in alleviating these differences. This requires strengthening existing medication reviewing services through collaboration between community pharmacists and health workers, and ensuring services are culturally appropriate. This Indigenous Medication Review Service (IMeRSe) study aims to develop and evaluate the feasibility of a culturally appropriate medication management service delivered by community pharmacists in collaboration with Aboriginal health workers.Methods and analysisThis study will be conducted in nine Aboriginal health services (AHSs) and their associated community pharmacies in three Australian states over 12 months. Community pharmacists will be trained to improve their awareness and understanding of Indigenous health and cultural issues, to communicate the quality use of medicines effectively, and to strengthen interprofessional relationships with AHSs and their staff. Sixty consumers (with a chronic condition/pregnant/within 2 years post partum and at risk of medication-related problems (MRPs) per site will be recruited, with data collection at baseline and 6 months. The primary outcome is the difference in cumulative incidence of serious MRPs in the 6 months after IMeRSe introduction compared with the 6 months prior. Secondary outcomes include potentially preventable medication-related hospitalisations, medication adherence, total MRPs, psychological and social empowerment, beliefs about medication, treatment satisfaction and health expenditure.Ethics and disseminationThe protocol received approval from Griffith University (HREC/2018/251), Queensland Health Metro South (HREC/18/QPAH/109), Aboriginal Health and Medical Research Council of New South Wales (1381/18), Far North Queensland (HREC/18/QCH/86-1256) and the Central Australian HREC (CA-18-3090). Dissemination to Indigenous people and communities will be a priority. Results will be available on the Australian Sixth Community Pharmacy Agreement website and published in peer-reviewed journals.Trial registration numberACTRN12618000188235; Pre-results.
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Chakraborty, Amal, Emma Walke, Roxanne Bainbridge, Ross Bailie, Veronica Matthews, Sarah Larkins, Paul Burgess, et al. "VOICE–Validating Outcomes by Including Consumer Experience: A Study Protocol to Develop a Patient Reported Experience Measure for Aboriginal and Torres Strait Islander Peoples Accessing Primary Health Care." International Journal of Environmental Research and Public Health 20, no. 1 (December 26, 2022): 357. http://dx.doi.org/10.3390/ijerph20010357.
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Aboriginal and Torres Strait Islander peoples’ (hereafter respectfully referred to as Indigenous Australians) experiences of health care are shaped by historical, social and cultural factors, with cultural security critical to effective care provision and engagement between services and community. Positive patient experiences are associated with better health outcomes. Consequently, it is an accreditation requirement that primary health care (PHC) services must formally gather and respond to patient feedback. However, currently available patient feedback tools were not developed with Indigenous Australians, and do not reflect their values and world views. Existing tools do not capture important experiences of care of Indigenous Australians in PHC settings, nor return information that assists services to improve care. Consistent with the principles of Indigenous Data Sovereignty, we will co-design and validate an Indigenous-specific Patient Reported Experience Measure (PREM) that produces data by and for community, suitable for use in quality improvement in comprehensive PHC services. This paper presents the protocol of the study, outlining the rationale, methodologies and associated activities that are being applied in developing the PREM. Briefly, guided by an Aboriginal and Torres Strait Islander Advisory Group, our team of Indigenous and non-Indigenous researchers, service providers and policy makers will use a combination of Indigenous methodologies, participatory, and traditional western techniques for scale development. We will engage PHC service staff and communities in eight selected sites across remote, regional, and metropolitan communities in Australia for iterative cycles of data collection and feedback throughout the research process. Yarning Circles with community members will identify core concepts to develop an “Experience of Care Framework”, which will be used to develop items for the PREM. Staff members will be interviewed regarding desirable characteristics and feasibility considerations for the PREM. The PREM will undergo cognitive and psychometric testing.
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Haydon, Helen M., Liam J. Caffery, Centaine L. Snoswell, Emma E. Thomas, Roderick Wright, Rachel Doolan, Lisa Garner, Phil Aitken, and Anthony C. Smith. "Dementia ECHO: Evaluation of a telementoring programme to increase dementia knowledge and skills in First Nations-led health services." Journal of Telemedicine and Telecare 28, no. 10 (November 8, 2022): 757–63. http://dx.doi.org/10.1177/1357633x221119610.
