Journal articles on the topic 'Indigenous health services'
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Durie, M. "Providing health services to indigenous peoples." BMJ 327, no. 7412 (August 23, 2003): 408–9. http://dx.doi.org/10.1136/bmj.327.7412.408.
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Mashford-Pringle, Angela, Ian Ring, Fadwa Al-Yaman, John Waldon, and Michelle Chino. "Rethinking health services measurement for Indigenous populations." Statistical Journal of the IAOS 35, no. 1 (March 19, 2019): 139–46. http://dx.doi.org/10.3233/sji-180465.
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Barnabe, Cheryl. "Towards attainment of Indigenous health through empowerment: resetting health systems, services and provider approaches." BMJ Global Health 6, no. 2 (February 2021): e004052. http://dx.doi.org/10.1136/bmjgh-2020-004052.
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Colonial policies and practices have introduced significant health challenges for Indigenous populations in commonwealth countries. Health systems and models of care were shaped for dominant society, and were not contextualised for Indigenous communities nor with provision of Indigenous cultural approaches to maintain health and wellness. Shifts to support Indigenous health outcomes have been challenged by debate on identifying which system and service components are to be included, implementation approaches, the lack of contextualised evaluation of implemented models to justify financial investments, but most importantly lack of effort in ensuring equity and participation by affected communities to uphold Indigenous rights to health. Prioritising the involvement, collaboration and empowerment of Indigenous communities and leadership are critical to successful transformation of healthcare in Indigenous communities. Locally determined priorities and solutions can be enacted to meet community and individual needs, and advance health attainment. In this paper, existing successful and sustainable models that demonstrate the empowerment of Indigenous peoples and communities in advocating for, designing, delivering and leading health and wellness supports are shared.
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McConkey, Stephanie. "Indigenous access barriers to health care services in London, Ontario." University of Western Ontario Medical Journal 86, no. 2 (December 3, 2017): 6–9. http://dx.doi.org/10.5206/uwomj.v86i2.1407.
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Introduction: Indigenous peoples in Canada suffer higher rates of health inequalities and encounter a number of health services access barriers when compared to their non-Indigenous counterparts. Indigenous peoples experience social and economic challenges, cultural barriers, and discrimination when accessing mainstream health services.
Methods: In London, Ontario, 21 interviews and 2 focus groups (n = 25) with service providers were completed, each session spanning approximately 1 to 1.5 hours. Interviews were voice recorded and transcribed verbatim. Themes were identified using NVIVO 10 software.
Findings: Approximately 2 to 5% of clients are Indigenous in hospital-based services. There are a number of social factors that influence whether Indigenous peoples access health services. Indigenous peoples do not have access to adequate pain medications because physicians are reluctant to provide Indigenous patients with pain medications due to common perceptions of addiction. Indigenous peoples also have barriers accessing a family physician because physicians are reluctant to take on new patients with complex health needs.
Conclusion: Systemic discrimination is still alive in the health care system; therefore, there is a need for cultural safety training among physicians to increase awareness of access barriersand challenges that many Indigenous patients face when seeking health care.
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Devadasan, N. "Health of indigenous people: Use of health services by indigenous population can be improved." BMJ 327, no. 7421 (October 25, 2003): 988. http://dx.doi.org/10.1136/bmj.327.7421.988.
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Whelan, Stephen, and Donald J. Wright. "Health services use and lifestyle choices of Indigenous and non-Indigenous Australians." Social Science & Medicine 84 (May 2013): 1–12. http://dx.doi.org/10.1016/j.socscimed.2013.02.013.
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Scrimgeour, David. "Funding for community control of indigenous health services." Australian and New Zealand Journal of Public Health 20, no. 1 (February 1996): 17–18. http://dx.doi.org/10.1111/j.1467-842x.1996.tb01330.x.
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Davis, Jenny, and Janis Shaw. "Indigenous status a key issue for health services." New South Wales Public Health Bulletin 11, no. 12 (2000): 203. http://dx.doi.org/10.1071/nb00090.
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Lavoie, Josée, Derek Kornelsen, Yvonne Boyer, and Lloy Wylie. "Lost in Maps: Regionalization and Indigenous Health Services." HealthcarePapers 16, no. 1 (July 29, 2016): 63–73. http://dx.doi.org/10.12927/hcpap.2016.24773.
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Wright, A., O. Wahoush, M. Ballantyne, C. Gabel, and S. M. Jack. "Selection and Use of Health Services for Infants’ Needs by Indigenous Mothers in Canada: Integrative Literature Review." Canadian Journal of Nursing Research 50, no. 2 (February 19, 2018): 89–102. http://dx.doi.org/10.1177/0844562118757096.
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In Canada, Indigenous infants experience significant health disparities when compared to non-Indigenous infants, including significantly higher rates of birth complications and infant mortality rates. The use of primary health care is one way to improve health outcomes; however, Indigenous children may use health services less often than non-Indigenous children. To improve health outcomes within this growing population, it is essential to understand how caregivers, defined here as mothers, select and use health services in Canada. This integrative review is the first to critique and synthesize what is known of how Indigenous mothers in Canada experience selecting and using health services to meet the health needs of their infants. Themes identified suggest both Indigenous women and infants face significant challenges; colonialism has had, and continues to have, a detrimental impact on Indigenous mothering; and very little is known about how Indigenous mothers select and use health services to meet the health of their infants. This review revealed significant gaps in the literature and a need for future research. Suggestions are made for how health providers can better support Indigenous mothers and infants in their use of health services, based on what has been explored in the literature to date.
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Walker, Bruce F., Norman J. Stomski, Anne E. Price, and Elizabeth Jackson-Barrett. "Health professionals’ views on Indigenous Health and the delivery of healthcare services in the Pilbara." Australian Health Review 37, no. 4 (2013): 431. http://dx.doi.org/10.1071/ah13059.
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Purpose To explore health professionals’ views about Australian Indigenous people’s health and the delivery of healthcare to them in the Pilbara region of Western Australia. Methods An open-ended questionnaire was used to gather information from health professionals located across diverse regions in the Pilbara. The responses were analysed with the use of thematic analysis. In the first stage, codes were developed by assigning names to small sections of the interview transcripts. Next, the most salient incisive codes were identified and developed into themes that captured the most important issues. Findings Twenty-eight health professionals indicated that the most important health issues were chronic diseases, substance abuse and ear disease. These health issues were often attributed to a cycle of poor health perpetuated throughout generations. Educational initiatives were thought to be integral to intervening in this cycle. Of particular importance in improving the effectiveness of educational initiatives was facilitating the participation of Australian Indigenous peoples to determine the content of such initiatives. The other main issues the health professionals identified were lifting the standard of Australian Indigenous housing and implementing strategies to improve the continuity of healthcare. Conclusion Educational initiatives need to be prioritised to improve the health of Australian Indigenous people in the Pilbara and the initiatives should be delivered with the involvement of the local community in order to increase the likelihood of sustained behavioural change. Innovative solutions are required to improve the continuity of healthcare in the Pilbara, including increased use of mobile services. What is known about this topic? About two out of every three Indigenous adults in the Pilbara experience a chronic health condition. Moreover, compared with non-Indigenous peoples in the region, Indigenous peoples experience a significantly higher mortality rate for numerous chronic health conditions. Although some information is available about the provision of health services for Indigenous people in the Pilbara, little is known about its adequacy or how it could be most effectively delivered. What does this paper add? This study details health professionals’ views about the types of health conditions that need to be prioritised in addressing the health needs of Indigenous people in the Pilbara. It also details health professionals’ perceptions of gaps in health service delivery for Indigenous people in the Pilbara and examines how these services could be most effectively delivered. What are the implications for practitioners? Educational initiatives need to be prioritised to improve the health of Australian Indigenous people in the Pilbara and the initiatives should be delivered with the involvement of the local community in order to increase the likelihood of sustained behavioural change. Innovative solutions are required to improve the continuity of healthcare in the Pilbara, including increased use of mobile services.
