Lowitja Funded Research

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The Lowitja Institute is committed to investing in Aboriginal and Torres Strait Islander community-driven health research that privileges Indigenous ways of knowing, being and doing. The Lowitja Institute's investment upholds Aboriginal and Torres Strait Islander rights to sovereignty and self-determination throughout all stages of the research process and within the health research workforce. This collection features research funded by the Lowitja Institute and its predecessors, encompassing community-led studies and publications by researchers affiliated with the Lowitja Institute.
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A community-based co-designed genetic health service model for Aboriginal Australians.
(2021-01-15) Elsum I.; Massey L.; McEwan C.; LaGrappe D.; Kowal E.; Savarirayan R.; Baynam G.; Jenkins M.; Garvey G.; Kelaher M.
Background Aboriginal and Torres Strait Islander people experience a greater burden of disease and die younger than non-Indigenous Australians, with Aboriginal people living in remote areas of the Northern Territory of Australia having the lowest life expectancy estimates. Despite a high burden of chronic disease among Aboriginal and Torres Strait Islander people, access to specialist health services remains low and models of care that increase engagement, may improve health outcomes. Methods We describe client and staff perspectives of a model of clinical genetics services provided by the MJD Foundation (MJDF) in geographically and culturally complex contexts within the Northern Territory of Australia. We seek to understand the MJDF model's success in supporting Aboriginal families with the familial, neurodegenerative condition Machado-Joseph disease and how it could be applied in the provision of other specialist services. Thematic analysis was undertaken on semi-structured interviews with primary health care staff (n = 2), Non-Aboriginal MJDF Staff (n = 7) and Aboriginal MJDF Clients / Community workers (n = 13). Results Four key themes regarding the MJDF model of service delivery were identified with the service being; 1) client led 2) accepting of various understandings of genetic disease causation 3) focused on relationships, continuity and trust between the service provider and the clients, and 4) committed to incorporating an inclusive whole-of-family practice. The MJDF model takes a community-based, person-and family-centred approach to successfully deliver effective specialist genetic health services in remote community settings. We propose that these approaches have broad application in the future design and delivery of specialist health services particularly in culturally complex settings.Copyright © 2020 Elsum 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.
A culturally responsive trauma-informed public health emergency framework for Aboriginal and Torres Strait Islander communities in Australia, developed during COVID-19.
(2022-12-24) Graham S.; Kamitsis I.; Kennedy M.; Heris C.; Bright T.; Bennetts S.K.; Jones K.A.; Fiolet R.; Mohamed J.; Atkinson C.; Chamberlain C.
The Coronavirus Disease 2019 (COVID-19) pandemic impacted peoples' livelihoods and mental wellbeing. Aboriginal and Torres Strait Islander peoples in Australia continue to experience intergenerational trauma associated with colonization and may experience trauma-related distress in response to government responses to public health emergencies. We aimed to develop a culturally responsive trauma-informed public health emergency response framework for Aboriginal and Torres Strait Islander peoples. This Aboriginal and Torres Strait Islander-led study involved: (i) a review of trauma-informed public health emergency responses to develop a draft framework (ii) interviews with 110 Aboriginal and Torres Strait Islander parents about how COVID-19 impacted their lives, and (iii) a workshop with 36 stakeholders about pandemic experiences using framework analysis to refine a culturally responsive trauma-informed framework. The framework included: an overarching philosophy (cultural humility, safety and responsiveness); key enablers (local leadership and Eldership); supporting strategies (provision of basic needs and resources, well-functioning social systems, human rights, dignity, choice, justice and ethics, mutuality and collective responsibility, and strengthening of existing systems); interdependent core concepts (safety, transparency, and empowerment, holistic support, connectedness and collaboration, and compassion, protection and caring); and central goals (a sense of security, resilience, wellbeing, self- and collective-efficacy, hope, trust, resilience, and healing from grief and loss).Copyright © 2022 by the authors.
A pilot investigation into Aboriginal people's understandings of depression and anxiety.
Axleby-Blake T.; Bilney P.; Elliott P.; Evans C.; Fitz J.; Graham S.; Herbert P.; Kassman-Reid H.; Mills R.; Mundy D.; Naden M.; Peters R.; Moller J.; Malin M.
