Journal articles on the topic 'Torres Strait Islander health'
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Wilson, Annabelle, Tamara Mackean, Liz Withall, Eileen Willis, Odette Pearson, Colleen Hayes, Kim O'Donnell, et al. "Protocols for an Aboriginal-led, Multi-methods Study of the Role of Aboriginal and Torres Strait Islander Health Workers, Practitioners and Liaison Officers in Quality Acute Health Care." Journal of the Australian Indigenous HealthInfoNet 3, no. 1 (2022): 1–13. http://dx.doi.org/10.14221/aihjournal.v3n1.2.
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Objectives Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers play an important, often critical role providing advocacy and cultural and emotional support for Aboriginal and Torres Strait Islander patients. The main goals of this research are to explore i) how Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers are integrated in the routine delivery of care for Aboriginal and Torres Strait Islander peoples in hospital, and ii) how the role of Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers facilitates quality health outcomes. Methods This study is being conducted in three different hospitals using a multi-method approach including: yarning and Dadirri, patient journey mapping, survey and semi-structured interviews. Ethics approval has been provided from four ethics committees covering the three project sites in Australia (Adelaide, South Australia; Sydney, New South Wales and Alice Springs, Northern Territory). Significance This study uses innovative methodology founded on the privileging of Aboriginal and Torres Strait Islander knowledges to collect Aboriginal and Torres Strait Islander perspectives and understand patient journeys within acute health care systems. This project is led by Aboriginal and Torres Strait Islander researchers and guided by the Project Steering Committee comprised of stakeholders. Implications There is limited research that explores quality acute care processes and the integration of Aboriginal and Torres Strait Islander Health Workers/Practitioners work within health care teams. This research will make a valuable contribution to understanding how hospital services can achieve quality acute health care experiences for Aboriginal and Torres Strait Islander People.
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Garvey, Gail, Kate Anderson, Alana Gall, Tamara L. Butler, Joan Cunningham, Lisa J. Whop, Michelle Dickson, et al. "What Matters 2 Adults (WM2Adults): Understanding the Foundations of Aboriginal and Torres Strait Islander Wellbeing." International Journal of Environmental Research and Public Health 18, no. 12 (June 8, 2021): 6193. http://dx.doi.org/10.3390/ijerph18126193.
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Aboriginal and Torres Strait Islander people experience a greater range of health and social disadvantages compared to other Australians. Wellbeing is a culturally-bound construct, and to date, a national evidence base around the components of wellbeing for Aboriginal and Torres Strait Islander people is lacking. Understanding and measurement of wellbeing for this population is critical in achieving health equity. This paper aims to identify and describe the foundations of wellbeing for Aboriginal and Torres Strait Islander adults. This national qualitative study was underpinned by an Indigenist research approach which privileges the voices of Aboriginal and Torres Strait Islander people. Aboriginal and Torres Strait Islander adults were purposively recruited from around Australia between September 2017 and September 2018 to participate in Yarning Circles, led by Aboriginal and Torres Strait Islander researchers. Yarning Circles were audio recorded, transcribed and analyzed. A Collaborative Yarning Methodology was used, which incorporated reflexive thematic analysis to identify and describe the foundations of wellbeing reported by participants. A total of 359 Aboriginal and Torres Strait Islander adults participated. Our analysis revealed five foundations of wellbeing: belonging and connection; holistic health; purpose and control; dignity and respect; and basic needs. These foundations were deeply interwoven by three interconnected aspects of Aboriginal and Torres Strait Islander life: family, community and culture. The findings of this study will substantially aid our efforts to develop a new wellbeing measure for Aboriginal and Torres Strait Islander adults. The iterative Indigenist methods used in this study provide a robust research methodology for conducting large-scale, nationally-relevant qualitative research with Aboriginal and Torres Strait Islander people. Policies and practices that are informed by our results have the potential to address outcomes that are meaningful for Aboriginal and Torres Strait Islander people.
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Castles, Simon, Zoe Wainer, and Harindra Jayasekara. "Risk factors for cancer in the Australian Aboriginal and Torres Strait Islander population: a systematic review." Australian Journal of Primary Health 22, no. 3 (2016): 190. http://dx.doi.org/10.1071/py15048.
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Cancer incidence in the Australian Aboriginal and Torres Strait Islander population is higher and survival lower compared with non-Indigenous Australians. A proportion of these cancers are potentially preventable if factors associated with carcinogenesis are known and successfully avoided. We conducted a systematic review of the published literature to examine risk factors for cancer in the Australian Aboriginal and Torres Strait Islander population. Electronic databases Medline, Web of Science and the Australian Aboriginal and Torres Strait Islander Health Bibliographic Index were searched through August 2014 using broad search terms. Studies reporting a measure of association between a risk factor and any cancer site in the Australian Aboriginal and Torres Strait Islander population were eligible for inclusion. Ten studies (1991–2014) were identified, mostly with small sample sizes, showing marked heterogeneity in terms of methods used to assess exposure and capture outcomes, and often using descriptive comparative analyses. Relatively young (as opposed to elderly) and geographically remote Aboriginal and Torres Strait Islanders were found to be at increased risk for selected cancers while most modifiable lifestyle and behavioural risk factors were rarely assessed. Further studies examining associations between potential risk factors and cancer will help define public health policy for cancer prevention in the Australian Aboriginal and Torres Strait Islander population.
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Henson, Connie, Boe Rambaldini, Bronwyn Carlson, Monika Wadolowski, Carol Vale, and Kylie Gwynne. "A new path to address health disparities: How older Aboriginal & Torres Strait Islander women use social media to enhance community health (Protocol)." DIGITAL HEALTH 8 (January 2022): 205520762210844. http://dx.doi.org/10.1177/20552076221084469.
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Background Digital health offers a fresh avenue to address health disparities experienced by Aboriginal and Torres Strait Islanders. Despite the scant evidence about how Aboriginal and Torres Strait Islanders access and use health technology, the Australian government has prioritised research that uses technology to enable people to manage their health and promote better health outcomes. Older Aboriginal and Torres Strait Islander women are cultural leaders in their communities, enabling them to provide valuable insights about the safety and efficacy of health care messaging. However, no research has engaged older Aboriginal and Torres Strait Islander, women as partners in digital health research. Objective This paper provides a protocol for co-designed translational research that privileges older Aboriginal & Torres Strait Islander women’s cultural expertise to design and test a framework for accessible, culturally safe and feasible digital health technologies. Methods This mixed-methods research project will use the collective impact approach, a user-centred, co-design methodology and yarning circles, a recognised Indigenous research methodology. A series of yarning circles with three different communities will elucidate enablers and barriers to access health information; co-create a framework clarifying what works and does not work for digital health promotion in their communities; and test the framework by co-creating three digital health information programs. Conclusions Privileging the cultural expertise of older Aboriginal and Torres Strait Islander women will provide a novel perspective and vital guidance that end users and developers can trust and rely upon to create and evaluate culturally safe and efficacious digital health promotion programs.
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Fredericks, Bronwyn, Karen Adams, Sandra Angus, and Melissa Walker. "Setting a New Agenda." International Journal of Critical Indigenous Studies 4, no. 2 (June 1, 2011): 17–28. http://dx.doi.org/10.5204/ijcis.v4i2.61.
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The Australian National Aboriginal and Torres Strait Islander Women’s Health Strategy was developed to reflect the health priorities of Aboriginal and Torres Strait Islander women, as identified by Aboriginal and Torres Strait Islander women themselves. This article describes the process used by the Australian Women’s Health Network to develop the strategy. The women involved in the research used the talking circle method and engaged with Aboriginal and Torres Strait Islander women through a process referred to as ‘talkin’ up’, where women ‘talk back’ to one another about issues that matter to them. In this article, we describe the power of the talkin’ up process, as a way for Aboriginal and Torres Strait Islander women to identify their own issues, discuss them in context and talk in a culturally safe environment. The strategy which emerged from this process is an accurate reflection of the issues that are important to Australian Indigenous women and highlights the improvements needed in Aboriginal and Torres Strait Islander women’s health to strengthen and underpin women’s health, Indigeneity and their sense of well-being as Aboriginal and Torres Strait Islander women.
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Thomas, David P., Nadia Lusis, Anke E. Van der Sterren, and Ron Borland. "Electronic Cigarette Use and Understanding Among a National Sample of Australian Aboriginal and Torres Strait Islander Smokers." Nicotine & Tobacco Research 21, no. 10 (July 19, 2018): 1434–40. http://dx.doi.org/10.1093/ntr/nty154.
