Artykuły w czasopismach na temat „Aboriginal Australians – Health and hygiene – Research”
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Durey, A., D. McAullay, B. Gibson i L. M. Slack-Smith. "Oral Health in Young Australian Aboriginal Children". JDR Clinical & Translational Research 2, nr 1 (27.09.2016): 38–47. http://dx.doi.org/10.1177/2380084416667244.
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Despite dedicated government funding, Aboriginal Australians, including children, experience more dental disease than other Australians, despite it being seen as mostly preventable. The ongoing legacy of colonization and discrimination against Aboriginal Australians persists, even in health services. Current neoliberal discourse often holds individuals responsible for the state of their health, rather than the structural factors beyond individual control. While presenting a balanced view of Aboriginal health is important and attests to Indigenous peoples’ resilience when faced with persistent adversity, calling to account those structural factors affecting the ability of Aboriginal people to make favorable oral health choices is also important. A decolonizing approach informed by Indigenous methodologies and whiteness studies guides this article to explore the perceptions and experiences of Aboriginal parents ( N = 52) of young children, mainly mothers, in Perth, Western Australia, as they relate to the oral health. Two researchers, 1 Aboriginal and 1 non-Aboriginal, conducted 9 focus group discussions with 51 Aboriginal participants, as well as 1 interview with the remaining individual, and independently analyzed responses to identify themes underpinning barriers and enablers to oral health. These were compared, discussed, and revised under key themes and interpreted for meanings attributed to participants’ perspectives. Findings indicated that oral health is important yet often compromised by structural factors, including policy and organizational practices that adversely preclude participants from making optimal oral health choices: limited education about prevention, prohibitive cost of services, intensive marketing of sugary products, and discrimination from health providers resulting in reluctance to attend services. Current government intentions center on Aboriginal–non-Aboriginal partnerships, access to flexible services, and health care that is free of racism and proactively seeks and welcomes Aboriginal people. The challenge is whether these good intentions are matched by policies and practices that translate into sustained improvements to oral health for Aboriginal Australians. Knowledge Transfer Statement: Slow progress in reducing persistent oral health disparities between Aboriginal and non-Aboriginal Australians calls for a new approach to this seemingly intractable problem. Findings from our qualitative research identified that structural factors—such as cost of services, little or no education on preventing oral disease, and discrimination by health providers—compromised Aboriginal people’s optimum oral health choices and access to services. The results from this study can be used to recommend changes to policies and practices that promote rather than undermine Aboriginal health and well-being and involve Aboriginal people in decisions about their health care.
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Lavrencic, Louise M., Holly A. Mack, Gail Daylight, Sharon Wall, Margaret Anderson, Sue Hoskins, Emily Hindman, Gerald A. Broe i Kylie Radford. "Staying in touch with the community: understanding self-reported health and research priorities in older Aboriginal Australians". International Psychogeriatrics 32, nr 11 (21.11.2019): 1303–15. http://dx.doi.org/10.1017/s1041610219001753.
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ABSTRACTObjectives:Aboriginal Australians experience higher rates of non-communicable chronic disease, injury, dementia, and mortality than non-Aboriginal Australians. Self-reported health is a holistic measure and may fit well with Aboriginal views of health and well-being. This study aimed to identify predictors of self-reported health in older Aboriginal Australians and determine acceptable research methodologies for future aging research.Design:Longitudinal, population-based study.Setting:Five communities across New South Wales, Australia (two urban and three regional sites).Participants:Aboriginal and Torres Strait Islander people (n = 227; 60–88 years, M = 66.06, SD = 5.85; 145 female).Measurements:Participants completed baseline (demographic, medical, cognitive, mental health, and social factors) and follow-up assessments (self-reported health quantified with 5-point scale; sharing thoughts on areas important for future research). Predictors of self-reported health were examined using logistic regression analyses.Results:Self-reported health was associated with sex, activities of daily living, social activity participation, resilience, alcohol use, kidney problems, arthritis, falls, and recent hospitalization. Arthritis, kidney problems, and resilience remained significant in multiple logistic regression models.Conclusions:Perceived resilience and the absence of certain chronic age-related conditions predict older Aboriginal peoples’ self-reported health. Understanding these factors could inform interventions to improve well-being. Findings on acceptable research methodologies suggest that many older Aboriginal people would embrace a range of methodologies within long-standing research partnerships, which is an important consideration for Indigenous population research internationally.
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Emden, Carolyn, Inge Kowanko, Charlotte de Crespigny i Helen Murray. "Better medication management for Indigenous Australians: findings from the field". Australian Journal of Primary Health 11, nr 1 (2005): 80. http://dx.doi.org/10.1071/py05011.
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This paper reports findings from interviews and focus groups conducted within a multi-dimensional action research project concerning medication management among Indigenous Australians. Participants were Aboriginal people with mental health problems, carers and family members, and health and social service workers from different regions in South Australia. A meta-analysis of findings from each regional project component was conducted, and major themes conceptualised and developed into a coherent summary. The findings revealed problems of a magnitude not previously realised - mental health problems (including alcohol and drug problems) and medication management among Aboriginal people clearly are major issues requiring immediate and sustained attention if the health and welfare of the Australian Indigenous population are to be improved. Findings concerned eight major areas: social and emotional wellbeing issues; stressors on Aboriginal health services and providers; training for the Aboriginal health workforce; mainstream health services for Aboriginal people; trust and confidentiality within Aboriginal health services; English language literacy and numeracy skills of Aboriginal clients; remote living arrangements for many Aboriginal people; problems with alcohol use; and institutionalised and individual racism in the community at large.
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Atkinson-Briggs, Sharon, Alicia Jenkins, Christopher Ryan i Laima Brazionis. "Prevalence of Health-Risk Behaviours Among Indigenous Australians With Diabetes: A Review". Journal of the Australian Indigenous HealthInfoNet 3, nr 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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Thompson, Sandra C., Emma Haynes, John A. Woods, Dawn C. Bessarab, Lynette A. Dimer, Marianne M. Wood, Frank M. Sanfilippo, Sandra J. Hamilton i Judith M. Katzenellenbogen. "Improving cardiovascular outcomes among Aboriginal Australians: Lessons from research for primary care". SAGE Open Medicine 4 (1.01.2016): 205031211668122. http://dx.doi.org/10.1177/2050312116681224.
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Background: The Aboriginal people of Australia have much poorer health and social indicators and a substantial life expectancy gap compared to other Australians, with premature cardiovascular disease a major contributor to poorer health. This article draws on research undertaken to examine cardiovascular disparities and focuses on ways in which primary care practitioners can contribute to reducing cardiovascular disparities and improving Aboriginal health. Methods: The overall research utilised mixed methods and included data analysis, interviews and group processes which included Aboriginal people, service providers and policymakers. Workshop discussions to identify barriers and what works were recorded by notes and on whiteboards, then distilled and circulated to participants and other stakeholders to refine and validate information. Additional engagement occurred through circulation of draft material and further discussions. This report distils the lessons for primary care practitioners to improve outcomes through management that is attentive to the needs of Aboriginal people. Results: Aspects of primordial, primary and secondary prevention are identified, with practical strategies for intervention summarised. The premature onset and high incidence of Aboriginal cardiovascular disease make prevention imperative and require that primary care practitioners understand and work to address the social underpinnings of poor health. Doctors are well placed to reinforce the importance of healthy lifestyle at all visits to involve the family and to reduce barriers which impede early care seeking. Ensuring better information for Aboriginal patients and better integrated care for patients who frequently have complex needs and multi-morbidities will also improve care outcomes. Conclusion: Primary care practitioners have an important role in improving Aboriginal cardiovascular care outcomes. It is essential that they recognise the special needs of their Aboriginal patients and work at multiple levels both outside and inside the clinic for prevention and management of disease. A toolkit of proactive and holistic opportunities for interventions is proposed.
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Gentile, Victoria, Adrian Carter i Laura Jobson. "Examining the Associations Between Experiences of Perceived Racism and Drug and Alcohol Use in Aboriginal Australians". Journal of the Australian Indigenous HealthInfoNet 3, nr 1 (2022): 1–18. http://dx.doi.org/10.14221/aihjournal.v3n1.3.
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Objective This study aimed to explore the relationships between experiences of perceived racism, mental health and drug and alcohol use among Aboriginal Australians. Method Sixty-two Aboriginal Australians, ranging in age from 19-64 years (Mage = 33.71, SD = 12.47) and residing in Victoria completed an online questionnaire containing measures of perceived racism, alcohol use, substance use and mental health. Results First, 66% of the sample reported experiencing interpersonal racism, with the highest proportion of reported experiences occurring in health settings, educational/academic settings and by staff of government agencies. Second, perceived racism was significantly associated with poorer mental health and well-being. Finally, while perceived racism was not significantly associated with substance use, there was an indirect pathway from perceived racism to substance use through mental health concerns. Conclusions The current research indicates that racism is still frequently experienced by Aboriginal Australians and is directly associated with poorer mental health, and indirectly with substance use through poorer mental health. The findings demonstrate a clear need for further research in this area.
