Welcome to the Lowitja Institute Repository

This institutional research repository is for the work of the Lowitja Institute, Australia’s national Aboriginal and Torres Strait Research Institute. Our work focuses on the health and wellbeing of Aboriginal and Torres Strait Islander peoples and Indigenous peoples across the globe. This Repository tracks the research outputs of Lowitja Institute employees, funded researchers and scholars as well as showcases community-led Aboriginal and Torres Strait Islander health research.

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Exploring healthcare providers’ perspectives on the factors that facilitate primary health care access among Aboriginal and Torres Strait Islander young people: a qualitative study in Southeast Queensland.
(2025-08-19) Harfield S.; Dean J.A.; Azzopardi P.; Mishra G.D.; Ward J.
Background: Aboriginal and Torres Strait Islander young people aged 15–24 years of age often encounter challenges accessing and utilising primary health care (PHC). Providing health care responsive to the needs of Aboriginal and Torres Strait Islander young people requires the active involvement of healthcare providers (HCPs), who play a central role in healthcare delivery. This study explored perspectives of HCPs working in urban Aboriginal and Torres Strait Islander Community-Controlled Health Organisations (ATSICCHOs) on the factors that facilitate Aboriginal and Torres Strait young people accessing and utilising PHC services. Methods: Thirteen research yarns were conducted with HCPs in urban southeast Queensland (SEQ), Australia. Inductive thematic analysis was used to identify factors facilitating health care access and utilisation and were mapped to a social-ecological framework model. Results: Three overarching strength-based themes that facilitate access to health care were common across research yarns: (1) The ATSICCHO model of care addresses the needs of Aboriginal and Torres Strait Islander young people; (2) Family and community play a key role in facilitating Aboriginal and Torres Strait Islander young people’s access to healthcare services; and (3) The characteristics of Aboriginal and Torres Strait Islander young people that support health-seeking behaviour. Specific factors identified included targeted programs and initiatives specifically for Aboriginal and Torres Strait Islander young people; equitable access to holistic, comprehensive and culturally safe PHC; characteristics and skills of the ATSICCHO workforce that support young people’s engagement and access; and young people’s motivation to be healthy and to seek care. Barriers contrasting these themes were also identified. Conclusion: HCPs from urban ATSICCHOs provide a unique perspective on the healthcare experience of Aboriginal and Torres Strait Islander young people and the factors that facilitate and/or challenge their access to PHC services. Improving PHC access among Aboriginal and Torres Strait Islander young people should focus on multilevel strategies across all three levels of the social-ecological model, with a particular focus on increasing opportunities for equitable access to PHC services for young people, enhancing target programs and initiatives for young people, and supporting the knowledge, skills and capacity of HCPs to delivery appropriate, culturally safe and holistic care.
Aboriginal and Torres Strait Islander dental program evaluations: a mixed-methods systematic review.
(2025-08-27) Pham A.; Hedges J.; Flanagan E.; Mastrosavas T.; Jamieson L.; Nath S.
Objective: Over the last 20 years, the disparity in oral health between Aboriginal and Torres Strait Islander Australians and other Australians has continued to grow. This suggests that further programmes and programme improvements are needed to reach equitable oral health outcomes for Aboriginal and Torres Strait Islander Peoples. This mixed methods systematic review aims to assess Aboriginal and Torres Strait Islander Dental Programme Evaluations by measuring outcomes and cultural safety via the Lowitja Institute Evaluation Framework to Improve Aboriginal and Torres Strait Islander Health. Methods: Databases searched were PubMed, Embase, Dentistry & Oral Sciences Source, Public Health Database and Scopus. All years were included. The date of the last search was the 1 May 2025. Published articles researching dental health programmes with Aboriginal and Torres Strait Islander participants in Australia were identified. Quantitative, qualitative and mixed methods studies were included. The Joanna Briggs Institute approach to Mixed-Methods Systematic Reviews was followed, except for a deviation in critical appraisal, which utilised the Quality Assessment for Diverse Studies (QuADs) instead. This review protocol was registered in PROSPERO (CRD42025637868) a priori. Results: There were 54 studies included. New South Wales, South Australia, Queensland, Northern Territory and Western Australia were the states with the most data. The research designs included qualitative, quantitative and mixed-methods approaches. Most studies were of relatively high quality, as assessed by the QuADS criteria. Evaluations of dental programs for Aboriginal and Torres Strait Islander communities largely adhered to the Lowitja Framework, particularly in shared responsibility, partnerships and active engagement with Aboriginal and Torres Strait Islander peoples and their communities. Program effectiveness was primarily assessed through reductions in dental decay and participant feedback. Findings may be limited because the Lowitja Framework was developed via evaluation tenders, and the studies included were sourced from research articles. Conclusions: Strong partnerships between programs, evaluation teams and Aboriginal and Torres Strait Islander communities are critical for cultural safety. Effective study designs should be used, and culturally relevant and holistic outcome measures should be chosen. Lessons learnt from this systematic review can be used to improve the effectiveness of Aboriginal and Torres Strait Islander dental programme evaluations.