This project was conducted as part of the Certificate IV in Indigenous research capacity building in response to Aboriginal community concern about the extensive level of grief and high rates of psychological stress and mental illness being documented in Aboriginal communities. The research addressed the questions of what is known about depression and anxiety in Aboriginal communities, and how these conditions are dealt with and talked about. Thirteen semi-structured interviews were conducted with Aboriginal people working or studying at an Aboriginal community controlled health agency seeking people's stories about depression and anxiety. A survey questionnaire was then administered to 75 Aboriginal community people who were not health practitioners or teachers. The interviews were thematically analysed and the questionnaire data were analysed using Excel pivot tables. The project found that almost all the Aboriginal research participants had personal knowledge of someone suffering from depression or anxiety. All but two of the participants understood these to be serious conditions and had sound understandings of the antecedents, triggers, symptoms and long term impacts. Several stories were told of resilience where, despite harrowing life circumstances, people worked to overcome their depression or anxieties, in their own time, by becoming informed about the condition and, with professional support where necessary, devised strategies for managing them. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
A pilot study of the quality of informed consent materials for Aboriginal participants in clinical trials.
(2005-08-31) Russell F.M.; Carapetis J.R.; Liddle H.; Edwards T.; Ruff T.A.; Devitt J.
Objective: To pilot informed consent materials developed for Aboriginal parents in a vaccine trial, and evaluate their design and the informed consent process. Method(s): Cross sectional quantitative and qualitative survey of 20 Aboriginal and 20 non-Aboriginal women in Alice Springs. Information about the proposed research was presented to Aboriginal participants by an Aboriginal researcher, using purpose designed verbal, visual, and written materials. Non-Aboriginal participants received standard materials developed by the sponsor. Questionnaires were used to evaluate recall and understanding immediately and five days later. Qualitative analysis of Aboriginal participants' interviews was performed. Result(s): There were no differences between the groups in understanding of diseases prevented by the vaccine, the potential risks of participating, or the voluntary nature of participation. Most Aboriginal participants had difficulty with the concept of a "licensed" versus "unlicensed" vaccine. The non-Aboriginal group had a good understanding of this. Aboriginal participants identified the use of the flipchart, along with a presentation by a doctor and Aboriginal health worker, as preferred delivery modes. Group presentations were preferred rather than one-on-one discussions. The use of the questionnaire posed considerable methodological difficulties. Conclusion(s): A one-off oral presentation to Aboriginal participants is unlikely to produce "informed consent". Key but unfamiliar concepts require identification and particularly considered presentation.
A prospective evaluation of First People's health promotion program design in the Goulburn-Murray rivers region.
(2016-11-16) Doyle J.; Atkinson-Briggs S.; Atkinson P.; Firebrace B.; Calleja J.; Reilly R.; Cargo M.; Riley T.; Crumpen T.; Rowley K.
Background: 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. Method(s): 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. Result(s): 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. Conclusion(s): 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. Copyright © 2016 The Author(s).
A systematic review of barriers and facilitators to participation in randomized controlled trials by Indigenous people from New Zealand, Australia, Canada and the United States.
(2016-01-10) Glover M.; Kira A.; Johnston V.; Walker N.; Thomas D.; Chang A.B.; Bullen C.; Segan C.J.; Brown N.
Approach: The literature was systematically searched for published articles including information on the barriers and facilitators for Indigenous people's participation in health-related RCTs. Articles were identified using a key word search of electronic databases (Scopus, Medline and EMBASE). To be included, papers had to include in their published work at least one aspect of their RCT that was either a barrier and/or facilitator for participation identified from, for example, design of intervention, or discussion sections of articles. Articles that were reviews, discussions, opinion pieces or rationale/methodology were excluded. Results were analysed inductively, allowing themes to emerge from the data. Issue: Many randomized controlled trials (RCTs) are conducted each year but only a small proportion is specifically designed for Indigenous people. In this review we consider the challenges of participation in RCTs for Indigenous peoples from New Zealand, Australia, Canada and the United States and the opportunities for increasing participation. Key findings: Facilitators enabling Indigenous people's participation in RCTs included relationship and partnership building, employing Indigenous staff, drawing on Indigenous knowledge models, targeted recruitment techniques and adapting study material. Challenges for participation included both participant-level factors (such as a distrust of research) and RCT-level factors (including inadequately addressing likely participant barriers (phone availability, travel costs), and a lack of recognition or incorporation of Indigenous knowledge systems. Implication: The findings from our review add to the body of knowledge on elimination of health disparities, by identifying effective and practical strategies for conducting and engaging Indigenous peoples with RCTs. Future trials that seek to benefit Indigenous peoples should actively involve Indigenous research partners, and respect and draw on pertinent Indigenous knowledge and values. This review has the potential to assist in the design of such studies.Copyright © The Author(s) 2014.
