Northern perspectives on medical elective tourism: a qualitative study

PubMed Central

Coke, Sarah; Kuper, Ayelet; Richardson, Lisa; Cameron, Anita

2016-01-01

Background: The Royal College of Physicians and Surgeons of Canada recognizes education to be necessary for doctors to provide culturally safe care. Communities in northern Canada have large populations of Aboriginal people and other marginalized groups. Our goal was to identify the elements of appropriate predeparture curricula for these medical trainees. Methods: We conducted our study in Kenora, Ontario. With the help of a core collaborative group and the support of the local Aboriginal Health Access Centre, we interviewed a purposive sample of community members about their interactions with trainees from southern Canada. Aboriginal and non-Aboriginal researchers with roots in northern and southern Canada brought perspectives to the inductive analysis. Results: We conducted 17 semistructured interviews between February and March 2014. Participants felt that southern trainees were inadequately educated in northern politics, society and history. They identified 2 more themes: determinants of health affecting the local Aboriginal population, and provider and patient factors affecting delivery of culturally competent care. Participants also shared ideas on how best to implement this content into curricula. Interpretation: Providing culturally competent care to northern communities is a complex process requiring education. Using a collaborative method, we were able to delineate the experiences of members of a northern community and identify knowledge gaps of southern trainees travelling there. Our results provide a foundation for the content and structure of formal predeparture curricula to enable such trainees to provide culturally safe care. PMID:27398374

Culturally Responsive Pedagogy: Indigenizing Curriculum

ERIC Educational Resources Information Center

Ragoonaden, Karen; Mueller, Lyle

2017-01-01

This article examines the impact of culturally responsive pedagogy in an introduction to university course developed in collaboration with local and place-based First Nations communities, Aboriginal Access Studies and the Faculty of Education of the University of British Columbia's Okanagan Campus. In keeping with requests that Indigenous…

Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure.

PubMed

Clark, Robyn A; Fredericks, Bronwyn; Buitendyk, Natahlia J; Adams, Michael J; Howie-Esquivel, Jill; Dracup, Kathleen A; Berry, Narelle M; Atherton, John; Johnson, Stella

2015-01-01

There is a 70% higher age-adjusted incidence of heart failure (HF) among Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths as among non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community health care to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing. This study was conducted in two phases and utilised a mixed-methods approach (qualitative and quantitative). Phase 1 used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. An HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources, and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made. Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this, and members of the local community voiced the recordings for the resource. The other theme was comprehension; images were important and all text was converted to the first person and used plain language. Phase 2: Five Aboriginal participants, mean age 61.6±10.0 years, with NYHA Class III and IV heart failure were enrolled. Participants reported a high level of satisfaction with the resource (83.0%). HF knowledge (percentage of correct responses) increased from 48.0±6.7% to 58.0±9.7%, a 20.8% increase, and results of the self-care index indicated that the biggest change was in patient confidence for self-care, with a 95% increase in confidence score (46.7±16.0 to 91.1±11.5). Changes in management and maintenance scores varied between patients. By working in collaboration with HF experts, Aboriginal researchers and patients, a culturally safe HF resource has been developed for Aboriginal and Torres Strait Islander patients. Engaging Aboriginal researchers, capacity-building, and being responsive to local systems and structures enabled this pilot study to be successfully completed with the Aboriginal community and positive participant feedback demonstrated that the methodology used in this study was appropriate and acceptable; participants were able to engage with willingness and confidence.

Neglected infectious diseases in Aboriginal communities: Haemophilus influenzae serotype a and Helicobacter pylori.

PubMed

Ulanova, Marina; Tsang, Raymond; Altman, Eleonora

2012-11-19

This report describes proceedings of a workshop entitled "Neglected Infectious Diseases in Aboriginal Communities" which took place in Thunder Bay, Ontario, Canada, on October 12, 2011. This workshop was jointly organized by the National Research Council of Canada (NRC), the National Microbiology Laboratory (Public Health Agency of Canada) and Northern Ontario School of Medicine (NOSM) with participants from the Medical Sciences Division and Clinical Sciences Division of NOSM, NRC, National Microbiology Laboratory (NML), Public Health Laboratory (Thunder Bay), Thunder Bay District Health Unit, and Regional Health Survey at Chiefs of Ontario. The main purpose of the workshop was to summarize the current state of knowledge on two less publicized infectious disease agents afflicting Canadian Aboriginal communities: Haemophilus influenzae serotype a (Hia) and Helicobacter pylori. Another highlight of this workshop was the discussion on novel approaches for vaccination strategies in the control and prevention of such disease agents. In conclusion, a long-term collaborative research framework was established between NRC, NML and NOSM to develop carbohydrate-based vaccines against these pathogens that may benefit the health of Canadian Aboriginal peoples and other population groups at risk. Copyright © 2012. Published by Elsevier Ltd.. All rights reserved.

Owning solutions: a collaborative model to improve quality in hospital care for Aboriginal Australians.

PubMed

Durey, Angela; Wynaden, Dianne; Thompson, Sandra C; Davidson, Patricia M; Bessarab, Dawn; Katzenellenbogen, Judith M

2012-06-01

Well-documented health disparities between Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) and non-Aboriginal Australians are underpinned by complex historical and social factors. The effects of colonisation including racism continue to impact negatively on Aboriginal health outcomes, despite being under-recognised and under-reported. Many Aboriginal people find hospitals unwelcoming and are reluctant to attend for diagnosis and treatment, particularly with few Aboriginal health professionals employed on these facilities. In this paper, scientific literature and reports on Aboriginal health-care, methodology and cross-cultural education are reviewed to inform a collaborative model of hospital-based organisational change. The paper proposes a collaborative model of care to improve health service delivery by building capacity in Aboriginal and non-Aboriginal personnel by recruiting more Aboriginal health professionals, increasing knowledge and skills to establish good relationships between non-Aboriginal care providers and Aboriginal patients and their families, delivering quality care that is respectful of culture and improving Aboriginal health outcomes. A key element of model design, implementation and evaluation is critical reflection on barriers and facilitators to providing respectful and culturally safe quality care at systemic, interpersonal and patient/family-centred levels. Nurses are central to addressing the current state of inequity and are pivotal change agents within the proposed model. © 2011 Blackwell Publishing Ltd.

The role of families in youth sport programming in a Canadian aboriginal reserve.

PubMed

Schinke, Robert; Yungblut, Hope; Blodgett, Amy; Eys, Mark; Peltier, Duke; Ritchie, Stephen; Recollet-Saikkonen, Danielle

2010-03-01

There has been a recent push in the sport psychology literature for sport participants to be approached based on their cultural backgrounds. However, there are few examples where a cultural approach is considered, such as a culturally reflexive version of participatory action research (PAR). In the current study, the role of family is considered in relation to the sport engagement of Canadian Aboriginal youth. Mainstream researchers teamed with coresearchers from the Wikwemikong Unceded Indian Reserve for 5 years. Community meetings and talking circles were employed as culturally sensitive data collection techniques to uncover how to encourage youth participation in Wikwemikong's sport programs. The overarching methodology for the project is PAR. Themes and subthemes were determined by community consensus with terms indigenous (ie, culturally relevant) among the local Aboriginal culture. Family was considered important for youth involvement in Aboriginal community sport programs. Parents were expected to support their children by managing schedules and priorities, providing transportation, financial support, encouragement, and being committed to the child's activity. Aunts, uncles, cousins, siblings, grandparents, and the family as a whole were seen as sharing the responsibility to retain youth in sport through collateral support (ie, when gaps in parental support arose). Suggestions are proposed regarding how families in Aboriginal communities can collaborate to facilitate sport and physical activity among their youth. Further suggestions are proposed for researchers engaging in culturally reflexive research with participants and coresearchers from oppressed cultures.

Knowledge transfer and exchange processes for environmental health issues in Canadian Aboriginal communities.

PubMed

Jack, Susan M; Brooks, Sandy; Furgal, Chris M; Dobbins, Maureen

2010-02-01

Within Canadian Aboriginal communities, the process for utilizing environmental health research evidence in the development of policies and programs is not well understood. This fundamental qualitative descriptive study explored the perceptions of 28 environmental health researchers, senior external decision-makers and decision-makers working within Aboriginal communities about factors influencing knowledge transfer and exchange, beliefs about research evidence and Traditional Knowledge and the preferred communication channels for disseminating and receiving evidence. The results indicate that collaborative relationships between researchers and decision-makers, initiated early and maintained throughout a research project, promote both the efficient conduct of a study and increase the likelihood of knowledge transfer and exchange. Participants identified that empirical research findings and Traditional Knowledge are different and distinct types of evidence that should be equally valued and used where possible to provide a holistic understanding of environmental issues and support decisions in Aboriginal communities. To facilitate the dissemination of research findings within Aboriginal communities, participants described the elements required for successfully crafting key messages, locating and using credible messengers to deliver the messages, strategies for using cultural brokers and identifying the communication channels commonly used to disseminate and receive this type of information.

Knowledge Transfer and Exchange Processes for Environmental Health Issues in Canadian Aboriginal Communities

PubMed Central

Jack, Susan M.; Brooks, Sandy; Furgal, Chris M.; Dobbins, Maureen

2010-01-01

Within Canadian Aboriginal communities, the process for utilizing environmental health research evidence in the development of policies and programs is not well understood. This fundamental qualitative descriptive study explored the perceptions of 28 environmental health researchers, senior external decision-makers and decision-makers working within Aboriginal communities about factors influencing knowledge transfer and exchange, beliefs about research evidence and Traditional Knowledge and the preferred communication channels for disseminating and receiving evidence. The results indicate that collaborative relationships between researchers and decision-makers, initiated early and maintained throughout a research project, promote both the efficient conduct of a study and increase the likelihood of knowledge transfer and exchange. Participants identified that empirical research findings and Traditional Knowledge are different and distinct types of evidence that should be equally valued and used where possible to provide a holistic understanding of environmental issues and support decisions in Aboriginal communities. To facilitate the dissemination of research findings within Aboriginal communities, participants described the elements required for successfully crafting key messages, locating and using credible messengers to deliver the messages, strategies for using cultural brokers and identifying the communication channels commonly used to disseminate and receive this type of information. PMID:20616996

Barriers and enablers to the provision of alcohol treatment among Aboriginal Australians: a thematic review of five research projects.

PubMed

Gray, Dennis; Wilson, Mandy; Allsop, Steve; Saggers, Sherry; Wilkes, Edward; Ober, Coralie

2014-09-01

To review the results of five research projects commissioned to enhance alcohol treatment among Aboriginal Australians, and to highlight arising from them. Drafts of the papers were workshopped by project representatives, final papers reviewed and results summarised. Lessons arising were identified and described. While the impact of the projects varied, they highlight the feasibility of adapting mainstream interventions in Aboriginal Australian contexts. Outcomes include greater potential to: screen for those at risk; increase community awareness; build capacity and partnerships between organisations; and co-ordinate comprehensive referral networks and service provision. Results show a small investment can produce sustainable change and positive outcomes. However, to optimise and maintain investment, cultural difference needs to be recognised in both planning and delivery of alcohol interventions; resources and funding must be responsive to and realistic about the capacities of organisations; partnerships need to be formed voluntarily based on respect, equality and trust; and practices and procedures within organisations need to be formalised. There is no simple way to reduce alcohol-related harm in Aboriginal communities. However, the papers reviewed show that with Aboriginal control, modest investment and respectful collaboration, service enhancements and improved outcomes can be achieved. Mainstream interventions need to be adapted to Aboriginal settings, not simply transferred. The lessons outlined provide important reflections for future research. © 2014 Australasian Professional Society on Alcohol and other Drugs.

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

PubMed

Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

2015-01-01

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

The Strong Family Program: an innovative model to engage Aboriginal and Torres Strait Islander youth and Elders with reproductive and sexual health community education.

PubMed

Duley, P; Botfield, J R; Ritter, T; Wicks, J; Brassil, A

2017-08-01

Issue addressed Aboriginal youth in Australia often experience high rates of intimate partner violence (family violence) and poorer reproductive and sexual health than their non-Aboriginal counterparts. To address some of the disparities, the Strong Family Program was developed to deliver reproductive and sexual health education to Aboriginal communities in New South Wales. Methods Development of the program was based on an extensive consultation process with Aboriginal communities. It was implemented in three communities, with two groups from each hosting Aboriginal youth and Elders in a yarning circle within the culturally respectful frameworks of 'men and boys'' and 'women and girls'' business. An evaluation was conducted to measure reproductive and sexual health knowledge and attitude changes upon program completion, using pre- and post-program surveys and yarning (focus group discussions). Results Program participants comprised 48 females and 28 males. Overall, mean knowledge and attitude scores improved upon completion of the program (from 77% to 82% and from 4.15 to 4.32 out of 5, respectively). Among participants aged 20 years and under (the youngest participant was 13 years), there was an increase in knowledge (P=0.034); among participants aged over 20 years (the oldest participant was 78 years), there was an increase in positive attitudes (P=0.001). Participants perceived the information provided to be useful and relevant, with many reporting improved knowledge and attitudes around rights and respectful relationships. Conclusions Reproductive and sexual health education in Aboriginal communities should be based on community consultations and carried out within a culturally appropriate framework to promote greater success. Continued implementation of the Strong Family Program will promote increased understanding of respectful relationships and improved health outcomes for Aboriginal young people. So what? The Strong Family Program was based on an extensive consultative process that ensured leadership and involvement from Aboriginal communities, with program content and delivery based on Aboriginal pedagogy and reflecting Aboriginal cultural values. Reproductive and sexual health promotion in Aboriginal communities should be based on community consultations and carried out within a culturally appropriate framework to promote greatest success.

Pleasures and Risks Associated with Bingo Playing in an Australian Aboriginal Community: Lessons for Policy and Intervention.

PubMed

Maltzahn, Kathleen; Vaughan, Richard; Griffin, Tiffany; Thomas, Darlene; Stephens, Raelene; Whiteside, Mary; Maclean, Sarah

2018-06-05

Bingo playing in Australian Indigenous communities has received little academic attention. We report here on an exploratory study designed to understand the complex benefits and harms associated with bingo playing for Aboriginal people in Sunraysia, a regional community in Victoria, Australia. The research was strongly participatory, and conducted in collaboration with staff of an Aboriginal community-controlled organisation. Twenty-six members of the Sunraysia Aboriginal community were interviewed, with interviews primarily conducted by workers from the Aboriginal organisation. Echoing research from other countries, but with a unique focus on the experience of bingo for Aboriginal people in Australia, this study demonstrates compelling reasons why Aboriginal people in Sunraysia play bingo, and how bingo playing both exposes players to risk and mitigates against a wide range of harms. We found that, for many people in the study, bingo was variously a site that reinforces social connectedness, a source of fun and excitement and a strategy to find solace or respite in the face of personal pain and structural injustice. In contrast with other forms of gambling, bingo presents risks that can generally be managed, largely because of the smaller financial spend involved. However, people also described harms including exhausting the family budget, family conflict and encouragement to commence other forms of gambling. We argue for enhanced regulation of commercial bingo and suggest that not-for-profit bingo be implemented as a harm reduction strategy to enable people to experience some of the pleasures associated with gambling, with reduced risk of financial and social harms.

A decade of experience evolving visiting dental services in partnership with rural remote Aboriginal communities.

PubMed

Dyson, K; Kruger, E; Tennant, M

2014-06-01

Embedding research capabilities and workforce development activities with clinical service entities promotes the development of sustainable, innovative, quality-focused oral health care services. Clinical and strategic governance is an important area of consideration for rural and remote dental services, posing particular challenges for smaller service structures. Sustaining remote area dental services has some significant complexities beyond those involved in urban service models. This study describes the sustaining structure of a remote area dental service with a decade of history. In the current climate, chief among these challenges may be those associated with dental workforce shortages as these impact most heavily in the public sector, and most particularly, in remote areas. As sustained workforce solutions come from developing a future workforce, an essential element of the workforce governance framework for remote dental service provision should be the inclusion of a student participation programme. Collaborative partnership approaches with Aboriginal health services promote the development and maintenance of effective, culturally sensitive dental services within rural and remote Aboriginal communities. Having sustained care for 10 years, this collaborative model of integrated research, education and service has demonstrated its effectiveness as a service model for Aboriginal communities in Western Australia. This descriptive study finds the core values for this success have been communication, clinical leadership, mentorship within effective governance systems all linked to an integrated education and research agenda. © 2014 Australian Dental Association.

What constitutes 'support' for the role of the Aboriginal and Torres Strait Islander child health workforce?

PubMed

Watson, Karen; Young, Jeanine; Barnes, Margaret

2013-02-01

As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship.

Facilitators of community participation in an Aboriginal sexual health promotion initiative.

PubMed

Hulme Chambers, Alana; Tomnay, Jane; Stephens, Kylie; Crouch, Alan; Whiteside, Mary; Love, Pettina; McIntosh, Leonie; Waples Crowe, Peter

2018-04-01

Community participation is a collaborative process aimed at achieving community-identified outcomes. However, approaches to community participation within Aboriginal health promotion initiatives have been inconsistent and not well documented. Smart and Deadly was a community-led initiative to develop sexual health promotion resources with young Aboriginal people in regional Victoria, Australia. The principles of community-centred practice, authentic participatory processes and respect for the local cultural context guided the initiative. The aim of this article is to report factors that facilitated community participation undertaken in the Smart and Deadly initiative to inform future projects and provide further evidence in demonstrating the value of such approaches. A summative evaluation of the Smart and Deadly initiative was undertaken approximately 2 years after the initiative ended. Five focus groups and 13 interviews were conducted with a purposive sample of 32 participants who were involved with Smart and Deadly in one of the following ways: project participant, stakeholder or project partner, or project developer or designer. A deductive content analysis was undertaken and themes were compared to the YARN model, which was specifically created for planning and evaluating community participation strategies relating to Aboriginal sexual health promotion. A number of factors that facilitated community participation approaches used in Smart and Deadly were identified. The overarching theme was that trust was the foundation upon which the facilitators of community participation ensued. These facilitators were cultural safety and cultural literacy, community control, and legacy and sustainability. Whilst the YARN model was highly productive in identifying these facilitators of community participation, the model did not have provision for the element of trust between workers and community. Given the importance of trust between the project team and the Aboriginal community in the Smart and Deadly initiative, a suggested revision to the YARN model is that trust is included as the basis upon which YARN model factors are predicated. Adding trust to the YARN model as a basis upon which YARN model factors are grounded assists future Aboriginal health promotion projects in ensuring community participation approaches are more likely to be acceptable to the Aboriginal community.

Aboriginal parent support: A partnership approach.

PubMed

Munns, Ailsa; Toye, Christine; Hegney, Desley; Kickett, Marion; Marriott, Rhonda; Walker, Roz

2018-02-01

This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants' perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal. © 2017 John Wiley & Sons Ltd.

Communication disorders after stroke in Aboriginal Australians.

PubMed

Armstrong, Elizabeth; Hersh, Deborah; Hayward, Colleen; Fraser, Joan

2015-01-01

Limited research exists on acquired communication disorders (ACD) in Aboriginal Australians despite their high rates of stroke. Their uptake of rehabilitation services is low, and little information is available on functional consequences for this population. This pilot study explored consequences of ACD for Aboriginal Australians after stroke, including their experiences of services received. Semi-structured interviews were collected with 13 Aboriginal people with ACD, and family members, in Perth. Ages ranged from 30 to 78 years and time post stroke from 0.5 to 29 years. A qualitative, thematic analysis of interview transcripts was undertaken. The key themes which emerged were "getting on with life", coping with change, independence/interdependence, the importance of communication for maintaining family and community connection, role and identity issues and viewing the stroke consequences within the broader context of co-morbidities. While similar life disruptions were found to those previously reported in the general stroke population, this study highlighted differences, which reflect the particular context of ACD for Aboriginal people and which need to be considered when planning future services. While implications are limited due to small numbers, the findings emphasise the importance of a holistic approach, and integration of communication treatments into community-led social activities. Implications for Rehabilitation Aboriginal Australians frequently experience a range of concurrent and complex co-morbidities and demanding social or family circumstances at the same time as coping with communication disorders post-stroke. A holistic approach to post stroke rehabilitation may be appropriate with services that accommodate communication disorders, delivered in collaboration with Aboriginal organisations, emphasising positive attitudes and reintegration into community as fully as possible. Communication and yarning are important for maintaining family and community connection and identity, and family and community context should be incorporated into all assessment and treatment activities.

Generational Sex And HIV Risk Among Indigenous Women In A Street-Based Urban Canadian Setting

PubMed Central

Bingham, Brittany; Leo, Diane; Zhang, Ruth; Montaner, Julio

2014-01-01

In Canada, indigenous women are overrepresented among new HIV infections and street-based sex workers. Scholars suggest that Aboriginal women’s HIV risk stems from intergenerational effects of colonisation and racial policies. This research examined generational sex work involvement among Aboriginal and non-Aboriginal women and the effect on risk for HIV acquisition. The sample included 225 women in street-based sex work and enrolled in a community-based prospective cohort, in partnership with local sex work and Aboriginal community partners. Bivariate and multivariate logistic regression modeled an independent relationship between Aboriginal ancestry and generational sex work; and the impact of generational sex work on HIV infection among Aboriginal sex workers. Aboriginal women (48%) were more likely to be HIV-positive, with 34% living with HIV compared to 24% non-Aboriginal. In multivariate logistic regression model, Aboriginal women remained 3 times more likely to experience generational sex work (aOR:2.97; 95%CI:1.5,5.8). Generational sex work was significantly associated with HIV (aOR=3.01, 95%CI: 1.67–4.58) in a confounder model restricted to Aboriginal women. High prevalence of generational sex work among Aboriginal women and 3-fold increased risk for HIV infection are concerning. Policy reforms and community-based, culturally safe and trauma informed HIV prevention initiatives are required for Indigenous sex workers. PMID:24654881

Generational sex work and HIV risk among Indigenous women in a street-based urban Canadian setting.

PubMed

Bingham, Brittany; Leo, Diane; Zhang, Ruth; Montaner, Julio; Shannon, Kate

2014-01-01

In Canada, Indigenous women are over-represented among new HIV infections and street-based sex workers. Scholars suggest that Aboriginal women's HIV risk stems from intergenerational effects of colonisation and racial policies. This research examined generational sex work involvement among Aboriginal and non-Aboriginal women and the effect on risk for HIV acquisition. The sample included 225 women in street-based sex work and enrolled in a community-based prospective cohort, in partnership with local sex work and Aboriginal community partners. Bivariate and multivariate logistic regression modeled an independent relationship between Aboriginal ancestry and generational sex work and the impact of generational sex work on HIV infection among Aboriginal sex workers. Aboriginal women (48%) were more likely to be HIV-positive, with 34% living with HIV compared to 24% non-Aboriginal women. In multivariate logistic regression model, Aboriginal women remained three times more likely to experience generational sex work (AOR:2.97; 95%CI:1.5,5.8). Generational sex work was significantly associated with HIV (AOR = 3.01, 95%CI: 1.67-4.58) in a confounder model restricted to Aboriginal women. High prevalence of generational sex work among Aboriginal women and three-fold increased risk for HIV infection are concerning. Policy reforms and community-based, culturally safe and trauma informed HIV-prevention initiatives are required for Indigenous sex workers.

Yarning/Aboriginal storytelling: towards an understanding of an Indigenous perspective and its implications for research practice.

PubMed

Geia, Lynore K; Hayes, Barbara; Usher, Kim

2013-12-01

There is increasing recognition of Indigenous perspectives from various parts of the world in relation to storytelling, research and its effects on practice. The recent emergence of storytelling or yarning as a research method in Australian Aboriginal and Torres Strait Island studies and other Indigenous peoples of the world is gaining momentum. Narratives, stories, storytelling and yarning are emerging methods in research and has wide ranging potential to shape conventional research discourse making research more meaningful and accessible for researchers. In this paper we argue for the importance of Indigenous research methods and Indigenous method(ology), within collaborative respectful partnerships with non-Indigenous researchers. It is imperative to take these challenging steps together towards better outcomes for Indigenous people and their communities. In the Australian context we as researchers cannot afford to allow the gap between Aboriginal and Torres Strait Islanders and mainstream Australia health outcomes to grow even wider. One such pathway is the inclusion of Aboriginal storytelling or yarning from an Aboriginal and Torres Strait perspective within Indigenous and non-Indigenous research paradigms. Utilising Aboriginal storytelling or yarning will provide deeper understanding; complementing a two-way research paradigm for collaborative research. Furthermore, it has significant social implications for research and clinical practice amongst Indigenous populations; thus complementing the biomedical medical paradigm.

'Gotta be sit down and worked out together': views of Aboriginal caregivers and service providers on ways to improve dementia care for Aboriginal Australians.

PubMed

Smith, Kate; Flicker, Leon; Shadforth, Geraldine; Carroll, Emily; Ralph, Naomi; Atkinson, David; Lindeman, Melissa; Schaper, Frank; Lautenschlager, Nicola T; LoGiudice, Dina

2011-01-01

Dementia is five-fold more prevalent among Aboriginal than non-Aboriginal Australians. Despite this, the quality of care available to people living with dementia in remote Aboriginal communities is poor. The objective of this study was to determine ways to overcome factors affecting the successful delivery of services to Aboriginal people with dementia living in remote communities, and to their families and communities. This qualitative research took place in the Kimberley Region of Western Australia. Data collection occurred in three stages: (1) interviews with service providers to identify the services available; (2) interviews with the caregivers of Aboriginal people living with dementia and community-based care workers; and (3) focus groups with community representatives and community care staff. Each stage was concluded when no new themes emerged. At each stage the transcribed information was analysed and joint interpretation identified common themes. In total, 42 service providers, 31 caregivers and community-based care workers were interviewed and 3 focus groups were conducted. Obstacles to accessing quality care were mentioned and recommendations on ways to improve care were made. The key themes that emerged were caregiver role, perspectives of dementia, community and culturally-appropriate care, workforce, education and training, issues affecting remote communities and service issues. Detailed information on how each theme affects the successful delivery of dementia care is provided. These research findings indicate that people living with dementia and their caregivers in remote Aboriginal communities are struggling to cope. They are requesting and require better community care. Implementing a culturally safe model of dementia care for remote Aboriginal communities that encompasses the recommendations made and builds on the strengths of the communities could potentially deliver the required improvements to dementia care for this population.

Improving participation by Aboriginal children in blood lead screening services in Broken Hill, NSW.

PubMed

Thomas, Susan L; Boreland, Frances; Lyle, David M

2013-03-01

Lead poses a health risk to young children with detrimental effects on their intellectual development. Attendance rates for Aboriginal children at routine blood lead screening and at follow-up appointments in Broken Hill, NSW, have declined in recent years. This study sought to identify strategies to improve the participation of Aboriginal children aged 1-4 years in blood lead screening services in Broken Hill. Attendance rates during the period 2000-2010 were determined using the Broken Hill Lead Management database. From June to August 2011, Aboriginal community members, service providers and public health staff were invited to interviews and focus groups to explore barriers, enablers and suggestions for improving participation. In 2009, 27% of Aboriginal children aged 1-4 years attended blood lead screening and 29% of these children with blood lead levels over 15 µg/dL attended follow-up appointments. Barriers to participation in lead screening services included community perceptions, reduced service capacity, socio-economic and interorganisational factors. Enablers included using a culturally acceptable model, linking lead screening with routine health checks and using the finger-prick method of testing. The final report for the study included recommendations to improve participation rates of Aboriginal children including using social marketing, formalising collaboration between health services, supporting disadvantaged families and employing an Aboriginal Health Worker.

Needs of Aboriginal and Torres Strait Islander clients residing in Australian residential aged-care facilities.

PubMed

Brooke, Nicole J

2011-08-01

This review was undertaken to identify evidence-based practice guidelines to support the care needs of Aboriginal and Torres Strait Islander clients residing in residential aged-care facilities. A systematic literature review was undertaken. An electronic search of online databases and subsequent manual retrieval process was undertaken to identify relevant reports and studies that explored interventions for care of an Aboriginal and Torres Strait Islander person. Very limited published material identified strategies necessary within residential aged care. Sixty-seven articles were considered for inclusion, and a subsequent review resulted in 34 being included due to direct alignment with the study aim. Strategies recommended within the review cover areas such as care, communication, palliative care, activities and the environment. Care for an Aboriginal and Torres Strait Islander person in an Australian residential aged-care facility requires a collaborative and individual approach. Cultural safety principles should be maintained across a culturally competent workforce. Aboriginal and Torres Strait Islander persons in care is a significant experience that should not be considered 'routine' as there is much to consider in the care of this person and their community. © 2011 The Author. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Aboriginal and Torres Strait Islander community governance of health research: Turning principles into practice.

PubMed

Gwynn, Josephine; Lock, Mark; Turner, Nicole; Dennison, Ray; Coleman, Clare; Kelly, Brian; Wiggers, John

2015-08-01

Gaps exist in researchers' understanding of the 'practice' of community governance in relation to research with Aboriginal and Torres Strait Islander peoples. We examine Aboriginal community governance of two rural NSW research projects by applying principles-based criteria from two independent sources. One research project possessed a strong Aboriginal community governance structure and evaluated a 2-year healthy lifestyle program for children; the other was a 5-year cohort study examining factors influencing the mental health and well-being of participants. The National Health and Medical Research Council of Australia's 'Values and ethics: guidelines for ethical conduct in Aboriginal and Torres Strait Islander research' and 'Ten principles relevant to health research among Indigenous Australian populations' described by experts in the field. Adopt community-based participatory research constructs. Develop clear governance structures and procedures at the beginning of the study and allow sufficient time for their establishment. Capacity-building must be a key component of the research. Ensure sufficient resources to enable community engagement, conduct of research governance procedures, capacity-building and results dissemination. The implementation of governance structures and procedures ensures research addresses the priorities of the participating Aboriginal and Torres Strait Islander communities, minimises risks and improves outcomes for the communities. Principles-based Aboriginal and Torres Strait Islander community governance of research is very achievable. Next steps include developing a comprehensive evidence base for appropriate governance structures and procedures, and consolidating a suite of practical guides for structuring clear governance in health research. © 2015 National Rural Health Alliance Inc.

An Indigenous Knowledges Perspective on Valid Meaning Making: A Commentary on Research with the EDI and Aboriginal Communities

ERIC Educational Resources Information Center

Sam, Michele A.

2011-01-01

Offering an Indigenous perspective, this commentary discusses collaborative research, shared meaning making, and knowledge building specific to child development, and reflects on social, cultural, and historical aspects that influence these processes. Drawing upon experiences of developing a collaborative research approach with which to engage…

Prevalence of dementia in urban and regional Aboriginal Australians.

PubMed

Radford, Kylie; Mack, Holly A; Draper, Brian; Chalkley, Simon; Daylight, Gail; Cumming, Robert; Bennett, Hayley; Delbaere, Kim; Broe, Gerald A

2015-03-01

This study aimed to determine the prevalence of dementia in collaboration with urban/regional Aboriginal communities. A census of Aboriginal and Torres Strait Islander men and women aged 60 years and above in the target communities identified 546 potential participants, with 336 (61.5%) participating in this cross-sectional study. Participants completed a structured interview and cognitive screening tests. One hundred fifty-three participants also completed a detailed medical assessment. Assessment data were reviewed by a panel of clinicians who determined a diagnosis of dementia or mild cognitive impairment (MCI) according to standard criteria. Crude prevalence of dementia was 13.4%, and age-standardized prevalence was 21.0%. The most common types of dementia were Alzheimer's dementia (44%) and mixed dementia diagnoses (29%). Estimated prevalence of MCI was 17.7%. Consistent with previous findings in a remote population, urban and regional Aboriginal Australians face high rates of dementia at younger ages, most commonly Alzheimer's dementia. Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Collaborating toward improving food security in Nunavut.

PubMed

Wakegijig, Jennifer; Osborne, Geraldine; Statham, Sara; Issaluk, Michelle Doucette

2013-01-01

Community members, Aboriginal organizations, public servants and academics have long been describing a desperate situation of food insecurity in the Eastern Canadian Arctic. The Nunavut Food Security Coalition, a partnership of Inuit Organizations and the Government of Nunavut, is collaborating to develop a territorial food security strategy to address pervasive food insecurity in the context of poverty reduction. The Nunavut Food Security Coalition has carried out this work using a community consultation model. The research was collected through community visits, stakeholder consultation and member checking at the Nunavut Food Security Symposium. In this paper, we describe a continuous course of action, based on community engagement and collective action, that has led to sustained political interest in and public mobilization around the issue of food insecurity in Nunavut. The process described in this article is a unique collaboration between multiple organizations that has led to the development of a sustainable partnership that will inform policy development while representing the voice of Nunavummiut.

Collaborating toward improving food security in Nunavut

PubMed Central

Wakegijig, Jennifer; Osborne, Geraldine; Statham, Sara; Issaluk, Michelle Doucette

2013-01-01

Background Community members, Aboriginal organizations, public servants and academics have long been describing a desperate situation of food insecurity in the Eastern Canadian Arctic. Objective The Nunavut Food Security Coalition, a partnership of Inuit Organizations and the Government of Nunavut, is collaborating to develop a territorial food security strategy to address pervasive food insecurity in the context of poverty reduction. Design The Nunavut Food Security Coalition has carried out this work using a community consultation model. The research was collected through community visits, stakeholder consultation and member checking at the Nunavut Food Security Symposium. Results In this paper, we describe a continuous course of action, based on community engagement and collective action, that has led to sustained political interest in and public mobilization around the issue of food insecurity in Nunavut. Conclusions The process described in this article is a unique collaboration between multiple organizations that has led to the development of a sustainable partnership that will inform policy development while representing the voice of Nunavummiut. PMID:23984307

Closing the (service) gap: exploring partnerships between Aboriginal and mainstream health services.

PubMed

Taylor, Kate P; Thompson, Sandra C

2011-08-01

Although effective partnerships between Aboriginal and mainstream health services are critical to improve Aboriginal health outcomes, many factors can cause these partnerships to be tenuous and unproductive. Understanding the elements of best practice for successful partnerships is essential. A literature review was conducted in 2009 using keyword searches of electronic databases. Sourced literature was assessed for relevance regarding the benefits, challenges, lessons learnt and factors contributing to successful Aboriginal and mainstream partnerships. Key themes were collated. Although there is much literature regarding general partnerships generally, few specifically examine Aboriginal and mainstream health service partnerships. Twenty-four sources were reviewed in detail. Benefits include broadening service capacity and improving the cultural security of healthcare. Challenges include the legacy of Australia's colonial history, different approaches to servicing clients and resource limitations. Recommendations for success include workshopping tensions early, building trust and leadership. Although successful partnerships are crucial to optimise Aboriginal health outcomes, failed collaborations risk inflaming sensitive Aboriginal-non-Aboriginal relationships. Factors supporting successful partnerships remind us to develop genuine, trusting relationships that are tangibly linked to the Aboriginal community. Failure to invest in this relational process and push forward with 'business as usual' can ultimately have negative ramifications on client outcomes.

Addressing HIV/AIDS among Aboriginal People using a Health Status, Health Determinants and Health Care Framework: A Literature Review and Conceptual Analysis

PubMed Central

Nowgesic, Earl

2016-01-01

Objectives (1) To describe the Human Immunodeficiency Virus (HIV) infection among Aboriginal populations using a mixed methods approach (i.e. quantitative and qualitative methods); (2) to examine the individual-level and community-level relationships between HIV/AIDS, health determinants, and health care (e.g. diagnosis, access to treatment and health services planning); and (3) to explore innovative solutions to address HIV/AIDS among Aboriginal populations based upon research and infrastructure (e.g. partnerships, data sources and management, health indicators and culture) and policy (i.e. self-determination of Aboriginal Peoples). Methods Literature review and conceptual analysis using a health status, health determinants and health care framework. Results In comparison to non-Aboriginal persons, HIV infection is higher among Aboriginal persons, is more directly attributable to unique risk factors and socio-demographic characteristics, and yields more adverse health outcomes. Culture, poverty and self-determination are determinants of health for Aboriginal populations. Aboriginal people have inadequate primary care and, in particular, specialist care. It is necessary to include traditional Aboriginal approaches and culture when addressing Aboriginal health while understanding competing paradigms between modern medicine and Aboriginal traditions. Conclusion There is a need for self-determination of Aboriginal Peoples in order to improve the health of Aboriginal communities and those living with HIV/AIDS. Research and policy affecting Aboriginal people should be of the highest quality and based upon Aboriginal community relevance and involvement. PMID:27398110

Assessing and Validating an Educational Resource Package for Health Professionals to Improve Smoking Cessation Care in Aboriginal and Torres Strait Islander Pregnant Women.

PubMed

Bar-Zeev, Yael; Bovill, Michelle; Bonevski, Billie; Gruppetta, Maree; Reath, Jennifer; Gould, Gillian S

2017-09-29

Australian Aboriginal pregnant women have a high smoking prevalence (45%). Health professionals lack adequate educational resources to manage smoking. Resources need to be tailored to ensure saliency, cultural-sensitivity and account for diversity of Indigenous populations. As part of an intervention to improve health professionals' smoking cessation care in Aboriginal pregnant women, a resource package was developed collaboratively with two Aboriginal Medical Services. The purpose of this study was to assess and validate this resource package. A multi-centred community-based participatory 4-step process (with three Aboriginal Medical Services from three Australian states), included: (1) Scientific review by an expert panel (2) 'Suitability of Materials' scoring by two Aboriginal Health Workers (3) Readability scores (4) Focus groups with health professionals. Content was analysed using six pre-determined themes (attraction, comprehension, self-efficacy, graphics and layout, cultural acceptability, and persuasion), with further inductive analysis for emerging themes. Suitability of Material scoring was adequate or superior. Average readability was grade 6.4 for patient resources (range 5.1-7.2), and 9.8 for health provider resources (range 8.5-10.6). Emergent themes included 'Getting the message right'; 'Engaging with family'; 'Needing visual aids'; and 'Requiring practicality under a tight timeframe'. Results were presented back to a Stakeholder and Consumer Aboriginal Advisory Panel and resources were adjusted accordingly. This process ensured materials used for the intervention were culturally responsive, evidence-based and useful. This novel formative evaluation protocol could be adapted for other Indigenous and culturally diverse interventions. The added value of this time-consuming and costly process is yet to be justified in research, and might impact the potential adaption by other projects.

The acceptability to Aboriginal Australians of a family-based intervention to reduce alcohol-related harms.

PubMed

Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony; Allan, Julaine; Bliss, Donna; Doran, Christopher

2013-05-01

Cognitive-behavioural interventions that use familial and community reinforcers in an individual's environment are effective for reducing alcohol-related harms. Such interventions have considerable potential to reduce the disproportionately high burden of alcohol-related harm among Aboriginal Australians if they can be successfully tailored to their specific needs and circumstances. The overall aim of this paper is to describe the perceived acceptability of two cognitive-behavioural interventions, the Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT), to a sample of Aboriginal people. Descriptive survey was administered to 116 Aboriginal people recruited through an Aboriginal Community Controlled Health Service and a community-based drug and alcohol treatment agency in rural New South Wales, Australia. Participants perceived CRA and CRAFT to be highly acceptable for delivery in their local Aboriginal community. Women were more likely than men to perceive CRAFT as highly acceptable. Participants expressed a preference for counsellors to be someone they knew and trusted, and who has experience working in their local community. CRA was deemed most acceptable for delivery to individuals after alcohol withdrawal and CRAFT for people who want to help a relative/friend start alcohol treatment. There was a preference for five or more detailed sessions. Findings of this study suggest that CRA and CRAFT are likely to be acceptable for delivery to some rural Aboriginal Australians, and that there is potential to tailor these interventions to specific communities. © 2012 Australasian Professional Society on Alcohol and other Drugs.

Aboriginal Education in Winnipeg Inner City High Schools.

ERIC Educational Resources Information Center

Silver, Jim; Mallett, Kathy

This study investigated the educational circumstances of Aboriginal students in inner city high schools in Winnipeg, Manitoba, Canada. It is based on a literature review and interviews with Aboriginal high school students, Aboriginal school dropouts, adult members of the Aboriginal community, and teachers. Results indicate that there is a…

Tailoring a response to youth binge drinking in an Aboriginal Australian community: a grounded theory study.

PubMed

McCalman, Janya; Tsey, Komla; Bainbridge, Roxanne; Shakeshaft, Anthony; Singleton, Michele; Doran, Christopher

2013-08-07

While Aboriginal Australian health providers prioritise identification of local community health needs and strategies, they do not always have the opportunity to access or interpret evidence-based literature to inform health improvement innovations. Research partnerships are therefore important when designing or modifying Aboriginal Australian health improvement initiatives and their evaluation. However, there are few models that outline the pragmatic steps by which research partners negotiate to develop, implement and evaluate community-based initiatives. The objective of this paper is to provide a theoretical model of the tailoring of health improvement initiatives by Aboriginal community-based service providers and partner university researchers. It draws from the case of the Beat da Binge community-initiated youth binge drinking harm reduction project in Yarrabah. A theoretical model was developed using the constructivist grounded theory methods of concurrent sampling, data collection and analysis. Data was obtained from the recordings of reflective Community-Based Participatory Research (CBPR) processes with Aboriginal community partners and young people, and university researchers. CBPR data was supplemented with interviews with theoretically sampled project participants. The transcripts of CBPR recordings and interviews were imported into NVIVO and coded to identify categories and theoretical constructs. The identified categories were then developed into higher order concepts and the relationships between concepts identified until the central purpose of those involved in the project and the core process that facilitated that purpose were identified. The tailored alcohol harm reduction project resulted in clarification of the underlying local determinants of binge drinking, and a shift in the project design from a social marketing awareness campaign (based on short-term events) to a more robust advocacy for youth mentoring into education, employment and training. The community-based process undertaken by the research partnership to tailor the design, implementation and evaluation of the project was theorised as a model incorporating four overlapping stages of negotiating knowledges and meanings to tailor a community response. The theoretical model can be applied in spaces where local Aboriginal and scientific knowledges meet to support the tailored design, implementation and evaluation of other health improvement projects, particularly those that originate from Aboriginal communities themselves.

Research methods of Talking About The Smokes: an International Tobacco Control Policy Evaluation Project study with Aboriginal and Torres Strait Islander Australians.

PubMed

Thomas, David P; Briggs, Viki L; Couzos, Sophia; Davey, Maureen E; Hunt, Jennifer M; Panaretto, Kathryn S; van der Sterren, Anke E; Stevens, Matthew; Nicholson, Anna K; Borland, Ron

2015-06-01

To describe the research methods and baseline sample of the Talking About The Smokes (TATS) project. The TATS project is a collaboration between research institutions and Aboriginal community-controlled health services (ACCHSs) and their state and national representative bodies. It is one of the studies within the International Tobacco Control Policy Evaluation Project, enabling national and international comparisons. It includes a prospective longitudinal study of Aboriginal and Torres Strait Islander smokers and recent ex-smokers; a survey of non-smokers; repeated cross-sectional surveys of ACCHS staff; and descriptions of the tobacco policies and practices at the ACCHSs. Community members completed face-to-face surveys; staff completed surveys on paper or online. We compared potential biases and the distribution of variables common to the main community baseline sample and unweighted and weighted results of the 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS). The baseline survey (Wave 1) was conducted between April 2012 and October 2013. 2522 Aboriginal and Torres Strait Islander people in 35 locations (the communities served by 34 ACCHSs and one community in the Torres Strait), and 645 staff in the ACCHSs. Sociodemographic and general health indicators, smoking status, number of cigarettes smoked per day and quit attempts. The main community baseline sample closely matched the distribution of the Aboriginal and Torres Strait Islander population in the weighted NATSISS by age, sex, jurisdiction and remoteness. There were inconsistent differences in some sociodemographic factors between our sample and the NATSISS: our sample had higher proportions of unemployed people, but also higher proportions who had completed Year 12 and who lived in more advantaged areas. In both surveys, similar percentages of smokers reported having attempted to quit in the past year, and daily smokers reported similar numbers of cigarettes smoked per day. The TATS project provides a detailed and nationally representative description of Aboriginal and Torres Strait Islander smoking behaviour, attitudes, knowledge and exposure to tobacco control activities and policies, and their association with quitting.

Apparent dietary intake in remote aboriginal communities.

PubMed

Lee, A J; O'Dea, K; Mathews, J D

1994-06-01

Apparent per capita food and nutrient intake in six remote Australian Aboriginal communities using the 'store-turnover' method is described. The method is based on the analysis of community-store food invoices. The face validity of the method supports the notion that, under the unique circumstances of remote Aboriginal communities, the turnover of foodstuffs from the community store is a useful measure of apparent dietary intake for the community as a whole. In all Aboriginal communities studied, the apparent intake of energy, sugars and fat was excessive, while the apparent intake of dietary fibre and several nutrients, including folic acid, was low. White sugar, flour, bread and meat provided in excess of 50 per cent of the apparent total energy intake. Of the apparent high fat intake, fatty meats contributed nearly 40 per cent in northern coastal communities and over 60 per cent in central desert communities. Sixty per cent of the apparent high intake of sugars was derived from sugar per se in both regions. Compared with national Australian apparent consumption data, intakes of sugar, white flour and sweetened carbonated beverages were much higher in Aboriginal communities, and intakes of wholemeal bread, fruit and vegetables were much lower. Results of the store-turnover method have important implications for community-based nutrition intervention programs.

Healing the community to heal the individual: literature review of aboriginal community-based alcohol and substance abuse programs.

PubMed

Jiwa, Ashifa; Kelly, Len; Pierre-Hansen, Natalie

2008-07-01

To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for longterm program sustainability. Programs require increased documentation of their inroads in this developing field.

Confronting barriers and recognizing opportunities: Developing effective community-based environmental monitoring programs to meet the needs of Aboriginal communities

DOE Office of Scientific and Technical Information (OSTI.GOV)

McKay, Ariana J., E-mail: ariana.mckay@outlook.com; Johnson, Chris J., E-mail: chris.johnson@unbc.ca

Aboriginal communities can be negatively affected by resource development, but often they do not have a full opportunity to participate in project review and the resulting monitoring and mitigation activities. Cumulative impacts of resource development are also typically neglected in monitoring protocols that focus on a limited number of environmental values, rather than adopting a long-term, holistic view of development over time and space. Community-based environmental monitoring (CBEM) is emerging as a way to meaningfully include local Aboriginal citizens in the decision-making process as well as the assessment of the long-term impacts of the development of natural resources. We exploredmore » opportunities and barriers for developing CBEM programs that meet the needs of small and rural Aboriginal communities that are faced with the rapid and wide-spread development of natural resources. We conducted interviews with a local Aboriginal community, and natural resource management practitioners who could provide perspectives on the application of CBEM to resource management in north-central British Columbia, Canada. Results demonstrate that CBEM offers a locally adapted and culturally appropriate approach to facilitate the participation of Aboriginal communities in natural resource decision making and management. The interpretation of the specific role and purpose of CBEM differed among participants, depending on their objectives for and concerns about natural resource development. However, all parties were consistent in viewing CBEM as an effective method for engaging in dialogue, cooperation, and tracking environmental change. The development or improvement of CBEM programs should consider the efficacy of monitoring protocols, social cohesion and relationships, ability to inform decision-making, and effectiveness of CBEM for the members of the community. - Highlights: • We explored how to develop effective CBEM with a focus on Aboriginal communities. • We identified opportunities and barriers for developing CBEM programs. • CBEM can facilitate Aboriginal community participation in natural resource management.« less

Helicobacter pylori infection in Canadian and related Arctic Aboriginal populations

PubMed Central

Goodman, Karen J; Jacobson, Kevan; van Zanten, Sander Veldhuyzen

2008-01-01

In 2006, the Canadian Helicobacter Study Group identified Aboriginal communities among Canadian population groups most at risk of Helicobacter pylori-associated disease. The objective of this systematic review was to summarize what is known about the H pylori-associated disease burden in Canadian and related Arctic Aboriginal populations to identify gaps in knowledge. Six health literature databases were systematically searched to identify reports on H pylori prevalence in Canadian population groups, or any topic related to H pylori in Canadian Aboriginals, Alaska Natives or Aboriginals of other Arctic regions. Identified reports were organized by subtopic and summarized in narrative form. Key data from studies of H pylori prevalence in defined populations were summarized in tabular form. A few Arctic Aboriginal communities were represented in the literature: two Canadian Inuit; one Canadian First Nation; two Greenland Inuit; one Russian Chutkotka Native; and several Alaska Native studies. These studies uniformly showed elevated H pylori prevalence; a few studies also showed elevated occurrence of H pylori-related diseases and high rates of treatment failure. Based on the evidence, it would be warranted for clinicians to relax the criteria for investigating H pylori and related diseases in patients from Arctic Aboriginal communities, and to pursue post-therapy confirmation of eradication. Additional community-based research is needed to develop public health policies for reducing H pylori-associated health risks in such communities. PMID:18354758

Doctor-patient communications in the Aboriginal community: towards the development of educational programs.

PubMed

Towle, Angela; Godolphin, William; Alexander, Ted

2006-09-01

Aboriginal people in Canada have poorer health than the rest of the population. Reasons for health disparities are many and include problems in communication between doctor and patient. The objective of this study was to understand doctor-patient communication in Aboriginal communities in order to design educational interventions for medical students based on the needs and experiences of patients. Experiences of good and poor communication were studied by semi-structured interviews or focus groups with 22 Aboriginal community members, 2 community health representatives and 2 Aboriginal trainee physicians. Transcribed data were coded and subjected to thematic analysis. Positive and negative experiences of communicating with physicians fell into three broad and interrelated themes: their histories as First Nations citizens; the extent to which the physician was trusted; time in the medical interview. Aboriginal peoples' history affects their communication with physicians; barriers may be overcome when patients feel they have a voice and the time for it to be heard. Physicians can improve communication with Aboriginal patients by learning about their history, building trust and giving time.

Dog and Cat Interactions in a Remote Aboriginal Community.

PubMed

Kennedy, Brooke; Brown, Wendy Y; Vernes, Karl; Körtner, Gerhard; Butler, James R A

2018-04-26

This study examined dog and cat demographics, roaming behaviours, and interspecific interactions in a remote Aboriginal island community using multiple methods. Our results revealed temporal differences between the roaming behaviours of dogs, cats, and wildlife. Dogs showed crepuscular behaviour, being active around dawn (5:30 a.m. to 9:30 a.m.) and dusk (6:00 p.m. and 11:35 p.m.). The majority of cats were active between dawn (6:30 a.m.) and dusk (7:30 p.m.) and travelled shorter distances than dogs. However, some cats were also observed roaming between dusk and dawn, and were likely to be hunting since flightless wildlife were also recorded on our remote-sensing cameras during this time. These baseline data provide evidence to suggest that new management programs are needed to reduce the number of roaming cats and therefore their potential impacts on native wildlife. Collaborations between Aboriginal owners and other stakeholders is necessary to design innovative and effective animal management and policy on the island.

Astronomical Heritage and Aboriginal People: Conflicts and Possibilities

NASA Astrophysics Data System (ADS)

Martín López, Alejandro

2015-08-01

In this presentation we will address the issues relating to the astronomical heritage of contemporary aboriginal groups and othe minorities. We will deal specially with the intangible astronomical heritage and their particularities. We will study (from the ethnographic experience with Aboriginal groups, Creoles and Europeans in the Argentine Chaco) the conflicts referring to the different ways, in which the native's knowledge and practice are categorized by the natives themselves, by the scientists, the state politicians, the professional artists and NGOs. We will address several cases to illustrate this kind of conflicts. We will analyze the complexities of patrimonial policies when it are applied to practices and representations of contemporary communities involved in power relations with national states and the global system. The essentialization of identities, the folklorization of representations and practices, the fossilization of aboriginal peoples are some of the risks of give the label of "cultural heritage" without a careful consideration of each specific case.In particular we will suggest possible forms by which he international scientific community could collaborate to improve the agenda of national states instead of reproducing colonial prejudices. In this way we will contribute to promote the respect for ethnic and religious minorities.

Astronomical Heritage and Aboriginal People: Conflicts and Possibilities

NASA Astrophysics Data System (ADS)

López, Alejandro Martín

2016-10-01

In this presentation we address issues relating to the astronomical heritage of contemporary aboriginal groups and other minorities. We deal specially with intangible astronomical heritage and its particularities. Also, we study (from ethnographic experience with Aboriginal groups, Creoles and Europeans in the Argentine Chaco) the conflicts referring to the different ways in which the natives' knowledge and practice are categorized by the natives themselves, by scientists, state politicians, professional artists and NGOs. Furthermore, we address several cases that illustrate these kinds of conflicts. We aim to analyze the complexities of patrimonial policies when they are applied to practices and representations of contemporary communities involved in power relations with national states and the global system. The essentialization of identities, the folklorization of representations and practices, and the fossilization of aboriginal peoples are some of the risks of applying the label ``cultural heritage'' without a careful consideration of each specific case. In particular we suggest possible ways in which the international scientific community could collaborate to improve the agenda of national states instead of reproducing colonial prejudices. In this way, we aim to contribute to the promotion of respect for ethnic and religious minorities.

Australian Aboriginal and Torres Strait Islander-focused primary healthcare social and emotional wellbeing research: a systematic review protocol.

PubMed

Farnbach, Sara; Eades, Anne-Marie; Hackett, Maree Lisa

2015-12-30

Research with a focus on Aboriginal and Torres Strait Islander Australian's (hereafter referred to as Indigenous(1)) needs is crucial to ensure culturally appropriate evidence-based strategies are developed to improve health. However, concerns surrounding this research exist, arising from some previous research lacking community consultation, resulting in little community benefit or infringing on important cultural values. Values and Ethics: Guidelines for Ethical conduct in Aboriginal and Torres Strait Islander Health Research (hereafter referred to as Values and Ethics), developed by The National Health and Medical Research Council of Australia in 2003, is the ethical standard for Indigenous-focused health research. Researchers must address its Values in research design and conduct. However, its impact on research processes is unclear. Local Protocols should also be considered. This review aims to systematically examine practices related to Values and Ethics, Local Protocols and the processes of conducting Indigenous-focused primary healthcare research in collaboration with external researchers. The following electronic databases and grey literature will be searched (2003 to current): MEDLINE, EMBASE, CINAHL, Informit and HealthInfoNet--an Indigenous-specific research and program website. Indigenous-focused research will be included. Research must be conducted in one or more primary healthcare services, in collaboration with external researchers and with a focus on social and emotional well being. One reviewer will review titles and abstracts to remove obviously irrelevant research articles. Full-text research articles will be retrieved and independently examined by two reviewers. Data and quality assessment will be completed by one reviewer and verified by a second reviewer. Quality will be assessed using modified versions of established quality assessment tools. This review will provide information on research processes and the impact of Values and Ethics on Indigenous-focused primary healthcare research, informing communities and primary healthcare staff around research practices, and researchers and policy makers of strengths and weaknesses of practice. PROSPERO CRD42015024994.

The Picture Talk Project: Starting a Conversation with Community Leaders on Research with Remote Aboriginal Communities of Australia.

PubMed

Fitzpatrick, E F M; Macdonald, G; Martiniuk, A L C; D'Antoine, H; Oscar, J; Carter, M; Lawford, T; Elliott, E J

2017-05-11

Researchers are required to seek consent from Indigenous communities prior to conducting research but there is inadequate information about how Indigenous people understand and become fully engaged with this consent process. Few studies evaluate the preference or understanding of the consent process for research with Indigenous populations. Lack of informed consent can impact on research findings. The Picture Talk Project was initiated with senior Aboriginal leaders of the Fitzroy Valley community situated in the far north of Western Australia. Aboriginal people were interviewed about their understanding and experiences of research and consent processes. Transcripts were analysed using NVivo10 software with an integrated method of inductive and deductive coding and based in grounded theory. Local Aboriginal interpreters validated coding. Major themes were defined and supporting quotes sourced. Interviews with Aboriginal leaders (n = 20) were facilitated by a local Aboriginal Community Navigator who could interpret if necessary and provide cultural guidance. Participants were from all four major local language groups of the Fitzroy Valley; aged 31 years and above; and half were male. Themes emerging from these discussions included Research-finding knowledge; Being respectful of Aboriginal people, Working on country, and Being flexible with time; Working together with good communication; Reciprocity-two-way learning; and Reaching consent. The project revealed how much more there is to be learned about how research with remote Aboriginal communities should be conducted such that it is both culturally respectful and, importantly, meaningful for participants. We identify important elements in community consultation about research and seeking consent.

Culture, context and therapeutic processes: delivering a parent-child intervention in a remote Aboriginal community.

PubMed

Mares, Sarah; Robinson, Gary

2012-04-01

Little is written about the process of delivering mainstream, evidence-based therapeutic interventions for Aboriginal children and families in remote communities. Patterns of interaction between parents and children and expectations about parenting and professional roles and responsibilities vary across cultural contexts. This can be a challenging experience for professionals accustomed to work in urban settings. Language is only a part of cultural difference, and the outsider in a therapeutic group in an Aboriginal community is outside not only in language but also in access to community relationships and a place within those relationships. This paper uses examples from Let's Start, a therapeutic parent-child intervention to describe the impact of distance, culture and relationships in a remote Aboriginal community, on the therapeutic framework, group processes and relationships. Cultural and contextual factors influence communication, relationships and group processes in a therapeutic group program for children and parents in a remote Aboriginal community. Group leaders from within and from outside the community, are likely to have complementary skills. Cultural and contextual factors influence communication, relationships and group processes in a therapeutic group program for children and parents in a remote Aboriginal community. Group leaders from within and from outside the community, are likely to have complementary skills. Program adaptation, evaluation and staff training and support need to take these factors into account to ensure cultural accessibility without loss of therapeutic fidelity and efficacy.

The economic feasibility of price discounts to improve diet in Australian Aboriginal remote communities.

PubMed

Magnus, Anne; Moodie, Marj L; Ferguson, Megan; Cobiac, Linda J; Liberato, Selma C; Brimblecombe, Julie

2016-04-01

To estimate the cost-effectiveness of fiscal measures applied in remote community food stores for Aboriginal Australians. Six price discount strategies on fruit, vegetables, diet drinks and water were modelled. Baseline diet was measured as 12 months' actual food sales data in three remote Aboriginal communities. Discount-induced changes in food purchases were based on published price elasticity data while the weight of the daily diet was assumed constant. Dietary change was converted to change in sodium and energy intake, and body mass index (BMI) over a 12-month period. Improved lifetime health outcomes, modelled for the remote population of Aboriginal and Torres Strait Islanders, were converted to disability adjusted life years (DALYs) saved using a proportional multistate lifetable model populated with diet-related disease risks and Aboriginal and Torres Strait Islander rates of disease. While dietary change was small, five of the six price discount strategies were estimated as cost-effective, below a $50,000/DALY threshold. Stakeholders are committed to finding ways to reduce important inequalities in health status between Aboriginal and Torres Strait Islanders and non-Indigenous Australians. Price discounts offer potential to improve Aboriginal and Torres Strait Islander health. Verification of these results by trial-based research coupled with consideration of factors important to all stakeholders is needed. © 2015 The Authors.

Fall prevention services for older Aboriginal people: investigating availability and acceptability.

PubMed

Lukaszyk, Caroline; Coombes, Julieann; Keay, Lisa; Sherrington, Catherine; Tiedemann, Anne; Broe, Tony; Lovitt, Lorraine; Ivers, Rebecca

2016-12-14

Falls and fall-related injury are emerging issues for older Aboriginal people. Despite this, it is unknown whether older Aboriginal people access available fall prevention programs, or whether these programs are effective or acceptable to this population. To investigate the use of available fall prevention services by older Aboriginal people and identify features that are likely to contribute to program acceptability for Aboriginal communities in New South Wales (NSW), Australia. A questionnaire was distributed to Aboriginal and mainstream health and community services across NSW to identify the fall prevention and healthy ageing programs currently used by older Aboriginal people. Services with experience in providing fall prevention interventions for Aboriginal communities, and key Aboriginal health services that delivered programs specifically for older Aboriginal people, were followed up and staff members were nominated from within each service to be interviewed. Service providers offered their suggestions as to how a fall prevention program could be designed and delivered to meet the health and social needs of their older Aboriginal clients. Of the 131 services that completed the questionnaire, four services (3%) had past experience in providing a mainstream fall prevention program to Aboriginal people; however, there were no programs being offered at the time of data collection. From these four services, and from a further five key Aboriginal health services, 10 staff members experienced in working with older Aboriginal people were interviewed. Barriers preventing services from offering appropriate fall prevention programs to their older Aboriginal clients were identified, including limited funding, a lack of available Aboriginal staff, and communication difficulties between health services and sectors. According to the service providers, an effective and acceptable fall prevention intervention would be evidence based, flexible, community-oriented and social, held in a familiar and culturally safe location and delivered free of cost. This study identified a gap in the availability of acceptable fall prevention programs designed for, and delivered to, older Aboriginal people in NSW. Further consultation with older Aboriginal people is necessary to determine how an appropriate and effective program can be designed and delivered. Terminology: The authors recognise the two distinctive Indigenous populations of Australia: Aboriginal and Torres Strait Islander people. Because the vast majority of the NSW Aboriginal and Torres Strait Islander population is Aboriginal (95.4%)1, this population will be referred to as 'Aboriginal' in this manuscript.

Suicide Rates in Aboriginal Communities in Labrador, Canada

PubMed Central

Pollock, Nathaniel J.; Mulay, Shree; Valcour, James

2016-01-01

Objectives. To compare suicide rates in Aboriginal communities in Labrador, including Innu, Inuit, and Southern Inuit, with the general population of Newfoundland, Canada. Methods. In partnership with Aboriginal governments, we conducted a population-based study to understand patterns of suicide mortality in Labrador. We analyzed suicide mortality data from 1993 to 2009 from the Vital Statistics Death Database. We combined this with community-based methods, including consultations with Elders, youths, mental health and community workers, primary care clinicians, and government decision-makers. Results. The suicide rate was higher in Labrador than in Newfoundland. This trend persisted across all age groups; however, the disparity was greatest among those aged 10 to 19 years. Males accounted for the majority of deaths, although suicide rates were elevated among females in the Inuit communities. When comparing Aboriginal subregions, the Innu and Inuit communities had the highest age-standardized mortality rates of, respectively, 165.6 and 114.0 suicides per 100 000 person-years. Conclusions. Suicide disproportionately affects Innu and Inuit populations in Labrador. Suicide rates were high among male youths and Inuit females. PMID:27196659

An overview of Aboriginal health research in the social sciences: current trends and future directions.

PubMed

Wilson, Kathi; Young, T Kue

2008-06-01

To examine if Aboriginal health research conducted within the field of social sciences reflects the population and geographic diversity of the Aboriginal population. Review. We searched the Web of Science Social Science Citation Index, the Arts and Humanities Citation Index and Scholars Portal for the time period 1995-2005 using search terms to reflect different names used to refer to Canada's Aboriginal peoples. Citations that did not focus on health or Canada were eliminated. Each paper was coded according to 7 broad categories: Aboriginal identity group; geography; age; health status; health determinants; health services; and methods. Based on the 96 papers reviewed, the results show an under-representation of Métis and urban Aboriginal peoples. Most of the papers are on health status and non-medical determinants of health, with a particular focus on chronic conditions and life-style behaviours. Only 6 papers examined traditional approaches to healing and/or access to traditional healers/medicines. A small number involved the use of community-based research methods. Further research is required to address gaps in the current body of literature. Community-based research studies are necessary to address gaps that are most relevant to Aboriginal peoples.

Culturally appropriate methodology in obtaining a representative sample of South Australian Aboriginal adults for a cross-sectional population health study: challenges and resolutions.

PubMed

Marin, Tania; Taylor, Anne Winifred; Grande, Eleonora Dal; Avery, Jodie; Tucker, Graeme; Morey, Kim

2015-05-19

The considerably lower average life expectancy of Aboriginal and Torres Strait Islander Australians, compared with non-Aboriginal and non-Torres Strait Islander Australians, has been widely reported. Prevalence data for chronic disease and health risk factors are needed to provide evidence based estimates for Australian Aboriginal and Torres Strait Islanders population health planning. Representative surveys for these populations are difficult due to complex methodology. The focus of this paper is to describe in detail the methodological challenges and resolutions of a representative South Australian Aboriginal population-based health survey. Using a stratified multi-stage sampling methodology based on the Australian Bureau of Statistics 2006 Census with culturally appropriate and epidemiological rigorous methods, 11,428 randomly selected dwellings were approached from a total of 209 census collection districts. All persons eligible for the survey identified as Aboriginal and/or Torres Strait Islander and were selected from dwellings identified as having one or more Aboriginal person(s) living there at the time of the survey. Overall, the 399 interviews from an eligible sample of 691 SA Aboriginal adults yielded a response rate of 57.7%. These face-to-face interviews were conducted by ten interviewers retained from a total of 27 trained Aboriginal interviewers. Challenges were found in three main areas: identification and recruitment of participants; interviewer recruitment and retainment; and using appropriate engagement with communities. These challenges were resolved, or at least mainly overcome, by following local protocols with communities and their representatives, and reaching agreement on the process of research for Aboriginal people. Obtaining a representative sample of Aboriginal participants in a culturally appropriate way was methodologically challenging and required high levels of commitment and resources. Adhering to these principles has resulted in a rich and unique data set that provides an overview of the self-reported health status for Aboriginal people living in South Australia. This process provides some important principles to be followed when engaging with Aboriginal people and their communities for the purpose of health research.

Bioethics for clinicians: 18. Aboriginal cultures

PubMed Central

Ellerby, Jonathan H.; McKenzie, John; McKay, Stanley; Gariépy, Gilbert J.; Kaufert, Joseph M.

2000-01-01

Although philosophies and practices analogous to bioethics exist in Aboriginal cultures, the terms and categorical distinctions of "ethics" and "bioethics" do not generally exist. In this article we address ethical values appropriate to Aboriginal patients, rather than a preconceived "Aboriginal bioethic." Aboriginal beliefs are rooted in the context of oral history and culture. For Aboriginal people, decision-making is best understood as a process and not as the correct interpretation of a unified code. Aboriginal cultures differ from religious and cultural groups that draw on Scripture and textual foundations for their ethical beliefs and practices. Aboriginal ethical values generally emphasize holism, pluralism, autonomy, community- or family-based decision-making, and the maintenance of quality of life rather than the exclusive pursuit of a cure. Most Aboriginal belief systems also emphasize achieving balance and wellness within the domains of human life (mental, physical, emotional and spiritual). Although these bioethical tenets are important to understand and apply, examining specific applications in detail is not as useful as developing a more generalized understanding of how to approach ethical decision-making with Aboriginal people. Aboriginal ethical decisions are often situational and highly dependent on the values of the individual within the context of his or her family and community. PMID:11033715

Bioethics for clinicians: 18. Aboriginal cultures.

PubMed

Ellerby, J H; McKenzie, J; McKay, S; Gariépy, G J; Kaufert, J M

2000-10-03

Although philosophies and practices analogous to bioethics exist in Aboriginal cultures, the terms and categorical distinctions of "ethics" and "bioethics" do not generally exist. In this article we address ethical values appropriate to Aboriginal patients, rather than a preconceived "Aboriginal bioethic." Aboriginal beliefs are rooted in the context of oral history and culture. For Aboriginal people, decision-making is best understood as a process and not as the correct interpretation of a unified code. Aboriginal cultures differ from religious and cultural groups that draw on Scripture and textual foundations for their ethical beliefs and practices. Aboriginal ethical values generally emphasize holism, pluralism, autonomy, community- or family-based decision-making, and the maintenance of quality of life rather than the exclusive pursuit of a cure. Most Aboriginal belief systems also emphasize achieving balance and wellness within the domains of human life (mental, physical, emotional and spiritual). Although these bioethical tenets are important to understand and apply, examining specific applications in detail is not as useful as developing a more generalized understanding of how to approach ethical decision-making with Aboriginal people. Aboriginal ethical decisions are often situational and highly dependent on the values of the individual within the context of his or her family and community.

Aboriginal Families Study: a population-based study keeping community and policy goals in mind right from the start

PubMed Central

2013-01-01

Background Australian Aboriginal and Torres Strait Islander women are between two to five times more likely to die in childbirth than non-Aboriginal women, and two to three times more likely to have a low birthweight infant. Babies with a low birthweight are more likely to have chronic health problems in adult life. Currently, there is limited research evidence regarding effective interventions to inform new initiatives to strengthen antenatal care for Aboriginal families. Method/Design The Aboriginal Families Study is a cross sectional population-based study investigating the views and experiences of Aboriginal and non-Aboriginal women having an Aboriginal baby in the state of South Australia over a 2-year period. The primary aims are to compare the experiences and views of women attending standard models of antenatal care with those accessing care via Aboriginal Family Birthing Program services which include Aboriginal Maternal Infant Care (AMIC) Workers as members of the clinical team; to assess factors associated with early and continuing engagement with antenatal care; and to use the information to inform strengthening of services for Aboriginal families. Women living in urban, regional and remote areas of South Australia have been invited to take part in the study by completing a structured interview or, if preferred, a self-administered questionnaire, when their baby is between 4–12 months old. Discussion Having a baby is an important life event in all families and in all cultures. How supported women feel during pregnancy, how women and families are welcomed by services, how safe they feel coming in to hospitals to give birth, and what happens to families during a hospital stay and in the early months after the birth of a new baby are important social determinants of maternal, newborn and child health outcomes. The Aboriginal Families Study builds on consultation with Aboriginal communities across South Australia. The project has been implemented with guidance from an Aboriginal Advisory Group keeping community and policy goals in mind right from the start. The results of the study will provide a unique resource to inform quality improvement and strengthening of services for Aboriginal families. PMID:23767813

Kick the habit: a social marketing campaign by Aboriginal communities in NSW.

PubMed

Campbell, M A; Finlay, S; Lucas, K; Neal, N; Williams, R

2014-01-01

Tackling smoking is an integral component of efforts to improve health outcomes in Aboriginal communities. Social marketing is an effective strategy for promoting healthy attitudes and influencing behaviours; however, there is little evidence for its success in reducing smoking rates in Aboriginal communities. This paper outlines the development, implementation and evaluation of Kick the Habit Phase 2, an innovative tobacco control social marketing campaign in Aboriginal communities in New South Wales (NSW). The Aboriginal Health & Medical Research Council worked with three Aboriginal communities and a creative agency to develop locally tailored, culturally relevant social marketing campaigns. Each community determined the target audience and main messages, and identified appropriate local champions and marketing tools. Mixed methods were used to evaluate the campaign, including surveys and interviews with community members and Aboriginal Community Controlled Health Service staff. Community survey participants demonstrated high recall of smoking cessation messages, particularly for messages and images specific to the Kick the Habit campaign. Staff participating in interviews reported an increased level of interest from community members in smoking cessation programs, as well as increased confidence and skills in developing further social marketing campaigns. Aboriginal community-driven social marketing campaigns in tobacco control can build capacity, are culturally relevant and lead to high rates of recall in Aboriginal communities.

Communication between hospitals and isolated aboriginal community health clinics.

PubMed

Mackenzie, G; Currie, B J

1999-04-01

This study described the communication dynamics, identified problems and recommended changes to improve patient follow-up and communication between Royal Darwin Hospital (RDH) and isolated Aboriginal community health clinics (CHC) in the Northern Territory (NT). In 1995, staff interviews were conducted and an audit of isolated Aboriginal patients' RDH discharge summaries (DS). Eighteen per cent of RDH DSs never arrived in CHCs. DSs were often prepared late and more likely to be in CHC records if written on time and if the referral source was specified. Interviews revealed discontent between CHCs and RDH regarding: communication, DS documentation, the supply of discharge medication, as well as different hospital and community perceptions of Aboriginies' reliability to carry a DS and CHC desire for patients to be given DSs at discharge. Aboriginal patients should be given a DS at discharge and resident medical officers should be educated as to the function and importance of the DS. In 18 months following this study, RDH appointed unit-based Aboriginal health workers and a policy was produced for written communication between hospital and CHCs, as well as a discharge planning manual for Aboriginal communities. Projects investigating communication between hospitals and isolated Aboriginal clinics and patient follow-up may result in significant policy changes concerning these processes.