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Ponton, Sarah J., Mikaela Gabriel, Jay Lu, Suzanne Stewart, Roy Strebel, and Sabina Mirza. "The mental health of Indigenous Peoples during the COVID-19 pandemic: A scoping review." Journal of Community Safety and Well-Being 9, no. 2 (June 13, 2024): 94–103. http://dx.doi.org/10.35502/jcswb.379.
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Indigenous Peoples face significant disparities related to mental health and well-being due to colonization and its ongoing impacts, further impacted by COVID-19. Following Arksey and O’Malley’s six-stage framework and Bartlett’s Indigenous Two-Eyed Seeing approach, a reflexive review of the literature about Indigenous mental health during the pandemic was undertaken. Consultant interviews were also completed, and thematically organized, with Indigenous People from three Indigenous-serving mental health organizations in Ontario. Key themes included: highlighting Indigenous voices, historical context, challenges and strengths in culturally based services, virtual transition, financial support for Indigenous services, health service delivery and well-being, and culture and community connection. The themes bridge gaps in service provision, the mental health impacts of loss of connection with community due to pandemic restrictions, how mental health supports can be improved, and which services provided during the pandemic should continue. This review provides service providers clear recommendations based on the findings to help improve Indigenous mental health and service provision.
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Diehl, Eliana Elisabeth, and Helga Bruxel Carvalho Follmann. "Indigenous nurses: participation of nursing technicians and auxiliary in indigenous health care services." Texto & Contexto - Enfermagem 23, no. 2 (June 2014): 451–59. http://dx.doi.org/10.1590/0104-07072014000300013.
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The aim of this study was to analyze the participation of Indigenous nursing technicians and aides in Indigenous health care services offered in the Xapecó Reserve, Santa Catarina, Brazil, focusing on the training and activities executed. Data collection (participant observation and interviews) and analysis were based on the ethnographic method. Sixteen key informants were interviewed, including nursing technicians and aides, training instructors, staff nurses and health service users. The training courses contained little or no emphasis on local knowledge and health practices. Other than the role of facilitator and mediator between the health team and community, the activities performed by the Indigenous nursing technicians and aides differed little from those of non-Indigenous people in the same categories. In this context, both the training of these workers and the activities executed by them reinforce the clinical curative model, which hinders articulation with local knowledge and Indigenous health practices, a principle of the National Policy of Health Care for Indigenous People.
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Cotter, Philippa R., John R. Condon, Tony Barnes, Ian P. S. Anderson, Leonard R. Smith, and Teresa Cunningham. "Do Indigenous Australians age prematurely? The implications of life expectancy and health conditions of older Indigenous people for health and aged care policy." Australian Health Review 36, no. 1 (2012): 68. http://dx.doi.org/10.1071/ah11996.
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Objective. To assess whether Indigenous Australians age prematurely compared with other Australians, as implied by Australian Government aged care policy, which uses age 50 years and over for population-based planning for Indigenous people compared with 70 years for non-indigenous people. Methods. Cross-sectional analysis of aged care assessment, hospital and health survey data comparing Indigenous and non-indigenous age-specific prevalence of health conditions. Analysis of life tables for Indigenous and non-indigenous populations comparing life expectancy at different ages. Results. At age 63 for women and age 65 for men, Indigenous people had the same life expectancy as non-indigenous people at age 70. There is no consistent pattern of a 20-year lead in age-specific prevalence of age-associated conditions for Indigenous compared with other Australians. There is high prevalence from middle-age onwards of some conditions, particularly diabetes (type unspecified), but there is little or no lead for others. Conclusion. The idea that Indigenous people age prematurely is not well supported by this study of a series of discrete conditions. The current focus and type of services provided by the aged care sector may not be the best way to respond to the excessive burden of chronic disease and disability of middle-aged Indigenous people. What is known about the topic? The empirical basis for the Australian Government’s use of age 50 for Indigenous aged care planning, compared to age 70 for the non-indigenous population, is not well established. It is not clear whether Indigenous people’s poorer health outcomes and lower life expectancy are associated with premature ageing. What does this paper add? This paper compares Indigenous and non-indigenous life expectancy and prevalence of health conditions. Only some conditions associated with ageing appear to affect Indigenous people earlier than other Australians. The proposition of premature ageing based on this explanatory framework is uncertain. The estimated gap between Indigenous and non-indigenous life expectancy in later life is ~6 years. What are the implications for practitioners? The current rationale for using a lower Indigenous planning age is problematic; however, further research is required to assess the effectiveness of this policy measure. The much higher prevalence of preventable chronic conditions among Indigenous Australians in middle-age groups is clear. The ‘early ageing’ frame can imply irremediable disability and disease. The aged care sector may be filling gaps in other services. The community care services for this group require a more tailored approach than simply lowering the planning age for aged care services.
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吳鄭善明, 吳鄭善明. "原風優先！部落自顧！原住民族部落文化健康站." 臺灣社區工作與社區研究學刊 12, no. 3 (October 2022): 203–36. http://dx.doi.org/10.53106/222372402022101203005.
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<p>本文以原住民族文化為主體，探討「原住民族部落文化健康站」發展、內涵、本質、專管中心培力。並建構出照顧服務模式、照顧服務推動難題（1.行政績效面向共三項、2.專業服務面向共五項）。 最後，在未來推動方向提供建議（專業教育訓練形式改變等四項）。再次揭露「原風優先」、「部落自顧」之「原住民族部落文化健康站」照顧服務對原住民族長者在地老化重要性。</p> <p> </p><p>This study focuses on the indigenous culture and explores the development, content, nature, and project management training of the ’’center for indigenous tribal culture and health.’’ This study constructs a care-service model and reveals the difficulties of promoting a care service, including three administrative issues and four issues related to professional services. Finally, it provides suggestions for future development, including suggestions for resolving the issues related to changes in the professional educational training. The study highlights how the care services provided by the ’’center for indigenous tribal culture and health,’’ with an emphasis on ’’indigenous culture first’’ and ’’tribal self-care,’’ are important for aging indigenous seniors in the community.</p> <p> </p>
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Gentin, N., T. Howarth, and S. Heraganahally. "O039 Access to sleep health services for Indigenous children in the Northern Territory of Australia." SLEEP Advances 3, Supplement_1 (October 1, 2022): A15—A17. http://dx.doi.org/10.1093/sleepadvances/zpac029.038.
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Abstract Paediatric sleep disorders have significant impacts on physical and mental health, growth and development. Indigenous children may be further impacted due to high prevalence of other medical conditions, socioeconomic disparity and reduced access to healthcare. In 2016, a local paediatric sleep service in the Northern Territory (NT) was created. We assessed demographics and referral patterns of Indigenous and non-Indigenous paediatric patients referred to this service. Paediatric patients referred for a sleep study between 2016- 2020 were included. Demographics, referral source, time from consult to study and follow up were assessed and compared between Indigenous and non-Indigenous patients. There were 923 children referred for sleep studies. Indigenous patients made up 20%. Indigenous patients were older (median 7 vs. 5 years) and more likely to live remotely (24% vs. 10%). Most Indigenous patients were referred from the public hospital system (62%) and by a paediatrician (56%); while most non-Indigenous patients were referred from the private system (56%) and by an otorhinolaryngologist (55%). Indigenous patients had a median 33 days between referral and initial consult compared with 21 days for non-Indigenous patients (p<0.05). Reviews were scheduled for 81% of Indigenous and 77% of non-Indigenous patients, of which 6% and 2% respectively did not attend. Indigenous patients showed different demographic and referral patterns to non-Indigenous patients. Despite improvements made to sleep service access for NT Indigenous children; there are still barriers to treatment. Reasons for this and ways to overcome these barriers are important for the health and wellbeing of Indigenous people.