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Kerrigan, Vicki, Rarrtjiwuy Melanie Herdman, David P. Thomas i Marita Hefler. "'I still remember your post about buying smokes': a case study of a remote Aboriginal community-controlled health service using Facebook for tobacco control". Australian Journal of Primary Health 25, nr 5 (2019): 443. http://dx.doi.org/10.1071/py19008.
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Many Aboriginal Community Controlled Health Services (ACCHS) embrace Facebook as an organisational tool to share positive stories, which counter the negative narrative surrounding Aboriginal issues. However, the Facebook algorithm prioritises posts on personal pages over organisations. To take advantage of the algorithm, this project paid three Yolŋu employees of a north-east Arnhem Land ACCHS to share quit smoking messages on their personal Facebook pages. Smoking prevalence among Aboriginal and Torres Strait Islander Australians is nearly three-fold higher than non-Indigenous Australians, and previous research has identified the need for culturally appropriate communication approaches to accelerate the decline in Indigenous smoking. This research found Yolŋu participants nurtured healthy behaviours through compassionate non-coercive communications, in contrast to fear-inducing health warnings prevalent in tobacco control. Cultural tailoring of tobacco control messages was achieved by having trusted local health staff sharing, and endorsing, messages regardless of whether the content was Indigenous specific. This research also revealed online Facebook activity does not reflect the reach of posts, which may extend beyond social media users to individuals who do not have a Facebook profile.
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Bainbridge, Roxanne, Mary Whiteside i Janya McCalman. "Being, Knowing, and Doing". Qualitative Health Research 23, nr 2 (3.12.2012): 275–88. http://dx.doi.org/10.1177/1049732312467853.
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Researchers working with Aboriginal Australian partners are confronted with an array of historical, social, and political complexities which make it difficult to come to theoretical and methodological decisions. In this article, we describe a culturally safe and respectful framework that maintains the intellectual and theoretical rigor expected of academic research. As an Aboriginal woman and two non-Aboriginal women, we discuss the arguments and some of the challenges of using grounded theory methods in Aboriginal Australian contexts, giving examples from our studies of Aboriginal empowerment processes. We argue that the ethics of care and responsibility embedded in Aboriginal research methodologies fit well with grounded theory studies of Aboriginal social processes. We maintain that theory development grounded in data provides useful insights into the processes for raising the health, well-being, and prosperity of Aboriginal Australians.
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Shahid, Shaouli, Lizzie Finn, Dawn Bessarab i Sandra C. Thompson. "'Nowhere to room … nobody told them': logistical and cultural impediments to Aboriginal peoples' participation in cancer treatment". Australian Health Review 35, nr 2 (2011): 235. http://dx.doi.org/10.1071/ah09835.
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Background. Cancer mortality among Indigenous Australians is higher compared to the non-Indigenous population and attributed to poor access to cancer detection, screening, treatment and support services. A large proportion of Indigenous Australians live in rural and remote areas which makes access to cancer treatment services more challenging. Factors, such as transport, accommodation, poor socio-economic status and cultural appropriateness of services also negatively affect health service access and, in turn, lead to poor cancer outcomes. Design, setting and participants. Qualitative research with 30 in-depth interviews was conducted with Aboriginal people affected by cancer from across WA, using a variety of recruitment approaches. Results. The infrastructure around the whole-of-treatment experience affected the decision-making and experiences of Aboriginal patients, particularly affecting rural residents. Issues raised included transport and accommodation problems, travel and service expenses, displacement from family, concerns about the hospital environment and lack of appropriate support persons. These factors are compounded by a range of disadvantages already experienced by Aboriginal Australians and are vital factors affecting treatment decision-making and access. Conclusion. To improve cancer outcomes for Aboriginal people, logistical, infrastructure and cultural safety issues must be addressed. One way of ensuring this could be by dedicated support to better coordinate cancer diagnostic and treatment services with primary healthcare services. What is known about the topic? Cancer is a major cause of death among Indigenous Australians who are generally diagnosed later with their disease, have poorer continuity of care and lower uptake and completion of cancer treatment. For cancer diagnosis at an equivalent stage of cancer, Aboriginal people have poorer outcomes. What does this paper add? This study documents Aboriginal perspectives on basic infrastructure and logistical problems which impede their accessing hospital-based cancer treatments: transport, accommodation, preparation for the experience of hospital and cancer treatment, service affordability and the certainty of support services. What are the implications for practitioners? There are difficulties for practitioners in addressing the geographic, socioeconomic and cultural differences that Aboriginal people face in accessing cancer treatment. System level changes to ensure cultural safety, social support and better coordination with primary healthcare are essential to improve outcomes of Aboriginal people with cancer.
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Cheng, Yeu-Yao, Jack Nunn, John Skinner, Boe Rambaldini, Tiffany Boughtwood, Tom Calma, Alex Brown i in. "A Pathway to Precision Medicine for Aboriginal Australians: A Study Protocol". Methods and Protocols 4, nr 2 (21.06.2021): 42. http://dx.doi.org/10.3390/mps4020042.
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(1) Background: Genomic precision medicine (PM) utilises people’s genomic data to inform the delivery of preventive and therapeutic health care. PM has not been well-established for use with people of Aboriginal and Torres Strait Islander ancestry due to the paucity of genomic data from these communities. We report the development of a new protocol using co-design methods to enhance the potential use of PM for Aboriginal Australians. (2) Methods: This iterative qualitative study consists of five main phases. Phase-I will ensure appropriate governance of the project and establishment of a Project Advisory Committee. Following an initial consultation with the Aboriginal community, Phase-II will invite community members to participate in co-design workshops. In Phase-III, the Chief Investigators will participate in co-design workshops and document generated ideas. The notes shall be analysed thematically in Phase-IV with Aboriginal community representatives, and the summary will be disseminated to the communities. In Phase-V, we will evaluate the co-design process and adapt our protocol for the use in partnership with other communities. (3) Discussion: This study protocol represents a crucial first step to ensure that PM research is relevant and acceptable to Aboriginal Australians. Without fair access to PM, the gap in health outcome between Aboriginal and non-Aboriginal Australians will continue to widen.
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Bovill, Michelle, Yael Bar-Zeev, Maree Gruppetta, Peter O'Mara, Brett Cowling i Gillian S. Gould. "Collective and negotiated design for a clinical trial addressing smoking cessation supports for Aboriginal and Torres Strait Islander mothers in NSW, SA and Qld – developing a pilot study". Australian Journal of Primary Health 23, nr 6 (2017): 497. http://dx.doi.org/10.1071/py16140.
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Tobacco smoking leads to one in five deaths of Aboriginal Australians and accounts for 17% of the reversible health gap. One in two Aboriginal women are reported to smoke during pregnancy, with no effective strategies currently available for health practitioners to utilise for supporting Aboriginal women. Aboriginal community participation in primary health research is crucial to implementing ethical research, with a clear benefit to the people and communities involved. However, currently there is little evidence on how Aboriginal programs and interventions are being developed in partnership with Aboriginal people and communities. ‘Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy’ aims to address the prevalence of smoking during pregnancy by enhancing health providers’ training in offering evidence-based smoking cessation care to Aboriginal mothers during pregnancy. This paper outlines the participatory research approach adopted for the developmental phase of the ‘ICAN QUIT in Pregnancy’ project developed in partnership with two Aboriginal Community-Controlled Health Services in NSW, and negotiation processes undertaken to implement a pilot intervention across NSW, SA and Qld.
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Cosh, Suzanne, Lauren Maksimovic, Kerry Ettridge, David Copley i Jacqueline A. Bowden. "Aboriginal and Torres Strait Islander utilisation of the Quitline service for smoking cessation in South Australia". Australian Journal of Primary Health 19, nr 2 (2013): 113. http://dx.doi.org/10.1071/py11152.
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Smoking prevalence among Indigenous Australians far exceeds that of non-Indigenous Australians and is considered the greatest contributor to burden of disease for Indigenous Australians. The Quitline is a primary intervention for facilitating smoking cessation and, given the health implications of tobacco use, maximising its effectiveness for Indigenous Australians is imperative. However, the utilisation and effectiveness of this service within the Indigenous Australian population has not been examined. This study explores the utilisation of the South Australian Quitline by smokers identifying as Indigenous Australian. Quitline counsellors collected data regarding demographic characteristics, and smoking and quitting behaviour from Quitline callers in 2010. Results indicated that the proportion of Indigenous and non-Indigenous smokers who registered for the service was comparable. Demographic variables and smoking addiction at time of registration with the Quitline were similar for Indigenous and non-Indigenous callers. However, results indicated that Indigenous callers received significantly fewer callbacks than non-Indigenous callers and were significantly less likely to set a quit date. Significantly fewer Indigenous callers reported that they were still successfully quit at 3 months. Thus, Indigenous Australian callers may be less engaged with the Quitline and further research is required exploring whether the service could be tailored to make it more engaging for Indigenous Australians who smoke.