Asthma Prevention and Management for Aboriginal People: Lessons From Mi’kmaq Communities, Unama’ki, Canada, 2012

PubMed Central

Watson, Robert; Bennett, Ella; Masuda, Jeffrey; King, Malcolm; Stewart, Miriam

2016-01-01

Background Asthma affects at least 10% of Aboriginal children (aged 11 or younger) in Canada, making it the second most common chronic disease suffered by this demographic group; yet asthma support strategies specific to Aboriginal peoples have only begun to be identified. Community Context This research builds on earlier phases of a recent study focused on identifying the support needs and intervention preferences of Aboriginal children with asthma and their parents or caregivers. Here, we seek to identify the implications of our initial findings for asthma programs, policies, and practices in an Aboriginal context and to determine strategies for implementing prevention programs in Aboriginal communities. Methods Five focus groups were conducted with 22 recruited community health care professionals and school personnel in 5 Mi’kmaq communities in Unama’ki (Cape Breton), Nova Scotia, Canada, through a community-based participatory research design. Each focus group was first introduced to findings from a local “social support for asthma” intervention, and then the groups explored issues associated with implementing social support from their respective professional positions. Outcome Thematic analysis revealed 3 key areas of opportunity and challenges for implementing asthma prevention and management initiatives in Mi’kmaq communities in terms of 1) professional awareness, 2) local school issues, and 3) community health centers. Interpretation Culturally relevant support initiatives are feasible and effective community-driven ways of improving asthma support in Mi’kmaq communities; however, ongoing assistance from the local leadership (ie, chief and council), community health directors, and school administrators, in addition to partnerships with respiratory health service organizations, is needed. PMID:26766847

Confronting the Growing Crisis of Cardiovascular Disease and Heart Health Among Aboriginal Peoples in Canada.

PubMed

Reading, Jeffrey

2015-09-01

Although the prevalence of cardiovascular disease (CVD) has been decreasing worldwide, Aboriginal populations of Canada (including First Nations, Métis, and Inuit Peoples) continue to experience a rapidly growing burden of CVD morbidity and mortality. This article provides a succinct summary of the current crisis of CVD among Canadian Aboriginal peoples, including how and why it originated, elucidates the underlying population health risks driving higher rates of aboriginal CVD, and articulates the urgent need for community-engagement solutions and innovations in the areas of prevention, treatment and care, rehabilitation services, aboriginal-specific CVD surveillance, and advanced knowledge. In the past, particularly in rural and remote communities, Aboriginal Peoples' survival depended (and often still does) on hunting, fishing, and other forms of traditional food-gathering. However, the traditional life is being changed for many Aboriginal communities, resulting in significantly impaired dietary options and the undermining of a long-established way of life that was healthy and physically active. Reclaiming CVD health and well-being requires replacement of the calorie-dense and nutritionally inadequate diets of highly processed store-bought foods with fresh and nutritionally balanced diets and addressing the physically inactive lifestyles that together have contributed to an increase in CVD prevalence. Furthermore, disparities exist for hospital-based treatment experiences for patients from areas with high proportions of Aboriginal Peoples vs those with low proportions of Aboriginal Peoples. It is crucial to investigate and develop concrete plans to reduce the burden of CVDs among Aboriginal Peoples by improved prevention and treatment in a community-centred way. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Principles for the development of Aboriginal health interventions: culturally appropriate methods through systemic empathy.

PubMed

Kendall, Elizabeth; Barnett, Leda

2015-01-01

To increase Aboriginal participation in mainstream health services, it is necessary to understand the factors that influence health service usage. This knowledge can contribute to the development of culturally appropriate health services that respect Aboriginal ways of being. We used a community-based participatory approach to examine the reasons for underutilization of health services by Aboriginal Australians. Based on three focus groups and 18 interviews with Aboriginal health professionals, leaders, and community members in rural, regional, and urban settings, we identified five factors that influenced usage, including (1) negative historical experiences, (2) cultural incompetence, (3) inappropriate communication, (4) a collective approach to health, and (5) a more holistic approach to health. Given that these factors have shaped negative Aboriginal responses to health interventions, they are likely to be principles by which more appropriate solutions are generated. Although intuitively sensible and well known, these principles remain poorly understood by non-Aboriginal health systems and even less well implemented. We have conceptualized these principles as the foundation of an empathic health system. Without empathy, health systems in Australia, and internationally, will continue to face the challenge of building effective services to improve the state of health for all minority populations.

The Koorie Men's Health Day: an innovative model for early detection of mental illness among rural Aboriginal men.

PubMed

Isaacs, Anton; Lampitt, Berwyn

2014-02-01

To describe the design, implementation and outcomes of an innovative model for the early detection of mental illness among rural Aboriginal men. Through a collaborative effort between a University' Department of Rural and Indigenous Health, an Aboriginal organisation and a regional mental health service, an all-male team was set up which consisted of a doctor, a mental health nurse and four key individuals from the local Aboriginal community. Invitations to attend a Koorie Men's Health Day were distributed via flyers and posters. Using an assembly line technique and avoiding any reference to the term 'mental', all participants underwent a complete medical examination, a blood test for diabetes and a psychological assessment using the Kessler-10 schedule. The event was attended by 20 men. Of the 17 participants whose data were available, seven scored significantly (25 or higher) on the psychological assessment and were offered follow-up. When conducted on a regular basis, the Koorie Men's Health Day could be a useful method for the early detection of mental illness among rural Aboriginal men in Australia. Further research is needed to study the feasibility and sustainability of the model in different settings.

Feasibility of a novel participatory multi-sector continuous improvement approach to enhance food security in remote Indigenous Australian communities.

PubMed

Brimblecombe, J; Bailie, R; van den Boogaard, C; Wood, B; Liberato, S C; Ferguson, M; Coveney, J; Jaenke, R; Ritchie, J

2017-12-01

Food insecurity underlies and compounds many of the development issues faced by remote Indigenous communities in Australia. Multi-sector approaches offer promise to improve food security. We assessed the feasibility of a novel multi-sector approach to enhance community food security in remote Indigenous Australia. A longitudinal comparative multi-site case study, the Good Food Systems Good Food for All Project, was conducted (2009-2013) with four Aboriginal communities. Continuous improvement meetings were held in each community. Data from project documents and store sales were used to assess feasibility according to engagement, uptake and sustainability of action, and impact on community diet, as well as identifying conditions facilitating or hindering these. Engagement was established where: the community perceived a need for the approach; where trust was developed between the community and facilitators; where there was community stability; and where flexibility was applied in the timing of meetings. The approach enabled stakeholders in each community to collectively appraise the community food system and plan action. Actions that could be directly implemented within available resources resulted from developing collaborative capacity. Actions requiring advocacy, multi-sectoral involvement, commitment or further resources were less frequently used. Positive shifts in community diet were associated with key areas where actions were implemented. A multi-sector participatory approach seeking continuous improvement engaged committed Aboriginal and non-Aboriginal stakeholders and was shown to have potential to shift community diet. Provision of clear mechanisms to link this approach with higher level policy and decision-making structures, clarity of roles and responsibilities, and processes to prioritise and communicate actions across sectors should further strengthen capacity for food security improvement. Integrating this approach enabling local decision-making into community governance structures with adequate resourcing is an imperative.

The community network: an Aboriginal community football club bringing people together.

PubMed

Thorpe, Alister; Anders, Wendy; Rowley, Kevin

2014-01-01

There are few empirical studies about the role of Aboriginal sporting organisations in promoting wellbeing. The aim of the present study was to understand the impact of an Aboriginal community sporting team and its environment on the social, emotional and physical wellbeing of young Aboriginal men, and to identify barriers and motivators for participation. A literature review of the impact of sport on the health and wellbeing of Aboriginal participants was conducted. This informed a qualitative study design with a grounded theory approach. Four semistructured interviews and three focus groups were completed with nine current players and five past players of the Fitzroy Stars Football Club to collect data about the social, emotional and physical wellbeing impact of an Aboriginal football team on its Aboriginal players. Results of the interviews were consistent with the literature, with common concepts emerging around community connection, cultural values and identity, health, values, racism and discrimination. However, the interviews provided further detail around the significance of cultural values and community connection for Aboriginal people. The complex nature of social connections and the strength of Aboriginal community networks in sports settings were also evident. Social reasons were just as important as individual health reasons for participation. Social and community connection is an important mechanism for maintaining and strengthening cultural values and identity. Barriers and motivators for participation in Aboriginal sports teams can be complex and interrelated. Aboriginal sports teams have the potential to have a profound impact on the health of Aboriginal people, especially its players, by fostering a safe and culturally strengthening environment and encompassing a significant positive social hub for the Aboriginal community.

Aboriginal Self-Government in Canada: Current Trends and Issues. Purich's Aboriginal Issues Series.

ERIC Educational Resources Information Center

Hylton, John H., Ed.

This book contains 13 chapters analyzing important practical issues that must be addressed as Aboriginal self-government becomes fully operational in Canada. These issues are related to social problems and policies, criminal justice, community services, education, employment and job training, finance, the land base of government, women's rights…

The Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy Pilot Study protocol: a feasibility step-wedge cluster randomised trial to improve health providers' management of smoking during pregnancy

PubMed Central

Bonevski, Billie; Bovill, Michelle; Gruppetta, Maree; Oldmeadow, Chris; Palazzi, Kerrin; Atkins, Lou; Reath, Jennifer

2017-01-01

Introduction Indigenous women have the highest smoking prevalence during pregnancy (47%) in Australia. Health professionals report lack of knowledge, skills and confidence to effectively manage smoking among pregnant women in general. We developed a behaviour change intervention aimed to improve health professionals’ management of smoking in Indigenous pregnant women—the Indigenous Counselling And Nicotine (ICAN) QUIT in Pregnancy. This intervention includes webinar training for health professionals, an educational resources package for health professionals and pregnant women, free oral nicotine replacement therapy (NRT) for pregnant women, and audit and feedback on health professionals' performance. The aim of this study is to test the feasibility and acceptability of the ICAN QUIT in Pregnancy intervention to improve health professionals' provision of evidence-based culturally responsive smoking cessation care to Australian Indigenous pregnant smokers. Methods and analysis This protocol describes the design of a step-wedge cluster randomised pilot study. Six Aboriginal Medical Services (AMSs) are randomised into three clusters. Clusters receive the intervention staggered by 1 month. Health professionals report on their knowledge and skills pretraining and post-training and at the end of the study. Pregnant women are recruited and followed up for 3 months. The primary outcome is the recruitment rate of pregnant women. Secondary outcomes include feasibility of recruitment and follow-up of participating women, and webinar training of health professionals, measured using a designated log; and measures of effectiveness outcomes, including quit rates and NRT prescription rates. Ethics and dissemination In accordance with the Aboriginal Health and Medical Research Council guidelines, this study has been developed in collaboration with a Stakeholder and Consumer Aboriginal Advisory Panel (SCAAP). The SCAAP provides cultural consultation, advice and direction to ensure that implementation is acceptable and respectful to the Aboriginal communities involved. Results will be disseminated to AMSs, Aboriginal communities and national Aboriginal bodies. Registration details This protocol (version 4, 14 October 2016) is registered with the Australian and New Zealand Clinical Trials Registry (Ref #: ACTRN12616001603404). PMID:28780551

Help bring back the celebration of life: A community-based participatory study of rural Aboriginal women’s maternity experiences and outcomes

PubMed Central

2013-01-01

Background Despite clear evidence regarding how social determinants of health and structural inequities shape health, Aboriginal women’s birth outcomes are not adequately understood as arising from the historical, economic and social circumstances of their lives. The purpose of this study was to understand rural Aboriginal women’s experiences of maternity care and factors shaping those experiences. Methods Aboriginal women from the Nuxalk, Haida and 'Namgis First Nations and academics from the University of British Columbia in nursing, medicine and counselling psychology used ethnographic methods within a participatory action research framework. We interviewed over 100 women, and involved additional community members through interviews and community meetings. Data were analyzed within each community and across communities. Results Most participants described distressing experiences during pregnancy and birthing as they grappled with diminishing local maternity care choices, racism and challenging economic circumstances. Rural Aboriginal women’s birthing experiences are shaped by the intersections among rural circumstances, the effects of historical and ongoing colonization, and concurrent efforts toward self-determination and more vibrant cultures and communities. Conclusion Women’s experiences and birth outcomes could be significantly improved if health care providers learned about and accounted for Aboriginal people’s varied encounters with historical and ongoing colonization that unequivocally shapes health and health care. Practitioners who better understand Aboriginal women’s birth outcomes in context can better care in every interaction, particularly by enhancing women’s power, choice, and control over their experiences. Efforts to improve maternity care that account for the social and historical production of health inequities are crucial. PMID:23360168

Building Collaboration: A Scoping Review of Cultural Competency and Safety Education and Training for Healthcare Students and Professionals in Canada.

PubMed

Guerra, Olivia; Kurtz, Donna

2017-01-01

Phenomenon: This scoping literature review summarizes current Canadian health science education and training aimed to lessen health gaps between Aboriginal and non-Aboriginal peoples. Keyword searches of peer-reviewed and gray literature databases, websites, and resources recommended by local Aboriginal community members identified 1,754 resources. Using specific inclusion and exclusion criteria, 26 resources relevant to education and training of healthcare professionals and students in Canada were selected. Information included self-assessment for cultural competency/safety skills, advocacy within Canadian healthcare, and descriptions of current programs and training approaches. In spite of increasing awareness and use of cultural competency and safety concepts, few programs have been successfully implemented. Insights: A concerted effort among health science education and training bodies to develop integrated and effective programs could result in comprehensive processes that hasten the Canadian culturally safe healthcare provision, thus reducing the gaps among populations.

Living Alongside: Teacher Educator Experiences Working in a Community-Based Aboriginal Teacher Education Program

ERIC Educational Resources Information Center

Kitchen, Julian; Hodson, John

2013-01-01

Aboriginal education in Canada needs to shift away from the assimilative model to a model of culturally responsive pedagogy. Teacher education programs that serve Aboriginal teachers have an important role to play in developing an education system that both meets mainstream and Indigenous criteria for success. This paper examines the experiences…

Temporal trends in Inuit, First Nations and non-Aboriginal birth outcomes in rural and northern Quebec.

PubMed

Simonet, Fabienne; Wilkins, Russell; Luo, Zhong-Cheng

2012-01-01

The objective was to assess trends in Inuit, First Nations and non-Aboriginal birth outcomes in the rural and northern regions of Quebec. In a birth cohort-based study of all births to residents of rural and northern Quebec from 1991 through 2000 (n = 177,193), we analyzed birth outcomes and infant mortality for births classified by maternal mother tongue (Inuit, First Nations or non-Aboriginal) and by community type (predominantly First Nations, Inuit or non-Aboriginal). From 1991-1995 to 1996-2000, there was a trend of increasing rates of preterm birth for all 6 study groups. In all rural and northern areas, low birth weight rates increased significantly only for the Inuit mother tongue group [RR1.45 (95% CI 1.05-2.01)]. Stillbirth rates showed a non-significant increase for the Inuit mother tongue group [RR1.76 (0.64-4.83)]. Neonatal mortality rates decreased significantly in the predominantly non-Aboriginal communities and in the non-Aboriginal mother tongue group [RR0.78 (0.66-0.92)], and increased non-significantly for the First Nations mother tongue group [RR2.17 (0.71-6.62)]. Perinatal death rates increased for the First Nations mother tongue grouping in northern areas [RR2.19 (0.99-4.85)]. There was a disconcerting rise of some mortality outcomes for births to First Nations and Inuit mother tongue women and to women in predominantly First Nations and Inuit communities, in contrast to some improvements for births to non-Aboriginal mother tongue women and to women in predominantly non-Aboriginal communities in rural or northern Quebec, indicating a need for improving perinatal and neonatal health for Aboriginal populations in rural and northern regions.

Aboriginal community controlled health services: leading the way in primary care.

PubMed

Panaretto, Kathryn S; Wenitong, Mark; Button, Selwyn; Ring, Ian T

2014-06-16

The national Closing the Gap framework commits to reducing persisting disadvantage in the health of Aboriginal and Torres Strait Islander people in Australia, with cross-government-sector initiatives and investment. Central to efforts to build healthier communities is the Aboriginal community controlled health service (ACCHS) sector; its focus on prevention, early intervention and comprehensive care has reduced barriers to access and unintentional racism, progressively improving individual health outcomes for Aboriginal people. There is now a broad range of primary health care data that provides a sound evidence base for comparing the health outcomes for Indigenous people in ACCHSs with the outcomes achieved through mainstream services, and these data show: models of comprehensive primary health care consistent with the patient-centred medical home model; coverage of the Aboriginal population higher than 60% outside major metropolitan centres; consistently improving performance in key performance on best-practice care indicators; and superior performance to mainstream general practice. ACCHSs play a significant role in training the medical workforce and employing Aboriginal people. ACCHSs have risen to the challenge of delivering best-practice care and there is a case for expanding ACCHSs into new areas. To achieve the best returns, the current mainstream Closing the Gap investment should be shifted to the community controlled health sector.

Aboriginal women in rural Australia; a small study of infant feeding behaviour.

PubMed

Helps, Catherine; Barclay, Lesley

2015-06-01

Aboriginal women in rural areas have lower rates of breastfeeding than Australian averages. The reasons for this are poorly understood. Aboriginal people experience higher morbidity and increased rates of chronic disease throughout the life cycle. The protective effects of sustained breastfeeding could benefit rural Aboriginal communities. To explore the factors impacting upon infant feeding choices in a rural Aboriginal Community. Semi-structured interviews were conducted with eight Aboriginal rural dwelling first time mothers. These women received a continuity of midwife and Aboriginal Health Worker model of care. Interviews were also undertaken with five Aboriginal Health Workers and two Aboriginal community breastfeeding champions. The analysis was integrated with a conventional literature review and was further developed and illustrated with historical literature. Indigenist methodology guided the study design, analysis and the dissemination of results. Three key themes were identified. These were "I'm doing the best thing for..." which encompasses the motivations underpinning infant feeding decisions; "this is what I know..." which explores individual and community knowledge regarding infant feeding; and "a safe place to feed" identifying the barriers that negative societal messages pose for women as they make infant feeding decisions. It appears loss of family and community breastfeeding knowledge resulting from colonisation still influences the Aboriginal women of today. Aboriginal women value and trust knowledge which is passed to them from extended family members and women within their Community. Cultural, historical and socioeconomic factors all strongly influence the infant feeding decisions of individuals in this study. Efforts to normalise breastfeeding in the culture of rural dwelling Aboriginal women and their supporting community appear to be necessary and may promote breastfeeding more effectively than optimal professional care of individuals can do. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Design and implementation of a dental caries prevention trial in remote Canadian Aboriginal communities.

PubMed

Harrison, Rosamund; Veronneau, Jacques; Leroux, Brian

2010-05-13

The goal of this cluster randomized trial is to test the effectiveness of a counseling approach, Motivational Interviewing, to control dental caries in young Aboriginal children. Motivational Interviewing, a client-centred, directive counseling style, has not yet been evaluated as an approach for promotion of behaviour change in indigenous communities in remote settings. Aboriginal women were hired from the 9 communities to recruit expectant and new mothers to the trial, administer questionnaires and deliver the counseling to mothers in the test communities. The goal is for mothers to receive the intervention during pregnancy and at their child's immunization visits. Data on children's dental health status and family dental health practices will be collected when children are 30-months of age. The communities were randomly allocated to test or control group by a random "draw" over community radio. Sample size and power were determined based on an anticipated 20% reduction in caries prevalence. Randomization checks were conducted between groups. In the 5 test and 4 control communities, 272 of the original target sample size of 309 mothers have been recruited over a two-and-a-half year period. A power calculation using the actual attained sample size showed power to be 79% to detect a treatment effect. If an attrition fraction of 4% per year is maintained, power will remain at 80%. Power will still be > 90% to detect a 25% reduction in caries prevalence. The distribution of most baseline variables was similar for the two randomized groups of mothers. However, despite the random assignment of communities to treatment conditions, group differences exist for stage of pregnancy and prior tooth extractions in the family. Because of the group imbalances on certain variables, control of baseline variables will be done in the analyses of treatment effects. This paper explains the challenges of conducting randomized trials in remote settings, the importance of thorough community collaboration, and also illustrates the likelihood that some baseline variables that may be clinically important will be unevenly split in group-randomized trials when the number of groups is small. This trial is registered as ISRCTN41467632.

Design and implementation of a dental caries prevention trial in remote Canadian Aboriginal communities

PubMed Central

2010-01-01

Background The goal of this cluster randomized trial is to test the effectiveness of a counseling approach, Motivational Interviewing, to control dental caries in young Aboriginal children. Motivational Interviewing, a client-centred, directive counseling style, has not yet been evaluated as an approach for promotion of behaviour change in indigenous communities in remote settings. Methods/design Aboriginal women were hired from the 9 communities to recruit expectant and new mothers to the trial, administer questionnaires and deliver the counseling to mothers in the test communities. The goal is for mothers to receive the intervention during pregnancy and at their child's immunization visits. Data on children's dental health status and family dental health practices will be collected when children are 30-months of age. The communities were randomly allocated to test or control group by a random "draw" over community radio. Sample size and power were determined based on an anticipated 20% reduction in caries prevalence. Randomization checks were conducted between groups. Discussion In the 5 test and 4 control communities, 272 of the original target sample size of 309 mothers have been recruited over a two-and-a-half year period. A power calculation using the actual attained sample size showed power to be 79% to detect a treatment effect. If an attrition fraction of 4% per year is maintained, power will remain at 80%. Power will still be > 90% to detect a 25% reduction in caries prevalence. The distribution of most baseline variables was similar for the two randomized groups of mothers. However, despite the random assignment of communities to treatment conditions, group differences exist for stage of pregnancy and prior tooth extractions in the family. Because of the group imbalances on certain variables, control of baseline variables will be done in the analyses of treatment effects. This paper explains the challenges of conducting randomized trials in remote settings, the importance of thorough community collaboration, and also illustrates the likelihood that some baseline variables that may be clinically important will be unevenly split in group-randomized trials when the number of groups is small. Trial registration This trial is registered as ISRCTN41467632. PMID:20465831

[Oxidation of sulfur-containing substrates by aboriginal and experimentally designed microbial communities].

PubMed

Pivovarova, T A; Bulaev, A G; Roshchupko, P V; Belyĭ, A V; Kondrat'eva, T F

2012-01-01

Aboriginal and experimental (constructed of pure microbial cultures) communities of acidophilic chemolithotrophs have been studied. The oxidation of elemental sulfur, sodium thiosulfate, and potassium tetrathionate as sole sources of energy has been monitored. The oxidation rate of the experimental community is higher as compared to the aboriginal community isolated from a flotation concentrate of pyrrhotine-containing pyrite-arsenopyrite gold-arsenic sulfide ore. The degree of oxidation of the mentioned S substrates amounts to 17.91, 68.30, and 93.94% for the experimental microbial community and to 10.71, 56.03, and 79.50% for the aboriginal community, respectively. The degree of oxidation of sulfur sulfide forms in the ore flotation concentrate is 59.15% by the aboriginal microbial community and 49.40% by the experimental microbial community. Despite a higher rate of oxidation of S substrates as a sole source of energy by the experimental microbial community, the aboriginal community oxidizes S substrates at a higher rate in the flotation concentrate of pyrrhotine-containing pyrite-arsenopyrite gold-arsenic sulfide ore, from which it was isolated. Bacterial-chemical oxidation of the flotation concentrate by the aboriginal microbial community allows for the extraction of an additional 32.3% of gold from sulfide minerals, which is by 5.7% larger compared to the yield obtained by the experimental microbial community.

Healing the community to heal the individual

PubMed Central

Jiwa, Ashifa; Kelly, Len; Pierre-Hansen, Natalie

2008-01-01

ABSTRACT OBJECTIVE To understand the development of culturally based and community-based alcohol and substance abuse treatment programs for aboriginal patients in an international context. SOURCES OF INFORMATION MEDLINE, HealthSTAR, and PsycINFO databases and government documents were searched from 1975 to 2007. MeSH headings included the following: Indians, North American, Pacific ancestry group, aboriginal, substance-related disorders, alcoholism, addictive behaviour, community health service, and indigenous health. The search produced 150 articles, 34 of which were relevant; most of the literature comprised opinion pieces and program descriptions (level III evidence). MAIN MESSAGE Substance abuse in some aboriginal communities is a complex problem requiring culturally appropriate, multidimensional approaches. One promising perspective supports community-based programs or community mobile treatment. These programs ideally cover prevention, harm reduction, treatment, and aftercare. They often eliminate the need for people to leave their remote communities. They become focuses of community development, as the communities become the treatment facilities. Success requires solutions developed within communities, strong community interest and engagement, leadership, and sustainable funding. CONCLUSION Community-based addictions programs are appropriate alternatives to treatment at distant residential addictions facilities. The key components of success appear to be strong leadership in this area; strong community-member engagement; funding for programming and organizing; and the ability to develop infrastructure for long-term program sustainability. Programs require increased documentation of their inroads in this developing field. PMID:18625824

A Systematic Review of Community Interventions to Improve Aboriginal Child Passenger Safety

PubMed Central

Oudie, Eugenia; Desapriya, Ediriweera; Turcotte, Kate; Pike, Ian

2014-01-01

We evaluated evidence of community interventions to improve Aboriginal child passenger safety (CPS) in terms of its scientific merit and cultural relevance. We included studies if they reported interventions to improve CPS in Aboriginal communities, compared at least pre- and postintervention conditions, and evaluated rates and severity of child passenger injuries, child restraint use, or knowledge of CPS. We also appraised quality and cultural relevance of studies. Study quality was associated with community participation and cultural relevance. Strong evidence showed that multicomponent interventions tailored to each community improves CPS. Interventions in Aboriginal communities should incorporate Aboriginal views of health, involve the community, and be multicomponent and tailored to the community’s circumstances and culture. PMID:24754652

Yarning about fall prevention: community consultation to discuss falls and appropriate approaches to fall prevention with older Aboriginal and Torres Strait Islander people.

PubMed

Lukaszyk, Caroline; Coombes, Julieann; Turner, Norma Jean; Hillmann, Elizabeth; Keay, Lisa; Tiedemann, Anne; Sherrington, Cathie; Ivers, Rebecca

2017-08-01

Fall related injury is an emerging issue for older Indigenous people worldwide, yet few targeted fall prevention programs are currently available for Indigenous populations. In order to inform the development of a new Aboriginal-specific fall prevention program in Australia, we conducted community consultation with older Aboriginal people to identify perceptions and beliefs about falls, and to identify desired program elements. Yarning Circles were held with Aboriginal and Torres Strait Islander people aged 45 years and over. Each Yarning Circle was facilitated by an Aboriginal researcher who incorporated six indicative questions into each discussion. Questions explored the impact of falls on Yarning Circle participants, their current use of fall prevention services and investigated Yarning Circle participant's preferences regarding the design and mode of delivery of a fall prevention program. A total of 76 older Aboriginal people participated in ten Yarning Circles across six sites in the state of New South Wales. Participants associated falls with physical disability, a loss of emotional well-being and loss of connection to family and community. Many participants did not use existing fall prevention services due to a lack of availability in their area, having no referral provided by their GP and/or being unaware of fall prevention programs in general. Program elements identified as important by participants were that it be Aboriginal-specific, group-based, and on-going, with the flexibility to be tailored to specific communities, with free transport provided to and from the program. Older Aboriginal people reported falls to be a priority health issue, with a significant impact on their health and well-being. Few older Aboriginal people accessed prevention programs, suggesting there is an important need for targeted Aboriginal-specific programs. A number of important program elements were identified which if incorporated into prevention programs, may help to address the rising burden of falls.

Successful partnerships are the key to improving Aboriginal health.

PubMed

Bailey, Sandra; Hunt, Jennifer

2012-06-01

Partnership is a process that must be recognised as a fundamental part of any strategy for improving health outcomes for Aboriginal people. Addressing the inequities in health outcomes between Aboriginal people and other Australians will require a sustained, coordinated and well-informed approach that works to a set of goals and targets developed with input from the Aboriginal community. Partnerships provide the most effective mechanism for obtaining this essential input from Aboriginal communities and their representative organisations, enabling Aboriginal people to have an influence at all stages of the health-care process. Within the health sector, effective partnerships harness the efforts of governments and the expertise of Aboriginal Community Controlled Health Services, which offer the most effective means of delivering comprehensive primary health care to Aboriginal people.

The development of a culturally appropriate school based intervention for Australian Aboriginal children living in remote communities: A formative evaluation of the Alert Program® intervention.

PubMed

Wagner, Bree; Fitzpatrick, James; Symons, Martyn; Jirikowic, Tracy; Cross, Donna; Latimer, Jane

2017-06-01

Although previous research has demonstrated the benefits of targeting self-regulation in non-Aboriginal children, it is unclear whether such programs would be effective for Aboriginal children attending school in remote communities. Some of these children have been diagnosed with a fetal alcohol spectrum disorder (FASD) impairing their ability to self-regulate. The aim of this article is to describe a three phase formative process to develop and pilot a curriculum version of the Alert Program ® , a promising intervention for improving self-regulation that could be used in remote community schools. This modified version of the program will be subsequently tested in a cluster randomised controlled trial. A mixed methods approach was used. Modifications to the Alert Program ® , its delivery and evaluation were made after community and stakeholder consultation facilitated by a senior Aboriginal community researcher. Changes to lesson plans and program resources were made to reflect the remote community context, classroom environment and the challenging behaviours of children. Standardised study outcome measures were modified by removing several questions that had little relevance to the lives of children in remote communities. Program training for school staff was reduced in length to reduce staff burden. This study identified aspects of the Alert Program ® training, delivery and measures for evaluation that need modification before their use in assessing the efficacy of the Alert Program ® in remote Aboriginal community primary schools. © 2016 Occupational Therapy Australia.

Coping with stress among Aboriginal women and men with diabetes in Winnipeg, Canada.

PubMed

Iwasaki, Yoshi; Bartlett, Judith; O'Neil, John

2005-03-01

Many Aboriginal peoples are widely exposed to stress in their lives. This exposure to stress appears linked not only to their contemporary and immediate life circumstances (e.g., marginal economic and at-risk living conditions) but also to their historical, cultural, and political contexts. Recently, diabetes has become prevalent in many Aboriginal communities worldwide. The purpose of the present study was to gain a better understanding of the ways in which Aboriginal peoples with diabetes cope with stress. The study used a series of focus groups among First Nations and Metis women and men with diabetes in Winnipeg, Manitoba, Canada. Based on our cross-thematic analyses of the data, three overarching themes were identified: (1) individual and collective strengths of Aboriginal peoples with diabetes must be recognized and utilized to facilitate healing from or coping with the experience of stress and trauma; (2) healing must be accomplished holistically by maintaining balance or harmony among mind, body, and spirit; and (3) effective ways of coping with stress and healing from trauma potentially promote positive transformations for Aboriginal peoples and communities at both individual and collective levels. Also, sub-themes of stress-coping and healing that underlie and further describe the above three overarching themes emerged from the data. These include: (a) interdependence/connectedness, (b) spirituality/transcendence, (c) enculturation/facilitation of Aboriginal cultural identity, (d) self-control/self-determination/self-expression, and (e) the role of leisure as a means of coping with stress and healing from trauma. Accordingly, our deeper analyses resulted in the development of an emergent model of stress-coping and healing among Aboriginal peoples with diabetes, which is presented as a dynamic system in which the three overarching themes are embedded in the five specific themes of coping/healing. This evidence-based emergent model appears to provide some important insights into health policy and program planning for Aboriginal peoples with diabetes and their communities.

Supporting aboriginal knowledge and practice in health care: lessons from a qualitative evaluation of the strong women, strong babies, strong culture program.

PubMed

Lowell, Anne; Kildea, Sue; Liddle, Marlene; Cox, Barbara; Paterson, Barbara

2015-02-05

The Strong Women, Strong Babies, Strong Culture Program (the Program) evolved from a recognition of the value of Aboriginal knowledge and practice in promoting maternal and child health (MCH) in remote communities of the Northern Territory (NT) of Australia. Commencing in 1993 it continues to operate today. In 2008, the NT Department of Health commissioned an evaluation to identify enabling factors and barriers to successful implementation of the Program, and to identify potential pathways for future development. In this paper we focus on the evaluation findings related specifically to the role of Aborignal cultural knowledge and practice within the Program. A qualitative evaluation utilised purposive sampling to maximise diversity in program history and Aboriginal culture. Semi-structured, in-depth interviews with 76 participants were recorded in their preferred language with a registered Interpreter when required. Thematic analysis of data was verified or modified through further discussions with participants and members of the evaluation team. Although the importance of Aboriginal knowledge and practice as a fundamental component of the Program is widely acknowledged, there has been considerable variation across time and location in the extent to which these cultural dimensions have been included in practice. Factors contributing to this variation are complex and relate to a number of broad themes including: location of control over Program activities; recognition and respect for Aboriginal knowledge and practice as a legitimate component of health care; working in partnership; communication within and beyond the Program; access to transport and working space; and governance and organisational support. We suggest that inclusion of Aboriginal knowledge and practice as a fundamental component of the Program is key to its survival over more than twenty years despite serious challenges. Respect for the legitimacy of Aboriginal knowledge and practice within health care, a high level of community participation and control supported through effective governance and sufficient organisational commitment as well as competence in intercultural collaborative practice of health staff are critical requirements for realising the potential for cultural knowledge and practice to improve Aboriginal health outcomes.

Aboriginal child and adolescent mental health: a rural worker training model.

PubMed

Bartik, Warren; Dixon, Angela; Dart, Katrina

2007-04-01

The Third National Mental Health Plan places a strong emphasis on the development of an Aboriginal mental health workforce. This paper documents the establishment, implementation and initial evaluation of the Aboriginal and Torres Strait Islander Child and Adolescent Mental Health Traineeship Program, a partnership initiative involving Hunter New England Area Health Service (HNEAHS), Hunter New England Aboriginal Mental Health (HNEAMH) and the Department of Psychological Medicine at the Children's Hospital at Westmead (CHW), with guidance and input from additional collaborators. The program includes: (i) employment as a child and adolescent mental health worker and professional support and supervision through HNEAHS; (ii) a mentoring program provided through HNEAMH; (iii) formal academic studies in Aboriginal Mental Health; and (iv) a clinical education and supervision program conducted through the Department of Psychological Medicine, CHW. Initial feedback suggests that this is a promising program to train Aboriginal child and adolescent mental health workers. Further evaluation will provide information about its viability and effectiveness in providing an integrated, collaborative child and adolescent mental health service for Aboriginal and Torres Strait Islander children and their families.

Healthy Buddies[TM] Reduces Body Mass Index Z-Score and Waist Circumference in Aboriginal Children Living in Remote Coastal Communities

ERIC Educational Resources Information Center

Ronsley, Rebecca; Lee, Andrew S.; Kuzeljevic, Boris; Panagiotopoulos, Constadina

2013-01-01

Background: Aboriginal children are at increased risk for obesity and type 2 diabetes. Healthy Buddies [TM]-First Nations (HB) is a curriculum-based, peer-led program promoting healthy eating, physical activity, and self-esteem. Methods: Although originally designed as a pilot pre-/post-analysis of 3 remote Aboriginal schools that requested and…

Comparison of the 1996 and 2001 census data for Aboriginal and non-Aboriginal workers in health care occupations.

PubMed

Lecompte, Emily; Baril, Mireille

2008-01-01

To meet the unique health needs of Aboriginal peoples (First Nations, Inuit and Métis), it is important to increase and encourage Aboriginal representation in health care. One Federal initiative, the Aboriginal Health Human Resource Initiative (AHHRI) at Health Canada, focuses on: (1) increasing the number of Aboriginal people working in health careers; (2) adapting health care educational curricula to support the development of cultural competencies; and (3) improving the retention of health care workers in Aboriginal communities. A health care system that focuses on understanding the unique challenges, concerns, and needs of Aboriginal people can better respond to this specific population, which suffers disproportionately from ill health in comparison to their non-Aboriginal counterparts. This report examines the supply of Aboriginal health care providers in Canada, based on geographic region, area of residence, Aboriginal identity, and occupation. Findings are drawn from the 1996 and 2001 censuses from Statistics Canada. Quantitative results provide a greater understanding of labour force characteristics of First Nation, Inuit, Métis, and non-Aboriginal health providers.

Association between blood lead level and blood pressure in aborigines and others in central Taiwan.

PubMed

Kuo, Hsien-Wen; Lai, Li-Hsing; Chou, Sze-Yuan; Wu, Fang-Yang

2006-01-01

To investigate the relationship between the blood lead level (BLL) and blood pressure among aborigines and non-aborigines in central Taiwan, a community-based survey that included demographic data, medical history, and blood chemistry analyses was conducted among 2,565 adults during an annual health examination. BLLs were analyzed using a graphite furnace atomic absorption spectrometer (AAS). There was a dose response among the non-aborigines (high BLL odds ratio = 2.97, compared with low BLL) but not among aborigines. Based on multiple linear regression models, BLLs were positively correlated with both systolic (an increase of 0.85 mm Hg/microg/dL) and diastolic (an increase of 0.48 mm Hg/microg/dL) blood pressures after adjusting for age, gender, ethnic group, alcohol consumption, and body mass index. BLLs were higher among aborigines than non-aborigines and were significantly correlated with blood pressure, particularly systolic pressure. The association should be considered causal.

Temporal trends in Inuit, First Nations and non-Aboriginal birth outcomes in rural and northern Quebec

PubMed Central

Simonet, Fabienne; Wilkins, Russell; Luo, Zhong-Cheng

2012-01-01

Objectives The objective was to assess trends in Inuit, First Nations and non-Aboriginal birth outcomes in the rural and northern regions of Quebec. Study design and methods In a birth cohort-based study of all births to residents of rural and northern Quebec from 1991 through 2000 (n = 177,193), we analyzed birth outcomes and infant mortality for births classified by maternal mother tongue (Inuit, First Nations or non-Aboriginal) and by community type (predominantly First Nations, Inuit or non-Aboriginal). Results From 1991–1995 to 1996–2000, there was a trend of increasing rates of preterm birth for all 6 study groups. In all rural and northern areas, low birth weight rates increased significantly only for the Inuit mother tongue group [RR1.45 (95% CI 1.05–2.01)]. Stillbirth rates showed a non-significant increase for the Inuit mother tongue group [RR1.76 (0.64–4.83)]. Neonatal mortality rates decreased significantly in the predominantly non-Aboriginal communities and in the non-Aboriginal mother tongue group [RR0.78 (0.66–0.92)], and increased non-significantly for the First Nations mother tongue group [RR2.17 (0.71–6.62)]. Perinatal death rates increased for the First Nations mother tongue grouping in northern areas [RR2.19 (0.99–4.85)]. Conclusion There was a disconcerting rise of some mortality outcomes for births to First Nations and Inuit mother tongue women and to women in predominantly First Nations and Inuit communities, in contrast to some improvements for births to non-Aboriginal mother tongue women and to women in predominantly non-Aboriginal communities in rural or northern Quebec, indicating a need for improving perinatal and neonatal health for Aboriginal populations in rural and northern regions. PMID:22973566

STI in remote communities: improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing ‘usual practice’ STI care to enhanced care in remote primary health care services in Australia

PubMed Central

2013-01-01

Background Despite two decades of interventions, rates of sexually transmissible infections (STI) in remote Australian Aboriginal communities remain unacceptably high. Routine notifications data from 2011 indicate rates of chlamydia and gonorrhoea among Aboriginal people in remote settings were 8 and 61 times higher respectively than in the non-Indigenous population. Methods/design STRIVE is a stepped-wedge cluster randomised trial designed to compare a sexual health quality improvement program (SHQIP) to usual STI clinical care delivered in remote primary health care services. The SHQIP is a multifaceted intervention comprising annual assessments of sexual health service delivery, implementation of a sexual health action plan, six-monthly clinical service activity data reports, regular feedback meetings with a regional coordinator, training and financial incentive payments. The trial clusters comprise either a single community or several communities grouped together based on geographic proximity and cultural ties. The primary outcomes are: prevalence of chlamydia, gonorrhoea and trichomonas in Aboriginal residents aged 16–34 years, and performance in clinical management of STIs based on best practice indicators. STRIVE will be conducted over five years comprising one and a half years of trial initiation and community consultation, three years of trial conditions, and a half year of data analysis. The trial was initiated in 68 remote Aboriginal health services in the Northern Territory, Queensland and Western Australia. Discussion STRIVE is the first cluster randomised trial in STI care in remote Aboriginal health services. The trial will provide evidence to inform future culturally appropriate STI clinical care and control strategies in communities with high STI rates. Trial registration Australian and New Zealand Clinical Trials Registry ACTRN12610000358044 PMID:24016143

Community as Teacher Model: Health Profession Students Learn Cultural Safety from an Aboriginal Community

ERIC Educational Resources Information Center

Kline, Cathy C.; Godolphin, William J.; Chhina, Gagun S.; Towle, Angela

2013-01-01

Communication between health care professionals and Aboriginal patients is complicated by cultural differences and the enduring effects of colonization. Health care providers need better training to meet the needs of Aboriginal patients and communities. We describe the development and outcomes of a community-driven service-learning program in…

Oral health interventions in Australian Aboriginal communities: a review of the literature.

PubMed

Patel, J; Durey, A; Hearn, L; Slack-Smith, L M

2017-09-01

Aboriginal Australians experience significant disparities in oral health with even poorer outcomes reported in rural and remote areas. The high rates of preventable dental disease in Aboriginal communities are a serious concern from a social standpoint and in terms of service provision and health care expenditure. In this review, primary research literature was comprehensively reviewed. Papers were selected if they reported designing or implementing an intervention or oral health programme specific to the needs of Aboriginal communities. Twenty-one publications fulfilled the inclusion criteria with 19 different interventions being described. Interventions were categorized using a classification adapted from the work of Whitehead (2002). The review identified interventions that aimed to reduce early childhood caries, increase services to remote communities, develop the role of Aboriginal health workers, improve oral health literacy, establish water fluoridation and provide periodontal therapy. Implementing successful oral health interventions in Aboriginal communities is a challenge that is compounded by the complex interplay between psychosocial and cultural determinants. Even interventions that follow a rigorous and consultative design have a high failure rate in Aboriginal communities if upstream determinants of health are not adequately understood and addressed. © 2016 Australian Dental Association.

The Role of Effective Partnerships in an Australian Place-Based Intervention to Reduce Race-Based Discrimination

PubMed Central

Paradies, Yin; Kelaher, Margaret Anne

2013-01-01

Localities Embracing and Accepting Diversity (LEAD) is an ongoing place-based pilot program aimed at improving health outcomes among Aboriginal and migrant communities through increased social and economic participation. Specifically, LEAD works with mainstream organizations to prevent race-based discrimination from occurring. The partnership model of LEAD was designed to create a community intervention that was evidence-based, effective, and flexible enough to respond to local contexts and needs. LEAD's complex organizational and partnership model, in combination with an innovative approach to reducing race-based discrimination, has necessitated the use of new language and communication strategies to build genuinely collaborative partnerships. Allocating sufficient time to develop strategies aligned with this new way of doing business has been critical. However, preliminary data indicate that a varied set of partners has been integral to supporting the widespread influence of the emerging LEAD findings across partner networks in a number of different sectors. PMID:24179280

Prevalence of chlamydia, gonorrhoea, syphilis and trichomonas in Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.

PubMed

Graham, Simon; Smith, Lucy Watchirs; Fairley, Christopher K; Hocking, Jane

2016-04-01

Higher notification rates of sexually transmissible infections (STIs) are reported among Aboriginal and Torres Strait Islander (Aboriginal) compared with non-Aboriginal people in Australia. The aim of this study is to estimate the pooled prevalence of chlamydia, gonorrhoea, syphilis and trichomonas among Aboriginal people in Australia by sex, age-group, setting (clinic vs population/community-based) and population group [adults, pregnant females, young people (12-29 years) and prisoners]. The databases Medline, PubMed and Web of Science were searched in May 2015. A meta-analysis was conducted to estimate the pooled prevalence of the four STIs in Aboriginal people and if possible, by gender, age-group, setting and population group. A total of 46 studies were included. The pooled prevalence was 11.2% (95%CI: 9.4-13.0%) for chlamydia (36 studies), 12.5% (95%CI: 10.5-14.6%) for gonorrhoea (28 studies), 16.8% (95%CI: 11.0-22.6%) for syphilis (13 studies) and 22.6% (95%CI: 18.5-26.7%) for trichomonas (11 studies); however, there was significant heterogeneity between studies (I(2) <97.5%, P<0.01). In the subgroup analysis, a higher pooled prevalence occurred in females than males for chlamydia (12.7% vs 7.7%) and gonorrhoea (10.7% vs 8.1%). The prevalence of chlamydia was 12.4% in clinic-based compared with 4.3% in population-based studies. The highest pooled prevalence by population group was among pregnant females (16.8%) and young people (16.2%) for chlamydia, pregnant females (25.2%) for trichomonas; and young people for gonorrhoea (11.9%). This review highlights the need to decrease the prevalence of STIs among Aboriginal people through community-based programs that target asymptomatic young people.

Effects of Community Singing Program on Mental Health Outcomes of Australian Aboriginal and Torres Strait Islander People: A Meditative Approach.

PubMed

Sun, Jing; Buys, Nicholas

2016-03-01

To evaluate the impact of a meditative singing program on the health outcomes of Aboriginal and Torres Strait Islander people. The study used a prospective intervention design. The study took place in six Aboriginal and Torres Strait Islander communities and Community Controlled Health Services in Queensland, Australia. Study participants were 210 Australian Aboriginal and Torres Strait Islander adults aged 18 to 71 years, of which 108 were in a singing intervention group and 102 in a comparison group. A participative community-based community singing program involving weekly singing rehearsals was conducted over an 18-month period. Standardized measures in depression, resilience, sense of connectedness, social support, and singing related quality of life were used. The general linear model was used to compare differences pre- and postintervention on outcome variables, and structural equation modeling was used to examine the pathway of the intervention effect. Results revealed a significant reduction in the proportion of adults in the singing group classified as depressed and a concomitant significant increase in resilience levels, quality of life, sense of connectedness, and social support among this group. There were no significant changes for these variables in the comparison group. The participatory community singing approach linked to preventative health services was associated with improved health, resilience, sense of connectedness, social support, and mental health status among Aboriginal and Torres Strait Islander adults. © The Author(s) 2016.

Macrosomia, Perinatal and Infant Mortality in Cree Communities in Quebec, 1996-2010

PubMed Central

Xiao, Lin; Zhang, Dan-Li; Torrie, Jill; Auger, Nathalie; McHugh, Nancy Gros-Louis; Luo, Zhong-Cheng

2016-01-01

Background Cree births in Quebec are characterized by the highest reported prevalence of macrosomia (~35%) in the world. It is unclear whether Cree births are at greater elevated risk of perinatal and infant mortality than other First Nations relative to non-Aboriginal births in Quebec, and if macrosomia may be related. Methods This was a population-based retrospective birth cohort study using the linked birth-infant death database for singleton births to mothers from Cree (n = 5,340), other First Nations (n = 10,810) and non-Aboriginal (n = 229,960) communities in Quebec, 1996–2010. Community type was ascertained by residential postal code and municipality name. The primary outcomes were perinatal and infant mortality. Results Macrosomia (birth weight for gestational age >90th percentile) was substantially more frequent in Cree (38.0%) and other First Nations (21.9%) vs non-Aboriginal (9.4%) communities. Comparing Cree and other First Nations vs non-Aboriginal communities, perinatal mortality rates were 1.52 (95% confidence intervals 1.17, 1.98) and 1.34 (1.10, 1.64) times higher, and infant mortality rates 2.27 (1.71, 3.02) and 1.49 (1.16, 1.91) times higher, respectively. The risk elevations in perinatal and infant death in Cree communities attenuated after adjusting for maternal characteristics (age, education, marital status, parity), but became greater after further adjustment for birth weight (small, appropriate, or large for gestational age). Conclusions Cree communities had greater risk elevations in perinatal and infant mortality than other First Nations relative to non-Aboriginal communities in Quebec. High prevalence of macrosomia did not explain the elevated risk of perinatal and infant mortality in Cree communities. PMID:27517613

Reconciling Mixed Methods Approaches with a Community Narrative Model for Educational Research Involving Aboriginal and Torres Strait Islander Families

ERIC Educational Resources Information Center

Dakich, Eva; Watt, Tony; Hooley, Neil

2016-01-01

Researching the education of Aboriginal and Torres Strait Islander children in Australian schools is an exceedingly difficult and uncompromising task. Working respectfully with local Aboriginal and Torres Strait Islander communities must remain top priority with any research project regarding Aboriginal and Torres Strait Islander viewpoints of…

Community- and individual-level factors associated with smoking and heavy drinking among Aboriginal people in Canada.

PubMed

Kyu, Hmwe Hmwe; Georgiades, Katholiki; MacMillan, Harriet L; Boyle, Michael H

2015-02-03

1) To examine the association between place of residence (i.e., on- versus off-communities and between provinces) and daily smoking and heavy drinking among Aboriginal people in Canada; and 2) to identify community- and individual-level factors that may account for these associations. Data were from the Aboriginal Peoples Survey (2001). The sample included 52,110 Aboriginal people (≥ 15 years of age). Community-level variables included: place of residence, community socio-economic status (SES) and perceived community social problems. Individual-level variables included: age, sex, education, income, employment status, marital status, Aboriginal heritage and social support. Multilevel logistic regressions were conducted to analyze the data. Living in First Nations communities (compared with living off-communities) was associated with daily smoking, and this association was accounted for by perceived community social problems. However, the association between Inuit communities and daily smoking remained after controlling for all covariates (odds ratio (OR) = 1.97, 95% confidence intervals (CI) = 1.44-2.70). Residence in First Nations communities was associated with heavy drinking (OR = 1.54, 95% CI = 1.17-2.04), however this risk became evident only after controlling for community SES, which was also positively associated with heavy drinking (OR = 1.46, 95% CI = 1.26-1.69). Compared with Saskatchewan, Aboriginal people in Atlantic Provinces (OR = 2.80, 95% CI = 2.08-3.78) or Territories (OR = 1.39, 95% CI = 1.01-1.92) were more likely to engage in heavy drinking. Studies are needed to better understand the increased risk for smoking in Inuit communities and heavy drinking in First Nations communities, Atlantic Provinces and Territories, and to identify possible reasons for the positive association between community SES and heavy drinking among Aboriginal people.

The prevalence of hookworm infection, iron deficiency and anaemia in an aboriginal community in north-west Australia.

PubMed

Hopkins, R M; Gracey, M S; Hobbs, R P; Spargo, R M; Yates, M; Thompson, R C

1997-03-03

To determine the prevalence of hookworm infections, iron deficiency and anaemia in an Aboriginal community in the north of Western Australia. A cross-sectional survey conducted in 1992, examining faecal specimens and blood samples from Aboriginals and non-Aboriginals in a remote coastal community in the north of Western Australia. All those living in the community at the time of the survey. Parasite status and haematological values for haemoglobin, serum iron, ferritin, transferrin and mean red cell volume. Infections with hookworm were present throughout the Aboriginal population (77%; n = 243), with the highest prevalence in children aged 5-14 years (93%; n = 74). Hookworm was not detected in non-Aboriginals (n = 24). Iron deficiency was common throughout the Aboriginal population, especially in children aged 5-14 years (79%; n = 68) and women aged over 14 years (72%; n = 65). Anaemia was highly prevalent among Aboriginal children aged 5-14 years (84% in hookworm-positive children, 75% in hookworm-negative) and women aged over 14 years (63% in hookworm-positive women, 31% in hookworm-negative). Aboriginals over 14 years of age who had hookworm (n = 82) had significantly lower levels of haemoglobin, serum iron and serum ferritin, a lower mean red cell volume and significantly higher transferrin levels than uninfected Aboriginals (n = 38) and non-Aboriginals (n = 19) in the same age group. Hookworm infections were associated with anaemia (P < 0.01) and iron deficiency (P < 0.01) in people over 14 years of age. The species of hookworm, determined after examining 13 larval cultures and two adult worms, was found to be Ancylostoma duodenale. Infections with A. duodenale are endemic in Aboriginals in this community, and are likely to contribute to the high prevalence of iron deficiency and anaemia observed in the Aboriginal population, particularly in children and women.

Relation of child, caregiver, and environmental characteristics to childhood injury in an urban Aboriginal cohort in New South Wales, Australia.

PubMed

Thurber, Katherine; Burgess, Leonie; Falster, Kathleen; Banks, Emily; Möller, Holger; Ivers, Rebecca; Cowell, Chris; Isaac, Vivian; Kalucy, Deanna; Fernando, Peter; Woodall, Cheryl; Clapham, Kathleen

2018-04-01

Despite being disproportionately affected by injury, little is known about factors associated with injury in Aboriginal children. We investigated factors associated with injury among urban Aboriginal children attending four Aboriginal Community Controlled Health Services in New South Wales, Australia. We examined characteristics of caregiver-reported child injury, and calculated prevalence ratios of 'ever-injury' by child, family, and environmental factors. Among children in the cohort, 29% (n=373/1,303) had ever broken a bone, been knocked out, required stitches or been hospitalised for a burn or poisoning; 40-78% of first injuries occurred at home and 60-91% were treated in hospital. Reported ever-injury was significantly lower (prevalence ratio ≤0.80) among children who were female, younger, whose caregiver had low psychological distress and had not been imprisoned, whose family experienced few major life events, and who hadn't experienced alcohol misuse in the household or theft in the community, compared to other cohort members. In this urban Aboriginal child cohort, injury was common and associated with measures of family and community vulnerability. Implications for public health: Prevention efforts targeting upstream injury determinants and Aboriginal children living in vulnerable families may reduce child injury. Existing broad-based intervention programs for vulnerable families may present opportunities to deliver targeted injury prevention. © 2017 The Authors.

Community-based research in action: tales from the Ktunaxa community learning centres project.

PubMed

Stacy, Elizabeth; Wisener, Katherine; Liman, Yolanda; Beznosova, Olga; Lauscher, Helen Novak; Ho, Kendall; Jarvis-Selinger, Sandra

2014-01-01

Rural communities, particularly Aboriginal communities, often have limited access to health information, a situation that can have significant negative consequences. To address the lack of culturally and geographically relevant health information, a community-university partnership was formed to develop, implement, and evaluate Aboriginal Community Learning Centres (CLCs). The objective of this paper is to evaluate the community-based research process used in the development of the CLCs. It focuses on the process of building relationships among partners and the CLC's value and sustainability. Semistructured interviews were conducted with key stakeholders, including principal investigators, community research leads, and supervisors. The interview transcripts were analyzed using an open-coding process to identify themes. Key challenges included enacting shared project governance, negotiating different working styles, and hiring practices based on commitment to project objectives rather than skill set. Technological access provided by the CLCs increased capacity for learning and collective community initiatives, as well as building community leads' skills, knowledge, and self-efficacy. An important lesson was to meet all partners "where they are" in building trusting relationships and adapting research methods to fit the project's context and strengths. Successful results were dependent upon persistence and patience in working through differences, and breaking the project into achievable goals, which collectively contributed to trust and capacity building. The process of building these partnerships resulted in increased capacity of communities to facilitate learning and change initiatives, and the capacity of the university to engage in successful research partnerships with Aboriginal communities in the future.

Planning, implementing, and evaluating a program to address the oral health needs of aboriginal children in port augusta, australia.

PubMed

Parker, E J; Misan, G; Shearer, M; Richards, L; Russell, A; Mills, H; Jamieson, L M

2012-01-01

Aboriginal Australian children experience profound oral health disparities relative to their non-Aboriginal counterparts. In response to community concerns regarding Aboriginal child oral health in the regional town of Port Augusta, South Australia, a child dental health service was established within a Community Controlled Aboriginal Health Service. A partnership approach was employed with the key aims of (1) quantifying rates of dental service utilisation, (2) identifying factors influencing participation, and (3) planning and establishing a program for delivery of Aboriginal children's dental services that would increase participation and adapt to community needs. In planning the program, levels of participation were quantified and key issues identified through semistructured interviews. After 3.5 years, the participation rate for dental care among the target population increased from 53 to 70 percent. Key areas were identified to encourage further improvements and ensure sustainability in Aboriginal child oral health in this regional location.

Birthing on country: an elusive ideal?

PubMed

Felton-Busch, Catrina

2009-10-01

The concept of birthing on country for Aboriginal people means having babies born on traditional lands, and more recently the term is used to indicate the desire of Aboriginal communities to have our babies born in our communities. Being born on country connects an Aboriginal person to the land and community in a deeply cultural way and affords life-long privileges such as hunting and fishing rights, as well as life long responsibilities for looking after country, both land and people. For Aboriginal women, birthing has moved from the personal to the political as governments provide policies about what is 'best' for Aboriginal women and their babies.

Raising Awareness of Australian Aboriginal Peoples Reality: Embedding Aboriginal Knowledge in Social Work Education through the Use of Field Experiences

ERIC Educational Resources Information Center

Duthie, Deb; King, Julie; Mays, Jenni

2013-01-01

Effective social work practice with Aboriginal peoples and communities requires knowledge of operational communication skills and practice methods. In addition, there is also a need for practitioners to be aware of the history surrounding white engagement with Aboriginal communities and their cultures. Indeed, the Australian Association of Social…

Improving the health of future generations: the Canadian Institutes of Health Research Institute of Aboriginal Peoples' Health.

PubMed

Reading, Jeff; Nowgesic, Earl

2002-09-01

In the past and in the present, research studies and media reports have focused on pathology and dysfunction in aboriginal communities and have often failed to present a true and complete picture of the aboriginal experience. The Canadian Institutes of Health Research Institute of Aboriginal Peoples' Health is a national strategic research initiative led by both the aboriginal and research communities. This initiative aims to improve aboriginal health information, develop research capacity, better translate research into practice, and inform public health policy with the goal of improving the health of indigenous peoples.

Improving the Health of Future Generations: The Canadian Institutes of Health Research Institute of Aboriginal Peoples’ Health

PubMed Central

Reading, Jeff; Nowgesic, Earl

2002-01-01

In the past and in the present, research studies and media reports have focused on pathology and dysfunction in aboriginal communities and have often failed to present a true and complete picture of the aboriginal experience. The Canadian Institutes of Health Research Institute of Aboriginal Peoples’ Health is a national strategic research initiative led by both the aboriginal and research communities. This initiative aims to improve aboriginal health information, develop research capacity, better translate research into practice, and inform public health policy with the goal of improving the health of indigenous peoples. PMID:12197963

Cultural Immersion: Developing a Community of Practice of Teachers and Aboriginal Community Members

ERIC Educational Resources Information Center

Burgess, Cathie; Cavanagh, Paddy

2016-01-01

A lack of teacher awareness of the cultural and historical background of Aboriginal students has long been recognised as a major causative factor in the failure of Australian schools to fully engage Aboriginal students and deliver equitable educational outcomes for them. Using Wenger's communities of practice framework, this paper analyses the…

Blending Aboriginal and Western healing methods to treat intergenerational trauma with substance use disorder in Aboriginal peoples who live in northeastern Ontario, Canada.

PubMed

Marsh, Teresa Naseba; Coholic, Diana; Cote-Meek, Sheila; Najavits, Lisa M

2015-05-20

As with many Indigenous groups around the world, Aboriginal communities in Canada face significant challenges with trauma and substance use. The complexity of symptoms that accompany intergenerational trauma and substance use disorders represents major challenges in the treatment of both disorders. There appears to be an underutilization of substance use and mental health services, substantial client dropout rates, and an increase in HIV infections in Aboriginal communities in Canada. The aim of this paper is to explore and evaluate current literature on how traditional Aboriginal healing methods and the Western treatment model "Seeking Safety" could be blended to help Aboriginal peoples heal from intergenerational trauma and substance use disorders. A literature search was conducted using the keywords: intergenerational trauma, historical trauma, Seeking Safety, substance use, Two-Eyed Seeing, Aboriginal spirituality, and Aboriginal traditional healing. Through a literature review of Indigenous knowledge, most Indigenous scholars proposed that the wellness of an Aboriginal community can only be adequately measured from within an Indigenous knowledge framework that is holistic, inclusive, and respectful of the balance between the spiritual, emotional, physical, and social realms of life. Their findings indicate that treatment interventions must honour the historical context and history of Indigenous peoples. Furthermore, there appears to be strong evidence that strengthening cultural identity, community integration, and political empowerment can enhance and improve mental health and substance use disorders in Aboriginal populations. In addition, Seeking Safety was highlighted as a well-studied model with most populations, resulting in healing. The provided recommendations seek to improve the treatment and healing of Aboriginal peoples presenting with intergenerational trauma and addiction. Other recommendations include the input of qualitative and quantitative research as well as studies encouraging Aboriginal peoples to explore treatments that could specifically enhance health in their respective communities.

Illicit and prescription drug problems among urban Aboriginal adults in Canada: the role of traditional culture in protection and resilience.

PubMed

Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul

2013-07-01

Illicit and prescription drug use disorders are two to four times more prevalent among Aboriginal peoples in North America than the general population. Research suggests Aboriginal cultural participation may be protective against substance use problems in rural and remote Aboriginal communities. As Aboriginal peoples continue to urbanize rapidly around the globe, the role traditional Aboriginal beliefs and practices may play in reducing or even preventing substance use problems in cities is becoming increasingly relevant, and is the focus of the present study. Mainstream acculturation was also examined. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Associations were analysed using two sets of bootstrapped linear regression models adjusted for confounders with continuous illicit and prescription drug problem scores as outcomes. Psychological mechanisms that may explain why traditional culture is protective for Aboriginal peoples were examined using the cross-products of coefficients mediation method. The extent to which culture served as a resilience factor was examined via interaction testing. Results indicate Aboriginal enculturation was a protective factor associated with reduced 12-month illicit drug problems and 12-month prescription drug problems among Aboriginal adults in an urban setting. Increased self-esteem partially explained why cultural participation was protective. Cultural participation also promoted resilience by reducing the effects of high school incompletion on drug problems. In contrast, mainstream acculturation was not associated with illicit drug problems and served as a risk factor for prescription drug problems in this urban sample. Findings encourage the growth of programs and services that support Aboriginal peoples who strive to maintain their cultural traditions within cities, and further studies that examine how Aboriginal cultural practices and beliefs may promote and protect Aboriginal health in an urban environment. Copyright © 2013 Elsevier Ltd. All rights reserved.

Supporting youth wellbeing with a focus on eating well and being active: views from an Aboriginal community deliberative forum.

PubMed

Street, Jackie; Cox, Heather; Lopes, Edilene; Motlik, Jessie; Hanson, Lisa

2018-04-01

Including and prioritising community voice in policy development means policy is more likely to reflect community values and priorities. This project trialled and evaluated a storyboard approach in a deliberative community forum to engage Australian Aboriginal people in health policy priority setting. The forum was co-constructed with two Aboriginal community-controlled organisations. A circle storyboard was used to centre Aboriginal community knowledge and values and encourage the group to engage with broader perspectives and evidence. The forum asked a diverse (descriptively representative) group of Aboriginal people in a rural town what governments should do to support the wellbeing of children and youth, particularly to encourage them to eat well and be active. The storyboard provided a tactile device to allow shared stories and identification of community issues. The group identified policies they believed governments should prioritise, including strategies to combat racism and provide local supports and outlets for young people. An informed deliberative storyboard approach offers a novel way of engaging with Aboriginal communities in a culturally appropriate and inclusive manner. Implications for public health: The identification of racism as a major issue of concern in preventing children from living healthy lifestyles highlights the need for policy responses in this area. © 2018 The Authors.

Developing research in partnership with Aboriginal communities - strategies for improving recruitment and retention.

PubMed

Rae, K; Weatherall, L; Hollebone, K; Apen, K; McLean, M; Blackwell, C; Eades, S; Boulton, J; Lumbers, E; Smith, R

2013-01-01

Australian Aboriginal communities in urban, rural and remote areas are continuing to suffer high rates of perinatal mortality and morbidity that will impact on the future health of the community. It has been well documented that Aboriginal women have extreme distrust of mainstream pregnancy-related health care and suggested that late entry into antenatal care is as high as 50% in the Aboriginal population. Although medical and midwifery staff have long discussed strategies to improve uptake of antenatal health care for Aboriginal women, researchers in many areas have found the recruitment of Aboriginal people into scientific studies almost impossible. This article seeks to share the strategies that have been developed over a period of time by the authors that have proved useful for recruitment and retention into research. It is anticipated that these strategies would also apply for health practitioners in maintaining their patients for clinical care management. Although each research location (regional, rural and remote) has had to spend time determining what approach is best for meeting the research outcomes, many of these suggestions become applicable to clinicians seeking to develop better connections with Aboriginal patients in their clinics. With the management of ongoing chronic health conditions for Aboriginal people a priority in 'Closing the Gap', a number of these suggestions could easily be implemented by clinicians. Remembering that each community has specific needs that must be addressed, priorities for assistance for that community will be easily identifiable after community consultation (eg transport, or ability to access medical testing). Opportunities for the use of new social media (eg Facebook) as communication tools for researchers and clinicians will have increasing applicability as further software updates are created. With open and trusting dialogues between researchers, clinicians and Aboriginal communities, we can go a long way towards understanding the needs of individual communities and working in partnerships to close the gap.

Factors Influencing the Health and Wellness of Urban Aboriginal Youths in Canada: Insights of In-Service Professionals, Care Providers, and Stakeholders

PubMed Central

Yi, Kyoung June; Landais, Edwige; Kolahdooz, Fariba

2015-01-01

We addressed the positive and negative factors that influence the health and wellness of urban Aboriginal youths in Canada and ways of restoring, promoting, and maintaining the health and wellness of this population. Fifty-three in-service professionals, care providers, and stakeholders participated in this study in which we employed the Glaserian grounded theory approach. We identified perceived positive and negative factors. Participants suggested 5 approaches—(1) youth based and youth driven, (2) community based and community driven, (3) culturally appropriate, (4) enabling and empowering, and (5) sustainable—as well as some practical strategies for the development and implementation of programs. We have provided empirical knowledge about barriers to and opportunities for improving health and wellness among urban Aboriginal youths in Canada. PMID:25790390

Grannies, elders, and friends: aging Aboriginal women in Toronto.

PubMed

Baskin, Cyndy; Davey, Caitlin J

2015-01-01

Based on a research project in Toronto, Canada, this article highlights the strengths and resiliency of 12 female Aboriginal Elders and seniors as they age together. For these women, being actively involved in their families and the Aboriginal community gives them a solid grounding in who they are, what their roles are and how they contribute to the whole. Of particular significance is the support and friendship the women offer each other through their commonalities, activities, and sense of humor.

‘Doing the hard yards’: carer and provider focus group perspectives of accessing Aboriginal childhood disability services

PubMed Central

2013-01-01

Background Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results Seventeen health and social service providers representing local area government and non-government-funded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a number of considerations to address provision of disability services in an urban Australian Aboriginal community including building expertise and specialist capacity within Aboriginal Health Worker positions and services. Increasing awareness of services, facilitating linkages and referrals, eliminating complexities to accessing support, and working with families and Aboriginal community organisations within a framework of resilience and empowerment to ensure a relevant and acceptable model are necessary steps to improving support and care for Aboriginal children with a disability. PMID:23958272

An Opportunity for Healing and Holistic Care: Exploring the Roles of Health Care Providers Working Within Northern Canadian Aboriginal Communities.

PubMed

Rahaman, Zaida; Holmes, Dave; Chartrand, Larry

2016-05-22

The purpose of this qualitative study was exploring what the roles and challenges of health care providers working within Northern Canadian Aboriginal communities are and what resources can help support or impede their efforts in working toward addressing health inequities within these communities. The qualitative research conducted was influenced by a postcolonial epistemology. The works of theorists Fanon on colonization and racial construction, Kristeva on semiotics and abjection, and Foucault on power/knowledge, governmentality, and biopower were used in providing a theoretical framework. Critical discourse analysis of 25 semistructured interviews with health care providers was used to gain a better understanding of their roles and challenges while working within Northern Canadian Aboriginal communities. Within this research study, three significant findings emerged from the data. First, the Aboriginal person's identity was constructed in relation to the health care provider's role of delivering essential health services. Second, health care providers were not treating the "ill" patient, but rather treating the patient for being "ill." Third, health care providers were treating the Aboriginal person for being "Aboriginal" by separating the patient from his or her identity. The treatment involved reforming the Aboriginal patient from the condition of being "Aboriginal." © The Author(s) 2016.

Effective nutrition education for Aboriginal Australians: lessons from a diabetes cooking course.

PubMed

Abbott, Penelope A; Davison, Joyce E; Moore, Louise F; Rubinstein, Raechelle

2012-01-01

To examine the experiences of Aboriginal Australians with or at risk of diabetes who attended urban community cooking courses in 2002-2007; and to develop recommendations for increasing the uptake and effectiveness of nutrition education in Aboriginal communities. Descriptive qualitative approach using semistructured interviews with 23 Aboriginal course participants aged 19-72. Verbatim transcripts were coded using NVivo 7 software, and qualitative analysis was undertaken. Engagement and learning were increased by emphasizing the social aspects of the program, holding the course in a familiar Aboriginal community-controlled health setting and using small group learning with Aboriginal peers. Partnership with a vocational training institute provided teaching expertise, but there was conflict between vocational and health promotion objectives. Nutrition programs for Aboriginal Australians should be social, flexible, and held in accessible, culturally appropriate settings and focus on healthful cooking techniques using simple, affordable ingredients. Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Planning, Implementing, and Evaluating a Program to Address the Oral Health Needs of Aboriginal Children in Port Augusta, Australia

PubMed Central

Parker, E. J.; Misan, G.; Shearer, M.; Richards, L.; Russell, A.; Mills, H.; Jamieson, L. M.

2012-01-01

Aboriginal Australian children experience profound oral health disparities relative to their non-Aboriginal counterparts. In response to community concerns regarding Aboriginal child oral health in the regional town of Port Augusta, South Australia, a child dental health service was established within a Community Controlled Aboriginal Health Service. A partnership approach was employed with the key aims of (1) quantifying rates of dental service utilisation, (2) identifying factors influencing participation, and (3) planning and establishing a program for delivery of Aboriginal children's dental services that would increase participation and adapt to community needs. In planning the program, levels of participation were quantified and key issues identified through semistructured interviews. After 3.5 years, the participation rate for dental care among the target population increased from 53 to 70 percent. Key areas were identified to encourage further improvements and ensure sustainability in Aboriginal child oral health in this regional location. PMID:22577401

Aboriginal Language Knowledge and Youth Suicide

ERIC Educational Resources Information Center

Hallett, Darcy; Chandler, Michael J.; Lalonde, Christopher E.

2007-01-01

This brief report details a preliminary investigation into how community-level variability in knowledge of Aboriginal languages relate to "band"-level measures of youth suicide. In Canada, and, more specifically, in the province of British Columbia (BC), Aboriginal youth suicide rates vary substantially from one community to another. The…

A clash of paradigms? Western and indigenous views on health research involving Aboriginal peoples.

PubMed

Campbell, Theresa Diane

2014-07-01

To explore the issues of data management and data ownership with regard to health research conducted in aboriginal or indigenous populations in Canada. Research with aboriginal communities in Canada has often been conducted by researchers who had little or no understanding of the community in which the research was taking place. This led to 'helicopter' research, which benefitted the researcher but not the community. National aboriginal leadership developed the ownership, control, access, and possession (OCAP) principles, which outline how to manage research data regarding aboriginal people and to counteract disrespectful methodologies. However, these principles present their own set of challenges to those who would conduct research with aboriginal populations. Documents from the Assembly of First Nations, the Government of Canada, Aboriginal writers and researchers, and Nursing theorists and researchers. This is a methodology paper that reviews the issues of data ownership when conducting research with Aboriginal populations. The authors explore indigenous and Western views of knowledge development, outline and discuss the OCAP principles, and present the Canadian Institute of Health Research's guidelines for health research involving aboriginal people as a guide for those who want to carry out ethical and culturally competent research, do no harm and produce research that can benefit aboriginal peoples. There are special considerations associated with conducting research with Aboriginal populations. The Assembly of First Nations wants researchers to use the Ownership, Control, Access and Possession (OCAP) principles with First Nations data. These principles are restrictive and need to be discussed with stakeholders before research is undertaken. In Canada, it is imperative that researchers use the Canadian Institute of Health Research Guidelines for Health Research Involving Aboriginal People to ensure culturally sensitive and ethical conduct during the course of the research with Aboriginal populations. However, some communities may also want to use the OCAP principles and these principles will need to be taken into consideration when designing the study.

Learning through an Aboriginal Language: The Impact on Students' English and Aboriginal Language Skills

ERIC Educational Resources Information Center

Usborne, Esther; Peck, Josephine; Smith, Donna-Lee; Taylor, Donald M.