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Bailie, Ross S., Damin Si, Lyn OˈDonoghue, and Michelle Dowden. "Indigenous health: effective and sustainable health services through continuous quality improvement." Medical Journal of Australia 186, no. 10 (May 2007): 525–27. http://dx.doi.org/10.5694/j.1326-5377.2007.tb01028.x.
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Zabow, Tuviah. "Traditional healers and mental health in South Africa." International Psychiatry 4, no. 4 (October 2007): 81–83. http://dx.doi.org/10.1192/s174936760000521x.
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Psychiatric patients access both indigenous healers and services rendered by psychiatric facilities in South Africa. The various groups of healers which are available are clearly not all acceptable to the whole population and variable experiences are reported with different categories of healer and the different treatments provided. An increasing collaboration between psychiatric services and indigenous healers is becoming evident, as in other health services. Reports indicate that many African psychiatric patients seek treatment from indigenous healers while attending psychiatric clinics, in both rural and urban regions. This has led to much discussion and differing viewpoints as to the possible benefits and disadvantages of collaboration and simultaneous use of different treatment modalities. Included in this is the question of the medical competence of traditional healers and the possible neglect of serious conditions.
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Ou, Lixin, Jack Chen, Ken Hillman, and John Eastwood. "The comparison of health status and health services utilisation between Indigenous and non-Indigenous infants in Australia." Australian and New Zealand Journal of Public Health 34, no. 1 (February 2010): 50–56. http://dx.doi.org/10.1111/j.1753-6405.2010.00473.x.
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Pepler, Eileen, and Rebecca C. Martell. "Indigenous model of care to health and social care workforce planning." Healthcare Management Forum 32, no. 1 (December 4, 2018): 32–39. http://dx.doi.org/10.1177/0840470418809105.
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Indigenous people have always had the end in mind—a long range vision for the health and wellbeing of their families and communities. Creating Indigenous solutions-oriented approaches to strategic health and social care workforce planning is an essential component to the realization of self-determination and empowerment, accessible health services, community participation, and flexible approaches to care. This article suggests using an Indigenous “models of care” population health approach to health and social care workforce planning that takes a critical thinking, systems thinking, and design thinking approach using digital tools (eg, scenario planning and population health simulation). It also proposes to increase the number of Indigenous professionals through Indigenous partnership initiatives with professional groups and academic institutions. This article is written to encourage discussion on the use of a whole system approach to developing Indigenous models of health delivery and to inform strategic services and workforce planning.
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Dunt, David, Mitchell Anjou, Andrea Boudville, Arthur Hsueh, and Hugh Taylor. "Establishing the value of Indigenous eye health programs: health needs, economic priority and performance assessment approaches." Australian Health Review 38, no. 1 (2014): 99. http://dx.doi.org/10.1071/ah13132.
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Objectives The aim of this paper was to compare three different approaches that are used in support of additional funding of health programs, using Indigenous eye health programs (IEHPs) as an example. These approaches are Heath and Health Care Needs, Economic Priority (Value for Money) and Conformity with Health Services Performance Standards. Methods A review of relevant literature was conducted to identify relevant benchmarks and assess IEHPs. Results In terms of health needs, vision loss is the fourth highest contributor to the Indigenous health gap. Additional funding for Indigenous eye treatment services to remove the gap is estimated at A$28.1 million per annum. As an economic priority, IEHPs (specifically for refractive error, cataract, diabetic retinopathy and trachoma) demonstrate excellent value for money and compare favourably with other better-researched health programs. Evaluation of health performance measures indicated that IEHPs also perform well, as judged by Australian performance standards for health services generally and Indigenous health services more specifically, the later involving local delivery, including care coordination through Aboriginal-controlled community health services. Conclusion The value of IEHPs was demonstrated using all three approaches. Different approaches are likely to be more or less persuasive with different audiences. The application of these approaches is relevant to other health programs. What is known about this topic? Supporters of additional funding for health programs frequently use the impact of this additional funding on the health and health care needs of the affected populations and individuals. Indigenous Eye Health programs are considered for illustrative purposes. This argument is not necessarily persuasive to funders of health programs. What does this paper add? This paper demonstrates that two further approaches, namely Economic Priority and Conformity with Health Performance Measure Standards, both demonstrate good arguments in support of additional funding and that these outcomes may be more persuasive to funders of health programs. What are the implications for practitioners? Practitioners are able to harness additional approaches with a higher likelihood of success of submissions for additional funding for the program they are promoting.
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Taylor, Emma V., Marilyn Lyford, Lorraine Parsons, Michele Holloway, Karla Gough, Sabe Sabesan, and Sandra C. Thompson. "Putting Policy into Practice: How Three Cancer Services Perform against Indigenous Health and Cancer Frameworks." International Journal of Environmental Research and Public Health 19, no. 2 (January 6, 2022): 633. http://dx.doi.org/10.3390/ijerph19020633.
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Improving cancer outcomes for Indigenous people by providing culturally safe, patient-centred care is a critical challenge for health services worldwide. This article explores how three Australian cancer services perform when compared to two national best practice guidelines: the National Aboriginal and Torres Strait Islander Cancer Framework (Cancer Framework) and the National Safety and Quality Health Service (NSQHS) User Guide for Aboriginal and Torres Strait Islander Health (User Guide). The services were identified through a nationwide project undertaken to identify cancer services providing treatment to Indigenous cancer patients. A small number of services which were identified as particularly focused on providing culturally safe cancer care participated in case studies. Interviews were conducted with 35 hospital staff (Indigenous and non-Indigenous) and 8 Indigenous people affected by cancer from the three services. The interviews were analysed and scored using a traffic light system according to the seven priorities of the Cancer Framework and the six actions of the NSQHS User Guide. While two services performed well against the User Guide, all three struggled with the upstream elements of the Cancer Framework, suggesting that the treatment-focused Optimal Care Pathway for Aboriginal and Torres Strait Islander People with Cancer (Cancer Pathway) may be a more appropriate framework for tertiary services. This article highlights the importance of a whole-of-organisation approach when addressing and embedding the six actions of the User Guide. Health services which have successfully implemented the User Guide are in a stronger position to implement the Cancer Framework and Cancer Pathway.
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Wu, Jasmine, Victoria Smye, Bill Hill, Joseph Antone, and Arlene MacDougall. "Exploration of Existing Integrated Mental Health and Addictions Care Services for Indigenous Peoples in Canada." International Journal of Environmental Research and Public Health 20, no. 11 (May 25, 2023): 5946. http://dx.doi.org/10.3390/ijerph20115946.