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Meiklejohn, Judith A., Brian Arley, Ross Bailie, Jon Adams, Gail Garvey, Jennifer H. Martin, Euan T. Walpole i Patricia C. Valery. "Community-identified recommendations to enhance cancer survivorship for Aboriginal and Torres Strait Islander people". Australian Journal of Primary Health 24, nr 3 (2018): 233. http://dx.doi.org/10.1071/py17127.
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Indigenous Australians diagnosed with cancer experience higher mortality and lower survival rates compared to non-Indigenous Australians. Reasons are multifaceted and complex. Knowledge about Indigenous cancer survivors’ perspectives of positive cancer survivorship is a gap in research evidence. The study explored cancer survivorship perspectives of Indigenous cancer survivors, their support people and healthcare workers with a view to developing recommendations for cancer survivorship. Indigenous Australians who completed cancer treatment in the previous 6 months to 5 years, their support people and primary healthcare workers were recruited from primary healthcare centres and a large tertiary Queensland hospital. Semi-structured interviews and focus groups were conducted with written and informed consent obtained prior. Participants emphasised key action areas and recommendations to enhance cancer survivorship, namely: establishing a community cancer advocate and peer support program, availability and use of a cancer-specific Indigenous primary healthcare worker and hospital-based Indigenous patient navigator, as well as adoption of question prompt lists and cancer survivorship care plans. Existing research suggests significant benefits from implementing the key recommendations identified in this study. Greater support and commitment across health sectors and funding bodies is needed to promote institutional change and health system development.
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DiGiacomo, Michelle L., Sandra C. Thompson, Julie S. Smith, Kate P. Taylor, Lynette A. Dimer, Mohammed A. Ali, Marianne M. Wood, Timothy G. Leahy i Patricia M. Davidson. "'I don't know why they don't come': barriers to participation in cardiac rehabilitation". Australian Health Review 34, nr 4 (2010): 452. http://dx.doi.org/10.1071/ah09803.
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Objectives. To describe health professionals’ perceptions of Aboriginal people’s access to cardiac rehabilitation (CR) services and the role of institutional barriers in implementing the National Health and Medical Research Council (NHMRC) guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander peoples. Design. Qualitative study. Setting. Metropolitan and rural tertiary and community-based public CR services and Aboriginal health services in WA. Participants. Thirty-eight health professionals working in the CR setting. Method. Semistructured interviews were undertaken with 28 health professionals at public CR services and 10 health professionals from Aboriginal Medical Services in WA. The participants represented 17 services (10 rural, 7 metropolitan) listed in the WA Directory of CR services. Results. Emergent themes included (1) a lack of awareness of Aboriginal CR patients’ needs; (2) needs related to cultural awareness training for health professionals; and (3) Aboriginal health staff facilitate access for Aboriginal patients. Conclusions. Understanding the institutional barriers to Aboriginal participation in CR is necessary to recommend viable solutions. Promoting cultural awareness training, recruiting Aboriginal health workers and monitoring participation rates are important in improving health outcomes. What is already known about this subject? Significant health and social inequity exists for Aboriginal Australians. Despite the persisting high rates of morbidity and mortality related to cardiovascular disease in Aboriginal Australians, participation rates in cardiac rehabilitation remain low. What does this paper add? Despite widespread dissemination of NHMRC guidelines, there remains a disconnect between CR health professionals’ understandings and practices and the needs of Aboriginal people in WA. Increasing the volume and quality of cultural awareness training as well as access to Aboriginal health professionals are crucial in addressing this disparity. What are the implications for practitioners? Increasing the number and support of Aboriginal people trained as health professionals will assist the system to respond better to the needs of communities. Collaborative partnership models where Aboriginal and non-Aboriginal health professionals work together to increase mutual understanding are warranted.
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FISHER, MATTHEW, SAMANTHA BATTAMS, DENNIS MCDERMOTT, FRAN BAUM i COLIN MACDOUGALL. "How the Social Determinants of Indigenous Health became Policy Reality for Australia's National Aboriginal and Torres Strait Islander Health Plan". Journal of Social Policy 48, nr 1 (28.05.2018): 169–89. http://dx.doi.org/10.1017/s0047279418000338.
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AbstractThe paper analyses the policy process which enabled the successful adoption of Australia's National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (NATSIHP), which is grounded in an understanding of the Social Determinants of Indigenous Health (SDIH). Ten interviews were conducted with key policy actors directly involved in its development. The theories we used to analyse qualitative data were the Advocacy Coalition Framework, the Multiple Streams Approach, policy framing and critical constructionism. We used a complementary approach to policy analysis. The NATSIHP acknowledges the importance of Aboriginal and Torres Strait Islander (hereafter, Aboriginal) culture and the health effects of racism, and explicitly adopts a human-rights-based approach. This was enabled by a coalition campaigning to ‘Close the Gap’ (CTG) in health status between Aboriginal and non-Aboriginal Australians. The CTG campaign, and key Aboriginal health networks associated with it, operated as an effective advocacy coalition, and policy entrepreneurs emerged to lead the policy agenda. Thus, Aboriginal health networks were able to successfully contest conventional problem conceptions and policy framings offered by government policy actors and drive a paradigm shift for Aboriginal health to place SDIH at the centre of the NATSIHP policy. Implications of this research for policy theory and for other policy environments are considered along with suggestions for future research.
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Der Vartanian, Carolyn, Vivienne Milch, Gail Garvey, Cleola Anderiesz, Jane Salisbury, Candice-Brooke Woods, Melissa Austen, Rhona Wang i Dorothy Mary Kate Keefe. "COVID-19 and cancer: Strategic health promotion for indigenous Australians during a pandemic." Journal of Clinical Oncology 39, nr 15_suppl (20.05.2021): e24028-e24028. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e24028.
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e24028 Background: Given the impact of COVID-19 on Indigenous and ethnic minority populations observed globally, keeping COVID-19 out of vulnerable Aboriginal and Torres Strait Islander (Indigenous Australian) communities remains a priority. Compared to non-Indigenous Australians, Indigenous Australians experience disparities in cancer incidence and outcomes due to social disadvantage, increased cancer-related modifiable risk factors, poorer access to health services and lower participation in screening. During the pandemic, cancer-related investigations and treatment reduced significantly in Australia, leading to potential decreases in cancer diagnoses and consequences for future survival outcomes. Concerned about the risk of morbidity and mortality due to COVID-19 for Indigenous Australians, as well as worsening cancer outcomes, Cancer Australia undertook strategic health promotion initiatives, to inform and support optimal cancer care. Methods: In consultation with respected Indigenous colleagues to ensure cultural appropriateness of language and information, we published a dedicated webpage titled ‘ Cancer and COVID-19 – what it means for our Mob*’ with tailored information, advice, and links to key resources and support services for Indigenous Australians. We also released a video titled ‘ Act early for our Mob’s Health’, providing targeted, culturally appropriate, consumer-friendly information to encourage Indigenous Australians to see their doctor or Aboriginal Health Worker with symptoms that may be due to cancer. Results: The information hub has been well-received among the Indigenous Australian community, receiving over 3,200 visits, and the social media campaigns have received over 1.4 million impressions and 46,000 video views between mid-March 2020 to mid-February 2021. This campaign has supported proactivity among the Indigenous population in keeping their communities safe during the pandemic, maintaining a population rate of COVID-19 of less than one percent of all confirmed cases in Australia. Conclusions: Culturally appropriate information and resources developed through the process of co-design can help to influence positive health behaviour change in Indigenous populations. We predict that our strategic, multi-channel health promotion campaign is contributing to keeping the Indigenous Australian community safe and informed during the pandemic, with additional work needed to monitor cancer rates and outcomes and address the ongoing information needs of the community. *Mob is a colloquial term to identify a group of Indigenous Australians associated with a family or community from a certain place.
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Martin, Robyn, Christina Fernandes, Cheryl Taylor, Amanda Crow, Desmond Headland, Nicola Shaw i Simone Zammit. "“We Don’t Want to Live Like This”: The Lived Experience of Dislocation, Poor Health, and Homelessness for Western Australian Aboriginal People". Qualitative Health Research 29, nr 2 (10.09.2018): 159–72. http://dx.doi.org/10.1177/1049732318797616.