2011-01-01

Aboriginal communities across Canada are implementing Aboriginal language programs in their schools. In the present research, we explore the impact of learning through an Aboriginal language on students' English and Aboriginal language skills by contrasting a Mi'kmaq language immersion program with a Mi'kmaq as a second language program. The…

Education in Aboriginal Communities: Dilemmas around Empowerment.

ERIC Educational Resources Information Center

Taylor, Donald M.; And Others

1993-01-01

Sudden empowerment of Canadian Aboriginal communities has raised many dilemmas concerning community controlled education, including issues related to educational planning and decision making by inexperienced administrators, focusing educational goals on the community versus mainstream society, discontinuities between community and school culture,…

Diabetes screening of children in a remote First Nations community on the west coast of Canada: challenges and solutions.

PubMed

Panagiotopoulos, C; Rozmus, J; Gagnon, R E; Macnab, A J

2007-01-01

Type 2 diabetes (T2D) and its precursor, impaired glucose tolerance (IGT), are now reaching epidemic proportions among Aboriginal Canadians. Of particular concern is the appearance and increasing prevalence of T2D and IGT among Aboriginal youth. At the request of three communities in the Tsimshian nation on the northern coast of British Columbia (with which the Department of Pediatrics, University of British Columbia, had a pre-existing partnership) a screening program was undertaken to determine the prevalence of T2D and IGT among the children. The long-term goal was the collaborative development of intervention programs for each community. The challenges of meeting this request included the sociological and ethical issues associated with research in First Nations communities, as well as the pragmatic issues of conducting complex research in remote communities. Three separate visits were undertaken to respect the cultural dynamics and capacity of the community to accommodate a project of this magnitude. The process began with dialogue, listening and presentations to the community. Only then began the planning of logistics and application for funding. Next, the team visited the communities to ensure understanding of exactly what was involved for the community, each child and family, and to be certain that consent was fully informed. For the diabetes screening visit, special arrangements including chartering a Beaver float plane were needed for the transport of the five-member team with all the necessary equipment, including a -20(o)C freezer to safeguard the integrity of blood samples. The 100% consent rate, successful conduct of study, and retention of community support achieved by the process, indicate that population-based clinical research is possible in remote First Nations communities. This is best achieved with appropriate dialogue, care, respect and planning to overcome the sociological, ethical and practical challenges.

Research protocol for the Picture Talk Project: a qualitative study on research and consent with remote Australian Aboriginal communities

PubMed Central

Fitzpatrick, Emily F M; Carter, Maureen; Oscar, June; Lawford, Tom; Martiniuk, Alexandra L C; D’Antoine, Heather A; Elliott, Elizabeth J

2017-01-01

Introduction Research with Indigenous populations is not always designed with cultural sensitivity. Few publications evaluate or describe in detail seeking consent for research with Indigenous participants. When potential participants are not engaged in a culturally respectful manner, participation rates and research quality can be adversely affected. It is unethical to proceed with research without truly informed consent. Methods and analysis We describe a culturally appropriate research protocol that is invited by Aboriginal communities of the Fitzroy Valley in Western Australia. The Picture Talk Project is a research partnership with local Aboriginal leaders who are also chief investigators. We will interview Aboriginal leaders about research, community engagement and the consent process and hold focus groups with Aboriginal community members about individual consent. Cultural protocols will be applied to recruit and conduct research with participants. Transcripts will be analysed using NVivo10 qualitative software and themes synthesised to highlight the key issues raised by the community about the research process. This protocol will guide future research with the Aboriginal communities of the Fitzroy Valley and may inform the approach to research with other Indigenous communities of Australia or the world. It must be noted that no community is the same and all research requires local consultation and input. To conduct culturally sensitive research, respected local people from the community who have knowledge of cultural protocol and language are engaged to guide each step of the research process from the project design to the delivery of results. Ethics and dissemination Ethics approval was granted by the University of Sydney Human Research Ethics Committee (No. 2012/348, reference:14760), the Western Australia Country Health Service Ethics Committee (No. 2012:15), the Western Australian Aboriginal Health Ethics Committee and reviewed by the Kimberley Aboriginal Health Planning Forum Research Sub-Committee (No. 2012–008). Results will be disseminated through peer review articles, a local Fitzroy Valley report and conference presentations. PMID:29288181

Distance Education for Aboriginal Communities in Canada: Past Experience and Future Potential.

ERIC Educational Resources Information Center

Gruber, Steve; Coldevin, Gary

1995-01-01

Reviews problems with the current educational situation in Canadian aboriginal communities. Notes the potential of distance education to reduce problems associated with cultural assimilation and to enhance multimedia resources. Discusses strengths and weaknesses of two distance education programs for aboriginals and concludes with guidelines for…

Effective Nutrition Education for Aboriginal Australians: Lessons from a Diabetes Cooking Course

ERIC Educational Resources Information Center

Abbott, Penelope A.; Davison, Joyce E.; Moore, Louise F.; Rubinstein, Raechelle

2012-01-01

Objectives: To examine the experiences of Aboriginal Australians with or at risk of diabetes who attended urban community cooking courses in 2002-2007; and to develop recommendations for increasing the uptake and effectiveness of nutrition education in Aboriginal communities. Methods: Descriptive qualitative approach using semistructured…

Canadian Aboriginal people's experiences with HIV/AIDS as portrayed in selected English language Aboriginal media (1996-2000).

PubMed

Clarke, Juanne N; Friedman, Daniela B; Hoffman-Goetz, Laurie

2005-05-01

This paper describes the portrayal of HIV/AIDS in 14 mass print newspapers directed towards the Canadian Aboriginal population and published between 1996 and 2000. Based on qualitative content analysis the research examines both manifest and latent meanings. Manifest results of this study indicate that women and youth are under represented as persons with HIV/AIDS. The latent results note the frequent references to Aboriginal culture, and the political and economic position of Aboriginal Canadians when discussing the disease, the person with the disease, the fear of the disease and the reaction of the community to the person with the disease. Unlike mainstream media where the medical frame is dominant, HIV/AIDS are here contextualized by culture, identity, spirituality and political-economic issues.

Eclipses in Australian Aboriginal Astronomy

NASA Astrophysics Data System (ADS)

Hamacher, Duane W.; Norris, Ray P.

2011-07-01

We explore about fifty different Australian Aboriginal accounts of lunar and solar eclipses to determine how Aboriginal groups understood this phenomenon. We summarize the literature on Aboriginal references to eclipses. We show that many Aboriginal groups viewed eclipses negatively, frequently associating them with bad omens, evil magic, disease, blood and death. In many communities, elders or medicine men claimed to be able to control or avert eclipses by magical means, solidifying their roles as providers and protectors within their communities. We also show that some Aboriginal groups seem to have understood the motions of the Sun-Earth-Moon system, the connection between the lunar phases and tides, and acknowledged that solar eclipses were caused by the Moon blocking the Sun.

Paperbark and pinard: A historical account of maternity care in one remote Australian Aboriginal town.

PubMed

Ireland, Sarah; Belton, Suzanne; McGrath, Ann; Saggers, Sherry; Narjic, Concepta Wulili

2015-12-01

Maternity care in remote areas of the Australian Northern Territory is restricted to antenatal and postnatal care only, with women routinely evacuated to give birth in hospital. Using one remote Aboriginal community as a case study, our aim with this research was to document and explore the major changes to the provision of remote maternity care over the period spanning pre-European colonisation to 1996. Our research methods included historical ethnographic fieldwork (2007-2013); interviews with Aboriginal women, Aboriginal health workers, religious and non-religious non-Aboriginal health workers and past residents; and archival review of historical documents. We identified four distinct eras of maternity care. Maternity care staffed by nuns who were trained in nursing and midwifery serviced childbirth in the local community. Support for community childbirth was incrementally withdrawn over a period, until the government eventually assumed responsibility for all health care. The introduction of Western maternity care colonised Aboriginal birth practices and midwifery practice. Historical population statistics suggest that access to local Western maternity care may have contributed to a significant population increase. Despite population growth and higher demand for maternity services, local maternity services declined significantly. The rationale for removing childbirth services from the community was never explicitly addressed in any known written policy directive. Declining maternity services led to the de-skilling of many Aboriginal health workers and the significant community loss of future career pathways for Aboriginal midwives. This has contributed to the current status quo, with very few female Aboriginal health workers actively providing remote maternity care. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Beyond the Biomedical Paradigm: The Formation and Development of Indigenous Community-Controlled Health Organizations in Australia.

PubMed

Khoury, Peter

2015-01-01

This article describes the formation and development of Aboriginal Community-Controlled Health Services in Australia, with emphasis on the Redfern Aboriginal Medical Service in Sydney. These organizations were established in the 1970s by Indigenous Australians who were excluded from and denied access to mainstream health services. The aim of this research was to explore notions of Indigenous agency against a historical backdrop of dispossession, colonialism, and racism. Aboriginal Community-Controlled Health Services act as a primary source of healthcare for many Indigenous communities in rural and urban areas. This study examined their philosophy of healthcare, the range of services provided, their problems with state bureaucracies and government funding bodies, and the imposition of managerialist techniques and strategies on their governance. Essentially, these organizations transcend individualistic, biomedical, and bureaucratic paradigms of health services by conceptualizing and responding to Indigenous health needs at a grassroots level and in a broad social and political context. They are based on a social model of health. © SAGE Publications 2015.

Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service.

PubMed

Reeve, Carole; Humphreys, John; Wakerman, John; Carroll, Vicki; Carter, Maureen; O'Brien, Tim; Erlank, Carol; Mansour, Rafik; Smith, Bec

2015-01-01

The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.

VET Retention in Remote Aboriginal and Torres Strait Islander Communities. Good Practice Guide

ERIC Educational Resources Information Center

National Centre for Vocational Education Research (NCVER), 2017

2017-01-01

This good practice guide is based on the research project "Enhancing training advantage for remote Aboriginal and Torres Strait Islander learners" by John Guenther et al. on behalf of Ninti One Limited. The project examines five unique and successful vocational education and training (VET) programs in remote areas and identifies how…

Oral health care in remote Kimberley Aboriginal communities: the characteristics and perceptions of dental volunteers.

PubMed

Patel, J; Hearn, L; Slack-Smith, L M

2015-09-01

Aboriginal Australians face significant disparities in oral health and this is particularly the case in remote communities where access to dental services can be difficult. Using volunteers to provide dental care in the remote Kimberley region of Western Australia is a novel approach. This study comprised an anonymous online survey of volunteers working with the Kimberley Dental Team (KDT). The survey had a response fraction of 66% and explored volunteer demographic characteristics, factors that motivated their involvement, perceptions of oral health among Aboriginal communities, and barriers and enablers to oral health in remote Aboriginal communities. Volunteers were more likely to be female, middle-aged and engaged in full-time employment. The two most common reasons reported for volunteering were to assist the community and visit the Kimberley region. Education and access to reliable, culturally appropriate care were perceived as enablers to good oral health for Aboriginal people in the Kimberley while limited access to services, poor nutrition and lack of government support were cited as barriers. Volunteers providing dental services to remote areas in Western Australia had a diverse demographic profile. However, they share similar motivating factors and views on the current barriers and enablers to good oral health in remote Aboriginal communities. © 2015 Australian Dental Association.

From the bush to the big smoke--development of a hybrid urban community based medical education program in the Northern Territory, Australia.

PubMed

Morgan, S; Smedts, A; Campbell, N; Sager, R; Lowe, M; Strasser, S

2009-01-01

The Northern Territory (NT) of Australia is a unique setting for training medical students. This learning environment is characterised by Aboriginal health and an emphasis on rural and remote primary care practice. For over a decade the NT Clinical School (NTCS) of Flinders University has been teaching undergraduate medical students in the NT. Community based medical education (CBME) has been demonstrated to be an effective method of learning medicine, particularly in rural settings. As a result, it is rapidly gaining popularity in Australia and other countries. The NTCS adopted this model some years ago with the implementation of its Rural Clinical School; however, urban models of CBME are much less well developed than those in rural areas. There is considerable pressure to better incorporate CBME into medical student teaching environment, particularly because of the projected massive increase in student numbers over the next few years. To date, the community setting of urban Darwin, the NT capital city, has not been well utilised for medical student training. In 2008, the NTCS enrolled its first cohort of students in a new hybrid CBME program based in urban Darwin. This report describes the process and challenges involved in development of the program, including justification for a hybrid model and the adaptation of a rural model to an urban setting. Relationships were established and formalised with key partners and stakeholders, including GPs and general practices, Aboriginal medical services, community based healthcare providers and other general practice and community organisations. Other significant issues included curriculum development and review, development of learning materials and the establishment of robust evaluation methods. Development of the CBME model in Darwin posed a number of key challenges. Although the experience of past rural programs was useful, a number of distinct differences were evident in the urban setting. Change leadership and inter-professional collaboration were key strengths in the implementation and ongoing evaluation of the program. The program will provide important information about medical student training in urban community settings, and help inform other clinical schools considering the adoption of similar models.

The role of primary health care services to better meet the needs of Aboriginal Australians transitioning from prison to the community.

PubMed

Lloyd, Jane E; Delaney-Thiele, Dea; Abbott, Penny; Baldry, Eileen; McEntyre, Elizabeth; Reath, Jennifer; Indig, Devon; Sherwood, Juanita; Harris, Mark F

2015-07-22

Aboriginal Australians are more likely than other Australians to cycle in and out of prison on remand or by serving multiple short sentences-a form of serial incarceration and institutionalisation. This cycle contributes to the over-representation of Aboriginal Australians in prison and higher rates of recidivism. Our research examined how primary health care can better meet the health care and social support needs of Aboriginal Australians transitioning from prison to the community. Purposive sampling was used to identify 30 interviewees. Twelve interviews were with Aboriginal people who had been in prison; ten were with family members and eight with community service providers who worked with former inmates. Thematic analysis was conducted on the interviewees' description of their experience of services provided to prisoners both during incarceration and on transition to the community. Interviewees believed that effective access to primary health care on release and during transition was positively influenced by providing appropriate healthcare to inmates in custody and by properly planning for their release. Further, interviewees felt that poor communication between health care providers in custody and in the community prior to an inmate's release, contributed to a lack of comprehensive management of chronic conditions. System level barriers to timely communication between in-custody and community providers included inmates being placed on remand which contributed to uncertainty regarding release dates and therefore difficulties planning for release, cycling in and out of prison on short sentences and being released to freedom without access to support services. For Aboriginal former inmates and family members, release from prison was a period of significant emotional stress and commonly involved managing complex needs. To support their transition into the community, Aboriginal former inmates would benefit from immediate access to culturally- responsive community -primary health care services. At present, however, pre-release planning is not always available, especially for Aboriginal inmates who are more likely to be on remand or in custody for less than six months.

Making the best of the early years: the Tambellup way.

PubMed

Clark, Kim D; Oosthuizen, Jacques; Beerenfels, Susan; Rowell, Anne-Marie C

2010-01-01

Tambellup is a small rural town in the Great Southern region of Western Australia (WA), approximately 300 km south-east of state capital Perth. Tambellup has a much higher Aboriginal population than the national average and achieved very positive results for year one children in 2007 regional Australian Early Development Index testing. In 2009 the Great Southern GP Network (which has a facilitating role in providing early intervention strategies to families with young children at risk of disadvantage) requested that public health staff at Edith Cowan University, Perth, WA undertake an exploratory study to discover the factors protective of children's development in Tambellup. This article describes the subsequent research and its findings. This 2009 qualitative study interviewed both adult members of the local Aboriginal community (Noongar people; n = 23), and non-Aboriginal leaders from a cross-section of organisations, services and the community (n = 14) to determine what made growing up in Tambellup a positive experience. Aboriginal participants were introduced to the researchers by a local cultural consultant. Non-Aboriginal participants were initially sourced from a list provided by the GSGPN and extended by asking those listed to identify other appropriate contacts. Face-to-face interviews were carried out with Aboriginal participants and telephone interviews were undertaken with non-Aboriginal participants. All interviews were conducted using a standard schedule of questions as a guide, supplemented by clarifying and broadening questions from research team members. Data were analysed in a multi-stage process of collation, extraction of common themes and verification of themes with study participants and other stakeholders. Findings were presented to local Aboriginal leaders at a community meeting and a final report was prepared and circulated to community members. There was substantial evidence of widespread trust and positive relationships in this close-knit community, where adults looked out for and supported both their own and others' children. The primary school played a key role in supporting children's development even before children started school. Good relations generally existed between Aboriginal and non-Aboriginal residents, contributing to the stability of the population and providing many role models in successful cross-cultural relationships. Aboriginal people in Tambellup played significant but often under-recognised roles in promoting child and youth wellbeing in the community. The community had the capacity to respond to local needs and challenges. Communication channels were effective and there was a sense of belonging, pride and 'connectedness' in the community that promoted and supported a safe environment for children. High quality services and staff (eg school and community health centre) reinforced children's developmental opportunities. The results suggest that small rural communities offer significant and untapped resources for enhancing the health and wellbeing of children in the critical early years of life.

Challenges to uptake of cancer education resources by rural Aboriginal Health Workers: the Cancer Healing Messages flipchart experience.

PubMed

Bierbaum, Mia; Plueckhahn, Tania; Roth, Firona; McNamara, Carmel; Ramsey, Imogen; Corsini, Nadia

2017-12-01

The Australian Aboriginal and Torres Strait Islander (Aboriginal) population has a higher age-standardised cancer mortality rate and a significantly lower 5-year survival rate for all cancers than the non-Aboriginal population. Aboriginal people from regional and remote South Australia and the Northern Territory, are often required to travel to Adelaide to access specialist cancer care services. The burden and expenses associated with transport and accommodation and cultural and linguistic factors have been identified as barriers to accessing medical treatment and health services. In collaboration with community and stakeholders, Cancer Council South Australia led the development of the Cancer Healing Messages flipchart and patient flyer to assist health professionals in explaining cancer and the cancer journey to Aboriginal cancer patients and their families. This study examined the usage, acceptability and perceived usefulness of the resources, barriers to uptake, and strategies to improve their utilisation and sustainability. An evaluation survey was conducted among Aboriginal Health Workers (AHWs) and other health professionals working with Aboriginal clients in South Australia (n=18). Participants indicated whether they agreed that the resources are valuable, culturally appropriate, helpful for explaining aspects of cancer to Aboriginal cancer patients, and useful with regard patient outcomes, how frequently they used or would use the resources for information, and how they use the flipchart in practice. Participants were also asked to report any usage barriers. The resources were considered useful, valuable and culturally appropriate by almost all participants; however, there was a discrepancy between intentions to use the resources and actual uptake, which was low. The most commonly reported barriers related to appropriateness for certain patients and lack of availability of resources in some contexts. The Cancer Healing Messages flipchart and patient flyer are perceived as appropriate, valuable, and useful tools for AHWs. A long-term strategy and clear implementation plan involving education, training and promotion of the materials, is required to achieve broad reach and sustainable utilisation of the Cancer Healing Messages flipchart and patient flyer.

Tailoring a family-based alcohol intervention for Aboriginal Australians, and the experiences and perceptions of health care providers trained in its delivery

PubMed Central

2014-01-01

Background Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. Alcohol treatment approaches that simultaneously target individuals and families offer considerable potential to reduce these harms if they can be successfully tailored for routine delivery to Aboriginal Australians. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions that are consistent with Aboriginal Australians’ notions of health and wellbeing. This paper aims to describe the process of tailoring CRA and CRAFT for delivery to Aboriginal Australians, explore the perceptions of health care providers participating in the tailoring process, and their experiences of participating in CRA and CRAFT counsellor certification. Methods Data sources included notes recorded from eight working group meetings with 22 health care providers of a drug and alcohol treatment agency and Aboriginal Community Controlled Health Service (November 2009-February 2013), and transcripts of semi-structured interviews with seven health care providers participating in CRA and CRAFT counsellor certification (May 2012). Qualitative content analysis was used to categorise working group meeting notes and interview transcripts were into key themes. Results Modifying technical language, reducing the number of treatment sessions, and including an option for treatment of clients in groups, were key recommendations by health care providers for improving the feasibility and applicability of delivering CRA and CRAFT to Aboriginal Australians. Health care providers perceived counsellor certification to be beneficial for developing their skills and confidence in delivering CRA and CRAFT, but identified time constraints and competing tasks as key challenges. Conclusions The tailoring process resulted in Aboriginal Australian-specific CRA and CRAFT resources. The process also resulted in the training and certification of health care providers in CRA and CRAFT and the establishment of a local training and certification program. PMID:24708838

Tailoring a family-based alcohol intervention for Aboriginal Australians, and the experiences and perceptions of health care providers trained in its delivery.

PubMed

Calabria, Bianca; Clifford, Anton; Rose, Miranda; Shakeshaft, Anthony P

2014-04-07

Aboriginal Australians experience a disproportionately high burden of alcohol-related harm compared to the general Australian population. Alcohol treatment approaches that simultaneously target individuals and families offer considerable potential to reduce these harms if they can be successfully tailored for routine delivery to Aboriginal Australians. The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two related interventions that are consistent with Aboriginal Australians' notions of health and wellbeing. This paper aims to describe the process of tailoring CRA and CRAFT for delivery to Aboriginal Australians, explore the perceptions of health care providers participating in the tailoring process, and their experiences of participating in CRA and CRAFT counsellor certification. Data sources included notes recorded from eight working group meetings with 22 health care providers of a drug and alcohol treatment agency and Aboriginal Community Controlled Health Service (November 2009-February 2013), and transcripts of semi-structured interviews with seven health care providers participating in CRA and CRAFT counsellor certification (May 2012). Qualitative content analysis was used to categorise working group meeting notes and interview transcripts were into key themes. Modifying technical language, reducing the number of treatment sessions, and including an option for treatment of clients in groups, were key recommendations by health care providers for improving the feasibility and applicability of delivering CRA and CRAFT to Aboriginal Australians. Health care providers perceived counsellor certification to be beneficial for developing their skills and confidence in delivering CRA and CRAFT, but identified time constraints and competing tasks as key challenges. The tailoring process resulted in Aboriginal Australian-specific CRA and CRAFT resources. The process also resulted in the training and certification of health care providers in CRA and CRAFT and the establishment of a local training and certification program.

What factors contribute to positive early childhood health and development in Australian Aboriginal children? Protocol for a population-based cohort study using linked administrative data (The Seeding Success Study)

PubMed Central

Falster, Kathleen; Jorm, Louisa; Eades, Sandra; Lynch, John; Banks, Emily; Brownell, Marni; Craven, Rhonda; Einarsdóttir, Kristjana; Randall, Deborah

2015-01-01

Introduction Australian Aboriginal children are more likely than non-Aboriginal children to have developmental vulnerability at school entry that tracks through to poorer literacy and numeracy outcomes and multiple social and health disadvantages in later life. Empirical evidence identifying the key drivers of positive early childhood development in Aboriginal children, and supportive features of local communities and early childhood service provision, are lacking. Methods and analysis The study population will be identified via linkage of Australian Early Development Census data to perinatal and birth registration data sets. It will include an almost complete population of children who started their first year of full-time school in New South Wales (NSW), Australia, in 2009 and 2012. Early childhood health and development trajectories for these children will be constructed via linkage to a range of administrative data sets relating to birth outcomes, congenital conditions, hospital admissions, emergency department presentations, receipt of ambulatory mental healthcare services, use of general practitioner services, contact with child protection and out-of-home care services, receipt of income assistance and fact of death. Using multilevel modelling techniques, we will quantify the contributions of individual-level and area-level factors to variation in early childhood development outcomes in Aboriginal and non-Aboriginal children. Additionally, we will evaluate the impact of two government programmes that aim to address early childhood disadvantage, the NSW Aboriginal Maternal and Infant Health Service and the Brighter Futures Program. These evaluations will use propensity score matching methods and multilevel modelling. Ethics and dissemination Ethical approval has been obtained for this study. Dissemination mechanisms include engagement of stakeholders (including representatives from Aboriginal community controlled organisations, policy agencies, service providers) through a reference group, and writing of summary reports for policy and community audiences in parallel with scientific papers. PMID:25986640

Providing choices for a marginalized community. A community-based project with Malaysian aborigines.

PubMed

Kaur, P

1994-01-01

In 1991, the Family Planning Association (FPA) of the Malaysian state of Perak initiated a community-based development project in the remote Aborigine village of Kampung Tisong. The community consists of approximately 34 households who survive on an average income of about US $37. Malnutrition is pervasive, even minor ailments cause death, more serious afflictions are prevalent, and the closest government clinic is 20 kilometers away and seldom used by the Aborigines. 70% of the children have access to education, but parental illiteracy is a serious educational obstacle. The goals of the FPA program are to 1) promote maternal and child health and responsible parenthood, 2) provide health education, 3) encourage women to seek self-determination, and 4) encourage the development of self-reliance in the community as a whole. The first step was to survey the community's culture, beliefs, and health status with the help of the Aborigines Department and the village headman. After a series of preliminary meetings with other agencies, the FPA began to provide activities including health talks, health courses and demonstrations, medical examinations and check-ups, and first aid training. Environmental protection and sanitation measures were included in the educational activities, and following the traditional "mutual aid system," a small plot of land was cleared for vegetable production. Vegetable gardens and needlecraft will become income-producing activities for the women. Attempts to motivate the women to use family planning have been hindered by the fact that the health of 2 women deteriorated after they began using oral contraceptives. Positive changes are occurring slowly and steadily, however, and the FPA has been instrumental in having the settlement included in a program for the hardcore poor which will provide new housing and farming projects.

The Urgency of Postsecondary Education for Aboriginal Peoples

ERIC Educational Resources Information Center

Preston, Jane P.

2008-01-01

Canada has an unprecedented need to increase the number of Aboriginal peoples who undertake and complete postsecondary programs. Endorsing postsecondary education for Aboriginal peoples advocates an invigorating, fortifying future for Aboriginal peoples, their families, and their communities. Additionally, the postsecondary educational…

Closing the Gap: the need to consider perceptions about drinking water in rural Aboriginal communities in NSW, Australia.

PubMed

Jaravani, Fidelis G; Massey, Peter D; Judd, Jenni; Allan, Jason; Allan, Natalie

2016-04-15

A crucial objective of the Australian Government's Closing the Gap program is to improve Aboriginal health, and to achieve morbidity and mortality rates similar to those for non-Indigenous Australians. Reducing public health risks due to drinking water of unknown quality will help to close the gap. Factors such as hardness, taste, colour and odour of water may influence perceptions of risk and quality. Increased contact and familiarity with a hazard is associated with individuals becoming desensitised and habituated to its presence, so that their risk judgements may reflect their behavioural experiences. Consumption of water of unknown quality, such as rainwater, instead of treated town water in Australian Aboriginal communities may be a community norm, a part of a community's culture or a result of lack of trust in government water suppliers. Partnerships between service providers and communities can ensure that the service is responsive to community needs, is conducted in a culturally appropriate manner and is beneficial to the community. Governance of drinking water in Aboriginal communities cannot be comprehensive without active engagement of the communities involved, and greater understanding of cultural issues, perceptions and behaviours towards drinking water quality. This Perspective article reviews the literature to shed light on the need to consider New South Wales (NSW) Aboriginal perceptions about drinking water and its acceptability. We urge more dialogue and research, and a policy focus that includes partnerships with discrete NSW Aboriginal communities to develop a deeper understanding of perceptions of drinking water and encourage consumption of safe water.

Riding the rural radio wave: The impact of a community-led drug and alcohol radio advertising campaign in a remote Australian Aboriginal community.

PubMed

Munro, Alice; Allan, Julaine; Shakeshaft, Anthony; Snijder, Mieke

2017-10-01

Aboriginal people experience a higher burden of disease as a consequence of drug and alcohol (D&A) abuse. Although media campaigns can be a popular tool for disseminating health promotion messages, evidence of the extent to which they reduce the impact of substance abuse is limited, especially for rural Aboriginal communities. This paper is the first to examine the impact a locally designed D&A radio advertising campaign for Aboriginal people in a remote community in Western NSW. A post-intervention evaluation. The radio campaign was implemented in Bourke, (population 2465, 30% Aboriginal). Fifty-three community surveys were completed. The self-reported level of awareness of the campaign and the number of self-referrals to local D&A workers in the intervention period. Most respondents (79%) reported they listen to radio on a daily basis, with 75% reporting that they had heard one or more of the advertisements. The advertisement that was remembered best contained the voice of a respected, local person. There was one self-referral to local health services during the intervention timeframe. The community-led radio advertising campaign increased community awareness of substance abuse harms, but had limited impact on formal help-seeking. This paper highlights the value of radio as a commonly used, trusted and culturally relevant health promotion medium for rural communities, especially when engaging local respected Aboriginal presenters. © 2017 National Rural Health Alliance Inc.

Religio-Spiritual Participation in Two American Indian Populations

PubMed Central

Garroutte, Eva Marie; Anderson, Heather Orton; Nez-Henderson, Patricia; Croy, Calvin; Beals, Janette; Henderson, Jeffrey A.; Thomas, Jacob; Manson, Spero M.

2015-01-01

Following a previous investigation of religio-spiritual beliefs in American Indians, this article examined prevalence and correlates of religio-spiritual participation in two tribes in the Southwest and Northern Plains (N = 3,084). Analysis suggested a “religious profile” characterized by strong participation across three traditions: aboriginal, Christian, and Native American Church. However, sociodemographic variables that have reliably predicted participation in the general American population, notably gender and age, frequently failed to achieve significance in multivariate analyses for each tradition. Religio-spiritual participation was strongly and significantly related to belief salience for all traditions. Findings suggest that correlates of religious participation may be unique among American Indians, consistent with their distinctive religious profile. Results promise to inform researchers’ efforts to understand and theorize about religio-spiritual behavior. They also provide tribal communities with practical information that might assist them in harnessing social networks to confront collective challenges through community-based participatory research collaborations. PMID:26582964

Culturally Framing Aboriginal Literacy and Learning.

ERIC Educational Resources Information Center

Antone, Eileen

2003-01-01

More than just the development of reading and writing skills, Aboriginal literacy is a wholistic concept, with spiritual, physical, mental, and emotional aspects, involving relationships between self, community, nation, and creation. Models are presented for incorporating traditional Aboriginal knowledge and methodologies into Aboriginal learning…

Australian Aboriginal Education at the Fulcrum of Forces of Change: Remote Queensland Communities.

ERIC Educational Resources Information Center

Baker, Victoria J.

Schools in Australian Aboriginal communities are pulled between an educational model that stresses cultural pride and preservation and one that emphasizes uniformity of education to prepare Aboriginal students for a place in the dominant society. The tension between these objectives is seen in these case studies of schools in two remote Queensland…

Improving mental health awareness among rural Aboriginal men: perspectives from Gippsland.

PubMed

Isaacs, Anton; Maybery, Darryl

2012-04-01

To identify views of Aboriginal people in rural areas about improving mental health awareness among Aboriginal men. Semi-structured interviews were conducted with 17 Aboriginal people, including men, carers and health workers. Participants highlighted the need for mental health awareness programs in the community. They described the type of programs to be conducted as well as their method, content and frequency. This study demonstrates that mental health awareness programs designed specifically for rural Aboriginal men need to involve local Elders and other significant individuals from the community, be de-stigmatised by including mental health under Men's Health and by embedding the messages within a cultural framework.

Developing the rural health workforce to improve Australian Aboriginal and Torres Strait Islander health outcomes: a systematic review.

PubMed

Gwynne, Kylie; Lincoln, Michelle

2017-05-01

Objective The aim of the present study was to identify evidence-based strategies in the literature for developing and maintaining a skilled and qualified rural and remote health workforce in Australia to better meet the health care needs of Australian Aboriginal and/or Torres Strait Islander (hereafter Aboriginal) people. Methods A systematic search strategy was implemented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist. Exclusion and inclusion criteria were applied, and 26 papers were included in the study. These 26 papers were critically evaluated and analysed for common findings about the rural health workforce providing services for Aboriginal people. Results There were four key findings of the study: (1) the experience of Aboriginal people in the health workforce affects their engagement with education, training and employment; (2) particular factors affect the effectiveness and longevity of the non-Aboriginal workforce working in Aboriginal health; (3) attitudes and behaviours of the workforce have a direct effect on service delivery design and models in Aboriginal health; and (4) student placements affect the likelihood of applying for rural and remote health jobs in Aboriginal communities after graduation. Each finding has associated evidence-based strategies including those to promote the engagement and retention of Aboriginal staff; training and support for non-Aboriginal health workers; effective service design; and support strategies for effective student placement. Conclusions Strategies are evidenced in the peer-reviewed literature to improve the rural and remote workforce for health delivery for Australian Aboriginal people and should be considered by policy makers, funders and program managers. What is known about the topic? There is a significant amount of peer-reviewed literature about the recruitment and retention of the rural and remote health workforce. What does this paper add? There is a gap in the literature about strategies to improve recruitment and retention of the rural and remote health workforce for health delivery for Australian Aboriginal people. This paper provides evidence-based strategies in four key areas. What are the implications for practitioners? The findings of the present study are relevant for policy makers, funders and program managers in rural and remote Aboriginal health.

Exploring factors impacting early childhood health among Aboriginal and Torres Strait Islander families and communities: protocol for a population-based cohort study using data linkage (the ‘Defying the Odds’ study)

PubMed Central

Gubhaju, Lina; Jorm, Louisa; Preen, David; Jones, Jocelyn; Joshy, Grace; Shepherd, Carrington; McAullay, Daniel; Eades, Sandra; Ball, Stephen

2018-01-01

Introduction Empirical evidence on family and community risk and protective factors influencing the comparatively high rates of potentially preventable hospitalisations and deaths among Aboriginal and Torres Strait Islander infants and children is limited. As is evidence on geographical variation in these risks. The ‘Defying the Odds’ study aims to explore the impact of perinatal outcomes, maternal social and health outcomes and level of culturally secure service availability on the health outcomes of Western Australian (WA) Aboriginal infants and children aged 0–5 years. Methods and analysis The study combines a retrospective cohort study that uses state-wide linked health and administrative data from 12 data sources for multiple generations within Aboriginal families in WA, with specifically collected survey data from health and social services supporting Aboriginal families in regions of WA. Data sources include perinatal/birth registration, hospital, emergency department, mental health services, drug and alcohol service use, mortality, infectious disease notifications, and child protection and family services. Multilevel regression models will be used to examine the intensity of admissions and presentations, mortality, intensity of long stays and morbidity-free survival (no admissions) for Aboriginal children born in WA in 2000–2013. Relationships between maternal (and grand-maternal) health and social factors and child health outcomes will be quantified. Community-level variation in outcomes for Aboriginal children and factors contributing to this variation will be examined, including the availability of culturally secure services. Online surveys were sent to staff members at relevant services to explore the scope, reach and cultural security of services available to support Aboriginal families across selected regions of WA. Ethics and dissemination Ethics approvals have been granted for the study. Interpretation and dissemination are guided by the study team’s Aboriginal leadership and reference groups. Dissemination will be through direct feedback and reports to health services in the study and via scientific publications and policy recommendations. PMID:29599395

Complicated grief in Aboriginal populations

PubMed Central

Spiwak, Rae; Sareen, Jitender; Elias, Brenda; Martens, Patricia; Munro, Garry; Bolton, James

2012-01-01

To date there have been no studies examining complicated grief (CG) in Aboriginal populations. Although this research gap exists, it can be hypothesized that Aboriginal populations may be at increased risk for CG, given a variety of factors, including increased rates of all-cause mortality and death by suicide. Aboriginal people also have a past history of multiple stressors resulting from the effects of colonization and forced assimilation, a significant example being residential school placement. This loss of culture and high rates of traumatic events may place Aboriginal individuals at increased risk for suicide, as well as CG resulting from traumatic loss and suicide bereavement. Studies are needed to examine CG in Aboriginal populations. These studies must include cooperation with Aboriginal communities to help identify risk factors for CG, understand the role of culture among these communities, and identify interventions to reduce poor health outcomes such as suicidal behavior. PMID:22754293

Design of environmental education module towards the needs of aboriginal community learning

NASA Astrophysics Data System (ADS)

Dasman, Siti Mariam; Yasin, Ruhizan Mohammad

2017-05-01

Non-formal education (NFE) refers to a program that is designed for personal and social education for learners to improve the level of skills and competencies outside formal educational curriculum. Issues related to geography and environment of different Aboriginal communities with other communities play an important role in determining the types and methods that should be made available to the minority community groups. Thus, this concept paper is intended to cater for educational environment through the design and development of learning modules based on non-formal education to the learning of Aboriginal community. Methods and techniques in the design and construction of the modules is based on the Design and Development Research (DDR) that was based on instructional design model of Morrison, Kemp and Ross which is more flexible and prioritizes the needs and characteristics of learners who were involved in the learning modules of the future. The discussion is related to the module development which is suitable to the learning needs of the community and there are several recommendations which may be applied in the implementation of this approach. In conclusion, the community of Orang Asli should be offered the same education as other communities but it is important to distinguish acceptance of learning techniques or approaches used in the education system to meet their standards. The implications of this concept paper is to meet the educational needs of the environment which includes a few aspects of science and some learning activities using effective approaches such as playing and building their own knowledge of meaning.

The Marulu Strategy 2008-2012: overcoming Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley.

PubMed

Fitzpatrick, James P; Oscar, June; Carter, Maureen; Elliott, Elizabeth J; Latimer, Jane; Wright, Edie; Boulton, John

2017-10-01

Aboriginal leaders concerned about high rates of Fetal Alcohol Spectrum Disorder (FASD) in the Fitzroy Valley, remote north-western Australia, introduced restrictions on access to take-away full-strength alcohol. Following this, Aboriginal leaders engaged strategic partners in a broader strategy to address FASD in the region. The aim of this study was to develop and implement a community-led, researcher-supported, FASD strategy. A review of literature focusing on community-led FASD strategies identified key components that informed the Marulu FASD strategy. These included strategy ownership, leadership, and governance by participating communities, and a research framework. Community meetings and workshops led to the development of The Marulu FASD Strategy (2008). Feasibility and community consent to conduct a FASD prevalence study (the Lililwan Project) was confirmed, and implementation was progressed (2010-2013). Concurrent FASD prevention activities were conducted. In 2012, the Marulu FASD Unit was established within a local Aboriginal organisation to sustain and coordinate ongoing strategy activities. Community control of public health initiatives can be achieved when Aboriginal communities prioritise issues of significant concern, and engage strategic partners to overcome them. Implications for public health: The Marulu Strategy forms a template for action to address FASD and other public health issues in Aboriginal communities in Australia and internationally. © 2017 The Authors.

Specialist clinics in remote Australian Aboriginal communities: where rock art meets rocket science.

PubMed

Gruen, Russell; Bailie, Ross

2004-10-01

People in remote Aboriginal communities in the Northern Territory have greater morbidity and mortality than other Australians, but face considerable barriers when accessing hospital-based specialist services. The Specialist Outreach Service, which began in 1997, was a novel policy initiative to improve access by providing a regular multidisciplinary visiting specialist services to remote communities. It led to two interesting juxtapositions: that of 'state of the art' specialist services alongside under-resourced primary care in remote and relatively traditional Aboriginal communities; and that of attempts to develop an evidence base for the effectiveness of outreach, while meeting the short-term evaluative requirements of policy-makers. In this essay, first we describe the development of the service in the Northern Territory and its initial process evaluation. Through a Cochrane systematic review we then summarise the published research on the effectiveness of specialist outreach in improving access to tertiary and hospital-based care. Finally we describe the findings of an observational population-based study of the use of specialist services and the impact of outreach to three remote communities over 11 years. Specialist outreach improves access to specialist care and may lessen the demand for both outpatient and inpatient hospital care. Specialist outreach is, however, dependent on well-functioning primary care. According to the way in which outreach is conducted and the service is organised, it can either support primary care or it can hinder primary care and, as a result, reduce its own effectiveness.

Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cutoff scores for at-risk, high-risk, and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test.

PubMed

Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony P; Conigrave, Katherine M; Simpson, Lynette; Bliss, Donna; Allan, Julaine

2014-09-01

The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item alcohol screener that has been recommended for use in Aboriginal primary health care settings. The time it takes respondents to complete AUDIT, however, has proven to be a barrier to its routine delivery. Two shorter versions, AUDIT-C and AUDIT-3, have been used as screening instruments in primary health care. This paper aims to identify the AUDIT-C and AUDIT-3 cutoff scores that most closely identify individuals classified as being at-risk drinkers, high-risk drinkers, or likely alcohol dependent by the 10-item AUDIT. Two cross-sectional surveys were conducted from June 2009 to May 2010 and from July 2010 to June 2011. Aboriginal Australian participants (N = 156) were recruited through an Aboriginal Community Controlled Health Service, and a community-based drug and alcohol treatment agency in rural New South Wales (NSW), and through community-based Aboriginal groups in Sydney NSW. Sensitivity, specificity, and positive and negative predictive values of each score on the AUDIT-C and AUDIT-3 were calculated, relative to cutoff scores on the 10-item AUDIT for at-risk, high-risk, and likely dependent drinkers. Receiver operating characteristic (ROC) curve analyses were conducted to measure the detection characteristics of AUDIT-C and AUDIT-3 for the three categories of risk. The areas under the receiver operating characteristic (AUROC) curves were high for drinkers classified as being at-risk, high-risk, and likely dependent. Recommended cutoff scores for Aboriginal Australians are as follows: at-risk drinkers AUDIT-C ≥ 5, AUDIT-3 ≥ 1; high-risk drinkers AUDIT-C ≥ 6, AUDIT-3 ≥ 2; and likely dependent drinkers AUDIT-C ≥ 9, AUDIT-3 ≥ 3. Adequate sensitivity and specificity were achieved for recommended cutoff scores. AUROC curves were above 0.90.

Stolen from Our Embrace: The Abduction of First Nations Children and the Restoration of Aboriginal Communities.

ERIC Educational Resources Information Center

Fournier, Suzanne; Crey, Ernie

A deliberate policy to separate and forcibly assimilate Aboriginal First Nations children into the mainstream has pervaded every era of Aboriginal history in Canada. Each era saw a new reason to take Aboriginal children away from their homes, placing them in residential schools, foster care, or non-Aboriginal adoptive families. In the words of…

Traditional food availability and consumption in remote Aboriginal communities in the Northern Territory, Australia.

PubMed

Ferguson, Megan; Brown, Clare; Georga, Claire; Miles, Edward; Wilson, Alyce; Brimblecombe, Julie

2017-06-01

To explore availability, variety and frequency consumption of traditional foods and their role in alleviating food insecurity in remote Aboriginal Australia. Availability was assessed through repeated semi-structured interviews and consumption via a survey. Quantitative data were described and qualitative data classified. Aboriginal and non-Indigenous key informants (n=30 in 2013; n=19 in 2014) from 20 Northern Territory (NT) communities participated in interviews. Aboriginal primary household shoppers (n=73 in 2014) in five of these communities participated in a survey. Traditional foods were reported to be available year-round in all 20 communities. Most participants (89%) reported consuming a variety of traditional foods at least fortnightly and 71% at least weekly. Seventy-six per cent reported being food insecure, with 40% obtaining traditional food during these times. Traditional food is consumed frequently by Aboriginal people living in remote NT. Implications for public health: Quantifying dietary contribution of traditional food would complement estimated population dietary intake. It would contribute evidence of nutrition transition and differences in intakes across age groups and inform dietary, environmental and social interventions and policy. Designing and conducting assessment of traditional food intake in conjunction with Aboriginal leaders warrants consideration. © 2017 The Authors.

Worker compensation injuries among the Aboriginal population of British Columbia, Canada: incidence, annual trends, and ecological analysis of risk markers, 1987-2010.

PubMed

Jin, Andrew; George, M Anne; Brussoni, Mariana; Lalonde, Christopher E

2014-07-10

Aboriginal people in British Columbia (BC) have higher injury incidence than the general population, but information is scarce regarding variability among injury categories, time periods, and geographic, demographic and socio-economic groups. Our project helps fill these gaps. This report focuses on workplace injuries. We used BC's universal health care insurance plan as a population registry, linked to worker compensation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence rate and Standardized Relative Risk (SRR) of worker compensation injury, adjusted for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We assessed annual trend by regressing SRR as a linear function of year. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with community SRR of injury by multivariable linear regression. During the period 1987-2010, the crude rate of worker compensation injury in BC was 146.6 per 10,000 person-years (95% confidence interval: 146.4 to 146.9 per 10,000). The Aboriginal rate was 115.6 per 10,000 (95% CI: 114.4 to 116.8 per 10,000) and SRR was 0.88 (95% CI: 0.87 to 0.89). Among those living on reserves SRR was 0.79 (95% CI: 0.78 to 0.80). HSDA SRRs were highly variable, within both total and Aboriginal populations. Aboriginal males under 35 and females under 40 years of age had lower SRRs, but older Aboriginal females had higher SRRs. SRRs are declining, but more slowly for the Aboriginal population. The Aboriginal population was initially at lower risk than the total population, but parity was reached in 2006. These community characteristics independently predicted injury risk: crowded housing, proportion of population who identified as Aboriginal, and interactions between employment rate and income, occupational risk, proportion of university-educated persons, and year. As employment rates rise, so has risk of workplace injury among the Aboriginal population. We need culturally sensitive prevention programs, targeting regions and industries where Aboriginal workers are concentrated and demographic groups that are at higher risk.

Worker compensation injuries among the Aboriginal population of British Columbia, Canada: incidence, annual trends, and ecological analysis of risk markers, 1987–2010

PubMed Central

2014-01-01

Background Aboriginal people in British Columbia (BC) have higher injury incidence than the general population, but information is scarce regarding variability among injury categories, time periods, and geographic, demographic and socio-economic groups. Our project helps fill these gaps. This report focuses on workplace injuries. Methods We used BC’s universal health care insurance plan as a population registry, linked to worker compensation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence rate and Standardized Relative Risk (SRR) of worker compensation injury, adjusted for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We assessed annual trend by regressing SRR as a linear function of year. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with community SRR of injury by multivariable linear regression. Results During the period 1987–2010, the crude rate of worker compensation injury in BC was 146.6 per 10,000 person-years (95% confidence interval: 146.4 to 146.9 per 10,000). The Aboriginal rate was 115.6 per 10,000 (95% CI: 114.4 to 116.8 per 10,000) and SRR was 0.88 (95% CI: 0.87 to 0.89). Among those living on reserves SRR was 0.79 (95% CI: 0.78 to 0.80). HSDA SRRs were highly variable, within both total and Aboriginal populations. Aboriginal males under 35 and females under 40 years of age had lower SRRs, but older Aboriginal females had higher SRRs. SRRs are declining, but more slowly for the Aboriginal population. The Aboriginal population was initially at lower risk than the total population, but parity was reached in 2006. These community characteristics independently predicted injury risk: crowded housing, proportion of population who identified as Aboriginal, and interactions between employment rate and income, occupational risk, proportion of university-educated persons, and year. Conclusions As employment rates rise, so has risk of workplace injury among the Aboriginal population. We need culturally sensitive prevention programs, targeting regions and industries where Aboriginal workers are concentrated and demographic groups that are at higher risk. PMID:25012161

Modern contact investigation methods for enhancing tuberculosis control in aboriginal communities.

PubMed

Cook, Victoria J; Shah, Lena; Gardy, Jennifer

2012-05-25

The Aboriginal communities in Canada are challenged by a disproportionate burden of TB infection and disease. Contact investigation (CI) guidelines exist but these strategies do not take into account the unique social structure of different populations. Because of the limitations of traditional CI, new approaches are under investigation and include the use of social network analysis, geographic information systems and genomics, in addition to the widespread use of genotyping to better understand TB transmission. Guidelines for the routine use of network methods and other novel methodologies for TB CI and outbreak investigation do not exist despite the gathering evidence that these approaches can positively impact TB control efforts, even in Aboriginal communities. The feasibility and efficacy of these novel approaches to CI in Aboriginal communities requires further investigation. The successful integration of these novel methodologies will require community involvement, capacity building and ongoing support at every level. The outcome will not only be the systematic collection, analysis, and interpretation of CI data in high-burden communities to assess transmission but the prioritization of contacts who are candidates for treatment of LTBI which will break the cycle of transmission. Ultimately, the measure of success will be a clear and sustained decline in TB incidence in Aboriginal communities.

Racial discrimination, post-traumatic stress and prescription drug problems among Aboriginal Canadians.

PubMed

Currie, Cheryl; Wild, T Cameron; Schopflocher, Donald; Laing, Lory

2015-06-24

1) To examine associations between racial discrimination and drug problems among urban-based Aboriginal adults; and 2) to determine whether these associations are best explained by symptoms of psychological stress, distress or post-traumatic stress disorder (PTSD). Data were collected through in-person surveys with a community-based sample of Aboriginal adults (N = 372) living in a mid-sized city in western Canada in 2010. Associations were examined using bootstrapped linear regression models adjusted for confounders, with continuous prescription and illicit drug problem scores as outcomes. Mediation was examined using the cross-products of coefficients method. More than 80% of Aboriginal adults had experienced racial discrimination in the past year, with the majority reporting high levels in that period. Past-year discrimination was a risk factor for PTSD symptoms and prescription drug problems in models adjusted for confounders and other forms of psychological trauma. In mediation models, PTSD symptoms explained the association between discrimination and prescription drug problems; psychological stress and distress did not. PTSD symptoms also explained this association when the covariance between mediators was controlled. The results also indicate that participation in Aboriginal cultural traditions was associated with increased discrimination. Most efforts to address Aboriginal health inequities in Canada have focused on the role Aboriginal people play in these disparities. The current findings combine with others to call for an expanded focus. Non-Aboriginal Canadians may also play a role in the health inequities observed. The findings of this study suggest efforts to reduce discrimination experienced by Aboriginal adults in cities may reduce PTSD symptomology and prescription drug problems in these populations.

Aboriginal health learning in the forest and cultivated gardens: building a nutritious and sustainable food system.

PubMed

Stroink, Mirella L; Nelson, Connie H

2009-01-01

Sustainable food systems are those in which diverse foods are produced in close proximity to a market. A dynamic, adaptive knowledge base that is grounded in local culture and geography and connected to outside knowledge resources is essential for such food systems to thrive. Sustainable food systems are particularly important to remote and Aboriginal communities, where extensive transportation makes food expensive and of poorer nutritional value. The Learning Garden program was developed and run with two First Nation communities in northwestern Ontario. With this program, the team adopted a holistic and experiential model of learning to begin rebuilding a knowledge base that would support a sustainable local food system. The program involved a series of workshops held in each community and facilitated by a community-based coordinator. Topics included cultivated gardening and forest foods. Results of survey data collected from 20 Aboriginal workshop participants are presented, revealing a moderate to low level of baseline knowledge of the traditional food system, and a reliance on the mainstream food system that is supported by food values that place convenience, ease, and price above the localness or cultural connectedness of the food. Preliminary findings from qualitative data are also presented on the process of learning that occurred in the program and some of the insights we have gained that are relevant to future adaptations of this program.

Non-timber forest products and Aboriginal traditional knowledge

Treesearch

Robin J. Marles

2001-01-01

Ethnobotanical research was conducted in over 30 Aboriginal communities within Canada's boreal forest region. Specific methods for the research were developed that involved a high degree of participation by Aboriginal people in every stage of the project, with the result that well over 100 Aboriginal elders contributed information on the uses of more that 200...

School Sport Self-Concept of Urban Aboriginal School Children: Teacher Influences.

ERIC Educational Resources Information Center

Kickett-Tucker, Cheryl S.

This paper examines the self-concept of urban Western Australian Aboriginal school children, aged 11-12, in school sports settings. Most students were from the Nyoongar Aboriginal community of southwestern Western Australia. Data were collected from interviews with Aboriginal students and parents, class teachers, and sports teachers, and from…

Aboriginal Digital Opportunities: Addressing Aboriginal Learning Needs through the Use of Learning Technologies. 328-01 Detailed Findings.

ERIC Educational Resources Information Center

Greenall, David; Loizides, Stelios

Aboriginal educators and economic development practitioners in Canada are developing and implementing initiatives to promote the achievement of "digital opportunities" so that Aboriginal communities can both develop and be in a position to take advantage of economic opportunities without falling deeper into the "digital…

Aboriginal Students and School Mobility in British Columbia Public Schools

ERIC Educational Resources Information Center

Aman, Cheryl

2008-01-01

In British Columbia, K-12 school Aboriginal students' completion rates are far from equivalent to those of their non-Aboriginal peers. In addition, there is a high degree of variability in Aboriginal students' school completion rates across schools and communities. Administrative data associating approximately 1.5 million school census records of…

Guarding against an HIV epidemic within an Aboriginal community and cultural framework; lessons from NSW.

PubMed

Ward, James; Akre, Snehal P; Kaldor, John M

2010-01-01

The rate of HIV diagnosis in the Aboriginal and Torres Strait Islander population in Australia has been stable over the past 5 years. It is similar to the rate in non-Indigenous people overall, but there are major differences in the demographical and behaviour patterns associated with infection, with a history of injecting drug use and heterosexual contact much more prominent in Aboriginal people with HIV infection. Moreover there are a range of factors, such as social disadvantage, a higher incidence of sexually transmitted infections and poor access to health services that place Aboriginal people at special risk of HIV infection. Mainstream and Aboriginal community-controlled health services have an important role in preventing this epidemic. Partnerships developed within NSW have supported a range of services for Aboriginal people. There is a continuing need to support these services in their response to HIV, with a particular focus on Aboriginal Sexual Health Workers, to ensure that the prevention of HIV remains a high priority.

The importance of context in logic model construction for a multi-site community-based Aboriginal driver licensing program.

PubMed

Cullen, Patricia; Clapham, Kathleen; Byrne, Jake; Hunter, Kate; Senserrick, Teresa; Keay, Lisa; Ivers, Rebecca

2016-08-01

Evidence indicates that Aboriginal people are underrepresented among driver licence holders in New South Wales, which has been attributed to licensing barriers for Aboriginal people. The Driving Change program was developed to provide culturally responsive licensing services that engage Aboriginal communities and build local capacity. This paper outlines the formative evaluation of the program, including logic model construction and exploration of contextual factors. Purposive sampling was used to identify key informants (n=12) from a consultative committee of key stakeholders and program staff. Semi-structured interviews were transcribed and thematically analysed. Data from interviews informed development of the logic model. Participants demonstrated high level of support for the program and reported that it filled an important gap. The program context revealed systemic barriers to licensing that were correspondingly targeted by specific program outputs in the logic model. Addressing underlying assumptions of the program involved managing local capacity and support to strengthen implementation. This formative evaluation highlights the importance of exploring program context as a crucial first step in logic model construction. The consultation process assisted in clarifying program goals and ensuring that the program was responding to underlying systemic factors that contribute to inequitable licensing access for Aboriginal people. Copyright © 2016 Elsevier Ltd. All rights reserved.

Having a yarn about smoking: using action research to develop a 'no smoking' policy within an Aboriginal Health Organisation.

PubMed

Fletcher, Gillian; Fredericks, Bronwyn; Adams, Karen; Finlay, Summer; Andy, Simone; Briggs, Lyn; Hall, Robert

2011-11-01

This article reports on a culturally appropriate process of development of a smoke-free workplace policy within the peak Aboriginal Controlled Community Health Organisation in Victoria, Australia. Smoking is acknowledged as being responsible for at least 20% of all deaths in Aboriginal communities in Australia, and many Aboriginal health workers smoke. The smoke-free workplace policy was developed using the iterative, discursive and experience-based methodology of Participatory Action Research, combined with the culturally embedded concept of 'having a yarn'. Staff members initially identified smoking as a topic to be avoided within workplace discussions. This was due, in part, to grief (everyone had suffered a smoking-related bereavement). Further, there was anxiety that discussing smoking would result in culturally difficult conflict. The use of yarning opened up a safe space for discussion and debate, enabling development of a policy that was accepted across the organisation. Within Aboriginal organisations, it is not sufficient to focus on the outcomes of policy development. Rather, due attention must be paid to the process employed in development of policy, particularly when that policy is directly related to an emotionally and communally weighted topic such as smoking. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

75 FR 34088 - Fisheries in the Western Pacific; Community Development Program Process

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

.... Consist of community residents descended from aboriginal people indigenous to the western Pacific area who... involvement by the indigenous community members including the name, address, telephone and other contact... descended from aboriginal people indigenous to the western Pacific area who conducted commercial or...

What factors contribute to positive early childhood health and development in Australian Aboriginal children? Protocol for a population-based cohort study using linked administrative data (The Seeding Success Study).

PubMed

Falster, Kathleen; Jorm, Louisa; Eades, Sandra; Lynch, John; Banks, Emily; Brownell, Marni; Craven, Rhonda; Einarsdóttir, Kristjana; Randall, Deborah

2015-05-18

Australian Aboriginal children are more likely than non-Aboriginal children to have developmental vulnerability at school entry that tracks through to poorer literacy and numeracy outcomes and multiple social and health disadvantages in later life. Empirical evidence identifying the key drivers of positive early childhood development in Aboriginal children, and supportive features of local communities and early childhood service provision, are lacking. The study population will be identified via linkage of Australian Early Development Census data to perinatal and birth registration data sets. It will include an almost complete population of children who started their first year of full-time school in New South Wales (NSW), Australia, in 2009 and 2012. Early childhood health and development trajectories for these children will be constructed via linkage to a range of administrative data sets relating to birth outcomes, congenital conditions, hospital admissions, emergency department presentations, receipt of ambulatory mental healthcare services, use of general practitioner services, contact with child protection and out-of-home care services, receipt of income assistance and fact of death. Using multilevel modelling techniques, we will quantify the contributions of individual-level and area-level factors to variation in early childhood development outcomes in Aboriginal and non-Aboriginal children. Additionally, we will evaluate the impact of two government programmes that aim to address early childhood disadvantage, the NSW Aboriginal Maternal and Infant Health Service and the Brighter Futures Program. These evaluations will use propensity score matching methods and multilevel modelling. Ethical approval has been obtained for this study. Dissemination mechanisms include engagement of stakeholders (including representatives from Aboriginal community controlled organisations, policy agencies, service providers) through a reference group, and writing of summary reports for policy and community audiences in parallel with scientific papers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Aboriginal users of Canadian quitlines: an exploratory analysis

PubMed Central

Hayward, Lynda M; Campbell, H Sharon; Sutherland‐Brown, Carol

2007-01-01

Objectives To conduct an exploratory, comparative study of the utilisation and effectiveness of tobacco cessation quitlines among aboriginal and non‐aboriginal Canadian smokers. Setting Population based quitlines that provide free cessation information, advice and counselling to Canadian smokers. Subjects First time quitline callers, age 18 years of age and over, who called the quitline between August 2001 and December 2005 and who completed the evaluation and provided data on their ethnic status (n = 7082). Main measures Demographic characteristics and tobacco behaviours of participants at intake and follow‐up; reasons for calling; actions taken toward quitting, and 6‐month follow‐up quit rates. Results 7% of evaluation participants in the time period reported aboriginal origins. Aboriginal participants were younger than non‐aboriginals but had similar smoking status and level of addiction at intake. Concern about future health and current health problems were the most common reasons aboriginal participants called. Six months after intake aboriginals and non‐aboriginals had taken similar actions with 57% making a 24‐hour quit attempt. Quit rates were higher for aboriginals than non‐aboriginals, particularly for men. The 6‐month prolonged abstinence rate for aboriginal men was 16.7% compared with 7.2% for aboriginal women and 9.4% and 8.3% for non‐aboriginal men and women, respectively. Conclusions This exploratory analysis showed that even without targeted promotion, aboriginal smokers do call Canadian quitlines, primarily for health related reasons. We also showed that the quitlines are effective at helping them to quit. As a population focused intervention, quitlines can reach a large proportion of smokers in a cost efficient manner. In aboriginal communities where smoking rates exceed 50% and multiple health risks and chronic diseases already exist, eliminating non‐ceremonial tobacco use must be a priority. Our results, although exploratory, suggest quitlines can be an effective addition to aboriginal tobacco cessation strategies. PMID:18048634

Rebuilding from Resilience: Research Framework for a Randomized Controlled Trial of Community-led Interventions to Prevent Domestic Violence in Aboriginal Communities1

PubMed Central

Andersson, Neil; Shea, Beverley; Amaratunga, Carol; McGuire, Patricia; Sioui, Georges

2010-01-01

This research framework, which competed successfully in the 2008 CIHR open operating grants competition, focuses on protocols to measure the impact of community-led interventions to reduce domestic violence in Aboriginal communities. The project develops and tests tools and procedures for a randomized controlled trial of prevention of family violence. Women’s shelters mainly deal with victims of domestic violence, and the framework also addresses other types of domestic violence (male and female children, elderly, and disabled). The partner shelters are in Aboriginal communities across Canada, on and off reserve, in most provinces and territories. The baseline study applies a questionnaire developed by the shelters. Testing the stepped wedge design in an Aboriginal context, shelters randomized themselves to two waves of intervention, half the shelters receiving the resources for the first wave. A repeat survey after two years will measure the difference between first wave and second wave, after which the resources will shift to the second wave. At least two Aboriginal researchers will complete their doctoral studies in the project. The steering committee of 12 shelter directors guides the project and ensures ethical standards related to their populations. Each participating community and the University of Ottawa reviewed and passed the proposal. PMID:20975853

Growing up our way: the first year of life in remote Aboriginal Australia.

PubMed

Kruske, Sue; Belton, Suzanne; Wardaguga, Molly; Narjic, Concepta

2012-06-01

In this study, we attempted to explore the experiences and beliefs of Aboriginal families as they cared for their children in the first year of life. We collected family stories concerning child rearing, development, behavior, health, and well-being between each infant's birth and first birthday. We found significant differences in parenting behaviors and child-rearing practices between Aboriginal groups and mainstream Australians. Aboriginal parents perceived their children to be autonomous individuals with responsibilities toward a large family group. The children were active agents in determining their own needs, highly prized, and included in all aspects of community life. Concurrent with poverty, neocolonialism, and medical hegemony, child-led parenting styles hamper the effectiveness of health services. Hence, until the planners of Australia's health systems better understand Aboriginal knowledge systems and incorporate them into their planning, we can continue to expect the failure of government and health services among Aboriginal communities.

Outpatient alcohol withdrawal management for Aboriginal and Torres Strait Islander peoples.

PubMed

Brett, Jonathan; Lawrence, Leanne; Ivers, Rowena; Conigrave, Kate

2014-08-01

There is concern from within Aboriginal and Torres Strait Islander communities about the lack of access to alcohol withdrawal management ('detox') services. Outpatient detox is described within national Australian guidelines as a safe option for selected drinkers. However, uncertainly exists as to how suited Aboriginal and Torres Strait Islander peoples are to this approach. 
 Consultations were conducted with stakeholders of four health services providing outpatient detox for Aboriginal and Torres Strait Islander peoples in NSW. Thematic analysis was performed to determine elements perceived as important for success. Key themes that emerged were individual engagement, flexibility, assessment of suitability, Aboriginal staff and community engagement, practical support, counselling, staff education and support, coping with relapse and contingency planning. 
 There is a need to improve access to alcohol detox services for Aboriginal and Torres Strait Islander peoples. The outpatient setting seems to be a feasible and safe environment to provide this kind of service for selected drinkers.

Socioeconomic, social behaviour and dietary patterns among Malaysian aborigines and rural native Malays.

PubMed

Ali, O; Shamsuddin, Z; Khalid, B A

1991-09-01

The socioeconomic, social behaviour and dietary pattern of 100 Aborigines and Malays, aged 7 years and above from Kuala Pangsoon, Selangor Malaysia were studied by using pretested questionnaires. The individual's dietary intake was estimated using 24 hour recall for 3 days within one week which was chosen at random. The household's food consumption pattern was evaluated using food frequency questionnaires. There was no difference in the total income per month for both communities, as well as the educational attainment of the head of household and property ownership. The proportion of smokers among the Aborigines and the Malays was almost similar (33%) but the percentage of heavy smokers was higher among Aborigines compared to Malays. One third of the Aborigines regularly consume alcohol. The main energy source for both communities was rice, sugar and cooking oil whilst fish and eggs were the main sources of protein. More than 50% of the Aborigines take tapioca or tapioca leaves at least once a week compared to less than 20% among the Malays. There was no significant different in the intake of energy, protein and carbohydrate between the groups. However, the Aborigines take less fats and iron compared to the Malays. The difference in terms of smoking, drinking habit and dietary intake may determine the distribution of disease in both communities.

Psychological Sense of Community: An Australian Aboriginal Experience

ERIC Educational Resources Information Center

Bishop, Brian; Colquhoun, Simon; Johnson, Gemma

2006-01-01

Sense of community (SOC) is central to an individual's psychological wellbeing (Sarason, 1974). Eleven participants, mainly from the North West of Western Australia, took part in semistructured interviews investigating Australian Aboriginal notions of community and SOC. Five key themes emerged from the data. These included: kinship structure,…

Enough Bad News! Remote Social Health & Aboriginal Action in a Harsh Environment--Coober Pedy in South Australia's "Outback."

ERIC Educational Resources Information Center

Brice, G.; And Others

This paper focuses on the complexities of health care in Coober Pedy (South Australia) and the nearby Umoona Aboriginal community, and highlights the vital role of Aboriginal health workers in the implementation of primary health care principles. The Aboriginal population in this "outback" area is characterized by considerable economic…

Community-Based Suicide Prevention Research in Remote On-Reserve First Nations Communities

ERIC Educational Resources Information Center

Isaak, Corinne A.; Campeau, Mike; Katz, Laurence Y.; Enns, Murray W.; Elias, Brenda; Sareen, Jitender

2010-01-01

Suicide is a complex problem linked to genetic, environmental, psychological and community factors. For the Aboriginal population more specifically, loss of culture, history of traumatic events, individual, family and community factors may also play a role in suicidal behaviour. Of particular concern is the high rate of suicide among Canadian…

Fatherhood in Australian Aboriginal and Torres Strait Islander communities: An Examination of Barriers and Opportunities to Strengthen the Male Parenting Role.

PubMed

Reilly, Lyndon; Rees, Susan

2018-03-01

Traditional Australian Aboriginal and Torres Strait Islander societies value men's role as parents; however, the importance of promoting fatherhood as a key social determinant of men's well-being has not been fully appreciated in Western medicine. To strengthen the Aboriginal and Torres Strait Islander male parenting role, it is vital to examine current barriers and opportunities. The first author (a male Aboriginal health project officer) conducted yarning sessions in three remote Australian communities, two being Aboriginal, the other having a high Aboriginal population. An expert sample of 25 Aboriginal and 6 non-Aboriginal stakeholders, including maternal and child health workers and men's group facilitators, considered barriers and opportunities to improve men's parenting knowledge and role, with an aim to inform services and practices intended to support men's parenting. A specific aim was to shape an existing men's group program known as Strong Fathers, Strong Families. A thematic analysis of data from the project identified barriers and opportunities to support men's role as parents. Challenges included the transition from traditional to contemporary parenting practices and low level of cultural and male gender sensitivity in maternal and child health services. Services need to better understand and focus on men's psychological empowerment and to address shame and lack of confidence around parenting. Poor literacy and numeracy are viewed as contributing to disempowerment. Communities need to champion Aboriginal and Torres Strait Islander male father role models. Biases and barriers should be addressed to improve service delivery and better enable men to become empowered and confident fathers.

Queering Place: The Intersection of Feminist Body Theory and Australian Aboriginal Collaboration

ERIC Educational Resources Information Center

Somerville, Margaret

2016-01-01

In this article the author used an auto-ethnographic philosophical approach to construct a fragile history of the present. Margaret Somerville reports doing this through tracing key moments and movements of queering feminist poststructural theory and evolving a queering method of body/place writing through her embeddedness in Aboriginal stories.…

Opportunities and obstacles to the elimination of malaria from Peninsular Malaysia: knowledge, attitudes and practices on malaria among aboriginal and rural communities

PubMed Central

2010-01-01

Background Despite continuous efforts by the government and private sectors, malaria is still a public health problem in rural Peninsular Malaysia. This study investigated household knowledge, attitude and practices (KAP) regarding malaria in two malaria endemic communities, forest-aboriginal and rural communities, in the Lipis district of Pahang state, Malaysia. Methods A descriptive cross-sectional study with a semi-structured questionnaire was carried out among 100 and 123 households from forest-aboriginal and rural areas, respectively. Results Knowledge about malaria and its transmission is significantly higher among the rural participants than the aborigines (86.2% vs 76%, p < 0.01). However, use of medicinal plants and beliefs in witchcraft and sorcery in treating febrile diseases were significantly higher among the aboriginal population (p < 0.01). There were no significant differences between the two communities in terms of the knowledge about malaria symptoms, attitudes towards its severity and practices in preventive measures against malaria by using mosquito bed nets. However, the knowledge and practice of different preventive measures to combat malaria, such as insecticide and the elimination of breeding areas, was significantly higher among the rural population than the aborigines (p < 0.001). Conclusions Both communities were aware of malaria as a disease, but knowledge, attitudes and practices were inadequate. Providing efficient health education to people residing in malaria endemic areas would improve their understanding about malaria prevention in order to bring about the elimination of malaria from the country. PMID:20497543

Niyith NiyithWatmam [corrected] (the quiet story): exploring the experiences of Aboriginal women who give birth in their remote community.

PubMed

Ireland, Sarah; Wulili Narjic, Concepta; Belton, Suzanne; Kildea, Sue

2011-10-01

to investigate the beliefs and practices of Aboriginal women who decline transfer to urban hospitals and remain in their remote community to give birth. an ethnographic approach was used which included: the collection of birth histories and narratives, observation and participation in the community for 24 months, field notes, training and employment of an Aboriginal co-researcher, and consultation with and advice from a local reference group. a remote Aboriginal community in the Northern Territory, Australia. narratives were collected from seven Aboriginal women and five family members. findings showed that women, through their previous experiences of standard care, appeared to make conscious decisions and choices about managing their subsequent pregnancies and births. Women took into account their health, the baby's health, the care of their other children, and designated men with a helping role. narratives described a breakdown of traditional birthing practices and high levels of non-compliance with health-system-recommended care. standard care provided for women relocating for birth must be improved, and the provision of a primary maternity service in this particular community may allow Aboriginal Women's Business roles and cultural obligations to be recognised and invigorated. International examples of primary birthing services in remote areas demonstrate that they can be safe alternatives to urban transfer for childbirth. A primary maternity service would provide a safer environment for the women who choose to avoid standard care. Copyright © 2010 Elsevier Ltd. All rights reserved.

Not just bricks and mortar: planning hospital cancer services for Aboriginal people

PubMed Central

2011-01-01

Background Aboriginal people in Australia experience higher mortality from cancer compared with non-Aboriginal Australians, despite an overall lower incidence. A notable contributor to this disparity is that many Aboriginal people do not take up or continue with cancer treatment which almost always occurs within major hospitals. Thirty in-depth interviews with urban, rural and remote Aboriginal people affected by cancer were conducted between March 2006 and September 2007. Interviews explored participants' beliefs about cancer and experiences of cancer care and were audio-recorded, transcribed verbatim and coded independently by two researchers. NVivo7 software was used to assist data management and analysis. Information from interviews relevant to hospital services including and building design was extracted. Findings Relationships and respect emerged as crucial considerations of participants although many aspects of the hospital environment were seen as influencing the delivery of care. Five themes describing concerns about the hospital environment emerged: (i) being alone and lost in a big, alien and inflexible system; (ii) failure of open communication, delays and inefficiency in the system; (iii) practicalities: costs, transportation, community and family responsibilities; (iv) the need for Aboriginal support persons; and (v) connection to the community. Conclusions Design considerations and were identified but more important than the building itself was the critical need to build trust in health services. Promotion of cultural safety, support for Aboriginal family structures and respecting the importance of place and community to Aboriginal patients are crucial in improving cancer outcomes. PMID:21401923

Prevalence of HIV among Aboriginal and Torres Strait Islander Australians: a systematic review and meta-analysis.