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Abstract Introduction Adult daily smoking prevalence in the Aboriginal and Torres Strait Islander population is 2.8 times that of other Australians. There is little data on prevalence of electronic cigarette (e-cigarette) use among Aboriginal and Torres Strait Islander peoples. We measured e-cigarette use and beliefs about their harmfulness in national samples of Aboriginal and Torres Strait Islander smokers and of all Australian smokers. Methods The Talking About the Smokes project interviewed a nationally representative quota sample of 1301 Aboriginal and Torres Strait Islander smokers between August 2013 and August 2014. The Australian Wave 9 survey of the long-running International Tobacco Control Project interviewed 1093 smokers between February and May 2013. Estimates for all Australian smokers were standardized to the age and sex distribution of Aboriginal and Torres Strait Islander smokers. Results Fewer Aboriginal and Torres Strait Islander than all Australian smokers had tried an e-cigarette (21% vs. 30%). This was in part because of more Aboriginal and Torres Strait Islander smokers having not heard of e-cigarettes. Fewer Aboriginal and Torres Strait Islander smokers than all Australian smokers agreed that e-cigarettes are less harmful than conventional cigarettes (22% vs. 50%). Conclusions Many Aboriginal and Torres Strait Islander smokers have used e-cigarettes. However, there is considerable misunderstanding about the relative harm of e-cigarettes compared with conventional cigarettes, in part because of the tight regulatory environment in Australia. Implications The study describes e-cigarette use and understanding in national samples of Aboriginal and Torres Strait Islander smokers and of all Australian smokers. Only small studies have reported on e-cigarette use in this high smoking prevalence population. Fewer Aboriginal and Torres Strait Islander smokers than all Australian smokers had tried an e-cigarette and fewer agreed that e-cigarettes are less harmful than conventional cigarettes. Australian governments, health authorities, health professionals, and e-cigarette regulations should provide clearer messages that e-cigarettes are less harmful.
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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, Catrina Felton-Busch, and Sarah Larkins. "Aboriginal and Torres Strait Islander health." Australian Journal of Primary Health 24, no. 5 (2018): i. http://dx.doi.org/10.1071/pyv24n5_ed.
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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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Atkinson-Briggs, Sharon, Alicia Jenkins, Christopher Ryan, and Laima Brazionis. "Prevalence of Health-Risk Behaviours Among Indigenous Australians With Diabetes: A Review." Journal of the Australian Indigenous HealthInfoNet 3, no. 4 (2022): 1–30. http://dx.doi.org/10.14221/aihjournal.v3n4.6.
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Aboriginal and Torres Strait Islander Australians are at high risk of Type 2 diabetes and its complications. Optimal lifestyle choices can improve health outcomes. A thematic review of original research publications related to smoking, nutrition, alcohol intake, physical activity and emotional wellness in Aboriginal and Torres Strait Islander Australians with diabetes was performed. Overall, 7118 English-language publications were identified by search engines (PubMed, CINAHL, Scopus, Medline-Web of Science, and Google Scholar) with search terms Indigenous Australians OR Aboriginal and Torres Strait Islanders AND diabetes AND lifestyle OR smoking OR nutrition OR alcohol OR physical activity OR emotional wellbeing and their common synonyms. After review of abstracts and publication reference lists, 36 articles met inclusion criteria and were reviewed. In general, the self-reported health-related behaviours of Aboriginal and Torres Strait Islander Australian adults with diabetes, which is predominantly Type 2 diabetes, was suboptimal. An important clinical challenge in diabetes care is to sustainably reduce smoking, improve nutrition (including alcohol use), increase physical activity, reduce sedentary time, and improve emotional wellbeing, which should lead to reduced rates of diabetes complications. Regular assessments and multi-stakeholder input, including individuals, communities, clinical, health policy, societal and government inputs and partnerships, are desirable to facilitate closing the gap in health between Aboriginal and Torres Strait Islander and non-Indigenous Australians.
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Laccos-Barrett, Keera, Angela Elisabeth Brown, Vicki Saunders, Katherine Lorraine Baldock, and Roianne West. "Are We Teaching Nurses to Be Racist towards Aboriginal and Torres Strait Islander Peoples? A Critical Race Document Analysis of Discrete Aboriginal and Torres Strait Islander Health Courses." International Journal of Environmental Research and Public Health 19, no. 18 (September 12, 2022): 11455. http://dx.doi.org/10.3390/ijerph191811455.
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Background: Racism is responsible for health inequity and the harm perpetrated upon Aboriginal and Torres Strait Islander peoples by white institutions, building on attitudes and beliefs dominated by assumptions of white superiority. The National Aboriginal and Torres Strait Islander Health Curriculum Framework ‘Curriculum Framework’, released in 2014, was introduced to provide a framework for nursing programs and included the introduction of discrete Aboriginal and Torres Strait Islander health courses to draw attention to the relationship between racism health outcomes of Aboriginal and Torres Strait Islander peoples within health care settings. Methods: Using an Indigenist research paradigm with Colonial Critical Race Theory as the methodology and framework, this study presents a document analysis of discrete Aboriginal and Torres Strait Islander health courses taught in undergraduate nursing programs at 31 Australian Universities. Results: This work draws on the collective activism of Aboriginal and Torres Strait Islander nurses in challenging the systemic racism embedded in the Australian nursing curriculum. We demonstrate the utility of the Racial Segregation Audit Tool (RSAT), as an innovative approach to identify and respond to racism embedded in course learning outcomes. Conclusions: This study explores and uncovers how the learning outcomes assert the social construction of race as a tool of oppressive segregation.
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Garvey, Gail, Kate Anderson, Alana Gall, Tamara L. Butler, Lisa J. Whop, Brian Arley, Joan Cunningham, et al. "The Fabric of Aboriginal and Torres Strait Islander Wellbeing: A Conceptual Model." International Journal of Environmental Research and Public Health 18, no. 15 (July 21, 2021): 7745. http://dx.doi.org/10.3390/ijerph18157745.
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Wellbeing is culturally bound and is shaped by many aspects of life, including experiences, beliefs and values. As such, in order to accurately measure wellbeing for a specific cultural group, it is necessary to understand the experiences, beliefs and values that influence the conception and experience of wellbeing of that group. This paper presents a conceptual model of wellbeing for Aboriginal and Torres Strait Islander people, which was developed from a large national qualitative study that explored the views of 359 Aboriginal and Torres Strait Islander adults. An Aboriginal- and Torres Strait Islander-led research team used an Indigenist research approach to iteratively develop this conceptual model, called the Fabric of Aboriginal and Torres Strait Islander Wellbeing model, which takes inspiration from Aboriginal and Torres Strait Islander weaving traditions whereby individual strands are twined to create fabrics that are both beautiful and strong. This reflects our findings that the parts of life that are most important to wellbeing for many Aboriginal and Torres Strait Islander people are interwoven with their families, communities and culture.
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Bourke, Christopher J., Andrew McAuliffe, and Lisa M. Jamieson. "Addressing the oral health workforce needs of Aboriginal and Torres Strait Islander Australians." Australian Health Review 45, no. 4 (2021): 407. http://dx.doi.org/10.1071/ah20295.
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Tooth decay and gum disease, the main dental diseases affecting Australians, can cause pain and deformity as well as affecting eating and speech. Dental practitioners are efficient and effective in relieving dental pain, and they can effectively restore oral function. There is good evidence that better health care outcomes for Aboriginal and Torres Strait Islander patients are associated with care from Aboriginal and Torres Strait Islander health professionals. Unfortunately, the representation of Aboriginal and Torres Strait Islander people within the dental practitioner workforce is very low. We argue that a strategic approach, along with additional investment, is needed to increase the number of Aboriginal and Torres Strait Islander people qualified as dental practitioners.
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Adams, Mick, Kootsy (Justin) Canuto, Neil Drew, and Jesse John Fleay. "Postcolonial Traumatic Stresses among Aboriginal and Torres Strait Islander Australians." ab-Original 3, no. 2 (September 1, 2020): 233–63. http://dx.doi.org/10.5325/aboriginal.3.2.233.