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Introduction High rates of dementia among Australian First Nations’ peoples have resulted in an increased demand for dementia knowledge and skills among the primary health care professionals in these communities. The Dementia Extension for Community Healthcare Outcomes (ECHO) program aims to be a culturally safe way of increasing local health workforce capacity by facilitating dementia knowledge, skills and confidence among primary care professionals in First Nations community settings. Dementia ECHO is based on the international evidence-based telementoring programme, Project Extension for Community Healthcare Outcomes. Every Dementia ECHO session is delivered by videoconference and comprises a specialist-led presentation and a case discussion from a primary care health service participant. The aims of this study were to assess the uptake and reach of Dementia ECHO; examine the perceived importance of dementia care and dementia education among Aboriginal and Torres Strait Islander Community Controlled Health Service staff; and evaluate the potential impact of Dementia ECHO on health service staff pertaining to dementia knowledge, confidence to provide dementia care and professional isolation. Method Dementia ECHO service activity data maintained by the programme providers was reviewed to determine uptake and reach. A pre-implementation survey examined Aboriginal and Torres Strait Islander Community Controlled Health Service staff perspectives on the importance of dementia education and the priority of a range of health issues. After each Dementia ECHO session, a brief online survey gathered quantitative and qualitative data regarding the potential impact of the session. Results Of 30 completed pre-implementation surveys, all staff rated dementia education as either very important or important. Salient themes highlighting why it is important are presented. When asked to rank six different health priorities, dementia ( n = 10) and chronic disease ( n = 10) were placed as the top priority. The brief post-session feedback provided 44 complete survey responses demonstrating: perceived improvement in dementia knowledge and skills (88.4%); increased confidence to provide dementia care (83%); and a reduction in professional isolation (88%). Conclusion Dementia ECHO addresses a gap in dementia education that is much needed in health professionals with increasing numbers of First Nations people living with dementia. This current study shows that attending an evidence-based telementoring programme, such as Dementia ECHO, can increase dementia knowledge and confidence to care for someone living with dementia and their families.
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Sibthorpe, Beverly, Karen Gardner, Mier Chan, Michelle Dowden, Ginny Sargent, and Dan McAullay. "Impacts of continuous quality improvement in Aboriginal and Torres Strait islander primary health care in Australia." Journal of Health Organization and Management 32, no. 4 (June 6, 2018): 545–71. http://dx.doi.org/10.1108/jhom-02-2018-0056.
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PurposeContinuous quality improvement (CQI) programmes have been taken up widely by indigenous primary health care services in Australia, but as yet there has not been a systematic assessment of their focus and achievements. A scoping review of the literature from studies of CQI in indigenous primary health care services was undertaken to explore impacts on service systems, care and client outcomes with the aim of providing guidance on future evaluation efforts. The paper aims to discuss these issues,Design/methodology/approachSearches were conducted in MEDLINE, CINAHL and the Cochrane Database of Systematic Reviews to December 2016 and handsearching of key websites and publications. Studies of CQI programs or activities in Indigenous primary health care services which demonstrated some combination of CQI characteristics, as described by Rubenstein (2013) were included. A two-stage approach to analysis was undertaken. Stage 1 identified the range and scope of literature, and Stage 2 investigated impacts to service systems, care and client outcomes. The Framework for Performance Assessment in Primary Health Care was used to frame the Stage 2 analysis.FindingsThe majority of Aboriginal community controlled health services have been involved in CQI but there are gaps in knowledge about uptake in general practice and government clinics. There are as many baseline studies as studies on impacts over time. Of the 14 studies included for further analysis, 6 reported on impacts on service systems; all 14 reported on impacts on care and 6 on client outcomes. Changes to services systems are variable and studies of impacts on care and client outcomes show promising though uneven improvements. There are no economic studies or studies addressing community engagement in CQI activities.Research limitations/implicationsTo supplement existing limited knowledge about which service system change strategies are effective and sustainable for which problems in which settings, there needs to be investment in research and development. Research needs to be grounded in the realities of service delivery and contribute to the development of CQI capacity at the service level. Knowledge translation needs to be built into implementation to ensure maximum benefit to those endeavouring on a daily basis to constantly reflect on and improve the quality of the care they deliver to clients, and to the stewardship structures supporting services at regional, state/territory and national levels.Practical implicationsImproved approaches, methods, data capture and reporting arrangements are needed to enhance existing activity and to ensure maximum benefit to services endeavouring to reflect on and improve quality of care and to the stewardship structure supporting services at regional, state/territory and national levels.Originality/valueAlthough there is a growing body of research evidence about CQI both nationally and internationally, and considerable investment by the federal government in Australia to support CQI as part of routine practice, there has not been a systematic assessment of the achievements of CQI in Indigenous primary health care services. Many unanswered questions remain about the extent of uptake, implementation and impacts. This is a barrier to future investment and regional and local programme design, monitoring and evaluation. The authors conducted a scoping review to address these questions. From this, the authors draw conclusions about the state of knowledge in Australia with a view to informing how future CQI research and evaluation might be intensified.
