Browsing by Author "Mensah F."
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Item Aboriginal and Torres Strait Islander complex trauma and strengths questionnaire: psychometric evaluation.Gee G.; Bright T.; Morgan A.; Atkinson C.; Andrews S.; Clark Y.; Glover K.; Hirvonen T.; Davis E.; Jones K.A.; Reilly R.; Mensah F.; Hudson-Buhagiar M.; Bennetts S.K.; Herrman H.; Milroy H.; Mackinnon A.; Chamberlain C.eObjective: Complex post-traumatic stress disorder (complex trauma) describes a cluster of symptoms frequently associated with prolonged exposure to inescapable threats or abuse. For Aboriginal and Torres Strait Islander peoples in Australia impacted by complex trauma, there may be compounding factors, such as experiences of historical trauma, loss and socio-economic deprivation stemming from colonisation. However, there is no culturally appropriate tool to assess complex trauma. This paper presents the psychometric evaluation of a preliminary version Aboriginal and Torres Strait Islander Complex Trauma and Strengths Questionnaire (ACTSQ). Methods: Following 2 years of rigorous Aboriginal-led co-design, participants were recruited through community networks and partner health services in South Australia, Victoria, and Northern Territory (October 2020-May 2022). A trained interviewer contacted Aboriginal (n = 109) and Torres Strait Islander (n = 1) parents aged > 16 years by phone to complete the ACTSQ. Underlying domain structures were investigated with exploratory factor analysis and reviewed by experts to refine. Reliability and inter-rater reliability were assessed using McDonald's Omega and Intraclass Correlation Coefficient (ICC). Results: Forty-four items on five factors were retained. Factors were labelled complex trauma symptoms (16 items), grief, loss and disconnection (6 items), support and relationships (9 items), sense of self and strengths (7 items), and Cultural connections and resources (6 items). There were moderate correlations between factors, with the exception of factor 5. Omega was > 0.75 for all factors. The inter-rater reliability for each factor was fair to good (ICC 0.5-0.7). Conclusions: This study conducted a comprehensive psychometric validation that provides initial evidence towards the cultural validity of the ACTSQ to support assessment of complex trauma and strengths among Aboriginal and Torres Strait Islander peoples. Future studies are required to replicate and further evaluate the psychometric properties of the ACTSQ using larger samples. (PsycInfo Database Record (c) 2024 APA, all rights reserved)Item Challenges in monitoring the development of young children in remote Aboriginal health services: clinical audit findings and recommendations for improving practice.(20210615) D'Aprano A.; Silburn S.; Johnston V.; Bailie R.; Mensah F.; Oberklaid F.; Robinson G.Introduction: Early detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services. This study aimed to describe the developmental monitoring practice in two remote Australian Aboriginal primary healthcare services and to identify gaps in the delivery of developmental monitoring services. Method(s): A cross-sectional baseline medical record audit of all resident children aged less than 5 years in two remote Aboriginal health centres in the Northern Territory (NT) in Australia was undertaken between December 2010 and November 2011. Result(s): A total of 151 medical records were audited, 80 in Community A and 71 in Community B. Developmental checks were more likely among children who attended services more regularly. In Community A, 63 (79%) medical records had some evidence of a developmental check and in Community B there were 42 (59%) medical records with such evidence. However, there was little indication of how assessments were undertaken: only one record noted the use of a formal developmental screening measure. In Community A, 16 (16%) records documented parent report and 20 (20%) documented staff observations, while in Community B, the numbers were 2 (3%) and 11 (19%), respectively. The overall recorded prevalence of developmental difficulties was 21% in Community A and 6% in Community B. Conclusion(s): This is the first study to describe the quality of developmental monitoring practice in remote Australian Aboriginal health services. The audit findings suggest the need for a systems-wide approach to the delivery and recording of developmental monitoring services. This will require routine training of remote Aboriginal health workers and remote area nurses in developmental monitoring practice including the use of a culturally appropriate, structured developmental screening measure. Copyright © James Cook University 2016, http://www.jcu.edu.auItem Community views on 'can perinatal services safely identify Aboriginal and Torres Strait Islander parents experiencing complex trauma?'Chamberlain C.; Gray P.; Herrman H.; Mensah F.; Andrews S.; Krakouer J.; McCalman P.; Elliott A.; Atkinson J.; O'Dea B.; Bhathal A.; Gee G.Family and extended kinship systems which nurture healthy, happy children are central to Aboriginal and Torres Strait Islander cultures. Since colonisation, Aboriginal and Torres Strait Islander communities have been impacted by intergenerational cycles of trauma, stemming from colonial violence, genocidal policies and discrimination, including the forced removal of children from their families. Becoming a parent offers a unique life-course opportunity for trauma recovery and preventing intergenerational trauma. However, identifying or 'recognising' complex trauma carries significant risk of harm for Aboriginal and Torres Strait Islander parents due to reactive prenatal child protection involvement potentially compounding experiences of trauma, and limited benefits due to lack of culturally appropriate support. The Aboriginal-led participatory Healing the Past by Nurturing the Future project aims to co-design safe, accessible and feasible perinatal awareness, recognition, assessment and support strategies for Aboriginal and Torres Strait Islander