A unified call to action from Australian nursing and midwifery leaders: ensuring that Black lives matter.
(2020-08-21) Geia L.; Baird K.; Bail K.; Barclay L.; Bennett J.; Best O.; Birks M.; Blackley L.; Blackman R.; Bonner A.; Bryant Ao R.; Buzzacott C.; Campbell S.; Catling C.; Chamberlain C.; Cox L.; Cross W.; Cruickshank M.; Cummins A.; Dahlen H.; Daly J.; Darbyshire P.; Davidson P.; Denney-Wilson E.; De Souza R.; Doyle K.; Drummond A.; Duff J.; Duffield C.; Dunning T.; East L.; Elliott D.; Elmir R.; Fergie Oam D.; Ferguson C.; Fernandez R.; Flower Am D.; Foureur M.; Fowler C.; Fry M.; Gorman E.; Grant J.; Gray J.; Halcomb E.; Hart B.; Hartz D.; Hazelton M.; Heaton L.; Hickman L.; Homer Ao C.S.E.; Hungerford C.; Hutton A.; Jackson Ao D.; Johnson A.; Kelly M.A.; Kitson A.; Knight S.; Levett-Jones T.; Lindsay D.; Lovett R.; Luck L.; Molloy L.; Manias E.; Mannix J.; Marriott A.M.R.; Martin M.; Massey D.; McCloughen A.; McGough S.; McGrath L.; Mills J.; Mitchell B.G.; Mohamed J.; Montayre J.; Moroney T.; Moyle W.; Moxham L.; Northam Oam H.; Nowlan S.; O'Brien A.P.; Ogunsiji O.; Paterson C.; Pennington K.; Peters K.; Phillips J.; Power T.; Procter N.; Ramjan L.; Ramsay N.; Rasmussen B.; Rihari-Thomas J.; Rind B.; Robinson M.; Roche M.; Sainsbury K.; Salamonson Y.; Sherwood J.; Shields L.; Sim J.; Skinner I.; Smallwood G.; Smallwood R.; Stewart L.; Taylor S.; Usher Am K.; Virdun C.; Wannell J.; Ward R.; West C.; West R.; Wilkes L.; Williams R.; Wilson R.; Wynaden D.; Wynne R.
Nurses and midwives of Australia now is the time for change! As powerfully placed, Indigenous and non-Indigenous nursing and midwifery professionals, together we can ensure an effective and robust Indigenous curriculum in our nursing and midwifery schools of education. Today, Australia finds itself in a shifting tide of social change, where the voices for better and safer health care ring out loud. Voices for justice, equity and equality reverberate across our cities, our streets, homes, and institutions of learning. It is a call for new songlines of reform. The need to embed meaningful Indigenous health curricula is stronger now than it ever was for Australian nursing and midwifery. It is essential that nursing and midwifery leadership continue to build an authentic collaborative environment for Indigenous curriculum development. Bipartisan alliance is imperative for all academic staff to be confident in their teaching and learning experiences with Indigenous health syllabus. This paper is a call out. Now is the time for Indigenous and non-Indigenous nurses and midwives to make a stand together, for justice and equity in our teaching, learning, and practice. Together we will dismantle systems, policy, and practices in health that oppress. The Black Lives Matter movement provides us with a 'now window' of accepted dialogue to build a better, culturally safe Australian nursing and midwifery workforce, ensuring that Black Lives Matter in all aspects of health care.
Aboriginal and Torres Strait Islander human research ethics committees (HRECS) are essential in promoting our health and wellbeing.
(2023-07-12) Finlay S.M.; Doyle M.; Kennedy M.