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Due to the persistent impacts of colonialism, Indigenous peoples of Canada face disproportionate rates of mental health and substance use disorders, which are often insufficiently addressed by Eurocentric ‘mainstream’ mental health and addiction services. The need to better address Indigenous mental health has led to Indigenous mental health integrated care (hereafter integrated care): programs using both Indigenous and Western practices in their care delivery. This research describes the common lessons, disjunctures, and solutions experienced by existing integrated care programs for Indigenous adults across Canada. It reveals the best practices of integrated care for programs, and contributes to the Truth and Reconciliation Commission of Canada’s Calls to Action #20 and #22. This study, co-designed by an Indigenous Knowledge Keeper and Practitioner, explores the programs’ relational processes through interviews with key informants. The data was analyzed in consultation with Indigenous collaborators to highlight Indigenous values and interpretations, and knowledge co-production. In highlighting the complexity of integrated care, study results show the lessons of ‘Real Commitment to Communities and Community Involvement,’ and tensions and disjunctures of ‘Culture as Healing,’ ‘People-focused vs. Practitioner-focused Programs,’ ‘Community-oriented vs. Individual-oriented Programs,’ and ‘Colonial Power Dynamics in Integrated Care.’ The discussion explores why tensions and disjunctures exist, and suggests how to move forward using integrated care’s lessons and the concept of IND-equity. Ultimately, Indigenous-led partnerships are paramount to integrated care because they leverage Indigenous knowledge and approaches to achieve health equity within integrated care.
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Graham, Simon, Nicole M. Muir, Jocelyn W. Formsma, and Janet Smylie. "First Nations, Inuit and Métis Peoples Living in Urban Areas of Canada and Their Access to Healthcare: A Systematic Review." International Journal of Environmental Research and Public Health 20, no. 11 (May 25, 2023): 5956. http://dx.doi.org/10.3390/ijerph20115956.
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In Canada, approximately 52% of First Nations, Inuit and Métis (Indigenous) peoples live in urban areas. Although urban areas have some of the best health services in the world, little is known about the barriers or facilitators Indigenous peoples face when accessing these services. This review aims to fill these gaps in knowledge. Embase, Medline and Web of Science were searched from 1 January 1981 to 30 April 2020. A total of 41 studies identified barriers or facilitators of health service access for Indigenous peoples in urban areas. Barriers included difficult communication with health professionals, medication issues, dismissal by healthcare staff, wait times, mistrust and avoidance of healthcare, racial discrimination, poverty and transportation issues. Facilitators included access to culture, traditional healing, Indigenous-led health services and cultural safety. Policies and programs that remove barriers and implement the facilitators could improve health service access for Indigenous peoples living in urban and related homelands in Canada.
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Cheboi, Solomon K., Daisy N. Nyawira, Peter M. Ngolo, and Wanjiru S. Ng’ang’a. "Determinants of Patient Satisfaction in Indigenous Cancer Palliative Care Services." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 60 (January 2023): 004695802311677. http://dx.doi.org/10.1177/00469580231167733.
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Optimal quality of care remains an integral formal service along the continuum of care pathway. Patient satisfaction is an important health system responsiveness goal which has been shown to influence quality of care except in the indigenous settings. This study identified the determinants of patient satisfaction in the context of indigenous palliative care in Kenya. A descriptive cross-sectional study was conducted among cancer patients exiting indigenous care outlets located in 12 towns across Kenya using a structured modular questionnaire. Exit interviews were undertaken with 433 respondents leaving 193 mapped indigenous outlets. Overall services satisfaction was assessed as the dependent variable using a computed single-item satisfaction mean score. The data was analyzed using IBM Statistical Package for Social Sciences version 22. 0. Bivariate and multivariate analyses were conducted to identify the potential determinants. Against the 433 study respondents, 248 (57.3%) expressed overall satisfaction with indigenous palliative care services: Satisfaction was positively associated with waiting time (AOR = 2.663, 95% CI = 1.235-5.743), provider attention (AOR = 3.698, 95% CI = 1.657-8.254), provider politeness (AOR = 6.774, 95% CI = 3.697-12.413) and provider social communication skills (AOR = 6.520, 95% CI = 3.642-11.673). Good patient-provider interaction, provider social skills and service waiting time influence patient satisfaction with indigenous palliative care. The finding contributes to the understanding of indigenous palliative cancer care and provides scientific evidence for providers and policy makers to redesign and improve their service and outlet setting to provide patient centered holistic palliative care.
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Mehl-Madrona, L., and B. Mainguy. "Indigenous mental health therapies." European Psychiatry 64, S1 (April 2021): S321. http://dx.doi.org/10.1192/j.eurpsy.2021.862.
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IntroductionCultural differences exist among indigenous and mainstream peoples about the nature of mind and how one achieves mental health.ObjectivesWe aimed to determine what is important and different for indigenous communities from non-indigenous communities.MethodsWe assembled a focus group of 109 indigenous and non-indigenous mental health counselors who worked in indigenous communities to meet weekly for 90 minutes via an internet platform (Zoom) for 810weeks with asynchronous communication between meetings.ResultsThe metaphor of the Four Directions, represented with different colors, attributes, and animals, was important in indigenous communities. Participants emphasized the idea of relational, non-local mind which places identity in the relationships between people rather than an individual body. Illnesses were seen as conscious beings who visit people and bring teachings. The healing, participants said, comes from reaching within the suffering and the pain to find the answer from within which makes meaning from an illness. People are expected to make offerings and sacrifices to the spirit of the illness to move toward wellness. These sacrifices can include lifestyle changes that the person might otherwise not make. Using substances without the proper protocols and prayers was likened to sorcery or witchcraft which can become a powerful incentive to stop disrespecting these substances and to find meaning in setting them aside with the help of a supportive community.ConclusionsWhat participants saw as important for indigenous populations was different from what is usual for non-indigenous mental health services. Participants stressed the importance of non-indigenous providers understanding this and not dismissing these ideas.
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Diehl, Eliana Elisabeth, and Esther Jean Langdon. "Indigenous participation in primary care services in Brazil." Regions and Cohesion 8, no. 1 (March 1, 2018): 54–76. http://dx.doi.org/10.3167/reco.2018.080104.
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English abstract:In 1990, the Brazilian Unified Health System institutionalized new relationships between the government and society. In recognition of the inequalities and inequities inflicted upon Indigenous Peoples, the Indigenous Health Subsystem was established in 1999. Roles were created for the democratic exercise of Indigenous participation and prominence in three border spaces: Indigenous health agents as members of health teams; Indigenous representatives on health councils; and Indigenous organizations as primary care providers. This article explores these spaces based on ethnographic research from southern Brazil. It concludes that the roles created for Indigenous participation and governance are ambiguous and contradictory. When participating in new opportunities created by the government, Indigenous actors are subjected to a centralized and bureaucratized system that offers little possibility of autonomous decision- making or action.Spanish abstract:En 1990, el Sistema Único de Salud institucionalizó nuevas relaciones entre el gobierno y la sociedad, estableciendo en 1999 el Subsistema de Salud Indígena. Se crearon nuevos roles para el ejercicio democrático de la participación indígena con prominencia en tres espacios de frontera: agentes indígenas de salud como miembros de los equipos de salud; representantes indígenas en los consejos de salud; y organizaciones indígenas como proveedores de atención primaria. Este artículo explora estos espacios basado en investigación etnográfi ca del sur de Brasil. Se concluye que los roles creados para la participación y gobernanza indígena son ambiguos y contradictorios. Cuando se participa en nuevas oportunidades creadas por el gobierno, los actores indígenas son sometidos a un sistema que ofrece poca posibilidad de tomar decisiones autónomas o actuar.French abstract:1990 le système unique de santé brésilien, le SUS (Sistema Único de Saúde) institutionnalisait de nouvelles relations entre le gouvernement et la société en donnant aux usagers un rôle central et en leur att ribuant une large participation dans tous les secteurs des soins. En reconnaissance des inégalités et iniquités historiques infl igées aux peuples indigènes, le sous-système de soin indigène fut établi en 1999. De nouveaux rôles furent créés pour l’exercice démocratique de la participation indigène et sa reconnaissance dans trois zones d’action et de communication délimitées. Cet article explore ces espaces sur la base de recherches ethnographiques réalisées au Sud du Brésil et conclut que les rôles créés pour la participation indigène et la notion associée de gouvernance sont souvent ambigus et contradictoires.