PubMed

Graham, Simon; O'Connor, Catherine C; Morgan, Stephen; Chamberlain, Catherine; Hocking, Jane

2017-06-01

Background Aboriginal and Torres Strait Islanders (Aboriginal) are Australia's first peoples. Between 2006 and 2015, HIV notifications increased among Aboriginal people; however, among non-Aboriginal people, notifications remained relatively stable. This systematic review and meta-analysis aims to examine the prevalence of HIV among Aboriginal people overall and by subgroups. In November 2015, a search of PubMed and Web of Science, grey literature and abstracts from conferences was conducted. A study was included if it reported the number of Aboriginal people tested and those who tested positive for HIV. The following variables were extracted: gender; Aboriginal status; population group (men who have sex with men, people who inject drugs, adults, youth in detention and pregnant females) and geographical location. An assessment of between study heterogeneity (I 2 test) and within study bias (selection, measurement and sample size) was also conducted. Seven studies were included; all were cross-sectional study designs. The overall sample size was 3772 and the prevalence of HIV was 0.1% (I 2 =38.3%, P=0.136). Five studies included convenient samples of people attending Australian Needle and Syringe Program Centres, clinics, hospitals and a youth detention centre, increasing the potential of selection bias. Four studies had a sample size, thus decreasing the ability to report pooled estimates. The prevalence of HIV among Aboriginal people in Australia is low. Community-based programs that include both prevention messages for those at risk of infection and culturally appropriate clinical management and support for Aboriginal people living with HIV are needed to prevent HIV increasing among Aboriginal people.

Setting and meeting priorities in Indigenous health research in Australia and its application in the Cooperative Research Centre for Aboriginal health.

PubMed

Monk, Johanna M; Rowley, Kevin G; Anderson, Ian Ps

2009-11-20

Priority setting is about making decisions. Key issues faced during priority setting processes include identifying who makes these decisions, who sets the criteria, and who benefits. The paper reviews the literature and history around priority setting in research, particularly in Aboriginal health research. We explore these issues through a case study of the Cooperative Research Centre for Aboriginal Health (CRCAH)'s experience in setting and meeting priorities.Historically, researchers have made decisions about what research gets done. Pressures of growing competition for research funds and an increased public interest in research have led to demands that appropriate consultation with stakeholders is conducted and that research is of benefit to the wider society. Within Australian Aboriginal communities, these demands extend to Aboriginal control of research to ensure that Aboriginal priorities are met.In response to these demands, research priorities are usually agreed in consultation with stakeholders at an institutional level and researchers are asked to develop relevant proposals at a project level. The CRCAH's experience in funding rounds was that scientific merit was given more weight than stakeholders' priorities and did not necessarily result in research that met these priorities. After reviewing these processes in 2004, the CRCAH identified a new facilitated development approach. In this revised approach, the setting of institutional priorities is integrated with the development of projects in a way that ensures the research reflects stakeholder priorities.This process puts emphasis on identifying projects that reflect priorities prior to developing the quality of the research, rather than assessing the relevance to priorities and quality concurrently. Part of the CRCAH approach is the employment of Program Managers who ensure that stakeholder priorities are met in the development of research projects. This has enabled researchers and stakeholders to come together to collaboratively develop priority-driven research. Involvement by both groups in project development has been found to be essential in making decisions that will lead to robust and useful research.

The health of Canada's Aboriginal children: results from the First Nations and Inuit Regional Health Survey.

PubMed

MacMillan, Harriet L; Jamieson, Ellen; Walsh, Christine; Boyle, Michael; Crawford, Allison; MacMillan, Angus

2010-04-01

Reports on child health in Canada often refer to the disproportionate burden of poor health experienced by Aboriginal children and youth, yet little national data are available. This paper describes the health of First Nations and Inuit children and youth based on the First Nations and Inuit Regional Health Survey (FNIRHS). The FNIRHS combines data from 9 regional surveys conducted in 1996-1997 in Aboriginal reserve communities in all provinces. The target population consisted of all on-reserve communities. All households or a random sample of households or adults (depending on province) were selected based on their population representation. One child was randomly selected from each participating household, except in Ontario and Nova Scotia, where children were randomly selected based upon their population representation. Alberta did not include the section on children's health in their regional survey. Approximately 84% of adults, who were proxy respondents for their child, rated their children's health as very good or excellent. The most frequently reported conditions were ear problems (15%), followed by allergies (13%) and asthma (12%). Broken bones or fractures were the most frequently reported injuries (13%). Respondents reported that 17% of children had behavioural or emotional problems. Overall, 76% of children were reported to get along with the family "very well" or "quite well." While most respondents rated their child's health as very good or excellent, injuries, emotional and behavioural problems, respiratory conditions and ear problems were reported among many Aboriginal children. Issues such as substance abuse, exposure to violence and academic performance were not addressed in the 10 core survey questions. Clearly there is a need for more in-depth information about both the physical and emotional health of Aboriginal children and youth.

From benzos to berries: treatment offered at an Aboriginal youth solvent abuse treatment centre relays the importance of culture.

PubMed

Dell, Colleen Anne; Seguin, Maureen; Hopkins, Carol; Tempier, Raymond; Mehl-Madrona, Lewis; Dell, Debra; Duncan, Randy; Mosier, Karen

2011-02-01

First Nations and Inuit youth who abuse solvents are one of the most highly stigmatized substance-abusing groups in Canada. Drawing on a residential treatment response that is grounded in a culture-based model of resiliency, this article discusses the cultural implications for psychiatry's individualized approach to treating mental disorders. A systematic review of articles published in The Canadian Journal of Psychiatry during the past decade, augmented with a review of Canadian and international literature, revealed a gap in understanding and practice between Western psychiatric disorder-based and Aboriginal culture-based approaches to treatment and healing from substance abuse and mental disorders. Differing conceptualizations of mental health and substance abuse are discussed from Western psychiatric and Aboriginal worldviews, with a focus on connection to self, community, and political context. Applying an Aboriginal method of knowledge translation-storytelling-experiences from front-line workers in a youth solvent abuse treatment centre relay the difficulties with applying Western responses to Aboriginal healing. This lends to a discussion of how psychiatry can capitalize on the growing debate regarding the role of culture in the treatment of Aboriginal youth who abuse solvents. There is significant need for culturally competent psychiatric research specific to diagnosing and treating First Nations and Inuit youth who abuse substances, including solvents. Such understanding for front-line psychiatrists is necessary to improve practice. A health promotion perspective may be a valuable beginning point for attaining this understanding, as it situates psychiatry's approach to treating mental disorders within the etiology for Aboriginal Peoples.

Balancing Head and Heart: The Importance of Relational Accountability in Community-University Partnerships

ERIC Educational Resources Information Center

Kajner, Tania; Fletcher, Fay; Makokis, Pat

2012-01-01

In this article we introduce a "head and heart" approach to community-engaged scholarship. Through the literatures of Aboriginal scholarship and engaged scholarship we reflect on a community-university research and program development project undertaken in response to health and education concerns of Aboriginal people in Canada. We…

The beyond borders initiative: Aboriginal, Torres Strait Islander and international public health students: engaging partners in cross-cultural learning.

PubMed

Dickson, Michelle; Manalo, Giselle

2014-01-01

The University of Sydney's Graduate Diploma in Indigenous Health Promotion (GDIHP) and Masters of International Public Health (MIPH) students have expressed a consistent desire to engage more with each other through student tutorials or any small group activity. MIPH students have expressed an interest in learning about Aboriginal and Torres Strait Islander Aboriginal and Torres Strait Islanderpeople and their health issues recognising contextual similarities in health priorities and social-cultural determinants. A and TSI students enrolled in the GDIHP have traditionally had very little contact with other students and are often unaware of the innovative solutions implemented in developing countries. Through this inclusive teaching innovation the MIPH and GDIHP programmes utilised diversity in the student population and responded to the University's Strategic Plan to promote and enhance pathways for supporting Indigenous students. This innovation provided an opportunity for both groups to learn more about each other as they develop into globally competitive public health practitioners. The 'Beyond Borders' initiative exposed MIPH and GDIHP students to problem-based learning that incorporated global perspectives as well as focusing on the very specific and unique realities of life in Aboriginal and Torres Strait Islander communities. Both student cohorts reported that the knowledge and skill exchange was highly valuable and contributed to their development as health professionals. This simple yet effective initiative created a sustainable cross-cultural, interdisciplinary and community-oriented partnership that benefited all involved and assisted in addressing health inequities in Aboriginal and Torres Strait Islander communities and in developing countries.

Role, Impacts and Implications of Dedicated Aboriginal Student Space at a Canadian University

ERIC Educational Resources Information Center

Smith, Natasha L.; Varghese, Jeji

2016-01-01

This article draws on a case study of the University of Guelph's Aboriginal Resource Centre (ARC) to identify the role that dedicated spaces have in the lives of Aboriginal students. Three roles that were identified include how these spaces build a sense of community, foster and enhance Aboriginal identity, and provide a safe space for Aboriginal…

Validation of risk assessment scales and predictors of intentions to quit smoking in Australian Aboriginal and Torres Strait Islander peoples: a cross-sectional survey protocol

PubMed Central

Gould, Gillian Sandra; Watt, Kerrianne; McEwen, Andy; Cadet-James, Yvonne; Clough, Alan R

2014-01-01

Introduction Tobacco smoking is a very significant behavioural risk factor for the health of Australian Aboriginal and Torres Strait Islanders, and is embedded as a social norm. With a focus on women of childbearing age, and men of similar age, this project aims to determine how Aboriginal and Torres Strait Islander smokers assess smoking risks and how these assessments contribute to their intentions to quit. The findings from this pragmatic study should contribute to developing culturally targeted interventions. Methods and analysis A cross-sectional study using quantitative and qualitative data. A total of 120 Aboriginal and Torres Strait Islander community members aged 18–45 years will be recruited at community events and through an Aboriginal Community Controlled Health Service (ACCHS). Participants will be interviewed using a tablet computer or paper survey. The survey instrument uses modified risk behaviour scales, that is, the Risk Behaviour Diagnosis (RBD) scale and the Smoking Risk Assessment Target (SRAT) (adapted from the Risk Acceptance Ladder) to determine whether attitudes of Aboriginal and Torres Strait Islander smokers to health risk messages are predictors of intentions to quit smoking. The questionnaire will be assessed for face and content validity with a panel of Indigenous community members. The internal consistency of the RBD subscales and their patterns of correlation will be explored. Multivariate analyses will examine predictors of intentions to quit. This will include demographics such as age, gender, nicotine dependence, household smoking rules and perceived threat from smoking and efficacy for quitting. The two risk-assessment scales will be examined to see whether participant responses are correlated. Ethics and dissemination The Aboriginal Health & Medical Research Council Ethics Committee and university ethics committees approved the study. The results will be published in a peer-reviewed journal and a community report will be disseminated by the ACCHS, and at community forums. Note about terminology We use the term Aboriginal and Torres Strait Islander peoples, except where previous research has reported findings from only one group for example, Aboriginal people. Indigenous is used here to refer to Indigenous peoples in the international context, and issues, policies or systems, for example, Indigenous health, Indigenous tobacco control. PMID:24902729

Validation of risk assessment scales and predictors of intentions to quit smoking in Australian Aboriginal and Torres Strait Islander peoples: a cross-sectional survey protocol.

PubMed

Gould, Gillian Sandra; Watt, Kerrianne; McEwen, Andy; Cadet-James, Yvonne; Clough, Alan R

2014-06-05

Tobacco smoking is a very significant behavioural risk factor for the health of Australian Aboriginal and Torres Strait Islanders, and is embedded as a social norm. With a focus on women of childbearing age, and men of similar age, this project aims to determine how Aboriginal and Torres Strait Islander smokers assess smoking risks and how these assessments contribute to their intentions to quit. The findings from this pragmatic study should contribute to developing culturally targeted interventions. A cross-sectional study using quantitative and qualitative data. A total of 120 Aboriginal and Torres Strait Islander community members aged 18-45 years will be recruited at community events and through an Aboriginal Community Controlled Health Service (ACCHS). Participants will be interviewed using a tablet computer or paper survey. The survey instrument uses modified risk behaviour scales, that is, the Risk Behaviour Diagnosis (RBD) scale and the Smoking Risk Assessment Target (SRAT) (adapted from the Risk Acceptance Ladder) to determine whether attitudes of Aboriginal and Torres Strait Islander smokers to health risk messages are predictors of intentions to quit smoking. The questionnaire will be assessed for face and content validity with a panel of Indigenous community members. The internal consistency of the RBD subscales and their patterns of correlation will be explored. Multivariate analyses will examine predictors of intentions to quit. This will include demographics such as age, gender, nicotine dependence, household smoking rules and perceived threat from smoking and efficacy for quitting. The two risk-assessment scales will be examined to see whether participant responses are correlated. The Aboriginal Health & Medical Research Council Ethics Committee and university ethics committees approved the study. The results will be published in a peer-reviewed journal and a community report will be disseminated by the ACCHS, and at community forums. We use the term Aboriginal and Torres Strait Islander peoples, except where previous research has reported findings from only one group for example, Aboriginal people. Indigenous is used here to refer to Indigenous peoples in the international context, and issues, policies or systems, for example, Indigenous health, Indigenous tobacco control. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Family Violence and the Need for Prevention Research in First Nations, Inuit, and Métis Communities1

PubMed Central

Andersson, Neil; Nahwegahbow, Amy

2010-01-01

Existing sources produce widely varying estimates of family violence in First Nations, Inuit, and Métis communities; taken together, they imply a convincing if poorly quantified higher risk of family violence in Aboriginal communities, with the greater burden borne by women. With the accelerating HIV epidemic in some Aboriginal communities, prevention of domestic violence takes on even greater urgency. Five planks in a prevention research platform include: training emerging researchers from all Aboriginal groups to promote culturally specific research; systematic review of unpublished and published knowledge of interventions that reduce domestic violence; intervention theory development specific to each community; attention to the particular ethical issues; and methods development focused on interventions. PMID:20975851

Identifying Aboriginal-specific AUDIT-C and AUDIT-3 cutoff scores for at-risk, high-risk, and likely dependent drinkers using measures of agreement with the 10-item Alcohol Use Disorders Identification Test

PubMed Central

2014-01-01

Background The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item alcohol screener that has been recommended for use in Aboriginal primary health care settings. The time it takes respondents to complete AUDIT, however, has proven to be a barrier to its routine delivery. Two shorter versions, AUDIT-C and AUDIT-3, have been used as screening instruments in primary health care. This paper aims to identify the AUDIT-C and AUDIT-3 cutoff scores that most closely identify individuals classified as being at-risk drinkers, high-risk drinkers, or likely alcohol dependent by the 10-item AUDIT. Methods Two cross-sectional surveys were conducted from June 2009 to May 2010 and from July 2010 to June 2011. Aboriginal Australian participants (N = 156) were recruited through an Aboriginal Community Controlled Health Service, and a community-based drug and alcohol treatment agency in rural New South Wales (NSW), and through community-based Aboriginal groups in Sydney NSW. Sensitivity, specificity, and positive and negative predictive values of each score on the AUDIT-C and AUDIT-3 were calculated, relative to cutoff scores on the 10-item AUDIT for at-risk, high-risk, and likely dependent drinkers. Receiver operating characteristic (ROC) curve analyses were conducted to measure the detection characteristics of AUDIT-C and AUDIT-3 for the three categories of risk. Results The areas under the receiver operating characteristic (AUROC) curves were high for drinkers classified as being at-risk, high-risk, and likely dependent. Conclusions Recommended cutoff scores for Aboriginal Australians are as follows: at-risk drinkers AUDIT-C ≥ 5, AUDIT-3 ≥ 1; high-risk drinkers AUDIT-C ≥ 6, AUDIT-3 ≥ 2; and likely dependent drinkers AUDIT-C ≥ 9, AUDIT-3 ≥ 3. Adequate sensitivity and specificity were achieved for recommended cutoff scores. AUROC curves were above 0.90. PMID:25179547

Estimating tobacco consumption in remote Aboriginal communities using retail sales data: some challenges and opportunities.

PubMed

MacLaren, David; Redman-MacLaren, Michelle; Clough, Alan

2010-07-01

To describe and discuss challenges and opportunities encountered when estimating tobacco consumption in six remote Aboriginal communities using tobacco sales data from retail outlets. We consider tobacco sales data collected from retail outlets selling tobacco to six Aboriginal communities in two similar but separate studies. Despite challenges--including: not all outlets provided data; data not uniform across outlets (sales and invoice data); change in format of data; personnel change or management restructures; and anomalies in data and changes in community populations--tobacco consumption was estimated and returned through project newsletters and community feedback sessions. Amounts of tobacco sold were returned using graphs in newsletters and pictures of items common to the community in community feedback sessions. Despite inherent limitations of estimating tobacco consumption using tobacco sales data, returning the amount of tobacco sold to communities provided an opportunity to discuss tobacco consumption and provide a focal point for individual and community action. Using this method, however, may require large and sustained changes be observed over time to evaluate whether initiatives to reduce tobacco consumption have been effective. Estimating tobacco consumption in remote Aboriginal communities using tobacco sales data from retail outlets requires careful consideration of many logistical, social, cultural and geographic challenges.

Fatherhood in Australian Aboriginal and Torres Strait Islander communities: An Examination of Barriers and Opportunities to Strengthen the Male Parenting Role

PubMed Central

Reilly, Lyndon; Rees, Susan

2017-01-01

Traditional Australian Aboriginal and Torres Strait Islander societies value men’s role as parents; however, the importance of promoting fatherhood as a key social determinant of men’s well-being has not been fully appreciated in Western medicine. To strengthen the Aboriginal and Torres Strait Islander male parenting role, it is vital to examine current barriers and opportunities. The first author (a male Aboriginal health project officer) conducted yarning sessions in three remote Australian communities, two being Aboriginal, the other having a high Aboriginal population. An expert sample of 25 Aboriginal and 6 non-Aboriginal stakeholders, including maternal and child health workers and men’s group facilitators, considered barriers and opportunities to improve men’s parenting knowledge and role, with an aim to inform services and practices intended to support men’s parenting. A specific aim was to shape an existing men’s group program known as Strong Fathers, Strong Families. A thematic analysis of data from the project identified barriers and opportunities to support men’s role as parents. Challenges included the transition from traditional to contemporary parenting practices and low level of cultural and male gender sensitivity in maternal and child health services. Services need to better understand and focus on men’s psychological empowerment and to address shame and lack of confidence around parenting. Poor literacy and numeracy are viewed as contributing to disempowerment. Communities need to champion Aboriginal and Torres Strait Islander male father role models. Biases and barriers should be addressed to improve service delivery and better enable men to become empowered and confident fathers. PMID:29025357

Eye health programs within remote Aboriginal communities in Australia: a review of the literature.

PubMed

Durkin, Shane R

2008-11-01

To review the literature regarding the most sustainable and culturally appropriate ways in which to implement eye health care programs within remote Aboriginal communities in Australia from a primary health care perspective. The search included letters, editorials and papers (published and unpublished) from January 1955 to April 2006. The search revealed 1,106,758 papers, books and other related material. The relevancy of this material was determined by abstract and 378 relevant articles were reviewed in their entirety. After reading the relevant articles and the interview transcripts the themes that emerged from each source were extracted. The ten areas to consider include: clinical practice and access, sustainability, regional-based programs, information technology systems, health worker training, self-determination, cultural and language barriers, funding body responsibilities, embedding specialist programs in primary care services, and other considerations. Further research needs to be undertaken within Aboriginal communities in the area of primary eye health care and barriers to the acceptance of treatment. This may be undertaken using more interactive research methods such as cooperative and narrative inquiry.

Aboriginal Gambling and Problem Gambling: A Review

ERIC Educational Resources Information Center

Breen, Helen; Gainsbury, Sally

2013-01-01

The prevention of gambling-related problems amongst Aboriginal communities has been neglected by most public health strategies which concentrate on mainstream populations. Research indicates that rates of problem gambling are higher for Aboriginal groups than the general population. Specific cultural, familial, and social patterns influence…

Strongyloides seroprevalence before and after an ivermectin mass drug administration in a remote Australian Aboriginal community

PubMed Central

Currie, Bart J.; Cheng, Allen C.; McCarthy, James; Carapetis, Jonathan R.; Holt, Deborah C.; Page, Wendy; Shield, Jennifer; Gundjirryirr, Roslyn; Mulholland, Eddie; Ward, Linda; Andrews, Ross M.

2017-01-01

Background Strongyloides seroprevalence is hyper-endemic in many Australian Aboriginal and Torres Strait Islander communities, ranging from 35–60%. We report the impact on Strongyloides seroprevalence after two oral ivermectin mass drug administrations (MDAs) delivered 12 months apart in a remote Australian Aboriginal community. Methods Utilizing a before and after study design, we measured Strongyloides seroprevalence through population census with sequential MDAs at baseline and month 12. Surveys at months 6 and 18 determined changes in serostatus. Serodiagnosis was undertaken by ELISA that used sonicated Strongyloides ratti antigen to detect anti-Strongyloides IgG. Non-pregnant participants weighing ≥15 kg were administered a single 200 μg/kg ivermectin dose, repeated after 10–42 days if Strongyloides and/or scabies was diagnosed; others followed a standard alternative algorithm. A questionnaire on clinical symptoms was administered to identify adverse events from treatment and self-reported symptoms associated with serostatus. Findings We surveyed 1013 participants at the baseline population census and 1060 (n = 700 from baseline cohort and 360 new entrants) at month 12. Strongyloides seroprevalence fell from 21% (175/818) at baseline to 5% at month 6. For participants from the baseline cohort this reduction was sustained at month 12 (34/618, 6%), falling to 2% at month 18 after the second MDA. For new entrants to the cohort at month 12, seroprevalence reduced from 25% (75/297) to 7% at month 18. Strongyloides positive seroconversions for the baseline cohort six months after each MDA were 2.5% (4/157) at month 6 and 1% at month 18, whilst failure to serorevert remained unchanged at 18%. At 12 months, eosinophilia was identified in 59% of baseline seropositive participants and 89% of seropositive new entrants, compared with 47%baseline seronegative participants and 51% seronegative new entrants. Seropositivity was not correlated with haemoglobin or any self-reported clinical symptoms. Clinical symptoms ascertained on the day of treatment and 24–72 hrs after, did not identify any adverse events. Significance Two community ivermectin MDAs delivered 12 months apart by trained Aboriginal researchers in collaboration with non-Indigenous researchers resulted in a sustained and significant reduction in Strongyloides seroprevalence over 18 months. Similar reductions were seen in the baseline cohort and new entrants. PMID:28505198

Aboriginal Employment & Training Program Development--Toward an Internally Controlled Process.

ERIC Educational Resources Information Center

Stevenson, Phyllis Fay

A case study was conducted of the Peguis Adult High School program (PAHS), a community-based adult education in a Manitoba First Nation community for repeat dropouts and students who did not fit into regular high school. A literature review of the historical relationship between federal/provincial governments and First Nation communities examined…

Food and nutrition programs for Aboriginal and Torres Strait Islander Australians: an overview of systematic reviews.

PubMed

Browne, Jennifer; Adams, Karen; Atkinson, Petah; Gleeson, Deborah; Hayes, Rick

2017-09-19

Objective To provide an overview of previous reviews of programs that aimed to improve nutritional status or diet-related health outcomes for Aboriginal and Torres Strait Islander peoples, in order to determine what programs are effective and why. Methods A systematic search of databases and relevant websites was undertaken to identify reviews of nutrition interventions for Aboriginal and Torres Strait Islander Australians. Pairs of reviewers undertook study selection and data extraction and performed quality assessment using a validated tool. Results Twelve papers reporting 11 reviews were identified. Two reviews were rated high quality, three were rated medium and six were rated low quality. The reviews demonstrated that a positive effect on nutrition and chronic disease indicators can be a result of: 1) incorporating nutrition and breastfeeding advice into maternal and child health care services; and 2) multifaceted community nutrition programs. The evidence suggests that the most important factor determining the success of Aboriginal and Torres Strait Islander food and nutrition programs is community involvement in (and, ideally, control of) program development and implementation. Conclusions Community-directed food and nutrition programs, especially those with multiple components that address the underlying causes of nutrition issues, can be effective in improving nutrition-related outcomes. What is known about the topic? More effective action is urgently required in order to reduce the unacceptable health inequalities between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians. Food insecurity and nutrition-related chronic conditions are responsible for a large proportion of the ill health experienced by Australia's First Peoples. What does this paper add? This narrative overview of 11 reviews published between 2005 and 2015 provides a synthesis of the current evidence for improving Aboriginal and Torres Strait Islander nutrition across the lifespan. The findings suggest that community-based and community-controlled programs, especially those with multiple components that address the underlying causes of nutrition issues, have the greatest potential to improve nutrition-related health outcomes. What are the implications for practitioners? Food and nutrition programs that are initiated and designed by local Aboriginal and Torres Strait Islander people are most likely to be effective. Nutrition and breastfeeding education and advice should be consistently incorporated into maternal and child healthcare services. Nutrition issues should be addressed through multifaceted approaches that address improving individual knowledge and skills, as well as strategies that increase access to nutritious food and provide a healthy food environment.

Embracing Plurality through Oral Language

ERIC Educational Resources Information Center

Nguyen, Bich; Oliver, Rhonda; Rochecouste, Judith

2015-01-01

The transmission and dissemination of knowledge in Aboriginal societies for the most part occurs orally in an Aboriginal language or in Aboriginal English. However, whilst support is given to speaking skills in Indigenous communities, in our education system less emphasis is given to developing equivalent oral communicative competence in Standard…

Injury hospitalizations due to unintentional falls among the Aboriginal population of British Columbia, Canada: incidence, changes over time, and ecological analysis of risk markers, 1991-2010.

PubMed

Jin, Andrew; Lalonde, Christopher E; Brussoni, Mariana; McCormick, Rod; George, M Anne

2015-01-01

Aboriginal people in British Columbia (BC) have higher injury incidence than the general population. Our project describes variability among injury categories, time periods, and geographic, demographic and socio-economic groups. This report focuses on unintentional falls. We used BC's universal health care insurance plan as a population registry, linked to hospital separation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence and Standardized Relative Risk (SRR) of hospitalization for unintentional fall injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics with community SRR of injury by linear regression. During 1991 through 2010, the crude rate of hospitalization for unintentional fall injury in BC was 33.6 per 10,000 person-years. The Aboriginal rate was 49.9 per 10,000 and SRR was 1.89 (95% confidence interval 1.85-1.94). Among those living on reserves SRR was 2.00 (95% CI 1.93-2.07). Northern and non-urban HSDAs had higher SRRs, within both total and Aboriginal populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal than among the total population. Between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more among the Aboriginal population, so the gap between the Aboriginal and total population is narrowing, particularly among females and older adults. These community characteristics were associated with higher risk: lower income, lower educational level, worse housing conditions, and more hazardous types of employment. Over the years, as socio-economic conditions improve, risk of hospitalization due to unintentional fall injury has declined among the Aboriginal population. Women and older adults have benefited more.

Injury Hospitalizations Due to Unintentional Falls among the Aboriginal Population of British Columbia, Canada: Incidence, Changes over Time, and Ecological Analysis of Risk Markers, 1991-2010

PubMed Central

2015-01-01

Background Aboriginal people in British Columbia (BC) have higher injury incidence than the general population. Our project describes variability among injury categories, time periods, and geographic, demographic and socio-economic groups. This report focuses on unintentional falls. Methods We used BC’s universal health care insurance plan as a population registry, linked to hospital separation and vital statistics databases. We identified Aboriginal people by insurance premium group and birth and death record notations. We identified residents of specific Aboriginal communities by postal code. We calculated crude incidence and Standardized Relative Risk (SRR) of hospitalization for unintentional fall injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics with community SRR of injury by linear regression. Results During 1991 through 2010, the crude rate of hospitalization for unintentional fall injury in BC was 33.6 per 10,000 person-years. The Aboriginal rate was 49.9 per 10,000 and SRR was 1.89 (95% confidence interval 1.85-1.94). Among those living on reserves SRR was 2.00 (95% CI 1.93-2.07). Northern and non-urban HSDAs had higher SRRs, within both total and Aboriginal populations. In every age and gender category, the HSDA-standardized SRR was higher among the Aboriginal than among the total population. Between 1991 and 2010, crude rates and SRRs declined substantially, but proportionally more among the Aboriginal population, so the gap between the Aboriginal and total population is narrowing, particularly among females and older adults. These community characteristics were associated with higher risk: lower income, lower educational level, worse housing conditions, and more hazardous types of employment. Conclusions Over the years, as socio-economic conditions improve, risk of hospitalization due to unintentional fall injury has declined among the Aboriginal population. Women and older adults have benefited more. PMID:25793298

Climate change and health research: has it served rural communities?

PubMed

Bell, Erica J

2013-01-01

If climate change is the 21st Century's biggest public health threat, research faces the major challenge of providing adequate evidence for vulnerable communities to adapt to the health effects of climate change. Available information about best practice in climate adaptation suggests it is inclusive of socio-economic disadvantage and local community factors such as access to health services. Since 1995, at least 19 164 papers have been published on climate change in the health sciences and social sciences. This body of literature has not yet been systematically examined for how well it serves rural communities. The ultimate aim of the study was to contribute to better understandings about what climate adaptation research has been done and is needed for rural communities. The two research questions were: 'What kinds of content define climate change research in disciplines that could potentially contribute to adaptation for health?' and 'How is content about rural and Aboriginal communities and best practice in adaptation related to this content?' A quantitative content analysis was performed using 'computational linguistics' Leximancer software. The analysis included 19 164 health and social sciences abstracts, batched by years, from 1 January 1995 to 31 July 2012. The relative frequency and co-occurrence of 52 concepts in these abstracts were mapped, as well as associations with positive or negative sentiment for selected concepts. Aboriginal' concepts tend to be relatively infrequent (3% and 5% overall likelihood of occurrence, respectively) and are more associated with socio-economic concepts in the social sciences than the health sciences. Multiple concepts in the health sciences literature are typically connected with 'disease' and ultimately 'science' storylines, with a 38% likelihood of paired co-occurrence of 'health' and 'disease' concepts alone. The social sciences appear more focused on the local and particular issues of community in climate change than the health sciences. 'Rural' and 'Aboriginal' concepts have increased by 1% across both discipline areas, since 2011 for the 'rural' concept and since 2004 for the 'Aboriginal' concept. 'Health' concepts in the health sciences and 'economic' concepts in the social sciences, as well as 'urban' concepts, are referred to more positively than either the 'rural' or 'Aboriginal' concepts. While care needs to be taken in interpreting the results of this study too negatively for rural and Aboriginal communities, they suggest that a disease focus dominates climate and health research typically unconnected to wider socio-economic and human system factors. This finding needs to be considered in light of the accumulating evidence of the importance of such contextual systemic factors in understanding climate and health effects and responses. The study adds some support to the view that a key priority is bringing the learnings of applied community-based researchers, from those in rural health to those in the social sciences, to climate research. There is a need to build confidence, including in the rural health sector which has arguably been slow to participate in programs of climate change research, that community-based research could make a difference to rural health in a climate-changing world.

'Imagine if I gave up smoking ...': a qualitative exploration of Aboriginal participants' perspectives of a self-management pilot training intervention.

PubMed

Chapple, Kimberley; Kowanko, Inge; Harvey, Peter; Chong, Alwin; Battersby, Malcolm

2016-01-01

This paper reports on a pilot qualitative study investigating Aboriginal participants' perspectives of the Flinders Living Well Smoke Free (LWSF) 'training intervention'. Health workers nationally have been trained in this program, which offers a self-management approach to reducing smoking among Aboriginal clients. A component of the training involves Aboriginal clients volunteering their time in a mock care-planning session providing the health workers with an opportunity to practise their newly acquired skills. During this simulation, the volunteer clients receive one condensed session of the LWSF intervention imitating how the training will be implemented when the health workers have completed the training. For the purpose of this study, 10 Aboriginal clients who had been volunteers in the mock care-planning process, underwent a semi-structured interview at seven sites in Australia, including mainstream health services, Aboriginal community controlled health services and remote Aboriginal communities. The study aimed to gauge their perspectives of the training intervention they experienced. Early indications suggest that Aboriginal volunteer clients responded positively to the process, with many reporting substantial health behaviour change or plans to make changes since taking part in this mock care-planning exercise. Enablers of the intervention are discussed along with factors to be considered in the training program.

Development of the Aboriginal Communication Assessment After Brain Injury (ACAABI): A screening tool for identifying acquired communication disorders in Aboriginal Australians.

PubMed

Armstrong, Elizabeth M; Ciccone, Natalie; Hersh, Deborah; Katzenellebogen, Judith; Coffin, Juli; Thompson, Sandra; Flicker, Leon; Hayward, Colleen; Woods, Deborah; McAllister, Meaghan

2017-06-01

Acquired communication disorders (ACD), following stroke and traumatic brain injury, may not be correctly identified in Aboriginal Australians due to a lack of linguistically and culturally appropriate assessment tools. Within this paper we explore key issues that were considered in the development of the Aboriginal Communication Assessment After Brain Injury (ACAABI) - a screening tool designed to assess the presence of ACD in Aboriginal populations. A literature review and consultation with key stakeholders were undertaken to explore directions needed to develop a new tool, based on existing tools and recommendations for future developments. The literature searches revealed no existing screening tool for ACD in these populations, but identified tools in the areas of cognition and social-emotional wellbeing. Articles retrieved described details of the content and style of these tools, with recommendations for the development and administration of a new tool. The findings from the interview and focus group views were consistent with the approach recommended in the literature. There is a need for a screening tool for ACD to be developed but any tool must be informed by knowledge of Aboriginal language, culture and community input in order to be acceptable and valid.

Acceptability of Mental Health Apps for Aboriginal and Torres Strait Islander Australians: A Qualitative Study.

PubMed

Povey, Josie; Mills, Patj Patj Janama Robert; Dingwall, Kylie Maree; Lowell, Anne; Singer, Judy; Rotumah, Darlene; Bennett-Levy, James; Nagel, Tricia

2016-03-11

Aboriginal and Torres Strait Islander Australians experience high rates of mental illness and psychological distress compared to their non-Indigenous counterparts. E-mental health tools offer an opportunity for accessible, effective, and acceptable treatment. The AIMhi Stay Strong app and the ibobbly suicide prevention app are treatment tools designed to combat the disproportionately high levels of mental illness and stress experienced within the Aboriginal and Torres Strait Islander community. This study aimed to explore Aboriginal and Torres Strait Islander community members' experiences of using two culturally responsive e-mental health apps and identify factors that influence the acceptability of these approaches. Using qualitative methods aligned with a phenomenological approach, we explored the acceptability of two culturally responsive e-mental health apps through a series of three 3-hour focus groups with nine Aboriginal and Torres Strait Islander community members. Thematic analysis was conducted and coresearcher and member checking were used to verify findings. Findings suggest strong support for the concept of e-mental health apps and optimism for their potential. Factors that influenced acceptability related to three key themes: personal factors (eg, motivation, severity and awareness of illness, technological competence, and literacy and language differences), environmental factors (eg, community awareness, stigma, and availability of support), and app characteristics (eg, ease of use, content, graphics, access, and security and information sharing). Specific adaptations, such as local production, culturally relevant content and graphics, a purposeful journey, clear navigation, meaningful language, options to assist people with language differences, offline use, and password protection may aid uptake. When designed to meet the needs of Aboriginal and Torres Strait Islander Australians, e-mental health tools add an important element to public health approaches for improving the well-being of Aboriginal and Torres Strait Islander people.

Sustaining health education research programs in Aboriginal communities.

PubMed

Wisener, Katherine; Shapka, Jennifer; Jarvis-Selinger, Sandra

2017-09-01

Despite evidence supporting the ongoing provision of health education interventions in First Nations communities, there is a paucity of research that specifically addresses how these programs should be designed to ensure sustainability and long-term effects. Using a Community-Based Research approach, a collective case study was completed with three Canadian First Nations communities to address the following research question: What factors are related to sustainable health education programs, and how do they contribute to and/or inhibit program success in an Aboriginal context? Semi-structured interviews and a sharing circle were completed with 19 participants, including members of community leadership, external partners, and program staff and users. Seven factors were identified to either promote or inhibit program sustainability, including: 1) community uptake; 2) environmental factors; 3) stakeholder awareness and support; 4) presence of a champion; 5) availability of funding; 6) fit and flexibility; and 7) capacity and capacity building. Each factor is provided with a working definition, influential moderators, and key evaluation questions. This study is grounded in, and builds on existing research, and can be used by First Nations communities and universities to support effective sustainability planning for community-based health education interventions.

Australian Aboriginal Deaf People and Aboriginal Sign Language

ERIC Educational Resources Information Center

Power, Des

2013-01-01

Many Australian Aboriginal people use a sign language ("hand talk") that mirrors their local spoken language and is used both in culturally appropriate settings when speech is taboo or counterindicated and for community communication. The characteristics of these languages are described, and early European settlers' reports of deaf…

Reconsidering Approaches to Aboriginal Science and Mathematics Education

ERIC Educational Resources Information Center

Sterenberg, Gladys; Hogue, Michelle

2011-01-01

In Canada, Aboriginal postsecondary enrollment and completion rates are significantly lower than those of non-Aboriginal students. This is most evident in studies involving science and mathematics. The investigation of this issue was informed by focus group discussions with eight participants representing a Blackfoot community. Themes emerging in…

Creating Community: A Roundtable on Canadian Aboriginal Literature.

ERIC Educational Resources Information Center

Eigenbrod, Renate, Ed.; Episkenew, Jo-Ann, Ed.

This book contains 13 essays on Canadian Aboriginal literature. Topics include literary criticism, pedagogical issues, and the experiences of Native authors and of faculty teaching Aboriginal literature in mainstream institutions. Entries are: (1) "Natives on Native Literature: What Do We Rightly Write? Or: Shot Headfirst from the Canon"…

Not Just "Sunny Days": Aboriginal Students Connect Out-of-School Literacy Resources with School Literacy Practices

ERIC Educational Resources Information Center

Wiltse, Lynne

2015-01-01

In this paper, I report on a school-university collaborative research project that investigated which practices and knowledges of Canadian Aboriginal students not acknowledged in school may provide these students with access to school literacy practices. The study, which took place in a small city in Western Canada, examined ways to merge the…

Indian hospitals and Aboriginal nurses: Canada and Alaska.

PubMed

Drees, Laurie Meijer

2010-01-01

Between 1945 and the early 1970s, both Indian Health Services in Canada (IHS), and the Alaska Native Health Service (ANS) initiated programs and activities aimed at recruiting and training nurses/nurses aides from Canadian and Alaskan Native communities. In Alaska, the Mt. Edgecumbe Hospital in Sitka acted as a training facility for Alaska Native nurses' aides, while in Canada, the Charles Camsell Hospital served a similar function. These initiatives occurred prior to the devolution of health care to Aboriginal communities. The histories of these two hospitals provide a comparative opportunity to reveal themes related to the history of Aboriginal nurse training and Aboriginal health policies in the north. The paper outlines the structure and function of two main hospitals within the Indian Health and Alaska Native Health Services, discusses the historic training, and role of Aboriginal nurses and caregivers within those systems using both archival and oral history sources.

Circle of strength.

PubMed

Arnault-Pelletier, Valerie; Brown, Sandra; Desjarlais, Joyce; McBeth, Bev

2006-04-01

In 1984, the college of nursing at the University of Saskatchewan (U of S), the First Nations University of Canada and the University of Regina, with funding from Health Canada, established the National Native Access Program to Nursing (NNAPN). This program promoted nursing to aboriginal people, negotiated access seats for aboriginal students at all Canadian universities and offered a nine-week spring orientation program intended to prepare aboriginal students for the demands of campus life and nursing programs. A restructuring of the program in 1997 made it provincial in scope, becoming NAPN, which focuses on the recruitment, support and retention of aboriginal nursing students at the U of S's Nursing Education Program of Saskatchewan (NEPS). Currently, more than 200 self-identified aboriginal students are enrolled in NEPS. All aboriginal students are encouraged to access the NAPN services and to become involved in NAPN activities. NAPN advisers strive for success and excellence for aboriginal nursing students through support and advocacy (personal issues, social services, individual funding, academic assistance, advocacy with faculty), summer employment assistance, recruitment efforts and community partnerships (including community-building activities among the students and building partnerships with outside stakeholders, both First Nations and non-First Nations).

"We need our own food, to grow our own veggies…" Remote Aboriginal food gardens in the Top End of Australia's Northern Territory.

PubMed

Hume, Andrew; O'Dea, Kerin; Brimblecombe, Julie

2013-10-01

Remote Aboriginal community gardens (gardens) frequently operate below their full potential. A set of gardening sustainability principles may improve their planning, operation and long-term sustainability. This paper aims to document the principles of sustainability of non-profit remote Aboriginal community gardens in the Top End of the Northern Territory. Throughout 2011, gardens in the Top End of the Northern Territory were visited. Interviews and observational data were used to explore the principles of garden sustainability with participants. Subsequent iterative thematic analysis informed development of a set of gardening sustainability principles. Principles of sustainability included effective garden planning; community autonomy, consultation and engagement; growing community vetted crops; employing long-term, effective, culturally sensitive managers; long-term, transparent funding organisations and cycles; garden integration into existing food supply chains; culturally appropriate employment arrangements; and physical aspects of successful gardening. This work uniquely consults gardeners, managers and Aboriginal and non-Aboriginal people of both genders in the largest reported study of its type, resulting in new and expanded findings, particularly including new social factors for gardening success. Expanding the understanding of what makes gardens work to include the important social factors identified here may have merit. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

[Health system and aboriginal communities in the province of Formosa, Argentina].

PubMed

Mirassou, Cristina S

2013-01-01

The author comments her experience in the practice of medicine and public health among aborigines in Formosa, a long neglected province in northeast Argentina. Her experience goes through a span of 34 years, 11 in a small community in a far off region. The province has 530162 inhabitants, 43358 (6.5%) aborigines of the Wichí, Qom, and Pilagá ethnicities. Some particular public health problems of these aborigines are due to the great distance between communities and the regular medical assistance while others are related to cultural differences. The situation has gradually improved in the last 30 years due to government awareness in providing easy and close access to medical care, making the most of the abilities of local aborigines midwifes, teaching health assistants and conventional measures. The most apparent results are the decrease in infant mortality rates and the lower incidence of tuberculosis, with no deaths due to tuberculous meningitis since 1999. No less important was the opening of new opportunities for education and the teaching of both native and Spanish language in the schools retaining local customs. The changes have brought about new risks and challenges such as: traffic accidents involving youngsters riding motorcycles, alcoholism, obesity, diabetes (undiagnosed beforehand), high rate of adolescence pregnancy, and crisis of leadership within the communities.

Otitis Media, Learning and Community.

ERIC Educational Resources Information Center

McSwan, David; Clinch, Emma; Store, Ron

This paper reviews selected literature on otitis media (OM) and its learning consequences in Aboriginal children in rural Australia and reports on a project to develop a community approach to the problem. Aboriginal people are the most disadvantaged group in Australia; have much poorer health and lower life expectancy than other Australians; and…

The pattern of psychiatric morbidity in a Victorian urban aboriginal general practice population.

PubMed

McKendrick, J; Cutter, T; Mackenzie, A; Chiu, E

1992-03-01

Victorian Aboriginal people, most of whom live an urban lifestyle, form a distinct cultural group within the wider Victorian community. This paper describes a unique psychosocial study of urban Aboriginal adults attending a general practitioner at the Victorian Aboriginal Health Service in Fitzroy. The frequency and nature of psychiatric disorders among survey respondents is reported, together with a discussion of the association between this morbidity and certain sociodemographic variables.

A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation.

PubMed

Kanowski, Len G; Jorm, Anthony F; Hart, Laura M

2009-06-03

Mental Health First Aid (MHFA) training was developed in Australia to teach members of the public how to give initial help to someone developing a mental health problem or in a mental health crisis situation. However, this type of training requires adaptation for specific cultural groups in the community. This paper describes the adaptation of the program to create an Australian Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) course and presents an initial evaluation of its uptake and acceptability. To evaluate the program, two types of data were collected: (1) quantitative data on uptake of the course (number of Instructors trained and courses subsequently run by these Instructors); (2) qualitative data on strengths, weaknesses and recommendations for the future derived from interviews with program staff and focus groups with Instructors and community participants. 199 Aboriginal people were trained as Instructors in a five day Instructor Training Course. With sufficient time following training, the majority of these Instructors subsequently ran 14-hour AMHFA courses for Aboriginal people in their community. Instructors were more likely to run courses if they had prior teaching experience and if there was post-course contact with one of the Trainers of Instructors. Analysis of qualitative data indicated that the Instructor Training Course and the AMHFA course are culturally appropriate, empowering for Aboriginal people, and provided information that was seen as highly relevant and important in assisting Aboriginal people with a mental illness. There were a number of recommendations for improvements. The AMHFA program is culturally appropriate and acceptable to Aboriginal people. Further work is needed to refine the course and to evaluate its impact on help provided to Aboriginal people with mental health problems.

A program to respond to otitis media in remote Australian Aboriginal communities: a qualitative investigation of parent perspectives.

PubMed

Jones, Caroline; Sharma, Mridula; Harkus, Samantha; McMahon, Catherine; Taumoepeau, Mele; Demuth, Katherine; Mattock, Karen; Rosas, Lee; Wing, Raelene; Pawar, Sulabha; Hampshire, Anne

2018-03-06

Indigenous infants and children in Australia, especially in remote communities, experience early and chronic otitis media (OM) which is difficult to treat and has lifelong impacts in health and education. The LiTTLe Program (Learning to Talk, Talking to Learn) aimed to increase infants' access to spoken language input, teach parents to manage health and hearing problems, and support children's school readiness. This paper aimed to explore caregivers' views about this inclusive, parent-implemented early childhood program for 0-3 years in an Aboriginal community health context. Data from in-depth, semi-structured interviews with 9 caregivers of 12 children who had participated in the program from one remote Aboriginal community in the Northern Territory are presented. Data were analysed thematically. Caregivers provided overall views on the program. In addition, three key areas of focus in the program are also presented here: speech and language, hearing health, and school readiness. Caregivers were positive about the interactive speech and language strategies in the program, except for some strategies which some parents found alien or difficult: such as talking slowly, following along with the child's topic, using parallel talk, or baby talk. Children's hearing was considered by caregivers to be important for understanding people, enjoying music, and detecting environmental sounds including signs of danger. Caregivers provided perspectives on the utility of sign language and its benefits for communicating with infants and young children with hearing loss, and the difficulty of getting young community children to wear a conventional hearing aid. Caregivers were strongly of the opinion that the program had helped prepare children for school through familiarising their child with early literacy activities and resources, as well as school routines. But caregivers differed as to whether they thought the program should have been located at the school itself. The caregivers generally reported positive views about the LiTTLe Program, and also drew attention to areas for improvement. The perspectives gathered may serve to guide other cross-sector collaborations across health and education to respond to OM among children at risk for OM-related disability in speech and language development.

Understanding Race and Racism in Nursing: Insights from Aboriginal Nurses

PubMed Central

Vukic, Adele; Jesty, Charlotte; Mathews, Sr. Veronica; Etowa, Josephine

2012-01-01

Purpose. Indigenous Peoples are underrepresented in the health professions. This paper examines indigenous identity and the quality and nature of nursing work-life. The knowledge generated should enhance strategies to increase representation of indigenous peoples in nursing to reduce health inequities. Design. Community-based participatory research employing Grounded Theory as the method was the design for this study. Theoretical sampling and constant comparison guided the data collection and analysis, and a number of validation strategies including member checks were employed to ensure rigor of the research process. Sample. Twenty-two Aboriginal nurses in Atlantic Canada. Findings. Six major themes emerged from the study: Cultural Context of Work-life, Becoming a Nurse, Navigating Nursing, Race Racism and Nursing, Socio-Political Context of Aboriginal Nursing, and Way Forward. Race and racism in nursing and related subthemes are the focus of this paper. Implications. The experiences of Aboriginal nurses as described in this paper illuminate the need to understand the interplay of race and racism in the health care system. Our paper concludes with Aboriginal nurses' suggestions for systemic change at various levels. PMID:22778991

Racial discrimination, post traumatic stress, and gambling problems among urban Aboriginal adults in Canada.

PubMed

Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul; Parlee, Brenda

2013-09-01

Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events.

Rock, Paper, Protest: The Fight for the Boreal Forest

ERIC Educational Resources Information Center

Gunz, Sally; Whittaker, Linda

2016-01-01

Canada's boreal forests are second only to the Amazon in producing life-giving oxygen and providing a habitat for thousands of species, from the large woodland caribou to the smallest organisms. The boreal forests are the lifeblood of many Aboriginal communities and the thousands of workers, Aboriginal and non-Aboriginal, who harvest and process…

Aboriginal Identity: The Need for Historical and Contextual Perspectives.

ERIC Educational Resources Information Center

Restoule, Jean-Paul

2000-01-01

The issue of Aboriginal identity is most often played out in Canadian law. Aboriginal "difference" from others is used to maintain inequities in power relations when it is convenient for those with power. Canada Natives should identify themselves from inside themselves, their communities, and their traditions, and not allow others to…

Aboriginal Education with Anti-Racist Education: Building Alliances across Cultural and Racial Identity Politics

ERIC Educational Resources Information Center

St. Denis, Verna

2007-01-01

A critical race analysis could provide both Aboriginal students and their university student advisors with knowledge to understand and potentially challenge the effects and processes of racialization that have historically, legally, and politically divided Aboriginal communities and families. Coalition and alliances can be made within and across…

The new "Indigenous health" incentive payment: issues and challenges.

PubMed

Couzos, Sophie; Delaney Thiele, Dea

2010-02-01

Paying incentives above the baseline Medicare Benefits Schedule to health services for the additional work required to meet the health needs of Aboriginal people or Torres Strait Islanders might mitigate inequalities of care, but evidence supporting this is lacking. The proposed "Indigenous health" incentive payment to reduce Aboriginal health disadvantage, which is largely aimed at increasing the responsiveness of mainstream general practices, provides an opportunity to examine the assumptions behind this and other recent health reform bids. Contentious implementation issues include: the ineligibility of several Aboriginal community controlled health services (ACCHSs) to receive this payment; determining Aboriginality and the potential for misappropriation of payments; the difficulty accounting for practice population diversity and patient mobility; and concerns about the benefits or otherwise to the Aboriginal community. Evaluation of the measure will present problems: to attribute outcomes, an evaluation must disaggregate outcomes by type of service provider (general practice or ACCHS). If these challenges are not addressed, this initiative may end up merely funding coordination of care for those Aboriginal people and Torres Strait Islanders who are already regular users of the health system.

Using Graph Theory to Understand First Nations Connections

ERIC Educational Resources Information Center

Peters, Jehu; Metz, Don

2015-01-01

Children of the Earth High School in Winnipeg, Manitoba, is a school dedicated to incorporating Aboriginal perspectives into all areas of the Manitoba curriculum and is attended by an almost exclusive Aboriginal population. Many of these students come from a First Nations community and are related to others who come from such communities, the…

A case study in the use of evidence in a changing political context: an Aboriginal and Torres Strait Islander health service re-examines practice models, governance and financing.

PubMed

Gajjar, Deepa; Zwi, Anthony B; Hill, Peter S; Shannon, Cindy

2014-09-01

This paper examines the response of a regional body, the Institute for Urban Indigenous Health (IUIH), coordinating Aboriginal community controlled health organisations (ACCHOs) in south-east Queensland, to research evidence as they prioritise and plan services in response to internal economic and organisational factors, as well as external policy change. An event-based analysis of a quarterly management meeting of the IUIH allowed an exploration of how the IUIH uses a range of evidence to respond to the challenges faced within the Aboriginal community controlled health sector. The study identified three distinct but interconnected processes: (1) identifying evidence for change; (2) exploring and reframing this evidence; and (3) the application of this evidence at different levels of policy and practice. These processes were evident in each of the three major agendas addressed during the meeting, namely navigating current political change, reforming the ACCHO business model and reframing the available evidence for advocacy. The result has been the emergence of a new service delivery model, in which evidence supports accountability, change management, self-sufficiency and attempts to redefine community control.

Domestic violence.

PubMed

Bennett, B

1997-01-01

This article explores the usefulness of white feminist domestic intervention to Aboriginal women who are victims of domestic violence. The discussion opens with a brief history of Aboriginal society before the age of colonization, followed by a summary of feminist intervention to fight domestic violence and the reactions of the Aboriginal women and communities towards this. It also presents a brief description of works conducted overseas where more appropriate frameworks are being used in intervening against domestic violence such as anti-racist social work. Towards the end, this paper explores some future possibilities for workers, in both Aboriginal and non-Aboriginal societies.

[Comparing the Health Needs of Older Aboriginal and Older Ethnic Chinese Individuals in Taiwan].

PubMed

Lee, Ling-Ling; Lin, Shu-Shuan; Yen, Chia-Feng; Chuang, Jui-Ling

2016-04-01

Providing healthcare to older people is an essential policy in Taiwan. Previous studies have assessed the health needs of older people residing in urban areas. Evidence related to the differences in healthcare needs between older aboriginal and older ethnic Chinese people in Taiwan is insufficient. As both groups exhibit mutually distinct physical and socio-cultural attributes, understanding their different health needs is necessary to provide tailored and effective healthcare. To investigate the distinct health needs of older aboriginal and older ethnic Chinese using a comprehensive health-needs assessment tool. A cross-sectional study design was used. Older people aged 65 or over were proportionally sampled from communities. The Elderly Assessment System Care Standard instrument was used to collect data through interviews held in participant homes or in community activity centers between October 20th and December 20th, 2011. A total of 180 older people were recruited. A majority of participants had at least one chronic disease, disability, or frailty. Across a range of dimensions and categories of health needs, older aboriginal people had statistically significant higher health needs than non-aboriginal ones. However, older ethnic Chinese participants had higher levels of need in the domains of housing/financing and social participation/isolation. Regression analysis found that independence, risk of frailty, and risk of falls explained the majority of health needs, with R2 values of 64% and 69.6% for older aboriginal and older ethnic Chinese participants, respectively. However, the respective impact of these three categories on overall health needs varied between the two groups. Based on our findings, healthcare providers should focus on improving the self-care capabilities of older aboriginal people and on reducing the risk of breakdowns in care for older ethnic Chinese people in order to enhance the quality of elderly care in Taiwan.

Soil-transmitted helminthiasis: a critical but neglected factor influencing school participation of Aboriginal children in rural Malaysia.

PubMed

Ahmed, Abdulhamid; Al-Mekhlafi, Hesham M; Azam, Mohammad Nurul; Ithoi, Init; Al-Adhroey, Abdulelah H; Abdulsalam, Awatif M; Surin, Johari

2012-05-01

Soil-transmitted helminthiasis (STH), among the most common neglected tropical diseases, is a major public health problem in Malaysia with a possible impact on the nutritional status and school participation of rural children. This study was carried out among Aboriginal schoolchildren, living in an endemic area for STH in Malaysia, to determine the possible relationship between intestinal helminthiasis and school absenteeism. We also evaluated whether successful treatment of the infection will affect school attendance among the subjects. Stool analysis revealed that more than 90% of the subjects were infected with at least 1 helminth species, with Ascaris lumbricoides and Trichuris trichiura infections being most prevalent. Infection of moderate-to-heavy worm burdens, low level of fathers' education and anaemia were identified as the significant predictors of high absenteeism among the subjects (P<0·05). Following treatment of the infected children, it was found that school absenteeism was reduced significantly (P<0·01). In conclusion, STH continues to have significant impacts on public health, particularly in rural communities with a negatively significant effect on the school participation of Aboriginal children. A school-based de-worming programme should be introduced and incorporated in the current educational assistance targeted towards the Aboriginal communities, under the auspices of the government.

Sugar-sweetened beverage consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review protocol

PubMed Central

Avery, Jodie C; Bowden, Jacqueline A; Dono, Joanne; Gibson, Odette R; Brownbill, Aimee; Keech, Wendy; Miller, Caroline L

2017-01-01

Introduction Aboriginal and Torres Strait Islander communities of Australia experience poorer health outcomes in the areas of overweight and obesity, diabetes and cardiovascular disease. Contributing to this burden of disease in the Australian community generally and in Aboriginal and Torres Strait Islander communities, is the consumption of sugar-sweetened beverages (SSBs). We have described a protocol for a review to systematically scope articles that document use of SSBs and interventions to reduce their consumption with Aboriginal and Torres Strait Islander people. These results will inform future work that investigates interventions aimed at reducing harm associated with SSB consumption. Methods and analysis This scoping review draws on a methodology that uses a six-step approach to search databases including PubMed, SCOPUS, CINAHL, Informit (including Informit: Indigenous Peoples), Joanna Briggs Institute EBP Database and Mura, between January 1980 and February 2017. Two reviewers will be engaged to search for and screen studies independently, using formulated selection criteria, for inclusion in our review. We will include primary research studies, systematic reviews including meta-analysis or meta-synthesis, reports and unpublished grey literature. Results will be entered into a table identifying study details and characteristics, summarised using a Preferred Reporting Items for Systematic Reviews and Meta-Analysis chart and then critically analysed. Ethics and dissemination This review will not require ethics committee review. Results will be disseminated at appropriate scientific meetings, as well as through the Aboriginal and Torres Strait Islander community. PMID:28760797

The impact of fatal pediatric trauma on aboriginal children.

PubMed

Bratu, Ioana; Lowe, Danielle; Phillips, Leah

2013-05-01

Injuries are the leading cause of death in young people. Our aim is to examine the differences between aboriginal and non-aboriginal pediatric trauma mortality as a means to focus on prevention strategies. The records for all traumatic pediatric (0-18 years) deaths between 1996 and 2010 were reviewed from the regional Medical Examiner's office. The majority of the total 932 pediatric deaths were the result of non-intentional injuries (640) followed by suicide (195), homicide (65), child abuse (15), and undetermined (17). Despite being only 3.3% of the provincial population, Aboriginals represented 30.9% of pediatric trauma fatalities. Aboriginal fatalities occurred most commonly in the home, with males and females equally affected. Road related events were the main causes of injury overall. Up to three-quarters of Aboriginal children who died in a non-pedestrian road related event did not wear an indicated protective device. Pedestrian deaths were over-represented in Aboriginal children. The second most common cause of death was suicide for both non-Aboriginal and Aboriginal children. Almost half of all of the suicides were Aboriginal. Homicide and child abuse had similar proportions for both non-Aboriginal and Aboriginal children. Pediatric Aboriginal injury prevention should be a priority and tailored for Aboriginal communities. Copyright © 2013 Elsevier Inc. All rights reserved.

Improving Aboriginal maternal and infant health services in the 'Top End' of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change.

PubMed

Barclay, Lesley; Kruske, Sue; Bar-Zeev, Sarah; Steenkamp, Malinda; Josif, Cathryn; Narjic, Concepta Wulili; Wardaguga, Molly; Belton, Suzanne; Gao, Yu; Dunbar, Terry; Kildea, Sue

2014-06-02

Health services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia. A mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of 'out of hospital' or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated. Cost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the required skills for providing care for infants, and an 'outpatient' model of care. Services were also characterised by absent Aboriginal leadership and inadequate coordination between remote and tertiary services that is essential to improve quality of care and reduce 'system-introduced' risk. Evidence-informed redesign of maternity services and delivery of care has improved clinical effectiveness and quality for women. However, more work is needed to address substandard care provided for infants and their parents.

A case study of physical and social barriers to hygiene and child growth in remote Australian Aboriginal communities

PubMed Central

McDonald, Elizabeth; Bailie, Ross; Grace, Jocelyn; Brewster, David

2009-01-01

Background Despite Australia's wealth, poor growth is common among Aboriginal children living in remote communities. An important underlying factor for poor growth is the unhygienic state of the living environment in these communities. This study explores the physical and social barriers to achieving safe levels of hygiene for these children. Methods A mixed qualitative and quantitative approach included a community level cross-sectional housing infrastructure survey, focus groups, case studies and key informant interviews in one community. Results We found that a combination of crowding, non-functioning essential housing infrastructure and poor standards of personal and domestic hygiene underlie the high burden of infection experienced by children in this remote community. Conclusion There is a need to address policy and the management of infrastructure, as well as key parenting and childcare practices that allow the high burden of infection among children to persist. The common characteristics of many remote Aboriginal communities in Australia suggest that these findings may be more widely applicable. PMID:19761623

Chagas' disease in Aboriginal and Creole communities from the Gran Chaco Region of Argentina: Seroprevalence and molecular parasitological characterization.

PubMed

Lucero, R H; Brusés, B L; Cura, C I; Formichelli, L B; Juiz, N; Fernández, G J; Bisio, M; Deluca, G D; Besuschio, S; Hernández, D O; Schijman, A G

2016-07-01

Most indigenous ethnias from Northern Argentina live in rural areas of "the Gran Chaco" region, where Trypanosoma cruzi is endemic. Serological and parasitological features have been poorly characterized in Aboriginal populations and scarce information exist regarding relevant T. cruzi discrete typing units (DTU) and parasitic loads. This study was focused to characterize T. cruzi infection in Qom, Mocoit, Pit'laxá and Wichi ethnias (N=604) and Creole communities (N=257) inhabiting rural villages from two highly endemic provinces of the Argentinean Gran Chaco. DNA extracted using Hexadecyltrimethyl Ammonium Bromide reagent from peripheral blood samples was used for conventional PCR targeted to parasite kinetoplastid DNA (kDNA) and identification of DTUs using nuclear genomic markers. In kDNA-PCR positive samples from three rural Aboriginal communities of "Monte Impenetrable Chaqueño", minicircle signatures were characterized by Low stringency single primer-PCR and parasitic loads calculated using Real-Time PCR. Seroprevalence was higher in Aboriginal (47.98%) than in Creole (27.23%) rural communities (Chi square, p=4.e(-8)). A low seroprevalence (4.3%) was detected in a Qom settlement at the suburbs of Resistencia city (Fisher Exact test, p=2.e(-21)).The kDNA-PCR positivity was 42.15% in Aboriginal communities and 65.71% in Creole populations (Chi square, p=5.e(-4)). Among Aboriginal communities kDNA-PCR positivity was heterogeneous (Chi square, p=1.e(-4)). Highest kDNA-PCR positivity (79%) was detected in the Qom community of Colonia Aborigen and the lowest PCR positivity in two different surveys at the Wichi community of Misión Nueva Pompeya (33.3% in 2010 and 20.8% in 2014). TcV (or TcII/V/VI) was predominant in both Aboriginal and Creole communities, in agreement with DTU distribution reported for the region. Besides, two subjects were infected with TcVI, one with TcI and four presented mixed infections of TcV plus TcII/VI. Most minicircle signatures clustered according to their original localities, but in a few cases, signatures from one locality clustered with signatures from other village, suggesting circulation of the same strains in the area. Parasitic loads ranged from undetectable to around 50 parasite equivalents/mL, showing higher values than those generally observed in chronic Chagas disease patients living in urban centers of Argentina. Our findings reveal the persistence of high levels of infection in these neglected populations. Copyright © 2016. Published by Elsevier B.V.

Breaking down barriers to eye care for Indigenous people: a new scheme for delivery of eye care in Victoria.

PubMed

Napper, Genevieve; Fricke, Tim; Anjou, Mitchell D; Jackson, A Jonathan

2015-09-01

This report describes the implementation of and outcomes from a new spectacle subsidy scheme and de-centralised care options for Aboriginal and Torres Strait Islander peoples in Victoria, Australia. The Victorian Aboriginal Spectacle Subsidy Scheme (VASSS) commenced in 2010, as an additional subsidy to the long-established Victorian Eyecare Service (VES). The Victorian Aboriginal Spectacle Subsidy Scheme aimed to improve access to and uptake of affordable spectacles and eye examinations by Indigenous Victorians. The scheme is overseen by a committee convened by the Victorian Government's Department of Health and Human Services and includes eye-health stakeholders from the Aboriginal community and government, not-for-profit, university and Aboriginal communities. Key features of the Victorian Aboriginal Spectacle Subsidy Scheme include reduced and certain patient co-payments of $10, expanded spectacle frame range, broadened eligibility and community participation in service design and implementation. We describe the services implemented by the Australian College of Optometry (ACO) in Victoria and their impact on access to eye-care services. In 2014, optometric services were available at 36 service sites across Victoria, including 21 Aboriginal Health Services (AHS) sites. Patient services have increased from 400 services per year in 2009, to 1,800 services provided in 2014. During the first three years of the Victorian Aboriginal Spectacle Subsidy Scheme program (2010 to 2013), 4,200 pairs of glasses (1,400 pairs per year) were provided. Further funding to 2016/17 will lift the number of glasses to be delivered to 6,600 pairs (1,650 per year). This compares to population projected needs of 2,400 pairs per year. Overcoming the barriers to using eye-care services by Indigenous people can be difficult and resource intensive; however the Victorian Aboriginal Spectacle Subsidy Scheme provides an example of positive outcomes achieved through carefully designed and targeted approaches that engender sector and stakeholder support. Sustained support for the Victorian Aboriginal Spectacle Subsidy Scheme at a level that meets population needs is an ongoing challenge. © 2015 The Authors. Clinical and Experimental Optometry © 2015 Optometry Australia.

Grounded in Country: Perspectives on Working within, alongside and for Aboriginal Communities

ERIC Educational Resources Information Center

Jackson-Barrett, Elizabeth; Price, Anne; Stomski, Norman; Walker, Bruce F.

2015-01-01

This paper presents the experiences of four researchers working within, alongside and for the Gumala Aboriginal Corporation in the Pilbara region of Western Australia. The focus of the research was a health and education needs analysis of Gumala Aboriginal Corporation members that would inform future education and health planning in the region.…

Skills, systems and supports: An Aboriginal Community Controlled Health Service (Apunipima) approach to building health promotion evaluation capacity of staff.

PubMed

Nichols, Nina; McFarlane, Kathryn; Gibson, Priscilla; Millard, Fiona; Packer, Andrew; McDonald, Malcolm

2018-04-01

Building the health promotion evaluation capacity of a workforce requires more than a focus on individual skills and confidence. We must also consider the organisational systems and supports that enable staff to embed learnings into practice. This paper describes the processes used to build health promotion evaluation capacity of staff in an Aboriginal Community Controlled Health Service (ACCHS). To build health promotion evaluation capacity three approaches were used: (i) workshops and mentoring; (ii) strengthening systems to support program reporting; and (iii) recruitment of staff with skills and experience. Pre- and post-questionnaires determined levels of individual skills and confidence, updated systems were assessed for adequacy to support new health promotion practices and surveys captured the usefulness of workshops and mentoring. There was increased participant skills and confidence. Participants completed program impact evaluation reports and results were successfully presented at national conferences. The health promotion team was then able to update in-house systems to support new health promotion practices. Ongoing collaboration with experienced in-house researchers provided basic research training and professional mentoring. Building health promotion evaluation capacity of staff in an ACCHS can be achieved by providing individual skill development, strengthening organisational systems and utilising professional support. SO WHAT?: Health promotion practitioners have an ongoing professional obligation to improve the quality of routine practice and embrace new initiatives. This report outlines a process of building evaluation capacity that promotes quality reporting of program impacts and outcomes, reflects on ways to enhance program strengths, and communicates these findings internally and to outside professional bodies. This is particularly significant for ACCHSs responsible for addressing the high burden of preventable disease in Aboriginal and Torres Strait Islander populations. © 2017 Australian Health Promotion Association.

Comets in Australian Aboriginal Astronomy

NASA Astrophysics Data System (ADS)

Hamacher, Duane W.; Norris, Ray P.

2011-03-01

We present 25 accounts of comets from 40 Australian Aboriginal communities, citing both supernatural perceptions of comets and historical accounts of historically bright comets. Historical and ethnographic descriptions include the Great Comets of 1843, 1861, 1901, 1910, and 1927. We describe the perceptions of comets in Aboriginal societies and show that they are typically associated with fear, death, omens, malevolent spirits, and evil magic, consistent with many cultures around the world. We also provide a list of words for comets in 16 different Aboriginal languages.

Private business: the uptake of confidential HIV testing in remote aboriginal communities on the Anangu Pitjantjatjara Lands.

PubMed

Miller, P J; Torzillo, P J

1998-10-01

Despite a concentration of risk factors for HIV transmission, many remote Aboriginal communities in central Australia have a low uptake of HIV testing. We studied the uptake of HIV testing in six clinics in remote Aboriginal communities following the introduction of voluntary confidential testing to assess the impact of the intervention and to determine if the program was reaching people most at risk of HIV infection and transmission. The study was conducted by Nganampa Health Council, an Aboriginal-controlled health service on the Anangu Pitjantjatjara Lands in the far north-west of South Australia. Since the introduction of confidential coded testing in August 1994 the number of HIV tests provided through the remote clinics has increased from 83 tests/year to 592 tests/year. In the 12-month audit period (August 1, 1995, to July 31, 1996) 62.7% of women aged 20-24 years, 44.6% of people aged 12-40 years and 24% of the total population had an HIV test. Fifty per cent of tests were accounted for by the 15-25 year age groups and 60% of tests related to an STD consult. This study shows that a high uptake of HIV testing in high-risk groups can be achieved in remote Aboriginal communities where a high level of confidentiality is maintained.

More bark than bite: Comparative studies are needed to determine the importance of canine zoonoses in Aboriginal communities. A critical review of published research.

PubMed

Smout, F; Schrieber, L; Speare, R; Skerratt, L F

2017-11-01

The objective of this review was to identify and critique over forty years of peer-reviewed literature concerned with the transmission of canine zoonoses to Aboriginal people and determine the zoonotic organisms documented in dogs in Australian Aboriginal communities. A systematic literature search of public health, medical and veterinary databases identified 19 articles suitable for critical appraisal. Thirteen articles documented the occurrence of recognized zoonotic organisms in dogs in Aboriginal communities, including Toxocara canis, Dirofilaria immitis, Streptococcus dysgalactiae, Rickettsia felis, Sarcoptes scabiei and Giardia. Currently, there is definitive evidence indicating that dogs act as a reservoir for human scabies in Aboriginal communities. However, there is a need for large-scale, high-quality, comparative studies of dogs and humans from the same household to assess the occurrence and importance of transmission of S. scabiei and other diseases between dogs and humans. These studies should use current genetic and molecular techniques along with traditional techniques to identify and type organisms in order to better understand their epidemiology. This review has revealed that there is a lack of high-quality comparative studies to determine whether dogs are contributing to human disease by transmitting zoonoses. Our recommendations differ significantly from current public health policy and may have substantial implications for human and dog health. © 2017 Blackwell Verlag GmbH.

The community network: an Aboriginal community football club bringing people together. Who or what is making the assists to score social goals?

PubMed

Parnell, Daniel; Hylton, Kevin

2016-01-01

Providing pragmatic interventions (through sport) to tackle social issues in hard-to-reach communities, including those in Aboriginal and black minority ethnic (BME) communities, this study highlights how a community football club was able to deliver positive outcomes for racism, discrimination and health. The article compares findings geographically originating from Australia with those in the UK. The program highlighted herein does not have the so-called 'power' and backing of a brand (of a professional football club) to rely on, and the appealing factor is football alone; football in its purest sense: the activity. We call upon those strategically placed in funding and commissioning roles to draw on the evidence base to support non-professional football (and sport and recreation) clubs to deliver on the health agenda. Adding further conclusions that this mechanism and context of delivery can support positive social and health changes, but requires further examination.

A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries.

PubMed

Blinkhorn, Fiona; Brown, Ngiare; Freeman, Ruth; Humphris, Gerry; Martin, Andrew; Blinkhorn, Anthony

2012-08-21

Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. ACTRN12612000712808.

Definitions of Suicide and Self-Harm Behavior in an Australian Aboriginal Community

ERIC Educational Resources Information Center

Farrelly, Terri; Francis, Karen

2009-01-01

In this small qualitative grounded theory study (21 interviews and focus groups with a total of 26 participants) investigating the understandings of and attitudes toward suicide and self-harm of Aboriginal peoples in a coastal region of New South Wales, Australia, we found that cultural factors particular to these communities influence the way…

Community Arts as Public Pedagogy: Disruptions into Public Memory through Aboriginal Counter-Storytelling

ERIC Educational Resources Information Center

Quayle, Amy; Sonn, Christopher; Kasat, Pilar

2016-01-01

Community Arts and Cultural Development (CACD) is a form of public pedagogy that seeks to intervene into the reproduction of meaning in public spaces. In this article, we explore the Bush Babies and Elders portrait project that sought to contribute to the empowerment of Aboriginal participants through counter-storytelling. Drawing on interview and…

The Development of Cross-Cultural Relations with a Canadian Aboriginal Community through Sport Research

ERIC Educational Resources Information Center

Schinke, Robert J.; Hanrahan, Stephanie J.; Eys, Mark A.; Blodgett, Amy; Peltier, Duke; Ritchie, Stephen Douglas; Pheasant, Chris; Enosse, Lawrence

2008-01-01

When sport psychology researchers from the mainstream work with people from marginalized cultures, they can be challenged by cultural differences as well as mistrust. For this article, researchers born in mainstream North America partnered with Canadian Aboriginal community members. The coauthors have worked together for 5 years. What follows is…

The Learning Circle: A New Model of BSW Education for Alberta's Rural, Remote, and Aboriginal Communities.