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Many policy interventions have attempted to address the entrenched disadvantage of Aboriginal Australians1; however, sustained improvement in social, cultural, physical, and emotional well-being is not evident. This disadvantage is compounded by paternalistic practices which do not promote Aboriginal self-determination or empowerment. This article presents the lived experience and voice of Aboriginal Australians spending time in parks in Perth, Western Australia. A community-based participatory action research approach informed by critical Indigenous methodologies involving collaboration between Aboriginal and non-Aboriginal service providers was used. Participants experienced disconnection from kin and country, serious risk to personal safety, homelessness, and problematic health; all related to, and intersecting with, time spent in the parks. The participants’ narratives highlight the enduring impacts of colonization, dispossession, and racism. These lived experiences are situated within contexts of rising moral panic from politicians, residents and mass media, and siloed policy and service delivery responses.
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Blignault, Ilse, Liz Norsa, Raylene Blackburn, George Bloomfield, Karen Beetson, Bin Jalaludin i Nathan Jones. "“You Can’t Work with My People If You Don’t Know How to”: Enhancing Transfer of Care from Hospital to Primary Care for Aboriginal Australians with Chronic Disease". International Journal of Environmental Research and Public Health 18, nr 14 (6.07.2021): 7233. http://dx.doi.org/10.3390/ijerph18147233.
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Indigenous Australians experience significantly poorer health compared to other Australians, with chronic disease contributing to two-thirds of the health gap. We report on an evaluation of an innovative model that leverages mainstream and Aboriginal health resources to enable safe, supported transfer of care for Aboriginal adults with chronic conditions leaving hospital. The multisite evaluation was Aboriginal-led and underpinned by the principles of self-determination and equity and Indigenous research protocols. The qualitative study documented processes and captured service user and provider experiences. We found benefits for patients and their families, the hospital and the health system. The new model enhanced the patient journey and trust in the health service and was a source of staff satisfaction. Challenges included staff availability, patient identification and complexity and the broader issue of cultural safety. Critical success factors included strong governance with joint cultural and clinical leadership and enduring relationships and partnerships at the service delivery, organisation and system levels. A holistic model of care, bringing together cultural and clinical expertise and partnering with Indigenous community organisations, can enhance care coordination and safety across the hospital–community interface. It is important to consider context as well as specific program elements in design, implementation and evaluation.
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Wotherspoon, Craig, i Cylie M. Williams. "Exploring the experiences of Aboriginal and Torres Strait Islander patients admitted to a metropolitan health service". Australian Health Review 43, nr 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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Porykali, Bobby, Alyse Davies, Cassandra Brooks, Hannah Melville, Margaret Allman-Farinelli i Julieann Coombes. "Effects of Nutritional Interventions on Cardiovascular Disease Health Outcomes in Aboriginal and Torres Strait Islander Australians: A Scoping Review". Nutrients 13, nr 11 (15.11.2021): 4084. http://dx.doi.org/10.3390/nu13114084.
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Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.
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Rashidi, Amineh, Peter Higgs i Susan Carruthers. "Factors affecting hepatitis C treatment intentions among Aboriginal people in Western Australia: a mixed-methods study". Australian Health Review 44, nr 5 (2020): 755. http://dx.doi.org/10.1071/ah19194.
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ObjectiveThe aim of this study was to identify the hepatitis C treatment intentions of Aboriginal people living with hepatitis C virus (HCV) in Western Australia. MethodsThis study used a mixed-methods design. In the cross-sectional survey, 123 Aboriginal people who inject drugs and self-report as living with hepatitis C completed a purpose-designed questionnaire. In the qualitative phase, 10 participants were interviewed about the factors influencing their future intentions to undertake hepatitis C treatment. ResultsAnalysis of the survey data revealed significant associations between an intention to undertake hepatitis C treatment and support, community attachment, stable housing and stigma. In addition, there was a high overall level of expressed intention to undertake HCV treatment, with 54% of participants responding positively. Analysis of the qualitative data supported quantitative findings, revealing concerns about stigma, lack of social support and unstable housing as factors affecting the intention to undertake hepatitis C treatment. ConclusionThis mixed methods study with Aboriginal people living with self-reported HCV indicates interventions focused on reducing stigma and unstable housing could positively affect hepatitis C treatment intentions. These findings have implications for developing holistic programs to promote and support people on hepatitis C treatment. What is known about the topic?Substantial knowledge gaps need to be resolved if HCV elimination among Aboriginal Australians is to be achieved. Current research has prioritised non-Aboriginal communities. What does this paper add?This study found that stigma and unstable housing require attention if Aboriginal Australians are to obtain the full benefits of direct acting antiviral (DAA) hepatitis C treatment. What are the implications for practitioners?Reducing stigma (in the primary healthcare setting) and providing access to stable housing are vital components of supportive, non-judgemental and culturally appropriate care for Aboriginal people. This study highlights the importance of education for nurses and other primary care providers to increase engagement in the hepatitis cascade of care. To achieve this, scaling-up of HCV treatment engagement, trained Aboriginal community healthcare workers and HCV treatment advocates must mobilise and support Aboriginal people to avoid the negative effects of stigma, build positive and enabling relationships and reinforce positive attitudes towards DAA hepatitis C treatment.
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Armstrong, Elizabeth, Deborah Hersh, Judith M. Katzenellenbogen, Juli Coffin, Sandra C. Thompson, Natalie Ciccone, Colleen Hayward, Leon Flicker, Deborah Woods i Meaghan McAllister. "Study Protocol:Missing Voices– Communication Difficulties after Stroke and Traumatic Brain Injury in Aboriginal Australians". Brain Impairment 16, nr 2 (20.07.2015): 145–56. http://dx.doi.org/10.1017/brimp.2015.15.
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Background:Aboriginal and Torres Strait Islander Australians experience stroke and traumatic brain injury (TBI) with much greater frequency than non-Aboriginal Australians. Acquired communication disorders (ACD) can result from these conditions and can significantly impact everyday life. Yet few Aboriginal people access rehabilitation services and little is known about Aboriginal peoples’ experiences of ACD. This paper describes the protocol surrounding a study that aims to explore the extent and impact of ACD in Western Australian Aboriginal populations following stroke or TBI and develop a culturally appropriate screening tool for ACD and accessible and culturally appropriate service delivery models.Method/Design:The 3-year, mixed methods study is being conducted in metropolitan Perth and five regional centres in Western Australia. Situated within an Aboriginal research framework, methods include an analysis of linked routine hospital admission data and retrospective file audits, development of a screening tool for ACD, interviews with people with ACD, their families, and health professionals, and drafting of alternative service delivery models.Discussion:This study will address the extent of ACD in Aboriginal populations and document challenges for Aboriginal people in accessing speech pathology services. Documenting the burden and impact of ACD within a culturally secure framework is a forerunner to developing better ways to address the problems faced by Aboriginal people with ACD and their families. This will in turn increase the likelihood that Aboriginal people with ACD will be diagnosed and referred to professional support to improve their communication, quality of life and functioning within the family and community context.
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Stevens, Matthew, Dom Barry, Sue Bertossa, Mark Thompson i Robert Ali. "First-Stage Development of the Pitjantjatjara Translation of the World Health Organization’s Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)". Journal of the Australian Indigenous HealthInfoNet 3, nr 4 (2022): 1–32. http://dx.doi.org/10.14221/aihjournal.v3n4.2.
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Substance use is a leading contributor to global disease, illness and death. Compared with non-Indigenous Australians, Aboriginal and Torres Strait Islander Australians are at an increased risk of substance-related harms due to the experience of additional social, cultural, and economic factors. While preventive approaches, including screening and early interventions are promising, currently there are limited options available to healthcare workers that are culturally appropriate for use in Aboriginal and Torres Strait Islander populations. Therefore, the aim of this research was to translate and culturally adapt the World Health Organization endorsed, Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) into Pitjantjatjara. This paper first describes the process of translation and adaptation of the instrument (Phase 1). The process of focus-group testing the translated instrument for accuracy and cultural appropriateness is also discussed (Phase 2). Key findings from both phases are presented in the context of how the research team worked with key stakeholders in the community to identify facilitators and work through barriers to implementation. The findings from this paper will be used to inform the development of a digital, app-based version of the instrument for the purposes of pilot-testing and validation.
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Devine, Kit. "On country: Identity, place and digital place". Virtual Creativity 11, nr 1 (1.06.2021): 111–23. http://dx.doi.org/10.1386/vcr_00045_1.