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Weerasinghe, Navisha, Amy L. Wright, Rachel VanEvery, and Shan Mohammed. "A Narrative Review of Mental Health Services for Indigenous Youth in Canada: Intersectionality and Cultural Safety as a Pathway for Change." Journal of Recovery in Mental Health 6, no. 2 (July 14, 2023): 33–55. http://dx.doi.org/10.33137/jrmh.v6i2.39353.
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Objectives: Indigenous youth who identify themselves as First Nations, Métis or Inuit living in Canada between the ages of 12-25 experience higher rates of depression and suicide than non-Indigenous youth. Using narrative review, this paper provides a critical analysis of the scholarly literature to explore the current delivery and accessibility of mental health services among Indigenous youth and suggests areas for improvements in system recovery.
Research Design and Methods: The narrative review selected papers from databases including Google Scholar, PubMed, APA PsychInfo, and Indigenous Peoples Atlas of Canada to capture literature from several academic disciplines between August 2020 to May 2022. Data was then synthesized to deliver broad perspectives on this topic.
Results: Three categories describe how the accessibility of mental health services for Indigenous youth is impacted by (1) research, (2) current mental health practice, and (3) the location of care services. The medicalization of mental health services, and its emphasis on individual causation and intervention, grounded this discussion. Intersectionality and cultural safety offered a counterpoint to medicalization since these ideas encourage the consideration of social, political, economic, and historical forces. These concepts inform possibilities for change at the micro, mezzo, and macro system levels to address this growing issue.
Conclusion: Future implications for improving mental health services and mental health recovery among Indigenous youth include advancing research and implementing innovative solutions that promote intersectionality and culturally safe care across multiple system levels.
Keywords: Mental health, Indigenous youth, Intersectionality, Cultural Safety, Narrative Review, Medicalization, Canada
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Turner, Nalita Nungarrayi, Judy Taylor, Sarah Larkins, Karen Carlisle, Sandra Thompson, Maureen Carter, Michelle Redman-MacLaren, and Ross Bailie. "Conceptualizing the Association Between Community Participation and CQI in Aboriginal and Torres Strait Islander PHC Services." Qualitative Health Research 29, no. 13 (April 23, 2019): 1904–15. http://dx.doi.org/10.1177/1049732319843107.
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Drawing from Australian Aboriginal and Torres Strait Islander perspectives, we conceptualize the association between community participation and continuous quality improvement (CQI) processes in Indigenous primary health care (PHC) services. Indigenous experiences of community participation were drawn from our study identifying contextual factors affecting CQI processes in high-improving PHC services. Using case study design, we collected quantitative and qualitative data at the micro-, meso-, and macro-health system level in 2014 and 2015 in six services in northern Australia. Analyzing qualitative data, we found community participation was an important contextual factor in five of the six services. Embedded in cultural foundations, cultural rules, and expectations, community participation involved interacting elements of trusting relationships in metaphorically safe spaces, and reciprocated learning about each other’s perspectives. Foregrounding Indigenous perspectives on community participation might assist more effective participatory processes in Indigenous PHC including in CQI processes.
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Lin, Jonathan C., Elaine Toombs, Chris Sanders, Candida Sinoway, Marni Amirault, Christopher J. Mushquash, Linda Barkman, et al. "Looking beyond the individual–The importance of accessing health and cultural services for Indigenous women in Thunder Bay, Ontario." PLOS ONE 18, no. 3 (March 1, 2023): e0282484. http://dx.doi.org/10.1371/journal.pone.0282484.
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Access to cultural activities and culturally relevant healthcare has always been significant for achieving holistic Indigenous health and continues to be a key factor in shaping the health journey of Indigenous individuals and communities. Previous research has indicated the importance of cultural practices and services in sustaining cultural identity for Indigenous peoples, which is a major influence on their wellbeing. This study marks the first phase in a project aimed at establishing an Indigenous healing program and uses a qualitative research approach to understand the health and cultural services that Indigenous women want and require in Thunder Bay, Ontario. During interviews, participants (n = 22) answered questions around their understandings of health and wellbeing, and how they are able to incorporate cultural practices into their circle of care. Thematic analysis was performed on interview transcripts, and 4 key themes were identified: ‘independence and self-care’, ‘external barriers to accessing services’, ‘finding comfort in the familiar’ and ‘sense of community’. Together these themes illustrate how Indigenous women feel a strong sense of personal responsibility for maintaining their health despite the multiple environmental factors that may act as barriers or supports. Furthermore, the necessity of embedding cultural practices into Indigenous women’s circle of care is highlighted by the participants as they describe the mental, spiritual, social, and emotional health benefits of engaging in cultural activities within their community. The findings demonstrate the need for current modes of care to look beyond the individual and consider the impacts that socio-environmental factors have on Indigenous women. To accomplish this, we hope to increase access to health and cultural services through the creation of an Indigenous healing program that can be adequately incorporated into Indigenous women’s circle of care if they wish to do so.
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Brooks, Spirit Dine'tah. "Including Community and Family in Indigenous Special Education: A Book Review of School –Parent Collaborations in Indigenous Communities: Providing Services for Children with Disabilities." Journal of Family Diversity in Education 1, no. 2 (November 25, 2014): 129–32. http://dx.doi.org/10.53956/jfde.2014.36.
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Globally, Indigenous communities face roadblocks that hinder their success in educational settings. These roadblocks include poverty, lack of social supports, limited access to education, and a high risk for health problems. Indigenous students with special needs face even greater challenges. School –Parent Collaborations in Indigenous Communities: Providing Services for Children with Disabilities provides a comprehensive overview of the context of disability within indigenous experience. The study comprehensively examines the uniqueness of indigenous communities on a global scale, psychological models of reactions to disability, the benefit of multidisciplinary teams in working with schools and families, factors affecting collaboration between indigenous parents of children with disabilities and school professionals, and core values of indigenously attuned collaboration. Manor-Binyamini discusses her pilot study conducted among the Bedouins of Southern Israel to illustrate the ways that special education teachers and personnel engage Bedouin parents in interventions for their children. Rather than focusing solely on cultural sensitivity as a guiding force, the model Manor-Binyamini advocates, “Knowledge in Action” calls for special educators and professionals to be cultural mediators between family and schools. The model has the potential to impact the ways in which special educators work with indigenous communities globally and locally to improve the health and well-being of indigenous students with special needs.
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Reading, Jeffrey, Charlotte Loppie, and John O’Neil. "Indigenous health systems governance." International Journal of Health Governance 21, no. 4 (December 5, 2016): 222–28. http://dx.doi.org/10.1108/ijhg-08-2016-0044.
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Purpose Almost 20 years after the Royal Commission on Aboriginal Peoples, indigenous peoples living in Canada continue to pursue their legitimate aspirations for greater control over factors affecting their lives. The purpose of this paper is to summarize two major policies (the Royal Commission on Aboriginal Peoples and the Truth and Reconciliation Commission (TRC)) that aimed to create equity for indigenous peoples’. Design/methodology/approach Commentary and rapid communication to inform and clarify evolving high-priority policy and governance issues related to indigenous peoples’ of Canada. Findings A need exists to create a platform for implementing the TRC actions to protect and promote education, language and culture, justice, youth programming, and professional training and development. Research limitations/implications Innovative intervention research needs to develop solutions to multi-generational disparities in health and well-being for indigenous peoples of Canada and globally. Practical implications Failure to implement longstanding changes to improve indigenous health and well-being will result if a growing burden of premature morbidity and mortality among indigenous population of Peoples’ of Canada, the fastest growing population group with the most challenging health status in Canada. Social implications Indigenous peoples continue to experience profound health vulnerability leading to high health risks, growing health disparities and unequal access to health care services. Originality/value Connecting policy over two decades, for implementation to proceed, sharing of knowledge is essential to formulate innovative approaches, to engage research and build capacity to implement policy actions related to closing educational gaps, to developing culturally appropriate curricula acknowledging and protecting Aboriginal languages, as well as skills-based training in intercultural competency, conflict resolution and respect for human dignity and human rights equality in settings of anti-racism and free of all forms of prejudice and discrimination.