ERIC Educational Resources Information Center

Zapf, M. K.; Bastien, B.; Bodor, R.; Carriere, J.; Pelech, W.

In 1998, a consortium including the University of Calgary (Alberta) and representatives from social service agencies and Native organizations developed a Bachelor of Social Work (BSW) model for delivery in rural, remote, and Aboriginal communities. The model called for innovative course content that was culturally and geographically relevant to…

Child Care and the Family-Work Balance: An International Perspective on Needs and Responses in Aboriginal Communities.

ERIC Educational Resources Information Center

Colbert, Judith A.

1999-01-01

Suggests that aboriginal child-care needs relate to educational, social, and cultural requirements, as well as parental workforce participation. Contends that research is needed to test the validity of findings from mainstream societies when applied to indigenous communities. Presents examples of child-care problems and solutions to needs from…

"Rebuilding our community": hearing silenced voices on Aboriginal youth suicide.

PubMed

Walls, Melissa L; Hautala, Dane; Hurley, Jenna

2014-02-01

This paper brings forth the voices of adult Aboriginal First Nations community members who gathered in focus groups to discuss the problem of youth suicide on their reserves. Our approach emphasizes multilevel (e.g., individual, family, and broader ecological systems) factors viewed by participants as relevant to youth suicide. Wheaton's conceptualization of stressors and Evans-Campbell's multilevel classification of the impacts of historical trauma are used as theoretical and analytic guides. Thematic analysis of qualitative data transcripts revealed a highly complex intersection of stressors, traumas, and social problems seen by community members as underlying mechanisms influencing heightened levels of Aboriginal youth suicidality. Our multilevel coding approach revealed that suicidal behaviors were described by community members largely as a problem with deep historical and contemporary structural roots, as opposed to being viewed as individualized pathology.

Reconstructing the star knowledge of Aboriginal Tasmanians

NASA Astrophysics Data System (ADS)

Gantevoort, Michelle; Hamacher, Duane W.; Lischick, Savannah

2016-12-01

The canopy of stars is a central presence in the daily and spiritual lives of Aboriginal Tasmanians. With the arrival of European colonists, Tasmanian astronomical knowledge and traditions were interrupted and dispersed. Fragments can be found scattered in the ethnographic and historical record throughout the nineteenth century. We draw from these ethnohistorical documents to analyse and reconstruct Aboriginal astronomical knowledge in Tasmania. This analysis demonstrates that stars, the Milky Way, constellations, dark nebula, the Sun, Moon, meteors and aurorae held cultural, spiritual and subsistence significance for the Aboriginal cultures of Tasmania. We move beyond a monolithic view of Aboriginal astronomical knowledge in Tasmania, commonly portrayed in previous research, to lay the groundwork for future ethnographic and archaeological fieldwork with Aboriginal elders and communities.

Challenges in conducting community-driven research created by differing ways of talking and thinking about science: a researcher's perspective.

PubMed

Colquhoun, Amy; Geary, Janis; Goodman, Karen J

2013-01-01

Increasingly, health scientists are becoming aware that research collaborations that include community partnerships can be an effective way to broaden the scope and enhance the impact of research aimed at improving public health. Such collaborations extend the reach of academic scientists by integrating a variety of perspectives and thus strengthening the applicability of the research. Communication challenges can arise, however, when attempting to address specific research questions in these collaborations. In particular, inconsistencies can exist between scientists and community members in the use and interpretation of words and other language features, particularly when conducting research with a biomedical component. Additional challenges arise from differing perceptions of the investigative process. There may be divergent perceptions about how research questions should and can be answered, and in expectations about requirements of research institutions and research timelines. From these differences, misunderstandings can occur about how the results will ultimately impact the community. These communication issues are particularly challenging when scientists and community members are from different ethnic and linguistic backgrounds that may widen the gap between ways of talking and thinking about science, further complicating the interactions and exchanges that are essential for effective joint research efforts. Community-driven research that aims to describe the burden of disease associated with Helicobacter pylori infection is currently underway in northern Aboriginal communities located in the Yukon and Northwest Territories, Canada, with the goal of identifying effective public health strategies for reducing health risks from this infection. This research links community representatives, faculty from various disciplines at the University of Alberta, as well as territorial health care practitioners and officials. This highly collaborative work will be used to illustrate, from a researcher's perspective, some of the challenges of conducting public health research in teams comprising members with varying backgrounds. The consequences of these challenges will be outlined, and potential solutions will be offered.

Mission-Driven Adaptability in a Changing National Training System

ERIC Educational Resources Information Center

Zoellner, Don; Stephens, Anne; Joseph, Victor; Monro, Davena

2017-01-01

This case study of an adult and community education provider based in far north Queensland describes its capacity to balance various iterations of public policy against its vision for the future of Aboriginal and Torres Straits Islanders. Community-controlled organisations wanting to contribute to economic and social development in regional/remote…

Addressing Disparities in Low Back Pain Care by Developing Culturally Appropriate Information for Aboriginal Australians: "My Back on Track, My Future".

PubMed

Lin, Ivan B; Ryder, Kim; Coffin, Juli; Green, Charmaine; Dalgety, Eric; Scott, Brian; Straker, Leon M; Smith, Anne J; O'Sullivan, Peter B

2017-11-01

Addressing disparities in low back pain care (LBP) is an important yet largely unaddressed issue. One avenue to addressing disparities, recommended by clinical guidelines, is to ensure that LBP information is culturally appropriate. Our objectives were, first, to develop LBP information that was culturally appropriate for Aboriginal Australians living in a rural area and, second, to compare this to traditional information. The overall information development process was guided by a "cultural security" framework and included partnerships between Aboriginal/non-Aboriginal investigators, a synthesis of research evidence, and participation of a project steering group consisting of local Aboriginal people. LBP information (entitled My Back on Track, My Future [MBOT]) was developed as five short audio-visual scenarios, filmed using Aboriginal community actors. A qualitative randomized crossover design compared MBOT with an evidence-based standard (the Back Book [BB]). Twenty Aboriginal adults participated. Qualitatively we ascertained which information participants' preferred and why, perceptions about each resource, and LBP management. Thirteen participants preferred MBOT, four the BB, two both, and one neither. Participants valued seeing "Aboriginal faces," language that was understandable, the visual format, and seeing Aboriginal people undertaking positive changes in MBOT. In contrast, many participants found the language and format of the BB a barrier. Participants who preferred the BB were more comfortable with written information and appreciated the detailed content. The MBOT information was more preferred and addressed important barriers to care, providing support for use in practice. Similar processes are needed to develop pain information for other cultural groups, particularly those underserved by existing approaches to care. © 2017 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Acceptability of Mental Health Apps for Aboriginal and Torres Strait Islander Australians: A Qualitative Study

PubMed Central

Mills, Patj Patj Janama Robert; Dingwall, Kylie Maree; Lowell, Anne; Singer, Judy; Rotumah, Darlene; Bennett-Levy, James; Nagel, Tricia

2016-01-01

Background Aboriginal and Torres Strait Islander Australians experience high rates of mental illness and psychological distress compared to their non-Indigenous counterparts. E-mental health tools offer an opportunity for accessible, effective, and acceptable treatment. The AIMhi Stay Strong app and the ibobbly suicide prevention app are treatment tools designed to combat the disproportionately high levels of mental illness and stress experienced within the Aboriginal and Torres Strait Islander community. Objective This study aimed to explore Aboriginal and Torres Strait Islander community members’ experiences of using two culturally responsive e-mental health apps and identify factors that influence the acceptability of these approaches. Methods Using qualitative methods aligned with a phenomenological approach, we explored the acceptability of two culturally responsive e-mental health apps through a series of three 3-hour focus groups with nine Aboriginal and Torres Strait Islander community members. Thematic analysis was conducted and coresearcher and member checking were used to verify findings. Results Findings suggest strong support for the concept of e-mental health apps and optimism for their potential. Factors that influenced acceptability related to three key themes: personal factors (eg, motivation, severity and awareness of illness, technological competence, and literacy and language differences), environmental factors (eg, community awareness, stigma, and availability of support), and app characteristics (eg, ease of use, content, graphics, access, and security and information sharing). Specific adaptations, such as local production, culturally relevant content and graphics, a purposeful journey, clear navigation, meaningful language, options to assist people with language differences, offline use, and password protection may aid uptake. Conclusions When designed to meet the needs of Aboriginal and Torres Strait Islander Australians, e-mental health tools add an important element to public health approaches for improving the well-being of Aboriginal and Torres Strait Islander people. PMID:26969043

Prevalences of overweight and obesity among children in remote Aboriginal communities in central Australia.

PubMed

Schultz, Rosalie

2012-01-01

The chronic diseases associated with overweight and obesity are major contributors to the excess disease burden of Aboriginal Australians. Surveillance of overweight and obesity is required to monitor these conditions, and to develop and evaluate interventions to improve health and wellbeing. Remote Aboriginal communities in Australia's Northern Territory (NT) are where approximately two-thirds of the NT Aboriginal people live, a proportion which has been stable over many years. However the remote communities suffer significant socioeconomic disadvantage including limited education and employment opportunities, and poor quality and overcrowded housing. Approximately one-third of Aboriginal people in NT live in central Australia, which consists of the Alice Springs and Barkly districts. The Healthy School-Aged Kids Program includes health promotion and child health screening, and is run in remote Aboriginal communities of NT. This report provides estimates of prevalences of overweight and obesity among children in central Australia who participated in health checks as part of Healthy School-Aged Kids Program in 2010. All children in remote central Australian Aboriginal communities were invited to participate in health checks. Children who attended were weighed and measured. Date of birth, sex, height and weight for each child were used to determine prevalence of overweight (≥+1 standard deviation [SD] BMI-for-age) and obesity (≥+2 SD BMI-for-age) according to WHO Growth standards. Differences in proportions of overweight and obesity by age group and sex, and their statistical significance were calculated. Weight, height, sex and age data were available for 996 children from a population of 1764. It was found that 22.1% of girls and 20.7% of boys were overweight; and 5.1% of girls and 5.8% of boys were obese as defined by BMI-for-age. Prevalence of overweight but not obesity increased with age (for overweight z=3.28, p=0.0011; for obesity z=0.68; p=0.50). The prevalences of overweight and obesity as estimated by BMI-for-age among children in remote central Australian Aboriginal communities were compared with those in other Australian surveys. They appear unlikely to reflect future relative risk of the chronic diseases with which overweight and obesity are associated. Routine collection of data on BMI-for-age may not provide adequate estimation of future risk of chronic disease burden attributable to overweight and obesity among these children. Alternative measures for surveillance for overweight such as waist circumference may prove more useful. Appropriate interventions to reduce risk of chronic disease are required, including interventions to reduce prevalences of overweight and obesity.

A Current Appraisal of Adult Education Activity in Australia with a Focus on Community-Based Education and Work among Women and Aboriginal People.

ERIC Educational Resources Information Center

Randell, Shirley

As adult education in Australia becomes a priority, emphases have changed. Structure has also changed, as traditional providers of adult education have begun to adjust to changing political, economic, and social realities. Changes in community-based education have occurred as government involvement has provided more funds and begun to encroach on…

Seeking a Pedagogy of Difference: What Aboriginal Students and Their Parents in North Queensland Say about Teaching and Their Learning

ERIC Educational Resources Information Center

Lewthwaite, Brian; Osborne, Barry; Lloyd, Natalie; Llewellyn, Linda; Boon, Helen; Webber, Tammi; Laffin, Gail; Kemp, Codie; Day, Cathy; Wills, Jennifer; Harrison, Megan

2015-01-01

This study presents the outcomes of the first phase of a three phase research initiative which begins by identifying through the voices of Aboriginal students and community members the teaching practices that influence Aboriginal student engagement and learning. The study occurs within the Diocese of Townsville Catholic Education schools in North…

Real Stories, Extraordinary People: Preliminary Findings from an Aboriginal Community-Controlled Cultural Immersion Program for Local Teachers

ERIC Educational Resources Information Center

Burgess, Cathie; Cavanagh, Pat

2012-01-01

This paper reports on effective strategies for developing the cultural competence of teachers involved in Aboriginal education and presents the preliminary findings of a review into the Connecting to Country Program (CTC), a joint venture of the NSW Aboriginal Education Consultative Group (AECG) and the NSW Department of Education and Communities…

The physician assistant role in Aboriginal healthcare in Australia.

PubMed

Laufik, Nanette

2014-01-01

Australia has a shortage of doctors in general and more so in Aboriginal communities. The 2011-2012 report by Health Workforce Australia endorses the relevance of physician assistants (PAs) in rural Australia, and this article describes the experience of a PA employed in rural Aboriginal Health Services in North Queensland. The author also shares recommendations and insights for expanded implementation of PAs.

Developing leaflets to give dental health advice to Aboriginal families with young children.

PubMed

Blinkhorn, Fiona; Wallace, Janet; Smith, Leanne; Blinkhorn, Anthony S

2014-08-01

Dental caries (decay) is a serious problem for young Aboriginal children, causing pain and stress. Treatment often involves extraction of teeth under a general anaesthetic. However, dental caries can be prevented by reducing the frequency of sugar consumption and brushing teeth twice a day with fluoride toothpaste. Such straightforward advice could be given to families by Aboriginal Health Workers who are trusted by their communities and have an existing advisory role. This paper reports on the development of dental health advice leaflets for use in Aboriginal communities. An Aboriginal reference panel was recruited to comment on dental health advice leaflets prepared by an Aboriginal graphic designer. The panel was asked to consider the design, cultural appropriateness and practicality of the leaflets. Comments were collected through email and face-to-face discussions, which were collated and the leaflets altered accordingly. The advice from the panel resulted in greater use of pictures. For example large green ticks and red crosses highlighted healthy and unhealthy behaviours, respectively. The tooth brushing leaflet was amended to emphasise the safe storage of toothpaste in order to keep it out of reach of young children. The panel stated that all leaflets should incorporate the Aboriginal flag, and proposed that fridge magnets might be beneficial as all family members would benefit from seeing the messages every day. The consultation process refined dental advice leaflets to reflect the views of an Aboriginal Reference Panel, in terms of design, cultural competence and practicality. © 2014 FDI World Dental Federation.

“They treated me like crap and I know it was because I was Native”: The healthcare experiences of Aboriginal Peoples living in Vancouver’s inner city

PubMed Central

Goodman, Ashley; Fleming, Kim; Markwick, Nicole; Morrison, Tracey; Lagimodiere, Louise; Kerr, Thomas

2017-01-01

There is growing evidence that Aboriginal peoples often experience healthcare inequalities due to racism. However, research exploring the healthcare experiences of Aboriginal peoples who use illicit substances is limited, and research rarely accounts for how multiple accounts of stigma intersect and contribute to the experiences of marginalized populations. Our research aimed to explore the healthcare experiences of Aboriginal peoples who use illicit drugs and or illicit alcohol (APWUID/A) living in Vancouver’s inner city. Using Indigenous methodologies, a community research team comprised of APWUID/A led the study design, data collection and analysis. Peer-facilitated talking circles explored community members’ experiences accessing healthcare services and patient-provider encounters. Using an intersectionality framework, our research demonstrated how healthcare inequalities among Aboriginal peoples are perpetuated by systemic racism and discrimination. Stigmatizing racial stereotypes were perceived to negatively influence individual attitudes and clinical practice. Participants’ experiences of medical dismissal often resulted in disengagement from care or delay in care. The findings suggest healthcare providers must understand the structural and historical forces that influence racial disparities in healthcare and personal attitudes in clinical practice. Adequate clinical protocols for pain management within the context of illicit substance use are urgently needed. The valuation of Aboriginal peoples and cultures within healthcare is paramount to addressing the health gap between Aboriginal and non-Aboriginal Canadians. PMID:28214449

Recall of anti-tobacco advertising and information, warning labels and news stories in a national sample of Aboriginal and Torres Strait Islander smokers.

PubMed

Nicholson, Anna K; Borland, Ron; Sarin, Jasmine; Wallace, Sharon; van der Sterren, Anke E; Stevens, Matthew; Thomas, David P

2015-06-01

To describe recall of anti-tobacco advertising (mainstream and targeted), pack warning labels, and news stories among a national sample of Aboriginal and Torres Strait Islander smokers, and to assess the association of these messages with attitudes that support quitting, including wanting to quit. A quota sampling design was used to recruit participants from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait. We surveyed 1643 Aboriginal and Torres Strait Islander smokers from April 2012 to October 2013. Frequency of recall of advertising and information, warning labels and news stories; recall of targeted and local advertising; attitudes about smoking and wanting to quit. More smokers recalled often noticing warning labels in the past month (65%) than recalled advertising and information (45%) or news stories (24%) in the past 6 months. When prompted, most (82%) recalled seeing a television advertisement. Just under half (48%) recalled advertising that featured an Aboriginal or Torres Strait Islander person or artwork (targeted advertising), and 16% recalled targeted advertising from their community (local advertising). Frequent recall of warning labels, news stories and advertising was associated with worry about health and wanting to quit, but only frequent advertising recall was associated with believing that society disapproves of smoking. The magnitude of association with relevant attitudes and wanting to quit increased for targeted and local advertising. Strategies to tackle Aboriginal and Torres Strait Islander smoking should sustain high levels of exposure to anti-tobacco advertising, news stories and warning labels. More targeted and local information may be particularly effective to influence relevant beliefs and subsequently increase quitting.

Emergency department presentations by Aboriginal children: issues for consideration for appropriate health services.

PubMed

Duncan, Catriona; Williams, Katrina; Nathanson, Dania; Thomas, Susan; Cottier, Carolyn; O'Meara, Matthew; Zwi, Karen

2013-09-01

This study describes the presentations made to the Sydney Children's Hospital (SCH) Emergency Department (ED) by local Aboriginal and Torres Strait Islander (Aboriginal) children with particular reference to children who present frequently or whose presentation was preventable. Data from the SCH ED Information System were extracted for all presentations made by children who identified as Aboriginal, aged between 0-15 years, who presented between 2005-2008. Presentations were coded according to the presenting problem, diagnosis, outcome, and whether the presentations were potentially preventable. Preventable presentations include those presentations considered to be avoidable and those that could have been managed by a local primary care or community service. There were 1252 presentations to the SCH ED by 453 Aboriginal children aged 0-15 years. More than 50% of children presented more than once. Seventy-nine children presented more than five times. Nearly 45% of presentations were coded as potentially preventable. A significant proportion of ED presentations were potentially preventable with the use of culturally appropriate and accessible local community and primary health care services and better referral pathways back to these services. Community engagement is required to raise awareness of common presentations and to look at strategies to prevent common problems both occurring and presenting to the ED. This will enhance the health of urban Aboriginal children. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Does Social Context Matter? Income Inequality, Racialized Identity, and Health Among Canada's Aboriginal Peoples Using a Multilevel Approach.

PubMed

Spence, Nicholas D

2016-03-01

Debates surrounding the importance of social context versus individual level processes have a long history in public health. Aboriginal peoples in Canada are very diverse, and the reserve communities in which they reside are complex mixes of various cultural and socioeconomic circumstances. The social forces of these communities are believed to affect health, in addition to individual level determinants, but no large scale work has ever probed their relative effects. One aspect of social context, relative deprivation, as indicated by income inequality, has greatly influenced the social determinants of health landscape. An investigation of relative deprivation in Canada's Aboriginal population has never been conducted. This paper proposes a new model of Aboriginal health, using a multidisciplinary theoretical approach that is multilevel. This study explored the self-rated health of respondents using two levels of determinants, contextual and individual. Data were from the 2001 Aboriginal Peoples Survey. There were 18,890 Registered First Nations (subgroup of Aboriginal peoples) on reserve nested within 134 communities. The model was assessed using a hierarchical generalized linear model. There was no significant variation at the contextual level. Subsequently, a sequential logistic regression analysis was run. With the sole exception culture, demographics, lifestyle factors, formal health services, and social support were significant in explaining self-rated health. The non-significant effect of social context, and by extension relative deprivation, as indicated by income inequality, is noteworthy, and the primary role of individual level processes, including the material conditions, social support, and lifestyle behaviors, on health outcomes is illustrated. It is proposed that social structure is best conceptualized as a dynamic determinant of health inequality and more multilevel theoretical models of Aboriginal health should be developed and tested.

"It's almost expected": rural Australian Aboriginal women's reflections on smoking initiation and maintenance: a qualitative study.

PubMed

Passey, Megan E; Gale, Jennifer T; Sanson-Fisher, Robert W

2011-12-09

Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation among Aboriginal girls and women. It is critical to acknowledge Aboriginal identity and culture as a source of empowerment; and to recognise the role of persistent marginalization in contributing to the high prevalence and initiation of smoking.

"It's almost expected": rural Australian Aboriginal women's reflections on smoking initiation and maintenance: a qualitative study

PubMed Central

2011-01-01

Background Despite declining smoking rates among the general Australian population, rates among Indigenous Australians remain high, with 47% of the Indigenous population reporting daily smoking - twice that of other Australians. Among women, smoking rates are highest in younger age groups, with more than half of Aboriginal women smoking during pregnancy. A lack of research focused on understanding the social context of smoking by Aboriginal women in rural Australia limits our ability to reduce these rates. This study aimed to explore the factors contributing to smoking initiation among rural Aboriginal women and girls and the social context within which smoking behaviour occurs. Methods We conducted three focus groups with 14 Aboriginal women and service providers and 22 individual interviews with Aboriginal women from four rural communities to explore their perceptions of the factors contributing to smoking initiation among Aboriginal girls. Results Four inter-related factors were considered important to understanding the social context in which girls start smoking: colonisation and the introduction of tobacco; normalization of smoking within separate Aboriginal social networks; disadvantage and stressful lives; and the importance of maintaining relationships within extended family and community networks. Within this context, young girls use smoking to attain status and as a way of asserting Aboriginal identity and group membership, a way of belonging, not of rebelling. Family and social structures were seen as providing strong support, but limited the capacity of parents to influence children not to smoke. Marginalization was perceived to contribute to limited aspirations and opportunities, leading to pleasure-seeking in the present rather than having goals for the future. Conclusions The results support the importance of addressing contextual factors in any strategies aimed at preventing smoking initiation or supporting cessation among Aboriginal girls and women. It is critical to acknowledge Aboriginal identity and culture as a source of empowerment; and to recognise the role of persistent marginalization in contributing to the high prevalence and initiation of smoking. PMID:22152218

Engaging First Nation and Inuit communities in asthma management and control: assessing cultural appropriateness of educational resources.

PubMed

Latycheva, O; Chera, R; Hampson, C; Masuda, J R; Stewart, M; Elliott, S J; Fenton, N E

2013-01-01

Asthma is a growing concern in First Nations and Inuit communities. As with many health indicators and outcomes, Aboriginal peoples living in remote areas experience greater disparities in respiratory health compared with non-Aboriginal Canadians. Therefore, it is critically important to take into account their unique needs when developing asthma educational materials and resources. The purpose of this study is to assess the cultural relevance of existing asthma education materials for First Nations and Inuit peoples. Five First Nations and Inuit communities from across Canada participated in the project. A combination of quantitative evaluations (eg surveys) and qualitative approaches (eg open discussion, live chats) were used to assess printed and web-based asthma education materials. Participants represented First Nations and Inuit communities from across Canada and were selected on the basis of age and role: 6 to 12 years old (children), 12 and over (youth), parents and grandparents, community leaders and teachers, and community advisory group members. In general, the results showed that although participants of all age categories liked the selection of asthma educational materials and resources, they identified pictures and images related to First Nations and Inuit people living and coping with asthma as ways of improving cultural relevance. This reinforces findings that tailoring materials to include Aboriginal languages, ceremonies and traditions would enhance their uptake. Our findings also demonstrate that visually based content in both printed and virtual form were the preferred style of learning of all participants, except young children who preferred to learn through play and interactive activities. Asthma is a growing concern in First Nations and Inuit communities. Given this concern, it is essential to understand cultural needs and preferences when developing asthma education materials and resources. The findings from this research emphasize the need to adapt existing asthma educational materials to better suit First Nations and Inuit cultures and the importance of directly engaging community members in the process.

Promoting women's health in remote Aboriginal settings: Midwifery students' insights for practice.

PubMed

Thackrah, Rosalie D; Thompson, Sandra C; Durey, Angela

2015-12-01

To describe midwifery students' insights on promoting health to Aboriginal women in remote Australia following a supervised clinical placement. Semistructured, in-depth interviews were conducted with all midwifery students who undertook the placement between 2010 and 2013. Aboriginal communities on the Ngaanyatjarra Lands, Western Australia. Undergraduate and postgraduate midwifery students from a Western Australian university. Remote cultural immersion clinical placement. Student learning related to culturally respectful health care delivery and promotion of health. Students observed that, despite vast distances, high rates of participation in a breast screening program were achieved due to the informal provision of culturally relevant information and support. Opportunistic encounters in communities also enabled sexual health messages to be delivered more widely and in less formal settings. The role played by Aboriginal Health Workers and female family members was vital. The importance of culturally respectful approaches to sensitive women's business, including discretion, the use of local language and pictorial representations of information, was recognised as was the socio-cultural context and its impact on the health and well-being of the community. Although short in duration, the Ngaanyatjarra Lands clinical placement provided midwifery students with a rare opportunity to observe the importance of local contexts and cultural protocols in Aboriginal communities, and to adapt health promotion strategies to meet local needs and ways of doing things. These strategies embraced the strengths, assets and capacities of communities, yet students also witnessed challenges associated with access, delivery and acceptance of health care in remote settings. © 2015 National Rural Health Alliance Inc.

The state of health hardware in Aboriginal communities in rural and remote Australia.

PubMed

Torzillo, Paul J; Pholeros, Paul; Rainow, Stephan; Barker, Geoffrey; Sowerbutts, Tim; Short, Tim; Irvine, Andrew

2008-02-01

Many of the health problems faced by rural and remote Aboriginal people have been attributed to a poor living environment. In the mid 1980s we began a process of defining problems with the immediate living environment that would affect health. These related particularly to safety, washing and hygiene practice. Between January 1999 and November 2006 we undertook a standardised and detailed assessment of housing in Aboriginal communities. This involved an initial assessment of 250 items in each house and living area, focusing on performance and their impact on these healthy living practices. At the first survey-fix we implemented a limited cost repair of non-functioning health hardware and then six months later returned to the communities for a repeat assessment to examine improvement in performance. Between January 1999 and November 2006 we assessed 4,343 houses in 132 communities in four States and the Northern Territory during survey-fix 1 (SF1) and have repeated that survey-fix assessment (SF2) in 3,448 houses in 112 of those communities. This survey demonstrates extraordinarily poor performance of Aboriginal houses. In the survey period, 71,869 items referred for repair by survey teams were inspected by licensed electricians or plumbers and 49,499 of these have so far been fixed. Only 10% of these house items requiring repair were due to vandalism or misuse. Improvements in the living environment for Aboriginal people will require a sustained commitment to the planning, funding and implementation of maintenance programs in addition to adherence to the design, construction and supervision detail outlined in the National Indigenous Housing Guide.

Diabetes mellitus and the Aboriginal diabetic initiative in Canada: An update review

PubMed Central

Leung, Lawrence

2016-01-01

Diabetes mellitus is a chronic disease of major global health concern due to its increasing prevalence in both developing and developed counties, with a projection increase of 214% from the year 2000 to 2030. Among the Aboriginal population of Canada (which includes the First Nations, Inuit and Metis), diabetes mellitus contribute significantly to their higher morbidity and increased health disparity when compared to the non-Aboriginal Canadians. In view of this, the Federal Government of Canada had launched the Aboriginal Diabetes Initiative (ADI) in 1999 as part of the bigger Canadian Diabetes Strategy to provide a better framework for surveillance, public education and community-based management of diabetes. Originally, ADI was intended for a 5-year cycle, but it was renewed twice in 2005 and then 2010, with a total funding of C$523 million. Given its long history of operation and the massive amount of revenue being injected, it is worthwhile to review the background information and the relevant data that had fostered the ADI; and more importantly, to critically evaluate the benefits and impact of the ADI in terms of the actual health of the Aboriginals and their social inequalities. PMID:27843824

Workforce insights on how health promotion is practised in an Aboriginal Community Controlled Health Service.

PubMed

McFarlane, Kathryn; Devine, Sue; Judd, Jenni; Nichols, Nina; Watt, Kerrianne

2017-07-01

Aboriginal Community Controlled Health Services deliver holistic and culturally appropriate primary health care to over 150 communities in Australia. Health promotion is a core function of comprehensive primary health care; however, little has been published on what enables or challenges health promotion practice in an Aboriginal Community Controlled Health Service. Apunipima Cape York Health Council (Apunipima) delivers primary health care to 11 remote north Queensland communities. The workforce includes medical, allied health, Aboriginal and Torres Strait Islander health workers and health practitioners and corporate support staff. This study aimed to identify current health promotion practices at Apunipima, and the enablers and challenges identified by the workforce, which support or hinder health promotion practice. Sixty-three staff from across this workforce completed an online survey in February 2015 (42% response rate). Key findings were: (1) health promotion is delivered across a continuum of one-on-one approaches through to population advocacy and policy change efforts; (2) the attitude towards health promotion was very positive; and (3) health promotion capacity can be enhanced at both individual and organisational levels. Workforce insights have identified areas for continued support and areas that, now identified, can be targeted to strengthen the health promotion capacity of Apunipima.

Talking About The Smokes: a large-scale, community-based participatory research project.

PubMed

Couzos, Sophia; Nicholson, Anna K; Hunt, Jennifer M; Davey, Maureen E; May, Josephine K; Bennet, Pele T; Westphal, Darren W; Thomas, David P

2015-06-01

To describe the Talking About The Smokes (TATS) project according to the World Health Organization guiding principles for conducting community-based participatory research (PR) involving indigenous peoples, to assist others planning large-scale PR projects. The TATS project was initiated in Australia in 2010 as part of the International Tobacco Control Policy Evaluation Project, and surveyed a representative sample of 2522 Aboriginal and Torres Strait Islander adults to assess the impact of tobacco control policies. The PR process of the TATS project, which aimed to build partnerships to create equitable conditions for knowledge production, was mapped and summarised onto a framework adapted from the WHO principles. Processes describing consultation and approval, partnerships and research agreements, communication, funding, ethics and consent, data and benefits of the research. The TATS project involved baseline and follow-up surveys conducted in 34 Aboriginal community-controlled health services and one Torres Strait community. Consistent with the WHO PR principles, the TATS project built on community priorities and strengths through strategic partnerships from project inception, and demonstrated the value of research agreements and trusting relationships to foster shared decision making, capacity building and a commitment to Indigenous data ownership. Community-based PR methodology, by definition, needs adaptation to local settings and priorities. The TATS project demonstrates that large-scale research can be participatory, with strong Indigenous community engagement and benefits.

Breast feeding practices as cultural interventions for early childhood caries in Cree communities.

PubMed

Cidro, Jaime; Zahayko, Lynelle; Lawrence, Herenia P; Folster, Samantha; McGregor, Margaret; McKay, Kristen

2015-04-09

Breastfeeding is a gift from mother to child and has a wide range of positive health, social and cultural impacts on infants. The link between bottle feeding and the prevalence of early childhood caries (ECC) is well documented. In Aboriginal communities, the higher rates of ECC are linked with low rates of breast feeding and inappropriate infant feeding of high sugar content liquids. The Baby Teeth Talk Study (BTT) is one project that is exploring the use of four interventions (motivational interviewing, anticipatory guidance, fluoride varnish and dental care to expectant mothers) for reducing the prevalence of ECC in infants within Aboriginal communities. This research explored cultural based practices through individual interviews and focus groups with older First Nations women in the community. Participants in a First Nations community identified cultural based practices that have also been used to promote healthy infant feeding and good oral health. A wide range of themes related to oral health and infant feeding emerged. However, this paper focuses on three themes including: breastfeeding attitudes, social support for mothers and birthing and supporting healthy infant feeding through community programs. The importance of understanding cultural health traditions is essential for those working in oral public health capacities to ensure there is community acceptance of the interventions.

Dependence in a national sample of Aboriginal and Torres Strait Islander daily smokers.

PubMed

Thomas, David P; Panaretto, Kathryn S; Stevens, Matthew; Borland, Ron

2015-06-01

To examine indicators of nicotine dependence in a national sample of Aboriginal and Torres Strait Islander daily smokers and their association with sustaining a quit attempt for at least 1 month, and to make comparisons with a national sample of Australian daily smokers. The Talking About The Smokes project used a quota sampling design to recruit 1392 daily smokers from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait from April 2012 to October 2013. These were compared with 1010 daily smokers from the general Australian population surveyed by the International Tobacco Control Policy Evaluation Project from September 2011 to February 2012. Cigarettes per day (CPD), time to first cigarette, Heaviness of Smoking Index (HSI), other indicators of dependence, and whether smokers had ever sustained a quit attempt for at least 1 month. There was little difference in the mean HSI scores for Aboriginal and Torres Strait Islander and other Australian daily smokers. A higher proportion of Aboriginal and Torres Strait Islander daily smokers smoked ≤ 10 CPD (40% v 33.4%), but more also smoked their first cigarette within 30 minutes of waking (75% v 64.6%). Lower proportions of Aboriginal and Torres Strait Islander smokers reported having strong urges to smoke at least several times a day (51% v 60.7%) or that it would be very hard to quit (39% v 47.9%). Most Aboriginal and Torres Strait Islander smokers reported experiencing difficulties during their most recent quit attempt. All indicators of dependence, except CPD and strong urges, were positively associated with not having made a sustained quit attempt. Reported difficulties during the most recent quit attempt were more strongly associated with being unable to sustain quit attempts than were traditional measures of dependence. Aboriginal and Torres Strait Islander smokers' experiences of past attempts to quit may be more useful than conventional indicators of nicotine dependence in understanding their dependence.

The Effectiveness of Web-Delivered Learning with Aboriginal Students: Findings from a Study in Coastal Labrador

ERIC Educational Resources Information Center

Philpott, David; Sharpe, Dennis; Neville, Rose

2009-01-01

This paper outlines the findings of a study that explores perspectives of e-learning for aboriginal students in five coastal communities in Labrador, Canada. The rural nature of many communities in the province of Newfoundland and Labrador, coupled with a dramatically declining enrollment, has resulted in expanding use of e-learning as a means to…

Mobile Devices for Tertiary Study--Philosophy Meets Pragmatics for Remote Aboriginal and Torres Strait Islander Women

ERIC Educational Resources Information Center

Townsend, Philip

2015-01-01

This paper outlines PhD research which suggests mobile learning fits the cultural philosophies and roles of Aboriginal and Torres Strait Islander women who are preservice teachers in the very remote Australian communities where the research was conducted. The problem which the research addresses is the low completion rates for two community-based…

The Public Health Implications of the Use and Misuse of Tobacco among the Aboriginals in Canada

PubMed Central

Orisatoki, Rotimi

2013-01-01

Tobacco smoking among the Aboriginal populations is a major public health issue in Canada. It remains a major contributory risk factor to the poor health status as well as years of potential life lost seen among the indigenous people. The use of tobacco has a spiritual importance to the people as a means of making connection to the Creator, but unfortunately tobacco smoking has taken a recreational aspect which has little or no connection with Aboriginal spirituality. The non-traditional use of tobacco is believed by the Elders to be disrespectful to the Aboriginal culture and traditional way of life. There is an increase in rate of use of smokeless tobacco as well as smoking of tobacco among the youth with increase in percentage among females. There are socioeconomic implications as well as adverse health effects of the misuse of tobacco on the Aboriginal people that need to be addressed. The healthcare professionals have a unique role in helping patients to reduce tobacco use within the community through programs that are culturally sensitive and relevant. Successful strategies requires general support from the community and it is very important that some of that support comes from community leaders, including spiritual, professional, administrative and elected policy makers. PMID:23283033

The red road to wellness: cultural reclamation in a Native First Nations community treatment center.

PubMed

Gone, Joseph P

2011-03-01

This article explores how Native American cultural practices were incorporated into the therapeutic activities of a community-controlled substance abuse treatment center on a "First Nations" reserve in the Canadian north. Analysis of open-ended interviews with nineteen staff and clients-as contextualized by participant observation, program records, and existing ethnographic resources-yielded insights concerning local therapeutic practice with outpatients and other community members. Specifically, program staff adopted and promoted a diverse array of both western and Aboriginal approaches that were formally integrated with reference to the Aboriginal symbol of the medicine wheel. Although incorporations of indigenous culture marked Lodge programs as distinctively Aboriginal in character, the subtle but profound influence of western "therapy culture" was centrally evident in healing activities as well. Nuanced explication of these activities illustrated four contributions of cultural analysis for community psychology.

Food-purchasing behaviour in an Aboriginal community. 1. Results of a survey.

PubMed

Rowse, T; Scrimgeour, D; Knight, S; Thomas, D

1994-03-01

Attempts to improve the nutritional status of Aboriginal people through nutritional education programs should be informed by an understanding of contemporary patterns of food procurement, preparation and distribution. This paper describes the results of a survey of food-purchasing behaviour in a central-Australian Aboriginal community. Every transaction occurring in each food outlet in the community over a two-week period was recorded and the data analysed. The results show that women play a much greater role than men in food purchasing, that there is a significant recourse to takeaway foods, that there is a cycle of expenditure determined by distribution of pension and Community Development Employment Project cheques, and that children have sufficient disposable income to be able to provision themselves from the food outlets, so that much of their food consumption is not determined by adult members of their family.

Developing anti-tobacco messages for Australian Aboriginal and Torres Strait Islander peoples: evidence from a national cross-sectional survey.

PubMed

Gould, Gillian S; Watt, Kerrianne; Stevenson, Leah; McEwen, Andy; Cadet-James, Yvonne; Clough, Alan R

2014-03-13

Smoking rates in Australian Aboriginal and Torres Strait Islander peoples remain high, with limited impact of government measures for many subgroups. The aim of this cross-sectional study was to investigate differences in organisational practice for developing anti-tobacco messages for these target populations. Telephone interviews were conducted with 47 organisation representatives using a structured questionnaire based on health communication and health promotion frameworks. Responses were coded into phases of message development, message types (educational, threat, positive or advocacy), target groups, message recommendations, and evaluations undertaken. Cultural sensitivity for message development was divided into surface structure (use of images, language, demographics) and deep structure (use of socio-cultural values). A categorical principal component analysis explored the key dimensions of the findings and their component relationships. Among organisations interviewed, a community-orientated, bottom-up approach for developing anti-tobacco messages was reported by 47% (n=24); 55% based message development on a theoretical framework; 87% used a positive benefit appeal; 38% used threat messages. More Aboriginal Medical Services (AMSs) targeted youth (p<0.005) and advised smokers to quit (p<0.05) than other types of organisations. AMSs were significantly more likely to report using deep structure in tailoring messages compared with non-government (p<0.05) and government organisations (p<0.05). Organisations that were oriented to the general population were more likely to evaluate their programs (p<0.05). A two-dimensional non-linear principal component analysis extracted components interpreted as "cultural understanding" (bottom-up, community-based approaches, deep structures) and "rigour" (theoretical frameworks, and planned/completed evaluations), and accounted for 53% of the variability in the data. Message features, associated with successful campaigns in other populations, are starting to be used for Aboriginal and Torres Strait Islander peoples. A model is proposed to facilitate the development of targeted anti-tobacco messages for Aboriginal and Torres Strait Islander peoples. Organisations could consider incorporating both components of cultural understanding-rigour to enable the growth of evidence-based practice.

Developing anti-tobacco messages for Australian Aboriginal and Torres Strait Islander peoples: evidence from a national cross-sectional survey

PubMed Central

2014-01-01

Background Smoking rates in Australian Aboriginal and Torres Strait Islander peoples remain high, with limited impact of government measures for many subgroups. The aim of this cross-sectional study was to investigate differences in organisational practice for developing anti-tobacco messages for these target populations. Methods Telephone interviews were conducted with 47 organisation representatives using a structured questionnaire based on health communication and health promotion frameworks. Responses were coded into phases of message development, message types (educational, threat, positive or advocacy), target groups, message recommendations, and evaluations undertaken. Cultural sensitivity for message development was divided into surface structure (use of images, language, demographics) and deep structure (use of socio-cultural values). A categorical principal component analysis explored the key dimensions of the findings and their component relationships. Results Among organisations interviewed, a community-orientated, bottom-up approach for developing anti-tobacco messages was reported by 47% (n = 24); 55% based message development on a theoretical framework; 87% used a positive benefit appeal; 38% used threat messages. More Aboriginal Medical Services (AMSs) targeted youth (p < 0.005) and advised smokers to quit (p < 0.05) than other types of organisations. AMSs were significantly more likely to report using deep structure in tailoring messages compared with non-government (p < 0.05) and government organisations (p < 0.05). Organisations that were oriented to the general population were more likely to evaluate their programs (p < 0.05). A two-dimensional non-linear principal component analysis extracted components interpreted as “cultural understanding” (bottom-up, community-based approaches, deep structures) and “rigour” (theoretical frameworks, and planned/completed evaluations), and accounted for 53% of the variability in the data. Conclusion Message features, associated with successful campaigns in other populations, are starting to be used for Aboriginal and Torres Strait Islander peoples. A model is proposed to facilitate the development of targeted anti-tobacco messages for Aboriginal and Torres Strait Islander peoples. Organisations could consider incorporating both components of cultural understanding-rigour to enable the growth of evidence-based practice. PMID:24625235

Toward Creation of a National Table for Aboriginal Literacy and Essential Skills (NTALES). Report on Meeting of May 27, 2014

ERIC Educational Resources Information Center

Canadian Literacy and Learning Network, 2014

2014-01-01

The Canadian Literacy and Learning Network (CLLN), in partnership with Aboriginal community leaders and literacy experts, is leading an initiative to create a National Table for Aboriginal Literacy and Essential Skills (NTALES). A potential role of the National Table will be to represent First Nation, Metis and Inuit literacy and essential skills…

Aboriginal Career Aspirations Program: School and Community Career Education. A Report and Discussion on a NSW Board of Studies Project.

ERIC Educational Resources Information Center

Lowe, Kevin; Tassone, Julie

A pilot program in New South Wales (Australia) aimed to engage Aboriginal students in the education process by making school more interesting and relevant to them specifically. The project used career education and Aboriginal perspectives to achieve these objectives. The development of aspirations within students was central, and it was hoped that…

The Role of Aboriginal Literacy in Improving English Literacy in Remote Aboriginal Communities: An Empirical Systems Analysis with the Interplay Wellbeing Framework

ERIC Educational Resources Information Center

Wilson, Byron; Quinn, Stephen J.; Abbott, Tammy; Cairney, Sheree

2018-01-01

Indigenous language endangerment is critical in Australia, with only 120 of 250 known languages remaining, and only 13 considered strong. A related issue is the gap in formal education outcomes for Aboriginal and Torres Strait Islander people compared with other Australians, with the gap wider in remote regions. Little empirical research exists in…

Definitions of suicide and self-harm behavior in an Australian aboriginal community.

PubMed

Farrelly, Terri; Francis, Karen

2009-04-01

In this small qualitative grounded theory study (21 interviews and focus groups with a total of 26 participants) investigating the understandings of and attitudes toward suicide and self-harm of Aboriginal peoples in a coastal region of New South Wales, Australia, we found that cultural factors particular to these communities influence the way such behavior is defined in an Aboriginal context. A continuation of certain "traditional" cultural forms of self-harm behavior was evident in participant definitions, notably the practice of female hair cutting, also described as a mourning ritual, which appears to serve as a marker both to the individual and others.

A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries

PubMed Central

2012-01-01

Background Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. Methods/Design This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. Discussion The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. Trial registration ACTRN12612000712808 PMID:22909327

Developing a culturally appropriate branding for a social and emotional wellbeing intervention in an Aboriginal community.

PubMed

Donovan, Robert J; Murray, Lesley; Hicks, Jolleen; Nicholas, Amberlee; Anwar-McHenry, Julia

2018-02-22

An initial consultation process to implement a culturally appropriate social and emotional wellbeing campaign in an Aboriginal community indicated that the fundamental principles of the Act-Belong-Commit mental health promotion campaign were acceptable, but that a cultural adaptation of the branding should be sought. A competition was held inviting community members to design a brand logo for the campaign in their community. Local judges selected "winners" in various categories, and six of the submissions were selected for testing in the broader community via street intercept interviews. Respondents were asked which logo they liked best, their perceived meanings of the designs and the perceived appropriateness of the designs for a social and emotional wellbeing campaign. A convenience sample of N = 26 local Aboriginal people who lived and/or worked in Roebourne completed the questionnaire. There was a clear majority preference for logo "D," which communicated appropriate meanings of pride and strength in standing together, and reflected the underlying strengths and capacities of Aboriginal people which this project seeks to harness and support. The approach of using a logo competition to develop the campaign brand was highly successful and enabled further meaningful engagement with the community and other service providers in the town. The success of the competition process resulted from an emphasis on relationship building, listening to the local community and involving the community in decision-making. So what? By conforming to established, but not always adhered to, recommendations for community consultation, successful and more enduring outcomes are likely. © 2018 Australian Health Promotion Association.

Stigma Experiences in Marginalized People Living With HIV Seeking Health Services and Resources in Canada.

PubMed

Donnelly, Leeann R; Bailey, Lauren; Jessani, Abbas; Postnikoff, Jonathan; Kerston, Paul; Brondani, Mario

HIV stigma may prevent people from obtaining a timely diagnosis and engaging in life-saving care. It may also prevent those who are HIV infected from seeking health and education resources, particularly if they are from marginalized communities. We inductively explored the roots of stigma and its impact on health services and resource seeking as experienced by HIV-infected members of marginalized communities in Vancouver, British Columbia, Canada, using a community-based participatory research framework. Five peer-facilitated focus groups were conducted with 33 Aboriginal, Latino, Asian, and African participants. Thematic analysis of the experiences revealed four dominant themes: beginnings of stigma, tensions related to disclosure, experiences of service seeking, and beyond HIV stigma and discrimination. Persons living with HIV from Aboriginal and refugee communities continue to experience disproportionate rates of stigma and discrimination. Fear remains a prime obstacle influencing these groups' abilities and willingness to access care in various settings. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Risk factors for dental caries in small rural and regional Australian communities.

PubMed

Zander, Alexis; Sivaneswaran, Shanti; Skinner, John; Byun, Roy; Jalaludin, Bin

2013-01-01

Dental decay (caries) can cause pain, infection and tooth loss, negatively affecting eating, speaking and general health. People living in rural and regional Australian communities have more caries, more severe caries and more untreated caries than those in the city. The unique environmental conditions and population groups in these communities may contribute to the higher caries burden. In particular, some towns lack community water fluoridation, and some have a high proportion of Aboriginal people, who have significantly worse oral health than their non-Aboriginal counterparts. Because of these and other unique circumstances, mainstream research on caries risk factors may not apply in these settings. This study aimed to gather contemporary oral health data from small rural or regional Australian communities, and investigate caries risk factors in these communities. A cross-sectional survey consisting of a standardized dental examination and questionnaire was used to measure the oral health of 434 children (32% Aboriginal) aged 3-12 years in three small rural or regional areas. Oral health was determined as the deciduous and permanent decayed, missing and filled teeth (dmft/DMFT), and the proportion of children without caries. Risk factors were investigated by logistic regression. The dmft/DMFT for children in this study was 1.5 for 5-6 year olds and 1.0 for 11-12 year olds (index groups reported). Independent predictors of having caries (Yes/No) were age group, holding a concession card (OR=2.45, 95%CI=1.58-3.80) and tooth-brushing less than twice per day (OR=2.11, 95% CI=1.34-3.34). Aboriginal status also became a significant variable under sensitivity analyses (OR 1.9, CI 1.12-3.24) when the tooth-brushing variable was removed. Gender, water fluoridation and parental education were not significant predictors of caries in these communities. The rural/remote children in this study had worse oral health than either state or national average in both the 5-6 year old and 11-12 year age group. Socioeconomic status, tooth-brushing and Aboriginal status were significantly associated with caries in these communities. To close the substantial gap in oral health outcomes between rural and metropolitan residents, approaches that target rural areas, Aboriginal people and those from low socioeconomic backgrounds are needed.

Influences of indigenous language on spatial frames of reference in Aboriginal English

NASA Astrophysics Data System (ADS)

Edmonds-Wathen, Cris

2014-06-01

The Aboriginal English spoken by Indigenous children in remote communities in the Northern Territory of Australia is influenced by the home languages spoken by themselves and their families. This affects uses of spatial terms used in mathematics such as `in front' and `behind.' Speakers of the endangered Indigenous Australian language Iwaidja use the intrinsic frame of reference in contexts where speakers of Standard Australian English use the relative frame of reference. Children speaking Aboriginal English show patterns of use that parallel the Iwaidja contexts. This paper presents detailed examples of spatial descriptions in Iwaidja and Aboriginal English that demonstrate the parallel patterns of use. The data comes from a study that investigated how an understanding of spatial frame of reference in Iwaidja could assist teaching mathematics to Indigenous language-speaking students. Implications for teaching mathematics are explored for teachers without previous experience in a remote Indigenous community.

Role of art centres for Aboriginal Australians living with dementia in remote communities.

PubMed

Lindeman, Melissa; Mackell, Paulene; Lin, Xiaoping; Farthing, Annie; Jensen, Heather; Meredith, Maree; Haralambous, Betty

2017-06-01

To explore the role art centres in remote communities play for Aboriginal and Torres Strait Islander Australians living with dementia. A comprehensive literature search was undertaken, with no restrictions on articles regarding year of publication. Art programmes have been found to be of benefit to both people living with dementia and their carers, particularly when programmes are administered in environments that are culturally revered. Findings indicate remote art centres play a key role in maintaining traditions, culture and practices unique to Aboriginal and Torres Strait Islanders, but there is a gap in knowledge regarding how they cater for the needs of people with dementia. Addressing this gap will be helpful in remote areas where prevalence of dementia is up to five times that of non-Aboriginal people, and there are limited health and support services. Further research is required to explore strengths and gaps of current practices. © 2017 AJA Inc.

Ethics in Community-University-Artist Partnered Research: Tensions, Contradictions and Gaps Identified in an 'Arts for Social Change' Project.

PubMed

Yassi, Annalee; Spiegel, Jennifer Beth; Lockhart, Karen; Fels, Lynn; Boydell, Katherine; Marcuse, Judith

Academics from diverse disciplines are recognizing not only the procedural ethical issues involved in research, but also the complexity of everyday "micro" ethical issues that arise. While ethical guidelines are being developed for research in aboriginal populations and low-and-middle-income countries, multi-partnered research initiatives examining arts-based interventions to promote social change pose a unique set of ethical dilemmas not yet fully explored. Our research team, comprising health, education, and social scientists, critical theorists, artists and community-activists launched a five-year research partnership on arts-for-social change. Funded by the Social Science and Humanities Research Council in Canada and based in six universities, including over 40 community-based collaborators, and informed by five main field projects (circus with street youth, theatre by people with disabilities, dance for people with Parkinson's disease, participatory theatre with refugees and artsinfused dialogue), we set out to synthesize existing knowledge and lessons we learned. We summarized these learnings into 12 key points for reflection, grouped into three categories: community-university partnership concerns ( n  = 3), dilemmas related to the arts ( n  = 5), and team issues ( n  = 4). In addition to addressing previous concerns outlined in the literature (e.g., related to consent, anonymity, dangerous emotional terrain, etc.), we identified power dynamics (visible and hidden) hindering meaningful participation of community partners and university-based teams that need to be addressed within a reflective critical framework of ethical practice. We present how our team has been addressing these issues, as examples of how such concerns could be approached in community-university partnerships in arts for social change.

Communicable diseases in rural and remote Australia: the need for improved understanding and action.

PubMed

Quinn, Emma K; Massey, Peter D; Speare, Rick

2015-01-01

Rural and remote communities of Australia, particularly those including Aboriginal people, experience greater morbidity and mortality across a range of health outcomes compared to urban communities. Previous national data have demonstrated that rural and remote communities experience a disproportionate burden of communicable diseases compared to their urban counterparts. This systematic review was undertaken to describe the types of research that have explored the epidemiology of communicable diseases in rural and remote communities in Australia, with particular reference to the social determinants of health. We conducted a keyword search of several databases (EMBASE, MEDLINE/PubMed, RURAL, Aboriginal and Torres Strait Islander Health Database, Web of Science Core Collection, and Google and Google Scholar websites) for peer-reviewed and grey literature that described or analysed the epidemiology of communicable diseases in rural and/or remote communities of Australia from 2004 to 2013. Exclusion criteria were applied to keep the review focused on rural and/or remote communities and the population-level epidemiological analysis of communicable diseases. From 2287 retrieved articles, a total of 50 remained after applying exclusion criteria. The majority of included articles were descriptive studies (41/50). Seven of the total 50 articles contained analytical studies; one systematic literature review and one experimental study were also identified. Due to the diversity of approaches in measuring disease burden, we performed a narrative synthesis of the articles according to the review objectives. Most of the articles investigated the disease burden in remote (n=37/50) and Aboriginal communities only (n=21/50). The studies highlighted a high prevalence or incidence of skin, eye and respiratory infections for remote Aboriginal communities, particularly children over the past decade. There was emerging evidence to suggest that housing and social conditions play an important role in determining the risk of skin, ear, respiratory and gastrointestinal infections in children. Other health service and sociocultural factors were also discussed by authors as influencing the epidemiology of communicable diseases in rural and remote communities. This systematic review identified several communicable diseases that continue to cause considerable morbidity in remote Aboriginal communities, including skin, eye and respiratory infections, particularly for children. Overall there is a substantial amount of descriptive epidemiology published, but few analytical or experimental studies. Despite a lack of empirical investigation into the social determinants of the burden of communicable disease, there is emerging evidence that has demonstrated a significant association between housing conditions and skin, ear, respiratory and gastrointestinal infections in children. There is also growing recognition of other social and environmental factors that can influence the burden of diseases in rural and remote communities. Further investment into higher quality community-based research that addresses the social determinants of communicable diseases in remote communities is warranted. The lack of research investigating zoonoses and tropical diseases was noted.

Killing the Mockingbird: Systems Failure and a Radical Hope for Re-Grounding Responsibility and Access to Health Care in a Mallee Town Community

ERIC Educational Resources Information Center

Coldwell, Ian

2010-01-01

The plight of Aboriginal health and the question of Aboriginal health care in a remote rural community came into focus when I realised that "the system" was peppered with in-built racist beliefs and values that discriminate against and disadvantage minority groups. Cyborg theory assists the difficulties of explaining the paradoxes that…

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians.

PubMed

Radford, Kylie; Mack, Holly A; Draper, Brian; Chalkley, Simon; Delbaere, Kim; Daylight, Gail; Cumming, Robert G; Bennett, Hayley; Broe, Gerald A

2015-01-01

Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population. © 2015 S. Karger AG, Basel.

Sugar-sweetened beverage consumption, correlates and interventions among Australian Aboriginal and Torres Strait Islander communities: a scoping review protocol.

PubMed

Avery, Jodie C; Bowden, Jacqueline A; Dono, Joanne; Gibson, Odette R; Brownbill, Aimee; Keech, Wendy; Roder, David; Miller, Caroline L

2017-07-31

Aboriginal and Torres Strait Islander communities of Australia experience poorer health outcomes in the areas of overweight and obesity, diabetes and cardiovascular disease. Contributing to this burden of disease in the Australian community generally and in Aboriginal and Torres Strait Islander communities, is the consumption of sugar-sweetened beverages (SSBs). We have described a protocol for a review to systematically scope articles that document use of SSBs and interventions to reduce their consumption with Aboriginal and Torres Strait Islander people. These results will inform future work that investigates interventions aimed at reducing harm associated with SSB consumption. This scoping review draws on a methodology that uses a six-step approach to search databases including PubMed, SCOPUS, CINAHL, Informit (including Informit: Indigenous Peoples), Joanna Briggs Institute EBP Database and Mura, between January 1980 and February 2017. Two reviewers will be engaged to search for and screen studies independently, using formulated selection criteria, for inclusion in our review. We will include primary research studies, systematic reviews including meta-analysis or meta-synthesis, reports and unpublished grey literature. Results will be entered into a table identifying study details and characteristics, summarised using a Preferred Reporting Items for Systematic Reviews and Meta-Analysis chart and then critically analysed. This review will not require ethics committee review. Results will be disseminated at appropriate scientific meetings, as well as through the Aboriginal and Torres Strait Islander community. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Men, hearts and minds: developing and piloting culturally specific psychometric tools assessing psychosocial stress and depression in central Australian Aboriginal men.

PubMed

Brown, Alex; Mentha, Ricky; Howard, Michael; Rowley, Kevin; Reilly, Rachel; Paquet, Catherine; O'Dea, Kerin

2016-02-01

The health inequalities experienced by Aboriginal and Torres Strait Islander Australians are well documented but there are few empirical data outlining the burden, consequences, experience and expression of depressive illness. This paper seeks to address the lack of accessible, culturally specific measures of psychosocial stress, depression or quality of life developed for, and validated within, this population. Building on an extensive qualitative phase of research, a psychosocial questionnaire comprising novel and adapted scales was developed and piloted with 189 Aboriginal men across urban and remote settings in central Australia. With a view to refining this tool for future use, its underlying structure was assessed using exploratory factor analysis, and the predictive ability of the emergent psychosocial constructs assessed with respect to depressive symptomatology. The latent structure of the psychosocial questionnaire was conceptually aligned with the components of the a priori model on which the questionnaire was based. Regression modelling indicated that depressive symptoms were driven by a sense of injury and chronic stress and had a non-linear association with socioeconomic position. This represents the first community-based survey of psychosocial stress and depression in Aboriginal men. It provides both knowledge of, and an appropriate process for, the further development of psychometric tools, including quality of life, in this population. Further research with larger and more diverse samples of Aboriginal people is required to refine the measurement of key constructs such as chronic stress, socioeconomic position, social support and connectedness. The further refinement, validation against criterion-based methods and incorporation within primary care services is essential.

The oral health behaviours and fluid consumption practices of young urban Aboriginal preschool children in south-western Sydney, New South Wales, Australia.

PubMed

George, Ajesh; Grace, Rebekah; Elcombe, Emma; Villarosa, Amy R; Mack, Holly A; Kemp, Lynn; Ajwani, Shilpi; Wright, Darryl C; Anderson, Cheryl; Bucknall, Natasha; Comino, Elizabeth

2018-04-01

Australian Aboriginal children have a higher risk of dental caries yet there is limited focus on oral health risk factors for urban Aboriginal preschool children. This study examined the oral health behaviours and fluid consumption practices of young children from an urban Aboriginal community in south-western Sydney, Australia. In total, 157 Aboriginal children who were recruited to the "Gudaga" longitudinal birth cohort participated in this study. A survey design was employed and parents responded to the oral health questions when their child was between 18 and 60 months. Few parents (20%) were concerned about their child's oral health across the time period. By 60 months, only 20% of children had seen a dentist while 80% were brushing their teeth at least once daily. High levels of bottle use were seen up to 30 months. Consumption of sugary drinks was also very high in the early years, although this was replaced by water by 36 months. While there are some encouraging findings, such as the rates of tooth brushing and increasing rates of water consumption, the findings do highlight the poor uptake of dental services and high levels of bottle usage among urban aboriginal children during their early years. SO WHAT?: Targeted oral health promotional programs are needed in the urban Aboriginal community to better support parents understanding of good oral health practices in the early years and engagement with dental health services. © 2017 Australian Health Promotion Association.

Boyfriends, Babies and Basketball: Present Lives and Future Aspirations of Young Women in a Remote Australian Aboriginal Community

ERIC Educational Resources Information Center

Senior, Kate A.; Chenhall, Richard D.

2012-01-01

This paper explores the aspirations of a group of young women in a remote Aboriginal community in the Northern Territory of Australia. It examines how their hopes and expectations are influenced by the reality of their everyday lives and the extent to which they are able to influence the course of their lives and become agents for change in their…

"If I Wanted to Have More Opportunities and Go to a Better School, I Just Had to Get Used to It": Aboriginal Students' Perceptions of Going to Boarding School in Western Australia

ERIC Educational Resources Information Center

Mander, David J.; Cohen, Lynne; Pooley, Julie Ann

2015-01-01

This study explored the experiences of 32 male Aboriginal students from regional and remote towns and communities while they attended a metropolitan boarding school away from home and family in Perth, Western Australia. Using narrative interviews it specifically investigated how these Aboriginal students construct meaning around the transition…

Improving Aboriginal maternal and infant health services in the ‘Top End’ of Australia; synthesis of the findings of a health services research program aimed at engaging stakeholders, developing research capacity and embedding change

PubMed Central

2014-01-01

Background Health services research is a well-articulated research methodology and can be a powerful vehicle to implement sustainable health service reform. This paper presents a summary of a five-year collaborative program between stakeholders and researchers that led to sustainable improvements in the maternity services for remote-dwelling Aboriginal women and their infants in the Top End (TE) of Australia. Methods A mixed-methods health services research program of work was designed, using a participatory approach. The study area consisted of two large remote Aboriginal communities in the Top End of Australia and the hospital in the regional centre (RC) that provided birth and tertiary care for these communities. The stakeholders included consumers, midwives, doctors, nurses, Aboriginal Health Workers (AHW), managers, policy makers and support staff. Data were sourced from: hospital and health centre records; perinatal data sets and costing data sets; observations of maternal and infant health service delivery and parenting styles; formal and informal interviews with providers and women and focus groups. Studies examined: indicator sets that identify best care, the impact of quality of care and remoteness on health outcomes, discrepancies in the birth counts in a range of different data sets and ethnographic studies of ‘out of hospital’ or health centre birth and parenting. A new model of maternity care was introduced by the health service aiming to improve care following the findings of our research. Some of these improvements introduced during the five-year research program of research were evaluated. Results Cost effective improvements were made to the acceptability, quality and outcomes of maternity care. However, our synthesis identified system-wide problems that still account for poor quality of infant services, specifically, unacceptable standards of infant care and parent support, no apparent relationship between volume and acuity of presentations and staff numbers with the required skills for providing care for infants, and an ‘outpatient’ model of care. Services were also characterised by absent Aboriginal leadership and inadequate coordination between remote and tertiary services that is essential to improve quality of care and reduce ‘system-introduced’ risk. Conclusion Evidence-informed redesign of maternity services and delivery of care has improved clinical effectiveness and quality for women. However, more work is needed to address substandard care provided for infants and their parents. PMID:24890910

A cross sectional study of animal and human colonization with Methicillin-Resistant Staphylococcus aureus (MRSA) in an Aboriginal community.

PubMed

Daley, Peter; Bajgai, Janak; Penney, Carla; Williams, Karen; Whitney, Hugh; Golding, George R; Weese, Scott

2016-07-19

Methicillin-resistant Staphylococcus aureus (MRSA) infections are common among humans in Aboriginal communities in Canada, for unknown reasons. Cross sectional study of humans and dogs in an Aboriginal community of approximately 1200 persons. Our objectives were to measure community-based prevalence of nasal MRSA colonization among humans, use multivariable logistic regression to analyze risk factors for MRSA colonization, and perform molecular typing of Staphylococci isolated to investigate interspecies transmission. 461 humans were approached for consent and 442 provided complete data. 109/442 (24.7 %, 95 % C.I. = 20.7-28.7 %) of humans were colonized with MRSA. 169/442 (38.2 %) of humans had received antibiotics in the last 12 months. Only number of rooms in the house (OR 0.86, p = 0.023) and recreational dog use (OR 7.7, p = 0.002) were significant risk factors for MRSA colonization. 95/109 (87.1 %) of MRSA strains from humans were of the same spa type (CMRSA10/USA300). 8/157 (5.1 %, 95 % C.I. = 1.7-8.5 %) of dogs were colonized with methicillin-susceptible S. aureus, and no dogs were colonized with MRSA. Human MRSA colonization in this community is very common, and a single clone is predominant, suggesting local transmission. Antibiotic use is also very common. Crowding may partially explain high colonization, but most considered risk factors including animal exposure were not predictive. Very few dogs carried human Staphylococcal strains.

Use of nicotine replacement therapy and stop-smoking medicines in a national sample of Aboriginal and Torres Strait Islander smokers and ex-smokers.

PubMed

Thomas, David P; Briggs, Viki L; Couzos, Sophia; Panaretto, Kathryn S; van der Sterren, Anke E; Stevens, Matthew; Borland, Ron

2015-06-01

To examine the use of nicotine replacement therapy (NRT) and the stop-smoking medicines (SSMs) varenicline and bupropion in a national sample of Aboriginal and Torres Strait Islander smokers and recent ex-smokers. The Talking About The Smokes (TATS) project used a quota sampling design to recruit a nationally representative sample of 1721 smokers and ex-smokers who had quit ≤ 12 months before from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait. Baseline surveys were conducted from April 2012 to October 2013. These were compared with 1017 daily smokers from the general Australian population surveyed by the International Tobacco Control Policy Evaluation Project (ITC Project) from July 2010 to May 2011. Past and intended use of NRT and SSMs, duration of use, and whether participants thought NRT and SSMs help smokers to quit. Compared with other daily Australian smokers, lower proportions of Aboriginal and Torres Strait Islander daily smokers had ever used any NRT or SSMs (TATS, 37% v ITC, 58.5%) or used them in the past year (TATS, 23% v ITC, 42.1%). Nicotine patches were most commonly used by Aboriginal and Torres Strait Islander smokers and recent ex-smokers (24%), followed by varenicline (11%) and nicotine gum (10%); most (74%) had got their last NRT at no cost. Among dependent Aboriginal and Torres Strait Islander daily smokers, those who were more socioeconomically advantaged were more likely than the disadvantaged to have used NRT or SSMs. Similar proportions of Aboriginal and Torres Strait Islander daily smokers and other Australian daily smokers said that NRT or SSMs help smokers to quit (TATS, 70% v ITC, 74.2%). Dependent Aboriginal and Torres Strait Islander smokers who had previously used NRT or SSMs were more likely to believe they help in quitting and to intend to use them in the future. Aboriginal and Torres Strait Islander daily smokers, particularly those who are most disadvantaged, are less likely to have used NRT or SSMs than other Australian daily smokers. Some of the barriers to use, including cost, are being overcome, but further improvements are possible.

A randomized controlled trial comparing sequential with triple therapy for Helicobacter pylori in an Aboriginal community in the Canadian North

PubMed Central

Morse, Amy L; Goodman, Karen J; Munday, Rachel; Chang, Hsiu-Ju; Morse, John; Keelan, Monika; Geary, Janis; van Zanten, Sander Veldhuyzen

2013-01-01

BACKGROUND: Helicobacter pylori infection occurs more frequently in Arctic Aboriginal settings than elsewhere in North America and Europe. Research aimed at reducing health risks from H pylori infection has been conducted in the Aboriginal community of Aklavik, Northwest Territories. OBJECTIVE: To compare the effectiveness of the Canadian standard therapy with an alternative therapy for eliminating H pylori infection in Aklavik. METHODS: Treatment-naive H pylori-positive individuals were randomly assigned to a 10-day regimen (oral twice-daily doses) with rabeprazole (20 mg): standard triple therapy (proton pump inhibitor, added clarithromycin [500 mg] and amoxicillin [1 g] [PPI-CA]); sequential therapy (ST) added amoxicillin (1 g) on days 1 to 5, and metronidazole (500 mg) and clarithromycin (500 mg) on days 6 to 10. Participants with clarithromycin-resistant H pylori were randomly assigned to ST or quadruple therapy. Treatment effectiveness was estimated as per cent (95% CI) with a negative urea breath test at least 10 weeks after treatment. RESULTS: Of 104 (53 PPI-CA, 51 ST) randomized participants, 89 (49 PPI-CA, 40 ST) had post-treatment results. Per-protocol treatment effectiveness was 59% (95% CI 45% to 73%) for PPI-CA and 73% (95% CI 58% to 87%) for ST. Based on intention to treat, effectiveness was 55% (95% CI 41% to 69%) for PPI-CA and 57% (95% CI 43% to 71%) for ST. Of 77 participants (43 PPI-CA, 34 ST) with 100% adherence, effectiveness was 63% (95% CI 43% to 82%) for PPI-CA and 81% (95% CI 63% to 99%) for ST. CONCLUSIONS: While additional evidence is needed to confirm that ST is more effective for Arctic Aboriginal communities than the Canadian standard H pylori treatment, these results show standard PPI-CA treatment to be inadequate for communities such as Aklavik. PMID:24340314

Hypertension: high prevalence and a positive association with obesity among Aboriginal and Torres Strait Islander youth in far north Queensland.

PubMed

Esler, Danielle; Raulli, Alexandra; Pratt, Rohan; Fagan, Patricia

2016-04-01

Hypertension and other chronic disease risks are common among Aboriginal and Torres Strait Islander adults but there is little evidence regarding the epidemiology of these risk factors during adolescence. This study examines the prevalence of pre-hypertension, hypertension and other cardiovascular risk factors in Aboriginal and Torres Strait Islander people aged 15-24 years living in remote Indigenous communities in north Queensland. In so doing, it aims to better inform the approach to cardiovascular disease in this population. This is a descriptive study that retrospectively examines health service data from a program of community screening, the Young Persons Check (YPC). Participants were 1,883 Aboriginal and Torres Strait Islander people aged 15-24 years who attended for a YPC in 11 remote communities in north Queensland between March 2009 and April 2011. Overall, the prevalence of pre-hypertension was 34.0%; stage I hypertension was 17.7% and stage II hypertension was 3.3%. The prevalence of elevated waist circumference was 47.6%, overweight or obesity 45.9%, elevated triglycerides 18.3%, decreased HDL 54.8% and proteinuria 24.3%. The prevalence of hypertension (stage I or II) among Torres Strait Islander males was 34.1%, Aboriginal males 26.9%, Torres Strait Islander females 12.6% and Aboriginal females 13.0%. Hypertension was associated with sex (males) (OR= 4.37, p<0.000), overweight (OR=2.46, p<0.000), obesity (OR=4.59, p<0.000) and elevated triglycerides (OR=2.38, p<0.000). Pre-hypertension, hypertension and other cardiovascular risk in this population is highly prevalent. Hypertension was particularly prevalent among male participants. The results reiterate the importance of early life experience in cardiovascular disease prevention. © 2015 The Authors.

“Rebuilding our community”: Hearing silenced voices on Aboriginal youth suicide

PubMed Central

Walls, Melissa L.; Hautala, Dane; Hurley, Jenna

2014-01-01

This paper brings forth the voices of adult Aboriginal First Nations community members who gathered in focus groups to discuss the problem of youth suicide on their reserves. Our approach emphasizes multilevel (e.g., individual, family, and broader ecological systems) factors viewed by participants as relevant to youth suicide. Wheaton’s conceptualization of stressors (1994; 1999) and Evans-Campbell’s (2008) multilevel classification of the impacts of historical trauma are used as theoretical and analytic guides. Thematic analysis of qualitative data transcripts revealed a highly complex intersection of stressors, traumas, and social problems seen by community members as underlying mechanisms influencing heightened levels of Aboriginal youth suicidality. Our multilevel coding approach revealed that suicidal behaviors were described by community members largely as a problem with deep historical and contemporary structural roots as opposed to being viewed as individualized pathology. PMID:24097414

Community capacity as an "inside job": evolution of perceived ownership within a university-aboriginal community partnership.

PubMed

Cargo, Margaret D; Delormier, Treena; Lévesque, Lucie; McComber, Alex M; Macaulay, Ann C

2011-01-01

PURPOSE. To assess the evolution of perceived ownership of a university-Aboriginal community partnership across three project stages. DESIGN. Survey administration to project partners during project formalization (1996-T1), mobilization (1999-T2), and maintenance (2004-T3). SETTING. Aboriginal community of Kahnawake, outside Montreal, Quebec, Canada. PARTICIPANTS. Partners involved in influencing decision making in the Kahnawake Schools Diabetes Prevention Project (KSDPP). MEASURE AND ANALYSIS . A measure of perceived primary ownership subjected to linear trend analysis. RESULTS. KSDPP staff were perceived as primary owner at T1 and shared ownership with Community Advisory Board (CAB) members at T2 and T3. Trend tests indicated greater perceived ownership between T1 and T3 for CAB (χ(2)(1)  =  12.3, p < .0001) and declining KSDPP staff (χ(2)(1)  =  10.5, p < .001) ownership over time. Academic partners were never perceived as primary owners. CONCLUSION. This project was community driven from the beginning. It was not dependent on an external academic change agent to activate the community and develop the community's capacity to plan and implement a solution. It still took several years for the grassroots CAB to take responsibility from KSDPP staff, thus indicating the need for sustained funding to build grassroots community capacity.