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Place is central to the identity of Aboriginal and Torres Strait Islander peoples. The Narrabeen Camp Project explores the use of immersive technologies to offer opportunities to engage with Indigenous histories, Storytelling and cultural heritage in ways that privilege place. While nothing can replace being ‘on Country’, the XR technologies of AR and VR support different modalities of engagement with real, and virtual, place. The project documents the Stories, Language and Lore associated with the Gai-mariagal clan and, in particular, with the Aboriginal Camp that existed on the north-western shore of Narrabeen Lakes from the end of the last ice age to 1959 when it was demolished to make way for the Sydney Academy of Sports and Recreation. The project will investigate evolving Aboriginal Storytelling dynamics when using immersive digital media to teach culture and to document a historically important site that existed for thousands of years prior to its demolition in the mid-twentieth century. It expects to generate new knowledge about Aboriginal Storytelling and about the history of urban Aboriginals. Expected outcomes include a schema connecting Aboriginal Storytelling with immersive digital technologies, and truth-telling that advances understanding of modern Australia and urban Aboriginal people. The research should promote better mental, social and emotional health and wellbeing for Indigenous Australians and benefit all Australians culturally, socially and economically.
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Garvey, Gail, Kate Anderson, Alana Gall, Tamara L. Butler, Joan Cunningham, Lisa J. Whop, Michelle Dickson i in. "What Matters 2 Adults (WM2Adults): Understanding the Foundations of Aboriginal and Torres Strait Islander Wellbeing". International Journal of Environmental Research and Public Health 18, nr 12 (8.06.2021): 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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de Crespigny, Charlotte, Inge Kowanko, Helen Murray, Carolyn Emden i Scott Wilson. "Improving Indigenous health through better medication management: an overview". Australian Journal of Primary Health 11, nr 1 (2005): 17. http://dx.doi.org/10.1071/py05003.
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This paper provides an overview of a major South Australian research project with implications for the health of all Indigenous Australians. The researchers set out to explore the medication needs of Aboriginal people with mental health problems and found that most Aboriginal people have to deal with profound challenges to social and emotional wellbeing with significant medication implications. No previous research had investigated the problem of medication use by Aboriginal people in metropolitan, rural and remote locations to the depth and extent of this project. The research therefore is of widespread relevance and holds interest for many Indigenous and non-Indigenous individuals and groups, consumers, service providers and policy-makers. As a research team comprising Indigenous and non-Indigenous members, we were committed to implementing strategies in the course of the project with immediate benefit to project participants as well as longer-term impact on improved use of medications. The design of the project enabled these strategic interventions and we are pleased to promote this model to other researchers. Recommendations from the project concern services, coordination of care, carers and family members, workforce education, and community development. Readers are advised where the project report and other published papers can be accessed. The project was funded by the Commonwealth Department of Health and Ageing.
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Thackrah, Rosalie D., Lenelle P. Papertalk, Karen Taylor, Emma V. Taylor, Heath Greville, Leanne G. Pilkington i Sandra C. Thompson. "Perspectives of Aboriginal People Affected by Cancer on the Need for an Aboriginal Navigator in Cancer Treatment and Support: A Qualitative Study". Healthcare 11, nr 1 (30.12.2022): 114. http://dx.doi.org/10.3390/healthcare11010114.
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Aboriginal and Torres Strait Islander Australians suffer higher rates of cancer and poorer outcomes than the wider population. These disparities are exacerbated by rurality and remoteness due to reduced access and limited engagement with health services. This study explored the cancer journeys of Aboriginal patients and carers, and their views on the establishment of an Aboriginal Patient Navigator role within the Western Australian healthcare system to support cancer patients and their families. Sixteen Aboriginal participants were interviewed either face to face, by telephone, or via video conferencing platforms. The interviews were then recorded, transcribed, and thematically analyzed using standard qualitative techniques. Close consultation within the research team enhanced the rigour and robustness of the study findings. Patients and carers identified many gaps in cancer service delivery that made their experiences stressful and unnecessarily complex. Challenges included a lack of stable accommodation, financial burdens, constant travel, being “off-Country”, and miscommunication with health professionals. Key sources of support and strength were the centrality of family and ongoing cultural connectedness. All participants were supportive of an Aboriginal Patient Navigator role that could address shortfalls in cancer service delivery, especially for patients from rural and remote communities. A culturally safe model of support has the potential to increase access, reduce anxiety and improve health outcomes.
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Firebrace, Shirley, Daryl Nayler i Penny Bisset. "Austin Health Celebrates Collaboration with Aboriginal People during NAIDOC Week in 2006". Australian Journal of Primary Health 12, nr 2 (2006): 13. http://dx.doi.org/10.1071/py06017b.
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Austin Health is one of Victoria's largest health care providers. It is a 950-bed major teaching and research hospital affiliated with the University of Melbourne. Austin Health employs more than 6,500 staff over three sites (the Repatriation Hospital, the Royal Talbot, and the Austin Hospital), and is renowned for providing high quality, comprehensive public health services. These services are provided to a significant number of the Aboriginal and Torres Strait Islander (ATSI) population. Throughout Australia, Aboriginal people are dying at almost three times the rate of other Australians and have a life expectancy 17 years lower than the rest of the population. All State-funded hospitals are required to give special attention to the needs of ATSI people by ensuring services are provided in a culturally appropriate way and meet the needs of ATSI people.
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Skoss, Rachel, Jane White, Mandy J. Stanley, Melanie Robinson, Sandra Thompson, Elizabeth Armstrong i Judith M. Katzenellenbogen. "Study protocol for a prospective process evaluation of a culturally secure rehabilitation programme for Aboriginal Australians after brain injury: the Healing Right Way project". BMJ Open 11, nr 9 (wrzesień 2021): e046042. http://dx.doi.org/10.1136/bmjopen-2020-046042.
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IntroductionAboriginal and Torres Strait Islander (hereafter respectfully referred to as Aboriginal) people are Australia’s First Peoples, having the longest continuous culture in the world and deep spiritual connections with ancestral land. Improvements in their health and well-being is a major policy goal of Australian governments, as the legacy of colonisation and disruption of cultural practices contribute to major health challenges. Lack of culturally secure services impacts participation of Aboriginal people in health services. Aboriginal people with a brain injury typically experience poor access to rehabilitation and support following hospital discharge. ‘Healing Right Way’ (HRW) is a randomised control trial aiming to improve access to interdisciplinary and culturally secure rehabilitation services for Aboriginal people after brain injury in Western Australia, improve health outcomes and provide the first best practice model. This protocol is for the process evaluation of the HRW trial.Methods and analysisA prospective mixed methods process evaluation will use the Consolidated Framework for Implementation Research to evaluate implementation and intervention processes involved in HRW. Data collection includes qualitative and quantitative data from all sites during control and intervention phases, relating to three categories: (1) implementation of trial processes; (2) cultural security training; and (3) Aboriginal Brain Injury Coordinator role. Additional data elements collected from HRW will support the process evaluation regarding fidelity and intervention integrity. Iterative cross-sectional and longitudinal data synthesis will support the implementation of HRW, interpretation of findings and inform future development and implementation of culturally secure interventions for Aboriginal people.Ethics and disseminationThis process evaluation was reviewed by The University of Western Australia Human Research Ethics Committee (RA/4/20/4952). Evaluation findings will be disseminated via academic mechanisms, seminars at trial sites, regional Aboriginal health forums, peak bodies for Aboriginal health organisations and the Australian Indigenous HealthInfoNet (https://healthinfonet.ecu.edu.au/).Trial registration numberACTRN12618000139279.
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Harvey, Peter W. "Science, research and social change in Indigenous health — evolving ways of knowing". Australian Health Review 33, nr 4 (2009): 628. http://dx.doi.org/10.1071/ah090628.
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History tells us of the overwhelming destructive influence of exotic culture, politics and knowledge forms upon the worldview and wellbeing of Indigenous Australians. The power of dominant culture to oppress, control and dominate traditional Indigenous ways of knowing and being has been identified as a being a crucial influence on the health status, future hopes and aspirations of Indigenous Australians. Fundamental to this assertion is that the alienating effect of the belief in and application of the scientific method in relation to learning and knowing is a phenomenon that is incompatible with the law and cultural ways of traditional Indigenous people. The establishment of the Centre of Clinical Research Excellence (CCRE) is predicated upon and responds to a deep need in our community today to synthesise the ideological and epistemological premises of an increasing range of cultures and world views. It recognises that clinical research, for example, is important to the health of Aboriginal and Torres Strait Islander peoples, but also that the way such research is designed and carried out is also crucial to its potential to effect change in and improve the state of Indigenous health in Australia. This paper examines knowledge principles and processes associated with research in Indigenous communities, explores emerging research trends in science and proposes an epistemological framework for synthesis of traditional approaches with those of the scientific paradigm.
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Chakraborty, Amal, Emma Walke, Roxanne Bainbridge, Ross Bailie, Veronica Matthews, Sarah Larkins, Paul Burgess i in. "VOICE–Validating Outcomes by Including Consumer Experience: A Study Protocol to Develop a Patient Reported Experience Measure for Aboriginal and Torres Strait Islander Peoples Accessing Primary Health Care". International Journal of Environmental Research and Public Health 20, nr 1 (26.12.2022): 357. http://dx.doi.org/10.3390/ijerph20010357.