The history of unethical and inhumane research conducted on Aboriginal and Torres Strait Islander people since colonisation highlights the critical need for specific Human Research Ethics for research involving Aboriginal and Torres Strait Islander peoples in Australia. The development of Aboriginal Human Research Ethics Committees (AHRECs) has played a vital role in ensuring research is safe and delivered for Aboriginal and Torres Strait Islander people in a way that protects and promotes their health and wellbeing. However, there remains a lack of appropriate and critical ethical governance for such research in areas without specific Aboriginal HRECs in each jurisdiction. This perspective argues that greater investment in state-based AHRECs and consideration of a national AHREC are essential to ensure the ongoing health and wellbeing of Aboriginal and Torres Strait Islander people in the research process -the ultimate aim of any research that involves them.
Aboriginal and Torres Strait Islander people's domains of wellbeing: a comprehensive literature review.
(2019-06-15) Butler T.L.; Anderson K.; Garvey G.; Cunningham J.; Ratcliffe J.; Tong A.; Whop L.J.; Cass A.; Dickson M.; Howard K.
There are significant health and social disparities between the world's Indigenous and non-Indigenous people on factors likely to influence quality of life (QOL) and wellbeing. However, these disparities in wellbeing are not captured in conventional QOL instruments, as they often do not include dimensions that are likely to be relevant to Indigenous people. The objective of this comprehensive literature review was to identify these wellbeing domains for Aboriginal and Torres Strait Islander people in Australia (hereafter, respectfully referred to collectively as Indigenous Australians). We searched PsycINFO, MEDLINE, Econlit, CINAHL, and Embase (from inception to June 2017, and updated in March 2019), and grey literature sources using keywords relating to adult Indigenous Australians' QOL and wellbeing. From 278 full-text articles assessed for eligibility, 95 were included in a thematic analysis. This synthesis revealed nine broad interconnected wellbeing dimensions: autonomy, empowerment and recognition; family and community; culture, spirituality and identity; Country; basic needs; work, roles and responsibilities; education; physical health; and mental health. The findings suggest domains of wellbeing relevant to and valued by Indigenous Australians that may not be included in existing QOL and wellbeing instruments, domains that may be shared with Indigenous populations globally. This indicates the need for a tailored wellbeing instrument that includes factors relevant to Indigenous Australians. Developing such an instrument will ensure meaningful, culturally-relevant measurement of Indigenous Australians' wellbeing.Copyright © 2019 Elsevier Ltd
Aboriginal and Torres Strait Islander smoke-free homes, 2002 to 2008.
(2015-11-16) Thomas D.P.; Stevens M.
Objective: To describe the social patterning of and trends in the prevalence of Aboriginal and Torres Strait Islander smoke-free homes, and the association between these smoke-free homes and smoking initiation, intensity and cessation. Methods: Analyses of responses to questions about whether any householders usually smoke inside in the 2004 National Aboriginal and Torres Strait Islander Health Survey, the 2008 National Aboriginal and Torres Strait Islander Social Survey, and in the comparable National Health Surveys in 2004 and 2007. Results: The proportion of Indigenous children living with at least one daily smoker who smokes inside declined significantly from 28.4% in 2004 to 20.8% in 2008, with significant improvements only detected among the most disadvantaged categories of Indigenous children. The proportion of Indigenous daily smokers who lived in multi-person households where no daily smoker householder usually smoked inside increased significantly from 45.0% in 2004 to 56.3% in 2008. The absolute size of these changes was greater among Indigenous children and smokers than among all Australians. More disadvantaged Indigenous children were more likely to be exposed to secondhand smoke at home, and more disadvantaged Indigenous smokers were more likely to live in households where smokers usually smoked inside. Indigenous smokers in smoke-free homes smoke significantly less cigarettes. Conclusions: The increases in Indigenous smoke-free homes are encouraging, especially as they are from the period before recent increased attention to Indigenous tobacco control, which should accelerate these trends and their resultant health benefits for Aboriginal and Torres Strait Islander children and families.Copyright © 2014 The Authors. ANZJPH © 2014 Public Health Association of Australia.
Acceptability of an Aboriginal wellbeing intervention for supporters of people using methamphetamines.
(2018-06-08) Whiteside M.; MacLean S.; Callinan S.; Marshall P.; Nolan S.; Tsey K.