Health and well-being of children and adolescents living in the Kimberley region of Western Australia: a scoping review protocol.
(2025-08-06) Cannon L.; Carter E.; Davies J.; Thomas S.; Elliott E.; Rice L.J.
Introduction: Aboriginal people in the Kimberley are concerned that scientific research, government Inquiries and Royal Commissions are not adequately informing policy and service design. In this protocol paper, we outline our proposed scoping review to identify and provide a broad overview of scientific literature regarding the health, well-being, mental health, disability, education and social outcomes of children and adolescents living in the Kimberley region of Western Australia and the recommendations that came from them. Methods and analysis: This scoping review is guided by Arksey and O’Malley’s (2005) methodological framework. We will conduct a comprehensive search across multiple databases using several search engines. Inclusion criteria were established to inform the selection of papers to be included in the review. After de-duplication, all titles and abstracts will be reviewed, followed by full-text screening. A second reviewer will independently screen 20% of the titles, abstracts and full texts. Two reviewers will discuss discrepancies, and a third reviewer will resolve any disagreements that may arise. We will use a data extraction template in Covidence to systematically extract relevant data.
Indigenist health system reform agenda.
(2025-07-25) Veasey A.; Bryant N.; Wenitong M.
Settler colonialism and neoliberalism have impacted the Australian health system’s ability to engage in authentic approaches to Aboriginal and Torres Strait Islander health and wellbeing. This chapter reflects on the historical socio-political context of health system policy and explores how this influences current strategic agendas in Indigenous health policy, workforce, services and research. Reflecting on the influence of Humphrey’s Indigenous Research Reform Agenda in strategically strengthening the Indigenous research health agenda, we then outline an argument for a similarly strategic approach to health system reform. In doing this we have drawn on the foundations of Indigenist Research Methodologies to outline a framework for an Indigenist Health System Reform Agenda grounded in Indigenous sovereignty. Finally, we outline a call to action to formulate a systems response through an Indigenous collective that progresses Indigenous Knowledge Translation to enable a just health system that is grounded in Indigenous Knowledges.
Experiences, impacts, and perspectives of recreational cannabis use among Indigenous communities: A scoping review.
(2025-05-19) Zentner D.; Dobischok S.; DeGrace S.; Wen R.A.; Wendt D.C.
Objective: Research on the patterns and correlates of cannabis use suggests a disproportionately higher use incidence across Indigenous populations in Canada and the United States. As cannabis use is related to several deleterious social and behavioral consequences for which Indigenous Peoples are disproportionately vulnerable, it is a public health concern. We gathered and organized the extant research on cannabis use among Indigenous groups to describe emergent themes and future research areas. Method: We conducted a scoping review of articles published between 2005 and February 2020 on Indigenous populations and cannabis use in Canada and the United States. We screened 1,934 articles indexed through APA PsycInfo, Scopus, and Medline, 152 of which were systematically coded and analyzed. Results: Most studies focused on the prevalence and patterns of cannabis use initiation, followed by protective and risk factors, correlations of cannabis use and other substance use, correlations of cannabis with mental health diagnoses and with other health consequences, interventions for cannabis use, and cannabis legalization issues. Most articles focused on youth, were analyzed quantitatively, and discussed cannabis use in the context of general substance use. Conclusions: Future research should explore culturally appropriate intervention programs and the impact of cannabis legalization issues. (PsycInfo Database Record (c) 2025 APA, all rights reserved) Impact Statement: This review indicates that although there is a disproportionate prevalence of cannabis use among Indigenous populations, these differences are no longer significant when controlling for other variables. (PsycInfo Database Record (c) 2025 APA, all rights reserved)