Successful chronic disease care for Aboriginal Australians requires cultural competence.

PubMed

Liaw, Siaw Teng; Lau, Phyllis; Pyett, Priscilla; Furler, John; Burchill, Marlene; Rowley, Kevin; Kelaher, Margaret

2011-06-01

To review the literature to determine the attributes of culturally appropriate healthcare to inform the design of chronic disease management (CDM) models for Aboriginal patients in urban general practice. A comprehensive conceptual framework, drawing on the Access to Care, Pathway to Care, Chronic Care, Level of Connectedness, and Cultural Security, Cultural Competency and Cultural Respect models, was developed to define the search strategy, inclusion criteria and appraisal methods for the literature review. Selected papers were reviewed in detail if they examined a chronic disease intervention for an Aboriginal population and reported on its evaluation, impacts or outcomes. In the 173 papers examined, only 11 programs met the inclusion criteria. All were programs conducted in rural and remote Aboriginal community-controlled health services. Successful chronic disease care and interventions require adequate Aboriginal community engagement, utilising local knowledge, strong leadership, shared responsibilities, sustainable resources and integrated data and systems. These success factors fitted within the conceptual framework developed. Research and development of culturally appropriate CDM models concurrently in both urban and rural settings will enable more rigorous evaluation, leading to stronger evidence for best practice. A partnership of mainstream and Aboriginal-controlled health services is essential to successfully 'close the gap'. Findings will inform and guide the development, implementation and evaluation of culturally appropriate CDM in mainstream general practice and primary care. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

A review of programs that targeted environmental determinants of Aboriginal and Torres Strait Islander health.

PubMed

Johnston, Leah; Doyle, Joyce; Morgan, Bec; Atkinson-Briggs, Sharon; Firebrace, Bradley; Marika, Mayatili; Reilly, Rachel; Cargo, Margaret; Riley, Therese; Rowley, Kevin

2013-08-09

Effective interventions to improve population and individual health require environmental change as well as strategies that target individual behaviours and clinical factors. This is the basis of implementing an ecological approach to health programs and health promotion. For Aboriginal People and Torres Strait Islanders, colonisation has made the physical and social environment particularly detrimental for health. We conducted a literature review to identify Aboriginal health interventions that targeted environmental determinants of health, identifying 21 different health programs. Program activities that targeted environmental determinants of health included: Caring for Country; changes to food supply and/or policy; infrastructure for physical activity; housing construction and maintenance; anti-smoking policies; increased workforce capacity; continuous quality improvement of clinical systems; petrol substitution; and income management. Targets were categorised according to Miller's Living Systems Theory. Researchers using an Indigenous community based perspective more often identified interpersonal and community-level targets than were identified using a Western academic perspective. Although there are relatively few papers describing interventions that target environmental determinants of health, many of these addressed such determinants at multiple levels, consistent to some degree with an ecological approach. Interpretation of program targets sometimes differed between academic and community-based perspectives, and was limited by the type of data reported in the journal articles, highlighting the need for local Indigenous knowledge for accurate program evaluation. While an ecological approach to Indigenous health is increasingly evident in the health research literature, the design and evaluation of such programs requires a wide breadth of expertise, including local Indigenous knowledge.

A Review of Programs That Targeted Environmental Determinants of Aboriginal and Torres Strait Islander Health

PubMed Central

Johnston, Leah; Doyle, Joyce; Morgan, Bec; Atkinson-Briggs, Sharon; Firebrace, Bradley; Marika, Mayatili; Reilly, Rachel; Cargo, Margaret; Riley, Therese; Rowley, Kevin

2013-01-01

Objective: Effective interventions to improve population and individual health require environmental change as well as strategies that target individual behaviours and clinical factors. This is the basis of implementing an ecological approach to health programs and health promotion. For Aboriginal People and Torres Strait Islanders, colonisation has made the physical and social environment particularly detrimental for health. Methods and Results: We conducted a literature review to identify Aboriginal health interventions that targeted environmental determinants of health, identifying 21 different health programs. Program activities that targeted environmental determinants of health included: Caring for Country; changes to food supply and/or policy; infrastructure for physical activity; housing construction and maintenance; anti-smoking policies; increased workforce capacity; continuous quality improvement of clinical systems; petrol substitution; and income management. Targets were categorised according to Miller’s Living Systems Theory. Researchers using an Indigenous community based perspective more often identified interpersonal and community-level targets than were identified using a Western academic perspective. Conclusions: Although there are relatively few papers describing interventions that target environmental determinants of health, many of these addressed such determinants at multiple levels, consistent to some degree with an ecological approach. Interpretation of program targets sometimes differed between academic and community-based perspectives, and was limited by the type of data reported in the journal articles, highlighting the need for local Indigenous knowledge for accurate program evaluation. Implications: While an ecological approach to Indigenous health is increasingly evident in the health research literature, the design and evaluation of such programs requires a wide breadth of expertise, including local Indigenous knowledge. PMID:23939388

Evaluating a handwashing with soap program in Australian remote Aboriginal communities: a pre and post intervention study design.

PubMed

McDonald, Elizabeth; Cunningham, Teresa; Slavin, Nicola

2015-11-27

The No Germs on Me (NGoM) Social Marketing Campaign to promote handwashing with soap to reduce high rates of infection among children living in remote Australian Aboriginal communities has been ongoing since 2007. Recently three new television commercials were developed as an extension of the NGoM program. This paper reports on the mass media component of this program, trialling an evaluation design informed by the Theory of Planned Behaviour (TPB). A survey questionnaire taking an ecological approach and based on the principals and constructs of the TPB was developed. Surveys were completed in six discrete Aboriginal communities immediately before and on completion of four weeks intensive televising of the three new commercials. Across the six communities access in the home to a television that worked ranged from 49 to 83 % (n = 415). Seventy-seven per cent (n = 319) of participants reported having seen one or more of the new commercials. Levels of acceptability and comprehension of the content of the commercials was high (97 % n = 308). Seventy-five per cent (n = 651) of participants reported they would buy more soap, toilet paper and facial tissues if these were not so expensive in their communities. For TPB constructs demonstrated to have good internal reliability the findings were mixed and these need to be interpreted with caution due to limitations in the study design. Cultural, social-economic and physical barriers in remote communities make it challenging to promote adults and children wash their hands with soap and maintain clean faces such that these behaviours become habit. Low levels of access to a television in the home illustrate the extreme level of disadvantage experienced in these communities. Highlighting that social marketing programs have the potential to increase disadvantage if expensive items such as television sets are needed to gain access to information. This trial of a theory informed evaluation design allowed for new and rich information to be obtained about community members' beliefs, attitudes and intentions towards teaching and assisting children so safe hygiene behaviours become habit. Findings will support an evidence-based approach is taken to plan future NGoM program activities.

Community-Based Research among Marginalized HIV Populations: Issues of Support, Resources, and Empowerment

PubMed Central

Brondani, Mario; Moniri, Nardin R.; Kerston, R. Paul

2012-01-01

A research question was posed to us by a local HIV-resource organization interested in exploring the educational and service needs of those unreached. In order to properly address this inquiry, we developed a community-based participatory research by training peer-led volunteers to facilitate focus-group discussions within Aboriginal and refugees participants following an interview guide. We gathered Aboriginal people and refugees separated into three focus groups each, enrolling a total of 41 self-identified HIV-positive, 38 males. The discussions were tape recorded upon consent and lasted between 59 and 118 minutes. We analyzed the thematic information collected interactively through constant comparison. The qualitative data leading to categories, codes, and themes formed the basis for the spatial representation of a conceptual mapping. Both groups shared similar struggles in living with HIV and in properly accessing local nonmedical HIV resources and discussed their concerns towards the need for empowerment and support to take control of their health. PMID:22997513

Partnership, knowledge translation, and substance abuse prevention with a First Nations community.

PubMed

Baydala, Lola; Fletcher, Fay; Worrell, Stephanie; Kajner, Tania; Letendre, Sherry; Letendre, Liz; Rasmussen, Carmen

2014-01-01

Having identified substance abuse as an issue of concern in their community, the Alexis Nakota Sioux Nation invited University of Alberta researchers to partner on the cultural adaptation, delivery, and evaluation of a school-based drug and alcohol abuse prevention program. Researchers conducted a literature review of available drug and alcohol prevention programs for children and youth, identifying the Life Skills Training (LST) program as a viable model for cultural adaptation. Four program objectives were developed: (1) Review and cultural adaptation of the elementary and junior high LST programs, (2) delivery of the adapted programs, (3) measurement of changes in students' knowledge of the negative effects of drug and alcohol use, attitudes toward drugs and alcohol, drug and alcohol refusal and life skills, and changes in self-esteem/self-concept, and (4) documentation of the community's experience of the project. Using the principles of community-based participatory research (CBPR), we employed both qualitative and quantitative methods to evaluate the impact of the project. Qualitative evaluation of the program adaptation and implementation were both positive. Qualitative measures of program impact on students revealed a positive effect, whereas results of the quantitative measures were mixed. Culturally adapted, evidence-based programs can have a positive effect on Aboriginal youth and their communities. Strategies to expand knowledge translation (KT) when working with Aboriginal communities include working to create an "ethical space" that draws on the strengths of both Western and Indigenous worldviews.

Wholesale data for surveillance of Australian Aboriginal tobacco consumption in the Northern Territory.

PubMed

Thomas, David P; Fitz, Joseph W; Johnston, Vanessa; Townsend, Joanne; Kneebone, Warwick

2011-07-01

Effective monitoring of trends in tobacco use is an essential element of tobacco control policy. Monitoring tobacco consumption using tobacco wholesale data has advantages over other methods of surveillance. In the present work, a research project that monitored tobacco consumption in 25 remote Aboriginal communities and its translation to a policy to implement this monitoring routinely in the entire Northern Territory of Australia is described. Tobacco consumption and trends were estimated using wholesale (or occasionally sales) data from all retail outlets in 25 remote Aboriginal communities. Self-reported consumption was estimated from the National Aboriginal and Torres Strait Islander Social Survey in 2008. Local consumption results were fed back in posters to local organisations and health staff. Estimates of consumption from wholesale data and self-report were similar (6.8 and 6.7 cigarettes/day/person aged 15 and over). Consumption was higher in the tropical Top End than in arid Central Australia, and 24% of tobacco was consumed as loose tobacco. The overall trend in monthly consumption was not significantly different from 0. Local communities could be ranked by their local trends in monthly consumption. Monitoring tobacco consumption using wholesale tobacco data is a practical and unobtrusive surveillance method that is being introduced as a new condition of tobacco retail licenses in the Northern Territory of Australia. It overcomes some problems with consumption estimates from routine surveys, enables rapid feedback and use of results and is particularly well suited for hard-to-reach discrete populations, such as remote Aboriginal communities in Australia. It has already been used to evaluate the impact of local tobacco control activities.

Childhood disability in Aboriginal and Torres Strait Islander peoples: a literature review

PubMed Central

2013-01-01

Introduction Aboriginal and Torres Strait Islander children have higher rates of disability than non-Indigenous children and are considered doubly disadvantaged, yet there is very little data reflecting prevalence and service access to inform design and delivery of services. Failing to address physical, social, and psychological factors can have life-long consequences and perpetuate longstanding health disparities. Methods A narrative literature review was undertaken to identify peer reviewed literature describing factors impacting on the prevention, recognition, and access to support and management of disability in Indigenous Australian children. Results Twenty-seven peer-reviewed journal articles met inclusion criteria. The majority of articles focused on the hearing loss and learning disabilities consequent of otitis media. Few articles reported data on urban or metropolitan Indigenous populations or described interventions. Individual/community-, provider-, and systems level factors were identified as impacting on recognition and management of disability in young Indigenous children. Conclusions Given the burden of childhood disability, the limited literature retrieved is concerning as this is a barometer of activity and investment. Solutions addressing childhood disability will require collaboration between health, social and educational disciplines as well as an increased investment in prevention, identification and promotion of access. PMID:23327694

Is Aboriginal nutrition a priority for local government? A policy analysis.

PubMed

Helson, Catherine; Walker, Ruth; Palermo, Claire; Rounsefell, Kim; Aron, Yudit; MacDonald, Catherine; Atkinson, Petah; Browne, Jennifer

2017-11-01

The present study aimed to explore how Australian local governments prioritise the health and well-being of Aboriginal populations and the extent to which nutrition is addressed by local government health policy. In the state of Victoria, Australia, all seventy-nine local governments' public health policy documents were retrieved. Inclusion of Aboriginal health and nutrition in policy documents was analysed using quantitative content analysis. Representation of Aboriginal nutrition 'problems' and 'solutions' was examined using qualitative framing analysis. The socio-ecological framework was used to classify the types of Aboriginal nutrition issues and strategies within policy documents. Victoria, Australia. Local governments' public health policy documents (n 79). A small proportion (14 %, n 11) of local governments addressed Aboriginal health and well-being in terms of nutrition. Where strategies aimed at nutrition existed, they mostly focused on individual factors rather than the broader macroenvironment. A limited number of Victorian local governments address nutrition as a health issue for their Aboriginal populations in policy documents. Nutrition needs to be addressed as a community and social responsibility rather than merely an individual 'behaviour'. Partnerships are required to ensure Aboriginal people lead government policy development.

SCSEEC Successful School Attendance Strategies Evidence-Based Project: Final Report

ERIC Educational Resources Information Center

Australian Institute of Health and Welfare, 2014

2014-01-01

Governments, schools and communities throughout Australia are working to improve school attendance among Aboriginal and Torres Strait Islander students using strategies such as incentive programs, improvement to literacy and numeracy skills, school-family partnerships, transport to school, attendance monitoring, ensuring that school is a welcoming…

SCSEEC Successful School Attendance Strategies Evidence-Based Project: Summary Report

ERIC Educational Resources Information Center

Australian Institute of Health and Welfare, 2014

2014-01-01

Governments, schools and communities throughout Australia are working to improve school attendance among Aboriginal and Torres Strait Islander students using strategies such as incentive programs, improvement to literacy and numeracy skills, school-family partnerships, transport to school, attendance monitoring, ensuring that school is a welcoming…

Using systems thinking and the Intervention Level Framework to analyse public health planning for complex problems: Otitis media in Aboriginal and Torres Strait Islander children

PubMed Central

Durham, Jo; Vaughan, Lisa; Willis, Cameron D.

2018-01-01

Background Middle ear disease (otitis media) is endemic among Aboriginal and Torres Strait Islander children in Australia and represents an important cause of hearing loss. The disease is the result of a mix of biological, environmental and host risk factors that interact in complex, non-linear ways along a dynamic continuum. As such, it is generally recognised that a holistic, systems approach is required to reverse the high rates of otitis media in Aboriginal and Torres Strait Islander children. The objective of this paper is to examine the alignment between efforts designed to address otitis media in Aboriginal and Torres Strait Islander children in Queensland, Australia and core concepts of systems thinking. This paper’s overall purpose is to identify which combination of activities, and at which level, hold the potential to facilitate systems changes to better support ear health among Aboriginal and Torres Strait Islander children. Methods We began with a review of documents identified in consultation with stakeholders and an online search. In addition, key informants were invited to participate in an online survey and a face-to-face or phone interview. Qualitative interviews using a semi-structured interview guide were used to explore survey responses in more depth. We also undertook interviews at the community level to elicit a diverse range of views. Ideas, statements or activities reported in the documents and interviews as being performed under the Intervention Level Framework were identified using qualitative thematic and content analysis. A quantitative descriptive analysis was also undertaken, whereby data was extracted into an Excel spreadsheet and coded under the relevant strategic directions and performance indicators of the Framework. Subsequently, we coded activities against the five-level intervention framework developed by Malhi and colleagues, that is: 1) paradigm; 2) goals; 3) system structure; 4) feedback and delays; and 5) structural elements. Results Overall, twenty documents were reviewed. We examined surveys and interviews with six key informants. Twenty-four individual and 3 group interviews were conducted across central and community level informants. One hundred and four items were coded from the 20 documents and 156 items from interview data. For both data sets, the majority of activities were coded at the structural elements level. The results suggested three key areas where further work is needed to drive sustained improvements: 1) build the governance structures needed for paradigm shift to achieve a multi-sectoral approach; 2) develop shared system level goals; 3) develop system-wide feedback processes. Conclusions Sustained progress in improving ear health within Aboriginal and Torres Strait Islander children requires a holistic, system-wide approach. To advance such work, governance structures for multi-sectoral collaboration including the development of joint goals and monitoring and feedback are required. Intervening at these higher leverage points could have a profound effect on persistent public health issues. PMID:29561891

Using systems thinking and the Intervention Level Framework to analyse public health planning for complex problems: Otitis media in Aboriginal and Torres Strait Islander children.

PubMed

Durham, Jo; Schubert, Lisa; Vaughan, Lisa; Willis, Cameron D

2018-01-01

Middle ear disease (otitis media) is endemic among Aboriginal and Torres Strait Islander children in Australia and represents an important cause of hearing loss. The disease is the result of a mix of biological, environmental and host risk factors that interact in complex, non-linear ways along a dynamic continuum. As such, it is generally recognised that a holistic, systems approach is required to reverse the high rates of otitis media in Aboriginal and Torres Strait Islander children. The objective of this paper is to examine the alignment between efforts designed to address otitis media in Aboriginal and Torres Strait Islander children in Queensland, Australia and core concepts of systems thinking. This paper's overall purpose is to identify which combination of activities, and at which level, hold the potential to facilitate systems changes to better support ear health among Aboriginal and Torres Strait Islander children. We began with a review of documents identified in consultation with stakeholders and an online search. In addition, key informants were invited to participate in an online survey and a face-to-face or phone interview. Qualitative interviews using a semi-structured interview guide were used to explore survey responses in more depth. We also undertook interviews at the community level to elicit a diverse range of views. Ideas, statements or activities reported in the documents and interviews as being performed under the Intervention Level Framework were identified using qualitative thematic and content analysis. A quantitative descriptive analysis was also undertaken, whereby data was extracted into an Excel spreadsheet and coded under the relevant strategic directions and performance indicators of the Framework. Subsequently, we coded activities against the five-level intervention framework developed by Malhi and colleagues, that is: 1) paradigm; 2) goals; 3) system structure; 4) feedback and delays; and 5) structural elements. Overall, twenty documents were reviewed. We examined surveys and interviews with six key informants. Twenty-four individual and 3 group interviews were conducted across central and community level informants. One hundred and four items were coded from the 20 documents and 156 items from interview data. For both data sets, the majority of activities were coded at the structural elements level. The results suggested three key areas where further work is needed to drive sustained improvements: 1) build the governance structures needed for paradigm shift to achieve a multi-sectoral approach; 2) develop shared system level goals; 3) develop system-wide feedback processes. Sustained progress in improving ear health within Aboriginal and Torres Strait Islander children requires a holistic, system-wide approach. To advance such work, governance structures for multi-sectoral collaboration including the development of joint goals and monitoring and feedback are required. Intervening at these higher leverage points could have a profound effect on persistent public health issues.

Prevalence of depression and its associations with cardio-metabolic control in Aboriginal and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study Phase II.

PubMed

Davis, Timothy M E; Hunt, Kerry; Bruce, David G; Starkstein, Sergio; Skinner, Timothy; McAullay, Daniel; Davis, Wendy A

2015-03-01

To determine the prevalence and associates of depression in Aboriginal and Anglo-Celt (AC) Australians with type 2 diabetes. Community-based patients were screened using the Patient Health Questionnaire (PHQ-9) as part of detailed assessment. The prevalence of any current depression, major depression and antidepressant use by racial group was compared after adjustment for age, sex, educational attainment and marital status. Multiple logistic regression was used to determine associates of current depression. The 107 Aboriginal participants were younger (mean±SD 54.3±11.8 vs. 67.2±10.6 years), less often male (34.6% vs. 50.9%) and married (39.3% vs. 61.7%), and more likely to smoke (44.6% vs. 8.1%) than the 793 AC subjects (P≤0.002). Fifty-two Aboriginal (48.5%) and 772 AC participants (97.4%) completed the PHQ-9; these Aboriginals had similar socio-demographic, anthropometric and diabetes-related characteristics to those without PHQ-9 data. A quarter of the Aboriginals had current depression vs 10.6% of ACs (P=0.16), 15.4% vs. 4.1% had major depression (P=0.029), and 68.8% vs. 29.7% had untreated depression (P=0.032). Compared with non-depressed participants, patients with current depression were younger and more likely to smoke, to be overweight/obese and to have worse glycaemic control (P≤0.024). Significant independent associates of current depression were educational attainment (inversely), smoking status, body mass index and fasting plasma glucose in the AC group and alcohol use in the Aboriginal group. Although prevalence of depression was not significantly increased in the Aboriginal patients, it was more likely to be major and untreated. Depression complicating type 2 diabetes is associated with adverse cardiovascular risk. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Q'epethet ye Mestiyexw, A Gathering of the People.

ERIC Educational Resources Information Center

Kenny, Carolyn; Archibald, Jo-ann

2000-01-01

A 4-week program in Vancouver (British Columbia) used traditional and academic formats to connect Aboriginal communities throughout British Columbia with each other and with Maori participants from New Zealand. A conference, a symposium and graduate courses covered the role of Aboriginal art, politics of transforming education, revitalization of…

Partnerships in Social Work Education

ERIC Educational Resources Information Center

Pierce, Joanna Lina; Hemingway, Dawn; Schmidt, Glen

2014-01-01

Historically, society has associated a visit from a child protection worker with the removal of children. In Canada in the 1960s, Aboriginal children were removed from their communities in alarming numbers and were referred to as the "sixties scoop." This may in part explain the difficulty in recruiting Aboriginal social workers into…

Enhancing Indigenous Participation in Higher Education Health Courses in Rural Victoria

ERIC Educational Resources Information Center

Kippen, Sandra; Ward, Bernadette; Warren, Lyn

2006-01-01

The poor health status of Australia's Indigenous people is well-documented, as are the links between health and education. Aboriginal communities recognise the utmost importance of improving educational, physical, social and economic well-being in an environment where disproportionate numbers of Aboriginal students fail to complete secondary…

The impact of a community-led program promoting weight loss and healthy living in Aboriginal communities: the New South Wales Knockout Health Challenge.

PubMed

Passmore, Erin; Shepherd, Brooke; Milat, Andrew; Maher, Louise; Hennessey, Kiel; Havrlant, Rachael; Maxwell, Michelle; Hodge, Wendy; Christian, Fiona; Richards, Justin; Mitchell, Jo

2017-12-13

Aboriginal people in Australia experience significant health burden from chronic disease. There has been limited research to identify effective healthy lifestyle programs to address risk factors for chronic disease among Aboriginal people. The Knockout Health Challenge is a community-led healthy lifestyle program for Aboriginal communities across New South Wales, Australia. An evaluation of the 2013 Knockout Health Challenge was undertaken. Participants' self-reported physical activity and diet were measured at four time points - at the start and end of the Challenge (via paper form), and 5 and 9 months after the Challenge (via telephone survey). Participants' weight was measured objectively at the start and end of the Challenge, and self-reported (via telephone survey) 5 and 9 months after the Challenge. Changes in body composition, physical activity and diet between time points were analysed using linear mixed models. As part of the telephone survey participants were also asked to identify other impacts of the Challenge; these were analysed descriptively (quantitative items) and thematically (qualitative items). A total of 586 people registered in 22 teams to participate in the Challenge. The mean weight at the start was 98.54kg (SD 22.4), and 94% of participants were overweight or obese. Among participants who provided data at all four time points (n=122), the mean weight loss from the start to the end of the Challenge was 2.3kg (95%CI -3.0 to -1.9, p<0.001), and from the start to 9 months after the Challenge was 2.3kg (95%CI -3.3 to -1.3, p<0.001). Body mass index decreased by an average of 0.9kg/m 2 (95%CI -1.0 to -0.7, p<0.001) from the start to the end of the Challenge, and 0.8kg/m 2 (95%CI -1.2 to -0.4, p<0.001) 9 months after. At the end of the Challenge, participants reported they were more physically active and had increased fruit and vegetable consumption compared with the start of the Challenge, and identified a range of other positive impacts. The Challenge was effective in reducing weight and promoting healthy lifestyles among Aboriginal people across New South Wales, and has potential to contribute to closing the health gap between Aboriginal and non-Aboriginal people.

Research Ethics Review and Aboriginal Community Values: Can the Two be Reconciled?

PubMed

Glass, Kathleen Cranley; Kaufert, Joseph

2007-06-01

CONTEMPORARY RESEARCH ETHICS REVIEW COMMITTEES (RECs) are heavily influenced by the established academic or health care institutional frameworks in which they operate, sharing a cultural, methodological and ethical perspective on the conduct of research involving humans. The principle of autonomous choice carries great weight in what is a highly individualistic decision-making process in medical practice and research. This assumes that the best protection lies in the ability of patients or research participants to make competent, voluntary, informed choices, evaluating the risks and benefits from a personal perspective. Over the past two decades, North American and international indigenous researchers, policy makers and communities have identified key issues of relevance to them, but ignored by most institutional or university-based RECs. They critique the current research review structure, and propose changes on a variety of levels in an attempt to develop more community sensitive research ethics review processes. In doing so, they have emphasized recognition of collective rights including community consent. Critics see alternative policy guidelines and community-based review bodies as challenging the current system of ethics review. Some view them as reflecting a fundamental difference in values. In this paper, we explore these developments in the context of the political, legal and ethical frameworks that have informed REC review. We examine the process and content of these frameworks and ask how this contrasts with emerging Aboriginal proposals for community-based research ethics review. We follow this with recommendations on how current REC review models might accommodate the requirements of both communities and RECs.

Evaluation of the pilot phase of an Aboriginal and Torres Strait Islander Male Health Module.

PubMed

Tsey, Komla; Chigeza, Philemon; Holden, Carol A; Bulman, Jack; Gruis, Hilton; Wenitong, Mark

2014-01-01

This article evaluates the pilot phase of an Aboriginal and Torres Strait Islander Male Health Module. Although men experience higher levels of illness and die younger than women, educational programs to support health workers utilise a gender-based approach to increase participation of Aboriginal and Torres Strait Islander males in health care are rare and lack appropriate content. Recognising this gap in service provision, and under the guidance of a Reference Group comprising community leaders in Aboriginal and Torres Strait male health, a comprehensive and culturally appropriate Male Health Module has been developed to enhance the capacity of health workers to improve access to services for Aboriginal and Torres Strait Islander males. Methods used were: in-depth interviews with Module developers, pilot workshops for trainers and health workers, questionnaires and focus group discussions with workshop participants, and participant observations. As well as enhancing capacity to facilitate access to health services for men, the Module was deemed relevant because of its potential to promote health worker empowerment and wellbeing. Findings revealed that improving access to services for men required male and female health workers working in partnership. Despite overall enthusiasm for the Module, the findings also revealed deep fear that it would end up 'collecting dust on shelves'. Strategies to improve the Module quality and accessibility are highlighted.

Using the risk behaviour diagnosis scale to understand Australian Aboriginal smoking — A cross-sectional validation survey in regional New South Wales

PubMed Central

Gould, Gillian Sandra; Watt, Kerrianne; Cadet-James, Yvonne; Clough, Alan R.

2014-01-01

Objective To validate, for the first time, the Risk Behaviour Diagnosis (RBD) Scale for Aboriginal Australian tobacco smokers, based on the Extended Parallel Process Model (EPPM). Despite high smoking prevalence, little is known about how Indigenous peoples assess their smoking risks. Methods In a cross-sectional study of 121 aboriginal smokers aged 18–45 in regional New South Wales, in 2014, RBD subscales were assessed for internal consistency. Scales included measures of perceived threat (susceptibility to and severity of smoking risks) and perceived efficacy (response efficacy and self-efficacy for quitting). An Aboriginal community panel appraised face and content validity. EPPM constructs of danger control (protective motivation) and fear control (defensive motivation) were assessed for cogency. Results Scales had acceptable to good internal consistency (Cronbach's alpha = 0.65–1.0). Most participants demonstrated high-perceived threat (77%, n = 93); and half had high-perceived efficacy (52%, n = 63). High-perceived efficacy with high-threat appeared consistent with danger control dominance; low-perceived efficacy with high-threat was consistent with fear control dominance. Conclusions In these Aboriginal smokers of reproductive age, the RBD Scale appeared valid and reliable. Further research is required to assess whether the RBD Scale and EPPM can predict quit attempts and assist with tailored approaches to counselling and targeted health promotion campaigns. PMID:26844043

"There's a housing crisis going on in Sydney for Aboriginal people": focus group accounts of housing and perceived associations with health.

PubMed

Andersen, Melanie J; Williamson, Anna B; Fernando, Peter; Redman, Sally; Vincent, Frank

2016-05-24

Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health. Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38). Inductive, thematic analysis was conducted using framework data management methods in NVivo10. Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children. Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians.

Childhood Stress and Adversity is Associated with Late-Life Dementia in Aboriginal Australians.

PubMed

Radford, Kylie; Delbaere, Kim; Draper, Brian; Mack, Holly A; Daylight, Gail; Cumming, Robert; Chalkley, Simon; Minogue, Cecilia; Broe, Gerald A

2017-10-01

High rates of dementia have been observed in Aboriginal Australians. This study aimed to describe childhood stress in older Aboriginal Australians and to examine associations with late-life health and dementia. A cross-sectional study with a representative sample of community-dwelling older Aboriginal Australians. Urban and regional communities in New South Wales, Australia. 336 Aboriginal and/or Torres Strait Islander Australians aged 60-92 years, of whom 296 were included in the current analyses. Participants completed a life course survey of health, well-being, cognition, and social history including the Childhood Trauma Questionnaire (CTQ), with consensus diagnosis of dementia and Alzheimer disease. CTQ scores ranged from 25-117 (median: 29) and were associated with several adverse childhood indicators including separation from family, poor childhood health, frequent relocation, and growing up in a major city. Controlling for age, higher CTQ scores were associated with depression, anxiety, suicide attempt, dementia diagnosis, and, specifically, Alzheimer disease. The association between CTQ scores and dementia remained significant after controlling for depression and anxiety variables (OR: 1.61, 95% CI: 1.05-2.45). In contrast, there were no significant associations between CTQ scores and smoking, alcohol abuse, diabetes, or cardiovascular risk factors. Childhood stress appears to have a significant impact on emotional health and dementia for older Aboriginal Australians. The ongoing effects of childhood stress need to be recognized as people grow older, particularly in terms of dementia prevention and care, as well as in populations with greater exposure to childhood adversity, such as Aboriginal Australians. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

'Bringing back respect': the role of participatory action research in transferring knowledge from an Aboriginal men's group to youth programs.

PubMed

McCalman, Janya; Tsey, Komla; Baird, Bradley; Connolly, Brian; Baird, Leslie; Jackson, Rita

2009-08-01

This case study describes the efforts of an Aboriginal men's group to facilitate and support the empowerment of young people in their community. It is part of a broader participatory action research (PAR) study of men's groups. Data was derived from quarterly reflective PAR sessions with men's and youth workers and steering committee members, interviews with workers, and focus groups with young people. The data was coded and categorized, with five themes identified. Key opportunities and challenges related to building staff capacity, engaging young people, giving voice to young people and reconciling diverse community views. Emerging outcomes included young people's definition of vision and values, social cohesion, personal achievements and recognition. The youth projects also resulted in local employment, improvements in workforce capacity and proposals to extend the empowerment model in Yarrabah and transfer it to another community. PAR frameworks provide a useful tool for facilitating and sustaining empowerment outcomes. They can be used to support the transfer of knowledge and skills from one Aboriginal community group to another.

Aboriginal health workers experience multilevel barriers to quitting smoking: a qualitative study.

PubMed

Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2012-05-23

Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes. Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting. Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community.

Aboriginal Health Workers experience multilevel barriers to quitting smoking: a qualitative study

PubMed Central

2012-01-01

Introduction Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. Methods We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes. Results Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting. Conclusions Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers; provide access to culturally relevant quitting resources; and address the prevailing normalisation of smoking in the family, workplace and community. PMID:22621767

SCSEEC Successful School Attendance Strategies Evidence-Based Project: Literature Review

ERIC Educational Resources Information Center

Australian Institute of Health and Welfare, 2014

2014-01-01

Governments, schools, and communities throughout Australia are working to improve school attendance among Aboriginal and Torres Strait Islander students using numerous strategies. Currently, however, little is known about the effectiveness of these strategies and the key factors which underpin programs and strategies which are successful. This…

Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study.

PubMed

Digiacomo, Michelle; Davidson, Patricia M; Taylor, Kate P; Smith, Julie S; Dimer, Lyn; Ali, Mohammed; Wood, Marianne M; Leahy, Timothy G; Thompson, Sandra C

2010-01-01

Aboriginal Australians have low rates of participation in cardiac rehabilitation (CR), despite having high rates of cardiovascular disease. Barriers to CR participation reflect multiple patient-related issues. However, an examination of the broader context of health service delivery design and implementation is needed. To identify health professionals' perspectives of systems related barriers to implementation of the National Health and Medical Research Council (NHMRC) guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples. Semi-structured interviews were conducted with health professionals involved in CR within mainstream and Aboriginal Community Controlled Health Services in Western Australia (WA). Thirty-eight health professionals from 17 services (ten rural, seven metropolitan) listed in the WA Directory of CR services and seven Aboriginal Medical Services in WA were interviewed. Respondents reported barriers encountered in health information management and the impact of access to CR services for Aboriginal people. Crucial issues identified by participants were: poor communication across the health care sector and between providers, inconsistent and insufficient data collection processes (particularly relating to Aboriginal ethnicity identification), and challenges resulting from multiple clinical information systems and incompatible technologies. This study has demonstrated that inadequate information systems and communication strategies, particularly those representing the interface between primary and secondary care, contribute to the low participation rates of Aboriginal Australians in CR. Although these challenges are shared by non-Aboriginal Australians, the needs are greater for Aboriginal Australians and innovative solutions are required.

Defining the gap: a systematic review of the difference in rates of diabetes-related foot complications in Aboriginal and Torres Strait Islander Australians and non-Indigenous Australians.

PubMed

West, Matthew; Chuter, Vivienne; Munteanu, Shannon; Hawke, Fiona

2017-01-01

The Aboriginal and Torres Strait Islander community has an increased risk of developing chronic illnesses including diabetes. Among people with diabetes, foot complications are common and make a significant contribution to the morbidity and mortality associated with this disease. The aim of this review was to systematically evaluate the literature comparing the rates of diabetes related foot complications in Aboriginal and Torres Strait Islander Australians to non-Indigenous Australians. MEDLINE, EMBASE, The Cochrane Library; PUBMED and CINAHL were searched from inception until August 2016. Inclusion criteria were: published cross-sectional or longitudinal studies reporting the prevalence of diabetes related foot complications in both a cohort of Aboriginal and Torres Strait Islander Australians and a cohort of one other Australian population of any age with diabetes. Risk of bias was assessed using the STROBE tool. Eleven studies including a total of 157,892 participants were included. Studies were set in Queensland, the Northern Territory and Western Australia, primarily in rural and remote areas. Aboriginal and Torres Strait Islander Australians experienced substantially more diabetes related foot complications with the mean age up to 14 years younger than non-Indigenous Australians. Aboriginality was associated with increased risk of peripheral neuropathy, foot ulceration and amputation. In several studies, Aboriginal and Torres Strait Islander Australians accounted for the vast majority of diabetes related foot complications (up to 91%) while comprising only a small proportion of the regional population. Reporting quality as assessed with the STROBE tool showed underreporting of: methods, sample description and potential sources of bias. There are no data available for some Australian states and for specific types of diabetes related foot complications. Aboriginal and Torres Strait Islander Australians have a 3-6 fold increased likelihood of experiencing a diabetes related foot complication compared to non-Indigenous Australians. Evidence-based, culturally appropriate screening and intervention programs and improved access to effective health care services are required to prevent a widening of the gap in diabetes related foot complications between Aboriginal and Torres Strait Islander and non-Indigenous Australians.

Iron deficiency anemia among children: Addressing a global public health problem within a Canadian context

PubMed Central

Christofides, Anna; Schauer, Claudia; Zlotkin, Stanley H

2005-01-01

Despite current Canadian pre- and perinatal nutrition programs, the prevalence of both iron deficiency and iron deficiency anemia (IDA) is very high among young Aboriginal children from Canada’s remote north. The major risk factors for IDA include prolonged consumption of evaporated cow’s milk, chronic infection and prolonged exclusive breastfeeding. In the present article, the authors discuss IDA as a significant public health problem in Canadian Aboriginal communities. Whereas the prevalence of IDA in Canadian children is between 3.5% and 10.5% in the general population, in two Northern Ontario First Nations communities and one Inuit community, the anemia rate was 36%, with 56% having depleted iron stores. Traditional methods of preventing IDA, including targeted fortification, dietary diversification and supplementation, have not solved the problem. The authors’ research group at The Hospital for Sick Children in Toronto, Ontario, conceived of the strategy of ‘home fortification’ with ‘Sprinkles’ – single-dose sachets containing micronutrients in a powder form, which are easily sprinkled onto any foods prepared in the household. In Sprinkles, the iron (ferrous fumarate) is encapsulated within a thin lipid layer to prevent the iron from interacting with food. Sprinkles have been shown to be efficacious in the treatment of anemia in many developing countries. Their use in Aboriginal communities to treat and prevent anemia is described in the present paper. The authors believe that children in Aboriginal communities across Canada would potentially benefit if Sprinkles were incorporated into Health Canada’s current distribution system, in combination with a social marketing strategy to encourage their use. PMID:19668671

Improving the mental health of rural New South Wales communities facing drought and other adversities.

PubMed

Hart, Craig Richard; Berry, Helen Louise; Tonna, Anne Maree

2011-10-01

NSW has just experienced its worst drought in a century. As years passed with insufficient rain, drought-related mental health problems became evident on farms. Our objective is to describe how, in response, the Rural Adversity Mental Health Program was introduced in 2007 to raise awareness of drought-related mental health needs and help address these needs in rural and remote NSW. The program has since expanded to include other forms of rural adversity, including recent floods. Rural NSW. DESIGN, PARTICIPANTS, INTERVENTIONS: Designed around community development principles, health, local service networks and partner agencies collaborated to promote mental health, education and early intervention. Strategies included raising mental health literacy, organising community social events and disseminating drought-related information. Priority areas were Aboriginal communities, older farmers, young people, women, primary health care and substance use. Over 3000 people received mental health literacy training in the four years of operation from 2007 to 2010. Stakeholders collaborated to conduct hundreds of mental health-related events attended by thousands of people. A free rural mental health support telephone line provided crisis help and referral to rural mental health-related services. Drought affected mental health in rural NSW. A community development model was accepted and considered effective in helping communities build capacity and resilience in the face of chronic drought-related hardship. Given the scale, complexity and significance of drought impacts and rural adjustment, and the threats posed by climate change, a long-term approach to funding such programs would be appropriate. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Opportunistic screening to detect atrial fibrillation in Aboriginal adults in Australia

PubMed Central

Flaskas, Yvonne; O'Brien, Ciaran; Jeffries, Thomas Lee; McCowen, Debbie; Finlayson, Heather; Martin, Tanya; Neubeck, Lis; Freedman, Ben

2016-01-01

Introduction There is a 10-year gap in life expectancy between Aboriginal and non-Aboriginal Australians. The leading cause of death for Aboriginal Australians is cardiovascular disease, including myocardial infarction and stroke. Although atrial fibrillation (AF) is a known precursor to stroke there are no published studies about the prevalence of AF for Aboriginal people and limited evidence about AF in indigenous populations globally. Methods and analysis This mixed methods study will recruit and train Aboriginal health workers to use an iECG device attached to a smartphone to consecutively screen 1500 Aboriginal people aged 45 years and older. The study will quantify the proportion of people who presented for follow-up assessment and/or treatment following a non-normal screening and then estimate the prevalence and age distribution of AF of the Australian Aboriginal population. The study includes semistructured interviews with the Aboriginal health workers about the effectiveness of the iECG device in their practice as well as their perceptions of the acceptability of the device for their patients. Thematic analysis will be undertaken on the qualitative data collected in the study. If the device and approach are acceptable to the Aboriginal people and widely adopted, it may help prevent the effects of untreated AF including ischaemic stroke and early deaths or impairment in Aboriginal people. Ethics and dissemination This mixed methods study received ethics approval from the Aboriginal Health and Medical Research Council (1135/15) and the Australian Health Council of Western Australia (HREC706). Ethics approval is being sought in the Northern Territory. The findings of this study will be shared with Aboriginal communities, in peer reviewed publications and at conferences. There are Aboriginal investigators in each state/territory where the study is being conducted who have been actively involved in the study. They will also be involved in data analysis, dissemination and research translation. Trial registration number ACTRN12616000459426. PMID:27852724

Perinatal depression and screening among Aboriginal Australians in the Kimberley.

PubMed

Kotz, Jayne; Munns, Ailsa; Marriott, Rhonda; Marley, Julia V

2016-02-01

Adhoc culturally questionable perinatal mental-health screening among Aboriginal women in the Kimberley. Mental-health issues, substance abuse and suicide attempts are high among young Aboriginal women in Australia. There is no evidence that the Edinburgh Postnatal Depression Scale (EPDS) is effective or culturally safe. Screening practices are complicated by limited understanding of the complex cultural interface between Western and Aboriginal beliefs and notions about health and mental-health. What is the current context of perinatal mental-health screening practices among Aboriginal women in the Kimberley and what might be considered a culturally safe approach? A review of the literature and exploration of current screening practices preceded community participatory action research (CPAR) of perinatal mental-health screening. More than 100 Kimberley women and 72 health practitioners contributed to this joint strategic body of work. Recommendations for practice include one single culturally appropriate Kimberley version of the EPDS.

A Controversial Reform in Indigenous Education: The Cape York Aboriginal Australian Academy

ERIC Educational Resources Information Center

McCollow, John

2012-01-01

This article examines a controversial initiative in Indigenous education: the establishment of the Cape York Aboriginal Australian Academy (CYAAA). The article provides a brief description of the Academy's three campuses and their communities and considers: the circumstances of its creation, including the role of Noel Pearson and Cape York…

Aboriginal Community Engagement in Primary Schooling: Promoting Learning through a Cross-Cultural Lens

ERIC Educational Resources Information Center

Turner, Angela; Wilson, Katie; Wilks, Judith L.

2017-01-01

This article reports on action research conducted at a primary school in rural New South Wales, Australia. The research responded to an expressed school aspiration to foster greater understanding of local Aboriginal culture, historical perspectives and knowledge systems within the school. An exploratory model was developed using a mixed methods…

Influences of Indigenous Language on Spatial Frames of Reference in Aboriginal English

ERIC Educational Resources Information Center

Edmonds-Wathen, Cris

2014-01-01

The Aboriginal English spoken by Indigenous children in remote communities in the Northern Territory of Australia is influenced by the home languages spoken by themselves and their families. This affects uses of spatial terms used in mathematics such as "in front" and "behind." Speakers of the endangered Indigenous Australian…

Navigating Two Worlds: Experiences of Counsellors Who Integrate Aboriginal Traditional Healing Practices

ERIC Educational Resources Information Center

Oulanova, Olga; Moodley, Roy

2010-01-01

There is revival in the use of traditional healing among Canadian Aboriginal communities and the therapeutic benefits of these practices have received much research attention. An argument is repeatedly made for incorporating indigenous healing into clinical interventions, yet recommendations on how this may be accomplished are lacking. The present…

Social Indicators in Surveys of Urban Aboriginal Residents in Saskatoon

ERIC Educational Resources Information Center

Anderson, Alan B.; Spence, Cara

2008-01-01

The Bridges and Foundations Project on Urban Aboriginal Housing, a Community-University Research Alliance (CURA) project financed primarily by the Social Sciences and Humanities Research Council of Canada (SSHRC) and the Canada Mortgage and Housing Corporation (CMHC), has been operational in Saskatoon since early 2001. During these past 5 years…

Story Telling: Australian Indigenous Women's Means of Health Promotion.

ERIC Educational Resources Information Center

Brock, Kaye; Acklin, F.; Newman, J.; Arbon, V.; Trindal, A.; Bermingham, M.; Thompson, B.

Story-telling, an oral tradition of the indigenous peoples of Australia, was recorded on video as a vehicle for conveying health promotion messages in several urban Aboriginal (Koori) communities in Sydney, Australia. The video was made by a group of Koori women Elders and two female Aboriginal academics. The Elders integrated their personal…

'Achievement, pride and inspiration': outcomes for volunteer role models in a community outreach program in remote Aboriginal communities.

PubMed

Cinelli, Renata L; Peralta, Louisa R

2015-01-01

There is growing support for the prosocial value of role modelling in programs for adolescents and the potentially positive impact role models can have on health and health behaviours in remote communities. Despite known benefits for remote outreach program recipients, there is limited literature on the outcomes of participation for role models. Twenty-four role models participated in a remote outreach program across four remote Aboriginal communities in the Northern Territory, Australia (100% recruitment). Role models participated in semi-structured one-on-one interviews. Transcripts were coded and underwent thematic analysis by both authors. Cultural training, Indigenous heritage and prior experience contributed to general feelings of preparedness, yet some role models experienced a level of culture shock, being confronted by how disparate the communities were to their home communities. Benefits of participation included exposure to and experience with remote Aboriginal peoples and community, increased cultural knowledge, personal learning, forming and building relationships, and skill development. Effective role model programs designed for remote Indigenous youth can have positive outcomes for both role models and the program recipients. Cultural safety training is an important factor for preparing role models and for building their cultural competency for implementing health and education programs in remote Indigenous communities in Australia. This will maximise the opportunities for participants to achieve outcomes and minimise their culture shock.

The Cedar Project: a comparison of HIV-related vulnerabilities amongst young Aboriginal women surviving drug use and sex work in two Canadian cities.

PubMed

Mehrabadi, Azar; Craib, Kevin J P; Patterson, Katharina; Adam, Warner; Moniruzzaman, Akm; Ward-Burkitt, Barbara; Schechter, Martin T; Spittal, Patricia M

2008-04-01

In Canada, Aboriginal women and youth continue to be overrepresented amongst new cases of HIV, and are considered at increased risk for sex and drug-related harm. Young women involved in sex work are particularly vulnerable. The purpose of this study is to determine HIV-related vulnerabilities associated with sex work amongst young Aboriginal women in two Canadian cities. This study is based on a community-based cohort of Aboriginal young people (status and non-status First Nations, Inuit and Métis) between the ages of 14 and 30 who used injection or non-injection illegal drugs (street drugs) in the previous month. Participants lived in Vancouver, Canada, or Prince George, a remote, northern Canadian city. Between October 2003 and July 2005, 543 participants were recruited by word of mouth, posters, and street outreach. A baseline questionnaire was administered by Aboriginal interviewers, and trained nurses drew blood samples for HIV and HCV antibodies and provided pre- and post-test counselling. This study included 262 young women who participated at baseline. Analyses were conducted to compare socio-demographics, drug use patterns, injection practices, sexual experiences, and HIV and HCV prevalence between young women who reported being involved in sex work in the last 6 months (n=154) versus young women who did not (n=108). Logistic regression was used to identify factors independently associated with recent sex work involvement. Both sexual violence and drug using patterns were found to be markedly different for women having recently been involved in sex work. Multivariate analysis revealed daily injection of cocaine (AOR=4.4; 95% CI: 1.9, 10.1 and smoking crack (AOR=2.9; 95% CI: 1.6, 5.2) in the previous 6 months, and lifetime sexual abuse (AOR=2.5; 95% CI: 1.4, 4.4) to be independently associated with sex work. Harm reduction and treatment programs that address historical and lifetime trauma amongst Aboriginal people and prioritize emotional and physical safety for young Aboriginal women involved in sex work are required.

"I just feel comfortable out here, there's something about the place": staff and client perceptions of a remote Australian Aboriginal drug and alcohol rehabilitation service.

PubMed

Munro, Alice; Allan, Julaine; Shakeshaft, Anthony; Breen, Courtney

2017-12-06

The need for effective, culturally safe residential rehabilitation services for Aboriginal people is widely acknowledged, however the combination of treatment components that is optimally effective, is not well defined. Most existing Aboriginal residential rehabilitation research has focused on describing client characteristics, and largely ignored the impact of treatment and service factors, such as the nature and quality of therapeutic components and relationships with staff. This qualitative study was undertaken as part of a three-year mixed methods community-based participatory research (CBPR) project that aimed to empirically describe a remote Aboriginal drug and alcohol rehabilitation service. Researchers utilised purposive sampling to conduct 21 in-depth, semi-structured interviews. The interviews used a 'research yarning' approach, a form of culturally appropriate conversation that is relaxed and narrative-based. The interview transcripts were thematically coded using iterative categorization. The emerging themes were then analysed from an Interpretative Phenomenological Analysis, focusing on how participants' lived experiences before and during their admission to the service shaped their perceptions of the program. A total of 12 clients (mean age 35 years, SD 9.07, 91% Aboriginal) and 9 staff (2 female, 7 male, mean age 48 years, SD 8.54, 67% Aboriginal) were interviewed. Five themes about specific program components were identified in the interview data: healing through culture and country; emotional safety and relationships; strengthening life skills; improved wellbeing; and perceived areas for improvement. This research found that Aboriginal drug and alcohol residential rehabilitation is not just about length of time in treatment, but also about the culture, activities and relationships that are part of the treatment process. This study highlights that cultural elements were highly valued by both clients and staff of a remote Aboriginal residential rehabilitation service, with the country or location being fundamental to the daily practice of, and access to, culture. Developing reliable and valid assessments of the program components of culture and treatment alliance would be valuable, given this study has reinforced their perceived importance in achieving positive treatment outcomes. Further, strengthening the aftercare program, as part of an integrated model of care, would likely provide greater support to clients after discharge.

Personal attitudes towards smoking in a national sample of Aboriginal and Torres Strait Islander smokers and recent quitters.

PubMed

Nicholson, Anna K; Borland, Ron; Bennet, Pele T; van der Sterren, Anke E; Stevens, Matthew; Thomas, David P

2015-06-01

To describe attitudes towards smoking in a national sample of Aboriginal and Torres Strait Islander smokers and recent quitters and assess how they are associated with quitting, and to compare these attitudes with those of smokers in the general Australian population. The Talking About The Smokes project used a quota sampling design to recruit participants from communities served by 34 Aboriginal community-controlled health services and one community in the Torres Strait. We surveyed 1392 daily smokers, 251 non-daily smokers and 78 recent quitters from April 2012 to October 2013. Personal attitudes towards smoking and quitting, wanting to quit, and attempting to quit in the past year. Aboriginal and Torres Strait Islander daily smokers were less likely than daily smokers in the general Australian population to report enjoying smoking (65% v 81%) and more likely to disagree that smoking is an important part of their life (49% v 38%); other attitudes were similar between the two groups. In the Aboriginal and Torres Strait Islander sample, non-daily smokers generally held less positive attitudes towards smoking compared with daily smokers, and ex-smokers who had quit within the past year reported positive views about quitting. Among the daily smokers, 78% reported regretting starting to smoke and 81% reported spending too much money on cigarettes, both of which were positively associated with wanting and attempting to quit; 32% perceived smoking to be an important part of their life, which was negatively associated with both quit outcomes; and 83% agreed that smoking calms them down when stressed, which was not associated with the quitting outcomes. Aboriginal and Torres Strait Islander smokers were less likely than those in the general population to report positive reasons to smoke and held similar views about the negative aspects, suggesting that factors other than personal attitudes may be responsible for the high continuing smoking rate in this population.

Timeliness of antenatal care for mothers of Aboriginal and non-Aboriginal infants in an urban setting.

PubMed

Robinson, Penelope; Comino, Elizabeth; Forbes, Andrew; Webster, Vana; Knight, Jennifer

2012-01-01

To compare the timing of first hospital antenatal care visit by mothers of Aboriginal and non-Aboriginal infants, and to identify the risk and protective factors associated with timeliness of accessing care, mothers who delivered at Campbelltown hospital between October 2005 and November 2006 were surveyed on the maternity ward. This survey was linked to hospital administrative data. Gestational age at first visit to a hospital-based antenatal clinic was compared for mothers of Aboriginal and non-Aboriginal infants. Risks and protective factors associated with timing of antenatal care were also examined using Cox regression and Kaplan-Meier survival curves. Data on 1520 deliveries were included in this study. Mothers of Aboriginal infants presented slightly later to hospital-based antenatal clinics than mothers of non-Aboriginal infants (median 15.6 weeks versus 14.0 weeks). This difference did not remain after adjustment for all risk and protective factors. The three significant factors remaining were: maternal smoking; not in paid employment; and residence in a disadvantaged suburb. The results may reflect the complex associations that exist between the clustering of disadvantage among families of Aboriginal infants. A multifaceted approach is required to improve the timeliness of hospital-based antenatal care for the mothers of Aboriginal infants.

Ethical and Epistemic Dilemmas in Knowledge Production: Addressing Their Intersection in Collaborative, Community-Based Research

ERIC Educational Resources Information Center

Glass, Ronald David; Newman, Anne

2015-01-01

Collaborative community-based research can bring a range of benefits to universities, communities, and the public more broadly. A distinct virtue of collaborative community-based research is that it makes the ethical-epistemic intersections and challenges in research a focal point of its methodology. This makes collaborative community-based…

'Talk, talk, cry, laugh': learning, healing and building an Aboriginal workforce to address family violence.

PubMed

Lauw, Marlene L; Spangaro, Jo; Herring, Sigrid; McNamara, Lorna D

2013-02-01

Sexual abuse and family violence are widespread and under-reported phenomena for which Aboriginal victims face even greater barriers to asking for and receiving assistance than do others in the community. There is a need for strategies to address abuse without disempowering and alienating Aboriginal people. A program developed by the New South Wales Health Education Centre Against Violence is addressing this issue at the same time as contributing towards a strengthened Aboriginal health workforce. The training program which is a 1-year qualification course has grown from a 52% rate of graduation in its first 6 years to 92%. Three practices in the classroom have contributed to this success. These are: (i) recognition of the emotional impact of the training and its links to participants own histories; (ii) providing space to address participants negative prior educational experiences; and (iii) further developing content on the recent sociopolitical history of Aboriginal people. These practices have strengthened this successful course, which is building a skilled workforce to provide accessible, culturally sensitive services for Aboriginal people experiencing abuse.

Playing Together: The Physical Activity Beliefs and Behaviors of Urban Aboriginal Youth.

PubMed

Kerpan, Serene; Humbert, Louise

2015-10-01

Urban Aboriginal youth are a rapidly growing segment of the Canadian population that unfortunately bears a disproportionate level of illness. One way to improve the health of urban Aboriginal youth is to increase their physical activity. It is important to understand what this group's beliefs and behaviors are on physical activity so that programs that meet their needs can be developed. This ethnographic study engaged 15 urban Aboriginal youth to understand what their physical activity beliefs and behaviors were. Results revealed 4 themes: "group physical activity preference," "focus on the family," "traditional physical activity," and "location of residence as a barrier." These themes illustrated that urban Aboriginal youth have a preference for group physical activity and enjoy traditional Aboriginal forms of activity. Results also showed that the family plays a critical role in their physical activity patterns. Lastly, participants in this study believed that their location of residence was a barrier to physical activity. Community leaders need to be sensitive to the barriers that this cultural group faces and build on the strengths that are present among this group when developing physical activity programming.

"I can't do this, it's too much": building social inclusion in cancer diagnosis and treatment experiences of Aboriginal people, their carers and health workers.

PubMed

Treloar, Carla; Gray, Rebecca; Brener, Loren; Jackson, Clair; Saunders, Veronica; Johnson, Priscilla; Harris, Magdalena; Butow, Phyllis; Newman, Christy

2014-04-01

Social inclusion theory has been used to understand how people at the margins of society engage with service provision. The aim of this paper was to explore the cancer care experiences of Aboriginal people in NSW using a social inclusion lens. Qualitative interviews were conducted with 22 Aboriginal people with cancer, 18 carers of Aboriginal people and 16 health care workers. Participants' narratives described experiences that could be considered to be situational factors in social inclusion such as difficulties in managing the practical and logistic aspects of accessing cancer care. Three factors were identified as processes of social inclusion that tied these experiences together including socio-economic security, trust (or mistrust arising from historic and current experience of discrimination), and difficulties in knowing the system of cancer treatment. These three factors may act as barriers to the social inclusion of Aboriginal people in cancer treatment. This challenges the cancer care system to work to acknowledge these forces and create practical and symbolic responses, in partnership with Aboriginal people, communities and health organisations.

75 FR 28540 - Fisheries in the Western Pacific; Community Development Program Process

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-21

... western Pacific); 2. Consist of community residents descended from aboriginal people indigenous to the...; and 7. A statement describing the degree of involvement by the indigenous community members including...

A Case Study of a Community-Based Transition Education Project.

ERIC Educational Resources Information Center

Lake, John; Williamson, John

Evaluation of a 3-year transition education program at the Pingelly School in Western Australia used data from 29 students and staff interviews, direct observation, and document analysis to compare 4 projects established to improve the employability of students (in particular, Aboriginal students and girls who were at highest risk of being early…

Cultural mismatch and the education of Aboriginal youths: the interplay of cultural identities and teacher ratings.

PubMed

Fryberg, Stephanie A; Troop-Gordon, Wendy; D'Arrisso, Alexandra; Flores, Heidi; Ponizovskiy, Vladimir; Ranney, John D; Mandour, Tarek; Tootoosis, Curtis; Robinson, Sandy; Russo, Natalie; Burack, Jacob A

2013-01-01

In response to the enduring "deficit" approach to the educational attainment of Aboriginal students in North America, we hypothesized that academic underperformance is related to a cultural mismatch between Aboriginal students' cultural background, which emphasizes connectedness and interdependence, and the mainstream White model of education, which focuses on independence and assertiveness. The participants included virtually all the secondary students (N = 115) in the Naskapi community of Kawawachikamach, Quebec, Canada. We obtained self-reports of identification with Aboriginal and White culture, teacher reports of assertiveness, and official grades. We found that high identification with either Aboriginal or White culture was related to higher grades, regardless of whether the students were perceived as assertive by their teacher. Conversely, at low levels of cultural identification toward Aboriginal or White culture, being perceived as low in assertiveness by one's teacher predicted lower grades. This suggests that both high cultural identification and assertiveness can contribute to enhancing the educational outcomes of Aboriginal students, but that Aboriginal students with low levels of both cultural identification and assertiveness are at particular risk as they are mismatched with the culture of mainstream schools and do not benefit from the protective effects of identity. The relationships among identity, cultural values, and academic performance point to the need to reject the notion of an inherent deficit in education among Aboriginal youths in favor of a different framework in which success can be attained when alternative ways of being are fostered and nurtured in schools.

Aboriginal youth suicide in Quebec: the contribution of public policy for prevention.

PubMed

Tousignant, Michel; Vitenti, Livia; Morin, Nathalie

2013-01-01

The high rate of youth suicide in some First Nations villages of Northern Quebec is an important public health problem. Based on a six-year field study in three villages belonging to the Atikamekw and Anishinabe groups, this paper proposes changes in three areas of social policy that could contribute to prevention of youth suicide. These three areas are: youth protection, administration of justice, and housing. An argument is made first to adapt the youth protection law of Quebec and to give greater responsibility to communities in individual cases in order to prevent child placement outside the villages. Regarding the administration of justice, we suggest initiatives to encourage rapid prosecution of crimes on reserves and the adoption of an approach based on reconciliation between perpetrator and victim. Finally, we indicate how housing measures could help safeguard children's wellbeing given that overcrowding can contribute to suicide. The discussion also proposes that these three key changes in social policy could be relevant in other Aboriginal communities both within and outside of Quebec. Copyright © 2013 Elsevier Ltd. All rights reserved.

"The Tongue of Pangcah and of Savages Are the Same": Language Ideology in a Multilingual Aboriginal Village in Taiwan

ERIC Educational Resources Information Center

Chang, Ya-ling

2011-01-01

This study examines incongruent languages ideologies as they exist among parents, grandparents and community members of Taiwan's aboriginal Pangcah people. The language ideologies of the villagers function as language policy that informs their decisions in favor of transmitting or abandoning their linguistic heritage. Taking a critical perspective…

An Exploration of the Connection between Child Sexual Abuse and Gambling in Aboriginal Communities

ERIC Educational Resources Information Center

Dion, Jacinthe; Collin-Vezina, Delphine; De La Sablonniere, Mireille; Philippe-Labbe, Marie-Pierre; Giffard, Tania

2010-01-01

Child sexual abuse (CSA) lead to short-term sequelae and long-lasting pervasive outcomes. Research has started addressing CSA as a potential risk factor for later addictions, including pathological gambling. Among Aboriginal peoples, it is plausible that the legacy of residential schooling and other historical traumas have led to unresolved grief…

Everywhere and Nowhere: Invisibility of Aboriginal and Torres Strain Islander Contact Languages in Education and Indigenous Language Contexts

ERIC Educational Resources Information Center

Sellwood, Juanita; Angelo, Denise

2013-01-01

The language ecologies of Aboriginal and Torres Strait Islander communities in Queensland are characterised by widespread language shift to contact language varieties, yet they remain largely invisible in discourses involving Indigenous languages and education. This invisibility--its various causes and its many implications--are explored through a…

Taking Ownership: The Implementation of a Non-Aboriginal Early Education Programme for on-Reserve Children

ERIC Educational Resources Information Center

Beatch, Michelle; Le Mare, Lucy

2007-01-01

In this qualitative study, over the period of one year, we assessed the appropriateness of a mainstream early childhood education intervention, the Home Instruction for Parents of Preschool Youngsters (HIPPY) programme, in five on-reserve First Nations communities, by focusing on the experiences of the Aboriginal women who delivered the programme.…

Flourishing on the Margins: A Study of Babies and Belonging in an Australian Aboriginal Community Childcare Centre

ERIC Educational Resources Information Center

Harrison, Linda J.; Sumsion, Jennifer; Bradley, Ben; Letsch, Karen; Salamon, Andi

2017-01-01

The colonisation of Australia brought significant change and interruption on the life-ways of Aboriginal and Torres Strait Islander peoples, including forced removals onto missions and reserves. The legacy of their dispossession is ongoing socio-economic disadvantage and racial discrimination within the dominant non-Indigenous culture. Indigenous…

Attitudes and characteristics of health professionals working in Aboriginal health.

PubMed

Wilson, Annabelle M; Magarey, Anthea M; Jones, Michelle; O'Donnell, Kim; Kelly, Janet

2015-01-01

There is an unacceptable gap in health status between Aboriginal and non-Aboriginal people in Australia. Linked to social inequalities in health and political and historical marginalisation, this health gap must be urgently addressed. It is important that health professionals, the majority of whom in Australia are non-Aboriginal, are confident and equipped to work in Aboriginal health in order to contribute towards closing the health gap. The purpose of this study was to explore the attitudes and characteristics of non-Aboriginal health professionals working in Aboriginal health. The research was guided and informed by a social constructionist epistemology and a critical theoretical approach. It was set within a larger healthy eating and physical activity program delivered in one rural and one metropolitan community in South Australia from 2005 to 2010. Non-Aboriginal staff working in the health services where the program was delivered and who had some experience or an interest working in Aboriginal health were invited to participate in a semi-structured interview. Dietitians working across South Australia (rural and metropolitan locations) were also invited to participate in an interview. Data were coded into themes that recurred throughout the interview and this process was guided by critical social research. Thirty-five non-Aboriginal health professionals participated in a semi-structured interview about their experiences working in Aboriginal health. The general attitudes and characteristics of non-Aboriginal health professionals were classified using four main groupings, ranging from a lack of practical knowledge ('don't know how'), a fear of practice ('too scared'), the area of Aboriginal health perceived as too difficult ('too hard') and learning to practice regardless ('barrier breaker'). Workers in each group had different characteristics including various levels of willingness to work in the area; various understandings of Australia's historical relationship with Aboriginal peoples; varying awareness of their own cultural identity and influence on working with Aboriginal people; and different levels of (dis)comfort expressed in discussions about social, political and intercultural issues that impact on the healthcare encounter. These groupings can be used to assist non-Aboriginal health professionals to reflect on their own levels of confidence, attitudes, characteristics, experiences, approaches and assumptions to Aboriginal health, as an important precursor to further practice and development in Aboriginal health. By encouraging self-reflection of non-Aboriginal health professionals about where their experiences, characteristics and confidence lie, the groupings presented in this paper can be used to encourage non-Aboriginal health professionals, rather than Aboriginal clients or workers, to be the focus for change and deliver health care that is more acceptable to patients and clients, hence influencing health service delivery. The groupings presented can also begin to enable discussions between all health professionals about working together in Aboriginal health.

Marked disparity in the epidemiology of tuberculosis among Aboriginal peoples on the Canadian prairies: The challenges and opportunities

PubMed Central

Long, Richard; Hoeppner, Vernon; Orr, Pamela; Ainslie, Martha; King, Malcolm; Abonyi, Sylvia; Mayan, Maria; Kunimoto, Dennis; Langlois-Klassen, Deanne; Heffernan, Courtney; Lau, Angela; Menzies, Dick

2013-01-01

BACKGROUND: While it is established that Aboriginal peoples in the prairie provinces of Canada are disproportionately affected by tuberculosis (TB), little is known about the epidemiology of TB either within or across provincial borders. METHODS: Provincial reporting systems for TB, Statistics Canada censuses and population estimates of Registered Indians provided by Aboriginal Affairs and Northern Development Canada were used to estimate the overall (2004 to 2008) and pulmonary (2007 to 2008) TB rates in the prairie provinces. The place of residence at diagnosis of pulmonary TB cases in 2007 to 2008 was also documented. RESULTS: The age- and sex-adjusted incidence of TB in Registered Indians was 52.6 per 100,000 person-years, 38 times higher than in Canadian-born ‘others’. Incidence rates in Registered Indians were highest in Manitoba and lowest in Alberta. In Alberta and Saskatchewan, on-reserve rates were more than twice that of off-reserve rates. Rates in the Métis and Registered Indians were similar in Saskatchewan (50.0 and 52.2 per 100,000 person-years, respectively). In 2007 to 2008, approximately 90% of Canadian-born pulmonary TB cases in the prairie provinces were Aboriginal. Outside of one metropolitan area (Winnipeg, Manitoba), most Registered Indian and Métis pulmonary TB cases were concentrated in a relatively small number of communities north of the 53rd parallel. Rates of pulmonary TB in 11 of these communities were >300 per 100,000 person-years. In Manitoba, 49% of off-reserve Registered Indian pulmonary cases were linked to high-incidence reserve communities. INTERPRETATION: The epidemiology of TB among Aboriginal peoples on the Canadian prairies is markedly disparate. Pulmonary TB is highly focal, which is both a concern and an opportunity. PMID:23717818

Trying to keep a balance: the meaning of health and diabetes in an urban aboriginal community.

PubMed

Thompson, S J; Gifford, S M

2000-11-01

Although the predominant paradigm of epidemiological investigation continues to focus narrowly on the individual and on individual risk factors, there is a growing body of work that calls for a rethinking of the current epidemiological models. In this paper we illustrate the need for a more comprehensive epidemiological approach towards understanding the risks for diabetes, by exploring the lived experiences of diabetes and lay meanings of risk among Aborigines living in Melbourne, Australia. Ethnographic fieldwork was conducted within the Melbourne Aboriginal community in the state of Victoria over a 22-month period (1994-1996). Melbourne Aborigines see non-insulin dependent diabetes mellitus (NIDDM) as the result of living a life out of balance, a life of lost or severed connections with land and kin and a life with little control over past, present or future. The lay model regarding diabetes that is derived from the narratives of Melbourne Aborigines, consists of three levels of connectedness important in determining an individual's susceptibility not only to diabetes but to all disease--(1) family, (2) community and (3) society. This structure of interactive systems at successive levels from the individual to the population fits within the framework of an ecological paradigm. The strength of ethnography as applied to epidemiology is that it has the capacity to discover previously unknown components of a system at several different levels, and to build models to explain how these components interact. This framework, developed using an ethno-epidemiological approach, has application in other indigenous populations who have been dispossessed of their land, their pasts and their future. There is great potential to apply this approach to the major public health challenges presented by rapid global socio-cultural and environmental change that are impacting negatively on population health.

Improving palliative care outcomes for Aboriginal Australians: service providers' perspectives.

PubMed

Shahid, Shaouli; Bessarab, Dawn; van Schaik, Katherine D; Aoun, Samar M; Thompson, Sandra C

2013-07-23

Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers' experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the 'cultural security' framework. Thematic analysis was carried out that identified patterns within data. Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people's willingness and ability to accept care and support from these services. This context needs to be understood and acknowledged at the system level. More cultural safety training was requested by care providers but it was not seen as replacing the need for an Aboriginal worker in the palliative care team.

Human Papillomavirus and Oropharyngeal Cancer Among Indigenous Australians: Protocol for a Prevalence Study of Oral-Related Human Papillomavirus and Cost-Effectiveness of Prevention

PubMed Central

Garvey, Gail; Hedges, Joanne; Mitchell, Amanda; Dunbar, Terry; Leane, Cathy; Hill, Isaac; Warren, Kate; Brown, Alex; Ju, Xiangqun; Roder, David; Logan, Richard; Johnson, Newell; Smith, Megan; Antonsson, Annika; Canfell, Karen

2018-01-01

Background Oropharyngeal cancer is an important, understudied cancer affecting Aboriginal and Torres Strait Islander Australians. The human papillomavirus (HPV) is a significant risk factor for oropharyngeal cancer. Current generation HPV vaccines are effective against the 2 most common types of high-risk HPVs in cancer (hrHPVs 16/18). Objectives This study aims (1) to yield population estimates of oncogenic genotypes of HPV in the mouth and oropharynx of defined Aboriginal and Torres Strait Islander populations; (2) to estimate the proportion of oropharyngeal cancer attributable to HPV among these Australian citizens; (3) to estimate the impact of HPV vaccination as currently implemented on rates of oropharyngeal cancer among Aboriginal and Torres Strait Islander Australians; and (4) taking into account impact on oropharyngeal as well as cervical cancer, to evaluate efficacy and cost-effectiveness of targeted extended HPV vaccination to older ages, among our study population. Methods Our study design and operation is straightforward, with minimal impost on participants. It involves testing for carriage of hrHPV in the mouth and oropharynx among 1000 Aboriginal South Australians by simple saliva collection and with follow-up at 12 and 24 months, collection of sexual history at baseline, collection of information for estimating health state (quality-of-life) utilities at baseline, genotyping of viruses, predictive outcome and cost-effectiveness modeling, data interpretation and development of vaccination, and follow-up management strategies driven by the Aboriginal community. Results Participant recruitment for this study commenced in February 2018 and enrollment is ongoing. The first results are expected to be submitted for publication in 2019. Conclusions The project will have a number of important outcomes. Synthesis of evidence will enable generation of estimates of the burden of oropharyngeal cancer among Aboriginal and Torres Strait Islander Australians and indicate the likely effectiveness and cost-effectiveness of prevention. This will be important for health services planning, and for Aboriginal health worker and patient education. The results will also point to important areas where research efforts should be focused to improve outcomes in Aboriginal and Torres Strait Islander Australians with oropharyngeal cancer. There will be a strong focus on community engagement and accounting for the preferences of individuals and the community in control of HPV-related cancers. The project has international relevance in that it will be the first to systematically evaluate prevention of both cervical and oropharyngeal cancer in a high-risk Indigenous population taking into account all population, testing, and surveillance options. Registered Report Identifier RR1-10.2196/10503 PMID:29884604

An ethnographic action research study to investigate the experiences of Bindjareb women participating in the cooking and nutrition component of an Aboriginal health promotion programme in regional Western Australia.