parents experiencing complex trauma. This paper presents views of 38 workshop participants to determine prerequisites for ensuring benefits outweigh risks of assessment to safely recognise parents experiencing complex trauma, consistent with screening criteria. Six essential elements were identified from thematic analysis: high-quality holistic care; cultural, social and emotional safety; empowerment, choice and control; flexible person-centred approaches; trusting relationships; and sensitive, skilled communication. Key Practitioner Messages The impacts of colonisation and rates of Aboriginal and Torres Strait children in out-of-home care mean that there can be a myriad of issues facing Aboriginal and Torres Strait Islander parents with regard to perinatal child protection involvement. The benefits must outweigh the risks of identifying parents experiencing complex trauma. Assessment must be offered within foundations of supportive relationships and holistic care in culturally-safe, empowering settings, where choices are respected and skilled communication approaches are used. (PsycInfo Database Record (c) 2023 APA, all rights reserved)Item Parenting after a history of childhood maltreatment: a scoping review and map of evidence in the perinatal period.(2019-03-26) Chamberlain C.; Gee G.; Harfield S.; Campbell S.; Brennan S.; Clark Y.; Mensah F.; Arabena K.; Herrman H.; Brown S.; Atkinson J.; Nicholson J.; Gartland D.; Glover K.; Mitchell A.; Atkinson C.; McLachlan H.; Andrews S.; Hirvoven T.; Ralph N.; Dyall D.Background and aims Child maltreatment is a global health priority affecting up to half of all children worldwide, with profound and ongoing impacts on physical, social and emotional wellbeing. The perinatal period (pregnancy to two years postpartum) is critical for parents with a history of childhood maltreatment. Parents may experience 'triggering' of trauma responses during perinatal care or caring for their distressed infant. The long-lasting relational effects may impede the capacity of parents to nurture their children and lead to intergenerational cycles of trauma. Conversely, the perinatal period offers a unique life-course opportunity for parental healing and prevention of child maltreatment. This scoping review aims to map perinatal evidence regarding theories, intergenerational pathways, parents' views, interventions and measurement tools involving parents with a history of maltreatment in their own childhoods. Methods and results We searched Medline, Psychinfo, Cinahl and Embase to 30/11/2016. We screened 6701 articles and included 55 studies (74 articles) involving more than 20,000 parents. Most studies were conducted in the United States (42/55) and involved mothers only (43/55). Theoretical constructs include: attachment, social learning, relational-developmental systems, family-systems and anger theories; 'hidden trauma', resilience, post-traumatic growth; and 'Child Sexual Assault Healing' and socioecological models. Observational studies illustrate sociodemographic and mental health protective and risk factors that mediate/moderate intergenerational pathways to parental and child wellbeing. Qualitative studies provide rich descriptions of parental experiences and views about healing strategies and support. We found no specific perinatal interventions for parents with childhood maltreatment histories. However, several parenting interventions included elements which address parental history, and these reported positive effects on parent wellbeing. We found twenty-two assessment tools for identifying parental childhood maltreatment history or impact. Conclusions Perinatal evidence is available to inform development of strategies to support parents with a history of child maltreatment. However, there is a paucity of applied evidence and evidence involving fathers and Indigenous parents.Copyright © 2019 Chamberlain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Item Supporting Aboriginal and Torres Strait Islander families to stay together from the start (Safest Start): urgent call to action to address crisis in infant removals.Chamberlain C.; Gray P.; Bennet D.; Elliott A.; Jackomos M.; Krakouer J.; Marriott R.; O'Dea B.; Andrews J.; Andrews S.; Atkinson C.; Atkinson J.; Bhathal A.; Bundle G.; Davies S.; Herrman H.; Hunter SA.; Jones-Terare G.; Leane C.; Mares S.; McConachy J.; Mensah F.; Mills C.; Mohammed J.; Hetti Mudiyanselage L.; O'Donnell M.; Orr E.; Priest N.; Roe Y.; Smith K.; Waldby C.; Milroy H.; Langton MReducing the rate of over-representation of Aboriginal and Torres Strait Islander children in out-of-home care (OOHC) is a key Closing the Gap target committed to by all Australian governments. Current strategies are failing. The "gap" is widening, with the rate of Aboriginal and Torres Strait Islander children in OOHC at 30 June 2020 being 11 times that of non-Indigenous children. Approximately, one in five Aboriginal and Torres Strait Islander children entering OOHC each year are younger than one year. These figures represent compounding intergenerational trauma and institutional harm to Aboriginal and Torres Strait Islander families and communities. This article outlines systemic failures to address the needs of Aboriginal and Torres Strait Islander parents during pregnancy and following birth, causing cumulative harm and trauma to families, communities and cultures. Major reform to child and family notification and service systems, and significant investment to address this crisis, is urgently needed. The Family Matters Building Blocks and five elements of the Aboriginal and Torres Strait Islander Child Placement Principle (Prevention, Participation, Partnership, Placement and Connection) provide a transformative foundation to address historical, institutional, well-being and socioeconomic drivers of current catastrophic trajectories. The time for action is now. Copyright © 2022 The Authors. Australian Journal of Social Issues published by John Wiley & Sons Australia, Ltd on behalf of Australian Social Policy Association.