Families and workers often suffer significant stress while supporting people who are experiencing problems related to methamphetamine use yet there is little evidence on how best to help. Small pilot studies can provide valuable information about potential ways to intervene. This paper presents a pilot study of an Aboriginal family wellbeing intervention with workers in an Aboriginal health service. The pilot indicated that participation in the intervention improved the psychosocial empowerment and wellbeing of workers, that these workers perceived the program as relevant to families, and that this was an intervention they felt they could deliver to clients themselves. Implications: An Aboriginal family wellbeing intervention was piloted and found to improve the empowerment and wellbeing of workers. Participants regarded it as highly relevant for families supporting people using methamphetamines and other drugs. This research has added to our knowledge about how to assist those supporting Aboriginal people using methamphetamines and other drugs. Copyright © 2018, © 2018 Australian Association of Social Workers.
Advancing the Australian global health community's commitment to climate change and global health.
(2023-12-19) Bone A.; Kaur P.; Capon A.; Lin V.K.-W.; Tu'itahi S.; Bowen K.; Watts N.; Fisher J.R.W.; Stewart P.J.; Evans H.; Lo S.N.
An Australian national survey of First Nations careers in health services.
(2024-10-18) Nathan S.; Meyer L.; Joseph T.; Blignault I.; Bailey J.; Demasi K.; Newman J.; Briggs N.; Williams M.; Lew Fatt E.
A strong First Nations health workforce is necessary to meet community needs, health rights, and health equity. This paper reports the findings from a national survey of Australia's First Nations people employed in health services to identify enablers and barriers to career development, including variations by geographic location and organisation type. A cross-sectional online survey was undertaken across professions, roles, and jurisdictions. The survey was developed collaboratively by Aboriginal and non-Aboriginal academics and Aboriginal leaders. To recruit participants, the survey was promoted by key professional organisations, First Nations peak bodies and affiliates, and national forums. In addition to descriptive statistics, logistic regression was used to identify predictors of satisfaction with career development and whether this varied by geographic location or organisation type. Of the 332 participants currently employed in health services, 50% worked in regional and remote areas and 15% in Aboriginal Community-Controlled Health Organisations (ACCHOs) with the remainder in government and private health services. All enablers identified were associated with satisfaction with career development and did not vary by location or organisation type. "Racism from colleagues"and "lack of cultural awareness,""not feeling supported by their manager,""not having role models or mentors,"and "inflexible human resource policies"predicted lower satisfaction with career development only for those employed in government/other services. First Nations people leading career development were strongly supported. The implications for all workplaces are that offering even a few career development opportunities, together with supporting leadership by Aboriginal and Torres Strait Islander staff, can make a major difference to satisfaction and retention. Concurrently, attention should be given to building managerial cultural capabilities and skills in supporting First Nations' staff career development, building cultural safety, providing formal mentors and addressing discriminatory and inflexible human resources policies. Copyright © 2023 S. Nathan et al.
An exploration of underrepresentation of Aboriginal cancer patients attending a regional radiotherapy service in Western Australia.
(2018-03-03) Lyford M.; Haigh M.M.; Baxi S.; Cheetham S.; Shahid S.; Thompson S.C.
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.Copyright © 2018 by the authors. Licensee MDPI, Basel, Switzerland.
Antenatal emotional wellbeing screening in Aboriginal and Torres Strait Islander primary health care services in Australia.
(2014-05-13) Gausia K.; Thompson S.; Nagel T.; Rumbold A.; Connors C.; Matthews V.; Boyle J.; Schierhout G.; Bailie R.
The aim of this study was to examine the extent to which antenatal emotional wellbeing (EW) assessments are undertaken in primary health care (PHC) centres and factors associated with completion of EW screening. Medical records of 797 pregnant women from 36 PHC centres in five states (NSW, QLD, SA, WA and NT) were audited. Overall, 85% of the women were Aboriginal. The proportion of women with documented screening for EW varied from 5 to 38% between states (mean 17%). Aboriginal women were four times more likely (adjusted Odds Ratio (OR = 4.13, 95% CI = 2.46-6.92) to not be screened for antenatal EW than non-Aboriginal women. Aboriginality, <4 antenatal visits, absence of an antenatal and birth care plan, and lack of counselling on financial support were independently linked with no screening of EW. Provision of training for health service providers and further research on appropriate screening tools for Aboriginal women are needed to help redress this gap.