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Abstract The mental health of Aboriginal and Torres Strait Islander males in Australia is often misunderstood, mainly because it has been poorly researched. When analyzing the quality of life of Aboriginal and Torres Strait Islander males, it is crucial to consider the associated factors that have directly and indirectly contributed to their poor health and wellbeing, that is, the effects of colonization, the interruption of cultural practices, displacement of societies, taking away of traditional homelands and forceful removal of children (assimilation and other policies). The displacement of families and tribal groups from their country broke up family groups and caused conflict between the original inhabitants of the lands and dislocated Aboriginal and Torres Strait Islander tribal groups. These dislocated Aboriginal and Torres Strait Islander people were forced to reside on the allocated government institutions where they would be (allegedly) protected. Whilst in the institutions they were made to comply with the authority rules and were forbidden to practice or participate in their traditional rituals or customs or speak their own tribal languages. Additionally, the dispossession from Aboriginal and Torres Strait Islander traditional lands and the destruction of culture and political, economic, and social structures have caused many Aboriginal and Torres Strait Islander people to have a pervading sense of hopelessness for the future. The traditional customs and life cycles of Aboriginal and Torres Strait Islander males were permanently affected by colonization adversely contributing to mental health problems in Aboriginal and Torres Strait Islander communities. In this article we aim to provide a better understanding of the processes impacting on Aboriginal and Torres Strait Islander males' social and emotional wellbeing.
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Bell, Lorraine, Kate Anderson, Afaf Girgis, Samar Aoun, Joan Cunningham, Claire E. Wakefield, Shaouli Shahid, et al. "“We Have to Be Strong Ourselves”: Exploring the Support Needs of Informal Carers of Aboriginal and Torres Strait Islander People with Cancer." International Journal of Environmental Research and Public Health 18, no. 14 (July 7, 2021): 7281. http://dx.doi.org/10.3390/ijerph18147281.
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Informal carers provide an important role in supporting people with cancer. Aboriginal and Torres Strait Islander peoples experience higher cancer mortality than other Australians. To date, very little is known about the support needs of carers of Aboriginal and Torres Strait Islander adults with cancer. This article explored these needs through a qualitative study. Twenty-two semi-structured qualitative interviews and one focus group were conducted with carers of Aboriginal and Torres Strait Islander adults with cancer (n = 12) and Aboriginal and Torres Strait Islander cancer survivors (n = 15) from Queensland, Australia. Half of the carers interviewed were Aboriginal or Torres Strait Islander Australians. Interviews were transcribed, coded and thematically analysed following an interpretive phenomenological approach. Thematic analysis of carer and survivor interviews revealed four key themes relating to carers’ needs: managing multiple responsibilities; maintaining the carer’s own health and wellbeing; accessing practical support and information; and engaging with the health system. Within these overarching themes, multiple needs were identified including specific needs relevant for carers of Aboriginal and Torres Strait Islander peoples, such as advocating for the patient; accessing Indigenous support services and health workers; and ensuring that the cultural needs of the person are recognised and respected. Identifying the needs of informal carers of Aboriginal and Torres Strait Islander cancer patients will enable greater understanding of the support that carers require and inform the development of strategies to meet these areas of need.
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Canuto, Kootsy, Stephen G. Harfield, Karla J. Canuto, and Alex Brown. "Aboriginal and Torres Strait Islander men and parenting: a scoping review." Australian Journal of Primary Health 26, no. 1 (2020): 1. http://dx.doi.org/10.1071/py19106.
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Aboriginal and Torres Strait Islander men rarely rate a mention within discussions of parenting unless framed in the negative, or as the cause of dysfunctional family life. Consequently, the roles and responsibilities of Aboriginal and Torres Strait Islander men within parenting have largely been neglected or ignored. This scoping review aimed to identify and describe Aboriginal and Torres Strait Islander parenting programs that focused on male parents. A comprehensive search was conducted of databases, PubMed and Informit ATSIhealth, to identify peer-review publications, while relevant websites were also searched for grey literature. The review identified eight programs that met the inclusion criteria. The review highlights the lack of rigorously researched and published literature on parenting programs that focus on Aboriginal and Torres Strait Islander male parents. The programs all reported positive outcomes and demonstrate that given the opportunity, Aboriginal and Torres Strait Islander male parents are ready and determined to fulfil their roles and responsibilities as parents to the best of their ability for the benefit of their families and communities. The provision of inclusive parenting programs and services will equip Aboriginal and Torres Strait Islander male parents to better support their families during these important times.
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Kelly, Janet, Anna Dowling, Katharine McBride, Wendy Keech, and Alex Brown. "‘We get so task orientated at times that we forget the people’: staff communication experiences when caring for Aboriginal cardiac patients." Australian Health Review 44, no. 1 (2020): 1. http://dx.doi.org/10.1071/ah17290.
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Objective The aim of this study was to describe the experiences of communication for staff providing cardiac care for Aboriginal and Torres Strait Islander patients in hospital and discuss potential improvements. Methods Focus group discussions were performed with 58 multidisciplinary staff who provide care for Aboriginal and Torres Strait Islander cardiac patients in two metropolitan and two regional hospitals in South Australia and Northern Territory. Inductive thematic analysis was undertaken to identify staff perceptions of communication challenges and strategies for improvement. Results There were five key themes: (1) communication is central to good care; (2) communication within busy clinical environments; (3) supporting a strong Aboriginal workforce; (4) a cultural as well as clinical focus; and (5) particular challenges working with patients from remote areas. Conclusions Providing effective communication that is both clinically and culturally appropriate is often challenging within a busy and non-adaptive hospital environment. Moving beyond clinical tasks, increased Aboriginal and Torres Strat Islander health workforce and cultural competency, supporting coordinated care and improved skills are required to meet the communication needs of Aboriginal and Torres Strait Islander patients. What is known about this topic? Communication between patients, their families and hospital staff is crucial for health care quality and safety. There is little understanding of the challenges and opportunities for staff to meet the communication needs of Aboriginal and Torres Strait Islander cardiac patients to address disparities in acute care settings. What does this paper add? This paper discusses the barriers and potential improvements, as identified by hospital staff providing care to Aboriginal and Torres Strait Islander cardiac patients in both metropolitan and regional settings. What are the implications for practitioners? Practitioners should be trained and supported in providing both clinically and culturally safe care for Aboriginal and Torres Strait Islander patients. This requires adequate time, two-way communication and resources to support and facilitate effective communication.
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Jackson Pulver, Lisa R., Alison Bush, and Jeanette Ward. "Identification of Aboriginal and Torres Strait Islander women using an urban obstetric hospital." Australian Health Review 26, no. 2 (2003): 19. http://dx.doi.org/10.1071/ah030019.
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Objectives: To determine the accuracy of routine identification of Aboriginal and Torres Strait Islander womenconfining at King George V (KGV) Hospital, located in Sydney, Australia.Design: Interviewer-administered survey.Participants: Consecutive sample of women who delivered live, well infants from May to July 1999.Main Outcome Measure: Comparison of hospital documentation compared with confidential self-disclosureof Aboriginal or Torres Strait Islander status to a female Aboriginal health professional.Results: Of 536 women in our sample, 29 (5%) self-disclosed as being Aboriginal or Torres Strait Islander.Only 10 of these were identified as Aboriginal or Torres Strait Islander in hospital records (p<0.001). While specificity as determined by us was 100%, sensitivity was low (34.5%). Those Aboriginal and Torres Strait Islander women referred by another organisation were significantly more likely than those who self-referred to the hospital to be correctly identified (p=0.011). Only 1% of non-Aboriginal women indicated they would have objected to an explicit question by staff about their Aboriginal or Torres Strait Islander status.Conclusions: Routine identification significantly under-represents Aboriginal or Torres Strait Islander women giving birth at an urban obstetric hospital. We recommend the development and use of a sensitive but also specific series of questions to ensure women always are given the opportunity to disclose their status, especially as few women appear to mind such questions.
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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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Williams, Hayley M., Kate Hunter, Bronwyn Griffin, Roy Kimble, and Kathleen Clapham. "Fire and Smoke: Using Indigenous Research Methodologies to Explore the Psychosocial Impact of Pediatric Burns on Aboriginal and Torres Strait Islander Families." International Journal of Qualitative Methods 20 (January 1, 2021): 160940692199048. http://dx.doi.org/10.1177/1609406921990486.
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Aboriginal and Torres Strait Islander children and adolescents are disproportionately affected by burn injuries, yet often omitted from burns literature or inadequately portrayed under Western frameworks. We highlight and address the urgent need for knowledge about pediatric burns among Aboriginal and Torres Strait Islander people to be produced from within Indigenous research methodologies and in response to Aboriginal and Torres Strait Islander peoples’ expressed needs. Through the use of decolonial ethnography, we applied a novel combination of participant observations, retrospective thinking aloud, and yarning methods to explore the psychosocial impact of pediatric burn injuries and care on Aboriginal and Torres Strait Islander families. To our knowledge, this is the first example of these three methods being interwoven to explore a multifaceted health issue and in a way that privileges Aboriginal and Torres Strait Islander peoples' knowledge systems, voices, and experiences. We suggest that these approaches have strong relevance and potential for other complex issues affecting Aboriginal and Torres Strait Islander people.