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Burn, Helen, Lisa Hamm, Joanna Black, Anthea Burnett, Matire Harwood, Matthew J. Burton, Jennifer R. Evans, and Jacqueline Ramke. "Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review." BMJ Global Health 6, no. 3 (March 2021): e004484. http://dx.doi.org/10.1136/bmjgh-2020-004484.
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PurposeGlobally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care services. We conducted a scoping review to identify and summarise service delivery models designed to improve access to eye care for Indigenous peoples in high-income countries.MethodsSearches were conducted on MEDLINE, Embase and Global Health in January 2019 and updated in July 2020. All study designs were eligible if they described a model of eye care service delivery aimed at populations with over 50% Indigenous peoples. Two reviewers independently screened titles, abstracts and full-text articles and completed data charting. We extracted data on publication details, study context, service delivery interventions, outcomes and evaluations, engagement with Indigenous peoples and access dimensions targeted. We summarised findings descriptively following thematic analysis.ResultsWe screened 2604 abstracts and 67 studies fulfilled our eligibility criteria. Studies were focused on Indigenous peoples in Australia (n=45), USA (n=11), Canada (n=7), New Zealand (n=2), Taiwan (n=1) and Greenland (n=1). The main disease focus was diabetic retinopathy (n=30, 45%), followed by ‘all eye care’ (n=16, 24%). Most studies focused on targeted interventions to increase availability of services. Fewer than one-third of studies reported involving Indigenous communities when designing the service. 41 studies reflected on whether the model improved access, but none undertook rigorous evaluation or quantitative assessment.ConclusionsThe geographical and clinical scope of service delivery models to improve access to eye care for Indigenous peoples in high-income countries is narrow, with most studies focused on Australia and services for diabetic retinopathy. More and better engagement with Indigenous communities is required to design and implement accessible eye care services.
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Usher, Kim, Navjot Bhullar, David Sibbritt, Suruchi Sue Anubha Amarasena, Wenbo Peng, Joanne Durkin, Reakeeta Smallwood, et al. "Influence of COVID-19 on the preventive health behaviours of indigenous peoples of Australia residing in New South Wales: a mixed-method study protocol." BMJ Open 11, no. 9 (September 2021): e047404. http://dx.doi.org/10.1136/bmjopen-2020-047404.
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IntroductionChronic conditions impact indigenous peoples of Australia at a much higher rate than non-indigenous Australians. Attendance at the Medicare Benefits Scheme (MBS) supported indigenous health checks are crucial to improve prevention and management of chronic health conditions. However, in conjunction with lifestyle and environmental factors, attendance rates at primary healthcare services for screening and treatment have fallen in Australia during the COVID-19 pandemic. This study aims to explore the influence of the COVID-19 pandemic on preventive health behaviours of indigenous Australians and the associated barriers to, and enablers of, engagement with health services to formulate a targeted intervention strategy.Methods and analysisA concurrent mixed-methods study (comprising quantitative and qualitative data collection methods) will be employed. Descriptive analysis of MBS data about the characteristics of indigenous peoples of Australia claiming health assessment services will be performed. Generalised estimating equation regression models will be used to examine the use of health assessment services over time. Qualitative interviews informed by indigenous research methods will be conducted. Interviews will investigate barriers to, and enablers of, engagement with health services. Thematic approach guided by the principles of indigenist praxis, storytelling and collaborative research will be used to analyse the interview data. The project commenced in July 2020 and will be completed by July 2022.Ethics and disseminationThe project received ethics approval from the Aboriginal Health and Medical Research Council of New South Wales and the University of New England Human Research Ethics Committee. Findings will be disseminated via peer-reviewed journal articles, conferences, government and relevant stakeholder reports, and infographics.
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Alati, Rosa, Chris Peterson, and Pranee Liamputtong Rice. "The Development of Indigenous Substance Misuse Services in Australia: Beliefs, Conflicts and Change." Australian Journal of Primary Health 6, no. 2 (2000): 49. http://dx.doi.org/10.1071/py00018.
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The aim of this paper is to overview earlier and recent issues in the field of Indigenous substance misuse intervention from its beginning to more recent developments. The overview will specifically analyse developments, advancements and change in the area of tertiary intervention or 'rehabilitation' as it is commonly referred to by Indigenous people. First, the paper will focus on Indigenous historical and theoretical constructs that have impacted on the development of Indigenous notions of 'rehabilitation' or intervention. Indigenous interpretations of the disease model of alcoholism, particularly the Alcoholics Anonymous philosophy, is analysed as well as the socio-cultural beliefs associated with those models. Second, conflicts with the mainstream management of substance misuse intervention are overviewed. Third, the paper highlights the complexity of more recent evolution of the services and discusses possible options for change. Attention is also devoted to Indigenous alternative interpretations of intervention and their relevance to the area of secondary intervention. Recent developments in the area of primary health care and their potential towards further improvement is also considered as well as obstacles to those changes.
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Walker, Bruce F., Norman J. Stomski, Anne Price, and Elizabeth Jackson-Barrett. "Perspectives of Indigenous people in the Pilbara about the delivery of healthcare services." Australian Health Review 38, no. 1 (2014): 93. http://dx.doi.org/10.1071/ah13074.
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Aim To identify Indigenous people’s views about gaps and practical solutions for the delivery of healthcare services in the Pilbara. Methods A structured guide was used to interview three Indigenous language groups from the Pilbara region of Western Australia. The responses were analysed with the use of content analysis. In the first stage, codes were developed by assigning names to small sections of the interview transcripts. Next, the most salient incisive codes were identified and developed into themes that captured the most important issues. Results Many respondents said that there were insufficient health professionals near country, which was compounded by a lack of adequate transport to reach healthcare services. Moreover, respondents commonly indicated that they would be unable to secure adequate accommodation for themselves and any carer when needing to leave country to undergo medical care. The importance of secondary healthcare interventions was highlighted, particularly health promotion initiatives that improved diet and exercise levels and reduced substance abuse. Assuming responsibility for one’s own health was seen as integral to improving the overall health of communities. The respondents saw role models as the most important influence in leading people to take responsibility for improving their own health. Conclusion This study provides Indigenous perspectives about gaps and solutions in healthcare service delivery in the Pilbara region of Western Australia. Although initiatives have commenced to address the shortfall in health professionals and inadequate transport to healthcare, there are still gaps in service provision. Mobile health services were strongly supported as an integral measure to address these gaps. What is known about this topic? About two out of every three Indigenous adults in the Pilbara experience a chronic health condition. Moreover, compared with non-Indigenous people in the region, Indigenous people experience a significantly higher mortality rate for numerous chronic health conditions. Although some information is available about the provision of health services for Indigenous people in the Pilbara, little is known about Indigenous people’s perspectives about its adequacy or how it should be delivered. What does this paper add? This study details three local language groups’ views about the gaps and solutions to delivery of healthcare for Indigenous people in the Pilbara. It highlights the need for secondary healthcare interventions given difficulties around providing adequate primary care in remote settings. What are the implications for practitioners? Health promotion initiatives need to be prioritised to improve the health of Australian Indigenous people in the Pilbara and the initiatives should be delivered with the involvement of the local communities. Innovative solutions are required to improve the continuity of healthcare in the Pilbara, including increased use of mobile services.
