Browsing by Author "Lynch J."
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Item Community perspectives on delivering trauma-aware and culturally safe perinatal care for Aboriginal and Torres Strait Islander parents.(2023-03-24) Fiolet R.; Woods C.; Moana A.H.; Reilly R.; Herrman H.; McLachlan H.; Fisher J.; Lynch J.; Chamberlain C.Background: Since colonisation, Aboriginal and Torres Strait Islander peoples have experienced violence, loss of land, ongoing discrimination and increased exposure to traumatic events. These include adverse childhood experiences which can lead to complex trauma, and are associated with increased incidence of high-risk pregnancies, birth complications and emergence of post-traumatic symptoms during the perinatal period, potentially impacting parenting and leading to intergenerational trauma. The perinatal period offers unique opportunities for processing experiences of trauma and healing yet can also be a time when parents experience complex trauma-related distress. Therefore, it is essential that trauma-aware culturally safe perinatal care is accessible to Aboriginal and Torres Strait Islander parents. Aim(s): This study aimed to understand community perspectives of what 'trauma-aware culturally safe perinatal care' would look like for Aboriginal and Torres Strait Islander parents. Method(s): Data were collected during a workshop held with predominantly Aboriginal and Torres Strait Islander key stakeholders to co-design strategies to foster trauma-aware culturally safe perinatal care. Data were thematically analysed. Finding(s): Four overarching themes represent proposed goals for trauma-aware culturally safe care: Authentic partnerships that are nurtured and invested in to provide the foundations of care; a skilled workforce educated in trauma awareness; empowering and compassionate care for building trust; and safe and accessible environments to facilitate parent engagement. Conclusion(s): Provision of trauma-aware culturally safe care achieving these goals is likely to enable parents experiencing complex trauma to access appropriate support and care to foster healing in the critical perinatal period.Copyright © 2022 Australian College of MidwivesItem Early influences on developmental outcomes among children, at age 5, in Australia's Northern Territory.Guthridge S.; Li L.; Silburn S.; Li S.Q.; McKenzie J.; Lynch J.Redressing developmental and school learning inequalities among children requires an understanding of the factors that influence development across population groups. This study utilized the 2009 Australian Early Development Census (AEDC) to explore the association of perinatal health and socio-demographic factors with early development of children in the Northern Territory of Australia. The study cohort included 1110 Aboriginal and 812 non-Aboriginal children, most aged 5 years, whose developmental status was assessed during their first year of full-time school enrollment. Individual-level information was probabilistically linked across three administrative datasets. Logistic regression models were used to estimate the association (odds ratio (OR)) between early life characteristics of children and teacher-rated vulnerability on one or more of five domains of development. The crude OR for developmental vulnerability was much greater for Aboriginal than non-Aboriginal children (OR: 6.93, 95% CI: 5.62-8.56). After adjustment for other variables, the increased risk of developmental vulnerability for Aboriginal children was substantially moderated (OR: 1.68, 95% CI: 1.21-2.32). Influential factors in the adjusted model included: English as a second language (OR: 3.11, 95% CI: 2.27-4.26), gestational age at birth of 34-36 weeks (OR: 2.08, 95% CI: 1.27-3.39) and living in a very remote area (OR: 1.68, 95% CI: 1.19-2.37). There was a gradient in the strength of the association with the level of primary caregiver's education. An additional risk, for Aboriginal children only, was not having attended a day care or pre-school program (OR: 1.43, 95% CI: 1.01-2.04). The study demonstrates the emerging capacity for linkage of data across administrative datasets to inform our understanding of the extent to which multiple factors in early-life operate in their association with children's early development. Our findings are of particular relevance to initiatives to improve outcomes for Aboriginal children by demonstrating that potentially modifiable health and socio-economic factors account for almost all of the difference in developmental vulnerabilities observed between Aboriginal and non-Aboriginal children. (PsycInfo Database Record (c) 2021 APA, all rights reserved)Item Impact of perinatal health and socio-demographic factors on school education outcomes: a population study of Indigenous and non-Indigenous children in the Northern Territory.(2015-03-12) Guthridge S.; Li L.; Silburn S.; Li S.Q.; McKenzie J.; Lynch J.Aim: This study investigated the association between early-life risk factors and school education outcomes. Methods This is an historical cohort study of 7601 children (61% were Indigenous) born in the Northern Territory between 1999 and 2004. Information was linked, for each child on: perinatal health, student enrolment and National Assessment Program - Literacy and Numeracy (NAPLAN) Year 3 results. Logistic regression was used to estimate the association between selected risk factors and a NAPLAN result 'below' the national minimum standard (NMS) in reading and numeracy. Results Indigenous children had much higher odds, than non-Indigenous children, of a result below the NMS for both reading (odds ratio (OR): 8.58, 95% confidence interval (CI): 7.55-9.74) ) and numeracy (OR: 11.52, 95% CI: 9.94-13.35). When adjusted for all other variables, the increased odds were attenuated for both reading (OR: 2.89, 95% CI: 2.46-3.40) and numeracy (OR: 3.19, 95% CI: 2.65-3.84). Common risk factors for Indigenous and non-Indigenous children included higher birth order, maternal smoking in pregnancy and being a boy. There were gradients of decreasing risk with increasing education level of primary care giver and increasing maternal age. Among Indigenous children only, risks increased when living in remote areas, with younger age (<8 years) and low birthweight. Conclusions The study highlights that many of the risk factors associated with poor education outcomes among Indigenous children are shared with the general population. The results inform a targeted, cross-agency response to address modifiable early-life risk factors for educational disadvantage. Data linkage, using existing administrative datasets, provides a useful addition to methods that identify priority areas for prevention and early intervention.Copyright © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).