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Aboriginal and Torres Strait Islander peoples’ (hereafter respectfully referred to as Indigenous Australians) experiences of health care are shaped by historical, social and cultural factors, with cultural security critical to effective care provision and engagement between services and community. Positive patient experiences are associated with better health outcomes. Consequently, it is an accreditation requirement that primary health care (PHC) services must formally gather and respond to patient feedback. However, currently available patient feedback tools were not developed with Indigenous Australians, and do not reflect their values and world views. Existing tools do not capture important experiences of care of Indigenous Australians in PHC settings, nor return information that assists services to improve care. Consistent with the principles of Indigenous Data Sovereignty, we will co-design and validate an Indigenous-specific Patient Reported Experience Measure (PREM) that produces data by and for community, suitable for use in quality improvement in comprehensive PHC services. This paper presents the protocol of the study, outlining the rationale, methodologies and associated activities that are being applied in developing the PREM. Briefly, guided by an Aboriginal and Torres Strait Islander Advisory Group, our team of Indigenous and non-Indigenous researchers, service providers and policy makers will use a combination of Indigenous methodologies, participatory, and traditional western techniques for scale development. We will engage PHC service staff and communities in eight selected sites across remote, regional, and metropolitan communities in Australia for iterative cycles of data collection and feedback throughout the research process. Yarning Circles with community members will identify core concepts to develop an “Experience of Care Framework”, which will be used to develop items for the PREM. Staff members will be interviewed regarding desirable characteristics and feasibility considerations for the PREM. The PREM will undergo cognitive and psychometric testing.
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Fatima, Y., S. King, S. Solomon, R. Bucks i T. Skinner. "P037 Indigenous Australians’ conceptualisation of sleep health differs from western interpretations". SLEEP Advances 2, Supplement_1 (1.10.2021): A33. http://dx.doi.org/10.1093/sleepadvances/zpab014.085.
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Abstract Purpose Despite a significant burden of poor sleep, Aboriginal and Torres Strait Islander peoples’ (Indigenous Australians) conceptualisation of sleep health is poorly understood. This research explored Indigenous Australians’ understanding and interpretation of sleep health and how that affects their health. Methods Indigenous people from remote Queensland were invited to participate in focus group discussions exploring their understanding of sleep health, the link between dreaming and sleep, and perceived implications of poor sleep. Participants were also asked to complete an adapted pictorial Epworth Sleepiness Scale (ESS). Descriptive statistics were used to summarise ESS data and participants’ demographic data. Thematic analysis was used to analyse focus group data. Results A total of 29 Indigenous Australians (82% females), median age 39 years (Interquartile range 26–51 years) from various geographical areas within North West Queensland participated in focus group discussions (n=6). The following themes emerged from the data: interconnection among sleep, emotional and physical health; challenges and successes in obtaining healthy sleep; the impact of dreams on waking life; and lack of support from health services in managing sleep issues. Scores from the modified pictorial scale indicate 24% of the participants had excessive daytime sleepiness (ESS score>10 points). Conclusion Indigenous Australians’ conceptualisation of sleep health is different from the western interpretation of sleep health. In particular, the connection between dreams and sleep is not adequately captured in current tools and resources to promote sleep health. This will limit effective prevention and management of sleep issues in Indigenous communities.
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Cosh, Suzanne, Kimberley Hawkins, Gemma Skaczkowski, David Copley i Jacqueline Bowden. "Tobacco use among urban Aboriginal Australian young people: a qualitative study of reasons for smoking, barriers to cessation and motivators for smoking cessation". Australian Journal of Primary Health 21, nr 3 (2015): 334. http://dx.doi.org/10.1071/py13157.
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Smoking prevalence among Aboriginal Australian young people greatly exceeds the prevalence in the broader population of Australian young people, yet limited research has explored the social context in which young Aboriginal Australians smoke. Four focus groups were conducted in 2009 with South Australian Aboriginal smokers aged 15–29 years residing in urban areas (n = 32) to examine attitudes and experiences surrounding smoking and quitting. The primary reasons for smoking initiation and maintenance among Aboriginal Australian young people were identified as stress, social influence and boredom. Motivators for quitting were identified as pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons. The barriers to cessation were identified as social influence, the perception of quitting as a distant event and reluctance to access cessation support. However, it appears that social influences and stress were particularly salient contributors to smoking maintenance among Aboriginal Australian young people. Smoking cessation interventions targeted at young urban Aboriginal Australian smokers should aim to build motivation to quit by utilising the motivators of pregnancy and/or children, sporting performance (males only), cost issues and, to a lesser extent, health reasons, while acknowledging the pertinent role of social influence and stress in the lives of young urban Aboriginal Australian smokers.
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Thompson, Sandra C., Maria Bonar, Heath Greville, Dawn Bessarab, Marisa T. Gilles, Heather D’Antoine i Bruce R. Maycock. "“Slowed right down”: Insights into the use of alcohol from research with Aboriginal Australians living with HIV". International Journal of Drug Policy 20, nr 2 (marzec 2009): 101–10. http://dx.doi.org/10.1016/j.drugpo.2008.02.003.
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Kruger, Estie, Irosha Perera i Marc Tennant. "Primary oral health service provision in Aboriginal Medical Services-based dental clinics in Western Australia". Australian Journal of Primary Health 16, nr 4 (2010): 291. http://dx.doi.org/10.1071/py10028.
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Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.
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Dudgeon, Pat, Maddie Boe i Roz Walker. "Addressing Inequities in Indigenous Mental Health and Wellbeing through Transformative and Decolonising Research and Practice". Research in Health Science 5, nr 3 (10.08.2020): p48. http://dx.doi.org/10.22158/rhs.v5n3p48.
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Aim: This paper discusses the current mental health and social and emotional wellbeing in Indigenous Australian mental health and wellbeing, the gaps in research, the need for transformative and decolonising research and practice, and the opportunities and recommendations to address existing mental health inequities. Method: This paper reviews key mental health and social and wellbeing policy documents and frameworks, and examines relevant literature documenting current decolonising strategies to improve programs, services and practice. It also draws on the key findings of the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention (CBPATSISP) and Transforming Indigenous Mental Health and Wellbeing research projects. In addition this work builds on the substantial work of the national Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) which outlines a range of solutions to reduce the causes, prevalence, and impact of Indigenous suicide by identifying, translating, and promoting the adoption of evidenced based best practice in Indigenous specific suicide prevention activities. Discussion and Conclusion: This paper details the challenges as well as the promise and potential of engaging in transformative and decolonising research and practice to address the existing health service inequities. Acknowledging and addressing these health inequities is an urgent and critical task given the current COVID-19 pandemic and potential for further increasing the adverse mental health and wellbeing gap for Indigenous Australians.
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Armstrong, Elizabeth, Juli Coffin, Deborah Hersh, Judith M. Katzenellenbogen, Sandra Thompson, Leon Flicker, Meaghan McAllister i in. "Healing Right Way: study protocol for a stepped wedge cluster randomised controlled trial to enhance rehabilitation services and improve quality of life in Aboriginal Australians after brain injury". BMJ Open 11, nr 9 (wrzesień 2021): e045898. http://dx.doi.org/10.1136/bmjopen-2020-045898.
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IntroductionDespite higher incidence of brain injury among Aboriginal compared with non-Aboriginal Australians, suboptimal engagement exists between rehabilitation services and Aboriginal brain injury survivors. Aboriginal patients often feel culturally insecure in hospital and navigation of services post discharge is complex. Health professionals report feeling ill-equipped working with Aboriginal patients. This study will test the impact of a research-informed culturally secure intervention model for Aboriginal people with brain injury.Methods and analysisDesign: Stepped wedge cluster randomised control trial design; intervention sequentially introduced at four pairs of healthcare sites across Western Australia at 26-week intervals.Recruitment: Aboriginal participants aged ≥18 years within 4 weeks of an acute stroke or traumatic brain injury.Intervention: (1) Cultural security training for hospital staff and (2) local, trial-specific, Aboriginal Brain Injury Coordinators supporting participants.Primary outcome: Quality-of-life using EuroQOL-5D-3L (European Quality of Life scale, five dimensions, three severity levels) Visual Analogue Scale score at 26 weeks post injury. Recruitment of 312 participants is estimated to detect a difference of 15 points with 80% power at the 5% significance level. A linear mixed model will be used to assess the between-condition difference.Secondary outcome measures: Modified Rankin Scale, Functional Independence Measure, Modified Caregiver Strain Index, Hospital Anxiety and Depression Scale at 12 and 26 weeks post injury, rehabilitation occasions of service received, hospital compliance with minimum care processes by 26 weeks post injury, acceptability of Intervention Package, feasibility of Aboriginal Brain Injury Coordinator role.Evaluations: An economic evaluation will determine the potential cost-effectiveness of the intervention. Process evaluation will document fidelity to study processes and capture changing contexts including barriers to intervention implementation and acceptability/feasibility of the intervention through participant questionnaires at 12 and 26 weeks.Ethics and disseminationThe study has approvals from Aboriginal, university and health services human research ethics committees. Findings will be disseminated through stakeholder reports, participant workshops, peer-reviewed journal articles and conference papers.Trial registration numberACTRN12618000139279.