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Tien, Hsiu-Chuan, Wen-Li Hou, and Yung-Mei Yang. "Experience of Indigenous Peoples’ Access to Long-Term Care Services in Taiwan: A Qualitative Study among Bunun Tribes." Healthcare 10, no. 12 (November 27, 2022): 2383. http://dx.doi.org/10.3390/healthcare10122383.
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Indigenous communities usually have poorer access to long-term care services than non-indigenous communities because of their remote locations and unique cultural backgrounds. However, there was little exploration into the experience of indigenous people’s access to the official long-term care services in Taiwan—the gap this study aimed to fill. A qualitative study design using semi-structured interviews was used to obtain data from a purposive sample. Fourteen participants who were disabled and lived among the indigenous communities of the Bunun tribes in central Taiwan were interviewed individually. The data were analyzed using Graneheim and Lundman’s qualitative content analysis. The theme—“helpful but still difficult and unfit”—and three categories with eight subcategories emerged. While official long-term care services provided by the government can benefit people with disabilities in indigenous tribes, their use of such services faces a number of obstacles, which points to the need for considering culturally appropriate care. To protect the rights and interests of indigenous tribal communities, long-term care policies and practical planning must be adopted, cultural differences at play must be respected and recognized, and the necessary support must be offered to eliminate inequalities in healthcare.
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Sullivan, Corrinne T., Duy Tran, William Trewlynn, Kim Spurway, John Leha, Linda Briskman, and Karen Soldatic. "‘We Want to Help but We Don’t Know What to Do’: Service Providers Working with Indigenous LGBTIQ+ Youth in Australia." Sexes 3, no. 2 (June 7, 2022): 308–24. http://dx.doi.org/10.3390/sexes3020024.
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Access to adequate and appropriate service provision has a direct positive impact on health and wellbeing. Experiences of inaccessible, discriminatory, and culturally unsafe services and/or service providers are considered a root cause for the health inequalities that exist among Indigenous queer youth. Experiences of discrimination and cultural inappropriateness are commonplace, with Indigenous queer youth noting issues related to access to services and treatment, stereotyping, and a lack of quality in the care provided, which discourage Indigenous people from accessing care. This paper examines the perspectives of Indigenous LGBTIQ+ youth and health service providers to identify what challenges, obstacles and opportunities are currently being faced and what could be implemented to improve the health and wellbeing outcomes for Indigenous LGBTIQ+ youth in the future.
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Kirkham, R., L. J. Maple-Brown, N. Freeman, B. Beaton, R. Lamilami, M. Hausin, A. M. Puruntatemeri, et al. "Incorporating indigenous knowledge in health services: a consumer partnership framework." Public Health 176 (November 2019): 159–62. http://dx.doi.org/10.1016/j.puhe.2018.08.009.
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Lakhani, Ali, Jennifer Cullen, and Clare Townsend. "The Cost of Disability for Indigenous People: A Systematic Review." Journal of Social Inclusion 8, no. 1 (September 7, 2017): 34–45. http://dx.doi.org/10.36251/josi116.
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It is expected that Indigenous people experience asymmetric disability costs compared to non-Indigenous people. No systematic review has investigated the cost of disability for Indigenous people. A systematic review can contribute to the evidence base and inform the health and social care services that Indigenous people with disability receive. Thus, this systematic review aimed to: (i) provide insight into the distinct cost of disability for Indigenous people and (ii) summarise the current state of knowledge concerning the cost of disability for Indigenous people. The PRISMA approach was applied and four databases - MEDLINE, ISI Web of Science, CINAHL and ProQuest Social Sciences - were searched for peer-reviewed literature published before January 2017. After a removal of duplicates, the titles of 193 sources were reviewed against the inclusion criteria. Of these, eight sources were considered for a full-text review. After a full-text review, zero sources met the entire inclusion criteria. While these eight studies did not entirely meet search criteria, findings from two studies closely met the review criteria and provided insight into service considerations that may contribute to distinct costs of disability for Indigenous people. These considerations include: i) providing culturally appropriate assessments and psychometric tools for the identification and monitoring of disability, (ii) ensuring healthcare and service provider cultural training, (iii) raising community awareness around disability services, (iv) delivering holistic integrated health-care models offered locally, and (v) building relationships with families. Irrespective of these considerations, the paucity of research in the area makes it impossible clarify the cost of disability for Indigenous people. Consequently, the need for research in this area is paramount. It is imperative that future research considers the distinct costs of providing health and social care services for Indigenous people with disability. This research will favourably inform health and social care services offered to Indigenous people with disability, and furthermore contribute towards positive health and wellbeing outcomes.
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O’Brien, Anthony (Tony). "Moving toward culturally sensitive services for Indigenous people: A non-Indigenous mental health nursing perspective." Contemporary Nurse 21, no. 1 (March 2006): 22–31. http://dx.doi.org/10.5172/conu.2006.21.1.22.
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Sveticic, Jerneja, Allison Milner, and Diego De Leo. "Contacts with mental health services before suicide: a comparison of Indigenous with non-Indigenous Australians." General Hospital Psychiatry 34, no. 2 (March 2012): 185–91. http://dx.doi.org/10.1016/j.genhosppsych.2011.10.009.
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Bullen, Jonathan, and Lynne Roberts. "Transformative Learning: A Precursor to Preparing Health Science Students to Work in Indigenous Health Settings?" Australian Journal of Indigenous Education 48, no. 2 (March 26, 2018): 129–40. http://dx.doi.org/10.1017/jie.2018.3.
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Australian undergraduate programmes are implementing curriculum aimed at better preparing graduates to work in Indigenous health settings, but the efficacy of these programmes is largely unknown. To begin to address this, we obtained baseline data upon entry to tertiary education (Time 1) and follow-up data upon completion of an Indigenous studies health unit (Time 2) on student attitudes, preparedness to work in Indigenous health contexts and transformative experiences within the unit. The research involved 336 health science first-year students (273 females, 63 males) who completed anonymous in-class paper questionnaires at both time points. Paired sample t-tests indicated significant change in student attitudes towards Indigenous Australians, perceptions of Indigenous health as a social priority, perceptions of the adequacy of health services for Indigenous Australians and preparedness to work in Indigenous health settings. Hierarchical multiple regression analyses indicated that after controlling for Time 1 measures, the number of precursor steps to transformative learning experienced by students accounted for significant variance in measures of attitudes and preparedness to work in Indigenous health contexts at Time 2. The knowledge gained further informs our understanding of both the transformative impact of such curriculum, and the nature of this transformation in the Indigenous studies health context.
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Broom, Dorothy. "Facing Facts, Facing Futures: Challenges to Women's Health." Australian Journal of Primary Health 4, no. 3 (1998): 40. http://dx.doi.org/10.1071/py98029.
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For people with a long history of involvement in progressive politics, these are times to try the soul. The achievements of the 1970s and '80s are looking vulnerable and many have been rolled back. The gap between rich and poor is widening internationally and nationally, youth suicide, already alarming, is on the increase, indigenous rights are being eroded and indigenous health remains poor (perhaps these trends are related), unemployment persists at stubbornly high levels, and many women's services, including health services, are being de-funded, out-sourced, amalgamated or mainstreamed. Governments are becoming corporations and citizens are being asked to become customers.
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Parter, Carmen, Josephine Gwynn, Shawn Wilson, John C. Skinner, Elizabeth Rix, and Donna Hartz. "Putting Indigenous Cultures and Indigenous Knowledges Front and Centre to Clinical Practice: Katherine Hospital Case Example." International Journal of Environmental Research and Public Health 21, no. 1 (December 20, 2023): 3. http://dx.doi.org/10.3390/ijerph21010003.