Antibiotic use for Australian Aboriginal children in three remote Northern Territory communities.
(2020-05-02) Howarth T.; Brunette R.; Davies T.; Andrews R.M.; Patel B.K.; Tong S.; Barzi F.; Kearns T.M.
Objective To describe antibiotic prescription rates for Australian Aboriginal children aged <2 years living in three remote Northern Territory communities. Design A retrospective cohort study using electronic health records. Setting Three primary health care centres located in the Katherine East region. Participants Consent was obtained from 149 mothers to extract data from 196 child records. There were 124 children born between January 2010 and July 2014 who resided in one of the three chosen communities and had electronic health records for their first two years of life. Main outcome measures Antibiotic prescription rates, factors associated with antibiotic prescription and factors associated with appropriate antibiotic prescription. Results There were 5,675 Primary Health Care (PHC) encounters for 124 children (median 41, IQR 25.5, 64). Of the 5,675 PHC encounters, 1,542 (27%) recorded at least one infection (total 1,777) and 1,330 (23%) had at least one antibiotic prescription recorded (total 1,468). Children had a median five (IQR 2, 9) prescriptions in both their first and second year of life, with a prescription rate of 5.99/person year (95% CI 5.35, 6.63). Acute otitis media was the most common infection (683 records, 38%) and Amoxycillin was the most commonly prescribed antibiotic (797 prescriptions, 54%). Of the 1,468 recorded prescriptions, 398 (27%) had no infection recorded and 116 (8%) with an infection recorded were not aligned with local treatment guidelines. Conclusion Prescription rates for Australian Aboriginal children in these communities are significantly higher than that reported nationally for non-Aboriginal Australians. Prescriptions predominantly aligned with treatment guidelines in this setting where there is a high burden of infectious disease.Copyright © 2020 Howarth 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.
Apunipima baby basket program: a retrospective cost study.
(2016-12-03) Edmunds K.; Searles A.; Neville J.; Ling R.; McCalman J.; Mein J.
Background: The Baby Basket initiative was developed by Apunipima Cape York Health Council (ACYHC) to address poor maternal and child health (MCH) in Cape York, the northernmost region of Queensland. While positive outcomes for Indigenous MCH programs are reported in the literature, few studies have a strong evidence base or employ a sound methodological approach to evaluation. The aim of the cost study is to identify the resources required to deliver the Baby Basket program in the remote communities of Cape York. It represents an initial step in the economic evaluation of the Apunipima Baby Basket program. The aim of this study was to report whether the current program represents an effective use of scarce resources. Method(s): The cost study was conducted from the perspective of the health providers and reflects the direct resources required to deliver the Baby Basket program to 170 women across 11 communities represented by ACYHC. A flow diagram informed by interviews with ACYHC staff, administrative documents and survey feedback was used to map the program pathway and measure resource use. Monetary values, in 2013 Australian dollars, were applied to the resources used to deliver the Baby Basket program for one year. Result(s): The total cost of delivering the Baby Basket progam to 170 participants in Cape York was $148,642 or approximately, $874 per participant. The analysis allowed for the cost of providing the Baby Baskets to remote locations and the time for health workers to engage with women and thereby encourage a relationship with the health service. Routinely collected data showed improved engagement between expectant women and the health service during the life of the program. Conclusion(s): The Apunipima Baby Basket cost study identifies the resources required to deliver this program in remote communities of Cape York and provides a framework that will support prospective data collection of more specific outcome data, for future cost-effectiveness analyses and cost-benefit analyses. An investment of $874 per Baby Basket participant was associated with improved engagement with the health service, an important factor in maternal and child health. Copyright © 2016 The Author(s).
Are general practitioners getting the information they need from hospitals and specialists to provide quality cancer care for Indigenous Australians?
(2020-01-17) Valery P.C.; Bernardes C.M.; de Witt A.; Martin J.; Walpole E.; Garvey G.; Williamson D.; Meiklejohn J.; Hartel G.; Ratnasekera I.U.; Bailie R.