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McKay, Fiona H., i Stephanie L. Godrich. "Interventions to address food insecurity among Aboriginal and Torres Strait Islander people: a rapid review". Applied Physiology, Nutrition, and Metabolism 46, nr 12 (grudzień 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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Gwynn, Josephine, Kyra Sim, Tania Searle, Alistair Senior, Amanda Lee i Julie Brimblecombe. "Effect of nutrition interventions on diet-related and health outcomes of Aboriginal and Torres Strait Islander Australians: a systematic review". BMJ Open 9, nr 4 (kwiecień 2019): e025291. http://dx.doi.org/10.1136/bmjopen-2018-025291.
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ObjectiveTo review the literature on nutrition interventions and identify which work to improve diet-related and health outcomes in Australian Aboriginal and Torres Strait Islander people.Study designSystematic review of peer-reviewed literature.Data sourcesMEDLINE, PubMed, Embase, Science Direct, CINAHL, Informit, PsychInfo and Cochrane Library, Australian Indigenous Health InfoNet.Study selectionPeer-reviewed article describing an original study; published in English prior to December 2017; inclusion of one or more of the following outcome measures: nutritional status, food/dietary/nutrient intake, diet-related biomedical markers, anthropometric or health measures; and conducted with Australian Aboriginal and Torres Strait Islander people.Data extraction and synthesisTwo independent reviewers extracted data and applied the Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project. A purpose designed tool assessed community engagement in research, and a framework was applied to interventions to report a score based on numbers of settings and strategies. Heterogeneity of studies precluded a meta-analysis. The effect size of health outcome results were estimated and presented as forest plots.ResultsThirty-five articles (26 studies) met inclusion criteria; two rated moderate in quality; 12 described cohort designs; 18 described interventions in remote/very remote communities; none focused solely on urban communities; and 11 reported moderate or strong community engagement. Six intervention types were identified. Statistically significant improvements were reported in 14 studies of which eight reported improvements in biochemical/haematological markers and either anthropometric and/or diet-related outcomes.ConclusionsStore-based intervention with community health promotion in very remote communities, fiscal strategies and nutrition education and promotion programmes show promise. Future dietary intervention studies must be rigorously evaluated, provide intervention implementation details explore scale up of programmes, include urban communities and consider a multisetting and strategy approach. Strong Aboriginal and Torres Strait Islander community engagement is essential for effective nutrition intervention research and evaluation.PROSPERO registration numberCRD42015029551.
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Flicker, Leon, i Dina Logiudice. "What can we learn about dementia from research in Indigenous populations?" International Psychogeriatrics 27, nr 12 (29.10.2015): 1957–58. http://dx.doi.org/10.1017/s1041610215001684.
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Indigenous peoples represent up to 5% of the world's population (almost 400 million people), representing thousands of individual cultures and language groups. The health status of older Indigenous peoples has been little researched, partly related to lower life expectancy and the consideration that Indigenous peoples do not live long enough to experience the common “geriatric syndromes” such as dementia, frailty, and falls. Statistics from Australia and Canada now report that Indigenous populations are undergoing rapid aging, with many examples of survivorship to old age (Arkleset al., 2010; Jacklinet al., 2012). The systematic review by Warrenet al. (2015) is a timely one, in that it reminds clinicians interested in old age that this “fourth” World population deserves further attention. Researchers that have worked with these groups to produce population estimates are relatively few. In their systematic review, Warrenet al.(2015) demonstrate wide variation in prevalence rates of dementia. They conclude that a major cause of this heterogeneity in prevalence is due to basic methodological differences. In particular, those studies that have utilized already acquired routine data may be biased. The type and direction of this bias can be complex. For example, Cotteret al.(2012) using routinely collected data, concluded that the prevalence of dementia in Aboriginal Australians in the Northern Territory was not higher than non-Aboriginal prevalence. Using similar methodologies some years later the conclusion was that the Aboriginal population had markedly higher rates (Liet al., 2014). In the intervening period, a dementia awareness campaign coupled with the development of a culturally appropriate screening tool probably resulted in greater detection in routine care.
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Lawlor, D., i R. Kosky. "Serious Suicide Attempts among Adolescents in Custody". Australian & New Zealand Journal of Psychiatry 26, nr 3 (wrzesień 1992): 474–78. http://dx.doi.org/10.3109/00048679209072073.
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The Royal Commission into Aboriginal Deaths in Custody has focused attention on people who are held in custody in police cells, prisons, remand centres and detention centres. A series of research papers has been released by the Royal Commission which delineates some important aspects of the needs of these people. Nearly half of the deaths which occur in these custodial settings appear to be self-inflicted. Suicide seems to be particularly common among younger age groups of those in custody [1,2]. This pattern parallels suicide levels among young people in the Australian community generally, so that suicide is now a leading cause of death among young Australians [3,4].
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O'Grady, Kerry-Ann F., Amber Revell, Graeme P. Maguire, Renate Millonig, Michael A. Newman, David W. Reid, Deborah C. Hill i Anne B. Chang. "Lung health care for Aboriginal and Torres Strait Islander Queenslanders: breathing easy is not so easy". Australian Health Review 35, nr 4 (2011): 512. http://dx.doi.org/10.1071/ah10973.
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Objectives. In Aboriginal and Torres Strait Islander peoples in Queensland, to (a) determine the disease burden of common chronic lung diseases and (b) identify areas of need with respect to lung health services. Methods. Literature reviews and analyses of hospitalisation and mortality data were used to describe disease epidemiology and available programs and services. Key stakeholder interviews and an online survey of health professionals were used to evaluate lung health services across the state and to identify services, needs and gaps. Results. Morbidity and mortality from respiratory diseases in the Indigenous population is substantially higher than the non-Indigenous population across all age groups and regions. There are inadequate clinical services and resources to address disease prevention, detection, intervention and management in an evidence-based and culturally acceptable fashion. There is a lack of culturally appropriate educational resources and management programs, insufficient access to appropriately engaged Indigenous health professionals, a lack of multi-disciplinary specialist outreach teams, fragmented information systems and inadequate coordination of care. Conclusions. Major initiatives are required at all levels of the healthcare system to adequately address service provision for Indigenous Queenslanders with lung diseases, including high quality research to investigate the causes for poor lung health, which are likely to be multifactorial. What is known about the topic? Chronic diseases, including lung disease contribute to, and influence outcomes of, the well-known health and socioeconomic disadvantage among Aboriginal and Torres Strait Islander Australians. Nationwide, the most common reason for hospitalisation of Indigenous Australians is for lung diseases (after renal dialysis). What does this paper add? There is currently no state- or nation-wide comprehensive review of chronic lung disease burden and the health services available to prevent, treat and manage lung disease. This review fills this gap in Queensland and has found that chronic lung disease burden is not homogenous. There are substantial gaps in, and barriers to, the provision of high quality, evidence based services and a paucity of well-designed research to inform policy and health service delivery. What are the implications for practitioners? Evidence-based strategies are needed at the primary, secondary and tertiary levels of the healthcare system. Fourteen recommendations relevant to practitioners and policy makers were formulated.
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Zengin, Ayse, Cat Shore-Lorenti, Marc Sim, Louise Maple-Brown, Sharon Lee Brennan-Olsen, Joshua R. Lewis, Jennifer Ockwell, Troy Walker, David Scott i Peter Ebeling. "Why Aboriginal and Torres Strait Islander Australians fall and fracture: the codesigned Study of Indigenous Muscle and Bone Ageing (SIMBA) protocol". BMJ Open 12, nr 4 (kwiecień 2022): e056589. http://dx.doi.org/10.1136/bmjopen-2021-056589.