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Costa, Nadia, Mary Sullivan, Rae Walker, and Kerin M. Robinson. "Emergency Department Presentations of Victorian Aboriginal and Torres Strait Islander People." Health Information Management Journal 37, no. 3 (October 2008): 15–25. http://dx.doi.org/10.1177/183335830803700303.
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This paper explains how routinely collected data can be used to examine the emergency department attendances of Victorian Aboriginal and Torres Strait Islander people. The data reported in the Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007 financial year were analysed. The presentations of Aboriginal and Torres Strait Islander and non-Aboriginal people were compared in terms of age, gender, hospital location (metropolitan and rural) and presenting condition. Aboriginal and Torres Strait Islander people were found to attend the emergency department 1.8 times more often than non-Aboriginal people. While the emergency department presentation rates of metropolitan Aboriginal and Torres Strait Islander and non-Aboriginal people were similar, rural Aboriginal and Torres Strait Islander people presented to the emergency department 2.3 times more often than non-Aboriginal people. The injuries or poisonings, respiratory conditions and mental disorders presentation rates of the Aboriginal and Torres Strait Islander and non-Aboriginal population were compared. No previous studies have assessed the accuracy of the Indigenous status and diagnosis fields in the VEMD; therefore the quality of this data is unknown.
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Lee, Grace Yeeun, Julie Robotham, Yun Ju C. Song, Jo-An Occhipinti, Jakelin Troy, Tanja Hirvonen, Dakota Feirer, et al. "Partnering with Aboriginal and Torres Strait Islander Peoples: An Evaluation Study Protocol to Strengthen a Comprehensive Multi-Scale Evaluation Framework for Participatory Systems Modelling through Indigenous Paradigms and Methodologies." International Journal of Environmental Research and Public Health 20, no. 1 (December 21, 2022): 53. http://dx.doi.org/10.3390/ijerph20010053.
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The social and emotional wellbeing of young Aboriginal and Torres Strait Islander peoples should be supported through an Indigenous-led and community empowering approach. Applying systems thinking via participatory approaches is aligned with Aboriginal and Torres Strait Islander research paradigms and can be an effective method to deliver a decision support tool for mental health systems planning for Indigenous communities. Evaluations are necessary to understand the effectiveness and value of such methods, uncover protective and healing factors of social and emotional wellbeing, as well as to promote Aboriginal and Torres Strait Islander self-determination over allocation of funding and resources. This paper presents modifications to a published evaluation protocol for participatory systems modelling to align with critical Aboriginal and Torres Strait Islander guidelines and recommendations to support the social and emotional wellbeing of young people. This paper also presents a culturally relevant participatory systems modelling evaluation framework. Recognizing the reciprocity, strengths, and expertise Aboriginal and Torres Strait Islander methodologies can offer to broader research and evaluation practices, the amended framework presented in this paper facilitates empowering evaluation practices that should be adopted when working with Aboriginal and Torres Strait Islander peoples as well as when working with other diverse, non-Indigenous communities.
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Bovill, Michelle, Catherine Chamberlain, Jessica Bennett, Hayley Longbottom, Shanell Bacon, Belinda Field, Paul Hussein, Robert Berwick, Gillian Gould, and Peter O’Mara. "Building an Indigenous-Led Evidence Base for Smoking Cessation Care among Aboriginal and Torres Strait Islander Women during Pregnancy and Beyond: Research Protocol for the Which Way? Project." International Journal of Environmental Research and Public Health 18, no. 3 (February 2, 2021): 1342. http://dx.doi.org/10.3390/ijerph18031342.
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Strong and healthy futures for Aboriginal and Torres Strait Islander people requires engagement in meaningful decision making which is supported by evidence-based approaches. While a significant number of research publications state the research is co-designed, few describe the research process in relation to Indigenous ethical values. Improving the health and wellbeing of Aboriginal and Torres Strait Islander mothers and babies is crucial to the continuation of the oldest living culture in the world. Developing meaningful supports to empower Aboriginal and Torres Strait Islander mothers to quit smoking during pregnancy is paramount to addressing a range of health and wellbeing outcomes. Aboriginal and Torres Strait Islander women have called for non-pharmacological approaches to smoking cessation during pregnancy. We describe a culturally responsive research protocol that has been co-designed and is co-owned with urban and regional Aboriginal communities in New South Wales. The project has been developed in line with the AH&MRC’s (Aboriginal Health & Medical Research Council) updated guidelines for ethical research with Aboriginal and Torres Strait Islander communities. Ethics approvals have been granted by AH&MRC #14541662 University of Newcastle HREC H-2020-0092 and the Local Health District ethics committee 2020/ETH02095. Results will be disseminated through peer reviewed articles, community reports, infographics, and online social media content.
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Kennedy, Michelle, Tess Bright, Simon Graham, Christina Heris, Shannon K. Bennetts, Renee Fiolet, Elise Davis, et al. "“You Can’t Replace That Feeling of Connection to Culture and Country”: Aboriginal and Torres Strait Islander Parents’ Experiences of the COVID-19 Pandemic." International Journal of Environmental Research and Public Health 19, no. 24 (December 13, 2022): 16724. http://dx.doi.org/10.3390/ijerph192416724.
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This Aboriginal-led study explores Aboriginal and Torres Strait Islander parents’ experiences of COVID-19. 110 Aboriginal and Torres Strait Islander parents were interviewed between October 2020 and March 2022. Participants were recruited through community networks and partner health services in South Australia, Victoria, and Northern Territory, Australia. Participants were predominantly female (89%) and based in Victoria (47%) or South Australia (45%). Inductive thematic analysis identified three themes: (1) Changes to daily living; (2) Impact on social and emotional wellbeing; and (3) Disconnection from family, community, and culture. COVID-19 impacted Aboriginal and Torres Strait Islander families. Disruption to cultural practice, and disconnection from country, family, and community was detrimental to wellbeing. These impacts aggravated pre-existing inequalities and may continue to have greater impact on Aboriginal and Torres Strait Islander parents and communities due to intergenerational trauma, stemming from colonisation, violence and dispossession and ongoing systemic racism. We advocate for the development of a framework that ensures an equitable approach to future public health responses for Aboriginal and Torres Strait Islander people.
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Browne, Jennifer, Deborah Gleeson, Karen Adams, Deanne Minniecon, and Rick Hayes. "Strengthening Aboriginal and Torres Strait Islander health policy: lessons from a case study of food and nutrition." Public Health Nutrition 22, no. 15 (May 22, 2019): 2868–78. http://dx.doi.org/10.1017/s1368980019001198.
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AbstractObjective:To examine key factors influencing the prioritisation of food and nutrition in Aboriginal and Torres Strait Islander health policy during 1996–2015.Design:A qualitative policy analysis case study was undertaken, combining document analysis with thematic analysis of key informant interviews.Setting:Australia.Participants:Key actors involved in Aboriginal and Torres Strait Islander health policy between 1996 and 2015 (n 38).Results:Prioritisation of food and nutrition in policy reduced over time. Several factors which may have impeded the prioritisation of nutrition were identified. These included lack of cohesion among the community of nutritionists, Aboriginal and Torres Strait Islander leaders and civil society actors advocating for nutrition; the absence of an institutional home for nutrition policy; and lack of consensus and a compelling policy narrative about how priority nutrition issues should be addressed. Political factors including ideology, dismantling of public health nutrition governance structures and missing the opportunities presented by ‘policy windows’ were also viewed as barriers to nutrition policy change. Finally, the complexity and multifaceted nature of nutrition as a policy problem and perceived lack of evidence-based solutions may also have constrained its prioritisation in Aboriginal and Torres Strait Islander health policy.Conclusions:Future advocacy should focus on embedding nutrition within holistic approaches to health and building a collective voice through advocacy coalitions with Aboriginal and Torres Strait Islander leadership. Strategic communication and seizing political opportunities may be as important as evidence for raising the priority of Aboriginal and Torres Strait Islander health issues.
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Williams, Megan. "Ngaa-bi-nya Aboriginal and Torres Strait Islander program evaluation framework." Evaluation Journal of Australasia 18, no. 1 (March 2018): 6–20. http://dx.doi.org/10.1177/1035719x18760141.