Background: Cancer care involves many different healthcare providers. Delayed or inaccurate communication between specialists and general practitioners (GP) may negatively affect care. Aim(s): To describe the pattern and variation of communication between primary healthcare (PHC) services and hospitals and specialists in relation to the patient's cancer care. Method(s): A retrospective audit of clinical records of Indigenous Australians diagnosed with cancer during 2010-2016 identified through 10 PHC services in Queensland is described. Poisson regression was used to model the dichotomous outcome availability of hospital discharge summary versus not. Result(s): A total of 138 patient records was audited; 115 of those patients visited the PHC service for cancer-related care after cancer diagnosis; 40.0% visited the service before a discharge summary was available, and 36.5% of the patients had no discharge summary in their medical notes. While most discharge summaries noted important information about the patient's cancer, 42.4% lacked details regarding the discharge medications regimen. Conclusion(s): Deficits in communication and information transfer between specialists and GP may adversely affect patient care. Indigenous Australians are a relatively disadvantaged group that experience poor health outcomes and relatively poor access to care. The low proportion of discharge summaries noting discharge medication regimen is of concern among Indigenous Australians with cancer who have high comorbidity burden and low health literacy. Our findings provide an insight into some of the factors associated with quality of cancer care, and may provide guidance for focus areas for further research and improvement efforts.Copyright © 2019 Royal Australasian College of Physicians
Assessing research impact: Australian research council criteria and the case of family wellbeing research.
(2019-08-21) Tsey K.; Onnis L.-A.; Whiteside M.; McCalman J.; Williams M.; Heyeres M.; Lui S.M.C.; Klieve H.; Cadet-James Y.; Baird L.; Brown C.; Watkin Lui F.; Grainger D.; Gabriel Z.; Millgate N.; Cheniart B.; Hunter T.; Liu H.-B.; Yinghong Y.; Yan L.; Lovett R.; Chong A.; Kinchin I.
Researchers worldwide are increasingly reporting the societal impact of their research as part of national research productivity assessments. However, the challenges they encounter in developing their impact case studies against specified government assessment criteria and how pitfalls can be mitigated are not reported. This paper examines the key steps taken to develop an Aboriginal Family Wellbeing (FWB) empowerment research impact case study in the context of an Australian Research Council (ARC) pilot research impact assessment exercise and the challenges involved in applying the ARC criteria. The requirement that researchers demonstrate how their institutions support them to conduct impactful research has the potential to create supportive environments for researchers to be more responsive to the needs of users outside academia. However, the 15-year reference period for the associated research underpinning the reported impact and the focus on researcher's current institutional affiliation constitute potential constraints to demonstrating the true impact of research. For researchers working with Indigenous people, relationships that build over long periods of time, irrespective of university affiliation, are critical to conducting impactful research. A more open-ended time-frame, with no institutional restrictions for the 'associated research' provides the best opportunity to demonstrate the true benefits of research not only for Indigenous people but for Australian society more broadly.Copyright © 2019. Published by Elsevier Ltd.
Australian cancer services: a survey of providers' efforts to meet the needs of Indigenous patients.
(2018-11-01) Taylor E.V.; Haigh M.M.; Shahid S.; Garvey G.; Cunningham J.; Holloway M.; Thompson S.C.
Objective: To examine where Indigenous Australians undergo cancer treatment and learn about specific service initiatives that have been implemented to meet their needs. Method(s): Public cancer treatment centres across Australia were invited to participate in an online survey about various characteristics of their centre, including the type of service provided, Indigenous patient numbers and policy, and implementation of Indigenous-specific initiatives. Result(s): Surveys were completed for 58 of 125 public cancer treatment centres. Almost half (47%) of the services saw more than 10 Indigenous patients per year, although Indigenous patients generally represented a small minority of patients. The most commonly reported initiatives were "having links with Indigenous health organisations in the community" (74% of services), "making a dedicated effort to address the needs of Indigenous patients" (69%) and proactively "creating partnerships with Indigenous communities and health organisations" (69%). Conclusion(s): The majority of respondents indicated that they were working to meet the needs of Indigenous patients and were interested in learning strategies from others to improve their services. More work is needed to describe and evaluate the specific initiatives that have been implemented. Implications for public health: Information from this study can assist cancer service providers to identify gaps in current services, plan new service delivery initiatives and ultimately improve Indigenous cancer outcomes. Copyright © 2018 The Authors

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