PubMed

Nilson, Caroline; Kearing-Salmon, Karrie-Anne; Morrison, Paul; Fetherston, Catherine

2015-12-01

To investigate the experiences of women participating in a cooking and nutrition component of a health promotion research initiative in an Australian Aboriginal regional community. Weekly facilitated cooking and nutrition classes were conducted during school terms over 12 months. An ethnographic action research study was conducted for the programme duration with data gathered by participant and direct observation, four yarning groups and six individual yarning sessions. The aim was to determine the ways the cooking and nutrition component facilitated lifestyle change, enabled engagement, encouraged community ownership and influenced community action. Regional Bindjareb community in the Nyungar nation of Western Australia. A sample of seventeen Aboriginal women aged between 18 and 60 years from the two kinships in two towns in one shire took part in the study. The recruitment and consent process was managed by community Elders and leaders. Major themes emerged highlighting the development of participants and their recognition of the need for change: the impact of history on current nutritional health of Indigenous Australians; acknowledging shame; challenges of change around nutrition and healthy eating; the undermining effect of mistrust and limited resources; the importance of community control when developing health promotion programmes; finding life purpose through learning; and the need for planning and partnerships to achieve community determination. Suggested principles for developing cooking and nutrition interventions are: consideration of community needs; understanding the impact of historical factors on health; understanding family and community tensions; and the engagement of long-term partnerships to develop community determination.

A prospective evaluation of first people's health promotion program design in the goulburn-murray rivers region.

PubMed

Doyle, Joyce; Atkinson-Briggs, Sharon; Atkinson, Petah; Firebrace, Bradley; Calleja, Julie; Reilly, Rachel; Cargo, Margaret; Riley, Therese; Crumpen, Tui; Rowley, Kevin

2016-11-10

Aboriginal Community Controlled Organisations (ACCOs) provide community-focussed and culturally safe services for First Peoples in Australia, including crisis intervention and health promotion activities, in a holistic manner. The ecological model of health promotion goes some way towards describing the complexity of such health programs. The aims of this project were to: 1) identify the aims and purpose of existing health promotion programs conducted by an alliance of ACCOs in northern Victoria, Australia; and 2) evaluate the extent to which these programs are consistent with an ecological model of health promotion, addressing both individual and environmental determinants of health. The project arose from a long history of collaborative research. Three ACCOs and a university formed the Health Promotion Alliance to evaluate their health promotion programs. Local community members were trained in, and contributed to developing culturally sensitive methods for, data collection. Information on the aims and design of 88 health promotion activities making up 12 different programs across the ACCOs was systematically and prospectively collected. There was a wide range of activities addressing environmental and social determinants of health, as well as physical activity, nutrition and weight loss. The design of the great majority of activities had a minimal Western influence and were designed within a local Aboriginal cultural framework. The most common focus of the activities was social connectedness (76 %). Physical activity was represented in two thirds of the activities, and nutrition, weight loss and culture were each a focus of about half of the activities. A modified coding procedure designed to assess the ecological nature of these programs showed that they recruited from multiple settings; targeted a range of individual, social and environmental determinants; and used numerous and innovative strategies to achieve change. First Peoples' health promotion in the Goulburn-Murray Rivers region encompasses a broad range of social, cultural, lifestyle and community development activities, including reclaiming and strengthening cultural identity and social connectedness as a response to colonisation.

Walanbaa Warramildanha: The Impact of Authentic Aboriginal Community and School Engagement on Teachers' Professional Knowledge

ERIC Educational Resources Information Center

Lowe, Kevin

2017-01-01

The conundrum of Indigenous education in Australia is that there are multiple, highly contested and polarising narratives that vie to inform both public and policy debate about how to construct effective schooling of Aboriginal students. Two of these contested discourses, which are seen to drive much of this debate, highlight the complexity of…

Enabling Voice: Aboriginal Parents, Experiences and Perceptions of Sending a Child to Boarding School in Western Australia

ERIC Educational Resources Information Center

Mander, David J.

2015-01-01

This study explored the experience of having a child educated away from home at boarding school for Aboriginal parents living in regional and remote communities in Western Australia (WA). In-depth interviews were conducted with 11 participants and thematic analysis found the following major themes emerged from the data: (1) Access, Standards and…

The role of Aboriginal family workers in delivering a child safety focused home visiting program for Aboriginal families in an urban region of NSW.

PubMed

Clapham, Kathleen; Bennett-Brook, Keziah; Hunter, Kate

2018-05-09

Aboriginal Australian children experience higher rates of injury than other Australian children. However few culturally acceptable programs have been developed or evaluated. The Illawarra Aboriginal Medical Service (IAMS) developed the Safe Homes Safe Kids program as an injury prevention program targeting disadvantaged Aboriginal families with children aged 0-5 in an urban region of NSW. Delivered by Aboriginal Family Workers the program aims to reduce childhood injury by raising awareness of safety in the home. A program evaluation was conducted to determine the effectiveness of the home visiting model as an injury prevention program. This paper reports on the qualitative interviews which explored the ways in which clients, IAMS staff, and external service providers experienced the program and assessed its delivery by the Aboriginal Family Workers. A qualitative program evaluation was conducted between January 2014 and June 2015. We report here on the semi-structured interviews undertaken with 34 individuals. The results show increased client engagement in the program; improved child safety knowledge and skills; increased access to services; improved attitudes to home and community safety; and changes in the home safety environment. Safe Homes Safe Kids provides a culturally appropriate child safety program delivered by Aboriginal Family Workers to vulnerable families. Clients, IAMS staff, and external service were satisfied with the family workers' delivery of the program and the holistic model of service provision. SO WHAT?: This promising program could be replicated in other Aboriginal health services to address unintentional injury to vulnerable Aboriginal children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Incidence of type 2 diabetes in Aboriginal Australians: an 11-year prospective cohort study.

PubMed

Wang, Zhiqiang; Hoy, Wendy E; Si, Damin

2010-08-17

Diabetes is an important contributor to the health inequity between Aboriginal and non-Aboriginal Australians. This study aims to estimate incidence rates of diabetes and to assess its associations with impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) among Aboriginal participants in a remote community. Six hundred and eighty six (686) Aboriginal Australians aged 20 to 74 years free from diabetes at baseline were followed for a median of 11 years. During the follow-up period, new diabetes cases were identified through hospital records. Cox proportional hazards models were used to assess relationships of the incidence rates of diabetes with IFG, IGT and body mass index (BMI). One hundred and twenty four (124) new diabetes cases were diagnosed during the follow up period. Incidence rates increased with increasing age, from 2.2 per 1000 person-years for those younger than 25 years to 39.9 per 1000 person-years for those 45-54 years. By age of 60 years, cumulative incidence rates were 49% for Aboriginal men and 70% for Aboriginal women. The rate ratio for developing diabetes in the presence of either IFG or IGT at baseline was 2.2 (95% CI: 1.5, 3.3), adjusting for age, sex and BMI. Rate ratios for developing diabetes were 2.2 (95% CI: 1.4, 3.5) for people who were overweight and 4.7 (95% CI: 3.0, 7.4) for people who were obese at baseline, with adjustment of age, sex and the presence of IFG/IGT. Diabetes incidence rates are high in Aboriginal people. The lifetime risk of developing diabetes among Aboriginal men is one in two, and among Aboriginal women is two in three. Baseline IFG, IGT and obesity are important predictors of diabetes.

Yaitya tirka madlanna warratinna: exploring what sexual health nurses need to know and do in order to meet the sexual health needs of young Aboriginal women in Adelaide.

PubMed

Kelly, Janet; Luxford, Yoni

2007-07-01

Young Aboriginal women are consistently identified as having poorer health outcomes and access to sexual health services than non-Indigenous Australians. Yet the literature is particularly silent on what sexual health nurses need to know and do in order to work well with young urban Aboriginal women. This paper reports on a qualitative pilot study undertaken by a non-Indigenous nurse in Adelaide. The participatory action research methods used in this study were sensitive to the history of problems associated with research in Aboriginal communities. A reference group of Elder Aboriginal women and Aboriginal health workers guided all aspects of the study. A partnership approach between the researcher and the Reference Group ensured that the methods, analysis, and final report were culturally safe. Three groups participated in this study: Elders and Aboriginal health workers; young Aboriginal women, and sexual health nurses. All participants acknowledged the importance of nurses being clinically competent. However, the overarching finding was a lack of a clear model of cultural care to guide health service delivery. Three interrelated themes emerged from the data to support this contention. These were: the structural and personal importance of establishing and maintaining trustworthy relationships between nurses, Aboriginal health workers and Elders; the recognition that Aboriginal culture does exist, and is important in urban areas; and the importance of gender considerations to understanding urban women's health business. A partnership approach was recommended as a way to use these findings to develop a transparent cultural model of care. Further research is currently being undertaken to progress this agenda.

First Nations Approaches to Childhood Obesity: Healthy Lifestyles in Canada Compared with Alternatives for Alaska Native Communities

PubMed Central

de Schweinitz, Peter A.; Wojcicki, Janet M.

2017-01-01

Alaska Native and American Indian children have among the highest prevalence of obesity in the United States. Canadian Aboriginal populations including First Nations also have high rates of obesity but obesity rates among children are noticeably lower. We highlight some of the important differences between American and Canadian approaches to healthy lifestyles and Aboriginal/Native health, including diet and physical activity, which may in part explain the differences in obesity prevalence. Specifically, the Canadian government provides a food subsidy program to bring perishable fruits and vegetable to remote, rural Canadian areas and secondly supports the use of traditional foods and harvesting/gathering through a number of government supported programs. Lastly, there may be a better sense of community and overall life satisfaction for Aboriginals compared with Alaska Natives, in part because of the incorporation of healthcare and other services within the larger overall community, as opposed to separate services as is the case for Alaska Natives. This perspective provides insight into some of these potential differences. PMID:28492517

Results of an Innovative Education, Training and Quality Assurance Program for Point-of-Care HbA1c Testing using the Bayer DCA 2000 in Australian Aboriginal Community Controlled Health Services

PubMed Central

Shephard, Mark D; Gill, Janice P

2003-01-01

This study describes the development, implementation and management of a multi-faceted quality assurance program called Quality Assurance for Aboriginal Medical Services (QAAMS) to support point-of-care HbA1c testing on the Bayer DCA 2000 in Aboriginal people with diabetes from 45 Australian Aboriginal Community Controlled Health Services. The quality assurance program comprised four elements: production of culturally appropriate education resources, formal training for Aboriginal Health Workers conducting HbA1c testing, an external quality assurance program and on-going quality management support services including a help hotline and an annual workshop. Aboriginal Health Workers were required to test two quality assurance (QAAMS) samples in a blind sense every month since July 1999. Samples were linearly related and comprised six paired levels of HbA1c. The short and long term performance of each service’s DCA 2000 was reviewed monthly and at the end of each six month testing cycle. The average participation rate over 7 six-monthly QAAMS testing cycles was 88%. 84% of 3100 quality assurance tests performed were within preset limits of acceptability. The median precision (CV%) for HbA1c testing has averaged 3.8% across the past 5 cycles (range 3.4 to 4.0%) and is continuing to improve. The introduction of a medical rebate for HbA1c testing has ensured the program’s sustainability. Through continuing education and training, Aboriginal Health Workers have achieved consistent analytical performance for HbA1c testing on the DCA 2000, equivalent to that of laboratory scientists using the same instrument. This unique quality assurance model can be readily adapted to other Indigenous health settings and other point-of-care tests and instruments. PMID:18568052

Schools and Neighborhood-Based Collaboration: Structural Resistances and Realities.

ERIC Educational Resources Information Center

Smithmier, Angela

Community-based interagency collaboration among schools and other public service agencies is one reform idea for addressing the complex conditions of children with a high level of needs. This paper presents findings of a study that explored the workings of one community-based collaboration, referred to as the Community-Based Collaboration for…

Need for an Australian Indigenous disability workforce strategy: review of the literature.

PubMed

Gilroy, John; Dew, Angela; Lincoln, Michelle; Hines, Monique

2017-08-01

To identify approaches for developing workforce capacity to deliver the National Disability Insurance Scheme (NDIS) to Indigenous people with disability in Australian rural and remote communities. A narrative review of peer-reviewed and gray literature was undertaken. Searches of electronic databases and websites of key government and non-government organizations were used to supplement the authors' knowledge of literature that (a) focused on Indigenous peoples in Australia or other countries; (b) referred to people with disability; (c) considered rural/remote settings; (d) recommended workforce strategies; and (e) was published in English between 2004 and 2014. Recommended workforce strategies in each publication were summarized in a narrative synthesis. Six peer-reviewed articles and 12 gray publications met inclusion criteria. Three broad categories of workforce strategies were identified: (a) community-based rehabilitation (CBR) and community-centered approaches; (b) cultural training for all workers; and (c) development of an Indigenous disability workforce. An Indigenous disability workforce strategy based on community-centered principles and incorporating cultural training and Indigenous disability workforce development may help to ensure that Indigenous people with a disability in rural and remote communities benefit from current disability sector reforms. Indigenous workforce development requires strategies to attract and retain Aboriginal workers. Implications for Rehabilitation Indigenous people with disability living in rural and remote areas experience significant access and equity barriers to culturally appropriate supports and services that enable them to live independent, socially inclusive lives. A workforce strategy based on community-centered principles has potential for ensuring that the disability services sector meets the rehabilitation needs of Aboriginal people with disability living in rural and remote areas. Cultural training and development of an Indigenous disability workforce may help to ensure a culturally safe disability services sector and workforce.

What are the factors associated with good mental health among Aboriginal children in urban New South Wales, Australia? Phase I findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH).

PubMed

Williamson, Anna; D'Este, Catherine; Clapham, Kathleen; Redman, Sally; Manton, Toni; Eades, Sandra; Schuster, Leanne; Raphael, Beverley

2016-07-05

To identify the factors associated with 'good' mental health among Aboriginal children living in urban communities in New South Wales, Australia. Cross-sectional survey (phase I of a longitudinal study). 4 Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban communities in New South Wales, Australia. 1005 Aboriginal children aged 4-17 years who participated in phase I of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Carer report version of the Strengths and Difficulties Questionnaire. Scores <17 were considered to indicate 'good' mental health for the purposes of this article. The majority (72%) of SEARCH participants were not at high risk for emotional or behavioural problems. After adjusting for the relative contributions of significant demographic, child and carer health factors, the factors associated with good mental health among SEARCH children were having a carer who was not highly psychologically distressed (OR=2.8, 95% CI 1.6 to 5.1); not suffering from frequent chest, gastrointestinal or skin infections (OR=2.8, 95% CI 1.8 to 4.3); and eating two or more servings of vegetables per day (OR=2.1, 95% CI 1.2 to 3.8). Being raised by a foster carer (OR=0.2, 95% CI 0.01 to 0.71) and having lived in 4 or more homes since birth (OR=0.62, 95% CI 0.39 to 1.0) were associated with significantly lower odds of good mental health. Slightly different patterns of results were noted for adolescents than younger children. Most children who participated in SEARCH were not at high risk for emotional or behavioural problems. Promising targets for efforts to promote mental health among urban Aboriginal children may include the timely provision of medical care for children and provision of additional support for parents and carers experiencing mental or physical health problems, for adolescent boys and for young people in the foster care system. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Stressful life events and resilience among carers of Aboriginal children in urban New South Wales: cross-sectional findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH).

PubMed

Young, Christian; Craig, Jonathan C; Clapham, Kathleen; Williams, Sandra; Williamson, Anna

2018-06-06

In caregivers of urban Aboriginal children, to determine the frequency of major stressful life events, the proportion who meet criteria for resilience, and factors that are associated with resilience. Cross-sectional survey. Four Aboriginal Community Controlled Health Services located in urban or regional areas in New South Wales, Australia. 574 caregivers of Aboriginal children participating in the Study of Environment on Aboriginal Resilience and Child Health. Resilience, defined as having experienced three or more stressful life events in the last 12 months, and having scores of ≤21 on the Kessler 10 Psychological Distress scale. Over half (315, 55%) of the caregivers reported three or more stressful life events-the most common being a close family member who was hospitalised with a serious medical problem (259, 45%). Of the participants who experienced three or more stressful life events, almost three-quarters (227, 72%) met the criteria for resilience. Using multivariable analysis, two factors were independently associated with resilience: not having a physical health problem that limited normal activities (adjusted OR (aOR) 4.3; 95% CI 2.0 to 9.0), and not having problems caused by alcohol within the home (aOR 5.3; 95% CI 2.2 to 12.8). Having a child whose behaviour placed a great deal of burden on the family was associated with less resilience (aOR 0.25; 95% CI 0.09 to 0.68). Caregivers of urban Aboriginal children experienced a large number of stressful events, the most common being the poor health of close family members, but most exhibited resilience. Resilience was associated with stable family environments and good physical health. The high number of stressful life events that caregivers experience is reflective of broader inequalities that Aboriginal communities face. The availability of easily accessible and long-term health and support services may go some way to reducing this inequality and improving social and emotional well-being for Aboriginal families. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Awareness and impact of the 'Bubblewrap' advertising campaign among Aboriginal smokers in Western Australia.

PubMed

Boyle, Terry; Shepherd, Carrington C J; Pearson, Glenn; Monteiro, Heather; McAullay, Daniel; Economo, Kristina; Stewart, Susan

2010-02-01

Antismoking mass media campaigns have been shown to reduce smoking prevalence in the mainstream community, however there is little published research on their effect on Aboriginal Australian smokers. To evaluate the awareness and impact of a mainstream mass media advertising campaign (the 'Bubblewrap' campaign) on Aboriginal smokers in the state of Western Australia. A personal intercept survey was conducted in July 2008 across three sites (the Perth metropolitan area and the non-metropolitan towns of Kalgoorlie and Broome). An opportunity or convenience sampling strategy was used to recruit Aboriginal participants, and face-to-face interviews were conducted with 198 Aboriginal smokers to ascertain awareness of the campaign advertisements, whether they were seen as believable and relevant, and the impact the advertisements had on smoking behaviour. The majority of the participants interviewed had seen and/or heard the 'Bubblewrap' campaign advertisements, although there was considerably greater awareness of the television advertisement than the radio advertisements. Both forms of advertising were considered to be believable and relevant by the majority of Aboriginal smokers. Most of the smokers interviewed thought about cutting down and/or quitting after seeing or hearing the advertisements. Our findings suggest that mainstream antismoking mass media campaigns can positively influence the thoughts and behaviours that Aboriginal smokers have, and exhibit, towards quitting smoking. Notwithstanding this, advertisers should continue to look for better ways to incorporate Aboriginal themes in campaign messages. Future mainstream antismoking campaigns should source sufficient funds to ensure that advertising messages reach the large Aboriginal populations in regional and remote Australia.

Strength-based well-being indicators for Indigenous children and families: A literature review of Indigenous communities' identified well-being indicators.

PubMed

Rountree, Jennifer; Smith, Addie

2016-01-01

Mainstream child and family well-being indicators frequently are based on measuring health, economic, and social deficits, and do not reflect Indigenous holistic and strength-based definitions of health and well-being. The present article is a review of literature that features Indigenous communities' self-identified strength-based indicators of child and family well-being. The literature search included Indigenous communities from across the world, incorporating findings from American Indians and Alaska Natives, First Nations, Native Hawaiians, Māori, Aboriginal Australians, and Sámi communities. Sorting the identified indicators into the quadrants of the Relational Worldview, an Indigenous framework for well-being based on medicine wheel teachings that views health and well-being as a balance among physical, mental, contextual, and spiritual factors, the authors discuss the findings.

Chronic disease and chronic disease risk factors among First Nations, Inuit and Métis populations of northern Canada.

PubMed

Bruce, S G; Riediger, N D; Lix, L M

2014-11-01

Aboriginal populations in northern Canada are experiencing rapid changes in their environments, which may negatively impact on health status. The purpose of our study was to compare chronic conditions and risk factors in northern Aboriginal populations, including First Nations (FN), Inuit and Métis populations, and northern non-Aboriginal populations. Data were from the Canadian Community Health Survey for the period from 2005 to 2008. Weighted multiple logistic regression models tested the association between ethnic groups and health outcomes. Model covariates were age, sex, territory of residence, education and income. Odds ratios (ORs) are reported and a bootstrap method calculated 95% confidence intervals (CIs) and p values. Odds of having at least one chronic condition was significantly lower for the Inuit (OR = 0.59; 95% CI: 0.43-0.81) than for non-Aboriginal population, but similar among FN, Métis and non-Aboriginal populations. Prevalence of many risk factors was significantly different for Inuit, FN and Métis populations. Aboriginal populations in Canada's north have heterogeneous health status. Continued chronic disease and risk factor surveillance will be important to monitor changes over time and to evaluate the impact of public health interventions.

50 CFR 665.20 - Western Pacific Community Development Program.

Code of Federal Regulations, 2012 CFR

2012-10-01

... from aboriginal people indigenous to the western Pacific who conducted commercial or subsistence... proposed fishing activity. (3) A statement describing the degree of involvement by the indigenous community...

50 CFR 665.20 - Western Pacific Community Development Program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... from aboriginal people indigenous to the western Pacific who conducted commercial or subsistence... proposed fishing activity. (3) A statement describing the degree of involvement by the indigenous community...

50 CFR 665.20 - Western Pacific Community Development Program.

Code of Federal Regulations, 2013 CFR

2013-10-01

... from aboriginal people indigenous to the western Pacific who conducted commercial or subsistence... proposed fishing activity. (3) A statement describing the degree of involvement by the indigenous community...

50 CFR 665.20 - Western Pacific Community Development Program.

Code of Federal Regulations, 2014 CFR

2014-10-01

... from aboriginal people indigenous to the western Pacific who conducted commercial or subsistence... proposed fishing activity. (3) A statement describing the degree of involvement by the indigenous community...

Creating Mechanisms for Meaningful Collaboration Between Members of Urban Communities and University-Based HIV Prevention Researchers.

PubMed

McKay, Mary M; Hibbert, Richard; Lawrence, Rita; Miranda, Ana; Paikoff, Roberta; Bell, Carl C; Madison-Boyd, Sybil; Baptiste, Donna; Coleman, Doris; Pinto, Rogério M; Bannon, William M

2007-01-01

This article provides a description of a Community/University Collaborative Board, a formalized partnership between representatives from an inner-city community and university-based researchers. This Collaborative Board oversees a number of research projects focused on designing, delivering and testing family-based HIV prevention and mental health focused programs to elementary and junior high school age youth and their families. The Collaborative Board consists of urban parents, school staff members, representatives from community-based agencies and university-based researchers. One research project, the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project) Family Program Study, an urban, family-based HIV prevention project will be used to illustrate how the Collaborative Board oversees a community-based research study. The process of establishing a Collaborative Board, recruiting members and developing subcommittees is described within this article. Examples of specific issues addressed by the Collaborative Board within its subcommittees, Implementation, Finance, Welcome, Research, Grant writing, Curriculum, and Leadership, are detailed in this article along with lessons learned.

Designing an implementation intervention with the Behaviour Change Wheel for health provider smoking cessation care for Australian Indigenous pregnant women.

PubMed

Gould, Gillian S; Bar-Zeev, Yael; Bovill, Michelle; Atkins, Lou; Gruppetta, Maree; Clarke, Marilyn J; Bonevski, Billie

2017-09-15

Indigenous smoking rates are up to 80% among pregnant women: prevalence among pregnant Australian Indigenous women was 45% in 2014, contributing significantly to the health gap for Indigenous Australians. We aimed to develop an implementation intervention to improve smoking cessation care (SCC) for pregnant Indigenous smokers, an outcome to be achieved by training health providers at Aboriginal Medical Services (AMS) in a culturally competent approach, developed collaboratively with AMS. The Behaviour Change Wheel (BCW), incorporating the COM-B model (capability, opportunity and motivation for behavioural interventions), provided a framework for the development of the Indigenous Counselling and Nicotine (ICAN) QUIT in Pregnancy implementation intervention at provider and patient levels. We identified evidence-practice gaps through (i) systematic literature reviews, (ii) a national survey of clinicians and (iii) a qualitative study of smoking and quitting with Aboriginal mothers. We followed the three stages recommended in Michie et al.'s "Behaviour Change Wheel" guide. Targets identified for health provider behaviour change included the following: capability (psychological capability, knowledge and skills) by training clinicians in pharmacotherapy to assist women to quit; motivation (optimism) by presenting evidence of effectiveness, and positive testimonials from patients and clinicians; and opportunity (environmental context and resources) by promoting a whole-of-service approach and structuring consultations using a flipchart and prompts. Education and training were selected as the main intervention functions. For health providers, the delivery mode was webinar, to accommodate time and location constraints, bringing the training to the services; for patients, face-to-face consultations were supported by a booklet embedded with videos to improve patients' capability, opportunity and motivation. The ICAN QUIT in Pregnancy was an intervention to train health providers at Aboriginal Medical Services in how to implement culturally competent evidence-based practice including counselling and nicotine replacement therapy for pregnant patients who smoke. The BCW aided in scientifically and systematically informing this targeted implementation intervention based on the identified gaps in SCC by health providers. Multiple factors impact at systemic, provider, community and individual levels. This process was therefore important for defining the design and intervention components, prior to a conducting a pilot feasibility trial, then leading on to a full clinical trial.

Resilience amongst Australian Aboriginal Youth: An Ecological Analysis of Factors Associated with Psychosocial Functioning in High and Low Family Risk Contexts

PubMed Central

Hopkins, Katrina D.; Zubrick, Stephen R.; Taylor, Catherine L.

2014-01-01

We investigate whether the profile of factors protecting psychosocial functioning of high risk exposed Australian Aboriginal youth are the same as those promoting psychosocial functioning in low risk exposed youth. Data on 1,021 youth aged 12–17 years were drawn from the Western Australian Aboriginal Child Health Survey (WAACHS 2000–2002), a population representative survey of the health and well-being of Aboriginal children, their families and community contexts. A person-centered approach was used to define four groups of youth cross-classified according to level of risk exposure (high/low) and psychosocial functioning (good/poor). Multivariate logistic regression was used to model the influence of individual, family, cultural and community factors on psychosocial outcomes separately for youth in high and low family-risk contexts. Results showed that in high family risk contexts, prosocial friendship and low area-level socioeconomic status uniquely protected psychosocial functioning. However, in low family risk contexts the perception of racism increased the likelihood of poor psychosocial functioning. For youth in both high and low risk contexts, higher self-esteem and self-regulation were associated with good psychosocial functioning although the relationship was non-linear. These findings demonstrate that an empirical resilience framework of analysis can identify potent protective processes operating uniquely in contexts of high risk and is the first to describe distinct profiles of risk, protective and promotive factors within high and low risk exposed Australian Aboriginal youth. PMID:25068434

Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines.

PubMed

Chalmers, Kathryn J; Bond, Kathy S; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Williams-Tchen, Aj

2014-01-28

It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37-41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members' satisfaction with the research method, participants were invited to provide their feedback after the final survey. From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a mental health crisis.

Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines

PubMed Central

2014-01-01

Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37–41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members’ satisfaction with the research method, participants were invited to provide their feedback after the final survey. Results From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Conclusion Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a mental health crisis. PMID:24467923

Early Childhood Development over Time for a Cohort of Australian Aboriginal Children Living in an Urban Environment

ERIC Educational Resources Information Center

Grace, Rebekah; Elcombe, Emma; Knight, Jennifer; McMahon, Catherine; McDonald, Jenny; Comino, Elizabeth

2017-01-01

Child development for a cohort of urban Aboriginal children was assessed at three time points: 12 months, 3 years and 4.5 years. This paper reports developmental findings and explores the impact of child, family, home and community variables over time. Overall, child development at 4.5 years was significantly below the standardised mean. Female…

Building co-management as a process: problem solving through partnerships in Aboriginal country, Australia.

PubMed

Zurba, Melanie; Ross, Helen; Izurieta, Arturo; Rist, Philip; Bock, Ellie; Berkes, Fikret

2012-06-01

Collaborative problem solving has increasingly become important in the face of the complexities in the management of resources, including protected areas. The strategy undertaken by Girringun Aboriginal Corporation in north tropical Queensland, Australia, for developing co-management demonstrates the potential for a problem solving approach involving sequential initiatives, as an alternative to the more familiar negotiated agreements for co-management. Our longitudinal case study focuses on the development of indigenous ranger units as a strategic mechanism for the involvement of traditional owners in managing their country in collaboration with government and other interested parties. This was followed by Australia's first traditional use of marine resources agreement, and development of a multi-jurisdictional, land to sea, indigenous protected area. In using a relationship building approach to develop regional scale co-management, Girringun has been strengthening its capabilities as collaborator and regional service provider, thus, bringing customary decision-making structures into play to 'care for country'. From this evolving process we have identified the key components of a relationship building strategy, 'the pillars of co-management'. This approach includes learning-by-doing, the building of respect and rapport, sorting out responsibilities, practical engagement, and capacity-building.

Building Co-Management as a Process: Problem Solving Through Partnerships in Aboriginal Country, Australia

NASA Astrophysics Data System (ADS)

Zurba, Melanie; Ross, Helen; Izurieta, Arturo; Rist, Philip; Bock, Ellie; Berkes, Fikret

2012-06-01

Collaborative problem solving has increasingly become important in the face of the complexities in the management of resources, including protected areas. The strategy undertaken by Girringun Aboriginal Corporation in north tropical Queensland, Australia, for developing co-management demonstrates the potential for a problem solving approach involving sequential initiatives, as an alternative to the more familiar negotiated agreements for co-management. Our longitudinal case study focuses on the development of indigenous ranger units as a strategic mechanism for the involvement of traditional owners in managing their country in collaboration with government and other interested parties. This was followed by Australia's first traditional use of marine resources agreement, and development of a multi-jurisdictional, land to sea, indigenous protected area. In using a relationship building approach to develop regional scale co-management, Girringun has been strengthening its capabilities as collaborator and regional service provider, thus, bringing customary decision-making structures into play to `care for country'. From this evolving process we have identified the key components of a relationship building strategy, `the pillars of co-management'. This approach includes learning-by-doing, the building of respect and rapport, sorting out responsibilities, practical engagement, and capacity-building.

Coronial Practice, Indigeneity and Suicide.

PubMed

Tait, Gordon; Carpenter, Belinda; Jowett, Stephanie

2018-04-16

All available data suggest that, like many other Indigenous peoples, Australian Aborigines are significantly more likely to kill themselves than are non-Aboriginal Australians. This statistical disparity is normally positioned an objective, ontological and undeniable social fact, a fact best explained as a function of endemic community disadvantage and disenfranchisement. This research explores the possibility that higher-than-normal Aboriginal suicide rates may also be a function of coronial decision-making practices. Based upon in-depth interviews with 32 coroners from across Australia, the following conclusions emerged from the data. First, coroners have differing perceptions of Indigenous capacity, and are less likely to have concerns about intent when the suicide is committed by an Indigenous person. Second, coroners have identified divergent scripts of Indigenous suicide, particularly its spontaneity and public location, and this supports rather than challenges, a finding of suicide. Third, the coronial perception of Indigenous life is a factor which influences a suicide determination for Indigenous deaths. Finally, the low level of Indigenous engagement with the coronial system, and the unlikelihood of a challenge to the finding of suicide by Indigenous families, means that a coronial determination of suicide is more likely.

Mood and anxiety problems in perinatal Indigenous women in Australia, New Zealand, Canada, and the United States: a critical review of the literature.

PubMed

Bowen, Angela; Duncan, Vicky; Peacock, Shelley; Bowen, Rudy; Schwartz, Laura; Campbell, Diane; Muhajarine, Nazeem

2014-02-01

We conducted a review of research literature related to anxiety, depression, and mood problems in Indigenous women in Canada, the United States (including Hawaii), Australia, and New Zealand. Quantitative and qualitative research studies published between 1980 and March 2010 were reviewed. The initial search revealed 396 potential documents, and after being checked for relevance by two researchers, data were extracted from 16 quantitative studies, one qualitative research article, and one dissertation. Depression is a common problem in Indigenous pregnant and postpartum women; however, the prevalence and correlates of anxiety and mood disorders are understudied. The review identified four key areas where further research is needed: (a) longitudinal, population-based studies; (b) further validation and modification of appropriate screening tools; (c) exploration of cultural diversity and meaning of the lived experiences of antenatal and postpartum depression, anxiety, and mood disorders; and (d) development of evidence-informed practices for researchers and practitioners through collaborations with Aboriginal communities to better understand and improve mental health of women of childbearing age.

Delivery of child health services in Indigenous communities: implications for the federal government's emergency intervention in the Northern Territory.

PubMed

Bailie, Ross S; Si, Damin; Dowden, Michelle C; Connors, Christine M; O'Donoghue, Lynette; Liddle, Helen E; Kennedy, Catherine M; Cox, Rhonda J; Burke, Hugh P; Thompson, Sandra C; Brown, Alex D H

2008-05-19

To describe delivery of child health services in Australian Aboriginal communities, and to identify gaps in services required to improve the health of Aboriginal children. Cross-sectional baseline audit for a quality improvement intervention. 297 children aged at least 3 months and under 5 years in 11 Aboriginal communities in the Northern Territory, Far West New South Wales and Western Australia in 2006. Adherence to guideline-scheduled services including clinical examinations, brief interventions or advice on health-related behaviour and risks, and enquiry regarding social conditions; and recorded follow-up of identified problems. Documentation of delivery of specific clinical examinations (26%-80%) was relatively good, but was poorer for brief interventions or advice on health-related behaviour and risks (5%-36%) and enquiry regarding social conditions (3%-11%). Compared with children in Far West NSW and WA, those attending NT centres were significantly more likely to have a record of growth faltering, underweight, chronic ear disease, anaemia, or chronic respiratory disease (P < 0.005). Only 11%-13% of children with identified social problems had an assessment report on file. An action plan was documented for 22% of children with growth faltering and 13% with chronic ear disease; 43% of children with chronic respiratory disease and 31% with developmental delay had an assessment report on file. Existing systems are not providing for adequate follow-up of identified medical and social problems for children living in remote Aboriginal communities; development of systems for immediate and longer-term sustainable responses to these problems should be a priority. Without effective systems for follow-up, screening children for disease and adverse social circumstances will result in little or no benefit.

Seroprevalence of Coxiella burnetii in Australian dogs.

PubMed

Shapiro, A J; Norris, J M; Heller, J; Brown, G; Malik, R; Bosward, K L

2016-09-01

The role of dogs in the transmission of Coxiella burnetii to humans is uncertain, and extensive seroprevalence studies of dogs have not been previously conducted in Australia. This study determined C. burnetii exposure in four diverse canine subpopulations by adapting, verifying and comparing an indirect immunofluoresence assay (IFA) and an enzyme-linked immunosorbent assay (ELISA) used to detect anti-C. burnetii antibodies in humans. Canine serum samples (n = 1223) were tested with IFA from four subpopulations [breeding establishments; household pets; free-roaming dogs in Aboriginal communities; shelter dogs]. The proportions of seropositive dogs were as follows: breeding (7/309, 2.3%), household pets (10/328, 3%), Aboriginal communities (21/321, 6.5%) and shelters (5/265, 1.9%). Dogs from Aboriginal communities were 2.8 times (CI 1.5-5.1; P < 0.001) more likely to be seropositive than dogs from other populations. The ELISA was used on 86 of 1223 sera tested with IFA, and a Cohen's Kappa coefficient of 0.60 (CI 0.43-0.78) indicated good agreement between the two assays. This study has established that Australian dogs within all four subpopulations have been exposed to C. burnetii and that a higher seroprevalence was observed amongst free-roaming dogs associated with Aboriginal communities. As C. burnetii recrudesces during pregnancy and birth products contain the highest concentration of organism, individuals assisting at the time of parturition, those handling pups shortly after birth as well as those residing in the vicinity of whelping dogs are potentially at risk of developing Q fever. However, the identification of active antigen shed in excreta from seropositive dogs is required in order to accurately define and quantify the public health risk. © 2016 Blackwell Verlag GmbH.

Improving palliative care outcomes for Aboriginal Australians: service providers’ perspectives

PubMed Central

2013-01-01

Background Aboriginal Australians have a lower rate of utilisation of palliative care services than the general population. This study aimed to explore care providers’ experiences and concerns in providing palliative care for Aboriginal people, and to identify opportunities for overcoming gaps in understanding between them and their Aboriginal patients and families. Methods In-depth, qualitative interviews with urban, rural and remote palliative care providers were undertaken in inpatient and community settings in Western Australia. Interviews were audio-recorded, transcribed verbatim and coded independently by two researchers with QSR NVivo 10 software used to help manage data. Data analysis was informed by multiple theoretical standpoints, including the social ecological model, critical cultural theories and the ‘cultural security’ framework. Thematic analysis was carried out that identified patterns within data. Results Fifteen palliative care providers were interviewed. Overall they reported lack of understanding of Aboriginal culture and being uncertain of the needs and priorities of Aboriginal people during end-of-life care. According to several participants, very few Aboriginal people had an understanding of palliative care. Managing issues such as anger, denial, the need for non-medical support due to socioeconomic disadvantage, and dealing with crises and conflicts over funeral arrangements were reported as some of the tensions between Aboriginal patients and families and the service providers. Conclusion Early referral to palliative care is important in demonstrating and maintaining a caring therapeutic relationship. Paramount to meeting the needs for Aboriginal patients was access to appropriate information and logistical, psychological and emotional support. These were often seen as essential but additional to standard palliative care services. The broader context of Aboriginal history and historical distrust of mainstream services was seen to impinge on Aboriginal people’s willingness and ability to accept care and support from these services. This context needs to be understood and acknowledged at the system level. More cultural safety training was requested by care providers but it was not seen as replacing the need for an Aboriginal worker in the palliative care team. PMID:23875957

Seroepidemiology of hepatitis A, B, C, and E viruses infection among preschool children in Taiwan.

PubMed

Lin, Jye-Bin; Lin, Ding-Bang; Chen, Shiuan-Chih; Chen, Pao-San; Chen, Wen-Kang

2006-01-01

Taiwan was a hyperendemic area for hepatitis A and B viruses (HAV and HBV) infection before late 1980s. To study the seroprevalence of hepatitis A, B, C, and E viruses (HCV and HEV) infection among preschool children in Taiwan, a community-based survey was carried out in 54 kindergartens in 10 urban areas, 10 rural areas, and 2 aboriginal areas randomly selected through stratified sampling. Serum specimens of 2,538 preschool children were screened for the hepatitis A, C, and E antibodies by a commercially available enzyme immunoassay and for HBV markers by radioimmunoassay methods. The multivariate-adjusted odd ratios (OR) with their 95% confidence intervals (CI) were estimated through the multiple logistic regression analysis. Females had a statistically significantly higher HAV seroprevalence than males. The seroprevalence of HCV infection increased significantly with age. The larger the sibship size, the higher the seroprevalence of HBV infection. Aboriginal children had a significantly higher seroprevalence of HBV and HEV infection and lower seroprevalence of HCV infection than non-aboriginal children. A significantly higher seroprevalence of HBV infection was found in rural children than urban children. There was no significant association between serostatus of HAV and HEV infection and between serostatus of HBV and HCV infection among preschool children in Taiwan. The poor environmental and hygienic conditions in the aboriginal areas might play a role in infection with HBV and HEV.

Implementing evidence-based continuous quality improvement strategies in an urban Aboriginal Community Controlled Health Service in South East Queensland: a best practice implementation pilot.

PubMed

Hogg, Sandra; Roe, Yvette; Mills, Richard

2017-01-01

The Institute for Urban Indigenous Health believes that continuous quality improvement (CQI) contributes to the delivery of high-quality care, thereby improving health outcomes for Aboriginal and Torres Strait Islander people. The opening of a new health service in 2015 provided an opportunity to implement best practice CQI strategies and apply them to a regional influenza vaccination campaign. The aim of this project was to implement an evidence-based CQI process within one Aboriginal Community Controlled Health Service in South East Queensland and use staff engagement as a measure of success. A CQI tool was selected from the Joanna Briggs Institute Practical Application of Clinical Evidence System (PACES) to be implemented in the study site. The study site was a newly established Aboriginal and Torres Strait Islander Community Controlled Health Service located in the northern suburbs of Brisbane. This project used the evidence-based information collected in PACES to develop a set of questions related to known variables resulting in proven CQI uptake. A pre implementation clinical audit, education and self-directed learning, using the Plan Do Study Act framework, included a total of seven staff and was conducted in April 2015. A post implementation audit was conducted in July 2015. There were a total of 11 pre- and post-survey respondents which included representation from most of the clinical team and medical administration. The results of the pre implementation audit identified a number of possible areas to improve engagement with the CQI process including staff training and support, understanding CQI and its impacts on individual work areas, understanding clinical data extraction, clinical indicator benchmarking, strong internal leadership and having an external data extractor. There were improvements to all audit criteria in the post-survey, for example, knowledge regarding the importance of CQI activity, attendance at education and training sessions on CQI, active involvement with CQI activity and a multidisciplinary team approach to problem solving within the CQI process. The study found that the implementation of regular, formally organized CQI strategies does have an immediate impact on clinical practice, in this case, by increasing staff awareness regarding the uptake of influenza vaccination against regional targets. The Plan Do Study Act cycle is an efficient tool to record and monitor the change and to guide discussions. For the CQI process to be effective, continued education and training on data interpretation is pivotal to improve staff confidence to engage in regular data discussions, and this should be incorporated into all future CQI sessions.

Aboriginal Health Care and Bioethics: A Reflection on the Teaching of the Seven Grandfathers.

PubMed

Kotalik, Jaro; Martin, Gerry

2016-05-01

Contemporary bioethics recognizes the importance of the culture in shaping ethical issues, yet in practice, a process for ethical analysis and decision making is rarely adjusted to the culture and ethnicity of involved parties. This is of a particular concern in a health care system that is caring for a growing Aboriginal population. We raise the possibility of constructing a bioethics grounded in traditional Aboriginal knowledge. As an example of an element of traditional knowledge that contains strong ethical guidance, we present the story of the Gifts of the Seven Grandfathers. We note a resemblance of this Ojibway teaching to virtue ethics in European traditions, but we suggest that there are also important differences in how these two traditions are currently presented. We hope that further engagement with a variety of indigenous moral teachings and traditions could improve health care involving Aboriginal patients and communities, and enrich the discipline of bioethics.

A Journey Toward Cultural Competence: The Role of Researcher Reflexivity in Indigenous Research.

PubMed

Nilson, Caroline

2017-03-01

This article highlights the personal journey of reflective development that a non-Aboriginal White researcher and health professional underwent to be "fully positioned" in the everyday lives of a rural Australian Aboriginal community in Western Australia. The article explains the researcher's personal development in areas important to building respect, building relationships, and ensuring reciprocity while undertaking Aboriginal research. The researcher reports on the reflective evaluation of her worldview. Understanding that judgment is a natural tendency, the researcher used reflexivity as a tool to examine and contextualize her judgments, presumptions, and preconceptions, which positioned her to be open to differing viewpoints and actively explore alternate perspectives. The researcher explores her evolutionary understanding that cultural competence is not a destination but a continual journey, and she details her knowledge development regarding the Aboriginal research paradigm, which requires that all the learning, sharing, and growth taking place is reciprocal and engages all parties actively.

Culture Matters. Community Report. Reporting on a Research Project To Explore Factors Affecting the Outcomes of Vocational Education and Training for Aboriginal and Torres Straits Islander People.

ERIC Educational Resources Information Center

Buchanan, Matthew; Egg, Mez

The factors leading to positive outcomes in vocational education and training (VET) for Aboriginal and Torres Strait Islander people were examined through person-to-person and telephone interviews with indigenous Australian students and VET providers. The interviews focused on the following: the range of VET provision and the extent of its…

Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach.

PubMed

Dawson, Anna P; Cargo, Margaret; Stewart, Harold; Chong, Alwin; Daniel, Mark

2013-02-01

Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted individuals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs.

Diet survey of two cultural groups in a coastal British Columbia community.

PubMed

Jin, A; Teschke, K; Marion, S A

1998-01-01

As part of a larger study of polychlorinated dibenzodioxin (PCDD) and dibenzofuran (PCDF) pollution, to describe and compare Aboriginal and non-Aboriginal residents' recalled diets. We surveyed a stratified random sample aged 25 to 64 years: forest products mill employees (n = 84), Aboriginal reserve residents (n = 78), and other residents (n = 80). We administered a questionnaire on intake of fish/seafood, wild game and plants, domesticated animal meat and eggs, dairy products, vegetable oils and cereals; age, gender, childbearing, lactation, residence and smoking. We measured height and weight. Reserve residents ate less seafood, but more fish roe, eulachon grease, smoked salmon, clams and sea urchins, more deer organs, hamburger meat, pork, fried chicken, and hot-dogs, but less rabbit, beef steaks/roasts, high-fibre cereals, potato chips, bread, cheese and milk. We cannot yet quantify PCDD and PCDF intakes. The wild food consumption data are unique and may be useful for risk assessments in the target population and similar communities.

Coronary heart disease events in Aboriginal Australians: incidence in an urban population.

PubMed

Bradshaw, Pamela J; Alfonso, Helman S; Finn, Judith C; Owen, Julie; Thompson, Peter L

2009-05-18

To determine the incidence of coronary heart disease (CHD) events in an urban Aboriginal population. Cohort study of 906 Aboriginal people without CHD from 998 who had undergone risk-factor assessment in the Perth Aboriginal Atherosclerosis Risk Study (PAARS) in 1998-1999. PAARS cohort data were electronically linked to a range of databases that included Western Australian hospital morbidity data and death registry data. We analysed data from January 1980 to December 2006 to identify previous admissions for CHD from 1980 to baseline (1998-1999) and new events from baseline to 2006. First CHD event (hospital admission or death). There were 891 linked records for the 906 participants without previous CHD. The event rate was 12.6/1000 person-years (95% CI, 10.2-15.6/1000 person-years). Annual CHD event rates ranged from 8 to 18/1000 person-years. After adjustment for age (sex was not associated with the risk factors assessed), factors associated with risk of a CHD event in the PAARS cohort were a history of diabetes, overweight or obesity (indicated by body mass index), smoking, and hypertension, but not waist circumference. People with these risk factors were 1.9-2.7 times more likely to experience a CHD event. Compared with previously published information from a remote Aboriginal community in the Northern Territory, the incidence of CHD events among urban-dwelling Aboriginal people was not significantly different (P > 0.05 overall and for subgroups defined by age and sex). City-dwelling Aboriginal Australians have an incidence of CHD events comparable to that of Aboriginal people living in remote northern Australia.

Time to bring down the twin towers in poor Aboriginal hospital care: addressing institutional racism and misunderstandings in communication.

PubMed

Durey, A; Thompson, S C; Wood, M

2012-01-01

Improvements in Aboriginal health have been slow. Research demonstrates ongoing discrimination towards Aboriginal Australians based on race, including in health services, leads to poor health outcomes. Using an eclectic methodology based on observations and discussions with health practitioners experienced in working with Aboriginal patients, this paper identifies how cross-cultural misunderstandings undermine the quality of care to Aboriginal patients in hospital and offers suggestions for improving practice. It also explores the concept of institutional racism and challenges doctors to reflect on their role in perpetuating power imbalances. We argue that physicians and healthcare providers need to do more than just deliver evidence-based interventions, by critically reflecting on their own attitudes to and practices with Aboriginal Australians and work collectively to effect systemic change which creates a more inclusive and safe environment for all people accessing healthcare. © 2011 The Authors. Internal Medicine Journal © 2011 Royal Australasian College of Physicians.

Bush tucker, shop tucker: production, consumption, and diet at an Aboriginal outstation.

PubMed

Scelza, Brooke A; Bird, Douglas W; Bird, Rebecca Bliege

2014-01-01

Foraging models have rarely been used to address how behavior is altered by the presence of non-foraged foods. Here, choices of store-bought and hunted foods in one Aboriginal community are analyzed. Hunting occurs frequently, but community residents also purchase food from the shop. Increases in the frequency of hunting certain large and small prey are associated with reduced access to food in the shop. Higher-variance hunt types are not associated with shop purchases, but continue to be acquired due to their cultural significance. The variation in these results highlights the complexity of dietary behavior in a mixed economy.

Intellectual disability in young people in custody in New South Wales, Australia - prevalence and markers.

PubMed

Haysom, L; Indig, D; Moore, E; Gaskin, C

2014-11-01

Intellectual disability (ID) is known to be more common in incarcerated groups, especially incarcerated youth. Aboriginal young people have higher rates of ID, and make up half of all youth in juvenile custody in New South Wales (NSW), Australia. We aimed to describe the prevalence of possible ID and borderline intellectual functioning (BIF) in young people in NSW custody, and to describe the association between possible ID and Aboriginality after adjusting for the inequalities in social disadvantage. Baseline study of all youth in NSW Custodial Centres between August and October 2009, with 18-month follow-up. Using Wechsler Intelligence Scale for Children - Fourth Edition (WISC-IV) and Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) cognitive assessments, possible ID was defined as Extremely Low Intellectual Quotient range (Full Scale Intellectual Quotient, FSIQ < 70), and possible BIF was defined as Borderline IQ range (FSIQ < 80). Risk factors for possible ID and BIF included age, gender, Aboriginality, socio-economic disadvantage, offending history and psychological disorders. N = 295 (65%) of all young people in NSW custody completed cognitive and psychological assessments (87% male, 50% Aboriginal, average age 17 years). Almost one half (45.8%) of young people had borderline or lower intellectual functioning (by IQ assessment), and 14% had an IQ in the extremely low range (FSIQ < 70), indicating a possible ID. Aboriginal participants were three times more likely than non-Aboriginal participants to have a possible ID, but after accounting for the excess disadvantage in the Aboriginal group, Aboriginality was no longer a marker of ID. Incarceration from a young age and psychosis were significantly associated with possible ID in Aboriginal participants, compared with Aboriginal participants first incarcerated at a later age, and Aboriginal participants without psychosis. The inequalities in criminal justice between Aboriginal and non-Aboriginal youth may exacerbate or contribute to the intellectual impairment of those incarcerated from a young age. Aboriginal young people with psychosis are also at high risk of cognitive impairments that might indicate a possible co-morbid ID, and these patients should be diverted at court into community assessment services, rather than incarcerated. These results highlight a need for better and earlier identification of young people (particularly Aboriginal youth) at risk of ID and other co-morbidities in the juvenile justice system. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Hospitalizations due to unintentional transport injuries among Aboriginal population of British Columbia, Canada: Incidence, changes over time and ecological analysis of risk markers

PubMed Central

George, M. Anne; Jin, Andrew; Amram, Ofer; McCormick, Rod; Lalonde, Christopher E.

2018-01-01

Background Worldwide, Indigenous people have disproportionately higher rates of transport injuries. We examined disparities in injury-related hospitalizations resulting from transport incidents for three population groups in British Columbia (BC): total population, Aboriginal off-reserve, and Aboriginal on-reserve populations. We also examined sociodemographic, geographic and ethnic risk markers for disparities. Methods We identified Aboriginal people through BC’s universal health care insurance plan insurance premium group and birth and death record notations. We calculated crude incidence rate and Standardized Relative Risk (SRR) of hospitalization for unintentional transport injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with SRR of transport injury by multivariable linear regression. Results During the period 1991–2010, the SRR for the off-reserve Aboriginal population was 1.77 (95% CI: 1.71 to 1.83); and 2.00 (95% CI: 1.93 to 2.07) among those living on-reserve. Decline in crude rate and SRRs was observed over this period among both the Aboriginal and total populations of BC, but was proportionally greater among the Aboriginal population. The best-fitting multivariable risk marker model was an excellent fit (R2 = 0.912, p<0.001), predicted SRRs very close to observed values, and retained the following terms: urban residence, population per room, proportion of the population with a high school certificate, proportion of the population employed; and multiplicative interactions of Aboriginal ethnicity with population per room and proportion of the population employed. Conclusions Disparities in risk of hospitalization due to unintentional transport injury have narrowed. Aboriginal ethnicity modifies the effects of socioeconomic risk factors. Continued improvement of socioeconomic conditions and implementation of culturally relevant injury prevention interventions are needed. PMID:29373595

Hospitalizations due to unintentional transport injuries among Aboriginal population of British Columbia, Canada: Incidence, changes over time and ecological analysis of risk markers.

PubMed

Brussoni, Mariana; George, M Anne; Jin, Andrew; Amram, Ofer; McCormick, Rod; Lalonde, Christopher E

2018-01-01

Worldwide, Indigenous people have disproportionately higher rates of transport injuries. We examined disparities in injury-related hospitalizations resulting from transport incidents for three population groups in British Columbia (BC): total population, Aboriginal off-reserve, and Aboriginal on-reserve populations. We also examined sociodemographic, geographic and ethnic risk markers for disparities. We identified Aboriginal people through BC's universal health care insurance plan insurance premium group and birth and death record notations. We calculated crude incidence rate and Standardized Relative Risk (SRR) of hospitalization for unintentional transport injury, standardized for age, gender and Health Service Delivery Area (HSDA), relative to the total population of BC. We tested hypothesized associations of geographic, socio-economic, and employment-related characteristics of Aboriginal communities with SRR of transport injury by multivariable linear regression. During the period 1991-2010, the SRR for the off-reserve Aboriginal population was 1.77 (95% CI: 1.71 to 1.83); and 2.00 (95% CI: 1.93 to 2.07) among those living on-reserve. Decline in crude rate and SRRs was observed over this period among both the Aboriginal and total populations of BC, but was proportionally greater among the Aboriginal population. The best-fitting multivariable risk marker model was an excellent fit (R2 = 0.912, p<0.001), predicted SRRs very close to observed values, and retained the following terms: urban residence, population per room, proportion of the population with a high school certificate, proportion of the population employed; and multiplicative interactions of Aboriginal ethnicity with population per room and proportion of the population employed. Disparities in risk of hospitalization due to unintentional transport injury have narrowed. Aboriginal ethnicity modifies the effects of socioeconomic risk factors. Continued improvement of socioeconomic conditions and implementation of culturally relevant injury prevention interventions are needed.

Measuring organisational-level Aboriginal cultural climate to tailor cultural safety strategies.

PubMed

Gladman, Justin; Ryder, Courtney; Walters, Lucie K

2015-01-01

Australian medical schools have taken on a social accountability mandate to provide culturally safe contexts in order to encourage Aboriginal and Torres Strait Islander people to engage in medical education and to ensure that present and future clinicians provide health services that contribute to improving the health outcomes of Aboriginal and Torres Strait Islander peoples. Many programs have sought to improve cultural safety through training at an individual level; however, it is well recognised that learners tend to internalise the patterns of behaviour to which they are commonly exposed. This project aimed to measure and reflect on the cultural climate of an Australian rural clinical school (RCS) as a whole and the collective attitudes of three different professional groups: clinicians, clinical academics and professional staff. The project then drew on Mezirow's Transformative Learning theory to design strategies to build on the cultural safety of the organisation. Clinicians, academic and professional staff at an Australian RCS were invited to participate in an online survey expressing their views on Aboriginal health using part of a previously validated tool. Survey response rate was 63%. All three groups saw Aboriginal health as a social priority. All groups recognised the fundamental role of community control in Aboriginal health; however, clinical academics were considerably more likely to disagree that the Western medical model suited the health needs of Aboriginal people. Clinicians were more likely to perceive that they treated Aboriginal patients the same as other patients. There was only weak evidence of future commitments to Aboriginal health. Importantly, clinicians, academics and professional staff demonstrated differences in their cultural safety profile which indicated the need for a tailored approach to cultural safety learning in the future. Through tailored approaches to cross-cultural training opportunities we are likely to ensure participants are able to engage with the material and reflect upon implications of a challenging cultural climate on the health and wellbeing outcomes of Aboriginal people.

Assisting an Australian Aboriginal and Torres Strait Islander person with gambling problems: a Delphi study.

PubMed

Bond, Kathy S; Dart, Katrina M; Jorm, Anthony F; Kelly, Claire M; Kitchener, Betty A; Reavley, Nicola J

2017-08-02

Gambling problems appear to be more prevalent in the Australian Aboriginal and Torres Strait Islander population than in the non-Indigenous population. Although gambling harms can be significant, treatment-seeking rates are low. The Delphi expert consensus method was used to develop a set of guidelines on how a family or community member can assist an Aboriginal or Torres Strait Islander person with gambling problems. Building on a previous systematic review of websites, books and journal articles a questionnaire was developed that contained items about the knowledge, skills and actions needed for supporting an Aboriginal or Torres Strait Islander person with gambling problems. These items were rated over three rounds by an expert panel comprising professionals who provide treatment to or conduct research with Aboriginal and Torres Strait Islander people with gambling problems. A total of 22 experts rated 407 helping statements according to whether they thought the statements should be included in these guidelines. There were 225 helping statements that were endorsed by at least 90% of participants. These endorsed statements were used to develop the guidelines. Experts were able to reach substantial consensus on how someone can recognise the signs of gambling problems and support an Aboriginal or Torres Strait Islander person to change.

Managing confidentiality in illicit drugs research: ethical and legal lessons from studies in remote Aboriginal communities.

PubMed

Clough, A; Conigrave, K

2008-01-01

Assuring participant confidentiality in illicit drugs research has raised legal questions and challenges both for researchers and ethics committees. There are similar challenges for clinicians. To study cannabis use in Aboriginal people in Arnhem Land (Northern Territory), a risk-management approach was successful. Aboriginal participants were informed in their own language that confidentiality could not be assured if they disclosed information about illegal behaviours. Researchers avoided questions of intrinsic interest to law enforcement. Relationships between researchers and study participants and the integrity of the study were preserved. These considerations have relevance for clinicians as well as researchers dealing with the influence of illicit behaviours on health.

Impact of swimming on chronic suppurative otitis media in Aboriginal children: a randomised controlled trial.

PubMed

Stephen, Anna T N; Leach, Amanda J; Morris, Peter S

2013-07-08

To measure the impact of 4 weeks of daily swimming on rates of ear discharge among Aboriginal children with a tympanic membrane perforation (TMP) and on the microbiology of the nasopharynx and middle ear. A randomised controlled trial involving 89 Aboriginal children (aged 5-12 2013s) with a TMP, conducted in two remote Northern Territory Aboriginal communities from August to December 2009. 4 school weeks of daily swimming lessons (45 minutes) in a chlorinated pool. Proportions of children with ear discharge and respiratory and opportunistic bacteria in the nasopharynx and middle ear. Of 89 children randomly assigned to the swimming or non-swimming groups, 58 (26/41 swimmers and 32/48 non-swimmers) had ear discharge at baseline. After 4 weeks, 24 of 41 swimmers had ear discharge compared with 32 of 48 non-swimmers (risk difference, - 8% (95% CI, - 28% to 12%). There were no statistically significant changes in the microbiology of the nasopharynx or middle ear in swimmers or non-swimmers. Streptococcus pneumoniae and non-typeable Haemophilus influenzae were the dominant organisms cultured from the nasopharynx, and H. influenzae, Staphylococcus aureus and Pseudomonas aeruginosa were the dominant organisms in the middle ear. Swimming lessons for Aboriginal children in remote communities should be supported, but it is unlikely that they will substantially reduce rates of chronic suppurative otitis media and associated bacteria in the nasopharynx and middle ear. However, swimming was not associated with increased risk of ear discharge and we found no reason to discourage it. Australian New Zealand Clinical Trials Registry ACTRN12613000634774.

[Thermoacidophilic micirobial community oxidizing the gold-bearing flotation concentrate of a pyrite-arsenopyrite ore].

PubMed

Paniushkina, A E; Tsaplina, I A; Grigor'eva, N V; Kondrat'eva, T F

2014-01-01

An aboriginal community of thermophilic acidophilic chemolithotrophic microorganisms (ACM) was isolated from a sample of pyrite gold-bearing flotation concentrateat 45-47 degrees C and pH 1.8-2.0. Compared to an experimental thermoacidophilic microbial consortium formed in the course of cultivation in parallel bioreactors, it had lower rates of iron leaching and oxidation, while its rate of sulfur oxidation was higher. A new thermophilic acidophilic microbial community was obtained by mutual enrichment with the micioorganisms from thie experimental and aboriginal communities during oxidation of sulfide ore flotation concentrate at 47 degrees C. The dominant bacteria of this new ACM community were Acidithiobacillus caldus strains (the most active sulfur oxidizers) and Sulfobacillus thermotolerans strains (active oxidizers of both iron and sulfur), while iron-oxidizing archaea of the family Ferroplasmaceae and heterotrophic bacteria Alicyclobacillus tolerans were the minor components. The new ACM community showed promise for leaching/oxidation of sulfides from flotation concentrates at high pulp density (S:L = 1:4).

Application of classification tree and logistic regression for the management and health intervention plans in a community-based study.

PubMed

Teng, Ju-Hsi; Lin, Kuan-Chia; Ho, Bin-Shenq

2007-10-01

A community-based aboriginal study was conducted and analysed to explore the application of classification tree and logistic regression. A total of 1066 aboriginal residents in Yilan County were screened during 2003-2004. The independent variables include demographic characteristics, physical examinations, geographic location, health behaviours, dietary habits and family hereditary diseases history. Risk factors of cardiovascular diseases were selected as the dependent variables in further analysis. The completion rate for heath interview is 88.9%. The classification tree results find that if body mass index is higher than 25.72 kg m(-2) and the age is above 51 years, the predicted probability for number of cardiovascular risk factors > or =3 is 73.6% and the population is 322. If body mass index is higher than 26.35 kg m(-2) and geographical latitude of the village is lower than 24 degrees 22.8', the predicted probability for number of cardiovascular risk factors > or =4 is 60.8% and the population is 74. As the logistic regression results indicate that body mass index, drinking habit and menopause are the top three significant independent variables. The classification tree model specifically shows the discrimination paths and interactions between the risk groups. The logistic regression model presents and analyses the statistical independent factors of cardiovascular risks. Applying both models to specific situations will provide a different angle for the design and management of future health intervention plans after community-based study.

"We Learn A Lot from Mr. Hart": A Qualitative Study of an Effective Teacher of Aboriginal Students.

ERIC Educational Resources Information Center

Harslett, Mort; Godfrey, John; Harrison, Bernard; Partington, Gary; Richer, Kaye

A profile of an effective teacher of Aboriginal Australian students was constructed based on research on the teaching of Aboriginal students. Using the profile as a framework, this paper reports on an ethnographic study of an effective teacher in action with Aboriginal students. The study consisted of semi-participative observation of a teacher of…

Progress Towards IYA2009 in Canada

NASA Astrophysics Data System (ADS)

Hesser, James E.; Canada Committee, IYA

2007-12-01

We want Canadians to reconnect with the night sky through seven themes identified for national focus during IYA. Our overarching goal is to offer an engaging astronomy experience to every Canadian, with special efforts towards young people. Our partnership between the Canadian Astronomical Society, the Fédération des Astronomes Amateurs du Québec and the Royal Astronomical Society of Canada is bolstered by diverse national collaborators, e.g., planetarium and science centre communities, a national broadcaster, Canada's Aboriginal communities, the National Research Council and the Canadian Space Agency. Canada's amateur astronomers are committing magnificently to IYA and will be key to meeting our ambitious vision. We describe our themes, as well as progress towards their realization. Our vision involves many elements in common with U.S. plans, with mutual benefits arising from good liaison between the AAS and Canadian Committees. Naturally, our team is addressing responsibilities and opportunities unique to Canada. Our efforts are led by volunteers. Through programmes that create a legacy, we seek strong impact beyond 2009. We are providing activities accessible in both French and English, and are striving to leverage and strengthen existing outreach efforts wherever possible (thus avoiding reinventing the wheel and maximizing the impact of our limited resources). We are encouraging individuals to take local initiative, and are offering them moral support within the national context provided by our steering committee, as well as within the context provided by the IAU. Among examples that are described are strong efforts to involve Canada's Aboriginals, musical and arts organizations, etc., as well as our efforts to secure national exposure through, e.g., a series of postal stamps.

Insights from a national study.

PubMed

Kulig, Judith C; Stewart, Norma J; Morgan, Debra; Andrews, Mary Ellen; MacLeod, Martha L P; Pitblado, J Roger

2006-04-01

Aboriginal registered nurses have been identified as an essential group in the delivery of health services in First Nations communities. Despite this, there is a lack of information about this group of nurses in Canada. This article presents information about this group taken from two components of a national study, The Nature of Nursing Practice in Rural and Remote Canada: documentary analysis and a national survey of nurses. The aboriginal nurse participants were predominantly female, between the ages of 40 and 49, diploma prepared and with licensure for less than 10 years. The survey data showed 41.4 per cent returned to their home communities to work. The participants noted how they enjoyed the challenges of rural and remote nursing and wanted to raise their families in these small communities. They have been able to create supportive work environments, particularly with their nursing colleagues. The nurses are committed to working in rural and remote communities.

The experience of collective trauma in Australian Indigenous communities.

PubMed

Krieg, Anthea

2009-08-01

The concept of collective trauma has predominantly been applied in the context of natural and human disasters. This paper seeks to explore whether collective trauma offers a respectful way in which to explore and respond to mental health and wellbeing issues for Aboriginal families and communities. A review of the international literature was undertaken in order to determine the elements of collective and mass trauma studies which may have relevance for Indigenous communities in Australia. Findings support the proposition that the patterns of human responses to disasters, particularly in protracted traumas such as war-zones, shows strong parallels to the contemporary patterns of experience and responses articulated by Aboriginal people affected by colonization and its sequelae in Australia. Adopting evidence-informed principles of family and community healing developed internationally in disaster situations may provide helpful ways of conceptualizing and responding in a coordinated way to mental health and wellbeing issues for Indigenous people within Australia.

Community College-Community Relationships and Civic Accountability.

ERIC Educational Resources Information Center

Gillet-Karam, Rosemary

1996-01-01

Provides a review of issues involved in interactions between community colleges and their communities, discussing community-based education and services, strategic planning, and community-based programming. Presents examples of current college-community collaborations to illustrate civic accountability. Suggests that these collaborations place…

What Is All That Learning for? Indigenous Adult English Literacy Practices, Training, Community Capacity and Health

ERIC Educational Resources Information Center

Kral, Inge; Falk, Ian

2004-01-01

In remote Indigenous communities in Australia there are minimal labour market opportunities, with the majority of jobs under the Community Development Employment Projects (CDEP), and limited education and training services. Yet Indigenous communities are under increasing pressure from the Aboriginal and Torres Strait Islander Commission (ATSIC)…

Otitis Media, Learning and Community.

ERIC Educational Resources Information Center

McSwan, David; Clinch, Emma; Store, Ron

2001-01-01

A 3-year research project in Queensland (Australia) implemented educational and health strategies to ameliorate effects of otitis media at three schools in remote Aboriginal communities. The interdisciplinary model brought together health and education professionals, teacher aides, and the community, with the school being the lead agency. However,…

Prevalence and determinants of biochemical dysfunction of the liver in Atayal Aboriginal community of Taiwan: Is betel nut chewing a risk factor?

PubMed Central

Lin, Ching-Feng; Shiau, Tun-Jen; Ko, Ying-Chin; Chen, Ping-Ho; Wang, Jung-Der

2008-01-01

Background We address the independent and interactive roles of habitual betel quid chewing and other known risk factors for biochemical dysfunction and cirrhosis of the liver. Methods To determine the prevalence rates and risk factors associated with biochemical dysfunction of the liver, a total of 3,010 adult residents in an Atayal Aboriginal community were invited to participate in the study. Abdominal ultrasonography was used to diagnose liver cirrhosis. Results There were 2,063 Atayal Aboriginal and 947 non-Aboriginal in this study. The result showed overall prevalence rates for hepatitis B surface antigen (HBsAg) and hepatitis C virus (HCV) were 21.2 % and 2.9 %, respectively. There were 16.5 %, 15.1 % and 22.4 % subjects with abnormal alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma glutamyl transpeptidase (GGT), accordingly. Multiple logistic regression analysis showed that combined infections with HBV and HCV presented with the highest risks with OR (odds ratio) and 95% CI (confidence interval) of 4.2 (1.2–17.4) and 3.8 (1.0–14.1), respectively for elevation of ALT and AST; followed by alcohol (1.7 and 3.1), male gender (1.7 and 1.6), betel quid (1.5 and 1.3), smoking (1.4 and 1.8), and aboriginal (1.4 and 1.3). There is effect-measure modification between viral infection and betel quid chewing for increased severity of abnormal ALT elevation. Among 1,382 subjects consenting to abdominal ultrasonography, 41(3.0%) were found to have liver cirrhosis with the same factors associated with higher risks. Conclusion In addition to infections with viral hepatitis B and/or C, we found Atayal Aboriginal, males, current smokers, drinkers and betel quid chewers were independently associated with biochemical dysfunction and probably cirrhosis of the liver. Further study is needed to corroborate the above hypothesis. PMID:18439308

Australian engineering educators' attitudes towards Aboriginal cultures and perspectives

NASA Astrophysics Data System (ADS)

Goldfinch, Thomas; Prpic, Juliana Kaya; Jolly, Lesley; Leigh, Elyssebeth; Kennedy, Jade

2017-07-01

In Australia, representation of Aboriginal populations within the engineering profession is very low despite participation targets set by Government departments, professional bodies and Universities. Progressing the Aboriginal inclusion agenda within Australian Engineering Education requires a clearer understanding of engineering educators' preparedness for increased numbers of students from this non-traditional cohort. This research stems from a recently completed project that explored Aboriginal perspectives in engineering education and proposed a model for embedding perspectives in curricula. Nine engineering academics were interviewed to explore attitudes towards Aboriginal perspectives in engineering and the viability of the proposed model. Results of the interviews indicate efforts to embed Aboriginal perspectives are starting from a small base of knowledge and experience. Individuals' motivations and values indicate that there is significant support for improving this, but that efforts can be hampered by conceptions of Aboriginal perspectives that do not consider how Aboriginal knowledges may change engineering itself.

Working at the interface in Aboriginal and Torres Strait Islander health: focussing on the individual health professional and their organisation as a means to address health equity.

PubMed

Wilson, Annabelle M; Kelly, Janet; Magarey, Anthea; Jones, Michelle; Mackean, Tamara

2016-11-17

Aboriginal and Torres Strait Islander people experience inequity in health outcomes in Australia. Health care interactions are an important starting place to seek to address this inequity. The majority of health professionals in Australia do not identify as Aboriginal and/or Torres Strait Islander people and the health care interaction therefore becomes an example of working in an intercultural space (or interface). It is therefore critical to consider how health professionals may maximise the positive impact within the health care interaction by skilfully working at the interface. Thirty-five health professionals working in South Australia were interviewed about their experiences working with Aboriginal people. Recruitment was through purposive sampling. The research was guided by the National Health and Medical Research Council Values and Ethics for undertaking research with Aboriginal communities. Critical social research was used to analyse data. Interviews revealed two main types of factors influencing the experience of non-Aboriginal health professionals working with Aboriginal people at the interface: the organisation and the individual. Within these two factors, a number of sub-factors were found to be important including organisational culture, organisational support, accessibility of health services and responding to expectations of the wider health system (organisation) and personal ideology and awareness of colonisation (individual). A health professional's practice at the interface cannot be considered in isolation from individual and organisational contexts. It is critical to consider how the organisational and individual factors identified in this research will be addressed in health professional training and practice, in order to maximise the ability of health professionals to work with Aboriginal and Torres Strait Islander people and therefore contribute to addressing health equity.

Hospital admissions for skin infections among Western Australian children and adolescents from 1996 to 2012.

PubMed

Abdalla, Tasnim; Hendrickx, David; Fathima, Parveen; Walker, Roz; Blyth, Christopher C; Carapetis, Jonathan R; Bowen, Asha C; Moore, Hannah C

2017-01-01

The objective of this study was to describe the occurrence of skin infection associated hospitalizations in children born in Western Australia (WA). We conducted a retrospective cohort study of all children born in WA between 1996 and 2012 (n = 469,589). Of these, 31,348 (6.7%) were Aboriginal and 240,237 (51.2%) were boys. We report the annual age-specific hospital admission rates by geographical location and diagnostic category. We applied log-linear regression modelling to analyse changes in temporal trends of hospitalizations. Hospitalization rates for skin infections in Aboriginal children (31.7/1000 child-years; 95% confidence interval [CI] 31.0-32.4) were 15.0 times higher (95% CI 14.5-15.5; P<0.001) than those of non-Aboriginal children (2.1/1000 child-years; 95% CI 2.0-2.1). Most admissions in Aboriginal children were due to abscess, cellulitis and scabies (84.3%), while impetigo and pyoderma were the predominant causes in non-Aboriginal children (97.7%). Admissions declined with age, with the highest rates for all skin infections observed in infants. Admissions increased with remoteness. Multiple admissions were more common in Aboriginal children. Excess admissions in Aboriginal children were observed during the wet season in the Kimberley and during summer in metropolitan areas. Our study findings show that skin infections are a significant cause of severe disease, requiring hospitalization in Western Australian children, with Aboriginal children at a particularly high risk. Improved community-level prevention of skin infections and the provision of effective primary care are crucial in reducing the burden of skin infection associated hospitalizations. The contribution of sociodemographic and environmental risk factors warrant further investigation.