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The Ngaa-bi-nya framework presented here is a practical guide for the evaluation of Aboriginal and Torres Strait Islander health and social programs. It has a range of prompts to stimulate thinking about critical success factors in programs relevant to Aboriginal and Torres Strait Islander people’s lives. Ngaa-bi-nya was designed from an Aboriginal practitioner-scholar standpoint and was informed by the holistic concept of Aboriginal health, case studies with Aboriginal-led social and emotional well-being programs, human rights instruments, and the work of Stufflebeam. Aboriginal and Torres Strait Islander health and social programs have been described as suffering from a lack of evaluation. Ngaa-bi-nya is one of the few tools developed specifically to reflect Aboriginal and Torres Strait Islander peoples’ contexts. It prompts the user to take into account the historical, policy, and social landscape of Aboriginal and Torres Strait Islander people’s lives, existing and emerging cultural leadership, and informal caregiving that supports programs. Ngaa-bi-nya’s prompts across four domains—landscape factors, resources, ways of working, and learnings—provide a structure through which to generate insights necessary for the future development of culturally relevant, effective, translatable, and sustainable programs required for Australia’s growing and diverse Aboriginal and Torres Strait Islander populations.
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Bernardes, Christina M., Stuart Ekberg, Stephen Birch, Renata F. I. Meuter, Andrew Claus, Matthew Bryant, Jermaine Isua, et al. "Clinician Perspectives of Communication with Aboriginal and Torres Strait Islanders Managing Pain: Needs and Preferences." International Journal of Environmental Research and Public Health 19, no. 3 (January 29, 2022): 1572. http://dx.doi.org/10.3390/ijerph19031572.
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Poor communication is an important factor contributing to health disparity. This study sought to investigate clinicians’ perspectives about communicating with Aboriginal and Torres Strait Islander patients with pain. This multi-site and mixed-methods study involved clinicians from three pain management services in Queensland, Australia. Clinicians completed a survey and participated in focus groups. Clinicians rated the importance of communication training, their knowledge, ability, and confidence in communicating with Aboriginal and Torres Strait Islander patients using a 5-point Likert scale. Rating scores were combined into low (scores 1–2); moderate (score 3) and high (scores 4–5). Informed by an interpretive description methodology, thematic analysis of focus group data was used to identify the communication needs and training preferences of clinicians. Overall (N = 64), 88% of clinicians rated the importance of communication training when supporting Aboriginal and Torres Strait Islander patients as “high”. In contrast, far fewer clinicians rated as “high” their knowledge (28%), ability (25%) and confidence (28%) in effectively communicating with Aboriginal and Torres Strait Islander patients. Thematic analysis identified three areas of need: knowledge of Aboriginal and Torres Strait Islander cultures, health beliefs, and understanding cross-cultural cues. Communication skills can be learned and training, in the form of a tailored intervention to support quality engagement with Aboriginal and Torres Strait Islander patients, should combine cultural and communication aspects with biomedical knowledge.
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Kee, Margaret Ah, and Clare Tilbury. "The Aboriginal and Torres Strait Islander Child Placement Principle is about self determination." Children Australia 24, no. 3 (1999): 4–8. http://dx.doi.org/10.1017/s1035077200009196.
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The Aboriginal and Torres Strait Islander Child Placement Principle has been the policy guiding the placement of indigenous children in most Australian child protection jurisdictions for around fifteen years. The Principle requires the involvement of Aboriginal and Torres Strait Islander community representatives in decision making concerning indigenous children, and ensuring that alternative care placements of Aboriginal and Torres Strait Islander children are with Aboriginal and Torres Strait Islander careproviders.Most Jurisdictions still have a significant number of Aboriginal and Torres Strait Islander children placed with non-indigenous careproviders, and community based Aboriginal and Islander child care agencies continue to express dissatisfaction about the nature and level of consultation which occurs when welfare departments are taking action to protect indigenous children.This paper, which was presented at the IFCO conference in Melbourne in July 1999, examines why there has been such limited improvement in Child Placement Principle outcomes. Work undertaken in Queensland to address the over representation of Aboriginal and Torres Strait Islander children in the child protection system will be outlined from both a departmental and community perspective. The paper argues that if strategies for addressing these issues are not located within a framework of self determination for Aboriginal and Torres Strait Islander people, then they will not work.
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Spurling, Geoffrey K., Claudette ‘Sissy' Tyson, Deborah Askew, and Jennifer Reath. "Mixed-methods evaluation of screening for hearing loss using the hearScreen™ mobile health application in Aboriginal and Torres Strait Islander children presenting to an urban primary healthcare service." Australian Journal of Primary Health 27, no. 5 (2021): 371. http://dx.doi.org/10.1071/py21059.
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Recommendations for hearing screening for Aboriginal and Torres Strait Islander children aged 4 years have a limited evidence base. Using the hearScreen™ (HearX, Camden, DE, USA) mobile health application as part of a mixed-methods study, the aim of this study was to assess the proportion of 4-year-old Aboriginal and Torres Strait Islander children with hearing difficulties, as well as the feasibility and acceptability of the test itself. Of the 145 4-year-old Aboriginal and Torres Strait Islander children who were regular patients of the service during the recruitment period, 50 were recruited to the present study. Of these 50 children, 42 (84%) passed the hearing screening test, 4 (8%) did not and 4 (8%) were unable to complete the test. Nine caregivers were interviewed. Themes included the priority given to children’s health by caregivers, positivity and trust in the test, preference for having the test conducted in primary care and the importance of an Aboriginal and Torres Strait Islander person providing the screening test. These findings lend support to hearing screening for school-age children in primary care provided by an Aboriginal and Torres Strait Islander healthcare worker using the hearScreen™ test.
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Ryder, Courtney, Tamara Mackean, Julieann Coombes, Kate Hunter, Shahid Ullah, Kris Rogers, Beverley Essue, Andrew J. A. Holland, and Rebecca Ivers. "Corrigendum to: Developing economic measures for Aboriginal and Torres Strait Islander families on out-of-pocket healthcare expenditure." Australian Health Review 45, no. 5 (2021): 654. http://dx.doi.org/10.1071/ah20299_co.
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Objective Out-of-pocket healthcare expenditure (OOPHE) has a significant impact on marginalised households. The purpose of this study was to modify a pre-existing OOPHE survey for Aboriginal and Torres Strait Islander households with children.Methods The OOPHE survey was derived through a scoping review, face and content validity, including judgement quantification with content experts. Exploratory factor analyses determined factor numbers for construct validity. Repeatability through test–retest processes and reliability was assessed through internal consistency.Results The OOPHE survey had 168 items and was piloted on 67 Aboriginal and Torres Strait Islander parents. Construct validity assessment generated a 62-item correlation matrix with a three-factor model. Across these factors, item loadings varied, 10 items with high correlations (>0.70) and 20 with low correlations (Conclusion The low level of item loadings to factors in the OOPHE survey indicates interconnectedness across the three-factor model, and reliability results suggest systemic differences. Impeding factors may include cohort homogeneity and survey length. It is unknown how cultural and social nuances specific to Aboriginal and Torres Strait Islander households impacts on results. Further work is warranted.What is known about the topic? Out-of-pocket healthcare expenditure (OOPHE) are expenses not covered by universal taxpayer-funded health insurance. In elderly Australians or those with chronic conditions, OOPHE can cause substantial burden and financial hardship and, in the most extreme cases, induce bankruptcy. Despite higher hospital admissions and disease burden, little is known about how OOPHE impacts Aboriginal and Torres Strait Islander families. Additionally, in Australia, no OOPHE survey tools have been appropriately assessed; this includes for use with Aboriginal and Torres Strait Islander families.What does this paper add? This pilot study modified a pre-existing Australian OOPHE survey for use with Aboriginal and Torres Strait Islander households with children. Knowledge interface methodology was used to bring together Indigenous knowledges with quantitative survey methods. This was critical to ensuring Indigenous knowledges were central to the overall pilot study across item creation, participant focus, outcome contextualisation, interpretation, and resetting dominant norms. Outcomes have demonstrated pertinent points for future work in this area, such as the complexities in developing robust, culturally safe and specific surveys, which reach ideal psychometric levels of validity and reliability for Aboriginal and Torres Strait Islander communities. Certainly, it raises questions for current and future research using surveys in Aboriginal and Torres Strait Islander communities, which are generic and not purpose-built.What are the implications for practitioners? We recommend that OOPHE surveys should be developed with Aboriginal and Torres Strait Islander families from the outset, so they can include important contextual factors for Aboriginal and Torres Strait Islander households.