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Freeman, Toby, Fran Baum, Ronald Labonté, Sara Javanparast, and Angela Lawless. "Primary health care reform, dilemmatic space and risk of burnout among health workers." Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine 22, no. 3 (February 17, 2017): 277–97. http://dx.doi.org/10.1177/1363459317693404.
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Health system changes may increase primary health care workers’ dilemmatic space, created when reforms contravene professional values. Dilemmatic space may be a risk factor for burnout. This study partnered with six Australian primary health care services (in South Australia: four state government–managed services including one Aboriginal health team and one non-government organisation and in Northern Territory: one Aboriginal community–controlled service) during a period of change and examined workers’ dilemmatic space and incidence of burnout. Dilemmatic space and burnout were assessed in a survey of 130 staff across the six services (58% response rate). Additionally, 63 interviews were conducted with practitioners, managers, regional executives and health department staff. Dilemmatic space occurred across all services and was associated with higher rates of self-reported burnout. Three conditions associated with dilemmatic space were (1) conditions inherent in comprehensive primary health care, (2) stemming from service provision for Aboriginal and Torres Strait Islander peoples and (3) changes wrought by reorientation to selective primary health care in South Australia. Responses to dilemmatic space included ignoring directives or doing work ‘under the radar’, undertaking alternative work congruent with primary health care values outside of hours, or leaving the organisation. The findings show that comprehensive primary health care was contested and political. Future health reform processes would benefit from considering alignment of changes with staff values to reduce negative effects of the reform and safeguard worker wellbeing.
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McNamara, Bridgette, Lina Gubhaju, Louisa Jorm, David Preen, Jocelyn Jones, Grace Joshy, Carrington Shepherd, Daniel McAullay, and Sandra Eades. "Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)." BMJ Open 8, no. 3 (March 2018): e021236. http://dx.doi.org/10.1136/bmjopen-2017-021236.
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IntroductionEmpirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years.Methods and analysisThe study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA.Ethics and disseminationEthics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations.
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Bell, Stephen, James Ward, Peter Aggleton, Walbira Murray, Bronwyn Silver, Andrew Lockyer, Tellisa Ferguson, et al. "Young Aboriginal people's sexual health risk reduction strategies: a qualitative study in remote Australia." Sexual Health 17, no. 4 (2020): 303. http://dx.doi.org/10.1071/sh19204.
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Background Surveillance data indicate that Aboriginal and Torres Strait Islander young people are more likely than their non-Indigenous counterparts to experience sexually transmissible infections (STIs) and teenage pregnancy. Despite increasing emphasis on the need for strengths-based approaches to Aboriginal sexual health, limited published data document how young Aboriginal people reduce sexual health risks encountered in their everyday lives. Methods: In-depth interviews with 35 young Aboriginal women and men aged 16–21 years in two remote Australian settings were conducted; inductive thematic analysis examining sexual health risk reduction practices was also conducted. Results: Participants reported individual and collective STI and pregnancy risk reduction strategies. Individual practices included accessing and carrying condoms; having a regular casual sexual partner; being in a long-term trusting relationship; using long-acting reversible contraception; having fewer sexual partners; abstaining from sex; accessing STI testing. More collective strategies included: refusing sex without a condom; accompanied health clinic visits with a trusted individual; encouraging friends to use condoms and go for STI testing; providing friends with condoms. Conclusion: Findings broaden understanding of young Aboriginal people’s sexual health risk reduction strategies in remote Aboriginal communities. Findings signal the need for multisectoral STI prevention and sexual health programs driven by young people’s existing harm minimisation strategies and cultural models of collective support. Specific strategies to enhance young people’s sexual health include: peer condom distribution; accompanied health service visits; peer-led health promotion; continued community-based condom distribution; enhanced access to a fuller range of available contraception in primary care settings; engaging health service-experienced young people as ‘youth health workers’.