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The inclusion of Indigenous cultures, known as the cultural determinants of health, in healthcare policy and health professional education accreditation and registration requirements, is increasingly being recognised as imperative for improving the appalling health and well-being of Indigenous Australians. These inclusions are a strengths-based response to tackling the inequities in Indigenous Australians’ health relative to the general population. However, conceptualising the cultural determinants of health in healthcare practice has its contextual challenges, and gaps in implementation evidence are apparent. In this paper, we provide a case example, namely the Katherine Hospital, of how healthcare services can implement the cultural determinants of health into clinical practice. However, to be effective, health professionals must concede that Australia’s Indigenous peoples’ knowledges involving cultural ways of being, knowing and doing must co-exist with western and biomedical knowledges of health practice. We use the Katherine Hospital ABC Radio National Background Briefing interview, which was mentioned by two research participants in a 2020 study, as an example of good practice that we can learn from. Additionally, the six Aboriginal and Torres Strait Islander Health actions contained in the 2nd Edition of the Australian National Safety and Quality Health Service Standards provide governance and accountability examples of how to enable Indigenous people’s cultures and their knowledges in the provision of services. The role of non-Indigenous clinical allies and accomplices is imperative when embedding and enacting Indigenous Australians’ cultures in service systems of health. When Indigenous Peoples access mainstream hospitals, deep self-reflection by allies and accomplices is necessary to enable safe, quality care, and treatment that is culturally safe and free from racism. Doing so can increase cultural responsiveness free of racism, thereby reducing the inherent power imbalances embedded within mainstream health services.
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Wickramasinghe, Sumudu I., Liam J. Caffery, Natalie K. Bradford, and Anthony C. Smith. "Enablers and barriers in providing telediabetes services for Indigenous communities: A systematic review." Journal of Telemedicine and Telecare 22, no. 8 (October 30, 2016): 465–71. http://dx.doi.org/10.1177/1357633x16673267.
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A systematic review of studies which reported on telediabetes services within Indigenous communities was undertaken in June 2016. The aim of this study was to identify enablers and barriers associated with the delivery of telehealth services for diabetes care amongst Indigenous people. A total of 14 articles met the study inclusion criteria, reporting work in Canada, Australia, India, and the US. Key enablers included the use of cultural and spiritual elements, acknowledgement of local beliefs and traditions, and appropriate community engagement. The involvement of Indigenous health workers was also very important because of their role in communication in local language, helping clinicians understand the community, and the transportation of patients. The main barriers associated with telediabetes services were the potentially high fail-to-attend rates, lack of technical skills associated with the operation of telehealth equipment, and the lack of availability of local staff. Knowledge of the enablers and barriers associated with the delivery of healthcare services to Indigenous communities is important when planning a telediabetes service.
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Hunter, Ernest. "‘Best Intentions’ Lives on: Untoward Health Outcomes of Some Contemporary Initiatives in Indigenous Affairs." Australian & New Zealand Journal of Psychiatry 36, no. 5 (October 2002): 575–84. http://dx.doi.org/10.1046/j.1440-1614.2001.01040.x.
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Objective: A shortened version of a presentation to the Australian Institute of Aboriginal and Torres Strait Islander Studies, this paper raises questions regarding policy and program directions in Indigenous affairs with consequences for Indigenous health. Method: The author notes the inadequate Indigenous mental health database, and describes contemporary conflicts in the arena of Indigenous mental health, drawing on personal experience in clinical service delivery, policy and programme development. Results: Medicalized responses to the Stolen Generations report and constructions of suicide that accompanied the Royal Commission into Aboriginal Deaths in Custody are presented to demonstrate unforeseen health outcomes. Examples are also given of wellintentioned social interventions that, in the context of contemporary Indigenous society appear to be contributing to, rather than alleviating, harm. Problems of setting priorities that confront mental health service planners are considered in the light of past and continuing social disadvantage that informs the burden of mental disorder in Indigenous communities. Conclusions: The importance of acknowledging untoward outcomes of initiatives, even when motivated by concerns for social justice, is emphasized. The tension within mental health services of responding to the underpinning social issues versus providing equity in access to proven mental health services for Indigenous populations is considered.
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Viscogliosi, Chantal, Hugo Asselin, Suzy Basile, Kimberly Borwick, Yves Couturier, Marie-Josée Drolet, Dominique Gagnon, et al. "Importance of Indigenous elders’ contributions to individual and community wellness: results from a scoping review on social participation and intergenerational solidarity." Canadian Journal of Public Health 111, no. 5 (February 27, 2020): 667–81. http://dx.doi.org/10.17269/s41997-019-00292-3.
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Abstract Objective Wellness is a challenge for Indigenous peoples, partly because Western services do not adopt a holistic approach. By devaluing traditional knowledge, Indigenous values and beliefs, these services lower Indigenous power and affect cultural identities. Indigenous elders participate in intergenerational solidarity by transmitting knowledge, values, and culture in a holistic approach. Despite widespread acceptance of the importance of Indigenous elders’ contributions to wellness, a rigorous synthesis of knowledge has never been done. This study aimed to provide a comprehensive understanding of how Indigenous elders’ social participation contributes to individual and community wellness. Method A scoping review was conducted with Indigenous elders and stakeholders in Québec (Canada). Sixteen databases were searched with 57 keywords. Data from the documents retrieved were analyzed, organized, and synthesized based on the International Classification of Functioning, Disability and Health. Synthesis A total of 144 documents were examined, comprising 74 scientific papers and 70 sources from the gray literature. Indigenous elders contributed to wellness mainly through relationships and interactions with other community members and non-Indigenous people (72.2%); intergenerational oral and written communications (70.1%); community, social and civic life (45.8%); volunteering and jobs (35.4%); and family life (29.9%). Elders transmit traditional knowledge, strengthen social cohesion, and help to develop positive attitudes such as reciprocity. Their actions favour disease prevention and health promotion, as including traditional approaches increases the acceptability of health and social services. Conclusion This scoping review highlights the need for longitudinal studies with mixed-method designs involving Indigenous communities at all stages of the research to deepen understanding of the contributions of Indigenous elders to individual and community wellness.
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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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Roybal, Carmela M., and Rodney C. Haring. "Abstract C137: Action-based modeling for national Indigenous cancer care partnerships: Patient navigation services, health policy, and sustainability." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (December 1, 2023): C137. http://dx.doi.org/10.1158/1538-7755.disp23-c137.
Full textAbstract:
Abstract Cancer-specific, Indigenous led patient navigation systems are often a gap for Indigenous communities. These communities often face greater cancer health disparities and increased mortality due to late-stage diagnoses. Early detection and navigation are key to life-saving treatment. This quality improvement study shares the foundations for implementation of an Indigenous/rural patient navigation program. The discussion shapes planning and evaluative efforts for the build out of a memorandum of understanding from an NCI-Designated cancer center’s Indigenous cancer service arm (Northeast) towards expansion to an Indigenous community-driven university-based Native American budget and policy institute (Southwest). Program development centers Indigenous underpinnings of wampum agreements, Pueblo cane agreements, tribal sovereignty, and governance. Findings include translational modeling of Indigenous based cancer focused patient navigation successes, robust cross-training collaborations, inter-tribal resource building, incorporation of virtual patient navigation, grass-root partnerships, Indigenous-led community outreach, and health policy development. Citation Format: Carmela M. Roybal, Rodney C. Haring. Action-based modeling for national Indigenous cancer care partnerships: Patient navigation services, health policy, and sustainability [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C137.