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O'Shea, K. "Torres strait islander mental health: Current issues." Australian and New Zealand Journal of Psychiatry 34, s1 (January 2000): A49. http://dx.doi.org/10.1080/000486700718.
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Lansbury, Nina, Andrew M. Redmond, and Francis Nona. "Community-Led Health Initiatives for Torres Straits Island Communities in a Changing Climate: Implementing Core Values for Mitigation and Adaptation." International Journal of Environmental Research and Public Health 19, no. 24 (December 9, 2022): 16574. http://dx.doi.org/10.3390/ijerph192416574.
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First Nations Peoples have a long history of living in Australia’s changing climate and a deep knowledge of their traditional estate (‘Country’). However, human-induced climate change raises unforeseen risks to the health of First Nations Peoples—especially in remotely located communities. This includes the Torres Strait Islands, where a local leader asked our Torres Strait Islander co-author, ’We know that you will return to your Country—unlike previous researchers. So how can you help with climate change?’ In response, this research describes four core values focused on supporting First Nations Peoples’ health and wellbeing: co-design, appropriate governance, support for self-determination, and respectfully incorporating Indigenous Knowledges into health-protective climate initiatives. Supporting the health and wellbeing of Torres Strait Islanders to continue living in the remote Torres Strait Islands in a changing climate can enable long-term care for Country, maintenance of culture, and a sense of identity for First Nations Peoples. Ensuring these core values are implemented can support the health of present and future generations and will likely be applicable to other First Nations communities.
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Mersha, Amanual Getnet, Raglan Maddox, Sian Maidment, Kade Booth, Karl Briscoe, Paul Hussein, Hayley Longbottom, Yael Bar-Zeev, and Michelle Kennedy. "“It Needs a Full-Time Dedicated Person to Do This Job in Our Local Communities with Our Aboriginal Health Services”—Aboriginal and Torres Strait Islander Health Workers and Practitioners Perspectives on Supporting Smoking Cessation during Pregnancy." International Journal of Environmental Research and Public Health 20, no. 1 (December 20, 2022): 28. http://dx.doi.org/10.3390/ijerph20010028.
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Background: Aboriginal and Torres Strait Islander women deserve improved smoking cessation support. Aboriginal health workers (AHW) and practitioners (AHP) can be central to the provision of culturally safe smoking cessation care (SCC). The objective of this study is to explore attitudes and the perceived role of AHWs/AHPs toward providing SCC to Aboriginal and Torres Strait Islander pregnant women. Method: A mixed-method study using quantitative and qualitative data was conducted among AHW/AHPs in 2021 across Australia. Descriptive and analytical statistics were used to characterise AHWs’/AHPs’ attitudes towards SCC and to evaluate the factors associated with perceptions of who is best placed to provide SCC. Results: From the total AHW/AHP workforce, 21.2% (223) completed the survey. Less than half (48.4%) believed that AHW/AHP were best placed to provide SCC for pregnant women. The majority believed that group-based supports (82.5%) and cultural support programs (63.7%) were the best strategies to support Aboriginal and Torres Strait Islander pregnant women to quit smoking. Conclusion: This study highlights the need to enhance SCC offered to Aboriginal and Torres Strait Islander pregnant women. A targeted workforce dedicated to smoking cessation should be resourced, including funding, standardised training, and ongoing SCC support tailored to Aboriginal and Torres Strait Islander pregnant women.
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Wotherspoon, Craig, and Cylie M. Williams. "Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service." Australian Health Review 43, no. 2 (2019): 217. http://dx.doi.org/10.1071/ah17096.
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Objective There continue to be disparate health outcomes for people who are Aboriginal and Torres Strait Islander. The aim of the present study was to measure whether there were any differences in in-patient experiences between Aboriginal and Torres Strait Islander people and those without an Aboriginal or Torres Strait Islander background. Methods Random samples of people were invited to complete a survey following admission at the hospitals at Peninsula Health, Victoria, Australia. This survey was based on the Victorian Patient Satisfaction Monitor. Open-ended questions were also asked to gauge perspectives on how the services could better meet needs of Aboriginal and Torres Strait Islander patients. Results A total of 154 responses was obtained. There were differences between the two groups of participants in the following variables: respect of privacy, representation of culture, assistance with meals and access to a culturally specific worker if needed. This was reflected in thematic analysis, with three main themes identified: (1) interactions with staff; (2) the challenging environment; and (3) not just about me, but my family too. Conclusion There were systemic differences in in-patient experiences. Healthcare services have a responsibility to make systemic changes to improve the health care of all Australians by understanding and reforming how services can be appropriately delivered. What is known about the topic? There is a disparity in health outcomes between Aboriginal and Torres Strait Islander Australians and those who do not identify as Aboriginal and/or Torres Strait Islander. In addition, Aboriginal and Torres Strait Islanders have different interactions within healthcare services. Many rural health services have models that aim to deliver culturally appropriate services, but it is unknown whether the same challenges apply for this group of Australians within metropolitan health services. What does this paper add? This paper identifies the structural supports that are required to help close the gap in health care provision inequality. Many of the key issues identified are not people but system based. Healthcare administrators should consider the factors identified and address these at a whole-of-service level. What are the implications for practitioners? Many practitioners are aware of the challenges of providing culturally appropriate services. This research raises awareness of how traditional healthcare is not a one size fits all and flexibility is required to improve health outcomes.
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Gould, Gillian S., Andy McEwen, and Joanne Munn. "Jumping the Hurdles for Smoking Cessation in Pregnant Aboriginal and Torres Strait Islander Women in Australia." Journal of Smoking Cessation 6, no. 1 (June 1, 2011): 33–36. http://dx.doi.org/10.1375/jsc.6.1.33.
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AbstractTobacco smoking perpetuates the disadvantages experienced by Aboriginal and Torres Strait Islander people in Australia. Tobacco smoking is a risk factor for poor maternal and infant outcomes in pregnancy. Over half of Aboriginal and Torres Strait Islander women smoke during pregnancy and few successfully quit. Aboriginal and Torres Strait Islander women face many intrinsic barriers to quitting such as low socioeconomic disadvantage and patterns of use in family networks. There are also several extrinsic hurdles surrounding current practice guidelines and policy that may limit success in reducing smoking rates among Aboriginal and Torres Strait Islander women during pregnancy: the use of the Stages of Change (SOC) model; delay in the use of nicotine replacement therapy (NRT); and the absence of subsidised intermittent NRT. A more proactive approach towards smoking cessation for pregnant Aboriginal and Torres Strait Islander women may be necessary, including moving away from the SOC model approach and subsidised provision of intermittent NRT. Comprehensive programs that take into account the family network and wider social context are also recommended.
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McKay, Fiona H., and Stephanie L. Godrich. "Interventions to address food insecurity among Aboriginal and Torres Strait Islander people: a rapid review." Applied Physiology, Nutrition, and Metabolism 46, no. 12 (December 2021): 1448–58. http://dx.doi.org/10.1139/apnm-2020-1075.
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Food insecurity disproportionately impacts Aboriginal and Torres Strait Islander Australians. This review sought to investigate research and evaluations of programs and interventions implemented to address food insecurity among Aboriginal and Torres Strait Islander communities. A rapid review was conducted to collate the available research from 6 databases. The search was conducted in May 2020. Search constructs related to food insecurity, Aboriginal and Torres Strait Islander people, and Australia. Twenty-five publications were included in this review, 24 reported on an intervention, while 9 were evaluations of an intervention. Interventions included behaviour change projects, including projects that sought to change purchasing and cooking behaviours, school-based education programs, and gardening programs. In general, the studies included in this sample were small and lacked a systematic consideration of the factors that shape the experience of food insecurity among Aboriginal and Torres Strait Islander people specifically. Based on the findings of this review, authors suggest greater consideration to the systematic determinants of food insecurity among Aboriginal and Torres Strait Islander communities to have lasting and sustainable impact on food insecurity. This review has been registered with the international prospective register of systematic reviews (PROSPERO: CRD42020183709). Novelty: Food insecurity among Aboriginal and Torres Strait Islander people poses significant risk to health and wellbeing. Small-scale food security interventions may not provide ongoing and sustained impact. Any intervention to promote food security will need to involve Aboriginal and Torres Strait Islander people and be sustained once external parties have left.
