Lowitja Institute:: Browsing by Author "Bessarab D."

Browsing by Author "Bessarab D."

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Community-based participatory action research on rheumatic heart disease in an Australian Aboriginal homeland: evaluation of the 'On Track Watch' project.
(2019-04-11) Haynes E.; Marawili M.; Marika B.M.; Mitchell A.G.; Phillips J.; Bessarab D.; Walker R.; Cook J.; Ralph A.P.
Strategies to date have been ineffective in reducing high rates of rheumatic heart disease (RHD) in Australian Aboriginal people; a disease caused by streptococcal infections. A remote Aboriginal community initiated a collaboration to work towards elimination of RHD. Based in 'both-way learning' (reciprocal knowledge co-creation), the aim of this study was to co-design, implement and evaluate community-based participatory action research (CBPAR) to achieve this vision. Activities related to understanding and addressing RHD social determinants were delivered through an accredited course adapted to meet learner and project needs. Theory-driven evaluation linking CBPAR to empowerment was applied. Data collection comprised focus groups, interviews, observation, and co-development and use of measurement tools such as surveys. Data analysis utilised process indicators from national guidelines for Aboriginal health research, and outcome indicators derived from the Wallerstein framework. Findings include the importance of valuing traditional knowledges and ways of learning such as locally-meaningful metaphors to explore unfamiliar concepts; empowerment through critical thinking and community ownership of knowledge about RHD and research; providing practical guidance in implementing empowering and decolonising principles / theories. Lessons learned are applicable to next stages of the RHD elimination strategy which must include scale-up of community leadership in research agenda-setting and implementation.Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.
Decolonising qualitative research with respectful, reciprocal, and responsible research practice: a narrative review of the application of yarning method in qualitative Aboriginal and Torres Strait Islander health research.
(2022-10-15) Kennedy M.; Maddox R.; Booth K.; Maidment S.; Chamberlain C.; Bessarab D.
Background: Indigenous academics have advocated for the use and validity of Indigenous methodologies and methods to centre Indigenous ways of knowing, being and doing in research. Yarning is the most reported Indigenous method used in Aboriginal and Torres Strait Islander qualitative health research. Despite this, there has been no critical analysis of how Yarning methods are applied to research conduct and particularly how they privilege Indigenous peoples. Objective(s): To investigate how researchers are applying Yarning method to health research and examine the role of Aboriginal and Torres Strait Islander researchers in the Yarning process as reported in health publications. Design(s): Narrative review of qualitative studies. Data sources: Lowitja Institute LitSearch January 2008 to December 2021 to access all literature reporting on Aboriginal and Torres Strait Islander health research in the PubMed database. A subset of extracted data was used for this review to focus on qualitative publications that reported using Yarning methods. Method(s): Thematic analysis was conducted using hybrid of inductive and deductive coding. Initial analysis involved independent coding by two authors, with checking by a third member. Once codes were developed and agreed, the remaining publications were coded and checked by a third team member. Result(s): Forty-six publications were included for review. Yarning was considered a culturally safe data collection process that privileges Indigenous knowledge systems. Details of the Yarning processes and team positioning were vague. Some publications offered a more comprehensive description of the research team, positioning and demonstrated reflexive practice. Training and experience in both qualitative and Indigenous methods were often not reported. Only 11 publications reported being Aboriginal and/or Torres Strait Islander led. Half the publications reported Aboriginal and Torres Strait Islander involvement in data collection, and 24 reported involvement in analysis. Details regarding the role and involvement of study reference or advisory groups were limited. Conclusion(s): Aboriginal and Torres Strait Islander people should be at the forefront of Indigenous research. While Yarning method has been identified as a legitimate research method to decolonising research practice, it must be followed and reported accurately. Researcher reflexivity and positioning, and Aboriginal and Torres Strait Islander ownership, stewardship and custodianship of data collected were significantly under detailed in the publications included in our review. Journals and other establishments should review their processes to ensure necessary details are reported in publications and engage Indigenous Editors and peer reviewers to uphold respectful, reciprocal, responsible and ethical research practice.Copyright © 2022, The Author(s).
The well-being of carers of older Aboriginal people living in the Kimberley region of remote Western Australia: empowerment, depression, and carer burden.
(2020-01-16) LoGiudice D.; Josif C.M.; Malay R.; Hyde Z.; Haswell M.; Lindeman M.A.; Etherton-Beer C.; Atkinson D.; Bessarab D.; Flicker L.; Smith K.