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ObjectivesAboriginal and Torres Strait Islander Australians have a substantially greater fracture risk, where men are 50% and women are 26% more likely to experience a hip fracture compared with non-Indigenous Australians. Fall-related injuries in this population have also increased by 10%/year compared with 4.3%/year in non-Indigenous Australians. This study aims to determine why falls and fracture risk are higher in Aboriginal and Torres Strait Islander Australians.SettingAll clinical assessments will be performed at one centre in Melbourne, Australia. At baseline, participants will have clinical assessments, including questionnaires, anthropometry, bone structure, body composition and physical performance tests. These assessments will be repeated at follow-up 1 and follow-up 2, with an interval of 12 months between each clinical visit.ParticipantsThis codesigned prospective observational study aims to recruit a total of 298 adults who identify as Aboriginal and Torres Strait Islander and reside within Victoria, Australia. Stratified sampling by age and sex will be used to ensure equitable distribution of men and women across four age-bands (35–44, 45–54, 55–64 and 65+ years).Primary and secondary outcome measuresThe primary outcome is within-individual yearly change in areal bone mineral density at the total hip, femoral neck and lumbar spine assessed by dual energy X-ray absorptiometry. Within-individual change in cortical and trabecular volumetric bone mineral density at the radius and tibia using high-resolution peripheral quantitative computed tomography will be determined. Secondary outcomes include yearly differences in physical performance and body composition.Ethical approvalEthics approval for this study has been granted by the Monash Health Human Research Ethics Committee (project number: RES-19–0000374A).Trial registration numberACTRN12620000161921.
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Hall, Nina Lansbury. "Challenges of WASH in remote Australian Indigenous communities". Journal of Water, Sanitation and Hygiene for Development 9, nr 3 (3.06.2019): 429–37. http://dx.doi.org/10.2166/washdev.2019.154.
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Abstract Health and well-being are influenced by access and quality to safe drinking water, wastewater treatment, and hygiene practices and settings. This is recognised in the United Nations' Sustainable Development Goals for water and health. As a signatory to the UN Goals, Australia has a commitment to ensure the access and quality of these resources is attained for all, including Indigenous Australians living in remote communities. This research sought to identify the status of water, sanitation and hygiene services within remote communities on mainland Australia. Interviews were conducted with representatives of organisations providing water, sanitation and/or hygiene to communities. The quality and access of WASH services in remote Indigenous communities were revealed in this research as lacking at times in many communities. The qualitative results indicate that drinking water supplies can be contaminated by microbes or naturally occurring chemicals, wastewater treatment can be poorly maintained with irregular monitoring, and the health of residents is negatively impacted by crowding in houses, which affects residents' ability to maintain healthy hygiene levels of people, clothing, bedding and infrastructure. Effective responses require a collaborative and systemic approach by the respective government agencies responsible that effectively partner with – and adequately fund – Indigenous communities to provide options that are ‘fit for purpose, place and people’.
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Gray, Dennis, Mandy Wilson, Steve Allsop, Sherry Saggers, Edward Wilkes i Coralie Ober. "Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: A thematic review of five research projects". Drug and Alcohol Review 33, nr 5 (30.03.2014): 482–90. http://dx.doi.org/10.1111/dar.12137.
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Ryder, Courtney, Tamara Mackean, Julieann Coombes, Kate Hunter, Shahid Ullah, Kris Rogers, Beverley Essue, Andrew J. A. Holland i Rebecca Ivers. "Corrigendum to: Developing economic measures for Aboriginal and Torres Strait Islander families on out-of-pocket healthcare expenditure". Australian Health Review 45, nr 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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Terare, Mareese, i Margot Rawsthorne. "Country Is Yarning to Me: Worldview, Health and Well-Being Amongst Australian First Nations People". British Journal of Social Work 50, nr 3 (17.06.2019): 944–60. http://dx.doi.org/10.1093/bjsw/bcz072.
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Abstract Health inequalities experienced by Australian First Nations People are amongst the most marked in the world, with First Nations People dying some ten years earlier than non-Indigenous Australians. The failure of existing responses to health inequalities suggests new knowledges and questions that need to be explored. It is likely that these new knowledges sit outside of western research or practice paradigms. Through the Indigenous practice of yarning, the importance of worldview and Country emerged as an under-acknowledged social determinant of Australian First Nations People well-being. Yarning is a process of storytelling that involves both sound and silence. It requires embodied deep listening through which stories emerge that create new knowledge and understanding. We anchor our learning by re-telling John’s creation story, a story of healing through discovering his Aboriginal Worldview through reconnecting to Country. Country for First Nations People is more than a physical place; it is a place of belonging and a way of believing. We argue for the recognition of trauma, recognition of diversity and the use of yarning in social work practice. We conclude that reconnecting to Aboriginal Worldview provides hopeful insights into the well-being of Australia’s First Nations People and the social determinants of health.
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Carey, Timothy A., James M. Fauth i George C. Tremblay. "Rethinking Evaluation for Improved Health Outcomes: Implications for Remote Australia". American Journal of Evaluation 41, nr 2 (14.02.2019): 234–54. http://dx.doi.org/10.1177/1098214018824040.
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Despite enduring and unacceptable disparities in health outcomes for Aboriginal and Torres Strait Islander Australians as well as people living in rural and remote locations, evidence indicates that health services are not routinely evaluated. This article describes an exploration of a context where evaluators and community partners have achieved considerable success in implementing and sustaining ongoing monitoring and evaluation for enhanced service effectiveness in rural and underserved communities of New Hampshire. The purpose of this project was to establish the principles supporting this success and to set the stage for future research investigating the applicability of these principles to the remote Australian context. Semistructured interviews were conducted with 15 people from different organizations and in different positions within those organizations. The results invite a reconsideration of the way in which evidence-based practice is conceptualized as well as the role of external evaluators. The study has important implications and recommendations for both policy and practice.
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Davies, Alyse, Julieann Coombes, Jessica Wallace, Kimberly Glover, Bobby Porykali, Margaret Allman-Farinelli, Trinda Kunzli-Rix i Anna Rangan. "Yarning about Diet: The Applicability of Dietary Assessment Methods in Aboriginal and Torres Strait Islander Australians—A Scoping Review". Nutrients 15, nr 3 (3.02.2023): 787. http://dx.doi.org/10.3390/nu15030787.
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Conventional dietary assessment methods are based predominately on Western models which lack Aboriginal and Torres Strait Islander knowledges, methodologies, and social and cultural contextualisation. This review considered dietary assessment methods used with Aboriginal and Torres Strait Islander populations and assessed their applicability. Four electronic databases and grey literature were searched with no time limit applied to the results. Screening, data extraction and quality appraisal were undertaken independently by two reviewers. Out of 22 studies, 20 were conducted in rural/remote settings, one in an urban setting, and one at the national population level. The most frequently used and applicable dietary assessment method involved store data. Weighed food records and food frequency questionnaires had low applicability. Modifications of conventional methods were commonly used to adapt to Indigenous practices, but few studies incorporated Indigenous research methodologies such as yarning. This highlights an opportunity for further investigation to validate the accuracy of methods that incorporate qualitative yarning-based approaches, or other Indigenous research methodologies, into quantitative data collection. The importance of developing validated dietary assessment methods that are appropriate for this population cannot be understated considering the high susceptibility to nutrition-related health conditions such as malnutrition, overweight or obesity, diabetes, and cardiovascular disease.
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Usher, Kim, Navjot Bhullar, David Sibbritt, Suruchi Sue Anubha Amarasena, Wenbo Peng, Joanne Durkin, Reakeeta Smallwood i in. "Influence of COVID-19 on the preventive health behaviours of indigenous peoples of Australia residing in New South Wales: a mixed-method study protocol". BMJ Open 11, nr 9 (wrzesień 2021): e047404. http://dx.doi.org/10.1136/bmjopen-2020-047404.
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IntroductionChronic conditions impact indigenous peoples of Australia at a much higher rate than non-indigenous Australians. Attendance at the Medicare Benefits Scheme (MBS) supported indigenous health checks are crucial to improve prevention and management of chronic health conditions. However, in conjunction with lifestyle and environmental factors, attendance rates at primary healthcare services for screening and treatment have fallen in Australia during the COVID-19 pandemic. This study aims to explore the influence of the COVID-19 pandemic on preventive health behaviours of indigenous Australians and the associated barriers to, and enablers of, engagement with health services to formulate a targeted intervention strategy.Methods and analysisA concurrent mixed-methods study (comprising quantitative and qualitative data collection methods) will be employed. Descriptive analysis of MBS data about the characteristics of indigenous peoples of Australia claiming health assessment services will be performed. Generalised estimating equation regression models will be used to examine the use of health assessment services over time. Qualitative interviews informed by indigenous research methods will be conducted. Interviews will investigate barriers to, and enablers of, engagement with health services. Thematic approach guided by the principles of indigenist praxis, storytelling and collaborative research will be used to analyse the interview data. The project commenced in July 2020 and will be completed by July 2022.Ethics and disseminationThe project received ethics approval from the Aboriginal Health and Medical Research Council of New South Wales and the University of New England Human Research Ethics Committee. Findings will be disseminated via peer-reviewed journal articles, conferences, government and relevant stakeholder reports, and infographics.