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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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Kum Sing, Selma, Daniel McDonough, and James Charles. "Health Website Evaluation - An Aboriginal and Torres Strait Islander Perspective: Assessing Quality and Cultrability of Health Websites in a Covid-19 Pandemic: A Literature Review." Journal of the Australian Indigenous HealthInfoNet 2, no. 3 (2021): 1–19. http://dx.doi.org/10.14221/aihjournal.v2n3.6.
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Introduction Health Websites have been used to improve the health and wellbeing of people since the internet was widely available to the world’s populations. The development of websites by health practitioners, hospitals, and governments has continued to grow over the past 20 years. Due to the restriction of movement and gatherings for populations globally caused by Covid-19, there has been a reliance on health information being disseminated via health websites. However, there has been little investigation into the appropriateness of health websites for Aboriginal and Torres Strait Islander communities. Aim Review literature on digital resources and evaluate health websites based on functionality, navigation, and usability. Assess the cultrability of the website design from an Aboriginal and Torres Strait Islander perspective and develop some evidence-based principles that can be used when designing and developing health websites for Aboriginal and Torres Strait Islander Peoples. Method The literature review explores essential website evaluation criteria and frameworks for assessing design, functionality, navigation, and usability. In addition, literature search for website evaluations of global Indigenous cultural appropriate design and content. The literature search accessed several databases i.e., Emerald, EBSCOhost, Medline Ovid, CINHAL and Google Scholar. Additional searches using Clinical Knowledge Networks Federation accessed through the Townsville Hospital Health Library. The search produced a total of 534 articles, and 14 were deemed relevant for inclusion. Discussion The thematic analysis identified that Indigenous global presence on the Internet has been extensive, and the most successful examples were developed in collaboration with Indigenous Peoples. A comprehensive evaluation of website content is paramount in validating the appropriateness of communication and engagement with Aboriginal and Torres Strait Islander People. A customer/end user model of evaluation is the recommended type of evaluation for websites intending to target Aboriginal and Torres Strait Islander People. There are significant challenges for Aboriginal and Torres Strait Islander People navigating digital technology and websites, especially families living in rural and remote areas. These difficulties are not being addressed by services or governments to alleviate these barriers. Conclusion Aboriginal and Torres Strait Islander Peoples are actively involved in digital technology and websites, however their experience on the internet has been challenging and disempowering. The evidence provided alluded to negative experiences and constant challenges to have a growing presence in the digital space. The studies showed no evidence of Aboriginal and Torres Strait Islander People’s experience of website design, or development, which demonstrated positive outcomes or future developments in this area. Improving health, health literacy and health services will take a collaborative effort across all areas of health and education. Indigenous knowledges in all its forms must be protected and respected through intellectual property and reciprocity with websites and digital resources.
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Gooda, Mick. "The research road less travelled." Microbiology Australia 30, no. 5 (2009): 169. http://dx.doi.org/10.1071/ma09169.
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If there is one thing that should be clear by now to anyone working in the area of Aboriginal and Torres Strait Islander health, it is that biomedical research carried out in isolation from the Aboriginal and Torres Strait Islander community will not significantly improve health outcomes for Australia?s Indigenous peoples.
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Pearce, Leilani, and Bronwyn Fredericks. "Establishing a Community-Controlled Multi-Institutional Centre for Clinical Research Excellence in Aboriginal and Torres Strait Islander Health." Australian Journal of Indigenous Education 36, S1 (2007): 121–28. http://dx.doi.org/10.1017/s1326011100004798.
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AbstractThe Queensland Aboriginal and Islander Health Council (QAIHC) lead and govern the Centre for Clinical Research Excellence (CCRE), which has a focus on circulatory and associated conditions in urban Aboriginal and Torres Strait Islander communities. The CCRE is a partnership between QAIHC and Monash University, the Queensland University of Technology, the University of Queensland, James Cook University, the National Heart Foundation, and the University of Wollongong. The establishment of the CCRE under the community-controlled model of governance is unique and presents both opportunities and challenges for innovative partnerships between universities and Aboriginal and Torres Strait Islander community organisations. This paper outlines the processes and strategies used to establish a multi-institutional research centre that is governed by the Aboriginal and Torres Strait Islander community-controlled health sector.
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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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Griffiths, Kalinda, Ian Ring, Richard Madden, and Lisa Jackson Pulver. "In the pursuit of equity: COVID-19, data and Aboriginal and Torres Strait Islander people in Australia." Statistical Journal of the IAOS 37, no. 1 (March 22, 2021): 37–45. http://dx.doi.org/10.3233/sji-210785.
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Since March 2020 in Australia, there has been decisive national, and state and territory policy as well as community led action involving Aboriginal and Torres Strait Islander people as information about COVID-19 arose. This has resulted in, what could only be framed as a success story in self-determination. However, there continues to be issues with the quality of data used for the surveillance and reporting of Aboriginal and Torres Strait Islander people during the pandemic. This article discusses some of the important events in pandemic planning regarding Aboriginal and Torres Strait Islander people and how this relates to surveillance and monitoring in the emerging and ongoing threat of COVID-19 within Aboriginal and Torres Strait Islander communities. The authors also identify some of the data considerations required in the future to monitor and address public health.
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Henson, Connie, Felicity Chapman, Gina Shepherd, Bronwyn Carlson, Josephine Y. Chau, Josephine Gwynn, Deb McCowen, Boe Rambaldini, Katrina Ward, and Kylie Gwynne. "Mature aged Aboriginal and Torres Strait Islander adults are using digital health technologies (original research)." DIGITAL HEALTH 8 (January 2022): 205520762211458. http://dx.doi.org/10.1177/20552076221145846.
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Background Aboriginal and Torres Strait Islander people avidly use technology for a variety of purposes. Digital health technologies offer a new way to build on Aboriginal and Torres Strait Islander peoples propensity for early adoption and innovation with technology. Only limited research has focused on mature aged adults in non-urban locations as partners in digital health research and there is no research related to wearables for health tracking for this cohort. Objective This paper provides insights into mature aged Aboriginal and Torres Strait Islander adults interest, use and trust of social media, apps and wearables to gain health information and manage health. Methods This cross-sectional survey study was co-designed and co-implemented with Aboriginal Community Controlled Health Services (ACCHS) in three locations in New South Wales, Australia. The 13-item survey was administered via a semi-structured interview. Results Aboriginal and Torres Strait Islander adults ( n = 78), in regional, rural and remote locations indicated their interest in and use of apps and wearables for health purposes. Mature aged participants, particularly women, used Facebook, ACCHS websites and YouTube for acquiring health-related information which they then shared online and in real life with a diversity of family, friends and colleagues. Conclusions Aboriginal and Torres Strait Islander people are using digital health technologies to acquire and share health information and want to use apps and wearables for health management. Co-designed research enables a greater understanding of the diverse needs for different cohorts and informs culturally responsible design. Broader use of co-design will foster effective user-focused digital health communication and health-management.
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Poirier, Brianna F., Joanne Hedges, Gustavo Soares, and Lisa M. Jamieson. "Aboriginal Community Controlled Health Services: An Act of Resistance against Australia’s Neoliberal Ideologies." International Journal of Environmental Research and Public Health 19, no. 16 (August 15, 2022): 10058. http://dx.doi.org/10.3390/ijerph191610058.
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The individualistic and colonial foundations of neoliberal socio-political ideologies are embedded throughout Australian health systems, services, and discourses. Not only does neoliberalism undermine Aboriginal and Torres Strait Islander collectivist values by emphasizing personal autonomy, but it has significant implications for Aboriginal and Torres Strait Islander health. Aboriginal Community Controlled Health Services (ACCHS) operate within Community-oriented holistic understandings of well-being that contradict neoliberal values that Western health services operate within. Therefore, this paper aims to explore the role of ACCHS in resisting the pervasive nature of neoliberalism through the prioritization of self-determination for Aboriginal and Torres Strait Islander Peoples. Utilizing a critical evaluative commentary, we reflect on Aboriginal political leadership and advocacy during the 1970s and 1980s and the development of neoliberalism in Australia in the context of ACCHS. Community controlled primary health services across Australia are the only remaining government-funded and Aboriginal-controlled organizations. Not only do ACCHS models resist neoliberal ideologies of reduced public expenditure and dominant individualistic models of care, but they also incontrovertibly strengthen individual and Community health. ACCHS remain the gold standard model by ensuring Aboriginal and Torres Strait Islander rights to the self-determination of health in accordance with the United Nations Declaration of the Rights of Indigenous Peoples.
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Ride, Katherine, and Samantha Burrow. "Review of diabetes among Aboriginal and Torres Strait Islander people." Journal of the Australian Indigenous HealthInfoNet 3, no. 2 (2022): 1–43. http://dx.doi.org/10.14221/aihjournal.v3n2.1.