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Boffa, John, Edward Tilton, and Donna Ah Chee. "Preventing alcohol-related harm in Aboriginal and Torres Strait Islander communities: The experience of an Aboriginal Community Controlled Health Service in Central Australia." Australian Journal of General Practice 47, no. 12 (December 1, 2018): 851–54. http://dx.doi.org/10.31128/ajgp-08-18-4661.
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Harrison, Kristie H., KS Kylie Lee, Timothy Dobbins, Scott Wilson, Noel Hayman, Rowena Ivers, Paul S. Haber, et al. "Supporting Aboriginal Community Controlled Health Services to deliver alcohol care: protocol for a cluster randomised controlled trial." BMJ Open 9, no. 11 (November 2019): e030909. http://dx.doi.org/10.1136/bmjopen-2019-030909.
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IntroductionIndigenous peoples who have experienced colonisation or oppression can have a higher prevalence of alcohol-related harms. In Australia, Aboriginal Community Controlled Health Services (ACCHSs) offer culturally accessible care to Aboriginal and Torres Strait Islander (Indigenous) peoples. However there are many competing health, socioeconomic and cultural client needs.Methods and analysisA randomised cluster wait-control trial will test the effectiveness of a model of tailored and collaborative support for ACCHSs in increasing use of alcohol screening (with Alcohol Use Disorders Identification Test-Consumption (AUDIT-C)) and of treatment provision (brief intervention, counselling or relapse prevention medicines).SettingTwenty-two ACCHSs across Australia.RandomisationServices will be stratified by remoteness, then randomised into two groups. Half receive support soon after the trial starts (intervention or ‘early support’); half receive support 2 years later (wait-control or ‘late support’).The supportCore support elements will be tailored to local needs and include: support to nominate two staff as champions for increasing alcohol care; a national training workshop and bimonthly teleconferences for service champions to share knowledge; onsite training, and bimonthly feedback on routinely collected data on screening and treatment provision.Outcomes and analysisPrimary outcome is use of screening using AUDIT-C as routinely recorded on practice software. Secondary outcomes are recording of brief intervention, counselling, relapse prevention medicines; and blood pressure, gamma glutamyltransferase and HbA1c. Multi-level logistic regression will be used to test the effectiveness of support.Ethics and disseminationEthical approval has been obtained from eight ethics committees: the Aboriginal Health and Medical Research Council of New South Wales (1217/16); Central Australian Human Research Ethics Committee (CA-17-2842); Northern Territory Department of Health and Menzies School of Health Research (2017-2737); Central Queensland Hospital and Health Service (17/QCQ/9); Far North Queensland (17/QCH/45-1143); Aboriginal Health Research Ethics Committee, South Australia (04-16-694); St Vincent’s Hospital (Melbourne) Human Research Ethics Committee (LRR 036/17); and Western Australian Aboriginal Health Ethics Committee (779).Trial registration numberACTRN12618001892202; Pre-results.
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Gajjar, Deepa, Anthony B. Zwi, Peter S. Hill, and Cindy Shannon. "A case study in the use of evidence in a changing political context: an Aboriginal and Torres Strait Islander health service re-examines practice models, governance and financing." Australian Health Review 38, no. 4 (2014): 383. http://dx.doi.org/10.1071/ah13221.
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This paper examines the response of a regional body, the Institute for Urban Indigenous Health (IUIH), coordinating Aboriginal community controlled health organisations (ACCHOs) in south-east Queensland, to research evidence as they prioritise and plan services in response to internal economic and organisational factors, as well as external policy change. An event-based analysis of a quarterly management meeting of the IUIH allowed an exploration of how the IUIH uses a range of evidence to respond to the challenges faced within the Aboriginal community controlled health sector. The study identified three distinct but interconnected processes: (1) identifying evidence for change; (2) exploring and reframing this evidence; and (3) the application of this evidence at different levels of policy and practice. These processes were evident in each of the three major agendas addressed during the meeting, namely navigating current political change, reforming the ACCHO business model and reframing the available evidence for advocacy. The result has been the emergence of a new service delivery model, in which evidence supports accountability, change management, self-sufficiency and attempts to redefine community control.