Objective: To describe demographic features and well-being of carers of Aboriginal Australians aged >=45 years in remote Western Australia. Method(s): Carer burden, empowerment, and depression were assessed in 124 Aboriginal carers in four remote Aboriginal communities. Result(s): Carers were aged 38.8 +/- 15.0 years, 73.4% were female, and 75.8% were children or grandchildren of the person cared for. The mean Zarit-6 score was 3.7 +/- 3.6. Attending high school (odds ratio [OR] = 0.3; 95% confidence interval [CI] = [0.1, 0.7]) and feeling empowered (OR = 0.2; 95% CI = [0.1, 0.8]) were inversely associated with carer burden; female carers were less likely to feel empowered (OR = 0.4; 95% CI = [0.2, 0.9]); and empowerment was inversely associated with depression (OR = 0.3; 95% CI = [0.1, 0.7]). Discussion(s): Aboriginal carers in remote communities are relatively young and most are children or grandchildren. Carer burden was lower than anticipated. However, existing tools may not adequately measure Aboriginal perspectives. Education and empowerment are key factors which support programs must consider.Copyright © The Author(s) 2020.
Yarning together: developing a culturally secure rehabilitation approach for Aboriginal Australians after brain injury.
(2020-01-31) Ciccone N.; Armstrong E.; Adams M.; Bessarab D.; Hersh D.; McAllister M.; Godecke E.; Coffin J.
Background and Objectives: Stroke and traumatic brain injury are more common in Aboriginal Australians than their non-Aboriginal counterparts, yet knowledge surrounding what constitutes a culturally secure and accessible rehabilitation service for Aboriginal Australians is sparse. This research (Lowitja Institute Funding 2018-2019) is working with Aboriginal people with an acquired communication disorder (ACD) following brain injury to (i) develop an understanding of the individual's perceptions of rehabilitation services and (ii) test the feasibility and acceptability of a culturally tailored model of speech pathology rehabilitation delivered via one of two modes: face to face or using telehealth technology. Method(s): Participants (n = 20) with an ACD after stroke or traumatic brain injury will be allocated to one of two groups: face-to-face therapy or therapy utilising telehealth technology and will receive 16 x 1 h treatment sessions provided twice weekly. Therapy utilises collaborative planning, integrates a yarning framework and is provided by a speech pathologist and Aboriginal co-worker. Improvement in participant communication skills is being measured through change in verbal output in discourse. The perspectives of the participants on the rehabilitation services accessed previously, the therapy provided through the study and change in everyday communication will be collected through semi-structured interviews. Result(s): This paper will present the therapy protocol, an explanation of the key elements involved in therapy implementation and some preliminary findings. Conclusion(s): The findings from this study will provide direction for rehabilitation therapists who provide services to Aboriginal brain injury survivors to improve quality of care.
Yarning together: incorporating telehealth into the provision of culturally secure speech pathology services for Aboriginal Australians after brain injury.
(2021-02-27) Ciccone N.; Armstrong E.; Adams M.; Hersh D.; McAllister M.; Bessarab D.; Godecke E.; Coffin J.; Walley M.
Background and objectives: Stroke and traumatic brain injury are more common in Aboriginal Australians than their non-Aboriginal counterparts, yet knowledge surrounding what Aboriginal Australians view as a culturally secure rehabilitation service is limited. Our previous research trialled a culturally secure model of rehabilitation which was feasible to deliver and acceptable to Aboriginal people who had an acquired communication disorder (ACD) following a stroke. The model involved the use of yarning principles and an Aboriginal co-worker (ACW) working in conjunction with the speech pathologist (SP). The current project (Lowitja Institute Funding 2018- 2019) extends this previous work by adding a telehealth component and again explores the feasibility and acceptability of the treatment delivered via one of two modes: face to face or using telehealth technology. Method(s): Participants (n = 11), Aboriginal adults with an ACD after stroke or traumatic brain injury (>1 year-18 years post-onset), were case-matched and allocated to one of two groups: face-to-face therapy or therapy utilising telehealth technology and received 16 x 1 h treatment sessions provided twice weekly. Therapy integrated a yarning framework and was provided jointly by a SP and ACW in the person's place of residence. Feasibility was measured by analysing the number of sessions conducted jointly by the SP and ACW and participant attendance. Improvement in the participants' communication skills were measured through change in verbal output within language samples collected at multiple time points. Semi-structured interviews were used to explore both the participants' perspectives and the ACW's and SP's perceptions on the acceptability of and change achieved through the therapy. All interviews were analysed through qualitative descriptive analysis. Result(s): Across all sessions, 235/258 (91.1%) were attended by the ACW and SP and 10 of the 11 participants completed all prescribed sessions. Positive feedback was provided by participants, the ACW and SPs on the key components of the programme including the use of telehealth technology. Conclusion(s): The findings from this study provide direction for rehabilitation therapists who provide services to Aboriginal people to improve quality of care and provide culturally secure services. This work demonstrates that therapy can be delivered remotely by a SP but that an ACW being physically present is an important part of this rehabilitation approach.

Browsing by Author "Bessarab D."

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