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Diabetes is the fastest growing chronic disease condition globally. Type 2 diabetes in particular, has reached epidemic proportions, with the greatest burden falling on socially disadvantaged groups and Indigenous peoples. This review focuses primarily on type 2 diabetes among Aboriginal and Torres Strait Islander people, which is responsible for the majority of cases of diabetes in this population. It provides general information on the social and cultural context of diabetes, and the behavioural and biomedical factors that contribute to diabetes among Aboriginal and Torres Strait Islander people. This review provides detailed information on: the extent of diabetes among Aboriginal and Torres Strait Islander people, including incidence and prevalence data; hospitalisations; mortality and burden of disease the prevention and management of diabetes relevant programs, services, policies and strategies that address the health issue of diabetes among Aboriginal and Torres Strait Islander people two special population groups: adolescents pregnant and post-partum women. This review concludes by suggesting possible future directions for combatting the growing epidemic of diabetes among Aboriginal and Torres Strait Islander people. This review is part of a suite of knowledge exchange products that includes a summary, a video, and a fact sheet.
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Dudgeon, Patricia, Jemma R. Collova, Kate Derry, and Stewart Sutherland. "Lessons Learned during a Rapidly Evolving COVID-19 Pandemic: Aboriginal and Torres Strait Islander-Led Mental Health and Wellbeing Responses Are Key." International Journal of Environmental Research and Public Health 20, no. 3 (January 25, 2023): 2173. http://dx.doi.org/10.3390/ijerph20032173.
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As the world journeys towards the endemic phase that follows a pandemic, public health authorities are reviewing the efficacy of COVID-19 pandemic responses. The responses by Aboriginal and Torres Strait Islander communities in Australia have been heralded across the globe as an exemplary demonstration of how self-determination can achieve optimal health outcomes for Indigenous peoples. Despite this success, the impacts of pandemic stressors and public health responses on immediate and long-term mental health and wellbeing require examination. In December 2021, Aboriginal and Torres Strait Islander mental health and wellbeing leaders and allies (N = 50) attended a virtual roundtable to determine the key issues facing Aboriginal and Torres Strait Islander peoples and communities, and the actions required to address these issues. Roundtable attendees critically reviewed how the rapidly evolving pandemic context has impacted Aboriginal and Torres Strait Islander mental health and social and emotional wellbeing (SEWB). This paper presents an overview of this national collaborative consultation process, and a summary of the key issues and actions identified. These results build on evidence from other roundtables held in Australia during 2020, and the emerging consensus across the globe that Indigenous self-determination remains essential to Indigenous SEWB, especially during and following a pandemic.
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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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Bird, Jennifer, Darlene Rotumah, James Bennett-Levy, and Judy Singer. "Diversity in eMental Health Practice: An Exploratory Qualitative Study of Aboriginal and Torres Strait Islander Service Providers." JMIR Mental Health 4, no. 2 (May 29, 2017): e17. http://dx.doi.org/10.2196/mental.7878.
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Background In Australia, mental health services are undergoing major systemic reform with eMental Health (eMH) embedded in proposed service models for all but those with severe mental illness. Aboriginal and Torres Strait Islander service providers have been targeted as a national priority for training and implementation of eMH into service delivery. Implementation studies on technology uptake in health workforces identify complex and interconnected variables that influence how individual practitioners integrate new technologies into their practice. To date there are only two implementation studies that focus on eMH and Aboriginal and Torres Strait Islander service providers. They suggest that the implementation of eMH in the context of Aboriginal and Torres Strait Islander populations may be different from the implementation of eMH with allied health professionals and mainstream health services. Objective The objective of this study is to investigate how Aboriginal and Torres Strait Islander service providers in one regional area of Australia used eMH resources in their practice following an eMH training program and to determine what types of eMH resources they used. Methods Individual semistructured qualitative interviews were conducted with a purposive sample of 16 Aboriginal and Torres Strait Islander service providers. Interviews were co-conducted by one indigenous and one non-indigenous interviewer. A sample of transcripts were coded and thematically analyzed by each interviewer and then peer reviewed. Consensus codes were then applied to all transcripts and themes identified. Results It was found that 9 of the 16 service providers were implementing eMH resources into their routine practice. The findings demonstrate that participants used eMH resources for supporting social inclusion, informing and educating, assessment, case planning and management, referral, responding to crises, and self and family care. They chose a variety of types of eMH resources to use with their clients, both culturally specific and mainstream. While they referred clients to online treatment programs, they used only eMH resources designed for mobile devices in their face-to-face contact with clients. Conclusions This paper provides Aboriginal and Torres Strait islander service providers and the eMH field with findings that may inform and guide the implementation of eMH resources. It may help policy developers locate this workforce within broader service provision planning for eMH. The findings could, with adaptation, have wider application to other workforces who work with Aboriginal and Torres Strait Islander clients. The findings highlight the importance of identifying and addressing the particular needs of minority groups for eMH services and resources.
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Ban, Paul. "Access and attitudes to health care of Torres Strait Islanders living in mainland Australia." Australian Journal of Primary Health 10, no. 2 (2004): 29. http://dx.doi.org/10.1071/py04023.
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Ninety-two mainland Torres Strait Islanders, across five communities on mainland Australia, were consulted in relation to their access to health service providers. Similar numbers were interviewed in different-sized locations encompassing urban, rural, and remote areas. This exploratory study was the first to consider the health access issues of mainland Torres Strait Islanders. Overall, community controlled health services were the most commonly used exclusive health service providers, followed by private medical services and hospital outpatient services. The two most common reasons for the choice of health service provider in each community were convenience of access and the quality of relationship and trust with the medical staff. In general, the Torres Strait Islanders interviewed stated they are not comfortable seeking medical treatment, and delay accessing any health services. There was a high level of satisfaction in all communities with private medical services. Concerns were raised regarding long waiting periods at community controlled health services and hospital outpatient services, along with lack of confidentiality at community controlled health services. People wanted to see Torres Strait Islander staff at community controlled health services and hospital outpatient services to help facilitate greater access.
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Thompson, Kelly J., Simon R. Finfer, Julieann Coombes, Sandra Eades, Kate Hunter, Robert Neil F. Leong, Ebony Lewis, and Bette Liu. "Incidence and outcomes of sepsis in Aboriginal and Torres Strait Islander and non-Indigenous residents of New South Wales: population-based cohort study." Critical Care and Resuscitation 23, no. 3 (September 6, 2021): 337–45. http://dx.doi.org/10.51893/2021.3.oa11.
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OBJECTIVE: To estimate the incidence and outcomes of sepsis hospitalisations in Aboriginal and Torres Strait Islander and non-Indigenous residents of New South Wales. DESIGN AND PARTICIPANTS: Prospective cohort study of residents aged 45 years and older, recruited between 2006 and 2009, and followed for hospitalisation for sepsis. MAIN OUTCOME MEASURES: Incidence and hazard ratio (HR) of sepsis hospitalisation and intensive care unit (ICU) admission identified using International Classification of Diseases (10th revision) coding on discharge data. Length of stay, readmission and mortality in those admitted for sepsis. RESULTS: Of 264 678 participants, 1928 (0.7%) identified as Aboriginal and/or Torres Strait Islander. Sepsis hospitalisation was higher in Aboriginal and Torres Strait Islander participants (8.67 v 6.12 per 1000 person-years; age- and sex-adjusted HR, 2.35; 95% CI, 1.98–2.80) but was attenuated after adjusting for sociodemographic factors, health behaviour and comorbidities (adjusted HR, 1.56; 95% CI, 1.31–1.86). Among those hospitalised for sepsis, after adjusting for age and sex, there were no differences between the proportions of Aboriginal and Torres Strait Islander and non-Indigenous participants admitted to an ICU (18.0% v 16.1%; P = 0.42) or deceased at 1 year (36.1% v 36.8%; P = 0.92). Aboriginal and Torres Strait Islander participants had shorter lengths of hospital stay (9.98 v 11.72 days; P < 0.001) and ICU stay (4.38 v 6.35 days; P < 0.001) than non-Indigenous participants. Overall, more than 70% of participants were readmitted to hospital within 1 year. CONCLUSION: We found that the rate of sepsis hospitalisation in NSW was higher for Aboriginal and Torres Strait Islander adults. Culturally appropriate, community-led strategies targeting chronic disease prevention and the social determinants of health may reduce this gap. Preventing readmission following sepsis is a priority for all Australians.