Incidence of and case fatality following acute myocardial infarction in Aboriginal and non-Aboriginal Western Australians (2000-2004): a linked data study.

PubMed

Katzenellenbogen, Judith M; Sanfilippo, Frank M; Hobbs, Michael S T; Briffa, Tom G; Ridout, Steve C; Knuiman, Matthew W; Dimer, Lyn; Taylor, Kate P; Thompson, Peter L; Thompson, Sandra C

2010-12-01

Despite Coronary Heart Disease exacting a heavy toll among Aboriginal Australians, accurate estimates of its epidemiology are limited. This study compared the incidence of acute myocardial infarction (AMI) and 28-day case fatality (CF) among Aboriginal and non-Aboriginal Western Australians aged 25-74 years from 2000-2004. Incident (AMI hospital admission-free for 15 years) AMI events and 28-day CF were estimated using person-based linked hospital and mortality data. Age-standardised incidence rates and case fatality percentages were calculated by Aboriginality and sex. Of 740 Aboriginal and 6933 non-Aboriginal incident events, 208 and 2352 died within 28 days, respectively. The Aboriginal age-specific incidence rates were 27 (males) and 35 (females) times higher than non-Aboriginal rates in the 25-29 year age group, decreasing to 2-3 at 70-74 years. The male:female age-standardised incidence rate ratio was 2.2 in Aboriginal people 25-54 years compared with 4.5 in non-Aboriginal people. Aboriginal age-standardised CF percentages were 1.4 (males) and 1.1 (females) times higher at age 25-54 years and 1.5 times higher at age 55-74 years. These data suggest higher CF and, more importantly, AMI incidence contribute to the excess ischaemic heart disease mortality in Aboriginal Western Australians. The poorer cardiovascular health in Aboriginal women, particularly in younger age groups, should be investigated. Copyright © 2010 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier B.V. All rights reserved.

Improving immunisation timeliness in Aboriginal children through personalised calendars

PubMed Central

2013-01-01

Background Delayed immunisation and vaccine preventable communicable disease remains a significant health issue in Aboriginal children. Strategies to increase immunisation coverage and timeliness can be resource intensive. In a low cost initiative at the Aboriginal Medical Service Western Sydney (AMSWS) in 2008–2009, a trial of personalised calendars to prompt timely childhood immunisation was undertaken. Methods Calendars were generated during attendances for early childhood immunisations. They were designed for display in the home and included the due date of the next immunisation, a photo of the child and Aboriginal artwork. In a retrospective cohort design, Australian Childhood Immunisation Register data from AMSWS and non-AMSWS providers were used to determine the delay in immunisation and percentage of immunisations on time in those who received a calendar compared to those who did not. Interviews were undertaken with carers and staff. Results Data on 2142 immunisation doses given to 505 children were analysed, utilising pre-intervention (2005–2007) and intervention (2008–2009) periods and a 2 year post-intervention observation period. 113 calendars were distributed (30% of eligible immunisation attendances). Improvements in timeliness were seen at each schedule point for those children who received a calendar. The average delay in those who received a calendar at their previous visit was 0.6 months (95% CI -0.8 to 2.6) after the due date, compared to 3.3 months (95% CI −0.6 to 7.5) in those who did not. 80% of doses were on time in the group who received a calendar at the preceding immunisation, 66% were on time for those who received a calendar at an earlier point and 57% of doses were on time for those who did not receive a calendar (P<0.0001, Cochran-Armitage trend test). Interview data further supported the value and effectiveness of the calendars as both a prompt to timely immunisations and a community health education project without undue resource implications. Conclusions Personalised calendars can increase the timeliness of immunisations in Aboriginal children. This simple, low cost tool appears practicable and effective in an Aboriginal community setting in improving early childhood vaccination timeliness and has high potential for local adaptation to suit the needs of diverse communities. PMID:23786829

No germs on me: a social marketing campaign to promote hand-washing with soap in remote Australian Aboriginal communities.

PubMed

McDonald, Elizabeth; Slavin, Nicola; Bailie, Ross; Schobben, Xavier

2011-03-01

A social marketing campaign promoting hand-washing with soap was implemented to reduce the high burden of infection experienced by Australian Aboriginal children living in remote communities. Epidemiological evidence of effect and other evidence were used to identify the hygiene intervention and health promotion approach for the project. We drew on the findings of: (i) a systematic literature review to identify the intervention for which there is strong effect in similar populations and contexts; and (ii) a narrative literature review to determine our health promotion approach. This process provided practitioners with confidence and understanding so they could address a complex problem in a politically and otherwise sensitive context.

Planning and implementing the first stage of an oral health program for the Pika Wiya Health Service Incorporated Aboriginal community in Port Augusta, South Australia.

PubMed

Parker, Eleanor J; Misan, Gary; Richards, Lindsay C; Russell, Angela

2005-01-01

The oral health of the Indigenous community in South Australia's mid-north has been a concern for some years. There has been a history of under-utilisation of available dental services by the local community. This is in part due to the services not meeting their cultural and holistic health care needs. The Indigenous community resolved to establish a culturally sensitive dental service within the Aboriginal Health Service already operating in Port Augusta in South Australia's mid-north. To achieve this, a partnership between Pika Wiya Health Service Incorporated, the South Australian Dental Service, the University of Adelaide Dental School and the South Australian Centre for Rural and Remote Health was formed. The aim of the project partners was to establish a culturally sensitive, quality dental service that caters to the needs of the Indigenous community serviced by Pika Wiya Health Service Inc. This article describes the process of planning and implementing the first stage of this project.

Coronial Practice, Indigeneity and Suicide

PubMed Central

Tait, Gordon; Carpenter, Belinda; Jowett, Stephanie

2018-01-01

All available data suggest that, like many other Indigenous peoples, Australian Aborigines are significantly more likely to kill themselves than are non-Aboriginal Australians. This statistical disparity is normally positioned an objective, ontological and undeniable social fact, a fact best explained as a function of endemic community disadvantage and disenfranchisement. This research explores the possibility that higher-than-normal Aboriginal suicide rates may also be a function of coronial decision-making practices. Based upon in-depth interviews with 32 coroners from across Australia, the following conclusions emerged from the data. First, coroners have differing perceptions of Indigenous capacity, and are less likely to have concerns about intent when the suicide is committed by an Indigenous person. Second, coroners have identified divergent scripts of Indigenous suicide, particularly its spontaneity and public location, and this supports rather than challenges, a finding of suicide. Third, the coronial perception of Indigenous life is a factor which influences a suicide determination for Indigenous deaths. Finally, the low level of Indigenous engagement with the coronial system, and the unlikelihood of a challenge to the finding of suicide by Indigenous families, means that a coronial determination of suicide is more likely. PMID:29659514

Mental Health Among Help-Seeking Urban Women: The Relationships Between Adverse Childhood Experiences, Sexual Abuse, and Suicidality.

PubMed

Hamdullahpur, Kevin; Jacobs, Kahá Wi J; Gill, Kathryn J

2018-03-01

Adverse childhood experiences (ACEs) and adult mental health were explored in a sample of urban Aboriginal ( n = 83) and non-Aboriginal ( n = 89) women. Childhood sexual abuse (CSA) was associated with negative home environments, teenage pregnancy, lifetime suicide attempts, and treatment seeking. Aboriginal women with CSA witnessed higher levels of physical/sexual abuse of family members. The severity of current psychological distress was associated with a history of childhood neglect. The results indicate that CSA rarely occurs in isolation, and that multiple ACEs are strongly associated with suicide attempts and treatment seeking in adulthood. Future studies should focus on the role of CSA in suicidality, as well as familial, community, and cultural protective factors.

Oral health inequalities between young Aboriginal and non-Aboriginal children living in Ontario, Canada.

PubMed

Lawrence, Herenia P; Binguis, Darlene; Douglas, Jan; McKeown, Lynda; Switzer, Bonita; Figueiredo, Rafael; Reade, Margaret

2009-12-01

To investigate (i) oral health inequalities between off-reserve Aboriginal and non-Aboriginal children entering junior kindergarten (JK) in the Thunder Bay District, Northwest Ontario, Canada, (ii) oral health inequalities between kindergarten-aged (4 years old) Aboriginal children living on reserves in the Sioux Lookout Zone (SLZ), Northwest Ontario and those living off-reserve in the Thunder Bay District and (iii) early childhood caries (ECC) trends among SLZ children between 2001 and 2005. Cross-sectional oral health data (dmft/s Indices) for 416 (2003/2004), 687 (2004/2005) and 544 (2005/2006) 3- to 5-year olds attending JK in the Thunder Bay District were collected by calibrated dental hygienists with the District's Health Unit. Secondary analysis of oral health status data from two studies conducted in the SLZ between 2001 and 2005 provided the dmft of random samples of children younger than 6 years of age living in 16-20 First Nations communities. When compared with non-Aboriginal children aged 3-5 years attending the same schools in the Thunder Bay District between 2003 and 2006, off-reserve Aboriginal children had 1.9 to 2.3 times the risk of having ECC (dmft > 0), 2.9 to 3.5 times the risk of a dmft > 3 and 1.8 to 2.5 times the risk of untreated decayed teeth after adjusting the prevalence ratios for child's age and sex, school's risk level and clustered-correlated data. The mean dmft of on-reserve Aboriginal 4-year olds in 2005 was 11.2 and 5.9 for their off-reserve Aboriginal counterparts. In 2001, the mean dmft scores (95% confidence interval) of 2-, 3- and 4-year-old Aboriginal children in the SLZ were: 9.1 (8.3-9.9), 12.4 (11.8-13.1), 13.1 (12.1-14.2). In 2005, similarly aged SLZ children had a mean dmft of: 6.2 (5.2-7.1), 8.9 (8.2-9.6), 11.2 (10.5-11.9), representing significant reductions in caries severity (32%, 28% and 14.5%, respectively). Significant disparities in caries experience exist between off-reserve Aboriginal and non-Aboriginal children living in the same locales and between Aboriginal children living on- and off-reserve in northwestern Ontario. The study showed decreased trends in the severity of ECC for children in the SLZ occurring over the 5-year period. Despite this progress, the oral health of young Aboriginal children in Ontario continues to lag far behind that of non-Aboriginal children, demanding further programs and policies to tackle the social determinants of oral health and resolve these inequalities.

Cancer Data and Aboriginal Disparities (CanDAD)-developing an Advanced Cancer Data System for Aboriginal people in South Australia: a mixed methods research protocol.

PubMed

Yerrell, Paul Henry; Roder, David; Cargo, Margaret; Reilly, Rachel; Banham, David; Micklem, Jasmine May; Morey, Kim; Stewart, Harold Bundamurra; Stajic, Janet; Norris, Michael; Brown, Alex

2016-12-23

In Australia, Aboriginal and Torres Strait Islander People carry a greater burden of cancer-related mortality than non-Aboriginal Australians. The Cancer Data and Aboriginal Disparities Project aims to develop and test an integrated, comprehensive cancer monitoring and surveillance system capable of incorporating epidemiological and narrative data to address disparities and advocate for clinical system change. The Advanced Cancer Data System will integrate routinely collected unit record data from the South Australian Population Cancer Registry and a range of other data sources for a retrospective cohort of indigenous people with cancers diagnosed from 1990 to 2010. A randomly drawn non-Aboriginal cohort will be matched by primary cancer site, sex, age and year at diagnosis. Cross-tabulations and regression analyses will examine the extent to which demographic attributes, cancer stage and survival vary between the cohorts. Narratives from Aboriginal people with cancer, their families, carers and service providers will be collected and analysed using patient pathway mapping and thematic analysis. Statements from the narratives will structure both a concept mapping process of rating, sorting and prioritising issues, focusing on issues of importance and feasibility, and the development of a real-time Aboriginal Cancer Measure of Experience for ongoing linkage with epidemiological data in the Advanced Cancer Data System. Aboriginal Community engagement underpins this Project. The research has been approved by relevant local and national ethics committees. Findings will be disseminated in local and international peer-reviewed journals and conference presentations. In addition, the research will provide data for knowledge translation activities across the partner organisations and feed directly into the Statewide Cancer Control Plan. It will provide a mechanism for monitoring and evaluating the implementation of the recommendations in these documents. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Exploring Australian Aboriginal Women’s experiences of menopause: a descriptive study

PubMed Central

2014-01-01

Background Despite extensive literature demonstrating differing experiences in menopause around the world, documentation of the experience of menopause in Australian Aboriginal women is scarce, and thus their menopausal experience is relatively unknown. This study aimed to understand Australian Aboriginal women’s understanding and experience of menopause and its impact on their lives. Methods The study was an exploratory qualitative study. Twenty-five Aboriginal women were recruited from a regional centre in the Mid-West region of Western Australia using opportunistic and snowballing sampling. Interviews and focus group discussions were undertaken from February 2011 to February 2012 using open-ended questioning with a yarning technique. Thematic analysis was undertaken of the transcribed interviews. Results A number of themes were revealed. These related to the language used, meanings and attitudes to menopause, symptoms experienced, the role of men, a lack of understanding, coping mechanisms and the attribution of menopausal changes to something else. The term “change of life” was more widely recognised and signified the process of ageing, and an associated gain of respect in the local community. A fear of menopausal symptoms or uncertainty about their origin was also common. Overall, many women reported insufficient understanding and a lack of available information to assist them and their family to understand the transition. Conclusion There are similarities between Aboriginal and non-Aboriginal experiences of menopause, including similar symptom profiles. The current language used within mainstream health settings may not be appropriate to this population if it fails to recognise the importance of language and reflect the attributed meaning of menopause. The fear of symptoms and uncertainty of their relationship to menopause demonstrated a need for more information which has not adequately been supplied to Australian Aboriginal women through current services. While this study is with a select population of Aboriginal Australian women, it reveals the importance of acknowledging differences, particularly in use of language to convey ideas and support Aboriginal women experiencing menopause. PMID:24646300

Cancer Data and Aboriginal Disparities (CanDAD)—developing an Advanced Cancer Data System for Aboriginal people in South Australia: a mixed methods research protocol

PubMed Central

Yerrell, Paul Henry; Roder, David; Cargo, Margaret; Reilly, Rachel; Banham, David; Micklem, Jasmine May; Morey, Kim; Stewart, Harold Bundamurra; Stajic, Janet; Norris, Michael; Brown, Alex

2016-01-01

Introduction In Australia, Aboriginal and Torres Strait Islander People carry a greater burden of cancer-related mortality than non-Aboriginal Australians. The Cancer Data and Aboriginal Disparities Project aims to develop and test an integrated, comprehensive cancer monitoring and surveillance system capable of incorporating epidemiological and narrative data to address disparities and advocate for clinical system change. Methods and analysis The Advanced Cancer Data System will integrate routinely collected unit record data from the South Australian Population Cancer Registry and a range of other data sources for a retrospective cohort of indigenous people with cancers diagnosed from 1990 to 2010. A randomly drawn non-Aboriginal cohort will be matched by primary cancer site, sex, age and year at diagnosis. Cross-tabulations and regression analyses will examine the extent to which demographic attributes, cancer stage and survival vary between the cohorts. Narratives from Aboriginal people with cancer, their families, carers and service providers will be collected and analysed using patient pathway mapping and thematic analysis. Statements from the narratives will structure both a concept mapping process of rating, sorting and prioritising issues, focusing on issues of importance and feasibility, and the development of a real-time Aboriginal Cancer Measure of Experience for ongoing linkage with epidemiological data in the Advanced Cancer Data System. Aboriginal Community engagement underpins this Project. Ethics and dissemination The research has been approved by relevant local and national ethics committees. Findings will be disseminated in local and international peer-reviewed journals and conference presentations. In addition, the research will provide data for knowledge translation activities across the partner organisations and feed directly into the Statewide Cancer Control Plan. It will provide a mechanism for monitoring and evaluating the implementation of the recommendations in these documents. PMID:28011808

Midway Through IYA2009 In Canada: Experiences, Past, Present And Future

NASA Astrophysics Data System (ADS)

Hesser, James E.; Bartlett, C.; Breland, K.; Hay, K.; Lane, D.; Lacasse, R.; Lemay, D.; Langill, P.; Percy, J.; Welch, D. L.; Woodsworth, A.

2009-05-01

Since our 'soft launch' in early January, tens of thousands of Canadians have experienced a 'Galileo Moment' of personal astronomical discovery through participation in one of our diverse set of activities, with opportunities for new activities and partnerships continuing to arise. Braving the cold of the Canadian winter, amateur and professional astronomers and educators have provided many well attended, traditional star-gazing opportunities. A beautiful animated video of the Mi'kmaq story of 'Muin and the Seven Bird Hunters' connecting circumpolar motion and the seasons has been published on www.astronomy2009.ca with narration in English, French or Mi'kmaq to showcase our vision for increased collaboration with Canadian Indigenous communities to preserve and share their knowledge of the skies. Links with the arts and cultural communities have produced numerous wildly successful, non-traditional opportunities to engage children as well as adults in astronomy discovery. Canadian planetaria premiered their 'Galileo Live!' production this spring. Two Canadian postal stamps featuring iconic observatory domes (Plaskett, CFHT) against striking nebular images from CFHT were issued during 100 Hours of Astronomy. Materials (such as Astronomy Trading Cards, Star Finders, and a light-pollution story for young children) developed for education and public outreach by volunteers from the amateur communities are distributed at all such events, where they are being exceptionally well received. New developments and collaborators continue to emerge, e.g., Canada's Parks Day in July is focusing on IYA. At the nominal 2009 mid-point we are in the midst of delivering literally thousands of events throughout Canada. Concurrently we also continue working with Canadian educators, Aboriginal communities, parks, and others to secure legacy programs that will ensure that IYA benefits extend far beyond 2009.

Racialized identity and health in Canada: results from a nationally representative survey.

PubMed

Veenstra, Gerry

2009-08-01

This article uses survey data to investigate health effects of racialization in Canada. The operative sample was comprised of 91,123 Canadians aged 25 and older who completed the 2003 Canadian Community Health Survey. A "racial and cultural background" survey question contributed a variable that differentiated respondents who identified with Aboriginal, Black, Chinese, Filipino, Latin American, South Asian, White, or jointly Aboriginal and White racial/cultural backgrounds. Indicators of diabetes, hypertension and self-rated health were used to assess health. The healthy immigrant effect suppressed some disparity in risk for diabetes by racial/cultural identification. In logistic regression models also containing gender, age, and immigrant status, no racial/cultural identifications corresponded with significantly better health outcomes than those reported by survey respondents identifying as White. Subsequent models indicated that residential locale did little to explain the associations between racial/cultural background and health and that socioeconomic status was only implicated in relatively poor health outcomes for respondents identifying as Aboriginal or Aboriginal/White. Sizable and statistically significant relative risks for poor health for respondents identifying as Aboriginal, Aboriginal/White, Black, Chinese, or South Asian remained unexplained by the models, suggesting that other explanations for health disparities by racialized identity in Canada - perhaps pertaining to experiences with institutional racism and/or the wear and tear of experiences of racism and discrimination in everyday life - also deserve empirical investigation in this context.

Anthropometric predictors of gestational hypertensive disorders in a remote aboriginal community: a nested case-control study.

PubMed

Sina, Maryam; Hoy, Wendy; Wang, Zhiqiang

2014-03-05

Australian Aboriginal women tend to have body shape and pregnancy risk profiles different from other Australian women. This study aims to examine the associations of anthropometric indices with gestational hypertensive disorders (GHD), and to determine the index that can best predict the risk of this condition occurring during pregnancy. This is a nested case-control study. Baseline body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were measured as part of a broader health screening program between 1992 and 1995 in a remote Aboriginal community. All subsequent pregnancies among the original participants were identified during 20 year follow-up period through hospital records (up to May 2012). Twenty eight women were diagnosed as having GHD, each of whom were individually matched by age at baseline with five women who were hospitalised for other pregnancy-related conditions and were free from GHD (n = 140). The associations of the baseline anthropometric measurements with GHD were assessed using conditional logistic regression. The best predictor of GHD was WC (OR = 1.8; (95% CI, 1.1-2.9) for one standard deviation increase in WC), followed by BMI with the corresponding OR = 1.7 (95% CI, 1.1- 2.6). Other measurements, HC, WHR, and WHtR, were also positively associated with GHD, but those associations were not statistically significant. WC and BMI prior to pregnancy are anthropometric predictors of GHD in Aboriginal women, and WC is the best predictor. These findings imply the importance of early weight control in preventing GHD in Aboriginal women.

Challenges and strategies for cohort retention and data collection in an indigenous population: Australian Aboriginal Birth Cohort.

PubMed

Lawrance, Megan; Sayers, Susan M; Singh, Gurmeet R

2014-02-26

Longitudinal prospective birth cohort studies are pivotal to identifying fundamental causes and determinants of disease and health over the life course. There is limited information about the challenges, retention, and collection strategies in the study of Indigenous populations. The aim is to describe the follow-up rates of an Australian Aboriginal Birth Cohort study and how they were achieved. Participants were 686 babies enrolled between January 1987 and March 1990, born to a mother recorded in the Delivery Suite Register of the Royal Darwin Hospital (RDH) as a self-identified Aboriginal. The majority of the participants (70%) resided in Northern Territory within rural, remote and very remote Aboriginal communities that maintain traditional connections to their land and culture. The Aboriginal communities are within a sparsely populated (0.2 people/ km2) area of approximately 900,000 km² (347 sq miles), with poor communication and transport infrastructures. Follow-ups collecting biomedical and lifestyle data directly from participants in over 40 locations were conducted at 11.4 years (Wave-2) and 18.2 years (Wave-3), with Wave-4 follow-up currently underway. Follow-ups at 11 and 18 years of age successfully examined 86% and 72% of living participants respectively. Strategies addressing logistic, cultural and ethical challenges are documented. Satisfactory follow-up rates of a prospective longitudinal Indigenous birth cohort with traditional characteristics are possible while maintaining scientific rigor in a challenging setting. Approaches included flexibility, respect, and transparent communication along with the adoption of culturally sensitive behaviours. This work should inform and assist researchers undertaking or planning similar studies in Indigenous and developing populations.

Management of diabetes in Indigenous communities: lessons from the Australian Aboriginal population.

PubMed

Nguyen, H D; Chitturi, S; Maple-Brown, L J

2016-11-01

Type 2 diabetes mellitus and other chronic cardio-metabolic conditions are significant contributors to the large disparities in life expectancy between Indigenous and non-Indigenous Australians. Type 2 diabetes is more prevalent from a young age among Indigenous Australians and is often preceded by a cluster of risk factors, including central obesity, dyslipidaemia, albuminuria and socio-economic disadvantage. Management of type 2 diabetes in Australian Indigenous peoples can be challenging in the setting of limited resources and socio-economic disadvantage. Key strategies to address these challenges include working in partnership with patients, communities and primary healthcare services (PHC, Aboriginal community controlled and government services) and working in a multidisciplinary team. Population prevention measures are required within and beyond the health system, commencing as early as possible in the life course. © 2016 Royal Australasian College of Physicians.

A postcolonial feminist discourse analysis of urban Aboriginal women's description of pregnancy-related weight gain and physical activity.

PubMed

Darroch, Francine E; Giles, Audrey R

2016-02-01

Excessive weight gain and physical inactivity in pregnancy have been identified as risk factors for negative health outcomes for mothers and fetuses, particularly among Aboriginal women. In this paper we engage with postcolonial feminist theory and critical discourse analysis to examine the question, "how do urban Aboriginal women understand pregnancy-related weight gain and physical activity." We conducted focus groups and semi-structured interviews with 25 urban Aboriginal pregnant or postpartum women between the ages of 16 and 39 in Ottawa, Canada. Three prominent discourses emerged: Aboriginal women have different pregnancies than non-Aboriginal women because Aboriginal women gain more weight and are more likely to develop gestational diabetes; Aboriginal women feel personally responsible for and shameful about excessive weight gain; finally, Aboriginal women need culturally safe pregnancy resources. Our results illuminate the complex and often paradoxical ways in which discourses around weight gain and physical activity are produced and taken-up by Aboriginal women and their healthcare providers. Based on these findings, we argue there is a lack of accessible and culturally safe resources for urban Aboriginal women, specifically concerning weight gain and physical activity in pregnancy. We recommend the development of resources that are created for/by/with Aboriginal women to better address that issues that urban Aboriginal women themselves identify as being of key importance. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

We've Got a Way to Go Yet!

ERIC Educational Resources Information Center

Keary, Anne

1994-01-01

Palm Island aboriginal women have a central role in family, community, and cultural maintenance. Adult and community education programs should focus on the specific experiences and educational needs of these women who are active agents in constructing their own reality. (SK)

Negotiating Nature: Collaboration and Conflict between Aboriginal and Conservation Interests in New South Wales, Australia

ERIC Educational Resources Information Center

Adams, Michael

2004-01-01

Faced with the paradox of a large global increase in conservation reserves and a simultaneous global decrease in actual effective protection for biodiversity, conservation scientists and policymakers are questioning established conservation theory and practice. I argue that the fundamental premises, the foundational myths, for Western-style…

Dental caries experience in Aboriginal and Torres Strait Islanders in the Northern Peninsula Area, Queensland.

PubMed

Hopcraft, M; Chowt, W

2007-12-01

A survey of dental caries experience in children was undertaken in five Aboriginal and Torres Strait Islander communities in the Northern Peninsula Area of Queensland prior to the introduction of water fluoridation. Data were obtained from screening dental examinations conducted by the Australian Army as part of a community assistance programme between May and September 2004 from 486 children aged 4-15 years. The clinical examinations were performed in a dental van using a dental chair, light, mirror and probe by a single calibrated examiner. Caries experience was high with a mean 6-year-old dmft of 6.37 and a mean 12-year-old DMFT of 3.50. The 6-year-old dmft Significant Caries Index (SiC) for the third of the population with the highest caries experience was 11.65 and the 12-year-old DMFT SiC was 7.08. Only 15.3 per cent of 6-year-old children had dmft = 0 and 28.9 per cent of 12-year-old children had DMFT = 0. Dental caries was a significant problem for these remote communities. Aboriginal and Torres Strait Islander children from the Northern Peninsula Area of Queensland had more than four times the caries experience of Australian children for both 6-year-old dmft and 12-year-old DMFT.

A cohort study: temporal trends in prevalence of antecedents, comorbidities and mortality in Aboriginal and non-Aboriginal Australians with first heart failure hospitalization, 2000-2009.

PubMed

Teng, Tiew-Hwa Katherine; Katzenellenbogen, Judith M; Hung, Joseph; Knuiman, Matthew; Sanfilippo, Frank M; Geelhoed, Elizabeth; Bessarab, Dawn; Hobbs, Michael; Thompson, Sandra C

2015-08-12

Little is known about trends in risk factors and mortality for Aboriginal Australians with heart failure (HF). This population-based study evaluated trends in prevalence of risk factors, 30-day and 1-year all-cause mortality following first HF hospitalization among Aboriginal and non-Aboriginal Western Australians in the decade 2000-2009. Linked-health data were used to identify patients (20-84 years), with a first-ever HF hospitalization. Trends in demographics, comorbidities, interventions and risk factors were evaluated. Logistic and Cox regression models were fitted to test and compare trends over time in 30-day and 1-year mortality. Of 17,379 HF patients, 1,013 (5.8%) were Aboriginal. Compared with 2000-2002, the prevalence (as history) of myocardial infarction and hypertension increased more markedly in 2006-2009 in Aboriginal (versus non-Aboriginal) patients, while diabetes and chronic kidney disease remained disproportionately higher in Aboriginal patients. Risk factor trends, including the Charlson comorbidity index, increased over time in younger Aboriginal patients. Risk-adjusted 30-day mortality did not change over the decade in either group. Risk-adjusted 1-year mortality (in 30-day survivors) was non-significantly higher in Aboriginal patients in 2006-2008 compared with 2000-2002 (hazard ratio (HR) 1.44; 95% CI 0.85-2.41; p-trend = 0.47) whereas it decreased in non-Aboriginal patients (HR 0.87; 95% CI 0.78-0.97; p-trend = 0.01). Between 2000 and 2009, the prevalence of HF antecedents increased and remained disproportionately higher in Aboriginal (versus non-Aboriginal) HF patients. Risk-adjusted 1-year mortality did not improve in Aboriginal patients over the period in contrast with non-Aboriginal patients. These findings highlight the need for better prevention and post-HF care in Aboriginal Australians.

Are hygiene and public health interventions likely to improve outcomes for Australian Aboriginal children living in remote communities? A systematic review of the literature

PubMed Central

McDonald, Elizabeth; Bailie, Ross; Brewster, David; Morris, Peter

2008-01-01

Background Australian Aboriginal children living in remote communities still experience a high burden of common infectious diseases which are generally attributed to poor hygiene and unsanitary living conditions. The objective of this systematic literature review was to examine the epidemiological evidence for a relationship between various hygiene and public health intervention strategies, separately or in combination, and the occurrence of common preventable childhood infectious diseases. The purpose was to determine what intervention/s might most effectively reduce the incidence of skin, diarrhoeal and infectious diseases experienced by children living in remote Indigenous communities. Methods Studies were identified through systematically searching electronic databases and hand searching. Study types were restricted to those included in Cochrane Collaboration Effective Practice and Organisation of Care Review Group (EPOC) guidelines and reviewers assessed the quality of studies and extracted data using the same guidelines. The types of participants eligible were Indigenous populations and populations of developing countries. The types of intervention eligible for inclusion were restricted to those likely to prevent conditions caused by poor personal hygiene and poor living environments. Results The evidence showed that there is clear and strong evidence of effect of education and handwashing with soap in preventing diarrhoeal disease among children (consistent effect in four studies). In the largest well-designed study, children living in households that received plain soap and encouragement to wash their hands had a 53% lower incidence of diarrhoea (95% CI, 0.35, 0.59). There is some evidence of an effect of education and other hygiene behaviour change interventions (six studies), as well as the provision of water supply, sanitation and hygiene education (two studies) on reducing rates of diarrhoeal disease. The size of these effects is small and the quality of the studies generally poor. Conclusion Research which measures the effectiveness of hygiene interventions is complex and difficult to implement. Multifaceted interventions (which target handwashing with soap and include water, sanitation and hygiene promotion) are likely to provide the greatest opportunity to improve child health outcomes in remote Indigenous communities. PMID:18462504

Are hygiene and public health interventions likely to improve outcomes for Australian Aboriginal children living in remote communities? A systematic review of the literature.

PubMed

McDonald, Elizabeth; Bailie, Ross; Brewster, David; Morris, Peter

2008-05-08

Australian Aboriginal children living in remote communities still experience a high burden of common infectious diseases which are generally attributed to poor hygiene and unsanitary living conditions. The objective of this systematic literature review was to examine the epidemiological evidence for a relationship between various hygiene and public health intervention strategies, separately or in combination, and the occurrence of common preventable childhood infectious diseases. The purpose was to determine what intervention/s might most effectively reduce the incidence of skin, diarrhoeal and infectious diseases experienced by children living in remote Indigenous communities. Studies were identified through systematically searching electronic databases and hand searching. Study types were restricted to those included in Cochrane Collaboration Effective Practice and Organisation of Care Review Group (EPOC) guidelines and reviewers assessed the quality of studies and extracted data using the same guidelines. The types of participants eligible were Indigenous populations and populations of developing countries. The types of intervention eligible for inclusion were restricted to those likely to prevent conditions caused by poor personal hygiene and poor living environments. The evidence showed that there is clear and strong evidence of effect of education and handwashing with soap in preventing diarrhoeal disease among children (consistent effect in four studies). In the largest well-designed study, children living in households that received plain soap and encouragement to wash their hands had a 53% lower incidence of diarrhoea (95% CI, 0.35, 0.59). There is some evidence of an effect of education and other hygiene behaviour change interventions (six studies), as well as the provision of water supply, sanitation and hygiene education (two studies) on reducing rates of diarrhoeal disease. The size of these effects is small and the quality of the studies generally poor. Research which measures the effectiveness of hygiene interventions is complex and difficult to implement. Multifaceted interventions (which target handwashing with soap and include water, sanitation and hygiene promotion) are likely to provide the greatest opportunity to improve child health outcomes in remote Indigenous communities.

A pilot study of Aboriginal health promotion from an ecological perspective

PubMed Central

2011-01-01

Background For health promotion to be effective in Aboriginal and Torres Strait Islander Communities, interventions (and their evaluation) need to work within a complex social environment and respect Indigenous knowledge, culture and social systems. At present, there is a lack of culturally appropriate evaluation methods available to practitioners that are capable of capturing this complexity. As an initial response to this problem, we used two non-invasive methods to evaluate a community-directed health promotion program, which aimed to improve nutrition and physical activity for members of the Aboriginal community of the Goulburn-Murray region of northern Victoria, Australia. The study addressed two main questions. First, for members of an Aboriginal sporting club, what changes were made to the nutrition environment in which they meet and how is this related to national guidelines for minimising the risk of chronic disease? Second, to what degree was the overall health promotion program aligned with an ecological model of health promotion that addresses physical, social and policy environments as well as individual knowledge and behaviour? Methods Rather than monitoring individual outcomes, evaluation methods reported on here assessed change in the nutrition environment (sports club food supply) as a facilitator of dietary change and the 'ecological' nature of the overall program (that is, its complexity with respect to numbers of targets, settings and strategies). Results There were favourable changes towards the provision of a food supply consistent with Australian guidelines at the sports club. The ecological analysis indicated that the design and implementation of the program were consistent with an ecological model of health promotion. Conclusions The evaluation was useful for assessing the impact of the program on the nutrition environment and for understanding the ecological nature of program activities. PMID:21961906

Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study.

PubMed

Hoy, Wendy E; Mott, Susan Anne; McLeod, Beverly June

2017-08-11

To describe trends in ages and causes of death in a remote-living Australian Aboriginal group over a recent 50-year period. A retrospective observational study, from 1960 to 2010, of deaths and people starting dialysis, using data from local clinic, parish, dialysis and birthweight registers. A remote island community in the Top End of Australia's Northern Territory, where a Catholic mission was established in 1911. The estimated Aboriginal population was about 800 in 1960 and 2260 in 2011. All Aboriginal residents of this community whose deaths had been recorded. Annual frequencies and rates of terminal events (deaths and dialysis starts) by age group and cause of death. Against a background of high rates of low birth weight, 223 deaths in infants and children and 934 deaths in adults (age > 15 years) were recorded; 88% were of natural causes. Most deaths in the 1960s were in infants and children. However, over time these fell dramatically, across the birthweight spectrum, while adult deaths progressively increased. The leading causes of adult natural deaths were chronic lung disease, cardiovascular disease and, more recently, renal failure, and rates were increased twofold in those of low birth weight. However, rates of natural adult deaths have been falling briskly since 1986, most markedly among people of age ≥45 years. The population is increasing and its age structure is maturing. The changes in death profiles, the expression of the Barker hypothesis and the ongoing increases in adult life expectancy reflect epidemiological and health transitions of astonishing rapidity. These probably flow from advances in public health policy and healthcare delivery, as well as improved inter-sectoral services, which are all to be celebrated. Other remote communities in Australia are experiencing the same phenomena, and similar events are well advanced in many developing countries. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The development of a network for community-based obesity prevention: the CO-OPS Collaboration

PubMed Central

2011-01-01

Background Community-based interventions are a promising approach and an important component of a comprehensive response to obesity. In this paper we describe the Collaboration of COmmunity-based Obesity Prevention Sites (CO-OPS Collaboration) in Australia as an example of a collaborative network to enhance the quality and quantity of obesity prevention action at the community level. The core aims of the CO-OPS Collaboration are to: identify and analyse the lessons learned from a range of community-based initiatives aimed at tackling obesity, and; to identify the elements that make community-based obesity prevention initiatives successful and share the knowledge gained with other communities. Methods Key activities of the collaboration to date have included the development of a set of Best Practice Principles and knowledge translation and exchange activities to promote the application (or use) of evidence, evaluation and analysis in practice. Results The establishment of the CO-OPS Collaboration is a significant step toward strengthening action in this area, by bringing together research, practice and policy expertise to promote best practice, high quality evaluation and knowledge translation and exchange. Future development of the network should include facilitation of further evidence generation and translation drawing from process, impact and outcome evaluation of existing community-based interventions. Conclusions The lessons presented in this paper may help other networks like CO-OPS as they emerge around the globe. It is important that networks integrate with each other and share the experience of creating these networks. PMID:21349185

Characteristics of Indigenous primary health care models of service delivery: a scoping review protocol.

PubMed

Harfield, Stephen; Davy, Carol; Kite, Elaine; McArthur, Alexa; Munn, Zachary; Brown, Ngiare; Brown, Alex

2015-11-01

The objective of the scoping review is to identify and describe within the existing literature the characteristics (values, principles, components and suggest practical applications) of primary health care models of service delivery for Indigenous people. More specifically, the review question is:What are the characteristics (values, principles, components and suggested practical applications) of primary health care models of service delivery for Indigenous people?Findings from this scoping review will inform two systematic reviews. One of these will explore the acceptability and the other the effectiveness of identified characteristics. The scoping review will follow the JBI Scoping Review methodology as outlined in the 2015 Joanna Briggs Institute Reviewers' Manual. Indigenous populations in colonized countries experience worse health outcomes relative to their non-Indigenous counterparts. In Australia, in the period 2010 to 2012 the estimated gap in life expectancy between Aboriginal and Torres Strait Islander Australians compared to non-Indigenous Australians was 10 years Similar gaps in life expectancy between Indigenous and non-Indigenous have been demonstrated in other countries, such as New Zealand, Canada and the United StatesThe gap in life expectancy and the health disadvantage experienced by Indigenous people is in part the result of mainstream health services not adequately meeting the health needs of Indigenous people and Indigenous people's inability to access mainstream services Part of the solution has been the establishment of primary health care services for and in many cases run by Indigenous people. Indigenous primary health services have been developed to provide culturally appropriate services that meet the needs of local Indigenous communities.In Australia, the first Aboriginal medical service was established in 1971 in Redfern, New South Wales, by "community activists in response to ongoing discrimination against Aboriginal people within mainstream health services to address the poor health and premature deaths of Aboriginal people, and to provide a culturally appropriate system of health care". There are now over 150 Aboriginal Community Controlled Health Services in Australia. Aboriginal Community Controlled Health Services are underpinned by common values such as culture, cultural respect, integrity, inclusion, self-determination, community control, sovereignty and leadership.Similar models of Indigenous health services exist in other countries, such as Māori health providers in New Zealand, First Nations and Inuit Health Authorities in Canada, and the Indian Health Services in the US. In New Zealand, Māori health providers deliver health and disability services to Māori and non-Māori clients. The difference between Māori health providers and mainstream services in New Zealand is that Māori health services are based on kaupapa, a plan or set of principles and ideas that informs behavior and customs, and the delivery framework which is distinctively Māori. First Nations and Inuit Health Authorities in Canada coordinate and integrate health programs and services to achieve better health outcomes for First Nations people. These community-based services largely focus on health promotion and prevention. First Nations and Inuit Health Authorities work under a unique health governance structure that includes local First Nations' leadership, based on the philosophy of self-governance and self-determination, which represent and address the health needs of First Nation communities. The Indian Health Service (IHS) in the US is responsible for providing comprehensive health services to American Indians and Alaska Natives. The IHS aims to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level, and its goal is "to ensure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people". The IHS "grew out of a special government-to-government relationship between the federal government and Indian Tribes".Evidence suggests that "a strong primary health care sector is essential to the health and wellbeing of a population, and that a strong primary health care sector is associated with better population health, reduced costs of health care provision, and greater efficiency within the system". A study of Aboriginal Canadians shows that poor access and ineffective primary health care services were directly related to increased avoidable hospital admissions. In addition, a recent study in Australia focusing on the costs and the health outcomes associated with primary care use by Indigenous people with diabetes in remote communities in the Northern Territory demonstrates that improved access to primary health care which is responsive to the needs of Aboriginal and Torres Strait Islander people is both cost-effective and associated with better health outcomes.Given the strong link between primary health care and health outcomes and the significant contribution Indigenous health services make towards reducing the health disadvantage experienced by Indigenous people, it is important to understand the characteristics that support the delivery of health provided by Indigenous health services and their unique models. While there is not a clear definition in the literature about what a model of care or model of service delivery is, for the purpose of this review, it will encompass all factors involved in the delivery of care including but not limited to the vision, values and strategies that underpin the delivery of care, healthcare services and programs, governance and leadership, workforce, organization and supply, and infrastructure and other resources.The aim of this scoping review is to determine the characteristics of Indigenous primary health care models of service delivery by drawing on existing literature that look at the way in which services are delivered in this setting.An initial search of literature was conducted to establish whether there are studies with findings available to answer the review question, and whether there is a systematic or scoping review addressing the knowledge gap currently underway or published. There are no systematic or scoping reviews published or underway that address the question proposed by this review.

Skills.net: Community Internet Access and Training in Victoria, Australia.

ERIC Educational Resources Information Center

Bates, Adrian

Skills.net is a 3-year program providing free or affordable Internet access and training to local Victorian (Australia) communities. It is especially aimed at those who would normally miss out on such access, such as the unemployed, women, people with disabilities, people from non-English speaking backgrounds, Aboriginals, and communities in…

Measuring the Impact of a Community of Practice in Aboriginal Health

ERIC Educational Resources Information Center

Delbridge, Robyn; Wilson, Annabelle; Palermo, Claire

2018-01-01

Effective strategies to enhance the competence of practising health professionals are limited. Communities of Practice are proposed as strategy, yet little is known about their ability to develop cultural competency and practice. This study aimed to measure the impact of a Community of Practice on the self-assessed cultural competency and change…

Calculation of the age of the first infection for skin sores and scabies in five remote communities in northern Australia.

PubMed

Lydeamore, M J; Campbell, P T; Cuningham, W; Andrews, R M; Kearns, T; Clucas, D; Gundjirryirr Dhurrkay, R; Carapetis, J; Tong, S Y C; McCaw, J M; McVernon, J

2018-05-08

Prevalence of skin sores and scabies in remote Australian Aboriginal communities remains unacceptably high, with Group A Streptococcus (GAS) the dominant pathogen. We aim to better understand the drivers of GAS transmission using mathematical models. To estimate the force of infection, we quantified the age of first skin sores and scabies infection by pooling historical data from three studies conducted across five remote Aboriginal communities for children born between 2001 and 2005. We estimated the age of the first infection using the Kaplan-Meier estimator; parametric exponential mixture model; and Cox proportional hazards. For skin sores, the mean age of the first infection was approximately 10 months and the median was 7 months, with some heterogeneity in median observed by the community. For scabies, the mean age of the first infection was approximately 9 months and the median was 8 months, with significant heterogeneity by the community and an enhanced risk for children born between October and December. The young age of the first infection with skin sores and scabies reflects the high disease burden in these communities.

The healing journey: empowering Aboriginal communities to close the health gap.

PubMed

Laliberté, Arlene; Haswell-Elkins, Melissa; Reilly, Lyndon

2009-08-01

This paper presents two arguments relevant to both past and present efforts to improve Indigenous health. It advocates for ways of thinking about and doing health promotion that begin with empowerment to help people gain a greater level of control over their lives and circumstances. A combination of the strengths of different approaches is in fact an empowering, dialectical view that can be achieved by considering Aboriginal people not as children in need, but as capable and efficacious individuals.

Contextual determinants of health behaviours in an aboriginal community in Canada: pilot project.

PubMed

Joseph, Pamela; Davis, A Darlene; Miller, Ruby; Hill, Karen; McCarthy, Honey; Banerjee, Ananya; Chow, Clara; Mente, Andrew; Anand, Sonia S

2012-11-07

Rapid change in food intake, physical activity, and tobacco use in recent decades have contributed to the soaring rates of obesity, type 2 diabetes and cardiovascular disease (CVD) in Aboriginal populations living in Canada. The nature and influence of contextual factors on Aboriginal health behaviours are not well characterized. To describe the contextual determinants of health behaviours associated with cardiovascular risk factors on the Six Nations reserve, including the built environment, access and affordability of healthy foods, and the use of tobacco.In this cross-sectional study, 63 adults from the Six Nations Reserve completed the modified Neighbourhood Environment Walkability Scale (NEWS), questionnaire assessing food access and availability, tobacco pricing and availability, and the Environmental Profile of Community Health (EPOCH) tool. The structured environment of Six Nations Reserve scored low for walkability, street connectivity, aesthetics, safety, and access to walking and cycling facilities. All participants purchased groceries off-reserve, although fresh fruits and vegetables were reported to be available and affordable both on and off-reserve. On average $151/week is spent on groceries per family. Ninety percent of individuals report tobacco use is a problem in the community. Tobacco is easily accessible for children and youth, and only three percent of community members would accept increased tobacco taxation as a strategy to reduce tobacco access. The built environment, access and affordability of healthy food and tobacco on the Six Nations Reserve are not perceived favourably. Modification of these contextual factors described here may reduce adverse health behaviours in the community.

"… Trial and error …": Speech-language pathologists' perspectives of working with Indigenous Australian adults with acquired communication disorders.

PubMed

Cochrane, Frances Clare; Brown, Louise; Siyambalapitiya, Samantha; Plant, Christopher

2016-10-01

This study explored speech-language pathologists' (SLPs) perspectives about factors that influence clinical management of Aboriginal and Torres Strait Islander adults with acquired communication disorders (e.g. aphasia, motor speech disorders). Using a qualitative phenomenological approach, seven SLPs working in North Queensland, Australia with experience working with this population participated in semi-structured in-depth interviews. Qualitative content analysis was used to identify categories and overarching themes within the data. Four categories, in relation to barriers and facilitators, were identified from participants' responses: (1) The Practice Context; (2) Working Together; (3) Client Factors; and (4) Speech-Language Pathologist Factors. Three overarching themes were also found to influence effective speech pathology services: (1) Aboriginal and Torres Strait Islander Cultural Practices; (2) Information and Communication; and (3) Time. This study identified many complex and inter-related factors which influenced SLPs' effective clinical management of this caseload. The findings suggest that SLPs should employ a flexible, holistic and collaborative approach in order to facilitate effective clinical management with Aboriginal and Torres Strait Islander people with acquired communication disorders.

Cross-sectional analysis of a community-based cooperative grocery store intervention in Saskatoon, Canada.

PubMed

Lotoski, Larisa C; Engler-Stringer, Rachel; Muhajarine, Nazeem

2015-03-12

The aim of this research is to examine the awareness and use of the Good Food Junction (GFJ), a not-for-profit full service cooperative grocery store in a former food desert in Saskatoon, Canada. Through door-to-door sampling, 365 residents in their neighbourhoods surrounding the GFJ grocery store were recruited. Quantitative surveys examined awareness, use and primary use of GFJ, mode of transportation to and from GFJ and primary grocery stores, other food program use and demographic data. Differences between those who had or had not shopped at GFJ were characterized using descriptive statistics and Pearson's chi-square test. Univariate and multivariate logistic regression models were developed to predict shopping at GFJ and the use of GFJ as a primary grocery store. Of those surveyed, 69% had shopped at GFJ. A significant proportion of shoppers were Aboriginal, had an annual household income per person of less than $20,000, and participated in other food-based programs and initiatives. Aboriginal people (OR = 2.0, p = 0.03) and users of neighbourhood-based fruit and vegetable markets (OR = 2.7, p = 0.04) were significantly more likely, but new immigrants to Canada (OR = 0.3, p = 0.05) were significantly less likely to have ever shopped at GFJ. Aboriginal respondents (OR = 2.6, p = 0.04) were significantly more likely to use GFJ as their primary grocery store. Our results confirm both that GFJ is able to serve households where food insecurity is likely and, based on the prevalence of users, the importance and need for a full-service supermarket in Saskatoon's inner city.

Predictors of intentions to quit smoking in Aboriginal tobacco smokers of reproductive age in regional New South Wales (NSW), Australia: quantitative and qualitative findings of a cross-sectional survey.

PubMed

Gould, Gillian Sandra; Watt, Kerrianne; McEwen, Andy; Cadet-James, Yvonne; Clough, Alan R

2015-03-13

To assess the predictors of intentions to quit smoking in a community sample of Aboriginal smokers of reproductive age, in whom smoking prevalence is slow to decline. A cross-sectional survey involved 121 Aboriginal smokers, aged 18-45 years from January to May 2014, interviewed at community events on the Mid-North Coast NSW. Qualitative and quantitative data were collected on smoking and quitting attitudes, behaviours and home smoking rules. Perceived efficacy for quitting, and perceived threat from smoking, were uniquely assessed with a validated Risk Behaviour Diagnosis (RBD) Scale. Logistic regression explored the impact of perceived efficacy, perceived threat and consulting previously with a doctor or health professional (HP) on self-reported intentions to quit smoking, controlling for potential confounders, that is, protection responses and fear control responses, home smoking rules, gender and age. Participants' comments regarding smoking and quitting were investigated via inductive analysis, with the assistance of Aboriginal researchers. Two-thirds of smokers intended to quit within 3 months. Perceived efficacy (OR=4.8; 95% CI 1.78 to 12.93) and consulting previously with a doctor/HP about quitting (OR=3.82; 95% CI 1.43 to 10.2) were significant predictors of intentions to quit. 'Smoking is not doing harm right now' was inversely associated with quit intentions (OR=0.25; 95% CI 0.08 to 0.8). Among those who reported making a quit attempt, after consulting with a doctor/HP, 40% (22/60) rated the professional support received as low (0-2/10). Qualitative themes were: the negatives of smoking (ie, disgust, regret, dependence and stigma), health effects and awareness, quitting, denial, 'smoking helps me cope' and social aspects of smoking. Perceived efficacy and consulting with a doctor/HP about quitting may be important predictors of intentions to quit smoking in Aboriginal smokers of reproductive age. Professional support was generally perceived to be low; thus, it could be improved for these Aboriginal smokers. Aboriginal participants expressed strong sentiments about smoking and quitting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

An Exploration of Underrepresentation of Aboriginal Cancer Patients Attending a Regional Radiotherapy Service in Western Australia

PubMed Central

Baxi, Siddhartha; Cheetham, Shelley; Shahid, Shaouli

2018-01-01

Travel logistics impede Aboriginal patients’ uptake of cancer treatments and is one reason for the poorer outcomes of Aboriginal people with cancer. This research examined benefits of a newly established rurally based radiotherapy unit in southwest Western Australia (WA), and included exploring the experience of Aboriginal patients and possible reasons for Aboriginal people’s underrepresentation in treatment. Semi-structured in-depth interviews with 21 service providers involved in the treatment and care of people with cancer, and 3 Aboriginal patients with cancer who undertook radiotherapy at the Service were undertaken. Data were subject to thematic analysis involving immersion in the data for familiarization, inductive coding, investigator discussion and refining of emerging themes and triangulation of patient and provider interviews. Aboriginal cancer patients were positive about the treatment and support they had received, highlighting the often complex challenges faced by rural Aboriginal cancer patients in accessing and maintaining treatment. Service providers offered suggestions for small numbers presenting to the Service, including late presentation, potential perceptions of cultural insensitivity on the part of service providers, out-of-pocket costs and under-ascertainment of Aboriginal status. The Service has put in place practices and initiatives to support patient health and wellbeing, including making the facility more welcoming towards Aboriginal people and ensuring culturally appropriate care. PMID:29443892

Comparing and contrasting 'innovation platforms' with other forms of professional networks for strengthening primary healthcare systems for Indigenous Australians.

PubMed

Bailie, Jodie; Cunningham, Frances Clare; Bainbridge, Roxanne Gwendalyn; Passey, Megan E; Laycock, Alison Frances; Bailie, Ross Stewart; Larkins, Sarah L; Brands, Jenny S M; Ramanathan, Shanthi; Abimbola, Seye; Peiris, David

2018-01-01

Efforts to strengthen health systems require the engagement of diverse, multidisciplinary stakeholder networks. Networks provide a forum for experimentation and knowledge creation, information exchange and the spread of good ideas and practice. They might be useful in addressing complex issues or 'wicked' problems, the solutions to which go beyond the control and scope of any one agency. Innovation platforms are proposed as a novel type of network because of their diverse stakeholder composition and focus on problem solving within complex systems. Thus, they have potential applicability to health systems strengthening initiatives, even though they have been predominantly applied in the international agricultural development sector. In this paper, we compare and contrast the concept of innovation platforms with other types of networks that can be used in efforts to strengthen primary healthcare systems, such as communities of practice, practice-based research networks and quality improvement collaboratives. We reflect on our ongoing research programme that applies innovation platform concepts to drive large-scale quality improvement in primary healthcare for Aboriginal and Torres Strait Islander Australians and outline our plans for evaluation. Lessons from our experience will find resonance with others working on similar initiatives in global health.

Factors influencing food choice in an Australian Aboriginal community.

PubMed

Brimblecombe, Julie; Maypilama, Elaine; Colles, Susan; Scarlett, Maria; Dhurrkay, Joanne Garnggulkpuy; Ritchie, Jan; O'Dea, Kerin

2014-03-01

We explored with Aboriginal adults living in a remote Australian community the social context of food choice and factors perceived to shape food choice. An ethnographic approach of prolonged community engagement over 3 years was augmented by interviews. Our findings revealed that knowledge, health, and resources supporting food choice were considered "out of balance," and this imbalance was seen to manifest in a Western-imposed diet lacking variety and overrelying on familiar staples. Participants felt ill-equipped to emulate the traditional pattern of knowledge transfer through passing food-related wisdom to younger generations. The traditional food system was considered key to providing the framework for learning about the contemporary food environment. Practitioners seeking to improve diet and health outcomes for this population should attend to past and present contexts of food in nutrition education, support the educative role of caregivers, address the high cost of food, and support access to traditional foods.

Efficient funding: a path to improving Aboriginal healthcare in Australia?

PubMed

Lloyd, Jane E; Wise, Marilyn J

2010-11-01

To identify the factors that contribute to the under-resourcing of Aboriginal health and to explore the impact that funding arrangements have on the implementation of Aboriginal health policy. Qualitative study based on 35 in-depth interviews with a purposive sample of frontline health professionals involved in health policy and service provision in the Northern Territory. Participants described three factors that contributed to the under-resourcing of Aboriginal health: inefficient funding arrangements, mainstream programs being inappropriate for Aboriginal Australians, and competing interests determining the allocation of resources. Insufficient capacity within the healthcare system undermines the multilevel implementation process whereby organisations need to have the capacity to recognise new policy ideas, assess their relevance to their existing work and strategic plan and to be able to incorporate the relevant new ideas into day-to-day practice. Insufficient resources for Aboriginal health were found to be a barrier to implementing Aboriginal health policy. Inadequate resources result from the cumbersome allocation of funding rather than simply the amount of funding provided to Aboriginal healthcare. Monitoring government performance and ensuring the efficient allocation of funds would allow us to develop the delivery system for Aboriginal healthcare and therefore provide greater opportunities to capitalise on current interventions and future efforts.

Oral cavity squamous cell carcinoma - characteristics and survival in aboriginal and non-aboriginal Western australians.

PubMed

Frydrych, A M; Slack-Smith, L M; Parsons, R; Threlfall, T

2014-01-01

Squamous cell carcinoma (SCC) is the most common type of malignancy affecting the oral cavity. While exposures to main risk factors for oral SCC such as smoking and alcohol use are higher amongst the Aboriginal people, little is known about oral cancer in this population. This study aimed to describe characteristics and survival of oral SCC in Aboriginal and non-Aboriginal Western Australians. All primary oral SCC cases reported to the Western Australian Cancer Registry (WACR) between 1990 and 1999 were analysed with respect to person characteristics including: date of birth, sex and indigenous status; and disease characteristics including: date of biopsy, disease stage and site as well as date of recurrence and date of death. Exclusion criteria included diagnosis not based on incisional or excisional biopsy, diagnosis other than oral SCC or a history of another malignant neoplasm. Aboriginal individuals were more likely to reside in rural areas. No statistically significant differences in oral SCC characteristics and survival were noted between Aboriginal and non-Aboriginal Western Australians. This study provides new information on person and disease characteristics of Aboriginal Western Australians diagnosed with oral SCC.

Understanding practitioner professionalism in Aboriginal and Torres Strait Islander health: lessons from student and registrar placements at an urban Aboriginal and Torres Strait Islander primary healthcare service.

PubMed

Askew, Deborah A; Lyall, Vivian J; Ewen, Shaun C; Paul, David; Wheeler, Melissa

2017-10-01

Aboriginal and Torres Strait Islander peoples continue to be pathologised in medical curriculum, leaving graduates feeling unequipped to effectively work cross-culturally. These factors create barriers to culturally safe health care for Aboriginal and Torres Strait Islander peoples. In this pilot pre-post study, the learning experiences of seven medical students and four medical registrars undertaking clinical placements at an urban Aboriginal and Torres Strait Islander primary healthcare service in 2014 were followed. Through analysis and comparison of pre- and post-placement responses to a paper-based case study of a fictitious Aboriginal patient, four learning principles for medical professionalism were identified: student exposure to nuanced, complex and positive representations of Aboriginal peoples; positive practitioner role modelling; interpersonal skills that build trust and minimise patient-practitioner relational power imbalances; and knowledge, understanding and skills for providing patient-centred, holistic care. Though not exhaustive, these principles can increase the capacity of practitioners to foster culturally safe and optimal health care for Aboriginal peoples. Furthermore, competence and effectiveness in Aboriginal health care is an essential component of medical professionalism.

'We've fallen into the cracks': Aboriginal women's experiences with breast cancer through photovoice.

PubMed

Poudrier, Jennifer; Mac-Lean, Roanne Thomas

2009-12-01

Despite some recognition that Aboriginal women who have experienced breast cancer may have unique health needs, little research has documented the experiences of Aboriginal women from their perspective. Our main objective was to explore and to begin to make visible Aboriginal women's experiences with breast cancer using the qualitative research technique, photovoice. The research was based in Saskatchewan, Canada and participants were Aboriginal women who had completed breast cancer treatment. Although Aboriginal women cannot be viewed as a homogeneous group, participants indicated two areas of priority for health-care: (i) Aboriginal identity and traditional beliefs, although expressed in diverse ways, are an important dimension of breast cancer experiences and have relevance for health-care; and (ii) there is a need for multidimensional support which addresses larger issues of racism, power and socioeconomic inequality. We draw upon a critical and feminist conception of visuality to interrogate and disrupt the dominant visual terrain (both real and metaphorical) where Aboriginal women are either invisible or visible in disempowering ways. Aboriginal women who have experienced breast cancer must be made visible within health-care in a way that recognizes their experiences situated within the structural context of marginalization through colonial oppression.

Adapting online learning for Canada's Northern public health workforce.

PubMed

Bell, Marnie; MacDougall, Karen

2013-01-01

Canada's North is a diverse, sparsely populated land, where inequalities and public health issues are evident, particularly for Aboriginal people. The Northern public health workforce is a unique mix of professional and paraprofessional workers. Few have formal public health education. From 2009 to 2012, the Public Health Agency of Canada (PHAC) collaborated with a Northern Advisory Group to develop and implement a strategy to strengthen public health capacity in Canada's 3 northern territories. Access to relevant, effective continuing education was identified as a key issue. Challenges include diverse educational and cultural backgrounds of public health workers, geographical isolation and variable technological infrastructure across the north. PHAC's Skills Online program offers Internet-based continuing education modules for public health professionals. In partnership with the Northern Advisory Group, PHAC conducted 3 pilots between 2008 and 2012 to assess the appropriateness of the Skills Online program for Northern/Aboriginal public health workers. Module content and delivery modalities were adapted for the pilots. Adaptations included adding Inuit and Northern public health examples and using video and teleconference discussions to augment the online self-study component. Findings from the pilots were informative and similar to those from previous Skills Online pilots with learners in developing countries. Online learning is effective in bridging the geographical barriers in remote locations. Incorporating content on Northern and Aboriginal health issues facilitates engagement in learning. Employer support facilitates the recruitment and retention of learners in an online program. Facilitator assets included experience as a public health professional from the north, and flexibility to use modified approaches to support and measure knowledge acquisition and application, especially for First Nations, Inuit and Metis learners. Results demonstrate that appropriate adaptations to online professional development can provide practical, accessible means for a wide range of Northern/Aboriginal public health workers to acquire core competencies for public health.

A Framework for Assessing Collaborative Capacity in Community-Based Public Forest Management

NASA Astrophysics Data System (ADS)

Cheng, Antony S.; Sturtevant, Victoria E.

2012-03-01

Community-based collaborative groups involved in public natural resource management are assuming greater roles in planning, project implementation, and monitoring. This entails the capacity of collaborative groups to develop and sustain new organizational structures, processes, and strategies, yet there is a lack of understanding what constitutes collaborative capacity. In this paper, we present a framework for assessing collaborative capacities associated with community-based public forest management in the US. The framework is inductively derived from case study research and observations of 30 federal forest-related collaborative efforts. Categories were cross-referenced with literature on collaboration across a variety of contexts. The framework focuses on six arenas of collaborative action: (1) organizing, (2) learning, (3) deciding, (4) acting, (5) evaluating, and (6) legitimizing. Within each arena are capacities expressed through three levels of social agency: individuals, the collaborative group itself, and participating or external organizations. The framework provides a language and set of organizing principles for understanding and assessing collaborative capacity in the context of community-based public forest management. The framework allows groups to assess what capacities they already have and what more is needed. It also provides a way for organizations supporting collaboratives to target investments in building and sustaining their collaborative capacities. The framework can be used by researchers as a set of independent variables against which to measure collaborative outcomes across a large population of collaborative efforts.

Nutritional status of haemodialysis patients: comparison of Australian cohorts of Aboriginal and European descent.

PubMed

Todd, Alwyn; Carroll, Robert; Gallagher, Meghan; Meade, Anthony

2013-12-01

It is not known whether nutritional status differs between Australian Aboriginal and non Aboriginal haemodialysis subjects. The aim of this study was to investigate the nutritional status of Australian Aboriginal and non-Aboriginal haemodialysis subjects at satellite dialysis centres. Seventy-six (25 Aboriginal, 51 non-Aboriginal) prevalent haemodialysis patients were enrolled in a 3-month cross-sectional study. Each month anthropometric and biochemical measurements were collected. Nutritional status (diet history, patient-generated subjective global assessment (PG-SGA), handgrip strength) was assessed by a dietitian. PG-SGA detected mild to moderate malnutrition in 35% of Aboriginal patients and 25% of non-Aboriginal patients. The overall physical rating on the PG-SGA was significantly higher in Aboriginal patients, indicating the presence of a greater deficit in muscle mass in this population. Inter-dialytic weight gain was significantly greater in Aboriginal subjects (median [range] 3.0 [2.1-5.7] vs 2.5 [-0.3-5.0] kg, P<0.001). Glucose and HbA1c were significantly higher in Aboriginal subjects with diabetes than in non-Aboriginal patients with diabetes (median [range] 9.4 [4.9-23.4] vs 5.7 [3.1-12.9], P=0.002; 7.0 [5.2-11.0] vs 5.8 [4.6-9.0], P<0.000; respectively). These findings occurred in the setting of each cohort having adequate dialysis parameters (median Kt/V of >1.6 and median normalized protein catabolic rate 1.5). Difficulties were encountered in obtaining dietary information from Aboriginal subjects using the diet history method. Subjects had acceptable parameters of dialysis adequacy; however, 35% had evidence of malnutrition. Further research should focus on establishing a knowledge base for the nutritional management for Aboriginal dialysis subjects, and the development of a validated individual dietary assessment method for use in this population group. © 2013 Asian Pacific Society of Nephrology.

Community-Based Participatory Research-Speed Dating: An Innovative Model for Fostering Collaborations Between Community Leaders and Academic Researchers.

PubMed

Tucker, Melanie T; Lewis, Dwight W; Payne Foster, Pamela; Lucky, Felecia; Yerby, Lea G; Hites, Lisle; Higginbotham, John C

2016-11-01

Developing meaningful community-based participatory relationships between researchers and the community can be challenging. The overall success of a community-based participatory relationship should be predicated on commitment and respect from empowered stakeholders. Prior to developing the technique discussed in this article, we hypothesized that the process of fostering relationships between researchers and the community was much like a social relationship: It has to develop organically and cannot be forced. To address this challenge, we developed a community-based participatory research-speed dating technique to foster relationships based on common interests, which we call CBPR-SD. This article describes the logistics of implementing CBPR-SD to foster scholarly collaborations. As part of a federally funded community-based research project, the speed dating technique was implemented for 10 researchers and 11 community leaders with a goal of developing scholarly collaborative groups who will submit applications for community-based research grants. In the end, four collaborative groups developed through CBPR-SD, three (75%) successfully submitted grant applications to fund pilot studies addressing obesity-related disparities in rural communities. Our preliminary findings suggest that CBPR-SD is a successful tool for promoting productive scholarly relationships between researchers and community leaders. © 2016 Society for Public Health Education.

"Nobody smokes in the house if there's a new baby in it": Aboriginal perspectives on tobacco smoking in pregnancy and in the household in regional NSW Australia.

PubMed

Gould, Gillian S; Munn, Joanne; Avuri, Sandra; Hoff, Susan; Cadet-James, Yvonne; McEwen, Andy; Clough, Alan R

2013-12-01

Smoking prevalence in Aboriginal and Torres Strait Islander pregnant women is quadruple that of non-Indigenous counterparts, impacting on the health of babies and children. To explore attitudes and experiences related to prenatal tobacco smoking by Aboriginal women and household smoking, and to provide recommendations for culturally appropriate interventions. We conducted five focus groups with clients and family members of a regional NSW Aboriginal maternity service (n=18). Committees, including Aboriginal representatives, oversaw the study. We analysed transcripts with the constant comparative method and developed key categories. Categories included: social and family influences, knowing and experiencing the health effects of smoking, responses to health messages, cravings and stress, giving up and cutting down, managing smoke-free homes and cars, and community recommendations. Smoking in pregnancy and passive smoking were acknowledged as harmful for babies and children. Anti-tobacco messages and cessation advice appeared more salient when concordant with women's lived experience. Reduced cigarette consumption was reported in pregnancy. Despite smoking in the home, families were engaged in the management of environmental tobacco smoke to reduce harm to babies and children. Abstinence was difficult to initiate or maintain with the widespread use of tobacco in the social and family realm. Anti-tobacco messages and interventions should relate to Aboriginal women's experiences, improve understanding of the quitting process, support efficacy, and capitalise on the positive changes occurring in smoke-free home management. Focus group participants recommended individual, group and family approaches, and access to cessation services and nicotine replacement therapy for Aboriginal pregnant women who smoke. Copyright © 2013 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Continuing disparities in cardiovascular risk factors and complications between aboriginal and Anglo-Celt Australians with type 2 diabetes: the Fremantle Diabetes Study.

PubMed

Davis, Timothy M E; Hunt, Kerry; McAullay, Daniel; Chubb, Stephen A P; Sillars, Brett A; Bruce, David G; Davis, Wendy A

2012-10-01

To determine whether disparities in the nature and management of type 2 diabetes persist between Aboriginal and the majority Anglo-Celt patients in an urban Australian community. Baseline data from the observational Fremantle Diabetes Study collected from 1993 to 1996 (phase I) and from 2008 to 2011 (phase II) were analyzed. Patients characterized as Aboriginal or Anglo-Celt by self-report and supporting data underwent comprehensive assessment, including questionnaires, examination, and biochemical testing in a single laboratory. Generalized linear modeling with age/sex adjustment was used to examine differences in changes in variables in the two groups between phases I and II. The indigenous participants were younger at entry and at diabetes diagnosis than the Anglo-Celt participants in both phases. They were also less likely to be educated beyond primary level and were more likely to be smokers. HbA(1c) decreased in both groups over time (Aboriginal median 9.6% [interquartile range 7.8-10.7%] to 8.4% [6.6-10.6%] vs. Anglo-Celt median 7.1% [6.2-8.4%] to 6.7% [6.2-7.5%]), but the gap persisted (P = 0.65 for difference between phases I and II by ethnic group). Aboriginal patients were more likely to have microvascular disease in both phases. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.90 or lower-extremity amputation) increased in Aboriginal but decreased in Anglo-Celt participants (15.8-29.7 vs. 30.7-21.5%; P = 0.055). Diabetes management has improved for Aboriginal and Anglo-Celt Australian patients, but disparities in cardiovascular risk factors and complications persist.

Continuing Disparities in Cardiovascular Risk Factors and Complications Between Aboriginal and Anglo-Celt Australians With Type 2 Diabetes

PubMed Central

Davis, Timothy M.E.; Hunt, Kerry; McAullay, Daniel; Chubb, Stephen A.P.; Sillars, Brett A.; Bruce, David G.; Davis, Wendy A.

2012-01-01

OBJECTIVE To determine whether disparities in the nature and management of type 2 diabetes persist between Aboriginal and the majority Anglo-Celt patients in an urban Australian community. RESEARCH DESIGN AND METHODS Baseline data from the observational Fremantle Diabetes Study collected from 1993 to 1996 (phase I) and from 2008 to 2011 (phase II) were analyzed. Patients characterized as Aboriginal or Anglo-Celt by self-report and supporting data underwent comprehensive assessment, including questionnaires, examination, and biochemical testing in a single laboratory. Generalized linear modeling with age/sex adjustment was used to examine differences in changes in variables in the two groups between phases I and II. RESULTS The indigenous participants were younger at entry and at diabetes diagnosis than the Anglo-Celt participants in both phases. They were also less likely to be educated beyond primary level and were more likely to be smokers. HbA1c decreased in both groups over time (Aboriginal median 9.6% [interquartile range 7.8–10.7%] to 8.4% [6.6–10.6%] vs. Anglo-Celt median 7.1% [6.2–8.4%] to 6.7% [6.2–7.5%]), but the gap persisted (P = 0.65 for difference between phases I and II by ethnic group). Aboriginal patients were more likely to have microvascular disease in both phases. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.90 or lower-extremity amputation) increased in Aboriginal but decreased in Anglo-Celt participants (15.8–29.7 vs. 30.7–21.5%; P = 0.055). CONCLUSIONS Diabetes management has improved for Aboriginal and Anglo-Celt Australian patients, but disparities in cardiovascular risk factors and complications persist. PMID:22815295

"I Thought People Would Be Mean and Shout." Introducing the Hobbema Community Cadet Corps: A Response to Youth Gang Involvement?

ERIC Educational Resources Information Center

Grekul, Jana; Sanderson, Kim

2011-01-01

Hobbema, Alberta, Canada is a community comprised of four First Nations. As with many of Canada's Aboriginal communities, Hobbema's population is young. High rates of socio-economic disadvantage, violence, family dysfunction, and substance abuse are linked to colonization, residential school policies, and discrimination. Crime rates, including…

Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait Islanders who are engaging in non-suicidal self-injury.

PubMed

Armstrong, Gregory; Ironfield, Natalie; Kelly, Claire M; Dart, Katrina; Arabena, Kerry; Bond, Kathy; Jorm, Anthony F

2017-08-22

Non-suicidal self-injury (NSSI) disproportionally affects Indigenous Australians. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is engaging in NSSI. Culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islanders who are engaging in NSSI were developed in 2009. This study describes the re-development of these guidelines to ensure they contain the most current recommended helping actions. The Delphi consensus method was used to elicit consensus on potential helping statements to be included in the guidelines. These statements describe helping actions that Indigenous community members and non-Indigenous frontline workers can take, and information they should have, to help someone who is engaging in NSSI. The statements were sourced from systematic searches of peer-reviewed literature, grey literature, books, websites and online materials, and existing NSSI courses. A panel was formed, comprising 26 Aboriginal and Torres Strait Islanders with expertise in NSSI. The panellists were presented with the helping statements via online questionnaires and were encouraged to suggest re-wording of statements and any additional helping statements that were not included in the original questionnaire. Statements were only accepted for inclusion in the guidelines if they were endorsed by ≥90% of panellists as essential or important. From a total of 185 statements shown to the expert panel, 115 were endorsed as helping statements to be included in the re-developed guidelines. A panel of Aboriginal and Torres Strait Islander people with expertise in NSSI were able to reach consensus on appropriate strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander engaging in NSSI. The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version. The re-developed guidelines will form the basis of an Aboriginal mental health first aid short course on NSSI for Indigenous community members and non-Indigenous frontline workers that will be evaluated in an upcoming trial.